What to expect at a women's health physiotherapy assessment
Written by Luiza, Women's Health Physiotherapist (POGP-registered) · Medically reviewed by Tommaso Luccarini, Osteopath & Physiotherapist (GOsC, HCPC, CSP) · Last reviewed: 4 August 2026
A women's health physiotherapy assessment starts with a detailed, private conversation about your symptoms and history, followed by a physical assessment, and any internal pelvic floor examination is optional and only carried out with your consent. The first appointment usually lasts about an hour. You will leave with a clear picture of what is going on and a plan to start on.
Most of the assessment is not what people fear. The conversation comes first: your concerns, your medical and, where relevant, gynaecological and birth history, your activity levels, and how symptoms affect your daily life. The physical part then looks at posture, breathing, core function and movement, because the pelvic floor works as part of a wider system rather than in isolation.
If you take one thing from this page, let it be this: the internal examination is always your choice. It is explained fully beforehand, only done with your consent, and it never has to happen at the first visit. There are other ways to assess the pelvic floor if you would prefer.
This guide walks through how to prepare, what the assessment involves, how the internal examination works and what it shows, and what happens afterwards.
Before your appointment: what to bring and how long it takes
Your first women's health physiotherapy appointment usually lasts about an hour; wear comfortable clothing and bring any scan results and a symptom list.
There is very little you need to do to prepare. Comfortable clothes you can move in are ideal. It helps to bring any relevant letters or imaging results, a short list of your main symptoms and how long you have had them, a list of any medications, and any questions you want answered. A bladder, bowel or symptom diary is useful to bring too.
You do not need a GP referral to book privately, though you should always see your GP or gynaecologist first for any new or unexplained pelvic pain, bleeding, or change in bladder or bowel habit, so that anything needing medical investigation is checked.
What a women's health physiotherapy assessment involves
The assessment begins with a private conversation about your symptoms and history, then a gentle physical check of posture, breathing, core and movement.
The conversation is the most important part, and it is simply talking. Your physiotherapist will ask about your current concerns, relevant medical and gynaecological history, pregnancy and birth history where appropriate, your exercise and activity levels, and the real-world impact your symptoms are having. You can say if there is anything you would rather not discuss, and you set the pace.
The physical assessment that follows is external and gentle. It typically looks at your posture, how you breathe, how your deep core and abdominal muscles are working, and how you move. These things matter because pelvic floor symptoms are often driven by patterns elsewhere, so the assessment builds a whole-body picture. If you are new to this, our overview of women's health physiotherapy explains what the service covers.
The internal examination: your choice, and what it shows
An internal pelvic floor examination is always optional and consent-based; when agreed, it shows whether the muscles are tight, weak or holding trigger points.
This is the part most people worry about, so it is worth being clear. An internal vaginal assessment can give the most detailed information about how the pelvic floor is working, but it is never a requirement. It is explained in full beforehand, only carried out if you are comfortable proceeding, and consent is ongoing, so you can pause or stop at any point for any reason. It does not have to be part of the first appointment, and it can be arranged for a later visit or declined altogether while you still receive treatment. Our service follows POGP assessment guidance on this.
When you do agree to it, the value is in what it reveals. Rather than assuming the pelvic floor is weak, the assessment shows whether it is actually overactive and tight, whether it can relax as well as contract, and whether there are tender trigger points referring pain. That distinction changes everything about your plan: an overactive pelvic floor needs down-training and release, not more squeezes, and getting that right is often why symptoms finally shift.
After the assessment: your plan and our integrated approach
After the assessment you get a clear, personalised plan, and because the clinic is integrated, the same visit can screen the back, hips and breathing.
Following the assessment, your physiotherapist talks you through the findings and you agree the next steps together. You leave with initial advice and exercises tailored to you, so you can start straight away rather than wait. Our women's health physiotherapy service is led by Luiza, a POGP-registered specialist, and the plan is built around your goals.
Because Complement brings physiotherapy, osteopathy and Pilates together, that first visit can also take account of the back, hips, breathing and posture that so often feed pelvic symptoms, through our integrated approach. Where your symptoms point to something outside the remit of physiotherapy, or need gynaecological investigation, we will say so and help you get to the right service rather than press on regardless.
Common questions
Do I have to have an internal examination?
No. An internal pelvic floor examination is always optional. It is explained fully beforehand and only carried out with your consent, and it does not have to happen at your first appointment. If you would rather not, there are other ways to assess the pelvic floor, and you can still be treated. You stay in control at every step.
Will the assessment hurt?
It should not. The conversation is simply talking, and the physical assessment is gentle. If you consent to an internal examination it may feel unusual, but it should not be painful, and you can pause or stop at any point. Tell your physiotherapist about any pain as you go, so they can adjust.
What should I wear and bring to my first appointment?
Wear comfortable clothing you can move in. It helps to bring any relevant letters or scan results, a list of your symptoms and medications, and any questions you want to ask. If an internal assessment is planned and you agree to it, you will be given privacy and a cover, and the room is kept secure.
Can I have the assessment if I am on my period?
Usually yes for the conversation and most of the physical assessment. An internal examination is often more comfortable on another day, so it can simply be arranged for a later visit if you prefer. Let the clinic know when you book, and the appointment can be planned around what suits you.
Do I need a GP referral?
Not for private care. You can book a women's health physiotherapy assessment directly. You should still see your GP first for any new or unexplained pelvic pain, bleeding, or a change in bladder or bowel habit, so anything needing medical investigation is checked before rehabilitation begins.
How long is the first appointment?
The initial assessment usually lasts about an hour. That allows time for a thorough history, a physical assessment, a discussion of the findings, and the start of a plan with initial advice and exercises. You should leave understanding what is going on and what the next steps are.
About the author
Luiza is a women's health physiotherapist at Complement Osteo & Physio in Islington, registered with the POGP (Pelvic, Obstetric and Gynaecological Physiotherapy), the UK professional body for pelvic health. She carries out women's health assessments with a consent-first approach, following POGP guidelines, and treats pelvic floor dysfunction, pelvic pain, and pregnancy and postnatal concerns. Read more about Luiza and the team.
Book your session at our Islington clinic
If you have been putting off getting help, an assessment is a calm, no-pressure first step. Our clinic is at Highbury Grove in N5, a short walk from Highbury & Islington station and easily reached from Angel, Canonbury and Barnsbury. Your first session includes a full history, an assessment carried out entirely with your consent, and a clear plan to work with between visits. We accept most major insurance providers and offer multi-session packages.
