Women’s Health PT
Women’s Health PT
From prenatal and post-partum care to perimenopause and menopause, many changes that women go through come with uncomfortable changes that are written off as “normal”. Freehold Physical Therapist, Theresa Wilk, has become passionate about trying to change the care that women traditionally receive throughout their life by expanding her own education and scope of treatment. She is excited to be able to offer help to women experiencing issues in all stages of life.
Incontinence (the involuntary loss of urine or feces)
Stress incontinence: the involuntary loss during coughing, laughing, or sneezing
Urge incontinence: the inability to make it to the bathroom in time
Mixed: both stress and urge
Nocturia: waking more than 1 time at night to use the bathroom when you are under 60 years of age, more than 2 times after the age of 60
Pelvic Organ Prolapse
This is when one or more of the organs in the pelvic floor begin to descend into, and sometimes out of the vaginal canal, due to loss of support. It is estimated to affect up to 50% of women.
Symptoms of prolapse can include:
- heaviness in abdomen or vaginal area
- low back or pelvic pain
- difficulties urinating or completely emptying the bladder
- a bulge at the vaginal opening.
Prolapse is described by the organ that is descending. It is also possible to have more than one organ descending.
Cystocele: bladder (most common)
Rectocele: rectum
Uterine prolapse
Urethrocele: urethra
Endocele: small intestine
It is graded by how far the organ descends into/or out of the vaginal canal, using the hymen as a reference point.
Grade 1: organ descent into the vaginal canal, no further than 1cm from the hymen
Grade 2: organ descent at least 1 cm from the hymen, or at most 1 cm further
Grade 3: organ descent 1-2cm from hymen
Grade 4: organ descent greater than 2 cm from hymen
There are many treatment options for pelvic organ prolapse, including surgery.
Conservative interventions include:
- strengthening of pelvic floor and hip musculature to improve stability
- management of constipation (constant bearing down encourages descent)
- pressure management during transfers, squatting, sit/stand to decrease valsalva and bearing down effect
- pessary: orthotic for the vaginal wall, prescribed and fitted by a urogynecologist
Endometriosis
is when tissue similar to the uterine lining is found outside the uterus.
Symptoms include:
- pain in the lower abdomen/pelvis and/or back,
- pain with menses, pain with and/or intimacy, and
- pain with bowel movements
This condition affects about 5 million women in the US, and is often hard to diagnose, or misdiagnosed. It can take up to 10 years to diagnose this condition in some women.
Physical therapy can help to reduce pain symptoms associated with endometriosis with gentle stretching, manual therapy and relaxation techniques.
Dyspareunia (painful sex)
Vaginitis/Vulvodynia/Vestibulodynia
These are terms that refer to pain at a specific location of the female genitalia:
Vaginitis – pain inside the vaginal canal
Vulvodynia – pain at the vulva, external area of the vaginal opening
Vestibulodynia – pain at the entrance of the vaginal opening (most common)
Any of these areas can become inflamed and irritated, and symptoms include burning, stinging, dryness and rawness. This can be caused by inflammation (internal or external), nerve irritation, muscular, and hormonal changes. It can be provoked (direct touch, intimacy, tampon use) or unprovoked (insidious, sitting postures, tight clothing). Physical therapy treatments include manual technique, vaginal/vulvar care and pain education.