A diagnosis of a gynecologic cancer, including endometrial (uterine), ovarian, cervical, vulvar, or vaginal cancer, can bring physical changes that are hard to manage. Surgery, chemotherapy, radiation, and hormone therapy can affect the pelvic area in ways that interfere with everyday comfort, mobility, bladder and bowel function, and intimacy.

Pelvic floor therapy is one supportive care option that can help address these changes and support quality of life during and after cancer treatment.

What is pelvic floor therapy?

The pelvic floor is a group of muscles and connective tissues that support the bladder, bowel, and reproductive organs. These muscles play an important role in bladder and bowel control, core strength, posture, and sexual function.

Pelvic floor therapy is a specialized form of physical therapy provided by clinicians with advanced training in pelvic health. Therapy is highly individualized and may include gentle exercises, breathing and relaxation techniques, hands-on therapy (with your consent), and education about bladder, bowel, and sexual health. The goal is not just to strengthen muscles, but also to help them relax and function properly, especially if they’ve been affected by cancer treatment.

Why pelvic floor therapy matters after cancer treatment

Many gynecologic cancer treatments directly affect the pelvis. Surgery can change anatomy or weaken muscles, radiation may cause stiffness or scarring, and hormonal changes can impact tissue health and elasticity. Over time, these changes can lead to symptoms such as urinary leakage, constipation, pelvic pain or pressure, pain with intercourse, or a feeling of weakness in the core.

Pelvic floor therapy helps address these symptoms by restoring balance, flexibility, and coordination to the pelvic muscles. For many patients, it can make daily activities more comfortable and help them feel more confident and in control of their bodies again.

What to expect with pelvic floor therapy

Your visits will likely focus on understanding how your pelvic muscles are working and how cancer treatment may have affected them. The first appointment typically begins with a private conversation about your symptoms, treatment history, and what you’re hoping to improve. From there, the therapist may gently assess things like posture, movement, and pelvic muscle function. Everything is explained along the way, and your comfort and consent guide every step.

Based on that first visit, your therapist will put together a plan designed specifically for you. Sessions might include simple movements or stretches, guided breathing, hands-on techniques, or tools that help retrain the pelvic muscles to relax or engage when they should. 

Why professional guidance helps

When you hear pelvic floor therapy, Kegels may be the first thing that you think of, but they’re not right for everyone. Some people need to relax their pelvic muscles rather than strengthen them, and doing the wrong exercises can lead to ongoing or worsening symptoms. A pelvic floor therapist can help you understand what your body actually needs and teach you how to move in ways that support healing.

How to access pelvic floor therapy

If you’re experiencing pelvic symptoms, the first step is to talk with your care team. They can help determine whether pelvic floor therapy may be beneficial and provide a referral if needed. Many insurance plans cover physical therapy with a referral, though coverage can vary.

When looking for a provider, it’s helpful to seek out a pelvic health physical therapist who has previous experience working with cancer patients or survivors. Pelvic floor therapy can be helpful during treatment, shortly after treatment ends, or even years later. There is no “wrong time” to ask for support.

What this means for you

Pelvic floor symptoms are common after gynecologic cancer, but they don’t have to be something you simply live with. Pelvic floor therapy offers a supportive, personalized approach to managing discomfort, improving function, and restoring confidence.

If something doesn’t feel quite right in your body, it’s worth bringing up. Pelvic floor therapy can be an important step toward feeling more comfortable, empowered, and supported throughout treatment and beyond.

Remember that you can always reach out to an oncology nurse practitioner at Outcomes4Me to help you better understand your diagnosis.