Kathy Kates ran sexual reproductive health programs at a community health center in Brighton, Massachusetts, before being diagnosed with breast cancer.
Once in remission, the vaginal pain came.
During a pelvic exam, the practitioner discovered that Kates had tight pelvic floor muscles and suggested she try pelvic physical therapy.
Kates was mortified. She’d spent 10 years treating reproductive health, and she had never heard of this kind of physical therapy. “How many women did I treat and totally ignore the pelvic floor?” Kates wondered.
Kates found physical therapy to be crucial in her recovery and created Pelvic Health Support, a physical therapy facility in Boston. However, Kates recognizes that a growing number of patients are still unable to get the care they so desperately need.
Pelvic floor physical therapy can ease chronic pelvic pain, strengthen pelvic floor muscles to improve bladder and bowel control, reduce pain with sex, and advance postpartum recovery.
And despite estimates that 1 in 3 women have a pelvic floor disorder, experts say pelvic floor physical therapy is rarely top mind. They want to fix that, but a broken system that makes care costly and hard to find is a big part of the problem.
1 in 3 women have pelvic floor disorder: What is it?
The National Institute of Health has documented that 24% of women have moderate to severe symptoms of at least one pelvic floor disorder, and this rate increases with age and the number of times a woman has given birth.
Among women with chronic pelvic pain, the most common comorbidities are endometriosis (70%), postpartum pelvic pain (44%), bladder pain syndrome (61%) and irritable bowel syndrome (39%). In 2021, a systematic review of women with chronic pelvic pain found the direct yearly cost burden, accounting for health care, prescription, physical therapy, and indirect costs to range from $16,500 to $21,000.
Women don’t know about pelvic physical therapy until after they need it
For Tami Lynn Kent, MSPT, the biggest barrier to care is awareness of pelvic physical therapy. “Some of it is shame and the oversexualization of that part of the body,” she says. “Much of medicine was set up by and for men, and it missed a lot of the the ways that (women) need care, but also the opportunities for care.”
Most of Kent’s patients find her practice through word of mouth, as pelvic health is rarely part of routine care.
“This is here so you don’t have to suffer,” Kent adds.
Physical therapists can’t keep up with the demand for treatment
The American Physical Therapy Association’s (APTA) Academy of Pelvic Health Physical Therapy has seen a 21% increase in membership since 2019, climbing from 3,338 to 4,032 members, according to Kristi Kliebert, the APTA Director of Communications.
Yet, for every 4,000 people in need of pelvic physical therapy, there is only one available provider, according to Kates.
Lexi Meister, a pelvic physical therapist and women’s health specialist, stumbled into the field after her clinical at a Veteran’s Hospital was canceled and replaced with a pelvic floor rotation – an area she knew almost nothing about.
Meister fell in love with the specialty. “I learned a lot about my own body that I didn’t even know just as a woman, let alone being a physical therapist,” Meister says.
Meister spent six years working as a pelvic physical therapist in the hospital system in Columbus, Ohio, where her patients would often have to wait up to three months before their initial appointment. As a provider, she’d enter each visit wanting to build rapport and get to know her patient, but “usually there was some sort of frustration about it taking months to get in.”
Since opening her private practice in 2021, she can now get patients in within a month, and feels she can provide higher quality of patient-centered care over an hourlong visit that assesses symptoms holistically rather than “checking boxes for what the insurance company would cover and reimburse.”
Experts blame shortage on high educational costs and insurance policies
For Meister, the pelvic physical therapy shortage begins in the education system.
Physical therapy students are unable to take specialized courses within their core curriculum while working toward their doctorate. Meister ended up enrolling in four additional courses and taking an additional board exam, spending approximately $5,500.
Plus, Meister describes the insurance companies as difficult to work with, especially for women’s health conditions.
“It’s driven top-down from what insurance is willing to cover,” Meister says. “If insurances were more easily reimbursing care, then it would be a lot easier for hospital systems to hire and train more pelvic physical therapists, because they would be getting enough funding to make it worthwhile.”
In contrast to high-wait times, an in-network appointment is only 30–45 minutes long. “People suffer for so long that by the time they get in the door, it’s really hard to do anything in a short amount of time,” Meister explains.
Kates also says the pelvic floor physical therapy shortage is a systemic problem: “As nurse practitioners, OBGYNs, doctors, if you’re not taught to assess the pelvic floor muscles, you’re never going to think about it.”
How to access pelvic physical therapy
Physical therapy – including pelvic floor treatment – is directly accessible without a doctor’s referral in the United States, though insurance policies may differ for coverage, according to Dr. Carrie Pagliano.
At your first appointment, you can expect to start by sharing your story and symptoms. Your physical therapist will then create a collaborative treatment plan, which may include physical and breathing exercises, stretches, posture and activity modifications and possibly internal muscle work.
“We’re that profession where we validate and listen because we know we can help,” Pagliano says.
“Pelvic health gets put in this bucket of things that we don’t talk about or get help for unless it’s really bad,” she adds. “But it should be valued just like any other part of our body and care.”
Pelvic Pain Floor Symptom Tracker Calculator
The Pelvic Pain Floor Symptom Tracker Calculator helps individuals track and monitor pelvic pain symptoms over time, providing insights into the frequency, intensity, and triggers of discomfort. Use this tool to identify patterns in your symptoms and better manage your pelvic health.
Pelvic Pain Floor Symptom Tracker Calculator
FAQs:
1. What is the Pelvic Pain Floor Symptom Tracker Calculator?
The Pelvic Pain Floor Symptom Tracker Calculator is a tool designed to help individuals track their pelvic pain symptoms over time, including intensity, frequency, and possible triggers. It assists in identifying patterns and managing pelvic health more effectively.
2. Who should use the Pelvic Pain Symptom Tracker?
Anyone experiencing chronic pelvic pain, pain during intercourse, or pelvic discomfort can benefit from using this tracker. It is especially useful for those managing pelvic floor dysfunction, endometriosis, or similar conditions.
3. How does the Pelvic Pain Tracker work?
The calculator allows you to input information about your symptoms, such as the severity of pain, types of discomfort, and associated activities. Over time, it helps you see patterns, making it easier to share this data with a healthcare professional.
4. What kind of symptoms can I track with this tool?
You can track symptoms like pain during intercourse, pelvic discomfort, burning sensations, bowel or bladder issues, and physical limitations associated with pelvic floor dysfunction.
5. How often should I use the Pelvic Pain Tracker?
For the most accurate results, it’s recommended to use the tracker daily or whenever you experience pelvic pain symptoms. Consistent tracking will help reveal symptom patterns over time.
6. How can this tool help manage pelvic pain?
By tracking the frequency, severity, and triggers of pelvic pain, the tool helps you understand your symptoms better. This data can be valuable for you and your healthcare provider when creating a treatment plan or adjusting current therapies.
7. Can I share my results with my healthcare provider?
Yes, you can share the tracked data with your healthcare provider. This detailed information can assist in making more informed decisions about your care and treatment options.
8. Is the Pelvic Pain Tracker Calculator free to use?
Yes, the Pelvic Pain Symptom Tracker Calculator is free to use and is designed to help you manage your pelvic health more effectively.
9. Can this tool diagnose a medical condition?
No, the Pelvic Pain Tracker is not a diagnostic tool. It is intended to help monitor and track symptoms. For a diagnosis or treatment plan, you should consult a healthcare professional.
10. What should I do if my symptoms worsen?
If your symptoms worsen or become unbearable, it’s important to contact your healthcare provider immediately. The tracker can help document any worsening symptoms, but it is not a substitute for professional medical advice.
Glossary for Pelvic Pain Floor Symptom Tracker Calculator
- Pelvic Pain
Discomfort or pain in the lower abdominal area, including the pelvic floor muscles, which can affect bowel movements, bladder function, and sexual activity. - Pelvic Floor Dysfunction
A condition where the muscles in the pelvic floor are too tight or too weak, causing pain, urinary issues, bowel problems, or sexual discomfort. - Dyspareunia
Pain during or after sexual intercourse, often associated with pelvic floor dysfunction or other pelvic health conditions. - Vaginismus
A condition where involuntary tightening of the vaginal muscles causes pain or discomfort, often linked to stress, anxiety, or previous trauma. - Endometriosis
A chronic condition where tissue similar to the lining inside the uterus grows outside of it, often leading to severe pelvic pain, especially during menstruation. - Chronic Pelvic Pain
Persistent pain in the pelvic region that lasts for six months or longer, often linked to multiple causes including infections, inflammation, or pelvic floor dysfunction. - Burning Sensation
A symptom where there is a feeling of heat or irritation, typically felt in the pelvic region, and can be a sign of infection or nerve irritation. - Trigger Points
Hyperirritable spots in the pelvic muscles that can cause pain, either locally or in referred areas, often contributing to pelvic pain syndromes. - Pain During Intercourse
Also known as dyspareunia, it refers to discomfort or pain that occurs before, during, or after sexual activity. - Lubrication
Moisture or lubrication applied to reduce friction during sexual activity, which can help alleviate pain for those experiencing dryness or discomfort. - Urinary Symptoms
Symptoms related to the bladder, including frequent urination, urgency, burning sensation during urination, or incontinence, often linked to pelvic floor issues. - Bowel Symptoms
Symptoms affecting bowel movements, such as constipation, diarrhea, or painful bowel movements, which may be associated with pelvic floor dysfunction. - Dilators
Medical devices used to stretch or relax the vaginal muscles, often used as part of treatment for conditions like vaginismus or chronic pelvic pain. - Lidocaine
A topical anesthetic often used to numb the pelvic region and provide temporary pain relief for conditions such as pelvic floor dysfunction or dyspareunia. - Stretching
Exercises designed to relax and lengthen the pelvic floor muscles, which can help alleviate tension and pain in the pelvic region. - Severity Scale
A numerical rating system (usually 1-10) used to quantify the intensity of pain or discomfort, with higher numbers indicating more severe pain. - Preparation Techniques
Methods used before intercourse or physical activity to reduce pain, including stretching, lubrication, or the use of dilators. - Inflammation
The body’s immune response to irritation, injury, or infection, which can cause redness, swelling, and pain in the pelvic region. - Pain Management
Strategies and treatments aimed at reducing pain, including medications, physical therapy, and lifestyle adjustments. - Physical Therapy
A form of rehabilitation that focuses on strengthening and relaxing the pelvic floor muscles, often used to treat pelvic pain and dysfunction.
Disclaimer
The information provided in the Pelvic Floor Pain Symptom Tracker and accompanying resources is for educational and informational purposes only. It is not intended to replace professional medical advice, diagnosis, or treatment. Always consult with a healthcare professional or your physician before starting any new treatment or therapy, especially if you are experiencing chronic pain or discomfort. The results from the symptom tracker should not be used as a diagnostic tool, and any concerns about your pelvic health should be addressed with a qualified healthcare provider. The creators of this tool are not liable for any adverse outcomes related to the use of this information or tool.