Pelvic health therapy helps Veterans improve quality of life

Through specialized pelvic health therapy services, VA Tennessee Valley Healthcare System (TVHS) is helping women Veterans address these concerns and improve their daily lives.

“The pelvic floor really supports the rest of your body,” Lynn Daugherty, TVHS Women Veteran Program Manager said. “When it’s not functioning properly, it can affect a woman’s quality of life in significant ways. The good news is there are treatments available, and women don’t have to simply live with these symptoms.”

The importance of pelvic health

The pelvic floor is a group of muscles and connective tissues that support the bladder, bowel, and reproductive organs. These muscles can become weakened or damaged due to pregnancy, childbirth, aging, physical strain, or injuries sustained during military service.

Women Veterans are more susceptible to pelvic health issues because of the unique physical demands associated with military service, including heavy lifting, repetitive physical training, and occupational stressors. Research shows that up to one-third of female Veterans experience conditions associated with pelvic health like urinary tract infections, kidney stones, and incontinence more than their male counterparts. 

Symptoms associated with pelvic floor dysfunction can include urinary leakage, incontinence, pelvic pain, pressure or discomfort, painful intercourse, and other conditions that impact daily activities.

“Many women assume that urinary leakage is just something that happens as they get older,” Daugherty said. “We’ve normalized it in society, but it’s not something women should simply accept or consider normal. There are therapies and treatments that can help.”

Benefits from pelvic health therapy

Pelvic health therapy uses specialized physical therapy techniques to strengthen and rehabilitate the pelvic floor muscles. Treatment plans are individualized and may include exercises, movement training, education and other evidence-based interventions designed to improve function and reduce symptoms. With consistent and routine care, Veterans have reported seeing improvements in their pelvic health by their second or third visit. 

While women who have experienced pregnancy and childbirth often benefit from pelvic floor therapy, Daugherty noted that pelvic health concerns can affect women at any stage of life.

“The physiological changes that occur during pregnancy and postpartum can affect a woman for the rest of her life,” Daugherty said. “Pelvic health isn’t only about pregnancy. As women age, the stresses of everyday life and other physical factors can impact pelvic floor stability and function.”

Addressing misconceptions

One of the biggest misconceptions about pelvic health is that it only affects women or those who have had children, according to Dr. Emilie Samp, a physical therapist specializing in pelvic health at TVHS.

“Everyone has a pelvic floor,” Samp said. “I’ve had male Veterans tell me they don’t need pelvic therapy because they haven’t had babies, but pelvic health is about much more than pregnancy and childbirth.”

Men and women can both experience symptoms associated with pelvic floor dysfunction, and these symptoms can interfere with daily activities, exercise, work, and social engagement.

Samp said another common misconception is that all pelvic floor issues are caused by weak muscles.

“People often assume that if they’re having leakage, they just need to do Kegel exercises,” she said. “Sometimes the muscles are actually too tight rather than too weak. Two people can have the same symptoms but completely different root causes. That’s why individualized evaluation and treatment are so important.”

Care tailored to the patient’s needs

For Veterans considering pelvic health therapy, Samp emphasizes that the process begins with a comprehensive one-on-one evaluation focused on understanding the whole person rather than simply treating symptoms, a key component of VA’s Whole Health model and holistic approach to health care.

The first appointment includes a detailed discussion about medical history, prior surgeries or injuries, bowel and bladder health, daily activities and personal goals. Physical therapists may also assess movement patterns involving the abdomen, hips, and lower back to identify factors contributing to symptoms.

A pelvic floor assessment may be performed externally or internally, but Samp stresses that patient comfort and choice always come first.

“We’re a team,” Samp said. “The Veteran is the expert on their body. If someone isn’t comfortable with a particular assessment, we have other tools and techniques available. It’s their body and their choice on what they’d prefer.”

Expanding services to meet growth and demand

As the population of women Veterans continues to grow, TVHS has expanded its ability to provide specialized women’s health services. The healthcare system now serves more than 17,000 enrolled women Veterans, an increase of nearly 2,000 women in less than three years.

To meet the growing demand, TVHS recently added two dedicated pelvic floor physical therapists, bringing this specialized service in-house for Veterans. The program has become highly popular, with sessions filling up quickly. Additionally, TVHS is expanding and building new facilities across middle Tennessee and southern Kentucky to enhance Veterans' access to VA care in communities like Nashville, Clarksville, Cookeville, Bowling Green, and Columbia.

“We recognized that this was a critical need for our women Veterans,” Daugherty said. “By bringing pelvic floor therapy to Tennessee Valley, we’re able to provide care closer to home and help Veterans receive treatment from providers who understand their unique experiences.”

Veterans interested in learning more about pelvic health services are encouraged to speak with their primary care provider about a referral to pelvic floor therapy. Women Veterans may also visit the TVHS Women Veteran Program website, or email TVHWomenHealthPivotalGroup@va.gov for additional information and support.

“Women Veterans gave their very best in service to our country,” Daugherty said. “They deserve access to the specialized care and resources that help them live healthy, fulfilling lives.”