Talking about pelvic floor health can still raise many questions. One of the most common concerns, especially before attending physiotherapy for the first time, is related to intimacy:
Will I be examined? Will I need an internal examination? What exactly happens during a pelvic floor assessment?
It is completely normal to have questions. Knowing what to expect during an assessment can help you attend your appointment feeling more comfortable and confident.
The assessment starts long before any examination
A pelvic floor assessment is not simply an examination of one specific area.
The first step is to get to know you, your symptoms, your needs and the reason for your visit. Your physiotherapist will gather information about what you are experiencing and the factors that may be related to your symptoms.
The assessment may then include different aspects of your body and how it functions, such as:
- Posture
- Breathing
- Activation of the core, including the diaphragm, abdomen and pelvic floor
- Lower back muscles
- Mobility
- Possible muscle tension
- Pelvic floor function and coordination
The aim is to gain a comprehensive and personalised understanding, rather than focusing on one area alone.
Is an internal examination always necessary?
No.
One of the main concerns patients have is whether attending a pelvic floor physiotherapy assessment automatically means having an internal examination.
The answer is that an internal examination is not always necessary.
When clinically appropriate, your physiotherapist may suggest an internal assessment to obtain more detailed information about aspects of the pelvic floor such as muscle tone, strength, coordination and the ability to relax.
However, an internal examination is only carried out when clinically indicated and always with the patient’s consent.
You have the right to know and decide
Before any internal examination takes place, your physiotherapist will explain what it involves, why it may be useful and what will be assessed.
You can ask any questions you may have and express any concerns or boundaries.
Consent is a fundamental part of the assessment.
The examination should take place in an environment of privacy, respect and trust, always adapting to your needs and comfort.
What if I don’t want an internal examination?
This is a completely valid question.
Communication between you and your physiotherapist is essential throughout the process. If you have concerns, feel uncomfortable or do not feel ready for a particular examination, you can discuss this with your physiotherapist.
The assessment should not feel like an uncomfortable or unexpected experience. It should be a process in which you understand what is being done and why.
A personalised assessment to find the right treatment
The pelvic floor is part of a system involving different structures and functions. A comprehensive assessment helps your physiotherapist better understand the possible causes or factors related to your symptoms and establish a treatment plan tailored to you.
Every patient is different. And every assessment is different too.
If you have symptoms, discomfort or simply questions about your pelvic floor, speaking to a specialised professional can be the first step towards understanding what is happening.
