Breaking Barriers: A Physical Therapist's Guide to Sexual Health & Pelvic Pain | Expert Interview with Dr. Rachel Rubin

When pelvic pain, sexual health, or women’s health patients come to physical therapy, they’ve often spent years being dismissed by other providers. We reached out to board-certified urologist and sexual medicine specialist Dr. Rachel Rubin and learned about the not-so-obvious connections between hormones, physical therapy, and sexual health that many providers fail to see.

Watch the complete interview on YouTube page here.

To get to know Dr. Rubin, a leading sexologist & gynecologist a bit better, check her out at www. rachelrubinmd. com.

Understanding the Mind-Body Connection in Women's Health

“I’m a sex detective,” says Dr. Rubin, noting that when it comes to sexual health issues, you have to investigate the whole person, not just their symptoms. This is the correct directional approach in women’s health physical therapy as well, where treatment can only be successful when understanding the followings:

• Medical history

• Lifestyle factors

• Previous treatments

• Personal goals

• Social support systems

The Hidden Impact of Hormones on Physical Therapy

One underdiagnosed and misunderstood aspect of women’s health that Dr. Rubin discusses is the “musculoskeletal syndrome of menopause.” This explains why so many women find:

• Joint stiffness and pain

• Decreased regeneration from exercise

• Increased inflammation

• Changes in tissue flexibility

• Resistance to traditional PT treatments.

“Hormones lubricate us intimately and lubricate your joints,” Dr. Rubin says. “When hormones are low, we have more inflammation and irritation of the body.”

Why Traditional Treatment Often Falls Short

Many women have trouble getting effective treatment because:

• Providers do not spend enough time to assess their symptoms

• Right now, treatment only addresses one part of health

• The pain-hormone connection is neglected

• Patients don’t have the words to express their issues — and it’s up to the healthcare provider to make them understand the words.

• Healthcare is siloed between specialties

The Role of Physical Therapy in Sexual Health

As physical therapists specializing in women’s health, we help firsthand how concrete care is changing impact. Success often requires:

Proper Assessment

• Detailed movement analysis

• Pelvic floor evaluation

• Strength testing

• Pain pattern recognition

• Hormone consideration

Comprehensive Treatment

• Manual therapy techniques

• Targeted exercise programs

• Pain management strategies

• Collaboration with hormone specialists

• Patient education

Breaking Down Treatment Barriers

Dr. Rubin shares a powerful success story of a patient who experienced pain with intimacy for ten years. The solution involved:

• Addressing hormone imbalances

• Working with pelvic floor physical therapy

• Using appropriate medical interventions

• Creating a comprehensive treatment plan

• Maintaining patient persistence

Once that comprehensive treatment plan was implemented, the patient was seeing relief for the first time and completely changed her life.

The Power of Hormone Health for Women

Only 1.8% of women currently use hormone therapy. This is despite its proven benefits for:

• Reducing fracture risk

• Improving joint health

• Enhancing physical therapy outcomes

• Supporting tissue healing

• Maintaining muscle strength

Hormone treatment is not for everyone, but it is definitely an under used treatment option and can help many people.

Taking Action for Your Health

If you're experiencing pelvic pain, sexual health issues, or menopause-related joint pain, consider these steps:

1. Schedule a Women's Health PT Evaluation

2. Get a comprehensive assessment

3. Discuss your complete health history

4. Set realistic treatment goals

5. Create a tailored plan

6. Consider Hormone Evaluation

7. Discuss symptoms with specialists

8. Track changes in joint pain

9. Monitor treatment response

10. Maintain open communication with providers

11. Build Your Healthcare Team

12. Find providers who listen

13. Seek specialists when needed

14. Ensure team communication

15. Stay involved in treatment decisions

Finding the Right Care

As Dr. Rubin emphasizes, "You have to advocate for yourself and find a team that will help advocate with you." Look for providers who:

• Take time to listen

• Consider multiple factors

• Communicate with other specialists

• Stay current with research

• Support your goals

The Path Forward

Whether you're dealing with pelvic pain, experiencing menopause-related changes, or seeking solutions for sexual health concerns, remember that comprehensive care often provides the best outcomes. 

Don't give up if your first attempts at treatment aren't successful. As Dr. Rubin reminds us, "No one will care about you the way you care about you." Keep advocating for yourself and seeking answers.

Ready to start your journey to better health? Contact our women's health physical therapy team to schedule your comprehensive evaluation.