Personal Physical Therapy Services: Women's Health & Orthopedic Care

12/12/2025

If you have had cancer and cancer treatments, especially breast cancer or gynecological cancers, PT can help you recover function. Chemo and other treatments zap your strength and endurance, and can impact your urogenital function (bladder and bowel control, and pain with gun exams or intimacy), this doesn’t have to just be the new normal. Ask for a referral to pelvic & women’s health PT specialist, or reach out directly today. Often no referral is required.

12/12/2025

Such important information for every woman to learn!

Read all about here: https://open.substack.com/pub/drmaryclairehaver/p/what-really-happens-to-the-vulva

12/03/2025

Are you familiar with the AUA/SUFU/AUGS guideline on Genitourinary Syndrome of Menopause (GSM)?

Here are 5 takeaways regarding s*xual function:
1️⃣ Sexual symptoms are a core component of GSM
Sexual-health problems such as decreased lubrication/arousal, increased pain with in*******se (dyspareunia), and delayed or diminished or***ms are explicitly recognized as part of GSM.
🗨️ This means when you’re working with patients, s*xual function must be part of the assessment, and not just urinary or vaginal atrophy symptoms.

2️⃣ GSM s*xual symptoms don’t tend to resolve without treatment
Unlike vasomotor symptoms of menopause (hot flashes, night sweats) that may reduce over time, or with medical treatment, GSM-related s*xual problems tend to persist or worsen unless addressed.
🗨️ For your clinical practice, this underscores the importance of early screening, approaching patients with a trauma-informed care lens, and referring to a s*x therapist or counselor as appropriate.

3️⃣ There is strong evidence that low-dose local vaginal estrogen improves s*xual health outcomes
Local (vaginal) low-dose estrogen therapy has the most robust evidence base for improving GSM symptoms, including s*xual discomfort and dyspareunia.
🗨️ As a pelvic health specialist, this supports recommending or collaborating with prescribing practitioners on vaginal estrogen therapies when appropriate (and safe) for improving patient s*xual outcomes, including those patients who are on systemic estrogen therapy.

4️⃣ Emerging evidence supports vaginal DHEA (dehydroepiandrosterone) for s*xual function
The guideline mentions that vaginal DHEA has been shown to improve s*xual function, decrease vaginal pH, and improve vaginal epithelial anatomy.
🗨️ Pelvic PTs should educate and collaborate with prescribing practitioners on vaginal DHEA when appropriate, including for those patients who are on systemic estrogen therapy.

5️⃣ Shared decision-making and addressing s*xual wellness beyond anatomy are essential
This guideline emphasizes the importance of shared decision-making with respect to a patient's s*xual goals, preferences, psychological context, and overall quality of life.
🗨️ Clinicians need to consider the whole person and not just the physical/tissue changes that occur with GSM care.

References:
Kaufman, M. R., Ackerman, A. L., Amin, K. A., Coffey, M., Danan, E., Faubion, S. S., Hardart, A., Goldstein, I., Ippolito, G. M., Northington, G. M., Powell, C. R., Rubin, R. S., Westney, O. L., Wilson, T. S., & Lee, U. J. (2025). Executive Summary: The AUA/SUFU/AUGS Guideline on Genitourinary Syndrome of Menopause. Urogynecology (Philadelphia, Pa.), 31(11), 1005–1014. https://doi.org/10.1097/SPV.0000000000001753

11/11/2025

Wow! I love Dr Rachel Rubin! A fierce advocate for women! Women’s health is having a moment! And as a women’s health/ pelvic health physical therapist provider, this is such an exciting time!!! Women’s health issues have been neglected but that’s changing a little every day. Recognition, validation for symptoms & suffering, and treatment options; that is something to be excited about!

11/10/2025

Wow. Progress toward safe and effective treatments options with less fear to help women address urogenital syndrome of menopause (GSM). Women are suffering with urinary leakage, serious UTIs, and vulvovaginal changes that can lead to pain with s*xual activity. Vaginal estrogen is a safe option for most women with GSM, or even Genitourinary Syndrome of Lactation (nursing mommas can have the same symptoms, due to decreased estrogen during the time they nurse). Ask for help if you are suffering with any of these issues, you can get help from your gynecologist, urologist, even your primary care possibly AND of course PT can be very helpful to address pelvic floor dysfunction.

The Food and Drug Administration will remove the "black box" warning from hormone replacement therapy (HRT) products for menopause.

08/16/2025

There is truth to this. Women coming to physical therapy at this clinic will get information and treatment to add quality to your life, empower you to make decisions about your medical care and have effective discussions with your providers.

08/07/2025

Pelvic floor physical therapy can be a solution to many symptoms. Reach out for help.

06/29/2025

The office is currently closed from Friday June 27 until approximately August 4th while I am out for surgery and a period of recovery, please call and leave a detailed message with your name, number, and reason for calling. If you would like schedule as a new patient please leave your name, who referred you for PT, what insurance you have, and what type of condition you are looking for treatment.

All messages will be responded to starting July 16th, via phone call, texting or email for approximately the last 2 weeks of July including scheduling new patients. I anticipate easing back into office hours starting August 4th.

Please call 540-450-0680 to leave a viicemail, OR send an email to info@ptservices.net. You may also text the office line 540-645-6741.

Thank you for your patience during this time.

I look forward to the opportunity to provide you with quality, personalized care in August.

06/27/2025

GSM. Genitourinary Syndrome of Menopause. Know the term. Know there’s treatment help available. Call your doctor. Call your PT.

05/19/2025

A sharp acceleration in loss of strength begins in our 40s—and it’s not just aging. It’s menopause.

The menopause transition is a critical intervention window and we must treat it as such. Strength isn’t vanity. It’s longevity.

Study: O’Bryan et al. 2025, *The Journal of Physiology

We’ve been told that muscle loss is just a natural part of aging. But a new study shows that for women, the story is very different—and it starts sooner than we think.

This landmark paper followed women ages 18 to 80 and mapped their neuromuscular function decade by decade—including strength, power, muscle composition, and hormone levels.

What did they find?

A sharp acceleration in loss of strength begins in our 40s—and it’s not just aging. It’s menopause.

Researchers found that:
• Muscle loss is driven by peripheral changes—meaning the muscle itself is deteriorating, not just the nerves
• The quadriceps are especially vulnerable, impacting walking, balance, and independence
• Hormonal changes—declines in estradiol, progesterone, and testosterone—were directly linked to loss of strength and power
• Factors like protein intake, activity levels, and body composition play a role, but hormones were consistently part of the picture

This study finally names what so many of us feel: something shifts during menopause, and it changes how we move, perform, and live.

We can’t afford to ignore this. Not as women. Not as doctors. Not as a society that cares about healthy aging.

The menopause transition is a critical intervention window and we must treat it as such. Strength isn’t vanity. It’s longevity.

Thank you to my friend for sending me this paper.
Study: O’Bryan et al. 2025, *The Journal of Physiology

05/13/2025

You are not alone. There are treatment options. Pelvic Floor Physical Therapy is an important part of the healing process.

05/10/2025

You can get better with the right help