Physical Therapy for Fertility Wellness
Fertility wellness is a newer niche within the pelvic health realm of physical therapy! When you think of “fertility”, you may think of hormones. Yes, hormones are a huge part of our fertility, of course! There’s no denying that. Can we change your hormones through physical therapy? Not exactly - that’s where medical/pharmacological treatment comes into play. But what we CAN do from a physical therapy perspective, is optimize the environment in which hormones do their thing!
Let’s dive into that a bit more.
We have evidence that manual therapy can change physiologic and mechanical processes within the reproductive environment (1).
We are full of a vast network of vessels…this includes arteries, veins, and lymphatic vessels. Fun fact: your abdomen and pelvis contain about 250 lymph nodes! (1)
Our urogenital system is composed of some ligaments that help to maintain optimal mobility and function of the pelvic organs. You might be familiar with ligaments playing a role in the structure and function of joints, but it is important to note that they are also crucial for ideal mobility and function of pelvic organs! So, by using manual therapy techniques, we can release facial and ligamentous restrictions which can thereby reduce pressure on vessels. This will promote optimal vascularity and efficiency of our lymphatic system. This then means excellent blood flow to our organs, which can help with hormone function. By addressing the lymphatic system in this way, we are decongesting the area! This will reduce excess waste from organs, allowing for organs to function in the best way possible. By decongesting the pelvic cavity, hormones can more easily target reproductive tissues. Follicles will be better nourished with oxygen and other nutrients. Theoretically, this can contribute to improved hormone levels and menstrual cycles! (1)
We also have evidence that exercise and diet can play a role on fertility outcomes (2). Physical activation recommendations for those trying to conceive are patient-specific. We can say the same for women undergoing assisted reproduction techniques. And, as always, physical activity has astronomic effects on our mental health, which is SO important to address! Furthermore (specially when paired with manual therapy), physical activity has anti-inflammatory effects, which is an ideal environment to help prepare the body to carry a baby.
What can you expect during your first visit?
A pelvic, abdominal, and hip assessment
A full history intake regarding your exercise routine, menstrual cycles, and diet
Questions about what previous tests, lab work (including for the males!), or treatments have been done (including IUI, IVF, frozen embryo transfers, frozen sperm)
Learning about other healthcare providers you may be seeing or are wanting to see (acupuncturists, nutritionists, dietitians, naturopaths, mental health counselors, functional medicine doctors, etc.)
Collecting any information related to any previous abdominal or pelvic surgeries (laparoscopies, hysteroscopies, tubal ligation reversals, appendectomies, etc.)
A discussion regarding any other pelvic floor symptoms (bladder issues, bowel issues, chronic pain, fibroids, cysts…)
A check-in on how you’re coping with the stress that is a fertility journey
Addressing any other concerns or goals you may have!
One last note…our hormonal health and our fertility are not just about the goal of achieving a pregnancy. We are here to help you live a healthier life, no matter what your desired outcomes may be. PCOS? Endometriosis? Dysmenorrhea? Chronic pelvic or abdominal pain? Pain with sex? Let’s talk about it!
Kramp, Mary Ellen. "Combined Manual Therapy Techniques for the Treatment of Women With Infertility: A Case Series" Journal of Osteopathic Medicine, vol. 112, no. 10, 2012, pp. 680-684. https://doi.org/10.7556/jaoa.2012.112.10.680
Mussawar, Minhal, et al. “The Effect of Physical Activity on Fertility : A Mini-Review.” Fertil Steril Rep, vol. 4, no. 2, 2023, pp. 150–58,
doi:10.1016/j.xfre.2023.04.005.