In this episode, I sit down with pelvic floor physical therapist Dr. Rachel Gelman to uncover the one part of the male body that almost no one talks about — the pelvic floor. From erection strength to ejaculation control and orgasm intensity, Rachel breaks down exactly how these muscles work in men and women alike, why most people are walking around with a pelvic floor that's too tense (not too weak), and why Kegels may be the most over-prescribed exercise in sexual health. We also get into male incontinence, what a pelvic floor internal exam actually looks like, how consent is handled in the clinical setting, and why trauma plays a bigger role in pelvic floor treatment than most people realize. This is Part 1 — and trust me, you don't want to miss Part 2.
In this episode:
00:00 - Podcast Intro & Show Hook
00:30 - Welcome & Karen's Introduction
01:15 - Meet Dr. Rachel Gelman – Pelvic Floor PT
02:40 - Women Are Learning About Pelvic Floor PT — But What About Men?
03:45 - Half of Rachel's Patients Are Men
04:30 - The Pelvic Floor Is Gender Neutral
05:15 - Pregnancy & the Pelvic Floor — The Common Misconception
06:10 - How the Pelvic Floor Works: The Muscular Hammock Explained
07:50 - Sexual Function & the Pelvic Floor (For All Genders)
09:30 - Karen's Tight Pelvic Floor — And Why Kegels Were Wrong for Her
10:40 - Why Most People Have a Tense, Not Weak, Pelvic Floor
12:00 - The Kegel Myth & Over-Prescription
12:45 - Pelvic Floor Machines: Do They Help or Hurt?
13:30 - Male Incontinence — How It Works & What Causes It
15:10 - Prostate Surgery & Its Impact on the Pelvic Floor
15:50 - The Internal Exam — Consent, Comfort & What to Expect
16:55 - Trauma, Body Language & Knowing When NOT to Proceed
17:25 - Wrap-Up, Part 2 Teaser & Outro
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
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