Created by Dr. Stefanie Mikulics
Pelvic Support & Bladder Score
Board-Certified OB/GYN & Women’s Pelvic Health Specialist
Let’s Talk About Something We Don’t Talk About Enough.
- Do you ever cross your legs before you sneeze?
- Do you ever avoid jumping during workouts?
- Do you ever sit near exits “just in case”?
- Do you ever scan for bathrooms the minute you walk into a new place?
You are not alone. And you are not broken. Bladder leakage is incredibly common — especially after babies and as hormones shift — but it is absolutely treatable.
This simple score helps us understand how much your bladder symptoms are affecting your confidence and daily life. Take a deep breath. Be honest. This is judgment‑free.
How to Take This Assessment
Think about the past 3 months. Choose the number that fits best:
0
Never
1
Rarely
2
Sometimes
3
Often
4
Daily or Severe
Section 1: Leakage Patterns
1. I leak urine when I cough, sneeze, or laugh.
2. I leak during exercise, lifting, running, or jumping.
3. I feel a sudden strong urge to urinate that is hard to delay.
4. I leak urine before reaching the bathroom.
Section 2: Daily Bladder Control
5. I urinate more than 8 times per day.
6. I wake more than once per night to urinate.
7. I feel like I don’t completely empty my bladder.
Section 3: Public Confidence
8. I avoid certain exercises because of fear of leaking.
9. I think about where bathrooms are when I go somewhere new.
10. I feel anxious about leaking in public.
11. I wear pads or liners because I don’t trust my bladder.
12. My bladder symptoms affect my social life, travel, or intimacy.
Section 4: Pelvic Support
13. I feel pelvic pressure or heaviness.
14. I notice or feel a vaginal bulge.
Section 5: Bowel Health (Because It All Connects)
15. I struggle with constipation.
16. I leak stool or gas unintentionally.
Where can we send your personalized results?
We’ll keep this private and only use it to follow up about your results.
Total possible: 64