Episode 17: Signs Your Pelvic Floor Needs Attention (Spoiler: It’s Not Only About Pregnancy) w/ Megan Jensen

When I first came to see Megan Jenson, I was dealing with several pelvic floor issues that I had just learned to accept as something I had to deal with. I was feeling very insecure in the bedroom due to pain during sex, and embarrassed by things like peeing when I sneezed or not being able to fully participate in HIIT classes for fear of leakage. I thought I just had to take the pain and discomfort, not realizing there may be an underlying cause or solution.

Megan Jenson is a pelvic floor physical therapist who works at Vitality Women’s Physical Therapy in Elmhurst, IL. She grew up in Michigan and went to Central Michigan University for her undergraduate degree. She competed on CMU’s gymnastics team becoming All American on the uneven bars her senior year despite a history of 3 ACL surgeries. After graduation, she pursued her 5th grade dream of becoming a physical therapist at Northwestern University. As a PT, she talks about sex, poop, pee, and pregnancy with her patients. When she’s not at the clinic, she’s working out at her CrossFit gym, seeing a movie with her husband, or cuddling with her two cats.

Megan helped bring to light that so many of the things I was experiencing are actually very common, and that there’s nothing wrong with me – it’s just that pelvic floor health is often overlooked or misunderstood. Through our discussion, I hoped to normalize these experiences and spread more awareness, since I know firsthand how the lack of information can lead men women to feel alone with issues they think they have to silently endure.

Here are some of the questions that were answered during the episode. The links that were mentioned are listed at the bottom of the page. If you would like more information about Megan Jensen or would like to be her patient, please visit Vitality Women’s Physical Therapy website to schedule an appointment. 

What is pelvic floor physical therapy? 

It is a type of therapy that looks at all the muscles that affect your bladder, bowel, and sexual function. Generally, a therapist will look at how you move your spine and hips. They will assess the strength of your abdominal muscles. An internal vaginal or rectal assessment of your pelvic floor muscles may also be performed to gather more information about what is causing your symptoms. 

Who is it for?

If you have any difficulties with leaking, going to the bathroom too much, constipation, or pain with sex, pelvic floor physical therapy is for you. We can also help you with any pain you have while you’re pregnant or postpartum. If you have pain in and around your penis or your vulva, pelvic floor physical therapy is for you! 

What is the pelvic floor?

The pelvic floor is a group of muscles that play a huge role in our lives every day. They are the muscles that are in between our two butt bones, our pubic bone in the front, and our tailbone in the back. We sit on them every day. They are used for bladder, bowel, and sexual function as well as a support system for all of our organs. 

What can I expect from my first visit from a pelvic floor physical therapist?

The pelvic floor physical therapist will start by getting to know you and your medical history. They will ask when you started to experience leakage or pain or any other symptom you would like addressed. We will also ask you what goals you have. Some examples are returning to running without leaking, having pain free sex, or having a healthy pelvic floor for the rest of your life. Then, we will look at your posture, your mobility, and your strength. We may let you know that an internal assessment would be helpful to get more information. We would explain exactly what to expect from an internal vaginal or rectal assessment, then show you on a model exactly what we would do. Once we have gathered all the information we need, we will present a plan to you on how to achieve your goals.

When should I go to the bathroom?

It’s normal to go to the bathroom every 2-4 hours. If you find yourself going to the bathroom sooner than every 2 hours, you should see a pelvic floor physical therapist. Your bladder works best when you only go to the bathroom if it’s full. Emptying your bladder before it’s full can lead to problems in the future. If you find yourself going to the bathroom “just in case,” when you leave your house or as soon as you get home, you probably need to work on your bladder habits. A pelvic floor physical therapist can help you decrease your urges to use the bathroom so you don’t have to be in the bathroom all the time. 

While pelvic floor health may seem like a women’s issue, the topics we discuss actually pertain to people of all genders. For men listening in, strengthening your pelvic floor can also improve sexual function and reduce issues like premature ejaculation. And as partners, it’s important for everyone to understand how factors like stress, breathing, and muscle tension impact intimate relationships. My hope is that this conversation helps normalize these subjects and encourages open communication between all people and their healthcare providers, regardless of gender.

It’s clear there is still so much work to be done to normalize pelvic health and prioritize pleasure, but specialists like Megan give me hope that change is happening. I encourage you to be your own advocate, learn about your amazing body, and don’t be afraid to speak up about what truly feels good.

I’m sure many of you still have questions after our fascinating discussion. The truth is, we could barely scratch the surface on everything Megan had to share. I’m thrilled to announce that we’ll be having Megan back as a repeat guest to dive even deeper. In our next episode, she’ll demonstrate exercises you can start doing today to relieve tension or strengthen your pelvic muscles. We’ll also get more practical advice for improving intimacy with partners.

So don’t forget to subscribe so you don’t miss part two of our conversation with Megan. And please, do spread the word – who knows how many people are suffering silently because they just don’t know it doesn’t have to be that way. Thanks so much for tuning in! Be kind to yourself and each other down there. 

How can a pelvic floor physical therapist help with pooping?

You should be able to have a bowel movement without straining. It’s normal to have a bowel movement as often as three times in one day or as little as every third day. However, you should have a bowel movement schedule that is regular for you. For instance, if you are used to having a bowel movement twice a day and then start to have a bowel movement every other day, a pelvic floor physical therapist can help you figure out what has changed in your life to make this happen. We can also look at how you are sitting on the toilet, how you are breathing, and what your pelvic floor muscles are doing when you are trying to have a bowel movement. We would work together to figure out what part of your body needs to be treated to help you have smooth and pain free bowel movements.

How can breathing help with my pelvic floor?

When you take a breath in, your air should travel down into your belly. This should then help relax your pelvic floor muscles. If you are breathing into your upper chest, your pelvic floor has a hard time relaxing. In pelvic floor physical therapy, we work on how you are breathing to make sure your pelvic floor muscles can contract and relax fully. 

It’s not normal to have pain with sex! 

What if I do have pain with sex?

If you are having any pain during sex, you should book an appointment with a pelvic floor physical therapist. We will work with you to figure out if your pain is coming from your hips, your back, your genital tissues, or your pelvic floor muscles. We often teach you how to breathe and relax your muscles. We may use internal vaginal or rectal techniques to help you stretch and move your muscles to get rid of your pain with sex. 

Warming up before sex can help decrease pain. Here are some examples of how to warm up: 

  • Gentle yoga focused on hip stretches (especially naked partnered yoga)
  • Slow diaphragmatic breathing 
  • Set the scene with good scents and dim light 
  • Use lubrication 

What is the mind-body connection to the pelvic floor?

There are many things that influence the mind-body connection to the pelvic floor. Oftentimes, when we clench our jaw muscles, our pelvic floor muscles also tense up. This means that when our bodies are stressed, they react by adding more tension to our pelvic floor muscles resulting in constipation, pain with sex, and/or incontinence. When we work to reduce the stress going on in our minds, our pelvic floor muscles move like they are supposed to!

It’s common, but it’s not normal.

You may know many people who are leaking urine and think it’s normal. Remember, it’s not normal to leak urine at any time, no matter how old or young you are. It’s not normal to have pain with sex at any time in your life. If you are experiencing any of these symptoms, a pelvic floor physical therapist can help you!

Links mentioned

Pelvic Wand from Intimate Rose. Use the code MEGAN23 for $5 off your purchase 

Vitality Women’s Physical Therapy website

@Dr.Meg_DPT

Find a Pelvic Physical Therapist using this PT Locator