You may not have heard of Pelvic Floor Physiotherapists (PFPs) but we thank Beyonce every damn day they exist because your vagina will love them!
A typical physiotherapist treats pain and mobility issues by teaching patients gentle stretches and exercises. A pelvic floor physio is specially trained to help rehabilitate pelvic floor muscles. (Wahooo thank you PFPs!)
PFPs can help people rehabilitate their pelvic floor muscles that may have been weakened by childbirth, surgery, heavy lifting, constipation, or menopause AND they can also help treat pelvic floor muscles that work overtime, even when no one has asked and no, they are not getting paid!
Your First Appointment
So what exactly do you do at the PFP and how should you prepare?
Your first PFP appointment will most likely include a diagnosis of vaginismus, as your regular doctor may not be across all the symptoms, (or heck they may not even understand what vaginismus is), so usually, the PFP will be able to give you an accurate and informed diagnosis. Hallelujah!
Your first PFP appointment will usually begin with a questionnaire on any relevant medical history and the type of pain you are experiencing in your pelvic region. It could be important for you to include any medications you are on or any accidents or injuries you have had.
Your PFP will then ask you to describe the pain you are feeling, where it is, and what situations trigger it.
They should then explain the pelvic floor muscles and how they work in detail and may ask you whether you have heard the term ‘vaginismus’ before (lol yeah only about 1000 times since I became woke to the world of sexual pain).
Your PFP may also ask you whether you are comfortable with having a physical examination and if you feel safe and comfortable to do so you may agree.
They will wear gloves and use a lubricant to perform the physical examination, which usually consists of touching on the outside of the vulva, examining inside the vagina (if possible), and the pelvic floor muscles within.
It could also include pressing the muscles around your pelvic region (tummy, thighs, buttocks). Usually, if your pelvic floor is holding lots of tension these surrounding muscles will also be tight.
Your PFP may ask you to describe or rate the intensity of any discomfort or pain you may be feeling, however, they should not hurt you or push you if you are experiencing pain or discomfort.
The purpose of the examination is to understand and locate the pain, not cause excessive pain or discomfort. This part can often feel weird and scary but remember you can stop at any time and your PFP is there to guide you and support you.
What won’t happen during your session:
- Multiple choice test on the history of the burrito
- Sharing of Netflix passwords and account details
- Nail art of any kind
After your first appointment, your PFP could refer you to a sex psychologist, recommend you start using dilators, ask that you undergo further tests or examinations, give you a list of breathing and stretching exercises to do, or provide some further literature to help you understand your condition (hold your horses! we will cover all of these).
Once you are at a stage where you can tolerate insertion, your PFP may also recommend regular visits to work on internal muscle massage and relaxation.
Yes, we are basically discussing an internal massage for the pelvic floor.
Yes, that means your PFP will massage you from the inside and work on relaxing and unlocking the tension you carry in your pelvic floor. BONKERS! But effective.
Reminders
Some important things to remember before your appointment:
- Some people may feel more comfortable being examined by a female PFP (that’s totally ok, and not a weird thing to ask when booking your appointment so feel free to ask the receptionist on the phone if you are unsure! Names can be tricky and the most important thing is that YOU feel comfortable)
- Any good PFP will ask or instruct you on what they are doing before or as they are doing it (‘is it ok if I touch you here?’, ‘I am just going to put some pressure on this spot’) if your PFP is not doing this, you can always ask that they explain or prepare you before they make any movements during your examination, to make you feel more comfortable
- It is totally 100% ok to cry! Seriously, we mean it. PFPs have seen it all and most of the GINAs they meet are scared, in pain, confused, and emotional beautiful butterflies who are on a tremendously personal journey and probably could use a shoulder to cry on (who doesn’t?!). Cry, breathe and get back on track, this appointment is about YOU, no need to feel embarrassed, you are not the first and you will not be the last
- If you don’t feel comfortable with a physical examination today, that’s ok!
- Depending on where you live (hello sweet dutch daisies we see you!) It may be more cost-effective to get a referral from your medical practitioner or family doctor to see a PFP, as they can be a little expeno (slang for expensive (thanks Australia!)).
- Feeling confused about what to say and what to do? Visit the ‘Helpful Conversations’ section of the app which contains a handy conversation script for your appointment with your PFP (super handy and you are super welcome).