Pelvic Health
Pelvic health concerns are common but not normal. They can be treated.
We specialize in rehabilitation and treatment of a variety of pelvic concerns and symptoms.
What is Pelvic Health?
Pelvic health is when the reproductive organs, bladder, bowel and their support systems are working their absolute best. It plays an important role in physical, mental, social and sexual wellness.
Pelvic Health concerns can be quite varied and most commonly include:
- Pelvic pain
- Bladder control, leakage, urge to urinate
- Sexual dysfunction and/or painful intercourse
- Bowel control, leakage, urgency, hemorrhoids
- Weakness and dysfunction around your pelvis
In cases of pelvic organ prolapse, we also have a Pessary Clinic to support those patients.
Our Pelvic Health Programs
In pelvic health, “female” and “male” refer to anatomy, not gender. Female pelvic care addresses concerns related to the uterus, cervix, and/or vagina; male pelvic care addresses concerns related to the prostate, penis, and/or testes. We recognize that anatomy varies across all genders, and that every individual comes with their own unique and complex anatomy and medical history. If you’re unsure which program applies to you, a free 15-minute phone consultation will help point you in the right direction.
Pelvic Physiotherapy for Those with Male Anatomy
Mel Untal, our physiotherapist specializing in male pelvic health, works with people who have a prostate, testes, and penis. Whether you’re navigating life after prostate surgery, dealing with chronic pelvic pain, or managing bladder or sexual health concerns, this is a judgment-free space to get support.
Common Concerns Mel treats:
- Bladder leakage, urgency, or trouble fully emptying the bladder
- Chronic pelvic pain, including Chronic Pelvic Pain Syndrome (CPPS)
- Erectile dysfunction and ejaculatory concerns
- Painful orgasms or ongoing testicular or penile pain
- Prostate surgery recovery — pre- and post-operative rehabilitation
- Neobladder management
- Bowel control issues and hemorrhoids
- Hernias
Physiotherapy Approach to Pelvic Health:
Pelvic health physical therapy is a focused area of physiotherapy that addresses concerns of the pelvic muscles and surrounding organs. The goal is to increase your ability to engage in meaningful activities and improve your quality of life.
Sessions are one-on-one and private. Consent is ongoing — you can pause, adjust, or stop any part of the assessment or treatment at any time.
Treatment may include:
- Manual therapy — external and internal techniques to release tight muscles and reduce pain
- Real-time ultrasound and EMG biofeedback so you can see your pelvic floor muscles working
- A personalized exercise program focused on strengthening, relaxing, or coordinating your pelvic floor
- Breathwork and nervous system techniques to address chronic pelvic pain
While it is important to have a pelvic assessment before beginning pelvic exercises, an internal assessment is always optional. Your pelvic assessment will allow the physiotherapist to determine your pelvic strength as well as the mobility and coordination of your pelvic muscles. Effective results are still achievable using external ultrasound and therapy alone.
Pelvic Care for those with Female Anatomy
Dr. Michelle Payne, our naturopathic physician specializing in pelvic health and trained in pelvic floor rehabilitation, supports people with uteruses, ovaries, and vaginas through a wide range of pelvic concerns — from pregnancy and postpartum recovery to pain, prolapse, and hormonal change related symptoms.
Common concerns Dr. Michelle treats:
- Pelvic pain, including pain during intercourse or tampon use
- Bladder leakage, urgency, or incomplete emptying
- Bowel control issues and constipation
- Pelvic organ prolapse
- Endometriosis and PCOS-related pelvic symptoms
- Vaginal dryness and hormonal pelvic changes
- Pregnancy, labour preparation, and postpartum recovery
- Painful periods
- Hernias
Naturopathic medicine
Dr. Michelle will listen to your concerns and explore the underlying causes of your symptoms, which may include hormonal factors, nutrition and lifestyle. Treatment can include pelvic floor exercises, hormone therapy, supplements, and referral to specific physiotherapy when appropriate.
Pessary services: For those experiencing pelvic organ prolapse or urinary incontinence, Dr. Payne offers pessary fitting and ongoing support as a non-surgical option. A pessary is an internal vaginal device used to support pelvic organs in individuals experiencing pelvic organ prolapse and/or urinary incontinence.
Naturopathic doctors also offer cervical cancer screening, when indicated.
Our Approach
We consider each client’s individual concerns and experiences and work to tailor treatments to your particular needs and therapeutic goals.
Learn More
Our pelvic health team works with you to build healthy habits, prevent future symptoms, and address unhelpful beliefs about your body.
- Reduced or eliminated pain or discomfort
- Improved muscle strength
- Improved sexual function and experience
- Improved bladder or bowel control
- Confidence and comfort in regular activity
Your First Step — Free 15-Minute Phone Consultation
Before booking your first appointment, we recommend starting with a free 15-minute phone consultation. It’s a chance to talk through your concerns, ask questions, and confirm you’re seeing the right person — no commitment required. Both Dr. Michelle Payne and Mel Untal offer this consultation
Please note, if you prefer not to have internal assessments or treatments, it is always your choice, and there are option going forward without that.
Initial assessments
60 minutes
Your first session is a thorough one-on-one appointment covering your symptoms, health history, and goals. Your clinician will assess the strength, mobility, and coordination of your pelvic floor muscles to understand what’s driving your symptoms — and to make sure any exercises or treatments are appropriate for your body.
From there, you’ll leave with a personalized treatment plan. Depending on your concerns and which clinician you’re seeing, this may include pelvic floor exercises, manual therapy, biofeedback tools, hormone therapy, or naturopathic support such as nutrition and supplements. If a referral to another discipline would help — for example, from naturopathic care to physiotherapy — your clinician will coordinate that as part of your plan.
Consent is ongoing throughout. You are always in control of the pace.
Follow-up appointment
30 to 60 minutes
Follow-up appointments are tailored to your treatment plan and will vary in length and frequency depending on your progress. Your clinician will recommend what’s appropriate as your care evolves.
Our Beliefs
Additional Reading
Love to learn as much as you can? You’ve come this far, so here is some more pelvis related content to fill in any blanks we might have left from above.
Pelvic health problems are far more common than most people realize — and far more treatable than most people assume.
In Canada, approximately 3 million people live with urinary incontinence alone. Pelvic organ prolapse affects 40–50% of people with a uterus over the age of 40. And those are just the people who report it — only 1 in 12 people with pelvic floor dysfunction actually seek treatment, most often because they feel embarrassed, assume their symptoms are a normal part of aging, or simply don’t know that help is available.
For many men, awareness is even lower. Pelvic floor physiotherapy is still widely seen as a women’s health service, which means many men live with bladder leakage, pelvic pain, or sexual health concerns for years without knowing that targeted, effective treatment exists.
Research shows that people live with pelvic floor symptoms for an average of one to five years before seeking care — and many for longer. That’s years of managing something that, in most cases, responds well to treatment.
If any of this sounds familiar, you’re in the right place.
The pelvic floor is a group of muscles, ligaments, and connective tissues that form the base of the pelvis. It supports your bladder, bowel, and reproductive organs, and plays a central role in urinary and bowel control, sexual function, and core stability.
The organs and structures it supports vary by anatomy and may include:
- Bladder
- Rectum and bowel
- Uterus and vagina
- Prostate, testes, and associated structures
Healthy pelvic floor muscles work in both directions — they contract to maintain continence and support organs, and they relax to allow urination, bowel movements, and comfortable intercourse. When this balance breaks down, it tends to go one of two ways.
When the pelvic floor is too weak or poorly coordinated — known as hypofunction — muscles can’t do their job effectively. This can lead to leakage, prolapse, and reduced sexual function. Common contributing factors include pregnancy and childbirth, prostate surgery, hormonal changes, obesity, and chronic straining.
When the pelvic floor is overactive or chronically tight — known as hyperfunction — the problem looks different. Rather than leaking, people with hyperfunction often experience pelvic pain, urinary urgency or frequency, difficulty fully emptying the bladder or bowel, and pain with intercourse or orgasm. Stress, past trauma, and certain movement or breathing patterns can all drive an overactive pelvic floor.
Both are real, both are common, and both respond to treatment — though the approach is quite different. This is why a proper assessment matters before beginning any pelvic floor exercises.
Sexual health and pelvic health are closely connected — more than most people expect, and more than is often talked about.
In people assigned female at birth (AFAB), the pelvic floor plays a role in arousal, sensation, and orgasm. Pelvic floor dysfunction is consistently associated with painful intercourse, reduced sensation, and difficulty with orgasm, particularly around hormonal transitions such as pregnancy, postpartum recovery, and menopause. Vaginal dryness, endometriosis, and pelvic organ prolapse can all affect sexual experience in ways that are treatable but frequently go unaddressed.
In people assigned male at birth (AMAB), the pelvic floor muscles are directly involved in erection and ejaculation. Research supports a clear relationship between pelvic floor dysfunction and erectile difficulties, ejaculatory concerns, and chronic pelvic pain — including conditions like Chronic Pelvic Pain Syndrome. These aren’t purely vascular or psychological issues; the muscular and neurological components are real and addressable through targeted physiotherapy.
In both cases, the barrier to getting help is rarely clinical — it’s social. Sexual health concerns are the ones people are least likely to bring up with a clinician, and most likely to manage in silence. But they respond to treatment, and the research supports this clearly.
This is a judgment-free space. Whatever brought you here, it’s worth a conversation.
Pelvic floor dysfunction is common, often undertreated, and in most cases genuinely improvable. Whether you’ve been managing symptoms for years or something has only recently changed, the first step is the same — a 15-minute conversation with one of our clinicians, at no cost and no commitment. We’re here when you’re ready.
Our Practitioners
We take an empathetic approach to your care and always provide the most up-to-date information and resources. We want to help you on your journey to recovery.
Not sure where to start? Call 250-475-1522, ext 2. and our patient care coordinators will help.
FAQ
Still have more questions? Check out the tabs below. If your questions are still unanswered, please reach out, we love to help get to the root of things.
For female pelvic health with Dr. Michelle, you can call the clinic at 250-475-1522 (ext 2), and one of our friendly patient care coordinators can book you in.
For male pelvic health, you can either call the clinic, or book online.
No referral is needed. You can book directly through our online booking system or call us at 250-475-1522 and our patient care coordinators will help you get started. If you’re unsure where to begin, we recommend booking a free 15-minute phone consultation with Dr. Michelle or Mel first.
Not necessarily, and never without your explicit consent. Internal assessment gives your clinician the most complete picture of your pelvic floor function, but it is always optional. Other assessment and treatment is possible using external techniques, ultrasound, and other tools. Your comfort sets the pace — you can pause, adjust, or stop any part of your appointment at any time.
This is also a great questions to ask your clinician at the 15-minute consult.
This comes down to anatomy. Mel Untal sees patients who were assigned male at birth (AMAB), and Dr. Michelle sees patients assigned female at birth (AFAB). If you’re unsure whether you’re in the right place, reach out — we’re happy to help point you in the right direction.
It varies depending on your condition, how long you’ve had symptoms, and how your body responds to treatment. Many patients notice meaningful changes within a few sessions. Others with longer-standing or more complex concerns take more time. What most people find is that even early sessions bring a clearer understanding of what’s happening — which on its own can reduce anxiety and help you feel more in control.
Your clinician will track your progress and adjust your plan as you go, keeping you in the loop all the way along.