Female Anatomy

This covers the female's life span from the age of menarche, through young adulthood, through childbearing, menopause, and into later stages of life. Women's health issues include prenatal/post-partum care, pelvic pain, incontinence, endometriosis, irritable bowel syndrome, osteoporosis, fibromyalgia, and musculoskeletal injuries.

Health Concerns

Female Anatomy - Pregnancy

Infertility:

The inability to conceive after one year of well timed and unprotected sexual intercourse. Physical therapy can help to free soft tissue restrictions and adhesions in order to increase the mobility of the reproductive organs. Treatment can also help decrease spasms around the reproductive organs, increase blood flow, and ease localized pain and related anxiety.

Post Mastectomy:

Lack of movement following surgery can result in stiffness in the shoulder and pain or swelling in the upper extremity. Physical therapy can assist to increase the range of motion, strength, improve posture and decrease swelling. Shoulder dysfunction can typically have concurrent limitations and pain in the neck, upper back, chest, and abdomen, which physical therapy can address as well. Manual techniques help by decreasing scar tissue, elongating restricted tissues, decrease trigger points, and increase circulation.

Hysterectomy:

The surgical removal of the uterus. It is performed for conditions such as uterine prolapse, fibroids, carcinoma, or abnormal vaginal bleeding. A hysterectomy can be carried out vaginally or through the abdomen laparoscopically.

  • Total abdominal hysterectomy
    The most common type of hysterectomy involves removal of the uterus and cervix (with or without the removal of the ovaries or Fallopian tubes) through an abdominal incision.
  • Vaginal hysterectomy
    The removal of the uterus and cervix through the vagina. Recovery from a vaginal hysterectomy is of shorter duration than an abdominal hysterectomy. Laparoscopically-assisted vaginal hysterectomy is a vaginal hysterectomy with the insertion of a laparoscope through a small incision in the navel.
  • Laparoscopic supracervical hysterectomy
    The removal of the uterus (sparing the cervix) through incisions in the navel and abdomen. This procedure has the shortest recovery time. Sparing of the cervix may have some benefits, which may reduce the risk of pelvic floor prolapse and urinary incontinence.

A complication of hysterectomies is pelvic adhesion or scar tissue that forms within the pelvis and causes organs to stick or bind to one another. Pelvic adhesions are also seen with other gynecologic surgeries such as cesarean section and in the treatment of endometriosis, and with pelvic inflammatory disease. It is thought that pelvic adhesions can contribute to pelvic pain, pain during intercourse, infertility, and bladder or small bowel obstruction.

Physical therapy has been shown to break down pelvic and abdominal adhesions and aid in increased mobility of the connective tissue and of the muscles. This, in turn, may decrease pelvic pain, pain during intercourse, infertility and any bowel or bladder obstructions.

Endometriosis

Endometriosis is a medical condition where endometrial tissue, like that which lines the inside of the uterus, is found outside the uterus. Typical areas where this can occur is on the ovaries, fallopian tubes, outside of intestines and rectum, and lining of the abdominal cavity. This tissue, like the endometrial tissue in the uterus, will grow and shed during menses. These sites within the abdomen and pelvis are recognized as foreign tissue by the body and inflammation, adhesions, and scar tissue result, causing many of the symptoms associated with this condition.

Lymphedema

Lymph is a clear watery fluid, separate from blood, that contains white blood cells and circulates through its own system of vessels and nodes, playing an important role in our immune system. It removes bacteria and certain proteins from the body's tissues, transports fat from the small intestine, and supplies mature lymphocytes into the blood to fight infection.

Lymphedema is the chronic swelling in the arm, leg, abdomen, genitals, following damage to the lymph nodes or lymph vessels.

Pelvic Floor Organ Prolapse:

Female Anatomy - Pelvic Floor
  • Cystocele:

    A cystocele is the fall of the bladder into the vagina due to pelvic floor muscle and connective tissue weakness and may result in incomplete emptying of the bladder and consequently urinary leakage. It is graded from mild (grade 1; possibly no symptoms) to severe (grade 3, wherein the bladder protrudes out of the vagina). It may occur due to repeated muscle straining (during childbirth) and/or estrogen deficiency (seen with menopause and/or oral contraceptive pill usage). Hysterectomies also weaken the pelvic floor muscles and may contribute to developing a cystocele.

    A cystocele can be managed with pelvic floor physical therapy, which includes strengthening of the pelvic floor muscles. A pessary (ex. Colpexin) may also be prescribed by the referring physician. Surgery is prescribed when physical therapy and/or a pessary are not effective. A cystocele may be prevented through correct body mechanics with lifting, avoidance of straining, controlling and treating constipation (increases pressure on the bladder during straining), weight control, and kegels (when appropriate, performed under the supervision of the physical therapist initially for correct technique.)

  • Enterocele:

    Herniation of the small intestine between rectum and vagina.

  • Rectocele:

    A rectocele is the herniation of rectal tissue in the vaginal wall and may sometimes lead to drooping of vaginal tissue out of the vaginal canal. It may occur with childbirth, chronic constipation, chronic coughing, heavy lifting, estrogen deficiency and/or obesity. Symptoms may include constipation and/or pelvic pain. A rectocele may be prevented through correct body mechanics with lifting, avoidance of straining, controlling and treating constipation, weight control, and kegels. A rectocele can be managed with pelvic floor physical therapy, pessary, or surgery.

Uterine Prolapse

Herniation of the uterus into the vagina.