An internal examination with a women's health physiotherapist may seem like

a daunting experience - here we have combined a list of some of the assessments

you may have during your examination, to try and take the fear and worry away!

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Your women's health physiotherapist should sit down with you on your first session to discuss all of your symptoms and goals, to tailor an individual assessment for you. Each person will have a different experience based on who they see and what symptoms they are having, so you may have one, all or some of these assessments.

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Externally:

1. The position of your perineum (space between your vagina and anus), in relation to the bones of your pelvis, to help understand how high/tight or low/relaxed your muscles are. This may be done with two thumbs externally on your sit bones. We can also assess the length of your muscles with a POP stick (shown in the image).

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2. Looking at the skin  at the entrance to the vagina, to assess if there are any lumps, bumps or changes in skin tone that suggest referral back to your GP or gynaecologist for further inspection.

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3. Asking you to squeeze, relax and push your pelvic floor +/- a cough to determine how flexible it is, and if any of your organs move when you push or cough. Also to determine when you push like you are emptying your bowels, if your pelvic floor relaxes as it should.

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Internally:

4. The tone of your muscles with 1-2 fingers internally, at rest and when you squeeze, relax and push to assess the support you have, how strong your are, what your endurance is like, and if you can relax your muscles. 

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5. The position of your internal organs (cervix) and the vaginal walls to look for prolapse.

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6. Can you squeeze your pelvic floor and cough/laugh without descent of your pelvic floor or pelvic organs?

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Your assessment may look similar or different to this based on your presentation and which women's health physiotherapist is performing the examination. 

It is always best to book in for a consult with a women's health physiotherapist if you are noticing any pelvic floor symptoms such as leakage, heaviness, or vaginal discomfort!

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