Is Pelvic Floor Physical Therapy Embarrassing?

Hey, girly. If you’re reading this, I’m assuming you’re on the verge of starting pelvic floor physical therapy but feeling a little nervous about it. You might be wondering if this is something you should feel embarrassed about or if it’s even worth it.

Let me walk you through this.

Let’s pretend we’re sitting at our favorite local coffee shop. I’m having an iced oatmeal latte, and you’re sipping on your drink of choice. We’re just talking through why you shouldn’t feel embarrassed about going to pelvic floor physical therapy.

Here’s the TLDR version:
Pelvic floor physical therapy can be life changing, and you should absolutely put on a brave face and get started.

I think a big reason women feel embarrassment or shame around pelvic floor physical therapy is because the things treated in pelvic floor physical therapy are not talked about in mainstream America, even though they are very, very, very common.

Pelvic floor physical therapy is for:

• Women

• Men

• Kids

The majority of people seeking care right now are women, but everyone needs pelvic floor physical therapy for different reasons throughout their lifespan.

Many of us are told to just woman up. We’re told that the symptoms treated in pelvic floor physical therapy are just a part of being a woman. Because of that, we’re often told these symptoms are normal and something we just have to live with.

That’s actually not the case.
There is a lot that can be done.

For the population I treat, another big fear is being dismissed again. Many patients I’ve seen have been dismissed so often that they have to put on a brave face just to try again. They are looking for a provider who will:

• Hear them

• Care

• Listen

• Give them answers

Instead of brushing off their symptoms as normal.

Feeling nervous before starting pelvic floor physical therapy is incredibly common. Almost all of my patients come in nervous for their first appointment:

• Nervous to meet someone new

• Nervous to talk about things that aren’t usually discussed

And almost every time, I can see a posture change within the first twenty minutes of the appointment.

If that’s you, just know this: pelvic floor physical therapists choose this specialty because we want to help people just like you.

Why Pelvic Floor Physical Therapy Feels Embarrassing at First

Let’s be real. Pelvic floor physical therapy can feel embarrassing at first because it involves talking about very private aspects of your life.

That can include:

• Your sex life

• A history of abuse

• Bowel issues

• Urinary leakage

These are things that are not talked about very often, sometimes not even in the medical field.

Outside the walls of a pelvic floor physical therapy clinic, there is a greater likelihood of being judged or misunderstood for these symptoms. Many people do not realize how common they actually are.

There is also the possibility of an internal pelvic floor muscle exam. For many people, that alone brings up a lot of anxiety.

You may be wondering:

• What is that going to be like

• Is it similar to a Pap smear

Just knowing that an internal exam is even on the table can make the entire experience feel intimidating.

In my area at least, pelvic floor physical therapy is still relatively new. There has been a lack of education around what it actually involves. Social media has been the primary driver of growth in this field, which means many people truly do not know what pelvic floor physical therapy looks like before walking into their first appointment.

For a lot of patients, starting pelvic floor physical therapy feels like a Hail Mary.

They reach a point where they cannot live with their symptoms anymore. It is affecting:

• Their life

• Their marriage

• Their family

• Their hobbies

So they decide to give it a try, often without a lot of hope that it is actually going to help.

What Actually Happens During Pelvic Floor Physical Therapy

When you know what to expect, your nervous system automatically feels safer.

One way to feel less nervous about pelvic floor physical therapy is to know exactly what is going to happen.

In my clinic, the first appointment is about:

• Getting to know you

• Understanding what you have experienced

• Learning a little bit about your life

An exam is potentially on the table, but it depends on why you are coming in.

That exam may be:

• An internal pelvic floor muscle exam

• A musculoskeletal assessment

It depends on your symptoms and your history.

For the first twenty to thirty minutes, I simply chat and get to know my patients. By the time you come in, you have already filled out a pretty extensive intake form. I can usually read that intake and have a good idea of:

• What is going on

• Why it is happening

• How I am going to treat it

If an internal exam is done, it is often used to:

• Confirm my hypothesis

• Guide your home exercise program

For every patient, an exam is always optional.

If someone has a history of abuse, I am even more likely to leave that exam on the table until a second appointment. In those cases, I can still get started with more general exercises that help the majority of my patients.

The general flow of an appointment looks like this:

• We spend twenty to thirty minutes getting to know each other

• There is some form of evaluation or exam

• I give you my assessment so you know exactly what is going on, why it is going on, and what we are going to do to treat it

• You leave with a clear game plan for home

Home exercises may include:

• Deep breathing

• Musculoskeletal strengthening or mobility work

• Paying attention to posture

Treatment also often includes lifestyle modifications like:

• Bowel routines

• Drinking more water

• Adding fiber

• Meditation and calming your nervous system

One important thing to say here is that pelvic floor physical therapists and occupational therapists are trained doctoral level professionals. We deal with these issues every single day.

This is what we talk about all day long.

If you ever get the vibe that someone feels uncomfortable discussing these topics, they may not be well trained or experienced, and it is okay to consider going somewhere else.

Why Most Patients Say Pelvic Floor Physical Therapy Is Less Embarrassing Than They Expected

By the end of their appointment, most of my patients leave feeling very hopeful about their treatment plan.

Many of them tell me:

• The exam was not nearly as bad as they expected

• The appointment went much better than anticipated

One big reason for this is education. I am very thorough in explaining:

• What is going on

• Why they are experiencing their symptoms

Understanding what is happening in your body can change the entire experience.

Another reason is that the exam is something patients actively participate in. It is not like a speculum Pap smear exam.

Patients give feedback such as:

• If something feels painful

• Where they feel it

• Whether it gets better or stays the same

They are an active participant rather than a passive person lying on a table.

Patients also leave with:

• A solid game plan

• A clear roadmap for treatment

The environment matters too. The space is designed to feel less clinical and more safe. Patients know exactly what the appointment will involve and the order of events.

I pay attention to things like:

• The music

• The colors and decor

• The way I talk

• The chair they sit in

All of this helps the nervous system feel safe and supported.

By the end of the appointment, or after a few follow up visits, many patients are telling their friends they need to try pelvic floor physical therapy too.

Conclusion

It is completely normal and okay to feel nervous before starting pelvic floor physical therapy.

Most people feel nervous before starting anything new, especially something that dives into symptoms many people feel ashamed of.

The embarrassment usually fades pretty quickly. Within fifteen to twenty minutes, most patients are already comfortable talking about what is going on.

Your pelvic floor physical therapist does this work because they want to help you. They want you to:

• Have pain free sex

• Feel emotionally connected in your marriage

• Exercise without leaking

• Have an optimal birth

• Return to what you enjoy postpartum without pain or symptoms

• Live your daily life without pain

So please use this as encouragement. I am rooting for you.

Advocate for yourself and get a referral for physical therapy if that is required in your state. Start this journey. I truly believe you will find it life changing.

This is not something to be ashamed of. There are pelvic floor physical therapy clinics all over the country with three to six month waitlists. That does not happen because these symptoms are rare. It happens because they are common and prevalent.

If you would like to schedule an appointment at Texas Pelvic Health, we are currently accepting new patients in:

• Sulphur Springs

• Rockwall

• Canton

You can reach out to us here and we will follow up with a phone call to get you scheduled, or you can call the office at 903-962-2600.