Pelvic floor dysfunction impacts people of all ages but unfortunately, it’s not widely talked about. Since conversations about it can be rare, many dealing with it may not even know that they’re experiencing pelvic floor dysfunction, and that there are solutions available to help. Regardless of age or life stage, pelvic floor therapy can help support you across reproductive life stages. Whether you’re navigating your own journey or looking to understand how you can support your loved ones – this discussion can provide helpful insight.
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The pelvic floor is a group of muscles that support the bladder, the bowel, and the uterus – functioning as a sort of supportive sling that plays a crucial role in bladder and bowel function, sexual function, and overall stability. Every human has a pelvic floor, which means everyone can also suffer from pelvic floor disorders, and it’s not just limited to people who’ve just had babies. Pelvic floor disorders can impact people across all life stages (e.g., puberty, pregnancy and postpartum, gender-affirming care, perimenopause) and concerns (e.g., those who’ve had pelvic surgeries, issues with sexual pain, or chronic constipation). That’s where pelvic floor therapy comes in.
Pelvic floor physical therapy (PFPT) is a subspecialty within physical therapy (PT) that focuses on how the pelvic floor muscles interact with the rest of the body. Pelvic floor therapists assess the patterns across the entirety of your body’s ecosystem – such as your breath, posture, core mechanics, nervous system, and hormones – and are trained to assess (through both internal and external exams) your pelvic floor muscles directly. The complexity of pelvic floor issues also means that care plans are individualized to your specific needs.
PFPT can be administered effectively both in-person and virtually. Despite common misconceptions that PFPT must be in-person to be effective, many issues can be effectively managed through virtual care. In fact, many find that virtual sessions are more comfortable, private, and convenient. What’s most important is there is a strong connection of trust between the therapist and the patient.
One of the population groups who can benefit from PFPT are those who are pregnant (or preparing to be pregnant) or postpartum. Symptoms may look like muscle aches or spasms in the pelvic or back area, pain during sex, or postpartum issues with bowel movements or stress incontinence. Pelvic floor therapists can help patients prep for birth and help ensure proper postpartum recovery.
For patients experiencing perimenopause and menopause, PFPT can be beneficial for helping with sexual pain, incontinence, and Genitourinary Syndrome of Menopause (GSM), a common chronic condition stemming from decreasing levels of estrogen that affects the tissues and muscles around the pelvis. PFPT may be used either on its own or in conjunction with interventions like vaginal estrogen to help improve elasticity, blood flow, and muscle and tissue relaxation to help abate the symptoms.
However, it’s important to note that pelvic floor dysfunction isn’t limited to specific life stages. Symptoms like pelvic pain, pain during sex, incontinence, and constipation affect a large swath of the population, to the point where a lot of people who could benefit from PFPT don’t even realize that there’s a solution out there for them.
For those who may not be sure if PFPT is right for them, a quick virtual consult can help confirm if they may benefit from treatment, and if so, whether they may be a good candidate for virtual PFPT. While in-person care may be better suited for treating more severe conditions, for most mild to moderate conditions virtual pelvic floor therapy can be effective. Skilled therapists can even guide you through conducting detailed self-assessments and self-administering therapy. If you’re experiencing any of these symptoms, always talk to your doctor to determine the best next steps.
Here are some ways in which pelvic floor health and therapy can impact key stages in someone’s reproductive and hormonal journey:
Individuals interested in seeking care for pelvic floor dysfunction can access care in a couple of different ways. The first way is to receive a referral from your primary care provider. You can share the symptoms you’re experiencing with your PCP, who can conduct a pelvic floor exam and provide you with a referral to a pelvic floor therapist. The second way is to self-refer, i.e., go directly to a pelvic floor physical therapist.
There is no one right way to seek care, but we recommend doing your research to determine whether you have coverage for pelvic floor physical therapy through your employer or your health insurance plan. Check whether there are any pelvic floor physical therapists in-network with your health insurance, or whether you have access to networks dedicated to physical therapy (including PFPT).
A big component of PFPT is education. If you do decide to seek care, your therapist will speak with you in detail about the physiological changes taking place in your body and provide a lot of guidance on behavioral strategies and actionable changes you can make. Depending on whether your PFPT is in-person or online, they may also administer manual physical therapy or teach you how to self-administer manual physical therapy. The most important role of a pelvic floor physical therapist, however, is helping you regain a sense of control over your body. They will work with you to create a highly individualized care program and help you adjust as needed to ensure you’re making progress. A good pelvic floor therapist will also encourage you to stay connected with your primary care doctor, to make sure that they are also informed and able to provide you with necessary care if any issues arise.
Those who do PFPT may experience improvements to overall wellbeing that can also make a world of difference for people’s emotional health and empower them to take back control of their life. If you ever have questions around symptoms you’re experiencing and want to discuss treatment options, always consult your healthcare provider to understand the best next steps for you.
If you are a Progyny member, know that Progyny is always here to support you across life’s milestones, and you can access additional resources on our website at progyny.com/education. Progyny members can contact Progyny at 888.597.5065 or via their employer specific phone number to learn more about your employer-specific benefit.