PerimenopauseMenopause Pelvic Floor Physical and Occupational Therapy

Menopause is more than just hot flushes, night sweats and mood changes! Even though 50% of the population goes through menopause the majority of people and healthcare providers are under-informed about menopause and safe and effective treatments. Too many people are suffering unnecessarily. Perimenopause, the precursor to menopause begins in the 40’s for most people and most women will be in menopause by their early 50’s. Beyond the systemic symptoms of menopause people will start to experience more subtle genitourinary symptoms that will continue to worsen over time if untreated. Painful sex, urinary urgency, frequency, leaking and burning, recurrent vaginal and urinary tract infections and vaginal dryness are symptoms of the Genitourinary Syndrome of Menopause (GSM). The symptoms of GSM  are also symptoms of pelvic floor dysfunction, which almost 50% of women suffer by the time they are in their 50s.

Systemic menopause symptoms are often treated with systemic hormonal therapy. This may not be sufficient for people developing GSM symptoms. The North American Menopause Society recommends vaginal estrogen for women in menopause to help counter GSM symptoms.

Differential Diagnosis:
GSM or Pelvic Floor Dysfunction

Symptoms of pelvic floor dysfunction and GSM include:

  • Urinary urgency, frequency, burning, nocturia
  • Feelings of bladder or pelvic pressure
  • Painful sex
  • Diminished or absent orgasm
  • Difficulty evacuating stool
  • Vulvovaginal pain and burning
  • Pain with sitting
Pelvic Floor Dysfunction

An informed healthcare provider – whether a pelvic floor physical and occupational therapists or medical doctor –  can do a vulvovaginal visual examination, a q-tip test to establish pain areas, and a digital manual examination to identify pelvic floor dysfunction, hormonal deficiencies, and pelvic organ prolapse. All women will experience GSM if enough time passes without appropriate medical management. The majority of people do not realize that menopausal women can benefit from a pelvic floor physical and occupational therapy examination to address the musculoskeletal factors that are also making them uncomfortable. The combination of pelvic floor physical and occupational therapy and medical management is key to help restore pleasurable sex and eliminate urinary and bowel concerns!

Why didn’t someone tell me?

We hear this question too frequently. First, the term GSM was not official until 2014. Leadership societies fought to help the medical community understand the genitourinary tract has its own hormonal needs. Pelvic floor physical and occupational therapy is on the rise, but there is still a lack of awareness and qualified providers to help suffering patients.

gentio-urinary 1
gentio-urinary 2

Hormone insufficiency can result in interlabial and vaginal itching. Other dermatologic issues such as Lichen Sclerosus and cutaneous yeast infections are just two of the many factors to also be considered.

Unfortunately people are vulnerable to recurrent vaginal and urinary tract infections in menopause due to:

  • pH and tissue changes
  • incomplete bladder emptying
  • pelvic organ prolapse compromising urinary function

Recurrent infections are a leading cause of pelvic floor dysfunction! They must be stopped or the noxious visceral-somatic input can cause further pain and dysfunction after the infection is cleared.  Furthermore, if the infections are  left untreated without hormone therapy infections continue to occur and the consequences can be severe. Women can develop unprovoked pain, sex may be impossible, and undetected UTIs can lead to kidney problems and more sinister issues.

We encourage people to work with a menopause expert to monitor, prevent, and treat these issues as they are serious and treatable! We need to normalize the conversation about what happens during GSM, it is nothing to be embarrassed about and with the right care vulva owners can live their best lives! Pelvic floor physical and occupational therapy and medical management go hand in hand.

Treatment:

How We Can Help You

pelvic pain rehab

If you are having issues with your sexual function, it is in your best interest to get evaluated by a therapist for pelvic floor therapy, so they can establish what part, if any, of your pelvic floor may be contributing to the symptoms you are experiencing. During the course of the examination, the physical and occupational therapists will talk to you about your medical history and symptoms, including what you have been previously diagnosed with, the treatments or therapies you have had, and how effective or ineffective these therapies have been for you. It is significant to mention that we fully comprehend what you’ve been dealing with and that the majority of individuals are angry by the time they make it to see us. The physical and occupational therapists will conduct an evaluation of the patient’s nerves, muscles, joints, tissues, and movement patterns while doing the physical examination. After the examination is finished, your therapist will go over the results of the assessment with you. The physical and occupational therapists will conduct an evaluation to determine the cause of your symptoms and will establish both short-term and long-term therapy goals based on the results of the evaluation. Physical therapy treatments are typically administered between once and twice each week for a period of around 12 weeks. Your physical and occupational therapists will assist you in coordinating your recovery with all the other experts on your treatment team. They will provide you with an exercise regimen to complete at home and the sessions you attend in person. We are here to assist you in getting better and living the best life possible.

For more information about IC/PBS please check out our IC/PBS Resource List.

A girl with writting Board

Treatment:

How We Can Help You

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By PHRC Admin

Menstruation is a natural part of life for most. However, navigating the world of menstrual products can be a daunting task, given the variety of options available today. This guide aims to break down the different types of menstrual products on the market, their benefits, and why you might choose one over another.

 

Traditional Disposable Products

1. Pads

Pads, or sanitary napkins, are often the first menstrual product one encounters. They are worn inside the underwear and absorb menstrual blood externally. Pads come in various sizes and absorption levels, making them versatile for light to heavy flow days.

2. Tampons

Tampons are inserted into the vagina where they absorb menstrual blood internally. They’re compact and discreet, offering freedom for physical activities such as swimming. However, they need to be changed every 4-8 hours to prevent Toxic Shock Syndrome.

 

Reusable Products

3. Menstrual Cups

Menstrual cups are bell-shaped devices made of medical-grade silicone, latex, or elastomer. They are inserted into the vagina to collect menstrual blood rather than absorb it. Menstrual cups are reusable, environmentally friendly, and can be left in for up to 12 hours.

4. Cloth Pads

Cloth pads function like disposable pads but can be washed and reused. They’re eco-friendly and free from potentially harmful chemicals found in some disposables.

5. Period Underwear

Period underwear is designed with multiple absorbent layers to catch menstrual flow. They can be worn alone on light days or as a backup with other menstrual products on heavier days.

 

Innovative Solutions

6. Menstrual Discs

Menstrual discs are similar to menstrual cups in that they collect menstrual blood. However, they sit at the base of the cervix instead of the vaginal canal. Some innovative menstrual discs come with TENS (Transcutaneous Electrical Nerve Stimulation) and heat features for pain relief.

7. Period Patches

Period patches are transdermal patches that release natural ingredients into the body to help alleviate menstrual cramps. They’re a non-invasive, drug-free option for pain management during periods.

Making the Right Choice

Making the ‘right’ choice means finding what works best for you. Choosing the right menstrual product depends on various factors such as comfort, lifestyle, flow volume, and personal preferences.

  • If you’re looking for convenience and single-use products, traditional disposable pads or tampons might be your go-to.
  • For those seeking eco-friendly alternatives, reusable options like menstrual cups, cloth pads, or period underwear would be ideal.
  • Active individuals might prefer tampons, menstrual cups, or discs for their ability to accommodate physical activities.
  • If cost-effectiveness over time is a critical factor, reusable options like menstrual cups or period underwear offer long-term savings.
  • For those who experience significant menstrual pain, menstrual discs with TENS and heat features or period patches can provide much-needed relief.

Remember, it’s okay to try different products before finding the one that suits you best. After all, comfort and convenience during your period are what matters most.

Ultimately, the evolution of menstrual products means that there’s something out there for everyone. It’s all about exploring your options and finding what works best for your body and your lifestyle.

 

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Are you unable to come see us in person in the Bay Area, Southern California or New England?  We offer virtual physical and occupational therapy appointments too!

Virtual sessions are available with PHRC pelvic floor physical and occupational therapistss via our video platform, Zoom, or via phone. For more information and to schedule, please visit our digital healthcare page.

Do you enjoy or blog and want more content from PHRC? Please head over to social media!

Facebook,

 YouTube Channel

Twitter, Instagram, Tik Tok

FAQ

What are pelvic floor muscles?

The pelvic floor muscles are a group of muscles that run from the coccyx to the pubic bone. They are part of the core, helping to support our entire body as well as providing support for the bowel, bladder and uterus. These muscles help us maintain bowel and bladder control and are involved in sexual pleasure and orgasm. The technical name of the pelvic floor muscles is the Levator Ani muscle group. The pudendal nerve, the levator ani nerve, and branches from the S2 – S4 nerve roots innervate the pelvic floor muscles. They are under voluntary and autonomic control, which is a unique feature only they possess compared to other muscle groups.

What is pelvic floor physical and occupational therapy?

Pelvic floor physical and occupational therapy is a specialized area of physical and occupational therapy. Currently, physical and occupational therapistss need advanced post-graduate education to be able to help people with pelvic floor dysfunction because pelvic floor disorders are not yet being taught in standard physical and occupational therapy curricula. The Pelvic Health and Rehabilitation Center provides extensive training for our staff because we recognize the limitations of physical and occupational therapy education in this unique area.

What happens at pelvic floor therapy?

During an evaluation for pelvic floor dysfunction the physical and occupational therapists will take a detailed history. Following the history the physical and occupational therapists will leave the room to allow the patient to change and drape themselves. The physical and occupational therapists will return to the room and using gloved hands will perform an external and internal manual assessment of the pelvic floor and girdle muscles. The physical and occupational therapists will once again leave the room and allow the patient to dress. Following the manual examination there may also be an examination of strength, motor control, and overall biomechanics and neuromuscular control. The physical and occupational therapists will then communicate the findings to the patient and together with their patient they establish an assessment, short term and long term goals and a treatment plan. Typically people with pelvic floor dysfunction are seen one time per week for one hour for varying amounts of time based on the severity and chronicity of the disease. A home exercise program will be established and the physical and occupational therapists will help coordinate other providers on the treatment team. Typically patients are seen for 3 months to a year.

What is pudendal neuralgia and how is it treated?

Pudendal Neuralgia is a clinical diagnosis that means pain in the sensory distribution of the pudendal nerve. The pudendal nerve is a mixed nerve that exits the S2 – S4 sacral nerve roots, we have a right and left pudendal nerve and each side has three main trunks: the dorsal branch, the perineal branch, and the inferior rectal branch. The branches supply sensation to the clitoris/penis, labia/scrotum, perineum, anus, the distal ⅓ of the urethra and rectum, and the vulva and vestibule. The nerve branches also control the pelvic floor muscles. The pudendal nerve follows a tortuous path through the pelvic floor and girdle, leaving it vulnerable to compression and tension injuries at various points along its path.

Pudendal Neuralgia occurs when the nerve is unable to slide, glide and move normally and as a result, people experience pain in some or all of the above-mentioned areas. Pelvic floor physical and occupational therapy plays a crucial role in identifying the mechanical impairments that are affecting the nerve. The physical and occupational therapy treatment plan is designed to restore normal neural function. Patients with pudendal neuralgia require pelvic floor physical and occupational therapy and may also benefit from medical management that includes pharmaceuticals and procedures such as pudendal nerve blocks or botox injections.

What is interstitial cystitis and how is it treated?

Interstitial Cystitis is a clinical diagnosis characterized by irritative bladder symptoms such as urinary urgency, frequency, and hesitancy in the absence of infection. Research has shown the majority of patients who meet the clinical definition have pelvic floor dysfunction and myalgia. Therefore, the American Urologic Association recommends pelvic floor physical and occupational therapy as first-line treatment for Interstitial Cystitis. Patients will benefit from pelvic floor physical and occupational therapy and may also benefit from pharmacologic management or medical procedures such as bladder instillations.

Who is the Pelvic Health and Rehabilitation Team?

The Pelvic Health and Rehabilitation Center was founded by Elizabeth Akincilar and Stephanie Prendergast in 2006, they have been treating people with pelvic floor disorders since 2001. They were trained and mentored by a medical doctor and quickly became experts in treating pelvic floor disorders. They began creating courses and sharing their knowledge around the world. They expanded to 11 locations in the United States and developed a residency style training program for their employees with ongoing weekly mentoring. The physical and occupational therapistss who work at PHRC have undergone more training than the majority of pelvic floor physical and occupational therapistss and as a result offer efficient and high quality care.

How many years of experience do we have?

Stephanie and Liz have 24 years of experience and help each and every team member become an expert in the field through their training and mentoring program.

Why PHRC versus anyone else?

PHRC is unique because of the specific focus on pelvic floor disorders and the leadership at our company. We are constantly lecturing, teaching, and staying ahead of the curve with our connections to medical experts and emerging experts. As a result, we are able to efficiently and effectively help our patients restore their pelvic health.

Do we treat men for pelvic floor therapy?

The Pelvic Health and Rehabilitation Center is unique in that the Cofounders have always treated people of all genders and therefore have trained the team members and staff the same way. Many pelvic floor physical and occupational therapistss focus solely on people with vulvas, this is not the case here.

Do I need pelvic floor therapy forever?

The majority of people with pelvic floor dysfunction will undergo pelvic floor physical and occupational therapy for a set amount of time based on their goals. Every 6 -8 weeks goals will be re-established based on the physical improvements and remaining physical impairments. Most patients will achieve their goals in 3 – 6 months. If there are complicating medical or untreated comorbidities some patients will be in therapy longer.

Join Let’s Talk Menopause on Friday, May 3rd, 2024 for our second annual half-day, IN-PERSON menoposium – this year in Chicago!

Learn from leading experts how perimenopause, menopause, and postmenopause can impact your body, mood, sleep, sexual/urinary health, and long-term health. Discover strategies for navigating these changes, including menopause hormone therapy.

 

This Menoposium will dive into symptoms of and treatments for:

➡️ Hot flashes & night sweats

➡️ Painful sex & decreased sexual desire

➡️ Urinary leaking & urinary tract infections

➡️ Anxiety, depression, irritability, sleep issues, and more!

We are thrilled to have Tamsen Fadal and Dr. Judith Joseph as our esteemed hosts. Tamsen is an influential and award-winning newscaster, journalist, author, and advocate with her own menopause story. Dr. Judith is a multi-faceted board-certified psychiatrist, researcher, media consultant, and award-winning content creator.

We will also learn from other top physicians, renowned researchers, and menopause advocates including Dr. Monica ChristmasDr. Mary Claire HaverDr. Sheryl KingsbergDr. Lisa LarkinDr. Pauline MakiDr. Sharon MaloneStephanie Prendergast, MPTDr. Sameena Rahman, and Dr. Lauren Streicher.

CONVENE, 333 North Green Street, Chicago, IL 60607
Doors open at 7:30 am for continental breakfast and networking

Program: 8:15 am—12:45 pm CT

Location: Convene 333 N. Green Street, Chicago

 

FAQ

What are pelvic floor muscles?

The pelvic floor muscles are a group of muscles that run from the coccyx to the pubic bone. They are part of the core, helping to support our entire body as well as providing support for the bowel, bladder and uterus. These muscles help us maintain bowel and bladder control and are involved in sexual pleasure and orgasm. The technical name of the pelvic floor muscles is the Levator Ani muscle group. The pudendal nerve, the levator ani nerve, and branches from the S2 – S4 nerve roots innervate the pelvic floor muscles. They are under voluntary and autonomic control, which is a unique feature only they possess compared to other muscle groups.

What is pelvic floor physical and occupational therapy?

Pelvic floor physical and occupational therapy is a specialized area of physical and occupational therapy. Currently, physical and occupational therapistss need advanced post-graduate education to be able to help people with pelvic floor dysfunction because pelvic floor disorders are not yet being taught in standard physical and occupational therapy curricula. The Pelvic Health and Rehabilitation Center provides extensive training for our staff because we recognize the limitations of physical and occupational therapy education in this unique area.

What happens at pelvic floor therapy?

During an evaluation for pelvic floor dysfunction the physical and occupational therapists will take a detailed history. Following the history the physical and occupational therapists will leave the room to allow the patient to change and drape themselves. The physical and occupational therapists will return to the room and using gloved hands will perform an external and internal manual assessment of the pelvic floor and girdle muscles. The physical and occupational therapists will once again leave the room and allow the patient to dress. Following the manual examination there may also be an examination of strength, motor control, and overall biomechanics and neuromuscular control. The physical and occupational therapists will then communicate the findings to the patient and together with their patient they establish an assessment, short term and long term goals and a treatment plan. Typically people with pelvic floor dysfunction are seen one time per week for one hour for varying amounts of time based on the severity and chronicity of the disease. A home exercise program will be established and the physical and occupational therapists will help coordinate other providers on the treatment team. Typically patients are seen for 3 months to a year.

What is pudendal neuralgia and how is it treated?

Pudendal Neuralgia is a clinical diagnosis that means pain in the sensory distribution of the pudendal nerve. The pudendal nerve is a mixed nerve that exits the S2 – S4 sacral nerve roots, we have a right and left pudendal nerve and each side has three main trunks: the dorsal branch, the perineal branch, and the inferior rectal branch. The branches supply sensation to the clitoris/penis, labia/scrotum, perineum, anus, the distal ⅓ of the urethra and rectum, and the vulva and vestibule. The nerve branches also control the pelvic floor muscles. The pudendal nerve follows a tortuous path through the pelvic floor and girdle, leaving it vulnerable to compression and tension injuries at various points along its path.

Pudendal Neuralgia occurs when the nerve is unable to slide, glide and move normally and as a result, people experience pain in some or all of the above-mentioned areas. Pelvic floor physical and occupational therapy plays a crucial role in identifying the mechanical impairments that are affecting the nerve. The physical and occupational therapy treatment plan is designed to restore normal neural function. Patients with pudendal neuralgia require pelvic floor physical and occupational therapy and may also benefit from medical management that includes pharmaceuticals and procedures such as pudendal nerve blocks or botox injections.

What is interstitial cystitis and how is it treated?

Interstitial Cystitis is a clinical diagnosis characterized by irritative bladder symptoms such as urinary urgency, frequency, and hesitancy in the absence of infection. Research has shown the majority of patients who meet the clinical definition have pelvic floor dysfunction and myalgia. Therefore, the American Urologic Association recommends pelvic floor physical and occupational therapy as first-line treatment for Interstitial Cystitis. Patients will benefit from pelvic floor physical and occupational therapy and may also benefit from pharmacologic management or medical procedures such as bladder instillations.

Who is the Pelvic Health and Rehabilitation Team?

The Pelvic Health and Rehabilitation Center was founded by Elizabeth Akincilar and Stephanie Prendergast in 2006, they have been treating people with pelvic floor disorders since 2001. They were trained and mentored by a medical doctor and quickly became experts in treating pelvic floor disorders. They began creating courses and sharing their knowledge around the world. They expanded to 11 locations in the United States and developed a residency style training program for their employees with ongoing weekly mentoring. The physical and occupational therapistss who work at PHRC have undergone more training than the majority of pelvic floor physical and occupational therapistss and as a result offer efficient and high quality care.

How many years of experience do we have?

Stephanie and Liz have 24 years of experience and help each and every team member become an expert in the field through their training and mentoring program.

Why PHRC versus anyone else?

PHRC is unique because of the specific focus on pelvic floor disorders and the leadership at our company. We are constantly lecturing, teaching, and staying ahead of the curve with our connections to medical experts and emerging experts. As a result, we are able to efficiently and effectively help our patients restore their pelvic health.

Do we treat men for pelvic floor therapy?

The Pelvic Health and Rehabilitation Center is unique in that the Cofounders have always treated people of all genders and therefore have trained the team members and staff the same way. Many pelvic floor physical and occupational therapistss focus solely on people with vulvas, this is not the case here.

Do I need pelvic floor therapy forever?

The majority of people with pelvic floor dysfunction will undergo pelvic floor physical and occupational therapy for a set amount of time based on their goals. Every 6 -8 weeks goals will be re-established based on the physical improvements and remaining physical impairments. Most patients will achieve their goals in 3 – 6 months. If there are complicating medical or untreated comorbidities some patients will be in therapy longer.

By PHRC Admin

 

Let us help you untangle something that should be so simple yet is not and continues to be a problem for many; accessibility to healthcare that thousands across the nation need and could benefit from. There exists a notable disparity in the healthcare sector, often overlooked. It’s the inequality faced by individuals going through menopause when it comes to accessing affordable hormone treatments, compared to the ease of accessibility for medications treating conditions such as erectile dysfunction. This discrepancy not only sheds light on the high costs of hormone therapy but also highlights an alarming lack of awareness among medical professionals about its benefits.

 

The Cost of Hormone Therapy

Menopause is a natural stage of life that many will experience. Despite this, many find themselves grappling with the high costs of hormone treatments, a vital part of managing menopause symptoms. Regrettably, while treatments for conditions like erectile dysfunction are readily accessible and reasonably priced, those going through menopause often struggle to find affordable options for their hormonal needs.

 

Take this quote by Deborah Copaken for example:

 

“If I were a middle-aged man suffering from erectile dysfunction, I could walk into my neighborhood pharmacy and buy a 30-day supply of Sildenafil (the generic for Viagra) for $8.67 out of pocket, and, no, that’s not the insurance copay.”

 

Copaken’s recent article, “How to Hack Insurance So You Can Get the Hormones You Need,” featured in Oprah Daily, really hit the nail on the head when discussing the accessibility of women’s healthcare and healthcare products.

The Role of Knowledge and Awareness

 

Contributing to this issue is a significant lack of awareness among doctors about the benefits of hormone therapy. This gap in knowledge often leads to a reluctance in prescribing these treatments, leaving many without access to this essential support during menopause. This discrepancy underscores the need for improved education and awareness among healthcare providers about the importance and benefits of hormone therapy.

 

Finding Affordable Hormone Treatments

 

However, there are several avenues for obtaining affordable hormone treatments. One such option is working with menopause specialists who have a detailed understanding of the hormonal changes individuals undergo during this phase of life and can provide tailored treatment plans.

 

Another promising option is online telemedicine start-ups. These platforms offer virtual consultations and treatments at a fraction of the cost, making them a viable alternative for those struggling with the high costs of traditional healthcare.

 

Furthermore, cost-saving initiatives like Cost Plus Drug offer a beacon of hope. These initiatives aim to make medication more affordable, ensuring that more people can access the hormone treatments they need.

 

Towards More Transparent and Equitable Healthcare

 

The challenges faced by those going through menopause highlight the pressing need for more transparency and equity in healthcare. As we move forward, it’s crucial to ensure that everyone has access to affordable treatments and that doctors are well-informed about the benefits of hormone therapy.

 

In conclusion, while the path to equitable healthcare might be fraught with challenges, the possibilities offered by specialists, telemedicine start-ups, and cost-saving initiatives provide hope. What’s clear is that a shift in perspective is needed – one that acknowledges the importance of healthcare during menopause and strives towards making it accessible and affordable for all.

 

Special shout out to our friends who were also featured in this article, Dr. Rachel Rubin, Dr. Ashley Winter, and Dr. Kelly Casperson.

 

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Are you unable to come see us in person in the Bay Area, Southern California or New England?  We offer virtual physical and occupational therapy appointments too!

Virtual sessions are available with PHRC pelvic floor physical and occupational therapistss via our video platform, Zoom, or via phone. For more information and to schedule, please visit our digital healthcare page.

Do you enjoy or blog and want more content from PHRC? Please head over to social media!

Facebook,

 YouTube Channel

Twitter, Instagram, Tik Tok

FAQ

What are pelvic floor muscles?

The pelvic floor muscles are a group of muscles that run from the coccyx to the pubic bone. They are part of the core, helping to support our entire body as well as providing support for the bowel, bladder and uterus. These muscles help us maintain bowel and bladder control and are involved in sexual pleasure and orgasm. The technical name of the pelvic floor muscles is the Levator Ani muscle group. The pudendal nerve, the levator ani nerve, and branches from the S2 – S4 nerve roots innervate the pelvic floor muscles. They are under voluntary and autonomic control, which is a unique feature only they possess compared to other muscle groups.

What is pelvic floor physical and occupational therapy?

Pelvic floor physical and occupational therapy is a specialized area of physical and occupational therapy. Currently, physical and occupational therapistss need advanced post-graduate education to be able to help people with pelvic floor dysfunction because pelvic floor disorders are not yet being taught in standard physical and occupational therapy curricula. The Pelvic Health and Rehabilitation Center provides extensive training for our staff because we recognize the limitations of physical and occupational therapy education in this unique area.

What happens at pelvic floor therapy?

During an evaluation for pelvic floor dysfunction the physical and occupational therapists will take a detailed history. Following the history the physical and occupational therapists will leave the room to allow the patient to change and drape themselves. The physical and occupational therapists will return to the room and using gloved hands will perform an external and internal manual assessment of the pelvic floor and girdle muscles. The physical and occupational therapists will once again leave the room and allow the patient to dress. Following the manual examination there may also be an examination of strength, motor control, and overall biomechanics and neuromuscular control. The physical and occupational therapists will then communicate the findings to the patient and together with their patient they establish an assessment, short term and long term goals and a treatment plan. Typically people with pelvic floor dysfunction are seen one time per week for one hour for varying amounts of time based on the severity and chronicity of the disease. A home exercise program will be established and the physical and occupational therapists will help coordinate other providers on the treatment team. Typically patients are seen for 3 months to a year.

What is pudendal neuralgia and how is it treated?

Pudendal Neuralgia is a clinical diagnosis that means pain in the sensory distribution of the pudendal nerve. The pudendal nerve is a mixed nerve that exits the S2 – S4 sacral nerve roots, we have a right and left pudendal nerve and each side has three main trunks: the dorsal branch, the perineal branch, and the inferior rectal branch. The branches supply sensation to the clitoris/penis, labia/scrotum, perineum, anus, the distal ⅓ of the urethra and rectum, and the vulva and vestibule. The nerve branches also control the pelvic floor muscles. The pudendal nerve follows a tortuous path through the pelvic floor and girdle, leaving it vulnerable to compression and tension injuries at various points along its path.

Pudendal Neuralgia occurs when the nerve is unable to slide, glide and move normally and as a result, people experience pain in some or all of the above-mentioned areas. Pelvic floor physical and occupational therapy plays a crucial role in identifying the mechanical impairments that are affecting the nerve. The physical and occupational therapy treatment plan is designed to restore normal neural function. Patients with pudendal neuralgia require pelvic floor physical and occupational therapy and may also benefit from medical management that includes pharmaceuticals and procedures such as pudendal nerve blocks or botox injections.

What is interstitial cystitis and how is it treated?

Interstitial Cystitis is a clinical diagnosis characterized by irritative bladder symptoms such as urinary urgency, frequency, and hesitancy in the absence of infection. Research has shown the majority of patients who meet the clinical definition have pelvic floor dysfunction and myalgia. Therefore, the American Urologic Association recommends pelvic floor physical and occupational therapy as first-line treatment for Interstitial Cystitis. Patients will benefit from pelvic floor physical and occupational therapy and may also benefit from pharmacologic management or medical procedures such as bladder instillations.

Who is the Pelvic Health and Rehabilitation Team?

The Pelvic Health and Rehabilitation Center was founded by Elizabeth Akincilar and Stephanie Prendergast in 2006, they have been treating people with pelvic floor disorders since 2001. They were trained and mentored by a medical doctor and quickly became experts in treating pelvic floor disorders. They began creating courses and sharing their knowledge around the world. They expanded to 11 locations in the United States and developed a residency style training program for their employees with ongoing weekly mentoring. The physical and occupational therapistss who work at PHRC have undergone more training than the majority of pelvic floor physical and occupational therapistss and as a result offer efficient and high quality care.

How many years of experience do we have?

Stephanie and Liz have 24 years of experience and help each and every team member become an expert in the field through their training and mentoring program.

Why PHRC versus anyone else?

PHRC is unique because of the specific focus on pelvic floor disorders and the leadership at our company. We are constantly lecturing, teaching, and staying ahead of the curve with our connections to medical experts and emerging experts. As a result, we are able to efficiently and effectively help our patients restore their pelvic health.

Do we treat men for pelvic floor therapy?

The Pelvic Health and Rehabilitation Center is unique in that the Cofounders have always treated people of all genders and therefore have trained the team members and staff the same way. Many pelvic floor physical and occupational therapistss focus solely on people with vulvas, this is not the case here.

Do I need pelvic floor therapy forever?

The majority of people with pelvic floor dysfunction will undergo pelvic floor physical and occupational therapy for a set amount of time based on their goals. Every 6 -8 weeks goals will be re-established based on the physical improvements and remaining physical impairments. Most patients will achieve their goals in 3 – 6 months. If there are complicating medical or untreated comorbidities some patients will be in therapy longer.