15 FAQs Pelvic Surgery And Menopause: How Physical Therapy Can Ease The Transition

1. Why is pelvic physical therapy helpful during menopause and after pelvic surgery?

Both menopause and pelvic surgery can weaken pelvic floor muscles, affect hormone-sensitive tissues, and alter mobility. Pelvic physical therapy supports healing, reduces symptoms, and helps restore strength, comfort, and function.

2. What types of pelvic surgeries are common during or after menopause?

• Hysterectomy

• Pelvic organ prolapse repair

• Bladder sling/incontinence procedures

• C-section (for those entering early menopause)

• Endometriosis or fibroid removal

3. How does menopause affect the pelvic floor?

Menopause leads to a drop in estrogen, which can cause:

• Thinning of vaginal and pelvic tissues

• Reduced muscle tone

• Increased dryness and discomfort

• Higher risk of prolapse or incontinence

4. What are signs that I might benefit from pelvic physical therapy during this time?

• Pelvic pressure or heaviness

• Pain with intimacy or internal exams

• Urinary leakage or urgency

• Constipation or bowel changes

• Core weakness or instability

• Hip, low back, or tailbone pain

5. Is pelvic pain common after surgery or during menopause?

Yes. Pain can be caused by scar tissue, muscle tension, or tissue changes due to hormonal shifts. Physical therapy can address these causes directly and gently.

6. Can PT help with painful sex or vaginal dryness?

Yes. Pelvic PT can improve blood flow, flexibility, and comfort of vaginal and pelvic tissues, often in combination with medical treatments like topical estrogen (if prescribed).

7. What does a pelvic PT actually do in sessions?

They assess how your core and pelvic muscles are functioning, check for mobility or tension issues, and guide you through manual therapy, breathwork, and movement strategies to improve comfort and strength.

8. Will I have to do internal pelvic therapy?

Not necessarily. Many treatments are external. If internal work is recommended, it’s always done with your full consent and comfort in mind.

9. How does scar tissue affect healing after surgery?

Scar tissue can cause tightness, limit mobility, or irritate nerves. Pelvic PTs use gentle scar mobilization techniques to reduce discomfort and restore healthy movement patterns.

10. Can pelvic physical therapy help with incontinence or urgency?

Yes. It can help retrain the pelvic floor muscles, bladder coordination, and behavioral habits to reduce leaks and urgency, which are common in both menopause and post-surgery recovery.

11. How soon after surgery can I start pelvic physical therapy?

Most patients start around 4–6 weeks after surgery, with clearance from their doctor. Some may begin earlier with breathing and mobility exercises.

12. What if my surgery or menopause was years ago—can PT still help?

Absolutely. It’s never too late to address symptoms. Many patients benefit from pelvic PT months or even years after surgery or the start of menopause.

13. Will therapy help me return to exercise or normal movement?

Yes. PT can safely guide you back to physical activity by improving core control, posture, balance, and confidence in movement.

14. Is pelvic physical therapy covered by insurance?

In many cases, yes. Check with your provider or insurance company. A referral from your doctor may be required depending on your location and plan.

15. How do I find a qualified pelvic physical therapist?

Search directories like:

• APTA Pelvic Health (USA)

• Pelvic Guru

• Your local women’s health or physical therapy clinic
  Ask your OB/GYN or primary care provider for recommendations