April 2024
Dr. Hannah Strom is a Pelvic Floor Physical Therapist and owns Awake Pelvic Health & Wellness, a physical therapy clinic located in Woodbury, MN. Her team of physical therapists specialize in helping individuals with pelvic floor conditions such as urinary leaking, pelvic pain, sexual dysfunction, prolapse, abdominal separation, low back pain, and hip pain. Dr. Hannah and her team also have a unique focus in helping women prepare for their birth and heal their pelvic floor and core after giving birth. Dr. Hannah is passionate about providing high quality and collaborative physical therapy care to help her patients live a better life.
1) How is your specialty impacted by the health of the microbiome?
I work with a wide variety of conditions and dysfunctions as a pelvic floor physical therapist. The pelvic floor, which consists of muscles, ligaments, and connective tissues, can be influenced by various factors including the microbiome. It is not uncommon for me to work with individuals who are struggling with urogenital conditions, chronic UTIs, pelvic pain, and vulvovaginal pain to have imbalances in the microbiome. That is why I believe it is so important that pelvic floor physical therapists are able to recognize and identify if their patients may have microbiome concerns.
2) What cases do you see that are impacted by imbalance in the microbiome?
The most common cases that I work with that are impacted imbalances in the microbiome include:
- Pelvic pain conditions, including: pelvic floor muscle dysfunction, interstitial cystitis, and vulvodynia. Imbalances in the microbiome can contribute to inflammation in the pelvic region, which may exacerbate these pelvic pain conditions. We make sure to address the underlying inflammation and drivers to pain, through interventions that support a healthy microbiome, such as vulvovaginal product recommendations (including Good Clean Love!), dietary modifications, supplementation, and referrals to specialty physicians. Improving the microbiome complements physical therapy efforts by reducing pain and improving treatment outcomes.
- Urinary Symptoms: Imbalances in the urogenital microbiome can contribute to urinary symptoms such as urinary urgency, frequency, and incontinence. Optimizing the urogenital microbiome through interventions such as avoiding irritants, using supportive vulvovaginal products, maintaining proper hygiene practices, and promoting healthy bacterial colonization may complement physical therapy efforts by reducing the risk of urinary tract infections (UTIs) and supporting urinary tract health.
- Sexual Dysfunction: Conditions affecting the vaginal microbiome, such as bacterial vaginosis (BV) or vulvovaginal candidiasis (VVC), can contribute to sexual dysfunction by causing vaginal discomfort, pain, or irritation. Many of our patients struggle with painful intercourse and vulvovaginal discomfort (including burning, stinging, and itching). We education on supporting vaginal health and microbial balance through interventions such as probiotic supplementation, vaginal pH regulation, and proper hygiene practices may complement physical therapy efforts by reducing vaginal symptoms and improving sexual comfort and function.
Pelvic floor physical therapy primarily focuses on addressing musculoskeletal dysfunction and promoting pelvic floor health, but interventions that support a healthy microbiome may indirectly enhance treatment outcomes by addressing underlying inflammation, optimizing bowel and bladder function, and improving vaginal and urinary tract health. In my work, I believe in a collaborative care model that integrates pelvic floor physical therapy with interventions targeting the microbiome to offer a comprehensive approach to managing pelvic floor conditions and optimizing pelvic health.
3) How does stabilizing the microbiome help to stabilize these issues?
Stabilizing and supporting the microbiome can enhance our pelvic floor physical therapy treatment outcomes by addressing underlying inflammation, improving vaginal pH, optimizing bladder function, and improving vaginal and urinary tract health. Taking a collaborative approach and integrating pelvic floor therapies and care for the microbiome, helps our patients have true, long lasting relief.
4) What are the most common conditions that you see in your practice?
The most common conditions that myself and my team see in my practice are bowel, bladder, and sexual function issues, pelvic pain conditions, and pregnancy and postpartum-related conditions. More specifically, we work with individuals struggling with urinary incontinence, pelvic organ prolapse, painful intercourse, chronic pelvic pain and vulvodynia, constipation and fecal incontinence issues, and tailbone pain.
5) What are the primary conditions that are referred to you by Ob/Gyns?
The primary conditions that are referred to us include: urinary incontinence, pelvic organ prolapse, painful intercourse, and musculoskeletal pain during pregnancy (such as hip, low back, or pelvic pain).