Pelvic floor physical therapy in GSM has been shown to do what?

Pelvic floor physical therapy in GSM has been shown to do what?

• A. It has no effect on GSM or sexual function.
• B. It worsens GSM symptoms.
• C. It is only effective for urinary incontinence.
• D. It improves GSM symptoms and sexual function.

Answer: (C)

Pelvic floor physical therapy trains the pelvic floor muscles to contract, relax, and coordinate with breathing and posture. This directly improves how the bladder and urethral sphincter work, which helps reduce urinary symptoms such as incontinence and urgency. In GSM, vaginal tissues become thinner and drier due to estrogen loss, so the mucosal changes underlying dryness and dyspareunia are not reversed by pelvic floor exercises. Those tissue-level changes respond best to estrogen-containing treatments, moisturizers, or lubricants, while pelvic floor therapy mainly supports continence and pelvic floor function. So, the strongest, most consistent evidence in the GSM context is that pelvic floor physical therapy helps urinary symptoms, but it does not reliably improve GSM-related vaginal atrophy or sexual function driven by mucosal estrogen deficiency. That’s why it’s viewed as primarily effective for urinary incontinence.

Pelvic floor physical therapy trains the pelvic floor muscles to contract, relax, and coordinate with breathing and posture. This directly improves how the bladder and urethral sphincter work, which helps reduce urinary symptoms such as incontinence and urgency. In GSM, vaginal tissues become thinner and drier due to estrogen loss, so the mucosal changes underlying dryness and dyspareunia are not reversed by pelvic floor exercises. Those tissue-level changes respond best to estrogen-containing treatments, moisturizers, or lubricants, while pelvic floor therapy mainly supports continence and pelvic floor function.

So, the strongest, most consistent evidence in the GSM context is that pelvic floor physical therapy helps urinary symptoms, but it does not reliably improve GSM-related vaginal atrophy or sexual function driven by mucosal estrogen deficiency. That’s why it’s viewed as primarily effective for urinary incontinence.