top of page
Do I have a Pelvic Floor Problem?
Answer the Following Questionnaire to see if you may !
COZEAN PELVIC DYSFUNCTION SCREENING PROTOCOL
Check All that Apply
​I sometimes have pelvic pain (in genitals, perineum, pubic or bladder area, or pain with urination) that exceeds a ‘3’ on a 1-10 pain scale, with 10 being the worst pain imaginable
I can remember falling onto my tailbone, lower back, or buttocks (even in childhood)
I sometimes experience one or more of the follow urinary problems
-
Accidental loss of urine
-
Feeling unable to completely empty my bladder
-
Having to void within a few minutes of a previous void
-
Pain or burning with urination
-
Difficulty starting or frequent stopping/starting of urine stream
I often or occasionally have to get up to urinate two or more times at night
I sometimes have a feeling of increased pelvic pressure or the sensation of my pelvic organs slipping down or falling out
I have a history of pain in my low back, hip, groin, or tailbone or have had sciatica
I sometimes experience one or more of the following symptoms
-
Loss of bowel control
-
Feeling unable to completely empty my bowels
-
Straining or pain with a bowel movement
-
Difficulty initiating a bowel movement
I sometimes experience pain or discomfort with sexual activity or intercourse
Sexual Activity Increases one or more of my symptoms
Prolonged sitting increases my symptoms
If you checked 3 or more circles, pelvic floor dysfunction is likely.
​
Do you have to change your lifestyle to manage your symptoms? If this bothers you,you may want to speak with your doctor or a pelvic floor therapist.
Contact us below or schedule a visit to further discuss your options!
bottom of page