What Actually Happens at Your First Pelvic Health Appointment?

Booking your first pelvic health appointment can feel like a big step. For a lot of women, it's something they've been thinking about for months, often years, before they finally pick up the phone or click the link. If that's you, firstly: well done for being here.

One of the things I hear most often is "I didn't know what would happen, so I kept putting it off." So let me walk you through exactly what to expect, from the moment you arrive to the moment you leave.

It's a conversation first

Every appointment starts with a proper, unhurried chat. Before anything else, I want to understand you, your symptoms, your history, your life, and what matters most to you.

I'll ask about:

• What's been bothering you, when it started, and how it's changed over time

• Your lifestyle, activity levels, fluid and dietary intake

• Your toileting habits (bladder and bowel, nothing is off limits here)

• Your birthing history if relevant, including how you healed and what helped or made things worse

• What you've already tried, and what hasn't worked

• Your goals, what you can't do right now that you want to get back to

There are no silly questions and nothing you can say will surprise me. This is a judgement-free space, always.

Then, a physical assessment

Once I have a clear picture of your symptoms and history, we move to the physical assessment. This will usually involve some degree of undress, wearing shorts and a vest top underneath your clothes can be helpful.

Depending on your concerns, the assessment might include some or all of the following:

• Posture

• Range of movement, strength and flexibility

• Core and pelvic floor control

• C-section or perineal scar assessment

• Diastasis recti (tummy muscle separation)

• Internal pelvic floor examination (vaginal or rectal)

That last point is the one that makes most women nervous. So let me be clear about how this works. Any intimate examination is always fully explained beforehand, using models to show exactly what's involved and why it would be helpful. Consent is always asked for explicitly, and you can decline at any time. An internal examination is never something that just happens, it is always your choice.

The examination involves touching the pelvic floor muscles with a gloved finger and using a water based gel. Communication is continual, where I explain what I’m touching and what I’m feeling for or asking you to do. Depending on symptoms, there may be additional parts added to the examination, including diagnosing type and degree of pelvic organ prolapse, cause of stress incontinence by assessing bladder neck and urethral support, assessing for levator ani avulsion.

At any time the assessment can be ended. You are always in control.

And finally, your treatment plan

At the end of the appointment, we'll talk through the options that are right for you and you'll always be given choice, with an explanation of why I'm suggesting each one.

You won't need to remember everything we discuss. A written summary of your treatment plan is sent to you by email after every appointment, so you can refer back to it in your own time.

Treatment might include:

• Targeted pelvic floor exercises

• Manual therapy (hands-on treatment)

• Biofeedback

• Electrical stimulation (NMES)

• Scar therapy including LymphaTouch®

• Lifestyle advice

• Core strengthening and breath work

• Pelvic floor relaxation and downtraining

• Posture and movement guidance

What are we working towards?

Before you leave, we'll talk about your specific goals, not vague ones, but real ones that mean something to you. Things like:

• Running without a pad

• Lifting your child without that internal heaviness

• Sleeping through the night without getting up to pee

• Feeling comfortable in your own body again

• A c-section scar that stretches and moves with you

• Getting back to the sport or exercise you love

These are the things that actually matter. That's what we're working towards together.

If you've been sitting on the fence, I hope this helps. The first appointment is always the hardest to book and almost always the one that women often wish they'd booked sooner.

Ready to take that first step? Book your initial appointment here →

Or if you still have questions, take a look at the FAQ page or get in touch. I'm always happy to chat things through before you commit to booking.