<p>Female pelvic floor dysfunction diseases (PFD) comprise pelvic floor stress dysfunction diseases (PFSD) and non-pelvic floor stress dysfunction diseases (non-PFSD), with PFSD accounting for the majority of pelvic floor issues. PFSD is a group of diseases caused by pelvic floor stress support function injury and stress imbalance, mainly associated with pelvic floor support structure defects, weaknesses, injuries, pregnancy, transvaginal delivery, age, etc. A key to resolving PFSD lies in establishing the concept of holistic pelvic floor and therapeutic strategies based on functional pelvic floor biomechanics, etiology, and a holistic view of the disease. This article presents our perspective on current advances, challenges, and future directions in understanding and treating PFSD, emphasizing the need for a paradigm shift from symptom-oriented to mechanism-based management.</p>