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Unlocking the Mysteries of the Pelvic Floor

A graphic of a person performing pelvic floor exercises on a blue background under the text 'Embodied.'
Maris Ava Cruz
Learning pelvic floor exercises can strengthen the muscles in the lower abdomen.

The pelvic floor is a sling of muscles that supports the organs in our lower abdomen. We can't see them, but they help with sexual function peeing and pooping — and can be connected to issues from pain during penetrative sex to urine or stool leakage. Increasing awareness of these muscles and common issues is still in progress by patients and the Western medical community.

How much do you know about your pelvic floor?

If the answer is not much — that’s pretty common. The pelvic floor is a sling of muscles, nerves and connective tissue in the lower abdomen. It holds vital organs in place that help us give birth and have comfortable and pleasurable sex, as well as pee and poop.

These muscles can get tight or injured like any others, but a lack of awareness about these issues can lead to misdiagnosis or a lack of treatment.

Host Anita Rao gets answers to burning pelvic floor questions from Ijeoma Nwankpa, a doctor of physical therapy who is a certified specialist in pelvic health as well as a trained sexuality counselor. She is the owner of the Center of Pelvic Excellence Physical Therapy & Wellness LLC. Also joining the conversation is Allyson Byers, a freelance writer and editor in Los Angeles who has written about her personal experience seeking help for pelvic floor pain.

And Rao also speaks with a researcher who has been pushing for more collaborative study on the pelvic floor as it relates to the bowels — her dad! Dr. Satish Rao is a professor of medicine at Augusta College and a specialist in gastroenterology.

Please note: This interview originally aired on June 25, 2021.

Interview Highlights

Allyson Byers on her journey to discovering pelvic floor physical therapy:

As friends started to have sex and talked about wearing tampons, I realized that not everyone experiences this type of pain I was feeling and I thought maybe I'm too sensitive, or I just need to push through the pain. And I did for a lot of years, just trying different things. And I moved to Los Angeles, and I found a gynecologist here, and I was told that it was anxiety and that I just need to relax. And she even told me that, you know, before I engaged in penetrative sex, I should drink or take, like, a Xanax or something. And I felt very weird about that and felt like I, you know, didn't want to have to drink or take something in order to, you know, have sex and relax. But I took her advice, and it went terribly. I still had that pain. And finally, it was my talk therapist who suggested pelvic floor therapy, and [I] kind of finally found that in my late 20s, after just years of pain and just fear of, you know, having sex or putting a tampon in.

Ijeoma Nwankpa on postpartum pelvic floor physical therapy:

It definitely should be a part of standard care. ... I think it's very beneficial, because there's a lot of things you don't know, there's always some type of physical ... impairment that happens with having a baby because things get stretched out, … you have laxity in the joints, things like that. So it's good to have some rehab just to lead you to the right direction of the best recovery.

Satish Rao on the causes of pelvic floor dysfunction:

There is a pelvic floor brain dysfunction. And we've been studying that for many years. And we've now identified that yes, there is a disconnect between the pelvic floor and the brain. In other words, the patient is telling the pelvic floor to do something, but the muscles there are not behaving and not working the way it's supposed to do.

Stay Connected
Kaia Findlay is the lead producer of Embodied, WUNC's weekly podcast and radio show about sex, relationships and health. Kaia first joined the WUNC team in 2020 as a producer for The State of Things.
Anita Rao is an award-winning journalist, host, creator, and executive editor of "Embodied," a weekly radio show and podcast about sex, relationships & health.