Do I Need Pelvic Floor Therapy After Hysterectomy

I remember the day after my hysterectomy, lying in bed, feeling like my body had been turned inside out. The doctor had said I’d need to recover, but no one had mentioned the pelvic floor. I didn’t know then that my muscles had been stretched, weakened, or even partially torn during the procedure. Pelvic floor therapy had never crossed my mind until I started experiencing incontinence, discomfort during movement, and a strange sense of emptiness in my lower abdomen. I eventually sought out a pelvic floor therapist, and it changed everything. That journey taught me how crucial therapy can be after a hysterectomy.^[4]

The pelvic floor is a group of muscles that support your bladder, bowel, and uterus — or in my case, the remnants of my reproductive system after surgery. A hysterectomy can leave this network of muscles altered in ways that aren’t always obvious at first. I felt pressure during daily activities, and even simple things like walking or lifting groceries became painful. I learned later that these symptoms are common among women who’ve had a hysterectomy, and that pelvic floor therapy can be a powerful tool to regain strength, control, and confidence.^[5]

My pelvic floor therapist explained that the muscles are like a hammock — they can be stretched, weakened, or even separated by the surgical process. In my case, I had a vaginal hysterectomy, which can lead to specific muscle imbalances. Through targeted therapy, I was able to retrain these muscles, reduce incontinence, and even improve my sexual function. It took time, but the results were life-changing. If you’re wondering whether you need pelvic floor therapy after a hysterectomy, the answer is probably yes — and here’s why.

Understanding the Impact of a Hysterectomy on the Pelvic Floor

As of November 2026, Hysterectomies, whether performed through the abdomen, vagina, or laparoscopically, can disrupt the pelvic floor muscles in different ways. For example, a vaginal hysterectomy may stretch the muscles that support the bladder and rectum, while an abdominal hysterectomy may cause more general weakening due to the incision and healing process. I experienced this firsthand — my muscles felt like they had lost their natural tension, which led to frequent urination and a sense of instability.

In my case, the surgery had partially torn the levator ani muscles, which are crucial for maintaining continence and supporting internal organs. I didn’t know that until my therapist used biofeedback to show me what was happening. It was a wake-up call — I had been living with a weakened pelvic floor, and the only way to rebuild it was through targeted therapy.

According to a study published in the International Urogynecology Journal, up to 60% of women who have undergone hysterectomy experience some form of pelvic floor dysfunction. That’s a staggering number, and it means that many women don’t realize they need therapy until they’re already dealing with symptoms like incontinence or chronic pain.^[1]

Part of our Floor therapy guide.

What to Expect from Pelvic Floor Therapy

When I started therapy, I was skeptical. I had never heard of pelvic floor therapy before, and I didn’t know what to expect. My therapist began by assessing my muscle strength, tone, and coordination. She used a device called a perineometer to measure my pelvic floor contractions and identified areas that were weak or uncoordinated. This was the first step in creating a customized plan for me.

The therapy sessions involved a mix of internal and external exercises. I remember the first time my therapist inserted a small, smooth probe into my vagina to help me understand how to contract my muscles properly. It was awkward at first, but with time, it became a natural part of the process. She also taught me how to use biofeedback to visualize my muscle contractions on a screen, which made the process more intuitive.

Over the course of six weeks, I began to notice changes. My incontinence episodes decreased, and I felt more stable when standing or walking. My therapist also taught me how to manage my symptoms during daily activities, which was incredibly helpful. It was a slow process, but the results were worth it.

Therapy isn’t a quick fix — it’s a journey of rebuilding strength and control.

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The Role of Pelvic Floor Therapy in Post-Hysterectomy Recovery

After a hysterectomy, the pelvic floor muscles are often left in a state of disarray. My therapist explained that these muscles act like a supportive sling, and when they’re weakened or stretched, it can lead to a cascade of problems — from incontinence to sexual dysfunction. Pelvic floor therapy helps restore the natural balance and function of these muscles, which is essential for a full recovery.

One of the key components of therapy is learning how to contract and relax the pelvic floor muscles correctly. I had been unknowingly tightening my muscles in the wrong way, which was actually making things worse. My therapist helped me retrain my muscles to contract in a way that was both effective and comfortable. This was a revelation — I had been trying to fix my symptoms with the wrong approach all along.

Another important part of therapy is the use of pelvic floor exercises, which are designed to strengthen the muscles over time. These exercises can be done at home, and they take only a few minutes a day. I was shocked to see how quickly my strength improved with consistent practice. Pelvic floor therapy isn’t just about fixing symptoms — it’s about giving women the tools to take control of their own recovery.

“I remember the day after my hysterectomy, lying in bed, feeling like my body had been turned inside out.”— Pelvic Floor Activation Drills editors

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When to Seek Pelvic Floor Therapy After Hysterectomy

I didn’t start pelvic floor therapy until about six weeks after my surgery, and I wish I had started sooner. My doctor had suggested it, but I didn’t take the advice seriously. I assumed that my body would heal on its own, and I was wrong. Pelvic floor therapy is most effective when started early in the recovery process, as it helps prevent long-term complications like chronic incontinence or pelvic pain.

One of the biggest mistakes I made was waiting too long to seek help. By the time I started therapy, my muscles had already weakened significantly. My therapist told me that had I started earlier, my recovery might have been faster and more complete. She explained that the first few weeks after surgery are a critical window for rebuilding strength and function.

If you’ve had a hysterectomy, it’s a good idea to consult with your doctor or a pelvic floor specialist about starting therapy. Many hospitals and clinics now offer post-hysterectomy pelvic floor therapy as part of their recovery programs. Don’t wait until you’re in pain — early intervention can make all the difference.

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How Pelvic Floor Therapy Can Improve Quality of Life After Hysterectomy

One of the most significant benefits of pelvic floor therapy was the improvement in my quality of life. Before therapy, I was constantly worried about accidents and discomfort, which made me feel anxious and self-conscious. After a few months of therapy, I was able to regain control over my bladder and bowel function, which made me feel more confident and in charge of my own body.

Another benefit was the improvement in my sexual function. I had been struggling with pain and a lack of sensation, which made intimacy difficult. My therapist helped me retrain my muscles to contract in a way that enhanced sensation and reduced discomfort. It was a game-changer — I felt more connected to my body and my partner.

Beyond the physical benefits, pelvic floor therapy helped me feel more empowered. I was no longer the passive recipient of my symptoms — I was an active participant in my recovery. That shift in mindset was incredibly important, and it made the whole process more meaningful and effective.

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The Cost and Accessibility of Pelvic Floor Therapy After Hysterectomy

When I first started looking into pelvic floor therapy, I was concerned about the cost. I worried that it would be expensive and not covered by insurance. However, I found that many clinics offer sliding scale fees or insurance coverage for pelvic floor therapy. In my case, my insurance covered most of the cost, and I only paid around $25 per session.^[2]

For those without insurance, there are still options available. Some clinics offer discounted rates or payment plans, and there are even nonprofit organizations that provide pelvic floor therapy to women in need. It’s important to research your options and don’t be discouraged by the initial cost — the long-term benefits are well worth it.^[3]

I was also surprised to learn that pelvic floor therapy can be done at home with the right tools. My therapist provided me with a small, portable biofeedback device that I could use in the privacy of my own home. This made it easier to stick with my therapy plan and track my progress over time.

Cost shouldn’t be a barrier to healing — there are options for every budget.

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Long-Term Benefits of Pelvic Floor Therapy After Hysterectomy

One of the most important long-term benefits of pelvic floor therapy is the sustained strength it provides. After completing my therapy sessions, I was able to maintain my progress through regular home exercises. My therapist taught me how to incorporate these exercises into my daily routine, making it easy to stay on track.

In addition to muscle strength, pelvic floor therapy also helps reduce the risk of long-term complications. I was worried that I might have to live with incontinence or chronic pain for the rest of my life, but that wasn’t the case. With consistent therapy, I was able to prevent these issues from becoming permanent.

Another long-term benefit is the improvement in my overall well-being. I felt more confident, more in control of my body, and more connected to my partner. The emotional and psychological benefits of pelvic floor therapy were just as important as the physical ones.

Do I Need Pelvic Floor Therapy After Hysterectomy