Can I come if I am menstruating?
Yes you can. You can even have an internal assessment, if it is deemed appropriate to your condition and in your culture. Sometimes, if pain is present during menses, that’s when we need to examine. If you are light, its not a problem; if you are heavy it may be less pleasant. The therapist is gloved up and observes universal precautions with all patients, hence periods (menses) are not an absolute no-no (contra-indication).
Can I have a pelvic assessment if I am pregnant?
Yes you can. In fact, we often need to do a internal vaginal examination to ‘balance’ the pull of the muscles in pregnancy related pelvic girdle pain.
If your pregnancy is assisted e.g. IVF, we tend to avoid any internal in the first trimester.
Can I bring my baby?
If your baby is not mobile, you are welcome to bring the little one into the session.
If your baby is mobile, it can be very distracting, especially during an internal examination or ultrasound. You are welcome to bring someone with you to care for your baby, during the manual assessment phase.
You are welcome to breastfeed during the consult.
Do I have to have an internal examination?
Not necessarily, and if you feel particularly uncomfortable, the therapist will:
- attempt appropriate assessment and treatment without an internal e.g. using ultrasound
- motivate why an internal would be of benefit in your case
An internal is advised, when indicated. Not all presentations require an internal examination. Some patient groups shouldn’t have internals (children), others may have with caution (pain, pregnancy), and yet others prefer not to (men, postmenopausal non-sexually active little old ladies). If an examination is not indicated, or the patient expresses a strong preference we are able to assess pelvic floor muscle function and movement with real-time ultrasound.
Will it hurt?
Simple answer: not if I am doing my job correctly.
More accurate answer: if you are a pain sufferer, who has never tolerated any penetration then we can’t promise its going to be pain-free. Also, if you have trigger points or tight areas these will be sensitive on palpation. That said, most patients are complementary regarding the gentle palpation skills of trained physiotherapists.
How many sessions will I need?
That depends on a few factors:
- who you are – some people respond quickly, others less so
- what condition you have
- how much you can do to decrease or modify the drivers (causes) of your problem
Do I have to do the exercises every day for the rest of my life?
No. But you do have to cultivate a living relationship of voluntary activity with your pelvic floor muscles.
What happens if the problem comes back?
If you cant or don’t catch it in time, you will need to return for physiotherapy.
If you feel physio hasn’t worked, you would move on to:
- more aggressive interventions e.g. medication, surgery
- complementary therapies e.g. mindfulness based stress release, cranio-sacral therapy
- alternative options e.g. colonic hydrotherapy
Have you ever treated anyone like me before?
Every patient has their own story and experience. We are all unique. I am constantly amazed at how supposedly hopeless patients undergo remarkable improvements – especially when there is trauma, stress and anxiety, pain and pelvic dysfunction. We will not know, until we assess…..