What is the role of pelvic floor physical therapy in genitourinary syndrome of menopause?

• A. Pelvic floor physical therapy has no effect on GSM.
• B. It worsens GSM symptoms.
• C. It is only used for urinary incontinence.
• D. Pelvic floor physical therapy improves GSM symptoms and sexual function.

Answer: (D)

Pelvic floor physical therapy helps genitourinary syndrome of menopause by addressing how the pelvic muscles function and how the pelvic tissues respond to estrogen loss. As menopause lowers estrogen, the vaginal lining becomes thinner and drier, and the supporting pelvic floor can develop tension or poor coordination. PFPT uses targeted exercises, manual therapy, and biofeedback to improve pelvic floor relaxation and strength, enhance blood flow to the pelvic tissues, and reduce pain with intercourse. This combination often alleviates GSM symptoms such as dryness-related discomfort and dyspareunia, and it can also improve urinary symptoms by teaching the pelvic floor to contract and relax in a balanced way. Because GSM is typically managed with multiple approaches, PFPT serves as an effective adjunct that can improve both GSM symptoms and sexual function, rather than being limited only to incontinence or having no effect.