This week, Jess is joined by Rachel Gelman, a pelvic floor physical therapist from San Francisco. Rachel shares her unique insight on pelvic floor health, sexual pain and the fact that Kegels are overprescribed. Tune in to find out if you should be doing Kegels.

Follow Rachel on Instagram here or on her website.

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Rough Transcript:

This is a computer-generated rough transcript, so please excuse any typos. This podcast is an informational conversation and is not a substitute for medical, health or other professional advice, diagnosis or treatment. Always seek the services of an appropriate professional should you have individual questions or concerns.

STOP! Don’t Do Kegels!

Participant #1:

Hello, my friends. This is Sexologist Jess O'Reilly. Of course, your friendly neighborhood sexpert. And every neighborhood should have a sex birth. That's what I think. And today, as usual, in the next 20 minutes or so, we're going to be covering some sex science and advice you can use tonight. Now, today I am joined by Rachel Gellman, the director of San Francisco's Pelvic Health and Rehabilitation Center. She has a doctorate in physical therapy, and her work specializes in pelvic floor health. Now, if you don't know what a pelvic floor physiotherapist does, you're going to learn today. I have learned in person already, and it was quite an experience. So for a long time, I've been wanting to ask more and more questions of somebody in this field, and I came across Rachel, actually via Instagram. So you'll make sure you follow her. She'll give you all the info. Happy to have Rachel here. Hi there. How are you? Hello. Thank you so much for having me. My pleasure. So most people have not heard of pelvic floor physiotherapy. Is that correct? That is very correct. Most people who I meet out in the world and patients obviously are a little confused by what I do and have a lot of questions and always makes for fun dinner conversations. Most people don't know what I do, but I'm always happy to tell everyone what I do. Okay, so let's start here if you go see if we come to your office and I'm a person with a vagina because it's going to be different, I suppose, whether I have a vagina or a penis. Yes. I mean, obviously, yeah, there is going to be some difference. But I'd say for the examination and everything we do, 75% of it is the same for if you're a man or a woman. So usually the first visit is a lot of talking. I want to get to know you. I want to hear your story, depending on what you're coming in for. I'm going to ask a lot of questions about your symptoms. And then I'm always going to ask questions about bowel bladder and sexual function, regardless of why you're coming in. I'm always going to ask questions about that. And then I'm always going to be looking externally first because I am a physical therapist. So I'm going to look at your posture, how things are moving. And then I'm going to be looking at all the muscles and connective tissue, all the soft tissue externally, basically from the ribcage to the knees, is usually how I describe it. So I'm going to look at your abdomen and look at your legs and look at your back, your glutes, your hips. And then I will do an internal examination. And that's where it is a little bit different for men and women, because obviously, men, there's only one way for me to access the pelvic floor and that's through the rectum. And then for women, I typically do the examination vaginally. But for some women, I may do it rectally depending on what their symptoms are. Really, it sometimes can be the same for both men and women. The only difference is, obviously that men have a penis, women have a Volvo and a vagina. So there's not too much of a difference in reality other than how I'm going to actually access the pelvic floor. Okay.