Five Reasons to See a Urogynecologist

It's common for patients with bladder and pelvic conditions to hesitate seeking help for issues they believe to be a natural part of aging or untreatable. But according to BIDMC urogynecologist Monica L. Richardson, MD, MPH, nothing could be further from the truth.

"Patients often struggle silently with symptoms they're either too embarrassed to talk about or think there's no solution for," she explains. "But there is a wide range of innovative and successful treatment options available. We can help."

BIDMC female pelvic medicine specialists, or urogynecologists, provide personalized, compassionate care for a variety of conditions, including:

1. Urinary incontinence. After having a baby or after menopause, patients may experience urine leakage with sneezing, laughing, coughing or exercise. "This could be temporary or stick around longer-term," Richardson says.

Lower estrogen levels or weakness in the pelvic floor could be contributing factors. "There are non-surgical solutions for this," she says.

2. Vaginal dryness. Thinning of the vaginal walls usually occurs after menopause, and is referred to as genitourinary syndrome of menopause (GSM). This condition can cause sensations of burning, dryness and pain with intercourse.

"Some patients dread or even stop having sex after menopause because of the pain. But you do not have to live with this discomfort," Richardson says.

3. Difficulties with sexual health. Persistent, recurrent problems with sexual response, desire or orgasm can cause strain on your relationship with your partner. "Medically, we refer to this as poor sexual health, and there are treatments available to help this," Richardson says.

Watch BIDMC patient Karen Perry's story on how treatment helped improve her relationship with her husband.

4. Vaginal prolapse. This occurs when part of the vagina loses its normal shape, sagging or dropping down into the vaginal canal or outside of it. Prolapse can occur alone or in addition to the bladder, urethra or rectum.

"Sometimes after babies or after menopause, your anatomy is different, and that's okay,” Richardson says. "These issues are usually related to pelvic support problems and we have a range of treatment options for that."

5. Accidental bowel leakage. Like urinary incontinence, some patients experience fecal incontinence with age. "Managing these issues can include dietary changes and exercise, to non-surgical procedures," Richardson says.

Urogynecologic treatment options are available at four BIDMC locations in and around Boston. Speak with your primary care doctor to see if you need a referral for a specialist.