
The Femina Physical Therapy Blog
Featuring original articles by our staff about current events and trends
Explore our insightful blog articles on pelvic health, where we delve into essential topics that empower and educate. From understanding pelvic floor disorders to strategies for conquering infertility, our content is designed for those seeking knowledge and support. We discuss the latest research, expert advice, and practical tips to enhance your well-being and foster a deeper connection to your body.
Featured From the Blog:
Running Mechanics and Pelvic Floor Health: The Impact of Footwear

Did You Know That Proper Footwear Can Improve Your Running Mechanics and Pelvic Floor Health?
How Do My Feet Impact My Pelvic Floor When I Run?
If you are a runner, you tend to look for ways to improve your running. If you’re thinking about starting up or returning to running, it can feel intimidating particularly if you have any symptoms related to pelvic floor dysfunction. This only complicates an exercise that, on the surface, seems fairly straight forward. There are some studies that have looked at how your feet can play a part in your pelvic floor muscle function while you run. And if you are looking to return to running postpartum, read on and also check out this article by one of our pelvic floor physical therapists.
Read more: Running Mechanics and Pelvic Floor Health: The Impact of...
Vulvovaginal Moisturizers: Who Needs One & Choosing the Right One

Choosing the Right Vulvovaginal Moisturizer
Assuming you need one, make sure it's got the right ingredient list
There are many reasons why those born with female anatomy may require the use of a vulvovaginal moisturizer throughout their lifetime. As you age, the vaginal and vulvar tissues tend to become drier and less elastic. This change is typically seen around the time one goes through menopause due to the drop in estrogen that occurs. The vulvovaginal tissues are very sensitive to hormonal changes and estrogen is the hormone that controls vaginal lubrication, as well as tissue elasticity and thickness.
Read more: Vulvovaginal Moisturizers: Who Needs One & Choosing the...
Therapeutic Breast Massage in Lactation (TBML)

Therapeutic Breast Massage in Lactation Can Help Make Breastfeeding Less Painful
Breastfeeding is widely accepted as the normal standard for providing nutrition to newborns, however, many women who do not reach their breastfeeding goals. US national data stated that breast pain was a commonly reported reason for women weaning less than 1 month postpartum. Within that segment, 29% of women who participated in the study stated that “breastfeeding was too painful” to continue.
In the same study, 24% of women reported “breasts feel(ing) too full or engorged” as another reason to discontinue breastfeeding prior to 1 month postpartum.1 Currently, The American Academy of Pediatrics recommends exclusive breastfeeding of infants for the first six months of life. As physical therapists who treat patients with postpartum conditions, we are well positioned to make a big impact on patients with breastfeeding related pain and reduce barriers to continued breastfeeding!
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- Written by: Anna Larson, PT, DPT
- 758 Views

Yoga Practice For Chronic Pelvic Pain Can Be a Very Helpful Routine
As stated in my last blog post, yoga can be so beneficial as a pain management tool due to its ability to modulate the sympathetic nervous system3,4 which plays a large role in chronic pain. The exact mechanism of how yoga helps with chronic pain is still being studied, however, it is reasonable to believe the full body relaxation promoted by a yoga practice helps to decrease tension in key muscle groups- including the hips and pelvic floor which are often tight in people with chronic pelvic pain.
Currently, evidence has mostly focused on one hour long practices as an intervention, although there are some studies that report improvements in pain with shorter practices, such as the routine below. As with any mobility/stretching routine, benefits will be seen with more frequent practice, however even twice weekly can help decrease pain.
Read more: Restorative 20 Minute Home Yoga Practice For Chronic...
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- Written by: Anna Larson, PT, DPT
- 1441 Views

We Take a Look at Combined Methods of Hormonal Birth Control and Vulvodynia
In this three part series, we will explore the effects of hormonal contraceptive methods and their relationship with vulvodynia.
What is Hormonal Birth Control?
Hormonal birth control methods, such as birth control pills, patches, injections, rings and hormonal intrauterine devices (IUDs), work by altering hormone levels in the body to prevent pregnancy. Hormonal contraceptives fall into two categories: combined, meaning they contain both estrogen and progestin (think the pill, patch, or ring), or contain progestin only (think progestin only pill or “POP”, arm implant, IUDs, or injections). While the primary intent of these drugs are for contraception, they are also widely prescribed for other common issues such as: mood imbalance related to periods, skin issues, irregular periods, and painful periods.
Read more: Hormonal Birth Control and Vulvodynia - Part 1: Combined...
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- Written by: Anna Larson, PT, DPT
- 1465 Views

Hormonal Birth Control and Vulvodynia - Part 2: Hormonal Intrauterine Devices (IUD)
This article takes a looks at intrauterine devices (IUDs) and it’s potential effect on vulvodynia, or vulvar pain.
Intrauterine devices, also called long-acting reversible contraceptives (LARC), have become more and more popular as a birth control method in the United States due to high efficacy, less side effects and higher continuation compared to other hormonal contraceptive methods1,2,6. They are offered in two forms; hormonal (common brand names are Mirena, Kyleena, Skyla, Liletta) and copper IUDs. For this blog, we will be exploring the effects of the hormonal IUD only. This type of IUD releases progestin into the body which suppresses endometrial cell growth (called proliferation) and thickens the cervical mucus to prevent pregnancy4.
I consider myself to be a case study when it comes to the topic of hormonal birth control and pelvic pain. I have tried several variations of the combo pill, progestin only pill, the Mirena IUD and most recently, the Nuvaring. When taking the combination methods, I definitely noticed the side effects previously mentioned in my last blog post. However, in my early twenties, when I was on the Mirena (hormonal IUD), I didn’t notice any of these side effects.
Read more: Hormonal Birth Control and Vulvodynia Part 2: Hormonal...
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- Written by: Anna Larson, PT, DPT
- 1038 Views

The Relationship Between Hormonal Birth Control and Vulvodynia
Is the hormonal birth control mini pill better than the regular pill?
If you have been following along, this is the third part of our hormonal birth control and vulvodynia series. First, we covered how combination methods of birth control (containing synthetic forms of both estrogen and progesterone) could lead to vulvodynia. We then explored if there is a risk of developing vulvodynia after the insertion of a hormonal intrauterine device IUD). In this post, we will delve into the relationship between the progesterone only birth control pill, also called “the mini pill,” and vulvodynia. As a quick refresher, vulvodynia is pain on the vulva, or external genital tissue. For more information about vulvodynia, check out this post on our website.
Similar to the hormonal IUD, the mini pill works as a contraceptive by thickening cervical mucus and thinning the lining of the uterus to prevent a fertilized egg from implanting. Similar to the IUD, it is an expected side effect to experience spotting in the first few months of use1. Interestingly, some women will no longer ovulate, while some will continue to, about 4 in 10, according to the American College of Obstetricians and Gynecologists1.
Read more: Hormonal Birth Control and Vulvodynia Part 3: The Mini Pill
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- Written by: Iris Xu
- 4363 Views

Don't Let Paradoxical Diarrhea Ruin Your Day
Have you ever experienced a peculiar mix of constipation and diarrhea at the same time? This unusual phenomenon, known as paradoxical diarrhea or overflow diarrhea, can be both confusing and uncomfortable. Here’s what you need to know about this condition:
What is Paradoxical Diarrhea?
Paradoxical diarrhea occurs when liquid stool leaks around impacted, hardened stool in the colon. This leakage leads to symptoms of both constipation and diarrhea simultaneously. It’s often associated with conditions like mixed irritable bowel syndrome (IBS-M).1
Read more: Understanding Paradoxical Diarrhea: Symptoms, Causes, and...
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- Written by: Debbie Dy, PT, DPT
- 1319 Views

In this article we’ll discuss how to assess if you may have a weak pelvic floor, what symptoms are and basic orientation to the pelvic floor.
What is the pelvic floor?
The pelvic floor is a very important group of muscles that live in the bottom of the pelvis. Both men and women have a pelvic floor. These muscles sit in the bottom of the pelvic floor like a hammock, and can move up and down like a trampoline to support your internal organs inside your body. They also help to control the openings and closures in the bottom of the pelvis, which is why they are so essential to urinary, bowel and sexual function. Just like any muscle, when they are weak, they can start to cause issues with any of these functions. Common signs of a weak pelvic floor include urinary incontinence, fecal (or bowel) incontinence, feeling of pelvic heaviness or pelvic organ prolapse, as well as low back or hip pain.
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- Written by: Stephany Tritt, PT, DPT
- 1135 Views

Does my pelvic girdle pain have anything to do with my mood and sexuality?
Many of our patients experience sexual dysfunction and anxiety, depression and chronic pain. These conditions are known to coexist, and we unpack each component of pain, mood and one’s behaviors, desires and attitudes related to sex and physical intimacy.
Pelvic girdle pain is defined as “pain between the posterior iliac crests and gluteal folds particularly in the vicinity of the sacroiliac joint” (Simonds). More simply stated: in the very low area of your back and buttock. Pelvic girdle pain is common postpartum and may impact disability in the fourth trimester. Many are aware of peripartum symptoms such as low back pain, incontinence, pelvic organ prolapse, pain with intercourse, and postpartum depression. Knowing that many women experience pain during and after pregnancy - what can we learn about the effects of pelvic girdle pain? Specifically, what impact does pelvic girdle pain have on symptoms of mood and sexuality?
Read more: Postpartum Sexuality & Mood Changes in Women with Pelvic...
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- Written by: Anna Larson, PT, DPT
- 974 Views

Learn All About the Benefits of Yoga for Chronic Pelvic Pain
Chronic pelvic pain is a common debilitating condition that greatly impacts a person’s health and quality of life. Often, the origin of the pain can have one or several causes including: endometriosis, vulvodynia, interstitial cystitis, irritable bowel syndrome, chronic pelvic inflammatory disease, adenomyosis, fibroids, celiac disease, fibromyalgia, degenerative disc disease, and chronic urinary tract infections, to name a few5.
Sometimes, the exact origin of the pain is unknown, even stated as high as 61% of chronic pelvic pain cases5. To learn more about the interactions between these conditions and how they can cause chronic pain, see this previous blog post here.