Maybe you’ve been told that leaking after having a baby is normal, that sex is supposed to hurt a little, or that painful periods are just part of being a woman. When those messages get repeated enough, it can be hard to know when to ask for help. But common doesn’t mean you have to simply put up with it.
In this conversation, Dr. Heather Jeffcoat and I talk about what the pelvic floor actually does, why Kegels aren’t the answer to every issue, and how stress and everyday habits can affect those muscles. We also explore painful sex, incontinence, endometriosis, and what getting support can look like—even if you’ve never had a baby or don’t know where to start.
Key takeaways
01 Common symptoms don’t have to be accepted as your normal. Dr. Heather explains that painful sex, urinary leakage, and period pain that disrupts your life deserve attention. Ask what could be contributing and whether pelvic health physical therapy belongs in your care plan.
02 A tight pelvic floor isn’t necessarily a strong one. These muscles need to relax and lengthen as well as contract, so more Kegels aren’t always the answer. An assessment can help identify whether tension, weakness, or coordination needs attention.
03 Pelvic health matters beyond pregnancy and postpartum. Your pelvic floor helps support your organs, bladder and bowel control, posture, and sexual function. You don’t need to have given birth for symptoms or questions about it to deserve care.
04 Stress can show up as pelvic muscle tension. Dr. Heather describes how stress can contribute to an overactive pelvic floor, making relaxation part of care—not an optional extra. Breathing, rest, and support tailored to your symptoms can be part of the conversation with your provider.
05 Everyday bathroom habits are worth a closer look. Hovering over the toilet can keep muscles active when they need to relax, Dr. Heather explains. If urgency, difficulty emptying, or leakage shapes your bathroom routine, bring those details to your provider rather than brushing them aside.
Conversations like this, every Thursday
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My favorite moments
As we talked about pelvic health, something that can feel awkward or intimidating started to feel much less scary. I appreciated her reminder that we should be able to talk about this part of our bodies the way we talk about a knee or a back—without shame getting in the way of care.
The conversation about stress stood out, too. I’m a big believer that what’s happening in our minds can show up in our bodies, and hearing how that can connect to pelvic tension gave me more to think about.
About the guest
Dr. Heather Jeffcoat is a Doctor of Physical Therapy trained at Duke University, the author of Sex Without Pain: A Self-Treatment Guide to the Sex Life You Deserve, and a past president of the Academy of Pelvic Health Physical Therapy. She began in sports medicine before moving into pelvic health, where she has worked for more than 20 years.
She opened the first pelvic health physical therapy program in the Pasadena/Glendale area in 2004 and later expanded to Beverly Hills and Sherman Oaks. Her work includes helping people with painful sex, incontinence, and pelvic pain understand their symptoms and access individualized care.
Explore her educational articles and care options at Femina Physical Therapy, learn about her book at Sex Without Pain, and connect on Instagram at @dr.heatherjeffcoat and @feminapt.
Pause here
Is there something you’ve been putting up with because you were told it was normal or because it felt too awkward to bring up?
You don’t have to figure out the cause on your own. Start by writing down what you’ve noticed, when it happens, and how it affects your day. Bring that to a healthcare provider and ask what should be evaluated, including whether pelvic health physical therapy might help.
What would it look like to give this part of your health the same attention you’d give a painful knee or back?
This conversation is for education and inspiration, not medical advice. Please talk with your own doctor about what’s right for your body and your fertility.
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