If your bladder, bowels, or intimacy feel different than they used to, you are not alone. Pregnancy, childbirth, menopause, and pelvic surgery can change pelvic support, bladder control, bowel function, and sexual comfort. Many women notice urine leakage with activity, a vaginal bulge or pressure, pelvic pain, or dryness and discomfort that makes daily life and intimacy stressful instead of satisfying.
The good news: most of these concerns respond to thoughtful, evidence-based pelvic floor care. At Boston Urogyn, our urogynecology team helps you regain comfort and confidence with a plan tailored to your body and goals.
Below, you will learn what the pelvic floor is, which symptoms a urogynecologist treats, how pelvic organ prolapse and incontinence develop, who to see for evaluation, what to expect at your first visit, and the full range of non-surgical through minimally invasive options that can improve support, continence, and sexual function.
Boston Urogyn offers in-office therapies and minimally invasive procedures; learn more about our procedure options and scheduling at https://bostonurogyn.com/procedures/.
What the pelvic floor is and why it matters
The pelvic floor is a hammock of muscles, ligaments, and connective tissue that supports the bladder, uterus, vagina, and rectum. When the pelvic floor is strong and well-coordinated, it helps you:
- Stay continent when you cough, sneeze, laugh, or exercise
- Empty your bladder and bowels completely and comfortably
- Enjoy pain-free, satisfying sexual activity
- Support your pelvic organs so they do not bulge or drop
Pelvic floor problems are common and can result from a combination of:
- Stretch and micro-tears from childbirth that alter connective tissue and support
- Collagen and elastin decline with aging and menopause that lowers tissue firmness
- Estrogen deficiency that thins and dries tissues, called genitourinary syndrome of menopause
- Pelvic floor muscle weakness or over-tightening that disrupts support and coordination
- Prior pelvic surgery or trauma
- Chronic coughing, heavy lifting, or constipation that increases pressure on the pelvic floor
These changes are not your fault. They are medical issues that deserve the same attention as heart or bone health.
Common pelvic floor and urogynecology conditions
Urogynecology focuses on female pelvic floor disorders. Common conditions include:
- Stress urinary incontinence – leakage with coughing, laughing, exercise, or sudden movements
- Urge incontinence / overactive bladder – strong, sudden urges to urinate and possible leakage
- Mixed incontinence – a combination of stress and urge leakage
- Pelvic organ prolapse – bulging or dropping of the bladder, uterus, or rectum into the vagina
- Fecal incontinence or difficulty with bowel control
- Painful bladder or interstitial cystitis
- Pelvic pain, painful intercourse, and pelvic floor muscle spasm
- Vaginal atrophy and dryness related to menopause
These conditions often overlap. A focused evaluation helps identify which issues are present and how they are connected.
Pelvic organ prolapse and incontinence: how they differ
Pelvic organ prolapse is a structural descent of pelvic organs into or through the vagina. Incontinence is a problem with bladder or bowel control.
Typical prolapse symptoms:
- A bulge at the vaginal opening or pressure that worsens late in the day
- Difficulty inserting tampons or feeling something “falling out”
- Trouble emptying the bladder or bowels, or needing to splint (press on the vagina or perineum) to empty
Typical incontinence symptoms:
- Leakage with coughing, sneezing, running, or lifting (stress incontinence)
- Sudden, hard-to-delay urges to urinate, with or without leakage (urge incontinence)
- Frequent urination, including waking multiple times at night
You can have both prolapse and incontinence. A urogynecologist can distinguish between them, explain why they are happening, and guide the right plan.
If you suspect prolapse or incontinence, see our overview of treatment options to understand non-surgical and surgical pathways at Boston Urogyn’s prolapse and incontinence services pages.
Why choose a urogynecologist for pelvic floor care
A urogynecologist is a fellowship-trained specialist in female pelvic floor disorders. Compared with general OB/GYNs or purely cosmetic providers, a urogynecology team prioritizes function, continence, pelvic comfort, and safety while using evidence-based therapies.
Reasons to choose Boston Urogyn:
- Function-first, medically supervised care
- Accurate diagnosis of overlapping issues, including pelvic pain, prolapse, and incontinence
- Access to a full spectrum of options, from pelvic floor physical therapy and medications to in-office energy-based therapies and minimally invasive surgery when appropriate
- Clinical research access and outcomes monitoring for selected therapies
If you need a discreet, expert evaluation, you can book a urogynecology consultation without a referral in most cases.
Your first pelvic floor / urogynecology visit at Boston Urogyn
Expect a kind, confidential, and efficient experience designed to get you answers quickly.
- Private history and symptom review, including bladder, bowel, and sexual function screening and a gentle discussion of your goals
- Focused pelvic exam to assess tissue health, support, and pelvic floor tone
- When indicated, bladder testing, pelvic floor evaluation, and targeted imaging
- Review of pregnancy, childbirth, surgical, and menopause history, plus medications and lifestyle factors
- Personalized plan that starts with conservative measures and advances as needed
Many women appreciate being heard and leaving with a clear next step rather than a wait-and-see approach.
Non-surgical pelvic floor treatments that improve support, comfort, and control
Your plan may combine the following:
Pelvic floor rehabilitation
Specialized pelvic floor physical therapy can recondition deep muscles for better support, continence, and comfort. Biofeedback-guided programs help you recruit the right muscles, coordinate breathing with movement, and avoid over-tightening.
Therapy can address:
- Stress urinary incontinence
- Urge incontinence and overactive bladder
- Prolapse-related pressure and support
- Pelvic pain and painful intercourse from muscle spasm
Home strategies and medical therapy
A structured home program complements PT and may include:
- Targeted exercises prescribed by your therapist
- Bladder training to space out trips to the bathroom
- Hydration guidance and avoidance of bladder irritants like caffeine or artificial sweeteners
- Bowel strategies to reduce straining and constipation
- Local vaginal estrogen or broader hormone therapy, when appropriate, to restore moisture, pH, and tissue quality
- Lubricants and long-acting vaginal moisturizers to reduce friction and micro-tears during intimacy
Energy-based and regenerative therapies
For selected pelvic floor and vaginal health concerns, our team may recommend the most cutting edge in-office energy-based or regenerative therapies as part of a broader plan:
- ThermiVa radiofrequency therapy gently heats tissue to stimulate collagen remodeling, which can improve vaginal support, moisture, and mild stress leakage with little to no downtime.
- MonaLisa Touch fractional CO2 laser targets vulvovaginal atrophy and dryness, often improving lubrication and comfort. We typically recommend several days before resuming intercourse.
- SoLá Pelvic Therapy is a low-level laser approach used for pelvic pain and healing that may also enhance local circulation and tissue recovery. Practice materials note many patients feel improvement within about two weeks; a money-back guarantee is referenced in our SoLá program materials.
Our urogynecology team will help you decide whether these advanced therapies fit your situation, set realistic expectations, and ensure they are used safely alongside core pelvic floor care.
Device-based strengthening
- EMSELLA high-intensity focused electromagnetic chair induces thousands of pelvic floor contractions while you remain clothed, helping rebuild strength for continence and sexual function.
Device-based options are often combined with pelvic floor physical therapy and lifestyle changes for best results.
When surgery is considered
If your symptoms extend beyond what conservative therapies can manage, for example, significant pelvic organ prolapse or stress urinary incontinence that does not respond to PT and other non-surgical treatments, minimally invasive surgery may be discussed.
Potential options can include:
- Prolapse repairs tailored to the specific organs involved
- Procedures for stress incontinence such as urethral bulking or sling procedures
Outcomes vary by condition and patient goals. Recovery expectations and risks are reviewed in detail so you can make a confident, informed choice about whether surgery is right for you.
Locations, access, and research opportunities
Boston Urogyn sees patients in two convenient locations:
- Hudson, MA: 157 Washington Street, Hudson, MA 01749
- Wellesley, MA: 70 Walnut Street, Suite 101, Wellesley, MA 02481
We offer rapid access for new patients and invite self-referral; no referral is required for most women. Medicare-eligible patients may qualify for our Connected Care program that provides monthly remote support and symptom tracking. Coverage for energy-based and regenerative therapies varies; conventional medical treatments may be covered while many in-office energy therapies are cash-pay. Ask our team to check your benefits and discuss research participation when available.
To learn more about our team and services, explore our site as your starting point to find a female pelvic health specialist in Hudson or connect with a urogynecology clinic in Wellesley for discreet, function-focused care.
FAQs
What does a urogynecologist treat?
Urogynecologists treat pelvic organ prolapse, urinary and fecal incontinence, overactive bladder, painful bladder, pelvic floor muscle problems, pelvic pain, and menopause-related vaginal changes.
How do I know if I have prolapse?
Common signs include a bulge at the vaginal opening, a feeling of vaginal pressure or heaviness, difficulty inserting tampons, or needing to press on the vagina or perineum to empty the bladder or bowels. An expert exam confirms the diagnosis.
What causes urinary incontinence?
Causes include pregnancy and childbirth, aging, hormonal changes with menopause, pelvic surgery, chronic coughing or heavy lifting, constipation, and certain medications. Pelvic floor muscle changes and bladder overactivity are common contributors.
Who should evaluate pelvic floor and bladder concerns?
A urogynecologist is best positioned to assess both function and safety, and to coordinate pelvic floor physical therapy, medications, devices, energy-based treatments, and surgery if needed.
What happens at my first Boston Urogyn visit?
You will have a private history, bladder and bowel symptom review, sexual function screening when relevant, a focused exam, and pelvic floor testing or imaging if indicated, followed by a personalized plan.
Which non-surgical options help?
Pelvic floor physical therapy and home programs, lifestyle and bladder training strategies, medications or vaginal hormone therapy when appropriate, ThermiVa, MonaLisa Touch, SoLá Pelvic Therapy, and EMSELLA can each play a role depending on your diagnosis.
When is surgery considered and what can I expect?
Surgery is considered for prolapse or stress urinary incontinence that persists after conservative care, or when symptoms significantly affect quality of life. Minimally invasive approaches are common; risks, recovery, and outcomes are reviewed individually.
Do I need a referral?
Most patients do not need a referral to see our urogynecology team.
Where are you located and how fast can I be seen?
We see patients in Hudson and Wellesley, with fast access for new patients. Contact us for the next available appointment.
Are energy-based or regenerative therapies covered?
Coverage varies by plan. Many energy-based therapies are cash-pay; our team can verify benefits and discuss any Medicare-connected programs that may apply.
Take the first step today
You do not have to live with leakage, pelvic pressure, or pain. The Boston Urogyn team in Hudson and Wellesley offers compassionate, discreet, and outcomes-focused urogynecology care so you can feel like yourself again. Request a consultation, ask about rapid access and Connected Care options for Medicare-eligible patients, and start a pelvic floor treatment plan that fits your life.
Helpful links:
- Learn about our procedures and scheduling at https://bostonurogyn.com/procedures/.
- If you are comparing prolapse, incontinence, and other pelvic floor symptoms, see our overview of prolapse and incontinence care to understand non-surgical and surgical options at our pelvic prolapse and bladder services pages.
