Pelvic Health

The bladder is a muscular sac that fills with urine which then leaves the body through a tube called the urethra. On average, it is typical to use the bathroom every 3-4 hours during the day and to sleep through the night. In a 24-hour period, you should be using the bathroom 6-8 times. If you use the bathroom less often, this can lead to overstretching of the bladder muscle and difficulty emptying your bladder in the future. If you use the bathroom more often than 6-8 times in 24 hours, there can be several causes for this including: fluid intake, type of fluids consumed (i.e. caffeine or alcohol), or an overactive bladder.

What does regular bladder function look like?

• using the bathroom every 3-4 hours during the day and sleeping through the night
• having the ability to delay the urge to go to the bathroom
• should not feel the need to rush to the bathroom
• having the ability to sit relaxed on the toilet without straining to empty the bladder
• void soon after sitting on the toilet with no pain or interruptions
• no instances of urine leakage with coughing, laughing, sneezing, etc. (also known as stress incontinence)
• no instances of urine leakage with feeling the urge to urinate or on the way to the bathroom (also known as urge incontinence)

What does regular bowel function look like?

• having a bowel movement somewhere between 3 times per day to every 3 days
• no straining to pass a bowel movement
• stool consistency should be soft and formed like a sausage, not small and hard (constipation) or liquidy/loose (diarrhea)
• having the ability to delay a bowel movement if you are not near a bathroom without experiencing loss of stool

Sexual health is an important part of our overall health and people often use their genitals to participate in sexual activities. It is important that all sexual activities involving a partner or partners are consensual. Sometimes, people can experience unexpected pain with sexual activity. If you are experiencing pain in these situations, please speak to your primary care provider as there are different treatments to be considered to help with the pain. Treatment can include seeing a health care provider who has experience treating pelvic pain such as a pelvic health physiotherapist, gynecologist, or urogynecologist. To access the services of a gynecologist or urogynecologist, you will need a referral from your family physician. In Edmonton, there are a couple options to access a urogynecologist familiar with the care of trans and gender diverse individuals. You may access their services through the LGBTQ+ Wellness Clinic or at the Urogynecology Clinic at the Royal Alexandra Hospital.

To access pelvic health physiotherapy, you can find a physiotherapist in your area by accessing this link and selecting “pelvic pain and disorders” on the left side of the webpage.

Some people may also find it helpful to speak with a psychologist or therapist about the pain they are experiencing as it often impacts many areas of life beyond physical pain.

People who undergo full-depth vaginoplasty are required to use dilators to keep the neovagina open. If you are experiencing pain, bleeding, or difficulty with dilations, please speak with your primary care provider. In some instances, it may be appropriate to see a trained physiotherapist who specializes in pelvic health to help you with difficult dilation once you have seen your physician.

Referral Processes:

• Urogynecologist (Dr. Flood): UofA Gender Program, Wellness Centre, Family Doctor
• Pelvic Floor Physiotherapy in community: none required
• Pelvic Floor Physiotherapy at Urogynecology Clinic: Urogynecologist would refer at initial appointment in clinic