The Truth About Your Pelvic Floor: What No One Told You About Healing, Sex & Strength

Body Image, Belly Tightness, and Self-Worth

Jamie Eads: Now that we have a basic understanding, I want to know more about how you know when your pelvic floor is maybe out of balance or dysfunctional. And as you were saying that, I was thinking about just being a woman and this conversation that I’ve had with a few friends about how our body image – maybe we suck in and are used to sucking in.

I mean, I have had a friend tell me it’s like we almost – even when you’re home, you start doing that and you’re like, usually you do that when you’re out, you’re bloated, you don’t want people to see your bloat. So the whole time you’re holding it in, and then you almost get so used to it that you start doing it at home.

Lauren Ohayon: Well, our sense of self-worth is tied into how flat our belly is. It is literally the currency of self-worth. The flatter the better.

It’s incredible because I even see all these nervous system content creators on Instagram who are like, “When I regulated my nervous system” – and they’re in a bikini – “when I regulated my nervous system, my belly flattened.” And I’m like, “You can’t actually call yourself a wellness expert when you are in a bikini promoting wellness as being something – I’m looking at your flat belly.”

You are duping me. You are continuing the shame cycle. You are continuing this toxic wellness cycle. But that’s what people want. The amount of women commenting being like, “Tell me how, what was the formula?”

And it’s like, “Oh my God, no. How about no?” So, but people strongly tie their self-worth to it. Even my three daughters – they’re being raised with me, super body positive, super anti-toxic wellness culture, anti-diet culture. TikTok is not a help. Instagram doesn’t help us women feel safe in our bodies and feel safe with any form of a belly.

The amount of clients who come to me with pelvic floor dysfunction who also happen to have a very, very tight abdominal wall, who told me that it started in childhood, where either they watched their own mothers fret about the ice cream cone they just ate – inherited disordered body image eating – or they were told by a caregiver, “Why don’t you exercise? You just eat a lot.”

All these messages don’t help us feel safe in our body and definitely don’t help us feel safe in – it’s never enough. I have clients who are no body fat and they are still finding issues with their abdominal wall. We are all conditioned. So yeah, we’re pulling and tightening our belly in all the time. It’s a problem. It’s an unfortunate pattern.

Signs of Pelvic Floor Imbalance

Jamie Eads: While we’re on the science of the pelvic floor, I want to talk about if I’m the average person and I’m having some symptoms, maybe I’m having some back pain or some other symptoms. How do I know if it’s my pelvic floor? How do I tell if there’s a problem with my pelvic floor?

Lauren Ohayon: It’s such a great question. Think about it. If your hand was bothering you, you’d be able to look at it. You’d be able to be like, “Oh, it’s got this shape and there’s tightness.” You can feel it and you touch it in response to you.

Because of this systemic erasure of the pelvic floor – think about it too – when you went to sex ed class in school, probably the conversation was about disease prevention and pregnancy prevention. None of it is empowering or encouraging or engaging.

I taught my children about sex and pleasure first. I was like, “You come first. Remember that. You come first.” But we’re not taught to think that we deserve pleasure. This part of our body is hidden. It’s inside. And we’re told that it’s shameful and dirty and disgusting.

Children, many children, naturally masturbate. They rub up against things. It’s very common. Many of them get shamed for it at a young age. That is the worst form of shame you can experience at a young age – being caught with your hands in your pants and then being shamed.

Who didn’t have their hands down their pants? It is one of the best places to have your hands. It is fun in there. That is, like, everything else around us is fabric and socks. And yet we’re told that it’s disgusting and gross.

We’re not trained to think about it in any unique, interesting, cool, curious, fun way. We’re trained to disregard the pelvic floor. So part of it is also: How much of your pelvic floor are you aware of?

I would love all women to be so familiar with their pelvic floor that whether they have an issue down the line or not, it’s like their hand. If you close your eyes and I ask you to do all sorts of things with your fingers, you can. Most people with their eyes open can’t do shit with their pelvic floor.

Can you do this? No. Can you feel that? No. Can you wag your tailbone? No. Can you move your clitoris? No. Your clitoris can move. It’s muscular.

Yaz Ketcherside: No way.

Lauren Ohayon: Yeah. It’s so hot. I have all my videos about wagging your clitoris. It nods like a head. So it goes in this direction. The clitoris can nod.

Yaz Ketcherside: Using a mirror is a great idea. Are you – do you unclench the clitoris and that’s what moves?

Lauren Ohayon: Clench is not a term I love. But if that’s what it feels like to you, go for it. Yes, the muscles around the pelvic floor facilitate the wagging and nodding of the clitoris. So it is a pelvic floor movement.

Even for something very basic, like if I said to you, “Move your fingers,” you might not be like, “Should I clench them?” You’d be like, “Oh, should I wave them?”

But when we talk about the pelvic floor – and I’m not shaming you, what you said was perfect – but so many people when they come to me and I’m asking them to do something with their pelvic floor, they’re like, “Wait, should I be squeezing? Should I be clenching? Should I be gripping?”

And it’s like, how about it’s this beautiful structure and we just feel it condensing and yielding and moving – think jellyfish. But none of us are taught to embody our pelvic floor in this beautiful way, in this kind of soft, nurturing way. Open, closed. Condense, yield.

It’s like squeeze, crunch, grip.

The Myth of the “Loose Vagina”

Yaz Ketcherside: And you’re saying with the pelvic floor, is it that it’s either loose or tight? Or what’s so – 

Lauren Ohayon: Great question. Nothing in our body is loose actually. My t-shirt is loose, which is why I keep tucking it in. But nothing in our body – it’s an incredible structure that we have. If you hang out upside down, your eyeballs are not going to fall out of your body. When you break an ankle, your foot doesn’t fall off. Things never get loose really.

Skin can get saggy, and it can feel loose. But that’s just the elasticity of the skin has changed. Vaginas are never really loose. It’s tons of tissue and the tissue elasticity can change. I say this because I personally don’t want people using language around their body that’s not factual.

When we use misinformation to describe parts of our body, it changes our experience of our body.

Vaginas are never loose. However, they can – your perception can be that it’s loose. It can feel loose to you for sure. But rather than thinking that it’s loose, the tissues maybe are different. Their orientation to each other is different.

If your uterus or bladder or rectum has changed position due to pressure or childbirth – I have a lot of clients who are long-time athletes who do not have any children who have major pelvic floor prolapse because of all the pressure. Gripping your core all the time creates a lot of pressure.

Athletes do tend to have a very high pressurized core. And when things are very high pressure, you don’t have a lot of space. So things shift, things move.

It’s common for the uterus – if you’ve denied it or your pattern has created less shape, less volume, less space – your uterus is smart. It moves out of the way. It’s like, “Okay, I’m not welcome in this space anymore. I’ll just descend.” And the only place for it to go is down into your vagina.

Those changes in tissue – and then your body will react differently when there’s a uterus inside your vagina. Your vagina is like, “This doesn’t belong here.” And what it starts to do is contract to try to either push it out of the way, or it feels like it might fall out.

People who have a prolapse will start tightening. And when you’re too tight, things can actually feel loose.

Yaz Ketcherside: Really?

Lauren Ohayon: Yeah. When you’re too tight, you can’t contract anymore. When you see bodybuilders, they’re really tight. When you’re too tight, you can’t actually shorten the muscle fiber anymore. It’s already short.

That’s why people are like, “I’m already too strong.” And I’m like, “You’re not wrong. You are strong. But those muscle fibers are actually too tight, which is why you can’t feel them and control them.”

When you’re too tight, you lose control. Super tight people with very, very tight hips who sit a lot struggle to do this movement – pulling my knee to my chest. If my hips are too tight, I can’t do it. And what it will feel like in my brain is that that movement is inaccessible.

That’s an arm and leg example, but when it’s a body part like the core or pelvic floor, that inaccessibility can be translated as “it’s too loose” because the muscles can’t generate any more tension. It feels loose because what you’re really feeling is “I don’t have the power to generate tension.”

If you don’t have the power to generate tension, you automatically think, “My vagina is loose. It can’t tighten. It’s loose.” No, it’s already too tight.

Restoring Responsiveness, Not Just Stretching

Yaz Ketcherside: In terms of the work that you do, is it more so changing the muscle? Like you were saying, the muscle in the pelvic floor can be really tight or be a little more elastic or what have you. Is the work that you do helping bring it back to balance?

Lauren Ohayon: Yeah, it’s a great loop to close. If I have – if I struggle with my arm with range of motion and therefore I’m unable to go through the full range of motion, I’m unable to straighten it, I’m unable to bend it fully, it’s kind of stuck mostly in this position – I’m unable to get a full range.

One would say that the arm is no longer responsive. When I go to lift something, because I don’t have this full range, I’m using all these other body parts to get there. I start overusing my shoulders or pulling my ribs forward or cranking my head in some way to kind of compensate because the body is super smart. It’s like, “Oh, this joint is no longer available. No problem. We’ve got all these other joints we can borrow from to get this movement happening.”

The work then doesn’t become about stretching the arm back out. It becomes about: How do we get this arm to be responsive again? And then the outcome of a responsive arm is one that can straighten fully and one that can bend fully.

The pelvic floor is no different. The pelvic floor is not designed to be relaxed, and it’s not designed to be overly tensed. It’s designed to react. If there’s a movement in which I need my pelvic floor to tense up in order to facilitate a different movement happening, it should do that. If my pelvic floor is no longer needed, there should not be that hyper-tension muscle activity happening.

The goal of really good pelvic floor therapy – and I’m not a pelvic floor physical therapist, by the way. I’m a movement teacher. But the goal of really good pelvic floor therapy, or what I do, which is pelvic floor education through movement – it’s not physical therapy – is to help somebody’s pelvic floor become responsive again.

When I do this, my pelvic floor should have a reaction. When I do this, my pelvic floor should have a reaction. When I do that, my pelvic floor should react. Depending on what I’m doing, the pelvic floor shouldn’t be a script. And it shouldn’t just be flatlining. It’s always in a state of responsiveness.

A lot of people with a very tight pelvic floor, they’re like, “How do I relax? How do I relax? How do I relax?” I get that desire to relax your pelvic floor. But it’s like saying, “How do I relax?” If you relaxed your body and walked around all day, you wouldn’t be happy. You can’t walk around like this.

The body needs tone.

Why Kegels Don’t Work for Most People

Lauren Ohayon: This is also why Kegels don’t work for pelvic floor dysfunction. Ask people who really have pelvic floor dysfunction – Kegels don’t actually work because they just tighten and squeeze. But that’s like saying to somebody with an arm issue, “Yeah, just do this all day long. Just 100 of these and you’ll be fine.”

There’s nothing functional about that. It’s not how the pelvic floor works. The pelvic floor is designed to be in relationship to the breath and the core – the spine, the breath, core, and abdominal wall make up the pelvic floor canister.

If you had a can of soda – think about a can of soda and what makes it bubbly and fun to drink and exciting on your lips and in your tongue is because when you open it and you drink it, the bubbles are still there. What makes those bubbles there is you’ve got this really tight, closed container of pressure.

If I were to remove the bottom, then I would have nothing in the can. I would also have no bubbles. The same thing goes – your core canister is literally a pressurized system like that. If you remove one part of it and you take out the pelvic floor, or your core is not working in a functional, integrated way, or your breathing mechanics or your spine – that’s your entire core canister. That can of soda is not going to have liquid. It’s not going to be delicious to drink because the bubbles are going to be all sorts of – I don’t know what – either flat or just semi-flat or whatever.

The core is no different. It is really those forces – the bottom, the back, the front, and the top have to be in their role.

Foreplay, Penetration, and Pelvic Floor Function

Jamie Eads: That was a great question to help give a full understanding. I want to circle back to a couple of sexual health questions. As you were talking about that, that came to mind. I’ve heard on previous podcasts about foreplay being necessary for your body to become relaxed or prepare for intercourse – having penetration. Is that true?

And also, when you do have a baby, from what you were explaining, it doesn’t sound like your vaginal canal actually changes. It just sounds like this is a responsiveness issue, not a physical change in the structure.

Lauren Ohayon: Yeah. I mean, pushing a baby out of your vagina creates a lot of change, let’s put it that way. Pushing a baby out – but the body is designed to come back to integrity. It’s not designed to stay stretched.

The tissues can stretch. It’s some crazy amount that the tissues can stretch. Fun fact people don’t know this, but your vagina – the walls of your vagina – next time you put your fingers up there, you can feel for this. But the walls of your vagina are full of folds – rugae, all these folds. So cool. And those folds help the vagina stretch open.

That’s also – if you are having intercourse with a very large object, penis or otherwise, your vagina can accommodate that because it stretches open. It’s got this ability to get way bigger than it currently is. But then it’s also designed to come back.

Yes, but I am saying that when people have had a baby and they feel like their vagina is stretched out or loose, it’s most likely that their perception of their vagina is not – they’re getting mixed messages from their vagina because there’s a tension pattern going on. Sometimes just connecting back into the pelvic floor with your movement, pelvic movement coordinated with breath and spine – remember we said it’s the whole thing you’ve got to do.

If you want to get the pelvic floor back to doing its thing – back to this kind of motion, this condensing and yielding and tightening and releasing – you’ve got to put the whole body through movement and use the breath.

That will wake up the map from the brain to the pelvic floor and start to bring the tissues back into their regular resting tone.

Sex, Arousal, and Muscle Function

Lauren Ohayon: As far as sex and foreplay, intercourse – foreplay is very important for a lot of people. Some people don’t need it. They can go straight to the main dish.

The thing we want to remember is that when you say “ready for penetration,” sex is so complicated. When you say ready for penetration, do you mean ready to have an orgasm or ready to receive a penis inside? The muscular system of the vagina – ready for insertion?

Those are two different things. Ready for insertion is so interesting. Some people are very, very tight. There are conditions that make certain people super tight. No amount of foreplay will necessarily change that because if they’re super tight before they’re going into this state, their brain is perceiving a threat and it needs to update its threat map.

And the way you update the threat map is off the field. You can’t just come onto the field and be like, “I’m ready. Here we go.” You’ve got to get the vagina – there’s dilators. It depends on the condition.

But if people are really tense in their pelvic floor, being lubricated is fabulous. Being turned on is amazing. Getting all of those things are part of it. But their pelvic floor, their vagina might not yield no matter how turned on they are. And it’s really frustrating because they haven’t done the work to tell the vagina, “It’s okay to let something in. It’s okay to let me in.”

Yaz Ketcherside: It’s muscular.

Lauren Ohayon: Yeah. Everything is nervous system. Everything. But yeah, it’s training. It’s increasing capacity.

An easy way to think about this is: Let’s say I’m a highly, highly, highly anxious person. Let’s say I really believe that if I walk out my front door, I could die. I’m anxious, I could die. But let’s say everyone around me knows that this is not true. And now they want to convince me to get out of my door.

The stupid thing to do would be like, “Let’s take a walk around the neighborhood.” The intelligent thing to do would be like, “Let’s start with you looking at the front door.” And maybe we have to do that for a week, ten days to two weeks. “Let’s start with you stepping towards the front door.” Again, take time. Give it time. “Let’s start with you putting your hand on the door. Can you handle that?”

Okay, let’s open the door. And you build what’s called tolerance and capacity to be able to take a step out the door. And it has to be super, super titrated. The dose has to be right.

What a lot of people do, unfortunately, is they skip all those steps. If they are having painful sex, they’re like, “Just wanting it should be enough.” But it’s not actually. It’s not.

Training the Body to Feel Safe with Penetration

Lauren Ohayon: How about we start with breaking down all those steps, but not again while you’re on the field, like ready to go. You have to just step away from the field and do a series of things that might take three months, five months, six months to train your body that it’s safe to have something inside it.

Your body does not feel safe with that. No amount of you telling your brain that you want it, and you telling your body that it’s okay will help. You need to show the brain. The brain works with show.

You’ve got to just slowly – they have dilators, and they’re really tiny. And then you get a bigger one and a bigger one and a bigger one and a bigger one. But you don’t start with the number ten dilator and start putting it inside you. No, you start with tiny. You even start with just holding it. You start with maybe holding it near you.

There’s just a lot of – we’ve got to break down the steps to make the body feel safe.

Daily Movements to Support Pelvic Floor Health

Jamie Eads: So we talked a lot about the responsiveness of the pelvic floor. What should we be doing? What type of movements should we introduce? What can we do on our day to day to help with it?

Lauren Ohayon: It’s a great question. Do you have three hours?

So yeah, it’s a great question. How do you start to connect to that? Again, we use the hand before. How do you start to connect to something that you can’t see? Well, you can actually map your brain to your pelvic floor. I like to help clients by mapping it to the front of the pelvic floor, the back of the pelvic floor.

It can start with something like: Can you wag your clitoris? What do you feel when you wag your clitoris? Can you wag your clitoris and feel like – imagine your clitoris was like ten inches long and you could then scoop it deep inside. Could you get more pulling up, starting at your clitoris but then pulling up? Does it – what does it feel like? Does it feel like clench, grip? Can you make that an embodied thing that you do?

Instead of doing 400 Kegels, can you instead think about like, “Oh yeah, that’s cool. I can feel my clitoris. I can feel going a little bit deeper up. I can feel my anal area.”

I like to help people feel the posterior by wagging their tailbone. You actually do have a joint in your tailbone. It is capable of a tiny bit of movement. It is a pelvic floor movement. All your pelvic – not all, but a bunch of – some muscles are attached to your tailbone.

Can you wag your tailbone back and forth? Can you do those? Can you bring your tailbone towards your clitoris and your clitoris towards your tailbone? Can you raise them up?

And then it’s like, can you start to feel them in conjunction with movement?

Using Breath and Core to Access Pelvic Floor

Lauren Ohayon: One of the best ways to map to your pelvic floor is via your core. If you put your hand on your lower belly and you take a long, slow breath like you’re blowing out 100 candles and you feel how your core reflexively tightens in – you don’t have to tighten it, and blowing out candles out of your mouth should engage your core to tighten in – what do you sense and feel in your pelvic floor when you do that?

It becomes a whole exploration. The more – during exercises and workouts, I never cue people to engage their pelvic floor. Instead, we cue a lot of this candles breath in a movement. It’s like, you want to take a side bend. Put your hand on your belly, take a breath, inhale, exhale, blow out your candles, feel your core engage. Now take the side bend. Notice what your core is doing. And then you’re noticing your core is engaging tighter.

This is an easy movement – arm straight up to the sky, hand on my belly, no load, nothing has to happen. The minute I take this side bend and I get my body off its vertical axis, that’s a big load on the core. My core has to react.

Then it becomes about: How does it react? When it reacts, does it bulge and push out? That’s a bearing down. Can we instead corset, draw in and up? That’s a lifting.

We get nuanced. But then ultimately you use your core to bring the pelvic floor along with the movements. And then it just becomes about: Can you feel it when it happens? Don’t do anything. It’s like the same thing when I pick up my AirPods. I can feel my fingers go around it. I don’t have to do anything. Just feel. Can you just notice, witness, look, feel, and be in it? Can you do that in your pelvic floor?

Can you not have to do it? Don’t do anything to your pelvic floor. Just feel it in reaction to your core, which is in reaction to your breath, which is in reaction to your movement. We just paired all those things together.

We were here. Inhale, arms straight up to the sky. Exhale, blow out breath. Now you’re integrating the breath. Now you’re integrating a core movement. As you take that side bend, and now you’re feeling – you’re updating your map by feeling: What do you do when you do what you do?

That’s my favorite question. What do you do when you do what you do?

“Oh Lauren, I bear down.”

Great. This is not what we want to be doing when we do what we do. But how amazing that you just felt your pelvic floor. And people will be like, “That was the first time I ever felt my pelvic floor.”

And it’s like, yay! Because it’s not about doing it right. There’s no right way. But are you bearing down all the time?

Re-Patterning Through Awareness

Lauren Ohayon: A lot of my clients bear down when they talk because what is talking? Talking happens on an exhale. Have you ever thought about that? When you talk, you’re exhaling. So what do you do when you exhale? “I bear down.”

Oh, let’s re-pattern that because you’re probably talking a lot and you’re probably exhaling a lot.

Yaz Ketcherside: When you do re-pattern something like that – like let’s say if I’m speaking and I’m bearing down right now – what is an example of something? Is it more so just making sure I’m trying like mind-body relaxed? Or are there actually – 

Lauren Ohayon: When you first notice that you’re bearing down, the first thing you do is you say to yourself, “It’s okay. I’ve lived this long bearing down. I’m not going to die today. I don’t need to fix this now.”

Then you do – this is why I created an online program. I’m not trying to sell it. But then you do exercises that reinforce a different way of patterning. So instead of exhaling and bearing down, you train your body to exhale and engage. But you don’t engage your pelvic floor. You just exhale. So blow candles.

Do that again. Inhale, hand on your belly. Exhale, blow 100 candles, long and slow. Do you feel your core engaging and pulling in?

Yaz Ketcherside: Yeah.

Lauren Ohayon: So you’ve already re-patterned it. That’s the re-pattern. Now let’s do it on our hands and knees. Now let’s do it in downward dog. Now let’s do it standing. Now let’s do it lying on our back. Now let’s do it in 3D.

This is why I hate Kegels. Because you’re just lying on your back squeezing. Now let’s do it in a variety of movements where your core is reacting to your breath and movement by drawing in and up. That’s the opposite of bearing down.

I didn’t tell you to grip your core. I didn’t tell you to tighten your core. I simply told you to feel your core reacting by drawing in and up. Your pelvic floor will come along for that ride. That is how they are paired. Your pelvic floor will.

You kind of have to just get your breathing and core strategy ironed out, and your pelvic floor will be fine. That’s what I do. I’ve been teaching this work for over 20 years. I have thousands of success clients. I never tell them to do anything to their pelvic floor.

The Restore Your Core^® Approach

Lauren Ohayon: Map to your pelvic floor. Feel your pelvic floor. Know what it feels like. Now we work on the breath and the core relationship in 3D, full body movement. It will take the pelvic floor along for the ride. Your pelvic floor will come.

And when you are really mapped to your pelvic floor, you start to feel that blowing candles in your core, you’ll start to be like, “Yeah, I feel my pelvic floor actually lifting with that.”

Now you’re in the zone. Now your pelvic floor is responding appropriately to your core. Your pelvic floor is bearing down? We need to work on that. But most people, when they learn to engage their core effectively, paired with the movement, paired with the breath, their pelvic floor just comes along.

So fucking beautiful and perfect. We think we have to do all this work to the pelvic floor. No. Work on the rest of that core canister. It’ll just take the pelvic floor along for the ride, like a really good friend does.

Jamie Eads: Yeah. And Lauren shares a lot of these movements on her Instagram as well. So if you do want to explore more, definitely check out her Instagram. She walks you through it and has a ton of really unique and cool exercises.

Lauren Ohayon: Thank you.