Women's pelvic health

Can pelvic floor therapy help with menopause symptoms?

Yes, for the pelvic symptoms: new or worsening leaking, urgency, nighttime urination, heaviness, and pain with intimacy. Pelvic floor physical therapy addresses the muscle and coordination side, and works alongside local estrogen or other treatment the physician may recommend for the tissue side.

The details

What to know

Answered by the practice of Dr. Elana Shalem, DPT, pelvic floor and orthopedic physical therapist.

After menopause the tissues of the vagina, urethra, and pelvic floor thin and lose elasticity, muscle mass declines, and the bladder becomes more irritable. Gynecologists call the tissue changes genitourinary syndrome of menopause; the muscle changes sit alongside them and respond to training at any age.

The program includes pelvic floor strengthening or relaxation as needed, bladder retraining, techniques for pain with intimacy, and strength training that protects bone and muscle. Recurrent urinary tract infections are sometimes linked to an overactive pelvic floor and incomplete emptying, which the program also addresses.

Combining physical therapy with the physician's treatment is more effective than either alone.

Where you live

Tell us where you are

Insurance, referral rules, and booking depend on where you live. Choose your area and we take you to the right page.

Not listed? Dr. Shalem can only treat patients located in a state where she holds a license. Send a message and we will tell you what is possible.

How it works

How a virtual visit works

Most of pelvic floor physical therapy is education, breathing and pressure management, movement retraining, and a home program. All of it works on camera. During the evaluation, Dr. Shalem guides a self-assessment so she can see how the pelvic floor is coordinating with breath and movement. An internal examination is not possible by video; if a hands-on assessment would change the plan, she says so and helps the patient find local care.

A woman at her kitchen table on a video visit with her physical therapist
  1. Discovery call

    15 minutes, free, by phone

    A short call to hear what is going on, explain how visits work, and check insurance or pricing. No pressure to book.

  2. Evaluation

    60 minutes, by video

    Dr. Shalem takes a full history, watches how you move and breathe, and guides the self-assessments she needs to build a plan.

  3. Your plan

    Same visit

    You leave the evaluation with a plain-language explanation and a short home program, usually a few minutes a day.

  4. Follow-ups

    45 minutes, every 1 to 2 weeks

    Progress checks, program updates, and techniques you can do yourself, for as long as they are useful.

For a video visit you will need

  • A phone, tablet, or laptop with a camera
  • A private room
  • A mat or towel
  • About an hour
Dr. Elana Shalem, DPT

Your physical therapist

Dr. Elana Shalem, DPT

Doctor of Physical Therapy, University of St. Augustine for Health Sciences, Miami. Licensed physical therapist.

Dr. Shalem treats pelvic health for women and men, from pregnancy and postpartum recovery to bladder, bowel, and pelvic pain conditions and recovery after prostate or pelvic surgery, and general orthopedic conditions of the back, neck, hips, knees, shoulders, and feet. Visits are one-on-one and unhurried, and she explains what she is seeing in plain language.

More about Dr. Shalem

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