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Pelvic floor descent occurs during straining, and occurs to a greater normal extent in those with a weak pelvic floor. Elderly women, particularly those who have had delivered multiple children by natural labour (multiparous women) are at risk. In pelvic floor descent, the pelvic floor stretches the pudendal nerve which is the main nerve supply to the pelvic floor. Over time, this becomes a vicious cycle with weakening of the nerve (neuropathy) and as a result further weakening and descent of the pelvic floor.
