The Role of Pelvic Floor Physiotherapy After a Hysterectomy A hysterectomy is a significant surgical procedure, and while it can be necessary for a range of medical conditions, recovery requires careful consideration. The pelvic floor and core do not automatically restore their previous function following surgery. Regardless of whether the procedure was performed via an abdominal, vaginal, or laparoscopic approach, targeted rehabilitation is often essential. Pelvic floor physiotherapy provides evidence-based strategies to optimise healing, restore function, and support long-term pelvic health. Below is an outline of how a physiotherapist may assist across the different stages of recovery. Early Recovery (0–6 Weeks) Focus: Education, Protection, Gentle Awareness During the initial post-operative phase, the priority is to protect healing tissues and establish safe movement patterns. A physiotherapist may provide: Pelvic floor education — guidance on how surgery has altered pelvic support, biomechanics, and bladder/bowel function. Breathing and core coordination — gentle diaphragmatic breathing techniques to reduce tension, support circulation, and minimise swelling. Safe movement and postural strategies — instruction on bed mobility, transfers, and walking to avoid unnecessary strain. Scar and tissue healing advice — information to optimise scar recovery, reduce the risk of adhesions, and monitor for signs of complications. Mid Recovery (6–12 Weeks) Focus: Activation, Strengthening, Confidence Once surgical healing is established, rehabilitation progresses to restoring muscle activation and movement control. This may include: Pelvic floor muscle retraining — graded internal or external exercises focusing on coordination, endurance, and strength. Core muscle activation — re-education of deep abdominal muscles, particularly the transversus abdominis, in synchrony with the pelvic floor. Postural alignment and movement retraining — addressing compensatory patterns or protective guarding to optimise pelvic loading. Scar mobilisation — manual therapy to improve tissue mobility, circulation, and sensitivity. Later Recovery (3+ Months) Focus: Return to Function, Fitness, and Lifestyle The longer-term phase of rehabilitation supports a safe return to higher levels of activity and addresses ongoing pelvic health needs. This may involve: Exercise progression and return-to-sport planning — individualised advice for safely resuming walking, lifting, gym training, Pilates, or sport while minimising risk of prolapse or core dysfunction. Bladder and bowel retraining — management of urgency, leakage, or constipation, which may present post-surgery. Support for intimacy and pelvic pain — rehabilitation for dyspareunia, vaginal tightness, or scar-related discomfort. Prolapse prevention and long-term pelvic health — strategies to manage intra-abdominal pressure and maintain pelvic organ support. Why Consult a Pelvic Floor Physiotherapist? Pelvic floor physiotherapists are trained to assess not only the muscles, but the integration of breath, core, scars, posture, and daily movement patterns following surgery. This holistic assessment allows for a tailored rehabilitation plan to support both short- and long-term recovery. Importantly, it is never too late to commence pelvic floor physiotherapy. Whether a patient is six weeks or six years post-hysterectomy, physiotherapy can assist in improving function, comfort, and quality of life. 

Understanding the Risk Factors for Pelvic Organ Prolapse (POP) Pelvic organ prolapse (POP) is a condition where one or more of the pelvic organs (such as the bladder, uterus, or rectum) shift downward and push into the vaginal wall due to weakened support from the pelvic floor. It’s more common than many realise, and while it can feel overwhelming, knowing the risk factors can help you take steps to protect your pelvic health. Key Risk Factors 1. Vaginal Birth Childbirth is one of the most significant contributors to POP. Vaginal deliveries, particularly when forceps are used, when the baby is large, or after multiple births, can place considerable strain on the pelvic floor muscles and connective tissues. 2. Age As we age, our muscles and tissues naturally weaken. This includes the pelvic floor, which means the likelihood of prolapse increases over time. 3. Obesity Carrying extra body weight increases pressure on the pelvic floor. Over time, this added strain can contribute to the development of POP. 4. Genetics Sometimes, pelvic health challenges run in families. If you have a close relative with POP or connective tissue disorders, you may be more predisposed to experiencing prolapse yourself. 5. Menopause Hormonal changes associated with menopause—particularly lower oestrogen levels—can lead to thinning and weakening of pelvic tissues, making them less supportive. 6. Prior Pelvic Surgery Procedures like a hysterectomy can affect pelvic support structures and increase the risk of prolapse later on. 7. Chronic Strain Repetitive straining from chronic constipation, persistent coughing (such as from smoking or lung disease), or frequent heavy lifting can all place continuous pressure on the pelvic floor, increasing the risk of POP. 8. Connective Tissue Disorders Some people have naturally weaker connective tissues due to genetic factors. Conditions like hypermobility can make the pelvic floor less resilient and more prone to prolapse. What Can You Do? While not all risk factors can be avoided, there are proactive steps you can take to support your pelvic health: Maintain a healthy weight to reduce pressure on the pelvic floor. Address chronic straining by managing constipation, cough, or lifestyle factors that increase abdominal pressure. Strengthen your pelvic floor muscles through targeted exercises. A pelvic health physiotherapist can guide you in learning the right techniques. Final Thoughts POP is influenced by many factors—some you can’t control, like age and genetics, and others you can actively address. By understanding your risk profile and making supportive lifestyle changes, you can strengthen your pelvic health and reduce the likelihood or severity of prolapse. If you’re concerned about your pelvic floor or would like personalised guidance, our team at Pelvic Health Melbourne is here to help.

Understanding Menopause: How a Pelvic Health Physiotherapist Can Help You Thrive Through the Change At Pelvic Health Melbourne, we know that menopause isn't just a stage of life—it’s a deeply personal transition that can impact your body, confidence, and quality of life in ways you may not expect. As pelvic health physiotherapists, we’re here to support and empower you with respectful, evidence-based care tailored to your needs. What Is Menopause and Perimenopause? Menopause marks the end of your menstrual cycle, officially diagnosed when you haven’t had a period for 12 consecutive months. The years leading up to this, known as perimenopause, are when many of the most noticeable symptoms begin normally from 40 years old During this time, fluctuating hormone levels—particularly a drop in oestrogen—can lead to a range of physical and emotional changes. Some are widely known, others less talked about, but all are valid and worthy of care. Common Symptoms of Perimenopause and Menopause Increased blood loss during periods Weight gain and bloating - especially new weight deposits around the stomach Low libido or sexual discomfort - our vagina shrinks both in length and width Bladder urgency, frequency, or leakage Vaginal dryness or pelvic discomfort - use silicon based lubes as water based just absorb in too easily Pelvic organ prolapse or heaviness Hot flushes and night sweats Mood swings, anxiety, and low mood Fatigue and disrupted sleep - waking for a few hours in middle of night then exhausted in morning Brain fog and memory changes These symptoms can feel overwhelming, but you are not alone—and you don’t need to suffer through them in silence. How Pelvic Health Physiotherapy Can Support You At Pelvic Health Melbourne, our experienced physiotherapists work with you holistically to address the physical changes of menopause that affect your pelvic floor, bladder, bowel, and sexual health. Here’s how we can help: 1. Pelvic Floor Rehabilitation We assess and treat pelvic floor muscle weakness, overactivity, or incoordination. This helps reduce urinary urgency, incontinence, heaviness, and discomfort. 2. Bladder & Bowel Retraining Menopause can alter bladder sensitivity and bowel regularity. We provide personalised strategies to restore control and confidence. 3. Sexual Wellness Support Painful intimacy or decreased sensation are common but treatable. We use gentle, respectful approaches including pelvic floor therapy, education, and support for vaginal tissue health including discussions about topical oestrogen therapy, vaginal dilation (if required), vibrators to assist blood supply and appropriate lubrication for stage of life. 4. Movement & Strength Programs Specific exercise program for you respecting non restorative sleep, need for more stretch and cardio allowing for adequate body recovery. 5. Education & Empowerment We take the time to explain what’s happening in your body, and why, so you feel more in control. Our goal is to help you make informed decisions about your health and wellbeing. Why Choose Pelvic Health Melbourne? At Pelvic Health Melbourne, we do more than treat symptoms—we care for the whole person. We offer: Longer, unrushed appointments Private, purpose-designed rooms Highly skilled and specialised clinicians An inclusive space and point of mond Care that respects your lived experience We believe every woman deserves dignity, support, and solutions—not dismissal or shame. Take the Next Step If you’re navigating perimenopause or menopause and feeling unsure where to turn, we invite you to start with us. Whether you’ve just started noticing changes or have been putting up with symptoms for years, now is the right time to seek support. Book an appointment with one of our experienced pelvic health physiotherapists today. Let’s work together to help you feel strong, supported, and at home in your body again.