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“Menstrual Irregularities: How Pelvic Health PT Can Help”

  • stephanytritt
  • Sep 7
  • 3 min read

Updated: Sep 8


Let's talk about menstrual health
Let's talk about menstrual health

Pelvic health physical therapy can impact symptoms beyond the pelvic floor muscle itself. For many people—especially those navigating menstrual irregularities, hormonal shifts, or chronic pelvic symptoms—PT can be a transformative part of healing.

Whether you're dealing with painful periods, fatigue, vulvovaginal discomfort, or overlapping symptoms that defy easy diagnosis, pelvic health PT offers a whole-body, whole-person approach to care.


Why Symptoms Are Often Overlooked

Conditions affecting the abdominopelvic region can stem from hormonal fluctuations evident through menstrual irregularities, and complicated with stress-related nervous system dysregulation. Symptoms often overlap with a variety of diagnoses, making it difficult to pinpoint the root cause. That’s why many people experience delays in receiving appropriate treatment.

Pelvic health PT helps bridge that gap.


When Menstrual Irregularities Signal Something More

Menstrual health is a vital sign. PTs often collaborate with medical providers when symptoms suggest deeper hormonal or gynecological conditions. It’s important to recognize typical and atypical symptoms:


TYPICAL PERIODS

ATYPICAL PERIODS

Duration of cycle

Teens: varies between 21-45 days and may be irregular for the first few years.

Adults: on average lasts 28 days


Oligomenorrhea - infrequent periods (less than 6-8 per year)

Amenorrhea - absence of period 

Primary vs. Secondary

Duration/amount 

of bleeding

2 to 7 days, with the heaviest bleeding in the first 3 days.

3-6 pads/tampons per day.


Menorrhagia - heavy periods leaking through 1+ tampons/pads in an hour. 

Bleeding more than 7 days


Pain

Tolerable ache/pain is common the first 1-2 days of period

Dysmenorrhea - painful periods. Pain that lasts more than 1-2 days. Period pain that prevents you from going to school, work or doing things you enjoy.

Atypical menstrual symptoms may be indicative of something else - it’s important to work with your doctor for a diagnosis. Some possible conditions you doctor may test for:


🌿 Endometriosis

  • Uterine-like tissue grows outside the uterus, responding to hormonal cycles

  • Onset typically begins at menstruation

  • May take 7–10 years to diagnose

  • Affects 1 in 10 women

Symptoms:

  • Heavy bleeding

  • Painful periods (may include nausea/vomiting)

  • Painful intimacy

  • Chronic pelvic pain

  • Painful bowel movements or urination (if colon/bladder involved)


⚖️ PCOS (Polycystic Ovary Syndrome)

  • Hormonal imbalance with increased androgen production

  • Onset at menstruation

  • Affects 6–13% of women of reproductive age

Symptoms:

  • Irregular or absent periods

  • Infertility

  • Obesity or weight management challenges

  • Excess hair growth (face, chest, abdomen, thighs)

  • Persistent or severe acne


🧬 POI (Primary Ovarian Insufficiency)

  • Early depletion or dysfunction of ovarian follicles

  • Cessation of menses before age 40

  • Affects 2–10% of women with amenorrhea

Symptoms:

  • Vaginal dryness and painful intimacy (dyspareunia)

  • Amenorrhea

  • Increased risk of bone loss and cardiovascular issues

  • Infertility (but 5–10% chance of spontaneous pregnancy)


🏃‍♀️ REDs (Relative Energy Deficiency in Sport)

  • Occurs when energy intake is insufficient for physical activity demands

  • Not age-related; linked to energy expenditure

  • Affects 15–80% of elite athletes

Symptoms:

  • Menstrual irregularities

  • Endocrine dysfunction (hair loss, fatigue)

  • Cardiovascular and psychological challenges

  • Poor bone health, stress fractures

  • Disordered eating (more prevalent in athletes)


How PT Supports the Whole Person

Pelvic health PT isn’t just about muscles—it’s about restoring balance across systems. Here’s how:

🌬️ Nervous System Regulation

  • Diaphragmatic breathing to support pelvic floor and vagal tone

  • Manual techniques to soothe the nervous system and reduce tension

🧠 Pain Science Education

  • Evidence shows that understanding pain improves outcomes

  • Patients learn how pain works and how to manage it effectively

🏃 Movement & Mechanics

  • Exercise progression tailored to menstrual phases and energy levels

  • Coaching on body mechanics for work, play, caregiving, and sleep

🧘 Soft Tissue & Fascial Work

  • Increases circulation, reduces scar tissue, and improves organ mobility

  • Supports healing from surgeries, injuries, or chronic inflammation


Pelvic health PT is more than rehab—it’s a way to reconnect with your body, understand your symptoms, and reclaim your energy. Whether you're navigating hormonal shifts, chronic pain, or simply want to feel more aligned in your daily life, PT offers tools that are both evidence-based and deeply human.

If you’re experiencing menstrual irregularities, pelvic discomfort, or unexplained fatigue, consider reaching out to Foothill PT. You deserve care that sees the whole you.


REFERENCES:

  1. Lepri B, Romani D, Storari L, Barbari V. Effectiveness of Pain Neuroscience Education in Patients with Chronic Musculoskeletal Pain and Central Sensitization: A Systematic Review. International Journal of Environmental Research and Public Health. 2023; 20(5):4098. https://doi.org/10.3390/ijerph20054098

  2. https://www.acog.org/womens-health

  3. Cabre HE, Moore SR, Smith-Ryan AE, Hackney AC. Relative Energy Deficiency in Sport (RED-S): Scientific, Clinical, and Practical Implications for the Female Athlete. Dtsch Z Sportmed. 2022;73(7):225-234. doi: 10.5960/dzsm.2022.546. Epub 2022 Nov 1. PMID: 36479178; PMCID: PMC9724109. https://pmc.ncbi.nlm.nih.gov/articles/PMC9724109/


 
 
 

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