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By Dr. Alaina Garbens, MD, PhD, FRCSC, is a fellowship-trained urologist and founder of Élevé. Her practice spans advanced urologic care, minimally invasive surgery, pelvic and urinary health, menopause, sexual wellness, and regenerative medicine.
On October 18, 2026, I will be at the National Menopause Show talking with women about their bodies. I know, that there’s one phrase I’m going to hear again and again, because I hear some version of it every week in clinic: “I thought that was just how it is.”
Leaking urine after children. Waking repeatedly to urinate. Pain with sex. Recurrent urinary infections (UTIs). A body that suddenly feels unfamiliar. Apparently, that is just part of being a woman.
That is a story many of us have heard. Often enough that we stop questioning it. But being common does not make a symptom unimportant. And it does not tell us whether something can be done about it.
Women’s healthcare can be surprisingly difficult to navigate, especially when you do not already know what is wrong. Services are organized by specialty. Treatments are organized by what they address. Even an internet search depends on knowing which words to type.
But you may not know whether you need a urologist, a menopause clinician, a pelvic health physiotherapist or somebody else entirely. You may only know that something has changed. That is an extraordinary amount of diagnostic responsibility to place on you, the patient.
A woman can attend appointments and complete recommended screening while quietly reorganizing her life around symptoms nobody has asked her about. The absence of a diagnosis can start to look like the absence of a problem. Those are not the same thing.
Urinary leakage postpartum is common. Vaginal dryness, UTIs and discomfort around menopause are so common they have a name, Genitourinary Syndrome of Menopause. Changes in sexual function are common. Common tells us how often something happens. It does not tell us how much it matters to the person experiencing it.
A woman stops running because she leaks. She stops lifting her child because something feels like “it’s falling out”. She checks where the bathroom is before agreeing to dinner. She avoids sex because it hurts. Eventually, accommodating the symptom becomes so ordinary that it turns into “just life.”
Not every change needs treatment. But something affecting your comfort, sleep, movement or relationships deserves a conversation.
Private healthcare offers plenty of answers. A device. A hormone program. A procedure. A supplement. A package. The existence of a treatment does not tell us whether it is appropriate for the woman considering it.
Similar symptoms can have different causes. A pelvic floor may need help with strength, relaxation or coordination. Pain with sex may involve tissue changes, muscle tension or other conditions. Changes in desire can involve sleep, medications, stress, relationships and whether sex has become painful. “Postpartum” and “menopause” give us context. They do not explain every symptom.
A menu tells you what is available.
It cannot tell you what is happening.
That requires the question to come first.
When I created ÉLEVÉ, I wanted assessment to be the starting point. Our Women’s Health Assessment asks what has changed, how it affects your life, what has already been tried and what matters most to you. We consider bladder, pelvic floor, hormonal and sexual health alongside recurrent infections, core and abdominal function, medical history and longer-term health.
Bodies do not read clinic signage. Someone arriving with bladder symptoms may also need a conversation about menopause or pelvic floor function. Someone describing low desire may first need help with pain.
The assessment may identify a treatment, further investigation, a referral or a reason for reassurance. It may also leave questions that need time and follow-up. The point is not to find more things to treat. It is to make better decisions about what deserves attention.
ÉLEVÉ is part of private healthcare too. That makes the distinction between what we can offer and what somebody actually needs our responsibility. What matters first? What needs investigating? What can wait? When is reassurance enough?
Part of why I created ÉLEVÉ was that I felt limited by the options I could offer within standard healthcare. I wanted more knowledge and tools to address the concerns affecting women’s everyday lives, and more ways to help.
That is why I wanted a multimodal approach: the ability to combine treatments when they serve different parts of the problem. That might mean pelvic health physiotherapy alongside hormone and medical treatment, with other options considered according to the diagnosis, and the woman’s goals. Sometimes treatments belong together. Sometimes one needs to come first.
As a surgeon, I know surgery has an important role. For some women, it will be the most appropriate option. I also wanted a broader range of ways to help women whose needs call for something else.
Our job is to make the picture clearer. The patient’s job is not to purchase the maximum number of things available to her.
Bringing ÉLEVÉ into FORM is an opportunity to make care easier to coordinate. Its value depends on what follows the assessment: a clear next step, communication between the people involved, and follow-up when the plan needs to change.
Sometimes that next step will be within FORM. Sometimes it will be with a family physician or another specialist. The patient should understand why it is recommended, what it may offer and what the alternatives are. Having more options in one place should make it easier to choose carefully.
A clearer starting point. A plan that can evolve.
What happens to the woman who only knows she does not feel like herself? Or who has accommodated something for so long that she no longer thinks to mention it?
Maybe women do not need to become better at diagnosing themselves before they arrive. Maybe we need to become better at asking.
So when someone says, “I thought that was just how it is,” I want to begin with the question that should have come before the treatment menu:
Has anyone actually asked why?
Apparently, by ÉLEVÉ. Common is not the same as inevitable.
