Under the Hood

For many, the road to an endometriosis diagnosis is a decade-long maze of debilitating fatigue, "rice cake weeks," and being told that agonizing period pain is "normal." But the conversation is finally starting to shift. This week, pelvic floor PT Dr. Alyssa Demeule joins Dr. Rebecca and Dr. Alex to share her journey from medical gaslighting to recovery. We dive into the new ACOG diagnostic guidelines that prioritize the patient’s voice, the importance of finding the right excision specialist, and why lasting relief requires a strategic, multimodal path. This isn’t just a clinical deep dive into a chronically misunderstood disease - it’s a conversation about reclaiming your body and getting your life back.

What You’ll Learn:

• Why a “clear” MRI or ultrasound doesn’t mean the pain is in your head, and why many specialists are now moving away from surgery as the only diagnostic tool.
• Why your general OBGYN might not be the right person for excision surgery, and how to find a vetted specialist who truly understands the disease.
• How the body creates a “pain memory” that persists even after the tissue is healed, and how to retrain those pathways.

Tune in if you’ve ever thought:

• “Am I crazy, or is this level of pain more than just a bad period? 
• “Why does my doctor keep telling me my tests are negative…when I can’t get out of bed?”
• “How am I supposed to advocate for myself when I’m exhausted from just trying to get through the day?”

Resources

• Nancy’s Nook (an advocacy and education resource used to find vetted endometriosis excision specialists): www.nancysnookendo.com 
• Beating Endo: How to Reclaim Your Life from Endometriosis by Dr. Iris Orbuch and Dr. Amy Stein.
• Endometriosis Association: www.endometriosisassn.org
• Endometriosis Foundation of America: www.endofound.org
• The Endometriosis Summit educational videos: www.youtube.com/@theendometriosissummit5427
• Find a pelvic floor PT near you: pelvicrehab.com or Pelvic Global Directory

Connect with us:

Dr. Rebecca Howard Eudy
Website: rebeccaeudy.com
Instagram: @rebeccahowardeudy
Newsletter: Parents in Love Substack

Dr. Alexandra DiGrado
Website: bostonpelvicpt.com
Instagram: @bostonpelvicpt
Newsletter: Under the Hood

Under the Hood Podcast
Instagram: @underthehooddocs
Website: underthehoodpod.com

If you’ve ever wondered how your pelvic health may be affecting your fertility, this episode offers a helpful perspective. In this conversation, our own Dr. Alex joins Nora DeBora, a Functional Fertility Coach, Holistic Nutritionist and Fertility Awareness Practitioner, on The Ultimate Pregnancy Prep Podcast. They discuss the role pelvic floor physical therapy can play in fertility, pelvic pain, and overall function.

Dr. Alex explains why “tight” doesn’t always mean strong, how simple daily practices can help reduce tension and improve mobility, and why addressing pelvic health before pregnancy can make a meaningful difference in your fertility journey.

This conversation goes beyond the basics—it’s about better understanding your body and creating the conditions that support getting (and staying) pregnant.

Dr. Alex’s Book Recommendations:

• Beating Endo: How to Reclaim Your Life from Endometriosis by Iris Kerin Orbuch, MD and Amy Stein, DPT 
• Heal Pelvic Pain by Amy Stein, DPT 
• Pelvic Pain Explained: What You Need to Know by Elizabeth H. Akincilar and Stephanie A. Prendergast 

Learn more about Nora and the Ultimately Pregnancy Podcast at

www.naturallynora.ca/blog

Most of us think consent is pretty straightforward: someone asks, you say yes or no. But in real life—especially in relationships—it’s much more layered and nuanced than we’ve been taught to think about it.

In this episode, Dr. Rebecca Howard Eudy (couples and sex therapist) and Dr. Alex DiGrado (pelvic floor physical therapist) unpack the Wheel of Consent, a framework developed by Dr. Betty Martin that reframes how we think about giving, receiving, and asking.

From oral sex to gift-giving to everyday relationship dynamics (because consent shows up everywhere), this conversation highlights how unclear consent can lead to pressure, resentment, and disconnection - and how getting more honest and specific can actually deepen trust and intimacy.

If you’ve ever said yes when you weren’t sure, struggled to ask for what you want, or felt responsible for someone else’s experience, this episode will help you understand why, and what to do differently.

What You’ll Learn:

• The difference between giving, receiving, and allowing, and why most of us have a comfort zone (and blind spots) within that
• How unclear or unspoken expectations can lead to pressure, resentment, and performative responses (like faking enjoyment), even when both people have good intentions
• Why it can be surprisingly hard to know what you want (and how conditioning and past experiences shape that)
• How getting more honest and specific about consent can build trust and make things feel easier and more connected

Tune in if you’ve ever thought:

• “Why is it so hard to just ask for what I want?”
• “Am I doing this because I want to—or because I feel like I should?”
• “How do I trust that my partner’s ‘yes’ is actually a yes?”
• “How did we get into this pattern—and how do we change it without making things weird?”

Helpful Resources

• The Wheel of Consent Website by Dr. Betty Martin
• The Art of Giving & Receiving: The Wheel of Consent by Dr. Betty Martin 
• Find a pelvic floor PT near you: pelvicrehab.com or Pelvic Global Directory
• Parents in Love: A Guide to Great Sex After Kids by Dr. Rebecca Howard Eudy 

Connect with us:

Dr. Rebecca Howard Eudy
Website: rebeccaeudy.com
Instagram: @rebeccahowardeudy
Newsletter: Parents in Love Substack

Dr. Alexandra DiGrado
Website: bostonpelvicpt.com
Instagram: @bostonpelvicpt
Newsletter: Under the Hood

Under the Hood Podcast
Instagram: @underthehooddocs
Website: underthehoodpod.com

We’ve all been there: the familiar sting, the constant urge to go, or pain during intimacy that sends us straight for the cranberry juice. But what happens when tests come back negative and antibiotics don't work?

In this episode, Dr. Rebecca Howard Eudy and Dr. Alex DiGrado are joined by Heather Florio, CEO of Desert Harvest, to talk about why so many people are dismissed when their bladder symptoms do not fit the standard mold. Heather shares how a family member’s experience with interstitial cystitis led to the creation of Desert Harvest, and we break down three major drivers of bladder pain, how aloe-based treatments are being used for vulvar irritation and painful sex, and emerging research on lactoferrin for menopause, iron balance, gut health, and endometriosis.

If you've felt confused by pelvic or bladder symptoms that don't have simple answers, this conversation offers language, context, and specific questions you can bring to your care team.

What You’ll Learn

• Why bladder problems and tight pelvic floor muscles can cause many of the same symptoms, but require different treatments.
• How aloe-based treatments are being used for bladder pain, vulvar irritation, painful sex, and radiation burns.
• Why a protein found in early breast milk is being studied for menopause, gut health, and endometriosis.

Tune in if you’ve ever thought:

• “Why does it feel like I have a UTI even though my tests are all normal?
• “Sex hurts, and I’m tired of being told to just relax or use more lube.”
• “My bladder symptoms keep coming back, and no one can tell me why.”

Resources

• Desert Harvest Website (Use for Relievium, SSAB Capsules, and UTI Defense)
  • Contact [email protected] or call toll-free (800)-222-3901 to request a free sample of their Desert Harvest Super-Strength Aloe Vera Capsules. 
• Find a pelvic floor PT near you: pelvicrehab.com or Pelvic Global Directory

Connect with us:

Dr. Rebecca Howard Eudy
Website: rebeccaeudy.com
Instagram: @rebeccahowardeudy
Newsletter: Parents in Love Substack

Dr. Alexandra DiGrado
Website: bostonpelvicpt.com
Instagram: @bostonpelvicpt
Newsletter: Under the Hood

Under the Hood Podcast
Instagram: @underthehooddocs
Website: underthehoodpod.com

Your pelvic floor can stretch up to 250 times its normal length during birth. Your brain undergoes a literal metamorphosis. Your hormones shift for as long as you’re lactating. So why are we expected to be “back to normal” by twelve weeks?? This week, Dr. Alex and Dr. Rebecca (both moms themselves) dive into “bounce-back” culture. We talk about the pressure to have a “good baby,” the quiet strain relationships feel in the “do no harm” phase, and how to protect your mental health in a society that profits from your insecurity. Because none of us ever really go back to who we were before baby — we learn to move forward differently.

What you'll learn:

• How long it actually takes to feel “normal” again after birth (hint: it’s nowhere near 6 weeks).
• Why unrealistic expectations (about sleep, breastfeeding, your body, and your relationship) often cause more suffering than the changes themselves.
• What really determines whether your baby sleeps (it’s not just your parenting skills).
• Why strong couples don’t “bounce back” — they relearn the dance.

Tune in if you’ve ever thought:

• “Everyone else seems to be handling this better than I am.”
• “Why does her baby sleep and mine doesn’t? I’m following the plan.”
• “If this is supposed to be natural, why do I need so much help?”
• “Will I ever feel like myself again?”

Resources

• Parents in Love: A Guide to Great Sex After Kids by Dr. Rebecca Howard Eudy
• The Postpartum Essentials Virtual course
• Sex After Baby Mini-Course 
• Find a pelvic floor PT near you: pelvicrehab.com or Pelvic Global Directory

Connect with us:

Dr. Rebecca Howard Eudy
Website: rebeccaeudy.com
Instagram: @rebeccahowardeudy
Newsletter: Parents in Love Substack

Dr. Alexandra DiGrado
Website: bostonpelvicpt.com
Instagram: @bostonpelvicpt
Newsletter: Under the Hood

Under the Hood Podcast
Instagram: @underthehooddocs
Website: underthehoodpod.com

**What topic should we cover next? Who should we have on as a special guest? We'd love to hear your ideas! Reach out at https://www.underthehoodpod.com/contact. **

‘Boundaries’ gets thrown around a lot these days, but actually setting them is another story. For many of us, enforcing boundaries feels so awkward and exhausting that it’s easier to just do the very thing we were trying to set a boundary around in the first place.

In this episode, couples and sex therapist Dr. Rebecca Howard Eudy and pelvic floor physical therapist Dr. Alex DiGrado unpack what boundaries actually are—and why they’re about much more than saying no. They explore the two types of boundaries we all use (what we allow in and what we share out), how both oversharing and shutting down can interfere with real connection, and why burnout, trauma, and gender expectations make boundaries especially hard for parents and caregivers.

If you’re trying to show up for your work, your kids, and yourself without burning out, this episode offers a clear, realistic way to think about boundaries so you can protect your energy and still stay close to the people you care about.

What You’ll Learn:

• Boundaries aren’t just about saying “no” (and what oranges have to do with it)
• How to use “the pause” instead of an automatic yes (and why “checking your schedule” is about more than just your calendar)
• Why oversharing and people-pleasing can make connection harder, not easier
• How gender and social conditioning shape the way we learn (or don’t learn) boundaries

Tune in if you’ve ever thought:

• “How do I set a boundary without it being this big, awkward thing?”
• “Why am I good at setting boundaries in some parts of my life, but not others?”
• “I want to be open and connect with people, but I’m never sure how much of myself to share.”
• “Why does setting boundaries seem to be so easy for some people, but not for me?”

Resources

• Boundary Boss by Terri Cole, MSW, LCSW
• Essentialism: The Disciplined Pursuit of Less by Greg McKeown
• Find a pelvic floor PT near you: pelvicrehab.com or Pelvic Global Directory
• Parents in Love: A Guide to Great Sex After Kids by Dr. Rebecca Howard Eudy 

Connect with us:

Dr. Rebecca Howard Eudy
Website: rebeccaeudy.com
Instagram: @rebeccahowardeudy
Newsletter: Parents in Love Substack

Dr. Alexandra DiGrado
Website: bostonpelvicpt.com
Instagram: @bostonpelvicpt
Newsletter: Under the Hood

Under the Hood Podcast
Instagram: @underthehooddocs
Website: underthehoodpod.com

Let’s be real: most people get squeamish talking about poop. But if your gut isn’t happy, you aren’t happy...which is why we’re breaking the taboo in this episode. Whether you’re dealing with "vacation constipation," incontinence, hemorrhoids, or just feel like your gut runs your life, this is a judgment-free conversation about getting things working again.

From the science behind Dr. Alex’s favorite Yankee swap gift (the Squatty Potty) to mastering a morning routine that supports regularity, this episode is packed with encouraging, practical tips to help you ditch the shame, fix your mechanics, and find lasting relief. 

What You’ll Learn:

• How small shifts in your bathroom routine can make pooping easier (step one: put your phone away!)
• The cool science behind why your gut is called the “second brain” (and how the vagus nerve connects the two)
• Why just adding fiber won’t help if the issue is muscle coordination (not slow movement)

Tune in if you’ve ever thought:

• “Why do I get blocked up every time I travel?”
• “Why am I constipated even though I eat healthy?”
• “Why do all my tests say everything’s ‘normal’ when I feel so miserable?”
• “Why am I going to the bathroom so often, but still don’t feel ‘done’?”

Helpful Resources:

• Femeeze: A small handheld tool that supports the vaginal wall during a bowel movement, helping people with a rectocele empty more comfortably and completely.
• Squatty Potty: A small footstool that raises your feet on the toilet to mimic a natural squat and make bowel movements easier.
• Mind Your Gut: The Science-based, Whole-body Guide to Living Well with IBS by digestive health specialist + registered dietitian Kate Scarlata and GI psychologist Megan Riehl.
• Find a pelvic floor PT near you: pelvicrehab.com or Pelvic Global Directory

Connect with us:

Dr. Rebecca Howard Eudy
Website: rebeccaeudy.com
Instagram: @rebeccahowardeudy
Newsletter: Parents in Love Substack

Dr. Alexandra DiGrado
Website: bostonpelvicpt.com
Instagram: @bostonpelvicpt
Newsletter: Under the Hood

Under the Hood Podcast
Instagram: @underthehooddocs
Website: underthehoodpod.com

Many parents assume that if they aren't "in the mood," something is wrong with them or their relationship. Usually, though, it’s because it’s just really hard to find your libido under piles of laundry and sleep deprivation. In this bonus episode of Under the Hood, we’re sharing a conversation that Dr. Rebecca had as a guest on Slate’s Care and Feeding podcast about the messy reality of sex and intimacy after kids. This is an honest (and sometimes hysterical) look at why desire can disappear in those early parenting years, and how to start finding your way back to your partner - and yourself - again.

What You’ll Learn:

• Why not being in the mood is often about nervous system overload, not a broken relationship
• The difference between spontaneous and responsive desire (and the importance of a longer runway)
• How a well-timed whisper can totally change the tone in your relationship

Tune in if you’ve ever thought:

• I love my kids, but if one more person touches me today, I’m gonna lose it.
• Why is my partner ready to go the second the kids leave the house…but I’m just here thinking about the bills?
• How do I stop feeling like sex is one more thing on the to-do list.
• Does scheduling sex means the spark is gone for good?

Resources

• Parents in Love: A Guide to Great Sex After Kids by Dr. Rebecca Howard Eudy
• The Postpartum Essentials Virtual course
• Sex After Baby Mini-Course 
• Find a pelvic floor PT near you: pelvicrehab.com or Pelvic Global Directory

Connect with us:

Dr. Rebecca Howard Eudy
Website: rebeccaeudy.com
Instagram: @rebeccahowardeudy
Newsletter: Parents in Love Substack

Dr. Alexandra DiGrado
Website: bostonpelvicpt.com
Instagram: @bostonpelvicpt
Newsletter: Under the Hood

Under the Hood Podcast
Instagram: @underthehooddocs
Website: underthehoodpod.com

In Part 2 of our orgasm series, Dr. Rebecca and Dr. Alex move beyond pelvic floor mechanics to explore the psychology of orgasm. You'll learn why your brain matters as much as physical technique, how “shame loops” hijack arousal, and why fantasy is a tool (not cheating). We tackle intrusive thoughts that kill the mood (like "my stomach looks weird in this position") and give you practical tools to communicate your desires without the awkwardness. This episode is your guide to getting out of your head and back into your body, so you can stop "should-ing" all over your sex life and start enjoying it again. 

What You’ll Learn:

• Why saying "I can’t stop thinking about the laundry" out loud actually helps your brain switch back to sex mode.
• How to use fantasy to get out of your head and into your body and why that’s ok. 
• How to tell your partner exactly what you need.
• Why solo play is the first step to amazing partnered sex!

Tune in if you’ve ever thought:

• "Why can I orgasm alone, but not with my partner?"
• "Why does my mind wander during sex?"
• "Am I cheating if I fantasize about someone else?"
• "How do I tell them what I want without making it awkward?"

Resources

• The Postpartum Essentials Virtual course
• Sex After Baby Mini-Course 
• Find a pelvic floor PT near you: pelvicrehab.com or Pelvic Global Directory
• Parents in Love: A Guide to Great Sex After Kids by Dr. Rebecca Howard Eudy 

Connect with us:

Dr. Rebecca Howard Eudy

• Website: https://www.rebeccaeudy.com
• Instagram: https://www.instagram.com/rebeccahowardeudy/
• Newsletter:  https://substack.com/@parentsinlove

Dr. Alexandra DiGrado

• Website: https://www.bostonpelvicpt.com 
• Instagram: https://www.instagram.com/bostonpelvicpt/
• Newsletter: https://bostonpelvicpt.myflodesk.com/underthehood 

Under the Hood Podcast

• Instagram: https://www.instagram.com/underthehooddocs/
• Website: http://www.underthehoodpod.com

Most people (including medical providers) aren’t taught how orgasms actually “work.” In this first half of a two-part series, Dr. Alex DiGrado (pelvic floor PT) and Dr. Rebecca Howard Eudy (sex therapist) unpack common misconceptions about orgasms and explore what’s going on in the body and brain. From breath and muscle coordination to nervous system regulation, they cover the physical and emotional patterns that can shape pleasure - and why these issues are often overlooked in medical care. Whether you’re confused, curious, or just want to understand your body better, this episode is a great place to start.

What you'll learn:

• Orgasm is a full-body reflex, involving your pelvic floor, breath, diaphragm, and nervous system (aka it’s not a simple on/off switch). 
• Orgasms require both relaxation and excitation at the right times (and how PFPT can help with that).
• You can orgasm without ejaculation.
• Most pelvic floor PTs aren't trained in orgasm function in school. 

Tune in if you’ve ever thought:

• “I’m not sure if I’ve ever had an orgasm.”
• “Why does it take me forever to finish (or not at all)?”
• “How can I feel more relaxed in my body during sex?”
• “How can pelvic floor PT help with orgasm issues?”

Helpful resources:

• Come As You Are: Revised and Updated: The Surprising New Science That Will Transform Your Sex Life by Emily Nagoski Ph.D.
• Come Together: The Science (and Art!) of Creating Lasting Sexual Connections by Emily Nagoski Ph.D.
• Becoming Cliterate: Why Orgasm Equality Matters - And How to Get It by Laurie Mintz 
• Parents in Love: A Guide to Great Sex After Kids by Dr. Rebecca Howard Eudy
• Sex After Baby Mini-Course
• Find a pelvic floor PT near you: Pelvic Rehab Directory or Pelvic Global Directory

Connect with Us:

Dr. Rebecca Howard Eudy
Website: rebeccaeudy.com
Instagram: @rebeccahowardeudy
Newsletter: Parents in Love Substack

Dr. Alexandra DiGrado
Website: bostonpelvicpt.com
Instagram: @bostonpelvicpt
Newsletter: Under the Hood

Podcast
Instagram: @underthehooddocs
Website: underthehoodpod.com