Do I Need to See a Pelvic Health Practitioner? Your Questions Answered
When people hear pelvic health, they often think pregnancy, postpartum or pelvic floor exercises.
But pelvic health is much broader than that.
Pelvic health appointments can help people experiencing bladder or bowel concerns, pelvic pain, painful intercourse, prolapse symptoms, period pain, pregnancy and postpartum changes, pelvic floor dysfunction and much more.
And you don't need to know whether your pelvic floor is “weak” or “tight” before you book — that's what we're here to help work out.
Here are some of the most common questions we get about pelvic health appointments.
What is pelvic health?
Pelvic health looks at the muscles, organs and structures within and around the pelvis and how they are functioning together.
This includes the pelvic floor muscles, but pelvic health isn't just about the pelvic floor.
Depending on your symptoms, we may also consider your bladder, bowel, abdomen, hips, lower back, breathing, sexual function, menstrual symptoms, pregnancy or postpartum recovery.
The aim is to understand what's contributing to your symptoms rather than treating one area in isolation.
What symptoms can a pelvic health practitioner help with?
There are many reasons someone might book a pelvic health appointment.
These can include:
Pelvic pain
Pain during or after intercourse
Pain with penetration
Bladder urgency or frequency
Urinary leakage
Feeling like you don't completely empty your bladder
Needing to push your urine out
Recurrent UTI-like symptoms when infection has been ruled out
Constipation or difficulty emptying your bowels
Straining to open your bowels
Pelvic heaviness, pressure or dragging
Pelvic organ prolapse
Painful periods
Endometriosis or adenomyosis-related symptoms
Pregnancy-related pelvic concerns
Birth preparation
Postpartum recovery
Pain or difficulty using tampons
Pain with pelvic examinations
Pelvic floor muscle overactivity
Pelvic floor weakness
You don't need to fit neatly into one of these categories. If you're experiencing symptoms around your pelvis, bladder, bowel or sexual function and aren't sure where to start, a pelvic health appointment may be appropriate.
Is pelvic health only for women who have had a baby?
No — this is one of the biggest misconceptions about pelvic health.
You do not need to have been pregnant or given birth to experience pelvic floor dysfunction.
We see people in their teens, 20s, 30s and beyond for symptoms such as painful periods, pain with sex, bladder urgency, constipation, difficulty emptying their bladder, pelvic pain and other pelvic floor concerns.
Some people have experienced symptoms for years without realising they could be related to their pelvic floor.
Pelvic health is relevant across many different stages of life — not just pregnancy and postpartum.
How do I know if my pelvic floor is tight or weak?
You often can't tell from symptoms alone.
A pelvic floor can be weak, overactive, poorly coordinated or a combination of these.
For example, leaking doesn't automatically mean your pelvic floor simply needs strengthening. Likewise, pelvic heaviness doesn't automatically mean you have a prolapse.
This is why doing Kegels without knowing what your pelvic floor actually needs isn't always the best starting point.
A pelvic health assessment looks at how your pelvic floor is functioning and what may be contributing to your individual symptoms.
What is an overactive pelvic floor?
An overactive pelvic floor has difficulty fully relaxing or lengthening when it needs to.
Some people may unknowingly hold tension through these muscles throughout the day, while for others it can develop alongside pain, stress, bladder or bowel dysfunction, pregnancy, birth, injury or other factors.
An overactive pelvic floor may be associated with symptoms such as:
Pain with intercourse
Pelvic pain
Urinary urgency or frequency
Difficulty emptying the bladder
Needing to push urine out
Constipation or difficulty emptying the bowels
Pelvic pressure or heaviness
Difficulty with penetration or tampon insertion
Importantly, an overactive pelvic floor can still be weak. Tight doesn't automatically mean strong.
Can pelvic floor problems cause bladder symptoms?
Yes. The pelvic floor plays an important role in both bladder control and bladder emptying.
Pelvic floor dysfunction may contribute to symptoms such as leakage, urgency, frequency, difficulty starting your urine stream, incomplete emptying or feeling like you need to push your urine out.
Bladder symptoms can have many different causes, so assessment is important — particularly if symptoms are new, changing or persistent.
Can pelvic health treatment help with bowel problems?
The pelvic floor is also involved in bowel emptying.
To pass a bowel movement effectively, the pelvic floor needs to coordinate and relax appropriately.
If this isn't happening, some people may experience constipation, straining, incomplete emptying or difficulty passing stool.
Pelvic health management may include looking at pelvic floor function alongside breathing, abdominal pressure, toileting position and bowel habits.
Can pelvic health help with painful sex?
Yes. Pelvic health assessment can be particularly useful when pain occurs during or after intercourse or with penetration.
Pelvic floor muscle tension, tenderness or difficulty relaxing can sometimes contribute to pain.
However, painful intercourse can have many different causes, so we don't automatically assume the pelvic floor is responsible.
Your appointment allows us to look at the bigger picture and determine what may be contributing to your symptoms.
Can pelvic health help with period pain, endometriosis or adenomyosis?
Pelvic health treatment doesn't cure endometriosis or adenomyosis, but it may help address some of the musculoskeletal and pelvic floor factors occurring alongside these conditions.
Living with ongoing pelvic or period pain can sometimes be associated with guarding and increased tension through areas such as the pelvic floor, abdomen, hips and surrounding muscles.
Treatment is individual and may involve working with these areas alongside movement, breathing, education and strategies to help manage your symptoms.
Can pelvic health help during pregnancy?
Absolutely.
Pregnancy places increasing demand on the pelvic floor and surrounding body as your baby grows.
Pelvic health appointments during pregnancy may address things such as pelvic pain, bladder symptoms, pelvic floor concerns, prolapse symptoms and preparation for birth.
Later in pregnancy, appointments may also focus on helping you understand how to relax and lengthen your pelvic floor, positions for labour, breathing and preparation for vaginal birth.
Should I have a pelvic health appointment after giving birth?
A postpartum pelvic health appointment can be useful whether you've had a vaginal or caesarean birth.
Pregnancy alone places significant demands on the pelvic floor, abdomen and pelvis, and childbirth adds another major physical event for your body to recover from.
Postpartum assessment may look at symptoms such as leakage, heaviness, pelvic pain, painful intercourse, abdominal changes, scar recovery, pelvic floor weakness or pelvic floor tension.
Importantly, postpartum pelvic health isn't always about strengthening.
Some women hold increased tension or guarding through their pelvic floor following pregnancy and birth. In these cases, helping the muscles relax and move appropriately may need to occur before or alongside strengthening.
What happens at a pelvic health appointment?
Your first appointment starts with a conversation.
We will ask about your symptoms, medical history and anything relevant to your concern. Depending on why you're attending, this may include questions about your bladder, bowel, periods, sexual function, pregnancy or birth history.
Your physical assessment will depend entirely on your presentation.
It may include looking at areas such as your abdomen, breathing, lower back, pelvis, hips and movement.
An internal vaginal pelvic floor assessment may also be discussed if it would provide useful information about your symptoms.
Do I have to have an internal pelvic floor examination?
No. An internal examination is never compulsory.
If an internal pelvic floor assessment may be useful, your practitioner will explain what it involves and why they are recommending it.
You can ask questions, decline, change your mind or stop the assessment at any time.
There are also many things we can assess and treat externally.
What treatments might be used during a pelvic health appointment?
There isn't one standard pelvic health treatment because everyone's presentation is different.
Depending on what we find, treatment may include:
Hands-on treatment
Internal pelvic floor assessment or treatment
Internal pelvic release work
Pelvic floor relaxation or strengthening
Breathing and diaphragm work
Abdominal treatment
Hip, pelvis or lower back treatment
Bladder retraining
Bowel and toileting strategies
Movement and strength exercises
Pregnancy or birth preparation
Education and self-management strategies
Your treatment plan should reflect what your pelvic floor and body actually need, rather than giving everyone the same set of pelvic floor exercises.
What is internal pelvic release work?
Internal pelvic release work is one hands-on technique that may be incorporated into a pelvic health appointment when appropriate.
It involves working vaginally with the pelvic floor muscles and may be used for reasons such as pelvic floor overactivity, painful intercourse, certain bladder or bowel presentations, postpartum pelvic floor tension or preparation for birth.
It is not a separate service at Yarra Valley Women's Health. If it is appropriate for your presentation, it may simply form part of your pelvic health treatment.
We have a separate guide to Internal Pelvic Release Work if you'd like to learn more about what it involves.
Do I need a referral for a pelvic health appointment?
In most cases, you can book a pelvic health appointment directly without a referral.
If we believe your symptoms require further investigation or input from another healthcare professional, we can discuss this with you.
When should I see someone about my pelvic health?
You don't need to wait until your symptoms become severe.
If you're experiencing bladder or bowel changes, pelvic pain, painful intercourse, pelvic heaviness, leakage, difficulty emptying, pregnancy or postpartum concerns, or simply feel like something isn't quite right, it's reasonable to seek an assessment.
And if you've had symptoms for years, that doesn't mean you've left it too late to ask about them.
Pelvic Health in Healesville and the Yarra Valley
At Yarra Valley Women's Health in Healesville, our pelvic health appointments are designed to look beyond individual symptoms and understand how your pelvic floor and surrounding body are functioning together.
You don't need to know exactly what's wrong or which treatment you need before booking.
That's what the assessment is for.
If you're experiencing pelvic pain, bladder or bowel symptoms, painful intercourse, prolapse symptoms, pregnancy or postpartum concerns or another pelvic health issue, you can book a pelvic health appointment to discuss what's happening and what your next steps may be.