Dr. Alyssa Hariprashad, a Manhattan-based pelvic floor therapist, breaks down all things pelvic floor.

The pelvic floor is a group of muscles that have become a popular topic within the past few years.

I have been a pelvic floor physical therapist for the past six years, and I can easily tell you that our field is continuously growing in the best way possible. 

What is the pelvic floor, and why is it so important? 

This group of muscles is in charge of very important functions of our body. The pelvic floor helps with urination, bowel movements, sexual function and helps to hold our organs steady. 

When you contract the pelvic floor, they lift the organs of the pelvis and tighten the openings of the vagina, anus, and urethra. Relaxing the pelvic floor allows passage of urine and stool and can also be beneficial for painless intercourse and other forms of intimacy in all genders. 

In men, these muscles are important for erectile function and ejaculation. In women, voluntary contractions (squeezing) of the pelvic floor contribute to sexual sensation and arousal. These muscles also provide support for the baby during pregnancy and need to be relaxed during the birthing process. 

How Stress Affects Your Pelvic Floor

In recent years, there has been more research in regards to how stress can impact your pelvic floor. 

Stress can lead to Nonrelaxing Pelvic Floor Dysfunction (NPFD). It is more commonly understood that various pelvic floor disorders are due to over-relaxed muscles.

In contrast, NPFD is not as easily identified because individuals can present with a wide range of nonspecific symptoms (pain, difficulty with urination or having a bowel movement, difficulty with relaxing, increased pressure). 

This may indicate that the pelvic floor muscles require relaxation rather than tightening. These symptoms are likely to have a negative impact on the quality of life, so it’s very important to figure out what life stressors are causing an impact on our pelvic health or vice versa. 

The Impact of Stress on Pelvic Health

Interventions can focus on managing stressors, such as patient education to help adopt healthy habits to control stress levels or referring individuals to seek further counseling if indicated.

A Team Approach to Pelvic Floor Wellness

A good team approach always helps my patients better.

It is very important to have a medical team (psychologists, primary care doctor, gynecologists, acupuncturists, etc.) and home program that includes all aspects of life—inclusive of how to break habits at home that may be causing tension within the pelvic floor along with prescribing exercises that are doable throughout my patients day to day. 

I have a trial-and-error approach that fits the needs and goals of each person. Our physical being is extremely important, but I find that a total body approach inclusive of our mental health and quality of life is even more important to address. 

Every practitioner is different and will have their own way of treating, but including all aspects of one’s life will lead to long-term symptom relief. 

Options for Pelvic Floor Therapy: In-Person vs. Virtual Care

There are different options for pelvic floor PT, including virtual/in-person appointments. I prefer in-person appointments because I have a more hands-on approach to my sessions. Many colleagues do virtual appointments, especially if that works better for a patient’s schedule. 

Conclusion: Taking Charge of Your Pelvic Health

All in all, there are different options that are extremely important when trying to make care more accessible for all. 

If you’re interested in starting pelvic floor therapy, reach out to set up a consult call!

More notes on somatics:

Dr. Alyssa Hariprashad is the proud owner of Blossom Pelvic Health located in Manhattan, NY. She holds a BS in Exercise Science from the University at Buffalo and a Doctorate in Physical Therapy from NYIT. She leverages an evidence-based, holistic approach to wellness, specializing in pelvic floor dysfunction, gender reassignment surgery rehabilitation, and orthopedic dance medicine. She also champions pelvic floor rehabilitation awareness through her Pelvic Rehab Practitioner Certification, her blog and Instagram page "The Pelvic Floor Playbook," and her podcast "All Things Pelvic." Alyssa's dedication to patient education, individualized care, and injury prevention underscores her commitment to enhancing patient wellness and advocating for often overlooked areas of physical therapy.