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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...
Hormonal Birth Control and Vulvodynia Part 2: Hormonal Intrauterine Devices (IUD)
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...
Hormonal Birth Control and Vulvodynia - Part 1: Combined Hormonal Methods
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: Kasia Gondek, PT, DPT, CLT, CSCS
- 6550 Views
Self-Care and Self-Management Strategies to Combat Endometriosis Symptoms During the COVID-19 Pandemic
Since March of 2020, people living with endometriosis symptoms are facing tough challenges and barriers due to the Covid-19 pandemic: canceled surgeries, canceled appointments with family physicians, gynecologists, fertility specialists and/or other allied healthcare providers, postponed in-office assessments and visits, and changes in overall work environment and social activities. This can worsen feelings of isolation, depression, anxiety, hopelessness, and have a negative impact on self-reported pain and disability levels during this time.
Read more: Self-Care to Combat Endometriosis Symptoms During the...
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- Written by: Staff
- 6016 Views
Endometriosis and Sexual Function Require a Specialized Approach
Endometriosis is a global disease affecting 5-15% of women during their reproductive years. It is characterized by the presence of endometrial-like tissue outside of the uterus which can trigger a local inflammatory response and can have a significant impact on patients’ quality of life.
One such domain of quality of life that is often affected is the correlation between endometriosis and sexual function. The DSM-V defines sexual dysfunction as a clinically significant disturbance in a person’s ability to respond sexually or to experience pleasure and includes pelvic pain, penetration disorders, lack of sexual interest, and/or arousal and orgasm disorders. Unfortunately, it is common, as approximately 40% of women with endometriosis and chronic pelvic pain suffer from sexual dysfunction.
Read more: Endometriosis and Sexual Function: A Multidisciplinary...
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- Written by: Kasia Gondek, PT, DPT, CLT, CSCS
- 4194 Views
Road to Boston Marathon Part 1
A Tribute to the First Female Runners
On April 18, 2022 I am excited and grateful to be able to run the historic and prestigious Boston Marathon! As a physical therapist at Fusion Wellness /Femina Physical Therapy and avid long-distance runner for over 20 years, I’m excited to share my training journey with you leading up to the race. This race holds a special place in the hearts of long-distance runners because you must run a qualifying race with a qualifying time. Females ages 18-34 must run 3 hours 30 minutes or better, and males ages 18-34 must run 3 hours flat or better.
Read more: Kasia's Road to The Boston Marathon Part 1: A Tribute to...
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- Written by: Staff
- 4592 Views
Postpartum Recovery Series Part 5
Managing Urinary Incontinence After Childbirth
Urinary incontinence is the unwanted leakage of urine, also known as accidental bladder leakage. There are a few main types. Stress urinary incontinence is leakage associated with activities, such as lifting, exercising, coughing, sneezing, or laughing. Urge urinary incontinence is leakage associated with the urge and people often experience leaking on the way to the toilet. There is also mixed incontinence which is a combination of the two types. Continence is managed by the complex interaction of bladder physiology, central nervous system, and the pelvic floor muscles. When there is dysfunction in any part of the three systems, incontinence may occur.
Read more: How to Manage Urinary Incontinence After Childbirth |...
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- Written by: Staff
- 5632 Views
Did You Know Physical Therapy Can Help Endometriosis?
What is the link between endometriosis and painful sex?
Endometriosis is a global disease affecting 5-15% of women during their reproductive years. It is characterized by the presence of endometrial-like tissue outside of the uterus which can trigger a local inflammatory response and can have a significant impact on patients’ quality of life.
Sexual Function
One such domain of quality of life that is often affected is sexual function. The DSM-V1 defines sexual dysfunction as a clinically siginifcant disturbance in a person’s ability to respond sexually or to experience pleasure and includes: pelvic pain, penetration disorders, lack of sexual interest and/or arousal and orgasm disorders. Unfortunately, it is common, as approximately 40% of women with endometriosis and chronic pelvic pain suffer from sexual dysfunction.
Read more: Physical Therapy Can Help Endometriosis and Painful Sex
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- Written by: Staff
- 6844 Views
What's the Link Between Endometriosis and Central Sensitization?
Endometriosis affects roughly about 10% of reproductive-age women, and is characterized by endometrial-like lesions that grow outside of the endometrium (the lining of the uterine wall). Women with endometriosis have symptoms such as: chronic pelvic pain, dysmenorrhea, abdominal pain, infertility, constipation, interstitial cystitis/painful bladder syndrome, and more.
Often endometriosis is treated through hormonal management and/or surgically. However, 18-27% of patients with endometriosis treated via hormonal medications reported no relief from symptoms. About 20% of patients with endometriosis treated through surgical excision or ablation continued to experience chronic pelvic pain and other endometriosis symptoms. Moreover, 70 to 80% of women with chronic pelvic pain with confirmed endometriosis lesions do not have lesions in the areas where they experience symptoms.
Read more: Endometriosis and Central Sensitization: Pain in...
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- Written by: Staff
- 4758 Views
What causes incontinence during pregnancy?
There are many causes for incontinence during pregnancy and postpartum. Some of the proposed factors are:
- hormonal changes,
- pelvic floor muscle and connective tissue modifications,
- bladder neck widening (due to the weight of both the uterus and the growing fetus),
- anatomical injuries during delivery.1, 2
A hormone called relaxin is produced during pregnancy to help soften the muscles and ligaments in preparation for delivery. As the uterus and baby grow throughout pregnancy more load is placed on the pelvic floor muscles causing the pelvic floor muscles to become weaker.3 Also constipation, which is commonly seen in pregnancy, puts an additional load on the pelvic floor.4 Furthermore, the pelvic floor has additional strain placed on it during labor; the pelvic floor muscle is stretched five times its original length.5
Read more: Incontinence During Pregnancy & Postpartum | Postpartum...
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- Written by: Staff
- 6937 Views
What Are The Connections Between Endometriosis and Sleep?
March is Endometriosis Awareness Month.
The endometrium is the lining of the uterus. When there is tissue similar to the endometrial lining that is growing outside of the uterus, it is called endometriosis. Endometrial lesions can be on the ovaries, vaginal walls, bladder, colon, and more. Endometriosis affects up to 10% of the general population and can be quite debilitating as common symptoms include dysmenorrhea, dyspareunia (pain with sex), infertility, bloating, gastrointestinal symptoms, and chronic pelvic pain.
Read more: Endometriosis and Sleep Blog: Improving Melatonin Levels
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- Written by: Staff
- 6035 Views
Pelvic Floor Rehabilitation for Prolapse Surgeries
Including both Pre and Post Operative Situations
Suffering from symptoms of pelvic heaviness? Experiencing a feeling that there is a bulge down there or something is falling out of your vagina? Have trouble having a bowel movement or experiencing incontinence? These are all common symptoms of pelvic organ prolapse (POP). Unfortunately, 2-48% of women may experience symptoms of POP.
Pelvic Floor Rehabilitation Treatment Options
There are treatment options such as pelvic floor rehabilitation through physical therapy techniques including lifestyle modifications such as managing intraabdominal pressure, promoting healthy bowel/bladder habits, as well as physical therapy, manual therapy, and strengthening exercises to decrease pelvic heaviness.
Read more: Pelvic Floor Rehabilitation for Pre/Post Operative...
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- Written by: Staff
- 21437 Views
What's the Connection Bewteen Eating Disorders and Pelvic Floor Dysfunction?
Read on for some answers.
Eating disorders are unfortunately common, with at least 9% of people worldwide suffering from an eating disorder. This translates to 28.8 million Americans will have an eating disorder in their lifetime. There are different types of eating disorders (ED) including anorexia nervosa, bulimia nervosa, and binge eating disorder. Other than the typical psychological and social implications that these eating disorders may cause, they also can affect our pelvic health and lead to pelvic floor dysfunction. It can lead to incontinence (either urine or feces), prolapse, increased urinary urge, pelvic pain (possibly associated with polycystic ovarian syndrome or PCOS), constipation, and sexual dysfunction.
Read more: Eating Disorders and Pelvic Floor Dysfunction | ED...
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- Written by: Staff
- 7245 Views
Contraceptives and Sexual Function Considered
As pelvic floor physical therapists, we work with a lot of women who have some type of female sexual dysfunction, whether it may be pain with initial penetration, pain with deep thrusting/deep penetration, pain with orgasms, or decreased sexual arousal, desire, libido. Unfortunately, about 30-50% of women may suffer from these symptoms.
We often see women with sexual impairments have the following conditions/scenarios:
- Postpartum (regardless of delivery)
- Vaginismus (involuntary spasms of the pelvic floor muscles)
- Post-menopausal
- Vulvodynia
- Skin inflammatory conditions such as lichen sclerosus
Read more: What Do We Know About Contraceptives and Sexual Function?
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- Written by: Kasia Gondek, PT, DPT, CLT, CSCS
- 5472 Views
SMART Pelvic Health Goals
As we enter 2022, the new year marks a time of both reflection on the previous year and forward-thinking and planning for the year ahead. That’s why the beginning of the year is a great time to reset your pelvic health goals! Here at Femina Physical Therapy, we like to use the S.M.A.R.T. goal setting with frequent review of progress toward these goals. S.M.A.R.T. goals offer a simple and proven method of creating and evaluating goals that are reachable, specific and achievable. The S.M.A.R.T. acronym stands for:
- Specific (simple, sensible, significant).
- Measurable (to help motivate and track your progress).
- Achievable (attainable).
- Relevant (reasonable, results-based, unique to you).
- Time-bound (time-based, time-limited).
When creating your list of pelvic health goals, keep in mind what is relevant and meaningful to you. Visualize what achieving your goals might look like, how will it feel, what will your reward to yourself be? It is important to keep these critical aspects in mind when creating goals in order to determine if they are reasonable, achievable, and meaningful! Plus, a reward for achieving our goals keeps us motivated to push through challenges and roadblocks along the way.
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- Written by: Heather Jeffcoat, DPT
- 10937 Views
Are You Wondering "Can A Vaginal Birth Ruin Your Sex Life?"
Medically, the answer is a resounding ‘no’… but postpartum sex is still an understandable concern for most pregnant women, especially in a digital age where whispered rumors have given way to detailed stories of difficult birth experiences splashed across social media pages.
In the greater debate over vaginal birth vs. C-section, the real issue on the minds of many expectant mothers is often whether one mode of delivery is somehow better than the other. It’s a complex question; but a group of researchers in Ontario, Canada recently attempted to answer the ‘sex after baby’ part of it. What they found out surprised even them; and shed some important light on the bigger question as well.
Researchers Studying the Impact of Vaginal Childbirth versus Cesarean on Postpartum Sex Find...
Read more: Can A Vaginal Birth Ruin Your Sex Life? | Femina PT Talks...
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- Written by: Heather Jeffcoat, DPT
- 5422 Views
First some facts about pelvic floor dysfunction:
- Nearly one in two women experience painful sex.
- One in three women suffers from urinary incontinence.
- 40% of all women and 50% of childbearing women have pelvic organ prolapse.
Because I’m a fan of scientific data, this isn’t the first time you’ve seen the truth by the numbers in this space.
Rarely, though, do I get to talk about a ‘study of many studies’ like the one published in Sexual Medicine Reviews.
Read more: Pelvic Floor Dysfunction: The Facts, Research, and Treatment
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- Written by: Staff
- 6303 Views
A Pelvic Floor PT Can Assist With Cervical Cancer and Recovery
Cervical cancer is the fourth most common cancer affecting women worldwide.
Luckily there are many wonderful treatments that can stop the cancer, either completely or from progressing further. However, the treatments do come with some unwanted side effects. But there is help and having a pelvic floor physical therapist added to your ervical cancer support team can truly guide you along the way.
Common Cervical Cancer Treatments
Some common treatments are pelvic external beam radiotherapy and/or brachytherapy, which unfortunately can adversely affect women’s sexual functioning and quality of life. Radiotherapy especially can cause vaginal stenosis, which is narrowing of the vaginal canal. This is due to radiation effects of collagen deposition, loss of elasticity in the vaginal tissue, and atrophic changes of the mucosa. Unfortunately, 88% of women after radiation will develop vaginal stenosis. As you can imagine, narrowing of the vaginal canal can impede women’s ability to tolerate penetrative sexual intercourse or gynecologic exams, for example.
Read more: Cervical Cancer and Recovery | A Pelvic Physical...
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- Written by: Staff
- 1846 Views
Restless Legs Syndrome (or RLS)
Restless legs syndrome (or RLS) is a condition where there are uncontrollable urges to move limbs (mostly in the legs, but sometimes in the arms) that follows a circadian pattern, namely evenings/overnight when resting.
The urges usually come with unpleasant sensations such as tingling, burning, itching, or otherwise pain. Usually, it can be alleviated by movement, but as you can imagine, it can be debilitating and impair sleep, and thus the quality of life. It is common to experience mood swings, anxiety, and depression.
It is estimated that about 3.9-14.3% of the general population suffers from RLS. It is the most common movement disorder in pregnant women. There is either primary (idiopathic) RLS, or secondary (acquired) RLS due to pregnancy, renal pathologies, diabetes, hypertension, and other metabolic conditions. The two most common risk factors for RLS are iron deficiency and kidney disease.
Read more: Restless Legs Syndrome & Physical Therapy | Postpartum...
