What does pelvic floor physiotherapy treat?

An assessment may look at breathing, posture, muscle strength, relaxation and how the pelvic floor works during movement. Treatment can support bladder control, bowel habits, pelvic organ support and comfortable sexual activity. It may be considered for vaginismus, vulvodynia or chronic pelvic pain, but the approach depends on the findings and may focus on releasing guarded muscles rather than strengthening them.

Sessions can include education, breathing practice, movement retraining, hands-on treatment with consent and a home programme. The aim is better control and comfort, not simply stronger muscles.

Tell the physiotherapist where symptoms occur, what triggers them and whether childbirth, surgery, injury or bowel and bladder changes are relevant. You can discuss whether an internal examination is appropriate; consent should be clear, and alternatives can be explained. Follow the prescribed exercises gradually and record changes in leakage, pain, urgency or pressure.

If symptoms do not fit a muscle problem, the physiotherapist can recommend medical assessment. Do not use a pelvic floor chair or other device as a substitute for an evaluation.

Book an assessment for persistent leaking urine, pain during sex, vulval pain, chronic pelvic pain or a vaginal bulge. Seek urgent care for severe or rapidly worsening pain, inability to pass urine, heavy bleeding, fever with pelvic symptoms or sudden loss of bladder or bowel control.

Would pelvic floor physiotherapy suit my symptoms? Do I need an examination or tests before starting? Should treatment prioritise strengthening, relaxation, desensitisation or movement retraining? What changes should prompt a review?