Article: Pelvic health therapy improves quality of life after treatment or prevention

Understanding the pelvic floor

The pelvic floor refers to the muscles, tissues and nerves that support organs like the bladder, uterus, vagina and rectum. These muscles play essential roles in:

• Bladder and bowel control
• Sexual comfort and function
• Core stability and posture 

What is pelvic health?

Pelvic health means that the pelvic floor muscles are working well and without pain. Cancer treatments such as surgery, radiation, hormone therapy and chemotherapy can cause changes to pelvic tissues and nerves, especially for breast, gynecologic, colorectal or prostate cancers. Risk-reducing surgery to remove the ovaries and uterus may also affect pelvic floor health. These changes can lead to:

• Pelvic pain
• Urinary or bowel incontinence and urgency
• Pain during intercourse
• Sexual dysfunction
• Reduced quality of life 

Pelvic floor therapy can help address changes that may occur after treatment.

Pelvic health therapy after treatment

In a recent CURE article, Dr. Alison Ankiewicz, PT, a pelvic health specialist with over 20 years of experience, discusses how she helps people restore tissue mobility and strength. She highlights the following 5 points for patients to keep in mind when considering pelvic health therapy:

1) Pelvic health therapy helps with post-treatment symptoms

Pelvic health therapy uses hands-on techniques and exercises to address post-treatment symptoms, such as:

• Pelvic pain
• Bladder and bowel dysfunction, including incontinence and urgency
• Sexual pain or dysfunction

Hands-on techniques are intended to improve tissue health and mobility, reduce pain and restore normal muscle function. These techniques can include treatment to reduce tension, pressure and pain. A pelvic health therapist can explain what to expect and how hands-on techniques are completed.

2. Strengthening the pelvic floor matters

Before strengthening exercises can occur, it is important that tissue health is first examined and restored. A pelvic health therapist can check to ensure that the tissue is healthy, flexible and able to function as expected. Otherwise, strengthening exercises can lead to issues like pain, tightness or weakness.

After restoring moving tissues and ensuring tissue health, the focus shifts to strengthening the pelvic floor muscles. These muscles are part of your core and help with bladder/bowel control, support of pelvic organs and sexual function. Techniques to strengthen the pelvic floor may include biofeedback-guided strengthening exercises.

3. Along with physical support, emotional support is key

Cancer treatment can severely impact intimacy, body image and confidence. Dr. Ankiewicz stresses emotional care and encourages collaboration with counselors, alongside physical rehab. The type of counseling support will vary for individuals who are recovering from surgery or treatment.

In addition to physical rehab, counseling support can address holistic recovery. Pelvic health specialists, certified sex therapists and oncology-informed therapists and social workers are just a few types of counselors that can help support an individual’s recovery.

4. Tools of the trade

Therapy may involve lubricants, gels, biofeedback and vaginal and/or rectal dilators to ease pain and restore elasticity to improve pelvic health. Additionally, sensory training techniques can help patients retrain bowel sensation and improve bowel control. Sensory training involves gently inserting a small balloon into the rectal area and inflating it to measure sensation. This technique helps to improve bowel control by teaching the body how to sense fullness again.

5. It’s not too late to seek pelvic health therapy

Even if symptoms have lasted for years, pelvic health therapy can still help improve comfort and function. Dr. Ankiewicz emphasizes that the pelvic floor, like any other muscle group, requires care. People are encouraged to talk about their pelvic health with their medical provider and ask for a referral to a pelvic floor expert; this may include physical therapists (PTs) or medical doctors who specialize in helping people regain strength or control pain (known as physical medicine and rehabilitation doctors or physiatrists).

What does this mean for me?
After cancer treatment, many people experience pelvic health issues such as pelvic pain, bladder or bowel control changes, and discomfort during intimacy. The Cure article highlights insight from specialist Dr. Alison Ankiewicz, PT, on how pelvic health therapy can help survivors regain comfort, function and confidence.

Pelvic health therapy uses manual techniques, strengthening exercises, biofeedback and supportive tools like dilators to restore pelvic floor function. The approach also addresses emotional well-being, recognizing the impact of treatment on body image and sexual health. Collaboration with the full care team, including oncologists, physical therapists, physical medicine and rehabilitation doctors (known as PM&R doctors or physiatrists) and counselors, is important to ensure a coordinated plan that addresses both physical and emotional aspects of recovery.

Even if symptoms have persisted for years, pelvic health therapy can significantly improve quality of life, and survivors are encouraged to talk openly with their healthcare provider about these options.

 

Reference

Feldman, S. (2025, Winter). Pelvic health therapy helps women reclaim comfort after cancer. CURE Today, 24(4).

FDA Office of Women’s Health. (2025). What Women Need to Know About Their Pelvic Floor.

Disclosure: FORCE receives funding from industry sponsors, including companies that manufacture cancer drugs, tests and devices. All XRAYS articles are written independently of any sponsor and are reviewed by members of our Scientific Advisory Board prior to publication to assure scientific integrity.

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