Pelvic Health physiotherapy following gynaecological cancer treatment and for vulval skin conditions such as Lichen Sclerosus By Nina Stuckey MCSP HCPC

Support following gynaecological cancer treatment

Pelvic floor symptoms are extremely common after gynaecological cancer treatment. In one study of survivors of Womb cancer, around 3/4 of women reported at least one symptom relating to discomfort in their pelvic floor.

Some of the symptoms experienced are

•  bladder - urgency, leakage or difficulty with emptying bladder

• bowel - urgency, leakage, constipation or difficulty emptying

• pelvic pain or discomfort

• vaginal tightness, dryness or sensitivity

• pain or difficulty with intimacy

• changes in pelvic floor strength, coordination or control

These symptoms can affect daily activities, exercise, relationships, confidence and overall quality of life. They can also feel difficult or embarrassing to discuss.

Pelvic floor symptoms often go unspoken after cancer treatment. Women may be focused on getting through their cancer treatment, feel overwhelmed by appointments and other side effects, or regard their symptoms as something they should tolerate in comparison with the cancer itself. Some women are simply unaware that specialist support is available.

You personally may feel that these concerns are not important enough to raise, or that you should simply put up with them. However, recovery is not only about treating the cancer. Your comfort, function, relationships and quality of life matter too.

Support for lichen sclerosus and other vulval skin conditions

Lichen sclerosus is a medical skin condition, and physiotherapy does not replace treatment or monitoring from your GP, dermatologist or vulval specialist. Pelvic health physiotherapy can, however, support the pelvic floor and functional difficulties that may occur alongside it.

Pain, soreness, extreme sensitivity, skin changes and fear of further discomfort can sometimes lead to protective tension within the pelvic floor. This may contribute to pain during intimacy, difficulty tolerating examination or touch, and reduced confidence in your body.

Bladder or bowel difficulties may add another layer of discomfort. Bladder or bowel leakage, moisture, friction and the use of continence pads can irritate sensitive vulval skin and make day-to-day skin care more challenging. Physiotherapy can help address these associated bladder, bowel and pelvic floor symptoms while working alongside your medical management.

A gentle approach that keeps you in control

We understand that seeking pelvic health support may feel daunting, particularly after repeated medical examinations, cancer treatment, painful experiences or a long and difficult journey to diagnosis.

Your first appointment begins with time to talk, we will listen carefully to your experiences, symptoms and concerns and explain the available options without rushing you. You do not have to disclose or do more than feels manageable.

Any physical assessment is approached gradually, with clear explanation and consent at every stage. An internal examination is never automatic. It is only considered when it may provide useful information and when you feel comfortable proceeding. You remain in control throughout and can pause, change your mind or stop at any time.

Treatment is tailored to what your body needs and may include:

• pelvic floor strengthening and coordination where weakness is contributing to symptoms

• relaxation and down-training where the muscles are tense or overactive

• bladder and bowel management strategies

• gentle soft-tissue, scar and manual techniques

• body-awareness, breathing and movement work

• gradual desensitisation and supported exposure to touch

• guidance with vaginal dilators when clinically appropriate

• advice and practical self-management strategies

• gradual support to rebuild general strength, activity and physical confidence

Together, we will work towards helping you feel more comfortable, confident and connected to your body—so that, over time, you can begin to feel more like yourself again.

AUTHOR: NINA STUCKEY MCSP HCPC

Please visit Nina's page on our website to find out more about her

To book in with Nina Stuckey in her Late Effects Clinic please visit www.invictuspelvichealth.com

email info@invictuspelvichealth.com

or phone or text 07379499756

Appointments are available with Nina on a Friday at Brinkworth House, Malmesbury Clinic