Why you should pay attention to your pelvic floor
We get it: vaginas, incontinence, and painful sex aren’t the most comfortable topics to discuss. And maybe you’re feeling anxious because you don’t know what an exam involves. Well, information combats fear. So let’s go ahead and demystify the process of what will happen during your first pelvic floor exam and why you should do something about it before you need to:
What happens at an appointment with a pelvic floor physiotherapist?
First, let me assure you that physiotherapists see bodies and symptoms like yours every day. Whether your symptoms are a minor nuisance or are having a major impact on your life, you deserve a consult with a physio. I’ve worked with several both as a patient and in a professional capacity, and I can assure you, these practitioners approach their patients with the utmost empathy and sensitivity. Most are in this field precisely because they’re passionate about helping women just like you.
Your first appointment will involve the usual intake paperwork and questions: why you came in and what symptoms you’re experiencing. Questions may also include other health considerations or challenges, general lifestyle questions (work, diet, etc.), and information about any pregnancies and deliveries. To get the most from your appointment, consider preparing a list of symptoms (lower back pain, pelvic pain, incontinence, sensations of pressure or sagging in your vagina, constipation, discomfort during intercourse) and when/how you feel them – doing certain movements, at certain times of the day, during specific points in your menstrual cycle. If you’ve delivered a baby, any information/chart you have from delivery may also be useful.
Then, the physio will do an external examination. Approach may vary slightly among providers, but generally this will include a postural assessment in various positions (standing, sitting, walking) and a check of your abdomen while you’re lying on your back. She may use an ultrasound to watch your abdominal muscles while you breathe and move. All of this information will provide a picture of the strength and coordination of all your abdominal and pelvic floor muscles.
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In many cases, physios will ask if you are willing to have an internal exam. For such an exam, you’ll be asked to remove undergarments and lie on your back under a towel or blanket. The therapist will check external genital structures, then insert a finger(s) in your vagina. You may be asked to contract and relax your pelvic floor (cues will be provided) to help the therapist assess the strength and flexibility of the muscles and connective tissue.
Does it hurt?
On a personal note, I find this assessment less invasive than my annual PAP smear, and completely painless. However, if you experience pain, communicate that to the provider — this is not be a “grin and bear it” kind of appointment. And let me emphasize: You should still see a physiotherapist even if you prefer not to have an internal exam. A good provider won’t pressure you into an internal exam if you are uncomfortable, and can still prescribe rehab on the basis of an external exam!
During and/or after the assessment, you can expect the physio to describe her observations and how they relate to your symptoms; education is a huge part of pelvic floor rehab! Then, she will propose a treatment plan that may include: breathing exercises, pelvic floor exercises (such as Kegels), more traditional strength and stretch movements, and internal pelvic floor release techniques.
Ideally, you leave with some “homework” to practice, and a follow-up appointment for re-assessment. Frequency and number of treatments will vary by person, but you should always leave feeling supported, with immediate action to take now and a plan for a big-picture goal to keep you pain-free, leak-free, and doing activities that you enjoy. In short, of all your health care visits, this is one that promises the greatest return in quality-of-life improvement.
OK ladies, pep talk over. What are you waiting for? It’s time to pick up the phone and make your appointment.
This article was originally published on Sassy Mama Singapore