◈ Homepage — https://pelvicpainrehab.com/locations/berkeley/Skip to content Open toolbar Accessibility Tools Increase Text Decrease Text Grayscale High Contrast Negative Contrast Light Background Links Underline Readable Font Reset HOME ABOUT OUR SERVICES LOCATIONS BLOG FOR PATIENTS CAREERS VIRTUAL SERVICES CONTACT US 2855 Telegraph Avenue, Ste 301, Berkeley, CA 94705 Phone: (510) 922-9836 Fax: (510) 922-9949 Hours: Mon-Fri 8am – 5pm Email: [email protected] CALL US BOOK YOUR APPOINTMENT NOW Services Male Pelvic Pain Female Pelvic Pain Pregnancy & Postpartum Pelvic Organ Prolapse Bladder Dysfunction Pudendal Neuralgia Pelvic Floor Physical and Occupational Therapy Perimenopause / Menopause Bowel Dysfunction Sexual Dysfunction Surgical Prehab and Rehab Transgender Health Services Interstitial Cystitis Endometriosis Hard Flaccid Clitoral Pain Treatment PHRC Pelvic Floor Therapists in Berkeley, CA FAQ What are pelvic floor muscles? The pelvic floor muscles are a group of muscles that run from the coccyx to the pubic bone. They are part of the core, helping to support our entire body as well as providing support for the bowel, bladder and uterus. These muscles help us maintain bowel and bladder control and are involved in sexual pleasure and orgasm. The technical name of the pelvic floor muscles is the Levator Ani muscle group. The pudendal nerve, the levator ani nerve, and branches from the S2 – S4 nerve roots innervate the pelvic floor muscles. They are under voluntary and autonomic control, which is a unique feature only they possess compared to other muscle groups. What is pelvic floor physical and occupational therapy? Pelvic floor physical and occupational therapy is a specialized area of physical and occupational therapy. Currently, physical and occupational therapistss need advanced post-graduate education to be able to help people with pelvic floor dysfunction because pelvic floor disorders are not yet being taught in standard physical and occupational therapy curricula. The Pelvic Health and Rehabilitation Center provides extensive training for our staff because we recognize the limitations of physical and occupational therapy education in this unique area. What happens at pelvic floor therapy? During an evaluation for pelvic floor dysfunction the physical and occupational therapists will take a detailed history. Following the history the physical and occupational therapists will leave the room to allow the patient to change and drape themselves. The physical and occupational therapists will return to the room and using gloved hands will perform an external and internal manual assessment of the pelvic floor and girdle muscles. The physical and occupational therapists will once again leave the room and allow the patient to dress. Following the manual examination there may also be an examination of strength, motor control, and overall biomechanics and neuromuscular control. The physical and occupational therapists will then communicate the findings to the patient and together with their patient they establish an assessment, short term and long term goals and a treatment plan. Typically people with pelvic floor dysfunction are seen one time per week for one hour for varying amounts of time based on the severity and chronicity of the disease. A home exercise program will be established and the physical and occupational therapists will help coordinate other providers on the treatment team. Typically patients are seen for 3 months to a year. What is pudendal neuralgia and how is it treated? Pudendal Neuralgia is a clinical diagnosis that means pain in the sensory distribution of the pudendal nerve. The pudendal nerve is a mixed nerve that exits the S2 – S4 sacral nerve roots, we have a right and left pudendal nerve and each side has three main trunks: the dorsal branch, the perineal branch, and the inferior rectal branch. The branches supply sensation to the clitoris/penis, labia/scrotum, perineum, anus, the distal ⅓ of the urethra and rectum, and the vulva and vestibule. The nerve branches also control the pelvic floor muscles. The pudendal nerve follows a tortuous path through the pelvic floor and girdle, leaving it vulnerable to compression and tension injuries at various points along its path. Pudendal Neuralgia occurs when the nerve is unable to slide, glide and move normally and as a result, people experience pain in some or all of the above-mentioned areas. Pelvic floor physical and occupational therapy plays a crucial role in identifying the mechanical impairments that are affecting the nerve. The physical and occupational therapy treatment plan is designed to restore normal neural function. Patients with pudendal neuralgia require pelvic floor physical and occupational therapy and may also benefit from medical management that includes pharmaceuticals and procedures such as pudendal nerve blocks or botox injections. What is interstitial cystitis and how is it treated? Interstitial Cystitis is a clinical diagnosis characterized by irritative bladder symptoms such as urinary urgency, frequency, and hesitancy in the absence of infection. Research has shown the majority of patients who meet the clinical definition have pelvic floor dysfunction and myalgia. Therefore, the American Urologic Association recommends pelvic floor physical and occupational therapy as first-line treatment for Interstitial Cystitis. Patients will benefit from pelvic floor physical and occupational therapy and may also benefit from pharmacologic management or medical procedures such as bladder instillations. Who is the Pelvic Health and Rehabilitation Team? The Pelvic Health and Rehabilitation Center was founded by Elizabeth Akincilar and Stephanie Prendergast in 2006, they have been treating people with pelvic floor disorders since 2001. They were trained and mentored by a medical doctor and quickly became experts in treating pelvic floor disorders. They began creating courses and sharing their knowledge around the world. They expanded to 11 locations in the United States and developed a residency style training program for their employees with ongoing weekly mentoring. The physical and occupational therapistss who work at PHRC have undergone more training than the majority of pelvic floor physical and occupational therapistss and as a result offer efficient and high quality care. How many years of experience do we have? Stephanie and Liz have 24 years of experience and help each and every team member become an expert in the field through their training and mentoring program. Why PHRC versus anyone else? PHRC is unique because of the specific focus on pelvic floor disorders and the leadership at our company. We are constantly lecturing, teaching, and staying ahead of the curve with our connections to medical experts and emerging experts. As a result, we are able to efficiently and effectively help our patients restore their pelvic health. Do we treat men for pelvic floor therapy? The Pelvic Health and Rehabilitation Center is unique in that the Cofounders have always treated people of all genders and therefore have trained the team members and staff the same way. Many pelvic floor physical and occupational therapistss focus solely on people with vulvas, this is not the case here. Do I need pelvic floor therapy forever? The majority of people with pelvic floor dysfunction will undergo pelvic floor physical and occupational therapy for a set amount of time based on their goals. Every 6 -8 weeks goals will be re-established based on the physical improvements and remaining physical impairments. Most patients will achieve their goals in 3 – 6 months. If there are complicating medical or untreated comorbidities some patients will be in therapy longer. Office information Realizing the need for pelvic health services and the difficulty of crossing the Bay Bridge to San Francisco, Liz and Stephanie opened their second location in the East Bay in 2010. We are conveniently located minutes from highways 24, 80, 580 and 880 making us easily accessible from anywhere in Berkeley and Oakland. We are a short walk from the Ashby BART station, or you can reach us via the MacArthur BART station and take the free Alta Bates Hospital Shuttle Bus to the Alta Bates Medical Campus which is one block from PHRC. There is also a AC Transit bus stop in front of our building as well as bus lines 6, 80, and 81 within a short walking distance to our office. There is hourly parking available in our building parking lot as well as metered street parking. CONTACT US Copyright © 2026 PHRC. All Rights Reserved. Our Services Locations Media Careers Contact Privacy Policy Terms of Service d d d d d d d Sign up for the Newsletter ◈ Interior Pages — 3 pages crawledFemale Pelvic Pain Berkeley: Tailored Therapy | PHRC Home About Our Story Meet the PHRC Team Our Services Female Pelvic Pain Interstitial Cystitis Pudendal Neuralgia Pregnancy and Postpartum Pelvic Organ Prolapse Bladder Dysfunction Bowel Dysfunction Chronic Prostatitis/ Chronic Pelvic Pain Syndrome Clitoral Pain Endometriosis Surgical Prehab and Rehab Transgender Health Services Male Pelvic Pain Pediatric Pelvic Floor Therapy Out-Of-Town Patient Programs Pelvic Floor Physical and Occupational Therapy Digital Health Hard Flaccid Perimenopause / Menopause Testicular Pain Ehlers-Danlos Syndrome Pelvic Floor Therapy for Erectile Dysfunction Pelvic Floor Therapy for Tailbone Pain Locations Blog For Patients New Patient Packets eBooks Insurance Careers Virtual Services Bladder Dysfunction Bowel Dysfunction Endometriosis Female Pelvic Pain Hard Flaccid Interstitial Cystitis Male Pelvic Pain Pediatric Pelvic Floor Therapy Pelvic Health Physical and Occupational Therapy Pelvic Organ Prolapse Perimenopause/Menopause Pregnancy and Postpartum Professional Mentorship Pudendal Neuralgia Sexual Dysfunction Surgical Prehab and Rehab Transgender Health Services Contact Us Female Pelvic Pain Physical and Occupational Therapy Berkeley Research reveals that pelvic pain caused by pelvic floor dysfunction affects one in three women at some point during their lives. While some of these symptoms may seem common, they are never normal and pelvic floor physical and occupational therapy can help! CONTACT US BOOK VIRTUAL APPOINTMENT NOW Female Pelvic Pain Physical and Occupational Therapy Berkeley CONTACT US BOOK VIRTUAL APPOINTMENT NOW Symptoms Pelvic pain generally refers to burning, itching, aching or other types of pain in the vulva, vagina, perineal, and/or anal area Women with pelvic pain often suffer from pain with intercourse, may experience hypersensitivity when wearing pants and/or underwear, and may have pain with sitting Exercise may provoke or exacerbate symptoms In addition to pelvic pain, women can also experience urinary urgency, frequency, pain with urinating, and/or urinary leakage Women may suffer from abdominal bloating, gastrointestinal distress, and constipation Symptoms can be provoked, meaning with penetrative intercourse or tampon insertion, or unprovoked and spontaneous Symptoms can be intermittent or constant Research reveals that pelvic pain caused by pelvic floor dysfunction affects one in three women at some point during their lives. While some of these symptoms may seem common, they are never normal and pelvic floor physical and occupational therapy can help! Symptoms Pelvic pain generally refers to burning, itching, aching or other types of pain in the vulva, vagina, perineal, and/or anal area Women with pelvic pain often suffer from pain with intercourse, may experience hypersensitivity when wearing pants and/or underwear, and may have pain with sitting Exercise may provoke or exacerbate symptoms In addition to pelvic pain, women can also experience urinary urgency, frequency, pain with urinating, and/or urinary leakage Women may suffer from abdominal bloating, gastrointestinal distress, and constipation Symptoms can be provoked, meaning with penetrative intercourse or tampon insertion, or unprovoked and spontaneous Symptoms can be intermittent or constant Associated Diagnoses Diagnoses such as Endometriosis, Vulvodynia, Interstitial Cystitis/Painful Bladder Syndrome, Pudendal Neuralgia, Lichen Sclerosus, Lichen Planus, and Irritable Bowel Syndrome are associated with pelvic pain and pelvic floor dysfunction. Causes of Pelvic Pain Repetitive vaginal and/or bladder infections and/or gynecologic, urologic, dermatologic or gastrointestinal conditions The majority of women with pelvic pain have pelvic floor dysfunction Prescription medications such as oral contraceptives, acne medications, and hormonal suppressive therapies for diseases such as Endometriosis and Polycystic Ovarian Syndrome (PCOS) Surgical trauma (childbirth, pelvic organ prolapse repair, hysterectomy) Orthopedic injuries or traumas Biomechanical or structural dysfunction (hip dysfunction, sacro-iliac joint dysfunction, piriformis syndrome, scoliosis, leg length discrepancy) Vaginal childbirth Menopause Genital cutting or genital mutilation Symptoms Repetitive vaginal and/or bladder infections and/or gynecologic, urologic, dermatologic or gastrointestinal conditions The majority of women with pelvic pain have pelvic floor dysfunction Prescription medications such as oral contraceptives, acne medications, and hormonal suppressive therapies for diseases such as Endometriosis and Polycystic Ovarian Syndrome (PCOS) Surgical trauma (childbirth, pelvic organ prolapse repair, hysterectomy) Orthopedic injuries or traumas Biomechanical or structural dysfunction (hip dysfunction, sacro-iliac joint dysfunction, piriformis syndrome, scoliosis, leg length discrepancy) Vaginal childbirth Menopause Genital cutting or genital mutilation Diagnostic Challenges Research shows that it can take up to five years for women with pelvic pain to get a proper diagnosis and up to 11 years for a woman with Endometriosis. This is because the symptoms of pelvic pain can mimic conditions such as urinary tract, yeast, bladder and sexually transmitted infections. When the pelvic floor is the culprit, the diagnostic tests for these infections are negative, leading to confusion for both the medical provider and the patient. Many medical providers are not aware that pelvic floor dysfunction can cause pelvic pain and it certainly does not occur to women to go to physical and occupational therapy when these symptoms arise. The majority of our patients tell us they did not know they even had a pelvic floor until things started to go wrong! Diagnostic Challenges Research shows that it can take up to five years for women with pelvic pain to get a proper diagnosis and up to 11 years for a woman with Endometriosis. This is because the symptoms of pelvic pain can mimic conditions such as urinary tract, yeast, bladder and sexually transmitted infections. When the pelvic floor is the culprit, the diagnostic tests for these infections are negative, leading to confusion for both the medical provider and the patient. Many medical providers are not aware that pelvic floor dysfunction can cause pelvic pain and it certainly does not occur to women to go to physical and occupational therapy when these symptoms arise. The majority of our patients tell us they did not know they even had a pelvic floor until things started to go wrong! Treatment: How We Can Help You Women experiencing pelvic pain can benefit from an evaluation with a pelvic floor physical and occupational therapists specializing in pelvic pain. During the evaluation, the physical and occupational therapists reviews your history and symptoms with you, what you have been diagnosed with in the past, the treatments you have undergone and how effective or not effective these treatments have been. Importantly, we understand what you have been going through and that most women are frustrated by the time they get to see us. During the physical examination the physical and occupational therapists examines muscles, tissues, joints, nerves, and movement patterns. Once your physical and occupational therapists completes the examination they review your findings with you. The physical and occupational therapists creates an assessment which explains how you developed pain and creates short and long-term goals for your treatment plan. Typically, the frequency of physical and occupational therapy treatment is one to two times per week for roughly 12 weeks. You are given a home exercise program to compliment your in-person sessions, and your physical and occupational therapists will help to coordinate your recovery with the other members of your treatment team. We are here to help you recover and live your best life! CONTACT US Treatment: How We Can Help You Women experiencing pelvic pa Sexual Dysfunction Berkeley: Innovative Care | PHRC Home About Our Story Meet the PHRC Team Our Services Female Pelvic Pain Interstitial Cystitis Pudendal Neuralgia Pregnancy and Postpartum Pelvic Organ Prolapse Bladder Dysfunction Bowel Dysfunction Chronic Prostatitis/ Chronic Pelvic Pain Syndrome Clitoral Pain Endometriosis Surgical Prehab and Rehab Transgender Health Services Male Pelvic Pain Pediatric Pelvic Floor Therapy Out-Of-Town Patient Programs Pelvic Floor Physical and Occupational Therapy Digital Health Hard Flaccid Perimenopause / Menopause Testicular Pain Ehlers-Danlos Syndrome Pelvic Floor Therapy for Erectile Dysfunction Pelvic Floor Therapy for Tailbone Pain Locations Blog For Patients New Patient Packets eBooks Insurance Careers Virtual Services Bladder Dysfunction Bowel Dysfunction Endometriosis Female Pelvic Pain Hard Flaccid Interstitial Cystitis Male Pelvic Pain Pediatric Pelvic Floor Therapy Pelvic Health Physical and Occupational Therapy Pelvic Organ Prolapse Perimenopause/Menopause Pregnancy and Postpartum Professional Mentorship Pudendal Neuralgia Sexual Dysfunction Surgical Prehab and Rehab Transgender Health Services Contact Us Pelvic Floor Physical and Occupational Therapy for Sexual Dysfunction Berkeley CONTACT US BOOK VIRTUAL APPOINTMENT NOW Pelvic Floor Physical and Occupational Therapy for Sexual Dysfunction Berkeley CONTACT US BOOK VIRTUAL APPOINTMENT NOW Sexual dysfunction is defined as persistent, recurrent difficulty with sexual response, desire, orgasm, or pain. The pelvic floor muscles are intimately involved in sexual function. In men, they help maintain the rigidity of an erection, and in both sexes, they rapidly and repetitively contract during orgasm, and under normal circumstances, they do not hurt before, during, or after sexual activity and are a source of pleasure for people. When pelvic floor dysfunction arises sexual pleasure is often replaced with pain and loss of normal function. The symptoms are understandably distressing for people, but the good news is, pelvic floor physical and occupational therapy can help. The Facts One in three premenopausal women will experience painful sex at some point during her life 15 -72% of men under 40 years old report symptoms of erectile dysfunction 52% of men aged 40 -70 years old experience mild to moderate erectile dysfunction Up to 80% of men have erectile dysfunction after prostatectomy 60% of women in menopause do not report painful sex to their doctors because they are embarassed Medications such as oral contraceptive pills and acne medications can cause vulvar pain and decreased ability to naturally lubricate 65% of postpartum women still experience painful sex 18 months after delivery Sexual dysfunction is defined as persistent, recurrent difficulty with sexual response, desire, orgasm, or pain. The pelvic floor muscles are intimately involved in sexual function. In men, they help maintain the rigidity of an erection, and in both sexes, they rapidly and repetitively contract during orgasm, and under normal circumstances, they do not hurt before, during, or after sexual activity and are a source of pleasure for people. When pelvic floor dysfunction arises sexual pleasure is often replaced with pain and loss of normal function. The symptoms are understandably distressing for people, but the good news is, pelvic floor physical and occupational therapy can help. The Facts One in three premenopausal women will experience painful sex at some point during her life 15 -72% of men under 40 years old report symptoms of erectile dysfunction 52% of men aged 40 -70 years old experience mild to moderate erectile dysfunction Up to 80% of men have erectile dysfunction after prostatectomy 60% of women in menopause do not report painful sex to their doctors because they are embarassed Medications such as oral contraceptive pills and acne medications can cause vulvar pain and decreased ability to naturally lubricate 65% of postpartum women still experience painful sex 18 months after delivery Symptoms *Sexual Dysfunction in people with a penis Erectile dysfunction: poor quality, inability to achieve erection, inability to maintain erection, premature ejaculation Decreased force or inability to ejaculate Climacturia (incontinence with orgasm) Post ejaculaory pain: tip and/or shaft of penis, perineum, scrotum Discoloration in penis/scrotum/perineum Postpartum Sexual Dysfunction Decreased lubrication during breastfeeding Perineal pain with touch from episiotomy or perineal trauma Diminished or absent orgasm Incontinence during orgasm or intercourse Painful sex *Sexual Dysfunction in people with vulvas/vaginas Inability or decreased ability to lubricate Pain upon vaginal penetration, with deep penetration only, and/or continuous pain with penetration Clitoral pain, hypersensitivity to touch Pain and/or burning after sexual contact Inability to orgasm, diminished orgasm Urinary incontinence during sexual activity Climacturia (incontinence with orgasm) Menopausal Sexual Dysfunction and Post-gynecologic cancer treatment Decreased ability to lubricate Inability to achieve or difficulty with vaginal penetration Painful sex: during and/or after Diminished or absent orgasm Symptoms *Sexual Dysfunction in people with a penis Erectile dysfunction: poor quality, inability to achieve erection, inability to maintain erection, premature ejaculation Decreased force or inability to ejaculate Climacturia (incontinence with orgasm) Post ejaculaory pain: tip and/or shaft of penis, perineum, scrotum Discoloration in penis/scrotum/perineum *Sexual Dysfunction in people with vulvas/vaginas Inability or decreased ability to lubricate Pain upon vaginal penetration, with deep penetration only, and/or continuous pain with penetration Clitoral pain, hypersensitivity to touch Pain and/or burning after sexual contact Inability to orgasm, diminished orgasm Urinary incontinence during sexual activity Climacturia (incontinence with orgasm) Postpartum Sexual Dysfunction Decreased lubrication during breastfeeding Perineal pain with touch from episiotomy or perineal trauma Diminished or absent orgasm Incontinence during orgasm or intercourse Painful sex Menopausal Sexual Dysfunction and Post-gynecologic cancer treatment Decreased ability to lubricate Inability to achieve or difficulty with vaginal penetration Painful sex: during and/or after Diminished or absent orgasm Associated Diagnoses Diagnoses such as Endometriosis, Vulvodynia, Interstitial Cystitis/Painful Bladder Syndrome, Pudendal Neuralgia, Chronic Pelvic Pain Syndrome/Male Pelvic Pain, Lichen Sclerosus, Lichen Planus, Pelvic Floor Dysfunction, post-prostatectomy complications, and Genitourinary Syndrome of Menopause are all associated with sexual dysfunction and pelvic pain. Associated Diagnoses Diagnoses such as Endometriosis, Vulvodynia, Interstitial Cystitis/Painful Bladder Syndrome, Pudendal Neuralgia, Chronic Pelvic Pain Syndrome/Male Pelvic Pain, Lichen Sclerosus, Lichen Planus, Pelvic Floor Dysfunction, post-prostatectomy complications, and Genitourinary Syndrome of Menopause are all associated with sexual dysfunction and pelvic pain. Causes of Sexual Dysfunction Pelvic pain syndromes associated with pelvic floor dysfunction (above) Childbirth Medications Obesity Cardiovascular disease Menopause Jelqing Genital mutilation, genital cutting Surgically-induced Pelvic Floor Reconstruction Prostatectomy Gender affirming surgery Episiotomy Vestibulectomy Pudendal Nerve Decompression Mesh excision Causes of Sexual Dysfunction Pelvic pain syndromes associated with pelvic floor dysfunction (above) Childbirth Medications Obesity Cardiovascular disease Menopause Jelqing Genital mutilation, genital cutting Surgically-induced Pelvic Floor Reconstruction Prostatectomy Gender affirming surgery Episiotomy Vestibulectomy Pudendal Nerve Decompression Mesh excision Diagnostic Challenges A recent study showed that the majority of medical providers are not comfort Effective Bladder Dysfunction Therapy in Berkeley | PHRC Home About Our Story Meet the PHRC Team Our Services Female Pelvic Pain Interstitial Cystitis Pudendal Neuralgia Pregnancy and Postpartum Pelvic Organ Prolapse Bladder Dysfunction Bowel Dysfunction Chronic Prostatitis/ Chronic Pelvic Pain Syndrome Clitoral Pain Endometriosis Surgical Prehab and Rehab Transgender Health Services Male Pelvic Pain Pediatric Pelvic Floor Therapy Out-Of-Town Patient Programs Pelvic Floor Physical and Occupational Therapy Digital Health Hard Flaccid Perimenopause / Menopause Testicular Pain Ehlers-Danlos Syndrome Pelvic Floor Therapy for Erectile Dysfunction Pelvic Floor Therapy for Tailbone Pain Locations Blog For Patients New Patient Packets eBooks Insurance Careers Virtual Services Bladder Dysfunction Bowel Dysfunction Endometriosis Female Pelvic Pain Hard Flaccid Interstitial Cystitis Male Pelvic Pain Pediatric Pelvic Floor Therapy Pelvic Health Physical and Occupational Therapy Pelvic Organ Prolapse Perimenopause/Menopause Pregnancy and Postpartum Professional Mentorship Pudendal Neuralgia Sexual Dysfunction Surgical Prehab and Rehab Transgender Health Services Contact Us Pelvic Floor Physical and Occupational Therapy for Bladder Dysfunction Berkeley CONTACT US BOOK VIRTUAL APPOINTMENT NOW Pelvic Floor Physical and Occupational Therapy for Bladder Dysfunction Berkeley CONTACT US BOOK VIRTUAL APPOINTMENT NOW The pelvic floor muscles play an important role in urinary function. Under normal circumstances, they provide support to the bladder, help us maintain continence, allow us to urinate when we want to, and for the most part, we don’t have to think about our bladder unless we have the urge to urinate. When pelvic floor muscles become dysfunctional symptoms can occur and the bladder can become a nuisance in our everyday lives. Bladder symptoms are quite common, but not normal, and pelvic floor physical and occupational therapy can help. The pelvic floor muscles play an important role in urinary function. Under normal circumstances, they provide support to the bladder, help us maintain continence, allow us to urinate when we want to, and for the most part, we don’t have to think about our bladder unless we have the urge to urinate. When pelvic floor muscles become dysfunctional symptoms can occur and the bladder can become a nuisance in our everyday lives. Bladder symptoms are quite common, but not normal, and pelvic floor physical and occupational therapy can help. Normal Bladder Function Normal urination frequency is six to eight times in a 24-hour period Leaking urine is never normal Bladder urge should not feel like a five-alarm fire Normal voiding time is roughly 20 seconds Starting the urinary stream should be easy and quick Bladder urgency should go away after voiding Increasing our fluid intake should increase the amount we urinate, not the frequency Normal bladder capacity is 300 – 600ml People under 60 years old may wake once per night to urinate, over 60 years old twice per night Pain before, during, or after urinating is never normal Normal Bladder Function Normal urination frequency is six to eight times in a 24-hour period Leaking urine is never normal Bladder urge should not feel like a five-alarm fire Normal voiding time is roughly 20 seconds Starting the urinary stream should be easy and quick Bladder urgency should go away after voiding Increasing our fluid intake should increase the amount we urinate, not the frequency Normal bladder capacity is 300 – 600ml People under 60 years old may wake once per night to urinate, over 60 years old twice per night Pain before, during, or after urinating is never normal Symptoms Stress incontinence (leaking urine when coughing, laughing, sneezing, and/or during exercise) Urge incontinence ( leaking on the way or before you get to the bathroom) Mixed Incontinence (both stress and urge incontinence) Pain or burning in the bladder and/or urethra before, during or after urinating Urinary urgency without a full bladder Urinary frequency without a full bladder Urinary hesitancy, slow or deviated urine stream Urinary urgency during sexual activity Urinary urgency/frequency after sexual activity or exercise Urethra or bladder pain Climacturia (leaking urine with orgasm) Symptoms Stress incontinence (leaking urine when coughing, laughing, sneezing, and/or during exercise) Urge incontinence ( leaking on the way or before you get to the bathroom) Mixed Incontinence (both stress and urge incontinence) Pain or burning in the bladder and/or urethra before, during or after urinating Urinary urgency without a full bladder Urinary frequency without a full bladder Urinary hesitancy, slow or deviated urine stream Urinary urgency during sexual activity Urinary urgency/frequency after sexual activity or exercise Urethra or bladder pain Climacturia (leaking urine with orgasm) Associated Diagnoses Bladder symptoms are commonly associated with pelvic floor dysfunction and other diagnoses. Syndromes such as Endometriosis, Vulvodynia, Interstitial Cystitis/Painful Bladder Syndrome, Pudendal Neuralgia, Chronic Pelvic Pain Syndrome/Male Pelvic Pain, post-prostatectomy complications, the Genitourinary Syndrome of Menopause, and postpartum women often have bladder issues. Associated Diagnoses Bladder symptoms are commonly associated with pelvic floor dysfunction and other diagnoses. Syndromes such as Endometriosis, Vulvodynia, Interstitial Cystitis/Painful Bladder Syndrome, Pudendal Neuralgia, Chronic Pelvic Pain Syndrome/Male Pelvic Pain, post-prostatectomy complications, the Genitourinary Syndrome of Menopause, and postpartum women often have bladder issues. Causes of Bladder Dysfunction Repetitive urinary tract and yeast infections Hormonal suppressive medications such as oral contraceptives, GnRH agonists (i.e. Lupron), acne medications Childbirth, breastfeeding, and menopause Surgical trauma Orthopedic injuries or traumas Biomechanical or structural dysfunction (hip dysfunction, sacro-iliac joint dysfunction, piriformis syndrome, scoliosis, leg length discrepancy) Pelvic floor dysfunction Pelvic organ prolapse Constipation and gastrointestinal distress/bloating Causes of Bladder Dysfunction Repetitive urinary tract and yeast infections Hormonal suppressive medications such as oral contraceptives, GnRH agonists (i.e. Lupron), acne medications Childbirth, breastfeeding, and menopause Surgical trauma Orthopedic injuries or traumas Biomechanical or structural dysfunction (hip dysfunction, sacro-iliac joint dysfunction, piriformis syndrome, scoliosis, leg length discrepancy) Pelvic floor dysfunction Pelvic organ prolapse Constipation and gastrointestinal distress/bloating Diagnostic Challenges Pelvic floor dysfunction can mimic the feelings of sexually transmitted infections and prostate and/or urinary tract and bladder infections which can lead to diagnostic confusion. It is common for people to feel certain they have an infection and then feel perplexed when the tests return normal. Bladder leaking is so common in women that it has become normalized, thereby making women less likely to seek help. Women are often told ‘it’s because you just had a baby’ or ‘it’s normal at your age’. Many men undergoing prostatectomy are not warned that up to 80% of men have post-surgical urinary incontinence. Regardless of your individual situation and underlying causes, an evaluation with a pelvic floor physical and occupational therapists is beneficial. Diagnostic Challenges Pelvic floor dysfunction can mimic the feelings of sexually transmitted infections and prostate and/or urinary tract and bladder infections which can lead to diagnostic confusion. It is common for people to feel certain they have an infection and then feel perplexed when the tests return normal. Bladder leaking is so common in women that it has become normalized, thereby making women less likely to seek help. Women are often told ‘it’s because you just had a baby’ or ‘