FAQ Pelvic Health

FAQs Pelvic Floor

Can I book a pelvic health appointment with only external (clothes-on) assessments, without the internal examination?

Of course, you can! An external pelvic floor muscle examination is where your muscles can be assessed externally (clothes-on) by feeling the muscles and landmarks around your pelvis. This is very similar to how other muscles in the body can be assessed. This examination is often performed with you standing, or lying on your back, tummy, or side. You can choose to wear thin clothing or underwear. We also gather much information from your history, other assessments, and other investigations for an evidence-informed treatment plan for you.

Is an internal pelvic floor exam required?

An internal pelvic exam is NOT MANDATORY but is the gold standard to assess how your pelvic floor muscles and connective tissue within the pelvis are working. An internal exam may be recommended to investigate further the symptoms you are describing.

There are various conditions that can be successfully treated with external treatment options if you don't wish to complete an internal exam. You will always be asked to provide consent before any assessment or treatment is provided and you are welcome to remove your consent at any time.

What exactly happens during the internal pelvic floor assessment?

We start with education about your anatomy and physiology and explain the different layers of the pelvic floor. The assessment can involve a group of muscles, ligaments and fascias involved with urinary, bowel and sexual function. Before the internal assessment, you will have an understanding and explanation of specific evaluations of the pelvic floor muscles and surrounding anatomy, and any questions that can be answered. Your osteopath will explain and ask for consent prior to each step of the assessment.

For the internal assessment, your osteopath will leave the room for you to undress from the waist down and have you lie on the treatment table and cover yourself with a sheet provided. Your osteopath will use a clean technique, using non-latex gloves for the internal exam.

They will first observe your pelvic floor externally. The internal portion involves your osteopath inserting one or two gloved fingers into the vaginal canal, and this is a gentle and sensitive assessment. This allows access to the front and back portions of the pelvic floor muscles as well as the multiple layers of muscle.

No equipment is needed, so it is very different to having a PAP test for example, and no pain should be experienced.

Internal vaginal palpation for pelvic floor strength (overactive and weak pelvic floor), tone, laxity, coordination and connective tissue are assessed this way. Along with pelvic floor mapping, a technique that involves assessing and treating areas of tension, trigger points, and altered sensation in the pelvic floor and surrounding tissues.

It is important to remember that you have a choice about your treatment and that if at any time you are uncomfortable, whether it is with discussing a subject, or with a technique, you can choose to stop.

When can an internal pelvic floor exam be done?

• Postnatal/postpartum check-up (after 6 weeks).

• Bladder leakage or Incontinence (urinary urgency and frequency).

• Voiding concerns, difficulty initiating urination or passing stool.

• Sexual dysfunction and pain.

• Pelvic pain or internal pelvic pain such as endometriosis, vaginismus or pain during intercourse, interstitial cystitis, and pain with menstruation.

• Pain associated with the low back, pelvic girdle, sacroiliac joint (SIJ), pubic symphysis or tailbone.

• Pelvic organ prolapse.

• To get pelvic floor strength and endurance measures for an appropriate pelvic floor exercise program.

• Incontinence or leaking of urine, stool or gas when you cough, laugh or exercise.

Do osteopaths have extra training to do pelvic health and internal exams?

Yes, pelvic health appointments are performed by our female osteopath, Dr Emma Power, who has done additional training to perform pelvic health examinations, both internal and external.

What is the duration and cost of the initial and follow-up pelvic health appointments?

• Initial Consultation 60mins $159.

• Subsequent Consultation 45mins $129.

Do I need a doctor's referral to come to osteopathy?

No, you can make an appointment directly with your osteopath without a referral. We have an easy, quick online booking system.

Under certain schemes such as Chronic Disease Management (CDM), you may need a referral. Read more

I'm on my period - should I still attend my in-person appointment?

Yes, you can still have an internal pelvic floor assessment and treatment while on your period. Your pelvic organ position and pelvic floor muscles are affected by hormonal changes during different times in your cycle, so it can actually be beneficial to assess and treat while on your period.

If you prefer not to have an internal assessment or treatment during your period, we can provide an external assessment and treatment, or you can reschedule your appointment (provided you give 24 hours’ notice). If less than 24 hours’ notice is given, an appointment fee will be charged as a late cancellation.