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A hysterectomy is a major abdominal and pelvic surgery involving the removal of the uterus, and possibly the cervix and part of the vaginal canal. If you suffer from fibroids, endometriosis, cancer, or other pelvic related issues, you might be facing making the hard decision to undergo a hysterectomy. The surgery can be performed laparoscopically, so the incision sites outside might be small. But don't let that fool you -- it's still a major surgery. For some, the decision is clear, as the outcome will drastically improve their quality of life. For others, the decision making process could be long and arduous with consideration of all of the options. Regardless, conditions like fibroids and endometriosis affect more than one-third of the population, and a hysterectomy is the second most frequently performed procedure for women or people assigned female at birth in the US. You are not alone: about one in 5 women between the ages of 44 and 65 will have a hysterectomy.
Pelvic floor therapy is a specialized form of physical or occupational therapy focused on issues related to the pelvic floor muscles. While this surgery can bring relief to individuals dealing with various gynecological conditions, having a hysterectomy can lead to pelvic floor dysfunction. Understanding the full scope of what this surgery involves, how it impacts your body and what the recovery process looks like can be very beneficial.
Pelvic Floor Therapy ~ Pre-Hysterectomy
Dr. Julianna Allen, with Embrace Pelvic Health, recommends consulting with a pelvic floor therapist prior to your surgery. Getting an assessment prior to a hysterectomy can be helpful to assess your pelvic floor function. A pelvic floor therapist can teach you pelvic floor relaxation and strengthening techniques, discuss recovery after surgery and help you prepare for post surgical bowel movements. If you are weak, pelvic floor therapy can help you go into surgery with a stronger pelvic floor and surrounding muscles like the glutes and abdominal muscles. However, many people benefit greatly from pelvic floor relaxation training. This will help you release muscles that can become tight after surgery to help have pain free bowel movements. Any type of surgery is an injury to the body, so muscles in the area may turn off and need help turning back on to support you. Therefore, we often teach core activation with your abdominals and pelvic floor so you can get back to pain free movement as soon as possible.
Pelvic Floor Therapy ~ Post-Hysterectomy
After surgery you are likely to experience physical symptoms which may include inflammation and swelling, incontinence, pain, vaginal dryness or pelvic organ prolapse. Hysterectomies can cause major hormonal shifts--since most parts of your pelvis have receptors for hormones like estrogen, the lack of it can contribute to both pain and weakness. Pelvic floor therapy can help address and alleviate these symptoms.
Restoring Pelvic Floor Function
After a hysterectomy, you may experience changes in your pelvic floor function, as that area has suffered major surgical trauma. Your abdominal and pelvic organs will shift to fill the space left empty by the removal of the uterus resulting in an altered anatomy. Pelvic floor therapy focuses on restoring strength, flexibility and coordination to this area, promoting better pelvic support and function.
Addressing Pain & Discomfort
Pain and discomfort are common post surgery symptoms, however with a hysterectomy the pain can be related to intimacy. The removal of the uterus leads to a drop in estrogen, causing thinner, drier vaginal tissue. Pelvic floor therapy incorporates techniques such as manual therapy, stretches and exercises to alleviate pain and improve overall comfort.
Preventing Pelvic Floor Dysfunction
Pelvic floor dysfunctions, like urinary incontinence and pelvic organ prolapse, can develop or worsen after a hysterectomy. Engaging in pelvic floor therapy can work as a preventive or corrective tool to minimize the impact of leaking or pelvic heaviness.
Utilizing pelvic floor therapy, pre & post-hysterectomy, will help you prepare your body for the surgery and allow for a smoother recovery process. Working with your therapist will help you address any pelvic floor dysfunction you may experience. Keeping your body functioning properly will help you feel better emotionally and physically following a hysterectomy surgery. If you're considering or have undergone a hysterectomy, consider the benefits of pelvic floor therapy for your preparation and recovery journey.
If you have pelvic health concerns and would like to see how our therapists at
Embrace can help, follow the link to schedule your free discovery call.