I get this question a lot and the short answer is: usually, yes! A typical pelvic floor exam is an internal vaginal exam, but unlike going to the gyno, there’s no speculum or stirrups involved. We aren’t checking your cervix, we’re assessing your muscles.
Only one gloved, lubricated finger is used for the internal component. Your therapist will first look externally to examine your skin and watch how your muscles activate. The internal exam will involve gentle touch and pressure to your vaginal muscles to make sure none of them are sore or tight. Your therapist will ask you to squeeze your muscles and assess your strength, coordination, and endurance. That’s pretty much it!
If you’re pregnant and want to be evaluated by a pelvic floor PT, we do ask you to check with your ob or midwife first. We want to make sure your medical team is aware of all treatments and to be certain that you can safely have a vaginal exam during pregnancy. For conditions like placenta previa, or preterm labor risk, your medical team may place you on “Pelvic Rest”, restricting you from intercourse or a vaginal exam during pregnancy. If this is you, we won’t do an internal exam.
If your ob/midwife doesn’t restrict you from vaginal intercourse during your pregnancy, they are almost definitely fine with you doing pelvic floor PT. Intercourse is much more invasive than what we do!
It’s helpful to mention what’s involved in a pelvic floor exam when you ask your ob/midwife...surprisingly lots of doctors/midwives don’t really know what we do! I’ve gotten a lot of strange responses from medical professionals like “Ok, as long as you don’t manipulate the cervix” or “Yes, if they wear gloves”. Don’t worry! We steer clear of the cervix and I’ve definitely never done a vaginal exam without gloves!?!”
If your doctor does say no or if you are uncomfortable with an internal exam, we can always do an external assessment, it just isn’t as informative.
Although a pelvic floor exam is used when a client is experiencing leakage, pelvic heaviness, and for perineal stretching/massage, there are other reasons to see a pelvic floor PT during pregnancy that don’t need a pelvic exam at all!
Pregnancy often comes with all sorts of fun issues...like back pain, rib pain, round ligament pain, pelvic girdle instability/pain, (you’re getting the hint that it can cause pain), core weakness, carpal tunnel syndrome, neck issues etc...
Sometimes pregnant women tell their medical team about these problems and they hear “It’ll be better when you aren’t pregnant, just stick it out”. I think it’s worth your comfort and quality of life to give treatment a try. Whatever the issue, you don’t need to suffer through symptoms alone, we’re here to help!