In this episode, I continue my conversation with pelvic floor physical therapist Dr. Rachel Gelman. We cover what actually brings people — of all genders — to see a pelvic floor PT, from pain and constipation to erectile dysfunction and urinary urgency. Rachel breaks down what a prostatectomy really does to sexual function, whether men can get sensation back after prostate removal, and why erectile dysfunction is almost always multifactorial. We also get into how the pelvic floor behaves during orgasm, why some people experience cramping or pain afterward, the fascinating jaw-pelvis connection, and the nerve link between your feet and your pelvic floor (yes, really). And Rachel shares her top tips for maintaining a healthy pelvic floor — including why she prescribes masturbation and vibrators far more often than Kegels.

In this episode:

00:00 - Podcast Intro & Show Hook

00:30 - Welcome Back & Part 1 Recap

01:10 - Why Vulva & Penis Owners Visit a Pelvic Floor PT

02:40 - Pain, Constipation & Gender-Neutral Symptoms

03:50 - Erectile Dysfunction, Urinary Urgency & More

05:00 - Diastasis Recti — Not Just a Women's Issue

05:40 - What Is a Prostatectomy & How It Affects Sexual Function

07:30 - Can You Get Sexual Function Back After Prostate Removal?

09:00 - Erectile Dysfunction: Is It Ever Just a Pelvic Floor Issue?

10:30 - How the Pelvic Floor Functions During Orgasm

12:00 - Why You Might Feel Cramping After Orgasm

12:50 - The Jaw-Pelvis Connection You Never Knew About

14:30 - Feet, Nerve Roots & Toe-Curling Orgasms — Explained

15:40 - Tips for a Healthy Pelvic Floor — Starting with Bowel Health

17:00 - Why Rachel Prescribes Masturbation & Vibrators Over Kegels

18:15 - Vibrator Recommendations for People with a Penis

19:20 - When & How to Find a Pelvic Floor Specialist

20:00 - Where to Find Dr. Rachel Gelman, Outro & Wrap-Up

Want a deeper look? Watch the full episode on YouTube for a more visual experience of today’s discussion. This episode is best enjoyed on video—don’t miss out!

Karen Bigman, a Sexual Health Alliance Certified Sex Educator, Life, and Menopause Coach, tackles the often-taboo subject of sexuality with a straightforward and candid approach. We explore the intricacies of sex during perimenopause, post-menopause, and andropause, offering insights and support for all those experiencing these transformative phases.

This podcast is not intended to give medical advice. Karen Bigman is not a medical professional. For any medical questions or issues, please visit your licensed medical provider.

Looking for some fresh perspective on sex in midlife? You can find me here:

Email: karen@taboototruth.com

Website: https://www.taboototruth.com/

Instagram: https://www.instagram.com/taboototruth

YouTube: https://www.youtube.com/@taboototruthpodcast

About the guest:

Dr. Rachel Gelman PT, DPT, CSC (she/her/hers) is a clinician, writer and educator. She received her Doctorate in Physical Therapy from Samuel Merritt University where she completed her clinical internship in pelvic floor rehabilitation. She has a special interest in sexual health and has received a certificate in sexuality counseling from the University of Michigan and is an AASECT certified sexuality counselor. She is a member of several sexual medicine associations including the International Society of Sexual Medicine and the International Society for the Study of Women's Sexual Health. She is the owner and founder of Pelvic Wellness & Physical Therapy in San Francisco. She is also an adjunct instructor at Samuel Merritt University where she teaches the pelvic health curriculum in the Doctor of Physical Therapy program.

Connect with Dr. Rachel Gelman:

Website: https://www.pelvicwellpt.com/

Instagram: https://www.instagram.com/pelvichealthsf

About the host:

Karen Bigman, a Sexual Health Alliance Certified Sex Educator, Life, and Menopause Coach, tackles the often-taboo subject of sexuality with a straightforward and candid approach. We explore the intricacies of sex during perimenopause, post-menopause, and andropause, offering insights and support for all those experiencing these transformative phases.

This podcast is not intended to give medical advice. Karen Bigman is not a medical professional. For any medical questions or issues, please visit your licensed medical provider.

Looking for some fresh perspective on sex in midlife? You can find me here:

Email: karen@taboototruth.com

Website: https://www.taboototruth.com/

Instagram: https://www.instagram.com/taboototruth

YouTube: https://www.youtube.com/@taboototruthpodcast

Substack: https://karenbigman.substack.com

Take control of your pleasure with my Pleasure Playbook, filled with tips to help you connect with your body and enhance intimacy. Download it now at www.taboototruth.com/pleasureplaybook.

LINKS, EXCLUSIVE VIP DISCOUNTS, COURSES & FREEBIES

🪄 Head to Mystery Vibe for award-winning devices that deliver precise vibrations to support erectile function and more!

🛒 Link: https://tidd.ly/4mePTpF

🚨 If you are a man navigating your partner’s menopause and feel lost, check out my NEW course ‘Men Meet Menopause’! AND to celebrate the launch, iI am giving you 20% off with code MMPLAUNCH20 https://bit.ly/MeenMeetMenopause

🥰 If you want her to want you more — start by understanding her body better. Free resources → https://www.taboototruth.com/free-resources

💋 Hotter, Wilder, Wiser | You’ve mastered everything else in life — now master pleasure! https://www.taboototruth.com/hotter-wilder-wiser

🔥 Ready to spice things up? This Yes/No/Maybe list is your permission slip for pleasure. https://www.taboototruth.com/free-resources-1/yes%2Fno%2Fmaybe%3F