The Pelvic Health Lady

The Pelvic Health Lady Welcome to The Pelvic Health Lady. My name is Madelaine and I am a pelvic floor physiotherapist that supports men and women with unruly bladder symptoms.

Symptoms such as bladder urgency, frequency, leakage, overactive bladder, bladder prolapse, or pain.

04/16/2026

Gentlemen, if you’re experiencing any of these symptoms, don’t ignore them:

• Bladder urgency
• Frequent urination
• Waking at night to p*e
• Leakage
• Hesitation when starting your stream
• Post-void dribble

The first step is seeing a urologist to rule out potential medical causes and determine whether there may be an obstruction, such as prostate enlargement.

But here’s something many men don’t realize:

Symptoms like urgency, frequency, leakage, nighttime waking, hesitation, and dribbling can also be related to pelvic floor muscle function.

Even when there is mild obstruction, improving pelvic floor coordination and bladder habits can help support the bladder symptoms from worsening.

The obstruction however is something the urologist monitors.

That’s why the best approach is often team-based care:
Urologist + pelvic floor physiotherapist.

If you’re noticing changes in your urination, it’s worth getting it checked out.

04/16/2026

Is it overactive bladder… or an enlarged prostate?

The tricky part is that the symptoms can look the same.

Urgency.
Frequency.
Leakage.
Waking up at night to p*e.

These are called storage symptoms, and they can happen for two main reasons:

1️⃣ Obstruction – such as an enlarged prostate pressing on the urethra.
2️⃣ Overactive bladder – where the bladder muscle becomes overly sensitive or reactive.

The best way to know the difference is to see a urologist, who may run tests and sometimes perform a cystoscopy to check if there’s an obstruction.

Why does this matter?

Because chronic obstruction needs to be treated, otherwise it can lead to longer-term bladder problems.

If you’re noticing changes in your urination:

✔️ See your doctor
✔️ Get referred to a urologist
✔️ Work with a pelvic floor physiotherapist to help manage urgency, frequency, leakage, and nighttime waking.

And if it turns out there’s no obstruction, then the symptoms may be more consistent with overactive bladder, which also has effective treatment options.

04/15/2026

Waking up at night to p*e? Don’t ignore it—especially if it’s new for you.

Sometimes there are simple, benign reasons this happens. For example:
• Drinking a lot of fluids later in the evening
• Caffeine or alcohol close to bedtime
• Changes in bladder habits that reduce bladder capacity
• Going to the bathroom more frequently during the day

But nighttime waking can also signal something medical that should be checked.

Your doctor may want to rule out things like:
• Diabetes
• Blood pressure issues (blood pressure should normally drop at night)
• Obstructive sleep apnea
• Other underlying health conditions

Whenever a new symptom appears, it’s important to have it evaluated.

Start with your doctor to rule in or rule out medical causes. Then working with a pelvic floor physiotherapist can help address the lifestyle, bladder, and muscle factors that may be contributing.

Follow along my page for more bladder and pelvic health education.

04/14/2026

Is your bladder causing you stress…
or is stress causing your bladder to act up?

Most people don’t realize this, but the relationship between stress and bladder symptoms goes both ways.

Stress can make the bladder more sensitive and reactive.
And when your bladder is acting up — urgency, frequency, leakage — that can create even more stress in the body.

It becomes a loop.

That’s exactly why I created a Bladder Meditation — designed to help calm your nervous system and bring ease not only to your bladder, but to your whole body.

Because when the body feels safer and more relaxed, the bladder often follows.

Comment MEDITATION and I’ll send you the link. 🌿

04/13/2026

Feeling pelvic tension? Maybe tightness in your low back, hips, or pelvis too?

This week on my Patreon, I’m walking you through a simple movement exercise on all fours designed to help you reconnect with your body through:

• Breath
• Mobility
• Gentle stretch
• Awareness and relaxation

It’s a great place to start if your body feels tight, guarded, or holding tension.

Comment CALM and I’ll send you the link.

04/13/2026

Starting tomorrow, whatever my bladder throws at me… I’m ducking so it can bug someone else.

But if your bladder keeps throwing punches — urgency, leaks, constant bathroom trips — it might be time to stop dodging and actually figure out what’s going on.

A pelvic floor physiotherapist can help you understand why your bladder is acting up and what you can do about it.

You don’t have to just live with it.

Book an appointment. Link in bio.

Did you know that prostate size does NOT predict how bad your symptoms are?A man with a slightly enlarged prostate can h...
04/12/2026

Did you know that prostate size does NOT predict how bad your symptoms are?

A man with a slightly enlarged prostate can have severe urgency, frequency, and nocturia. Another man with a significantly enlarged prostate may barely notice any symptoms at all.

That’s because it’s not just about size — factors like your pelvic floor muscles, your lifestyle, exercise can impact function.

Two things can be happening:
→ The enlarged tissue physically compresses your urethra making voiding difficult (mechanical)
→ The muscles around the prostate can get tight or weak, impacting bladder reflexes and can also contribute to symptoms of urgency and making your bladder “feel” like its fuller than it is (dynamic)

Both contribute. And both can be managed.

If you’ve been told “your prostate is a little big” and left it at that — there’s more to the story.

04/11/2026

If you’re a pelvic floor physio who wants to treat men’s pelvic health but feel a little uncertain about where to start, you’re not alone.

Many clinicians have the training… but still feel unsure about how to structure the assessment, what to prioritize, or how to move through the evaluation confidently.

After 10+ years treating men, I’ve distilled my process into a clear roadmap and flow chart that helps guide the assessment step-by-step so it feels organized and seamless.

If you’d like to see exactly how I approach a men’s pelvic health evaluation, check out my Men’s Pelvic Health Assessment Intensive.

Head to the link in my bio to learn more.

04/09/2026

For those of you with a prostate, this video is for you.

Did you know there are two types of obstruction that can affect how easily you urinate?

1️⃣ Structural obstruction
This happens when the prostate enlarges and begins to press on the urethra, narrowing the tube urine flows through. This type of obstruction is typically managed medically with a urologist.

2️⃣ Functional obstruction
This occurs when the pelvic floor muscles around the urethra become tight or poorly coordinated, which can also narrow the urethra and affect your stream, flow, and bladder symptoms.

This is where pelvic floor physiotherapy comes in.

During an assessment we look at:
• How well the pelvic floor muscles relax
• Their flexibility and mobility
• How well they activate and coordinate with bladder function

If you’re noticing changes in your urinary stream, bladder habits, or pelvic discomfort, it’s important to:

✔️ Speak with your doctor
✔️ Get referred to a urologist
✔️ Consider an assessment with a pelvic floor physiotherapist

When we work together as a team, outcomes are often much better.

Follow along my page for more education on men’s pelvic health.

04/08/2026

Chronic non-bacterial prostatitis — also called chronic pelvic pain syndrome (CPPS) — is one of the most common pelvic conditions I see in men.

If this was my diagnosis, these are the three areas I’d focus on first:

1️⃣ Pelvic floor downtraining
Many men with CPPS have pelvic floor muscles that are overactive or tense, not weak. Learning how to relax and coordinate these muscles can reduce pain and urinary symptoms.

2️⃣ Nervous system regulation
Chronic pelvic pain often involves a sensitized nervous system. Techniques that calm the nervous system can help reduce symptom flare-ups and improve recovery.

3️⃣ Mobility of the surrounding tissues
Improving flexibility and mobility in the abdominal wall, lower back, pelvis, inner thighs, and hips can decrease tension through the pelvic region and support better function.

If you’ve recently been diagnosed with chronic prostatitis, consider working with a pelvic floor physiotherapist.

And yes — I’m currently accepting new patients.
Head to the link in my bio to book an assessment.

04/07/2026

Gentlemen… does size matter?

I’m talking about the size of the prostate.

Sometimes, yes — size does matter.
A larger prostate can press against the urethra and create obstruction, which may contribute to symptoms like urgency, frequency, or nighttime waking.

But here’s the important part:
Not all bladder symptoms are caused by prostate size.

I see many men with significant bladder symptoms whose prostate size isn’t the main issue. Muscle tension, coordination, bladder habits, and nervous system responses can also play a big role.

So just because you’ve been told your prostate is a little enlarged doesn’t mean there’s nothing you can do.

Often the best results come from a team approach:
Urologist + pelvic floor physiotherapy.

Together, we can improve bladder function and quality of life.

If you’re experiencing urgency, frequency, or waking up multiple times at night, consider adding a pelvic floor physiotherapist to your care team.

Follow along for more men’s pelvic health education.

04/07/2026

PSA for Men:

Pelvic floor physiotherapy isn’t just for women.

In fact… about 70% of my practice is now men.

Men dealing with:
• Prostate-related symptoms
• Overactive bladder (urgency, frequency, night waking)
• Pelvic pain
• Recovery after prostate surgery

These issues are far more common than most men realize — and they’re often very treatable.

The best outcomes usually happen when urology and pelvic floor physiotherapy work together.

Don’t ignore symptoms, the sooner we can work on it, the better.

Address

76 Walnut Street South
Hamilton, ON

Telephone

905-803-0307

Website

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