What is a urogynecologist? Why this specialty matters for your pelvic health

From urinary leakage to symptoms from pelvic organ prolapse, many women don’t realize how common pelvic health issues are. Some women pass their symptoms off as a normal part of aging or they feel it’s too personal to talk about. But just because these issues are common, it doesn’t mean they’re normal. You do have options to help, and there’s a medical specialty dedicated specifically to caring for your needs—called urogynecology.

What is a urogynecologist?

A urogynecologist is a doctor with specialized training in female-specific problems related to the pelvic floor. This includes the reproductive organs, bladder, rectal area, and the muscles and ligaments that support them. These specialists provide both nonsurgical and surgical options to care for a variety of pelvic floor disorders.

Why would you see a urogynecologist?

Most women see a urogynecologist after they bring up pelvic floor symptoms with their primary care provider or OBGYN. Almost 1 in 4 women will experience a pelvic floor disorder, including conditions like urinary incontinence, pelvic organ prolapse or bowel dysfunction.

Persistent incontinence

Urinary incontinence is one of the most common pelvic floor disorders. This includes stress incontinence—where urine leaks happen during exercise or when you laugh or cough—and urge incontinence—where you have an uncontrollable urge to go to the bathroom. While not as common as urinary incontinence, some women also experience fecal incontinence, which leads to stool leaks.

While these conditions happen in many women after childbirth or as they age, it doesn’t mean that you have to live with them. If you’re having leakage problems, a urogynecologist can work with you to figure out the cause and offer you both conservative and surgical treatment options.

Overactive bladder

Overactive bladder is another common condition seen by urogynecologists. It causes the frequent, strong urge to go to the bathroom, and it can happen along with or separate from urge incontinence. Your urogynecologist may recommend lifestyle changes, bladder-specific medications or surgical options.

Recurrent urinary tract infections

Primary care providers and OBGYNs often care for urinary tract infections. But when you have UTIs that keep happening, specialized care from a urogynecologist may be the answer. UTIs are considered recurrent if you have two within six months or three in a year. A urogynecologist will partner with you to make a plan based on your specific symptoms and how frequently you get UTIs.

Pelvic organ prolapse (POP)

When the support muscles and ligaments in your pelvic area no longer work as they should, it can cause the organs in your pelvis to move downward, which can create a bulge in the vagina or rectum. There are several different types of pelvic organ prolapse depending on what pelvic organ is involved—such as the bladder, uterus, vagina, rectum or bowel.

It’s a common misconception that women who have a hysterectomy are more likely to have POP, but it can happen in women with and without a uterus. Depending on your needs, you may choose nonsurgical care—such as pelvic floor therapy or a pessary, which is an insertable vaginal support. Urogynecologists also offer surgical options to treat POP.

Pelvic pain or discomfort

The female pelvis includes multiple organ systems, so generalized pelvic pain can make it challenging for women to know where to turn. If you have pelvic pain without a known cause, a urogynecologist helps get to the root of the problem.

Two causes behind pelvic pain that are treated by urogynecologists include interstitial cystitis and high-tone pelvic floor dysfunction. Interstitial cystitis is a bladder inflammation syndrome that can cause pain throughout the pelvic area. High-tone pelvic floor dysfunction is an issue where the muscles of the vaginal canal are tight and stressed.

Blood in the urine If your primary care provider detects blood in your urine during a routine physical or urine test, you may see a urogynecologist. These specialists provide a routine workup for microscopic hematuria—where the blood isn’t visible and (less commonly) gross hematuria—when you can see the blood.

Menopausal transition difficulties

Your OBGYN is usually your first resource for general symptoms related to the transition to menopause, including hot flashes or mood disturbances. However, you may need to see a urogynecologist for more specific concerns.

These specialists provide care for genitourinary symptoms of menopause, such as vaginal atrophy or urethral issues. Some women also have discomfort with sexual activity or changes at the vaginal level after menopause that a urogynecologist can help address.

Urogynecologist vs. gynecologist

The main differences between a urogynecologist and a gynecologist are the types of training they receive and the focus of their practice. Both gynecologists and urogynecologists complete four years of general OBGYN residency training, but urogynecologists then go on to complete an additional three years of training in a urogynecology fellowship.

Urogynecologists and female urologists also have different training. While urogynecologists complete an OBGYN residency, female urologists complete five years of residency training in general urology. They then receive two years of specific training in female urology during fellowship.

Because urogynecologists are highly specialized, these doctors focus their entire practice on pelvic health issues, providing expertise and streamlined care for very specific concerns. For example, a urogynecologist might see as many cases of pelvic organ prolapse in a month as a general OBGYN sees in a year.

Does a urogynecologist do Pap smears?

While urogynecologists have training in general OBGYN needs, like Pap smears, that is not the focus of their practice. Typically, you’ll see your general OBGYN or primary care provider for routine women’s care and screenings and then go to a urogynecologist for specialized needs.

Speak up about your pelvic health

Even when they’ve been dealing with symptoms for years, many women are anxious about seeing a urogynecologist and speaking up about their concerns. If you’re dealing with a pelvic health condition, it’s most likely much more common than you realize.

Urogynecologists are there to support you and your specific needs. If you want to exhaust all conservative treatment options, then you have that choice. If you want to move toward surgery, you can discuss those options, too. With a dedicated focus on caring for women just like you, a urogynecologist can walk with you on your journey and help you regain your quality of life.

Have questions about your pelvic floor health? Find care near you today.