Personal Physical Therapy Services: Women's Health & Orthopedic Care

11/11/2025

Wow! I love Dr Rachel Rubin! A fierce advocate for women! Women’s health is having a moment! And as a women’s health/ pelvic health physical therapist provider, this is such an exciting time!!! Women’s health issues have been neglected but that’s changing a little every day. Recognition, validation for symptoms & suffering, and treatment options; that is something to be excited about!

11/10/2025

Wow. Progress toward safe and effective treatments options with less fear to help women address urogenital syndrome of menopause (GSM). Women are suffering with urinary leakage, serious UTIs, and vulvovaginal changes that can lead to pain with sexual activity. Vaginal estrogen is a safe option for most women with GSM, or even Genitourinary Syndrome of Lactation (nursing mommas can have the same symptoms, due to decreased estrogen during the time they nurse). Ask for help if you are suffering with any of these issues, you can get help from your gynecologist, urologist, even your primary care possibly AND of course PT can be very helpful to address pelvic floor dysfunction.

The Food and Drug Administration will remove the "black box" warning from hormone replacement therapy (HRT) products for menopause.

08/16/2025

There is truth to this. Women coming to physical therapy at this clinic will get information and treatment to add quality to your life, empower you to make decisions about your medical care and have effective discussions with your providers.

08/07/2025

Pelvic floor physical therapy can be a solution to many symptoms. Reach out for help.

06/29/2025

The office is currently closed from Friday June 27 until approximately August 4th while I am out for surgery and a period of recovery, please call and leave a detailed message with your name, number, and reason for calling. If you would like schedule as a new patient please leave your name, who referred you for PT, what insurance you have, and what type of condition you are looking for treatment.

All messages will be responded to starting July 16th, via phone call, texting or email for approximately the last 2 weeks of July including scheduling new patients. I anticipate easing back into office hours starting August 4th.

Please call 540-450-0680 to leave a viicemail, OR send an email to info@ptservices.net. You may also text the office line 540-645-6741.

Thank you for your patience during this time.

I look forward to the opportunity to provide you with quality, personalized care in August.

06/27/2025

GSM. Genitourinary Syndrome of Menopause. Know the term. Know there’s treatment help available. Call your doctor. Call your PT.

05/19/2025

A sharp acceleration in loss of strength begins in our 40s—and it’s not just aging. It’s menopause.

The menopause transition is a critical intervention window and we must treat it as such. Strength isn’t vanity. It’s longevity.

Study: O’Bryan et al. 2025, *The Journal of Physiology

We’ve been told that muscle loss is just a natural part of aging. But a new study shows that for women, the story is very different—and it starts sooner than we think.

This landmark paper followed women ages 18 to 80 and mapped their neuromuscular function decade by decade—including strength, power, muscle composition, and hormone levels.

What did they find?

A sharp acceleration in loss of strength begins in our 40s—and it’s not just aging. It’s menopause.

Researchers found that:
• Muscle loss is driven by peripheral changes—meaning the muscle itself is deteriorating, not just the nerves
• The quadriceps are especially vulnerable, impacting walking, balance, and independence
• Hormonal changes—declines in estradiol, progesterone, and testosterone—were directly linked to loss of strength and power
• Factors like protein intake, activity levels, and body composition play a role, but hormones were consistently part of the picture

This study finally names what so many of us feel: something shifts during menopause, and it changes how we move, perform, and live.

We can’t afford to ignore this. Not as women. Not as doctors. Not as a society that cares about healthy aging.

The menopause transition is a critical intervention window and we must treat it as such. Strength isn’t vanity. It’s longevity.

Thank you to my friend for sending me this paper.
Study: O’Bryan et al. 2025, *The Journal of Physiology

05/13/2025

You are not alone. There are treatment options. Pelvic Floor Physical Therapy is an important part of the healing process.

05/10/2025

You can get better with the right help

04/05/2025

Another unfortunate example of women being rather dismissed regarding concerning symptoms multiple times. In this situation, this young, postpartum momma was ultimately diagnosed with later stage colon cancer. Ladies listen to your instincts and keep advocating for yourself if you feel your concerns aren’t being listened to. In her case bleeding with bowel movements, pain, 30lb weight loss are all “red flags” and a simple colonoscopy recommendation would have found this cancer much sooner!

03/19/2025

Estrogen matters to so many areas of our health. This is a term, and condition that all women should be familiar with. If you are performing menopausal or menopausal and are having more unusual aches and pains, it might be musculoskeletal syndrome of menopause. Talk with your doctor to see if you would benefit from hormone therapy, and seek out the help of a women’s health PT.

03/08/2025

Mental health matters in perimenopause and menopause, and hormone therapy can directly benefit depression during this period.

Menopausal Depression: A Distinct, Hormone-Driven Condition

Menopausal depression is biologically different from traditional depression, and growing research confirms that fluctuating hormones during perimenopause directly impact brain chemistry — often years before physical symptoms like hot flashes even begin.

🔬 During the menopause transition, fluctuating estrogen and progesterone disrupt serotonin, dopamine, and GABA signaling, particularly in brain areas involved in mood regulation, memory, and stress response. Estrogen, for example, helps regulate serotonin receptor density, serotonin transport, and dopamine function — all of which decline as hormone levels drop. This creates a perfect neurochemical storm, increasing the risk of anxiety, irritability, depression, and cognitive struggles.

📉 Lower DHEA-S levels — an adrenal hormone that also supports GABA and serotonin signaling — are linked to higher rates of depression in midlife women, compounding the effects of estrogen decline.

⚠️ Unlike typical major depressive disorder, menopausal depression is directly tied to these hormonal disruptions — which is why SSRIs alone often fail in this population. Several studies have shown that adding estradiol to antidepressants enhances their efficacy, and in some cases, transdermal estradiol alone significantly improves depressive symptoms.

💊 Current guidelines from major menopause societies still recommend SSRIs as first-line treatment, despite mounting evidence that hormone therapy (MHT) — particularly transdermal estradiol with micronized progesterone — directly addresses the hormonal root cause of menopausal depression.

Menopausal depression is real, biological, and treatable — but it requires a fundamentally different approach than standard depression care.

📖 Reference: Kulkarni et al., 2024, Frontiers in Psychiatry