When Should I See a Women’s Health Physiotherapist?

Should I See a Women’s Health Physio?

Understanding Women’s Health Issues

Many women experience issues like bladder leaks, pain during sex, or a feeling of heaviness in the pelvis, but often feel like it is just something that women have to live with. The good news is, you don’t!  These are just some of the concerns that a women’s pelvic health physiotherapist can assess and provide you with a management plan to help you feel confident in your body again!

So, how do you know if you should book an appointment?

You have Bladder or Bowel Issues

Incontinence is a common issue, but it should not be considered a ‘normal’ part of aging or motherhood. If you experience urinary leakage when you cough, sneeze, laugh, or exercise, you may have stress urinary incontinence (SUI). Stress urinary incontinence occurs when there is an increase in intraabdominal pressure and your pelvic floor muscles are too weak or too slow to maintain the pressure required to prevent leaking.  If you feel a sudden, strong urge to go to the toilet and can’t hold it, it could be urgency urinary incontinence (UUI). UUI can be due to many different factors. Women’s health physios can help you understand the cause of these symptoms and provide exercises and strategies to regain control.

They can also help with bowel problems, such as constipation or fecal incontinence. A physio can assess your pelvic floor muscles and provide techniques to improve bowel function, and reduce straining.

You are Experiencing Pain

Pain in your pelvic area, hips, or lower back could be linked to your pelvic floor. This includes pain during sexual intercourse (dyspareunia) or endometriosis. Pelvic health physiotherapists are trained to assess the muscles, ligaments, and connective tissues of the pelvic floor to identify the source of the pain and create a plan to alleviate it.  Management for dyspareunia and endometriosis consists of a combination of techniques which will be tailored to your individual needs. Treatment options include manual therapy, pain management strategies, and exercises to help you manage your symptoms. 

You are Approaching or Going Through Menopause

Menopause can bring about changes in your pelvic health due to the reduction in oestrogen. This can lead to weaker muscles and connective tissues, increasing your risk of incontinence and prolapse. A women’s health physio can help you prepare for and navigate these changes by strengthening your pelvic floor and providing guidance on how to manage symptoms. 

Many of the changes you might experience are collectively known as Genitourinary Syndrome of Menopause (GSM). This syndrome describes a range of anatomical and functional changes to the external genitalia, urethra, bladder, and pelvic floor tissues due to lower estrogen levels.

Symptoms of GSM can include:

• Vaginal and Vulval Symptoms: Vaginal dryness, burning, itching, or irritation. The tissues of the vulva and vagina can become thinner, less flexible, and have reduced lubrication.

• Bladder Symptoms: Increased urinary urgency, frequency, and urinary incontinence. You may also experience pain or discomfort when urinating (dysuria) and an increased risk of recurrent urinary tract infections (UTIs).
• Sexual Symptoms: Painful intercourse (dyspareunia) and a decrease in libido. Lower estrogen can make vaginal tissues less elastic and supple, which can lead to irritation or pain during sex.

Although the above symptoms cannot necessarily be reversed, a pelvic health physiotherapist can provide you with solutions to manage your symptoms and reduce the risk of symptom progression.

Another common change to occur alongside menopause is osteoporosis. Osteoporosis consists of a reduction in bone strength, this occurs because of the reduction in oestrogen production which accelerates bone loss. In fact, some women can lose up to 20% of their bone density in the 5 to 7 years following menopause.

Both physiotherapists and exercise physiologists can help with managing osteoporosis. Exercise is one of the best ways to help stimulate bone growth, particularly exercises that increase the load going through your bones. Ask your physio if bone loading classes are a good fit for you. 

You have a Sensation of Heaviness or a “Bulge”

This could be a sign of pelvic organ prolapse (POP), a condition where the pelvic organs, such as the bladder, uterus, or rectum, descend into the vaginal canal. These are characterised as different types of prolapse and can have varied symptoms. 

• Front wall prolapse (Bladder Prolapse): This is the most common type of POP. It occurs when the muscles and tissues that support the bladder weaken, causing the bladder to bulge into the front wall of the vagina. Symptoms often include a feeling of pressure or fullness in the vagina, difficulty emptying the bladder, and urinary incontinence.
• Back wall prolapse (Rectal Prolapse): A rectocele happens when the rectum pushes against and bulges into the back wall of the vagina. This can make bowel movements difficult and cause a feeling of incomplete emptying, leading to chronic constipation.
• Uterine Prolapse (Dropped Uterus): In this condition, the uterus descends into the vaginal canal. In more severe cases, it can protrude outside of the vaginal opening. Symptoms may include a sensation of “something coming down” in the vagina, a feeling of heaviness or dragging in the pelvis, and lower back pain.

It’s important to know that a woman can have more than one type of prolapse at the same time, as they are often caused by the same underlying weakness in the pelvic floor.

A pelvic health physiotherapist can assess the type and stage of prolapse and guide you through a personalized program of pelvic floor exercises to improve muscle support. They can also discuss other management strategies, which can provide support and improve your symptoms.

Risk factors for POP include 

• Vaginal deliveries (risk increases as amount of vaginal deliveries increases)
• Large birth weights 
• Assisted deliveries with Forceps or Vacuum
• peri/post menopause (reduced oestrogen) 
• Obesity/overweight 
• Chronic increases in intraabdominal pressure (chronic cough, chronic constipation or heavy lifting)
• Connective tissue disorders 
• Hysterectomy or other pelvic surgeries

You are Pregnant or Postpartum

Pregnancy and childbirth can put significant strain on your body, especially your pelvic floor. A women’s health physio can help you prepare your body for birth, manage common pregnancy-related pain, and guide your recovery postpartum. Whether you’re dealing with back pain, pelvic girdle pain, abdominal separation, bladder/bowel symptoms or are unsure how/when to safely return to exercise after birth, a physio can provide a tailored plan. Please see our empowering mums blog for more information on perinatal supports!

Anything ringing true for you? Sounds like a review with a Women’s Health Physiotherapist is essential. Don’t delay, we have practitioners ready to assist you in your recovery. Book online or call our clinic today!