How to Talk to Your Patients/Clients About Pelvic Health

Are you struggling to talk to your patients or clients about their pelvic health concerns?

When it comes to addressing pelvic health, initiating conversations with patients can be challenging. Rebecca Slape, DPT and Alana Ogilvie, LMFT, CST would know! With a combined experience of over 15 years in the field of sexual health, they’ve had many conversations with clients and patients about sexual health concerns.

Unfortunately, most providers feel hesitant or uncomfortable discussing issues related to pelvic pain and sexual health… even though it is essential to proactively broach these subjects to ensure comprehensive care!

This can put many clinicians in a bit of a pickle and keep clients from receiving the care they need.

Here in this post, Rebecca and Alana explore three crucial points that will help you effectively communicate with your patients about their pelvic health concerns.

1. Initiate the Conversation

Recognize that clients often won’t bring up issues surrounding pelvic pain or sexual health unless prompted.

While many of our patients are more sexually liberated than the generations that came before, there is still a great deal of shame, embarrassment and sex-negative messaging out there that can stop people from broaching their concerns directly, even with a trusted professional.

Alana Ogilvie, Licensed Marriage and Family Therapist and Certified Sex Therapist

Alana: I can’t tell you how many times I’ve had clients come to me, already under the care of another professional, looking to talk to me about their sexual concerns because they don’t think their therapist will a) understand, b) have the necessary information or skills to talk to them about this. In the end, they don’t want to make their provider uncomfortable, and it’s not their job to worry about us.

Rebecca Slape, Doctor of Physical Therapy

Rebecca: Even in the context of pelvic floor physical therapy, it’s crucial to ask specific questions about all aspects of the care you provide. I’ve had patients come in for urinary incontinence who were also struggling with sexual dysfunction that was never asked about by any of the many other providers that they went through before coming to me. The patients didn’t know that those kinds of issues are very often related so they didn’t bring it up. 

So here’s the deal, as the provider it is your responsibility to create a safe and open space for discussion. Proactively addressing these topics means you can uncover vital information and provide the support and guidance your patients need.

Make it clear that you are open to discussing sensitive subjects by explicitly asking about it. Assure them that their concerns are valid and confidential and you’re here to listen.

2. Avoid Judgement and Foster Trust

When discussing pelvic health, it is crucial to approach the conversation with empathy and without judgement. Understand that each individual’s experiences, sexual habits, and knowledge may vary widely.

Alana Ogilvie, Licensed Marriage and Family Therapist and Certified Sex Therapist

Alana: Part of the necessary training to become a Certified Sex Therapist is to take what’s called a “Sexual Attitude Reassessment” or SAR. The SAR’s purpose is to expose professionals to a variety of sexual experiences and expressions and provide them with the opportunity to work through their judgements, biases and even their disgust response in the realm of sex and sexuality. While you don’t have to go that far, noticing your own reactions and not putting them on your clients/patients is the best foundation for a working relationship.

Rebecca Slape, Doctor of Physical Therapy

Rebecca: Practice asking neutral, judgment free questions with a close friend or coworker who can give you feedback on your language, tone, etc. Finding your standard, open-ended questions will make it easier to get this essential information from your patients so that you can provide them with the best care possible or refer them to the appropriate professional. 

Create an environment where patients/clients feel comfortable sharing intimate details about their lives without fear of being judged.

By withholding any preconceived notions, you can build trust and establish a foundation of open communication, allowing for more accurate diagnoses and tailored treatment plans.

3. Include Pelvic Health in Standard Assessments

Integrating questions about pelvic health into your standard assessments does two things:

  1. It ensures you are gathering the necessary information to address potential issues and provide appropriate treatment and support.
  2. The more routine these inquiries become, the more normalized they will feel for both you and your patients.

Start by including general questions about pelvic pain, sexual function, and any related concerns during initial assessments.

Alana Ogilvie, Licensed Marriage and Family Therapist and Certified Sex Therapist

Alana: A question as simple as, “Are you struggling with any sexual concerns?” is a great place to start. You are giving your clients an explicit and normalizing opening. If they can feel your comfort in asking the question, they’ll be more likely to feel comfortable talking about it with you.

These days, a lot of clinicians who are not sexual health professionals can get hung up on the fact that they don’t know what to do if their clients say, “Why yes, yes I am struggling with a pelvic health issue.” But you can’t let your fear of not-knowing stop you from posing the question.

The clients who are struggling with a sexual concern will be struggling whether you ask about it or not. Burying your head in the sand only hurts their treatment outcomes and has the potential to damage your alliance. If you don’t have the answer, be honest about it and work to educate yourself about the aspects of your client’s concerns you see being within your scope of practice.

Rebecca Slape, Doctor of Physical Therapy

Rebecca: If you’re a PT or other rehabilitation professional, you may think it would be crazy to ask this of every single patient – the standard rotator cuff repair isn’t likely to be coming in with a related pelvic floor complaint. However, we know that a huge percentage of the population has a pelvic health concern at some point in their life so by asking one simple question you could be saving them years of pain or embarrassment.

Consider making an information sheet and trusted provider list for pelvic health related topics part of your standard new patient packet so that those patients who may not feel comfortable endorsing a problem with you can get the care they need when they are ready. 

Talking to patients/clients about pelvic health requires sensitivity, open-mindedness, and proactive engagement. Initiating conversations, withholding judgment, and incorporating pelvic health questions into your standard assessments, is a great way to open dialogue, foster trust, and center your patients in your care.

Remember, your clients rely on your expertise and guidance, so be proactive in addressing their pelvic health concerns and providing the support they need to achieve optimal well-being.

If you want help in addressing pelvic and sexual health in your practice or you’re looking for ways to expand your knowledge and understanding, join us for the “Holistic Approaches to Pelvic Pain: A Multi-Disciplinary Workshop for Providers” on September 16, 2023!

This workshop is specifically designed to enhance your understanding of pelvic pain and equip you with practical tools and strategies to address this complex issue. We’re hoping this will be an amazing opportunity to learn from RCSHC’s sexual health experts (including Alana and Rebecca) and engage in interdisciplinary discussions.

Register now for the “Holistic Approaches to Pelvic Pain” workshop and take a significant step towards advancing your practice and improving patient outcomes. Together, we can transform the way pelvic pain is understood and treated!

Promoting pelvic health begins with effective communication, and you have the power to make a significant impact on your patients’/clients’ lives.