Maybe you cross your legs before you sneeze. You wear a liner every day, just in case. You know every bathroom on the way to carpool. Sex hurts, or you avoid it because you're bracing for it to hurt.
And Kegels don't help everyone. If your muscles are already too tight, squeezing harder can make things worse. That's why we start with an evaluation.
Pelvic floor therapy is rehabilitation for the muscles, ligaments, and connective tissue that support the bladder, bowel, and uterus. It is a first-line treatment for stress and mixed urinary incontinence. At Bespoke Rx in Tampa, a licensed occupational therapist (OTR/L) with specialized training in pelvic health, pregnancy, and postpartum care evaluates how these muscles work, then builds a plan of targeted exercises and hands-on techniques.
The pelvic floor is a hammock of muscles at the base of your pelvis. It needs to tighten to keep you dry, and relax so you can pee, have a bowel movement, have comfortable sex, and give birth. Problems start when these muscles are too weak, too tight, or out of sync.
In a national survey, 23.7% of U.S. women had at least one pelvic floor disorder, rising from 9.7% of women ages 20 to 39 to 49.7% of women 80 and older. In a 2018 Cochrane review, 56% of women with stress incontinence who did pelvic floor muscle training were cured, compared with 6% of women without it.
| What you feel | Clinical term | How therapy may help |
|---|---|---|
| Leaking when you cough, sneeze, laugh, or jump | Stress urinary incontinence | Strengthening and timing the pelvic floor with movement |
| Sudden urge, can't make it in time, peeing often | Urge incontinence, overactive bladder | Bladder retraining, urge-suppression techniques, muscle coordination |
| Pain with sex or tampons | Dyspareunia, pelvic floor muscle overactivity | Relaxation, down-training, hands-on release, dilator guidance |
| Heaviness, pressure, a bulge | Pelvic organ prolapse symptoms | Support strategies, strengthening, pressure management |
| Belly gap or doming after pregnancy | Diastasis recti | Deep core retraining and breathing |
| Trouble holding gas or stool | Fecal or flatal incontinence | Strengthening and coordination of the anal sphincter |
| Constipation, straining | Pelvic floor dyssynergia | Coordination, positioning, relaxation |
| Tailbone, hip, or low back pain | Pelvic girdle pain | Movement retraining, hands-on techniques |
Pelvic floor therapy and medical care under one roof. Your therapist and your Bespoke Rx nurse practitioner share notes. If hormones, tissue changes, or weight are part of the picture, hormone therapy, EmpowerRF, and GLP-1 weight management are down the hall.
Self-pay, with no visit caps or prior authorizations. Your plan is built around what you need, not what insurance approves. HSA and FSA cards are accepted, and we provide an itemized receipt you can submit for possible reimbursement.
Your comfort leads. Internal exams happen only when appropriate, and only with your consent. You can say no or stop at any time and still get care.
A straight answer on devices. We tell you when VTone may help, when therapy should come first, and which treatments are FDA-cleared for what.
Published prices. The evaluation is $250, sessions are $225, and six sessions are $1,200.
Both can strengthen your pelvic floor. They do it in very different ways. VTone, part of our EmpowerRF platform, uses electrical stimulation to contract your pelvic floor muscles for you while you relax. Pelvic floor therapy finds out why your muscles aren't working, whether they're weak, too tight, or not firing at the right time, then teaches you to use them when it counts: when you cough, lift your toddler, or go for a run.
VTone builds strength. Therapy teaches your body how and when to use it.
| Option | How it works | Best for | FDA status for this use | At Bespoke Rx |
|---|---|---|---|---|
| Pelvic floor therapy | One-on-one rehab: you learn to contract, relax, and coordinate the muscles yourself | Weak, tight, or uncoordinated muscles; pain with sex; prolapse symptoms; diastasis; bladder habits | A therapy, not a drug or device; first-line treatment for stress and mixed urinary incontinence | Yes |
| VTone (EmpowerRF) | Intravaginal electrical stimulation contracts the muscles for you | Building strength in weak muscles | FDA-cleared (510(k) K200293, 2020) for pelvic floor rehab in stress, urge, and mixed urinary incontinence in women | Yes |
| FormaV and Morpheus8V (EmpowerRF) | Radiofrequency heat, without or with microneedling, to vaginal and vulvar tissue | Tissue concerns, discussed at a separate consultation | FDA-cleared RF technology indicated for electrocoagulation and hemostasis in dermatologic and general surgical procedures. Use on vaginal and vulvar tissue is off-label. | Yes, see our pelvic and intimate health page |
| Empower Shot with PRF | Growth factors from your own blood, injected into intimate tissue | Sensation or tissue concerns | Not FDA-approved for sexual or intimate use (off-label) | Yes |
| Hormone therapy, including local vaginal estrogen | Prescription hormones for menopause symptoms such as dryness and painful sex | Dryness, painful sex, or repeat UTIs after menopause | Prescription treatment; see our HRT page | Yes, see our HRT page |
Many women do best with a combination: therapy to retrain the muscles, and VTone to build strength. If your pelvic floor is tight or painful, we start with therapy.
For some women, weight is part of the picture, and we can support that too. In a randomized trial of 338 women with incontinence, those who lost an average of 17 pounds had 47% fewer weekly leaking episodes, compared with 28% in the education-only group. Our nurse practitioners can pair therapy with GLP-1 weight management when it fits your goals.
| Detail | What to expect |
|---|---|
| Evaluation | 60 minutes, one-on-one, in a private treatment room |
| Treatment sessions | 60 minutes, one-on-one |
| Sessions needed | Varies by person and concern; your therapist gives you a realistic plan after your evaluation |
| When women notice change | Varies; your therapist gives you a realistic timeline after your evaluation |
| How long results last | As long as you keep up your home program. Muscle training works like any other strength training. |
| Downtime | None. You can go back to work or carpool right after. |
| Internal assessment | Only when appropriate, and only with your consent |
| Referral needed | No. Florida's occupational therapy practice law does not require a physician's prescription. |
| Availability | By appointment only |
| Price | Evaluation $250. Session $225. 6-session package $1,200. One session included in select women's wellness packages. |
| Payment | Self-pay. We don't bill insurance. HSA/FSA accepted. Itemized receipt provided. |
At Bespoke Rx in Tampa, the 60-minute pelvic floor evaluation is $250 and each 60-minute session is $225. A package of six sessions is $1,200, or $200 per session. Select women's wellness packages include one pelvic floor session.
No. Bespoke Rx pelvic floor therapy is self-pay, and we don't bill insurance. That means no visit caps, no prior authorizations, and more time with your therapist. HSA and FSA cards are accepted, and we provide an itemized receipt you can submit to your insurer for possible reimbursement.
No. You can book pelvic floor therapy at Bespoke Rx in Tampa without a doctor's referral. Florida's occupational therapy practice law does not require a physician's prescription. Some insurers require one for reimbursement, which matters only if you plan to submit your receipt.
Yes. Occupational therapists and physical therapists can both specialize in pelvic health with advanced training. Bespoke Rx's pelvic floor therapist in Tampa is a licensed occupational therapist (OTR/L) with specialized training in pelvic health, pregnancy, birth preparation, and postpartum recovery. Occupational therapy focuses on getting you back to daily life, from lifting your kids to running again.
Sometimes, and only with your consent. At Bespoke Rx, an internal exam is offered when appropriate because it gives your therapist the clearest picture of how your muscles work. It is never required, and you can decline or stop at any time and still get care.
No. Pelvic floor therapy at Bespoke Rx starts with an evaluation, because Kegels don't help everyone. Many women with leaking or pain have muscles that are too tight, not too weak, and squeezing harder can make that worse. Your plan may include relaxation, coordination, breathing, and core work as well as strengthening.
Leaking after a baby is common, but you don't have to live with it. Pelvic floor muscle training is a first-line treatment for stress urinary incontinence, and Bespoke Rx in Tampa sees women for postpartum leaking whether their baby is 3 months or 15 years old.
Many women start at Bespoke Rx after their six-week postpartum visit, once their OB or midwife clears them. It's never too late to start, even years later.
Yes, once you're past your first trimester and your pregnancy isn't high risk. Bespoke Rx in Tampa offers pelvic floor therapy during pregnancy to ease pelvic and back pain, prevent leaking, and help you prepare for birth.
Often, yes. Pain with sex is frequently linked to tight or overactive pelvic floor muscles, and Bespoke Rx's therapist uses relaxation, down-training, and hands-on techniques to reduce it. If dryness after menopause is part of the cause, your nurse practitioner may also discuss hormone therapy, including local vaginal estrogen.
Yes. Pelvic floor therapy at Bespoke Rx can help with the bladder urgency, leaking, and painful sex that often increase after menopause. Because falling estrogen changes the tissue, we can pair therapy with hormone therapy from our nurse practitioners, all in one Tampa office.
At Bespoke Rx, the answer depends on whether your symptoms come from muscles, tissue, hormones, or a mix. Pelvic floor therapy retrains how your muscles work, and VTone, FDA-cleared for urinary incontinence, builds muscle strength. FormaV and Morpheus8V use FDA-cleared RF technology indicated for electrocoagulation and hemostasis in dermatologic and general surgical procedures; their use on vaginal and vulvar tissue is off-label. The Empower Shot with PRF is not FDA-approved for intimate use. A nurse practitioner explains all of this before any treatment.
The number of sessions varies by person and concern, so your Bespoke Rx therapist gives you a realistic plan and timeline after your evaluation. Wear comfortable clothes you can move in. Your visit takes place in a private treatment room.
To jump. To run. To sleep through the night. To feel at home in your body again. Your first step is a conversation at our Tampa office.
Bespoke Rx · 442 W Kennedy Blvd, Suite 320, Tampa, FL 33606 · 813-203-6196 · Pelvic floor therapy by appointment only
Across from the University of Tampa, next to Oxford Exchange. Serving women from South Tampa, Hyde Park, Davis Islands, Westshore, and across Tampa Bay.
