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Heather Jeffcoat at Buzzfeed
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questions you are too embarrassed to ask
Yulia Lisitsa / Getty Images/iStockphoto
When Buzzfeed journalist Shelby Heinrich did a deep dive with her readership into the "questions you are too embarrassed to ask", I was honored to help. There were 15 questions in all, and here is a brief synopsis of the article, along with a link to the full article below.

Heather Jeffcoat, DPT

Questions You Are Too Embarrassed To Ask When it Comes to "Down There"

We asked the BuzzFeed Community if they ever had a question about ~down there~ that they might be too embarrassed or intimidated to ask, and they came through with lots of insightful questions! So, we reached out to Dr. Heather Jeffcoat, DPT, a licensed pelvic floor physical therapist and owner of Femina Physical Therapy in Los Angeles, to answer your pelvic health inquiries.

Here is a sampling of the questions you are too embarrassed to ask:

1. "Why do I have to pee so often? I barely drink any liquids throughout the day, because otherwise I’d be peeing even more than I already am."

Dr. Jeffcoat:

Patients will often tell me they restrict their fluid intake in order to reduce their urinary frequency, and are surprised when they have to pee more often. This happens because when you restrict your fluid intake, your urine becomes more concentrated, which acts as an irritant to your bladder, much in the same way that alcohol, and spicy or acidic food and drink will affect your bladder.

5."How can I stop having painful penetrative sex, and would a pelvic floor therapist help? If so, do I need a referral from my OB-GYN to see one?"

Dr. Jeffcoat:

A pelvic floor physical therapist is a crucial part of your care team if you're experiencing painful penetrative sex. Many states allow Direct Access for receiving a physical therapy evaluation and treatment. However, most offices that specialize in pelvic health still require medical clearance from a physician, since pelvic health specialists can’t test for infection, hormonal insufficiencies, or other medical causes of your pain. Many patients will come to my office and say, "My doctor couldn’t find anything wrong with me," which usually means the muscles and tissue in the area are contributing to the problem. This is exactly what a pelvic floor physical therapist will address.

11."I have difficulty urinating after sex, since I'm unable to get my body to relax enough to release anything. I know I’m supposed to urinate after, but is there anything I can do if I physically cannot urinate until much later? Is there anything I can do to try to relax my urethra enough to be able to pee?"

Dr. Jeffcoat:

Try taking the focus away from your urethra, and instead focus on general relaxation. You can do this while sitting on the toilet:

  1. Place your hands on the sides of your ribs. Take in a slow, five-second inhale. As you inhale, feel your ribs expand toward your hands. Visualize your lungs filling up with air and pushing your diaphragm downward.
  2. Hold your breath for two seconds.
  3. Slowly exhale for six to seven seconds.
  4. Repeat step 1, but now add the visual on the inhale of your pelvic floor muscles dropping and getting soft or heavy (whatever visual seems most relaxing to you). Don't tell your muscles to “relax," as that rarely works.
  5. Hold your breath for two seconds.

For answers to more of the questions you are too embarrassed to ask, click here to continue to the full article.

What Our Patients Have to Say

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Testimonial by M.N., age 28

A personal journey and testimonial from one of my patients:

I was diagnosed with vaginismus 4 years ago. I never heard of such medical condition until after I got married. At first my husband and I didn't know what to do, we didn't know what the issues were or how to overcome it. Being born and raised in Armenia and being Christian I wasn't that open about talking to sex with others and so it wasn't easy to seek help. But eventually I went to an Ob-Gyn and luckily she knew about the medical condition (not many doctors know). She referred me to a physical therapist and I couldn't believe it and thought it's something I can handle myself. I ordered a kit from vaginismus.com and started practicing with dilators. There was some small progress but wasn't much helpful.

Read more: Testimonial by M.N., age 28

Testimonial by A.M.

Months after giving birth, it was difficult for me to go from a sitting or lying position up to a full standing position without feeling that I had to remain hunched over until a bit of time had passed to get fully upright. However, after taking Heather’s course, I learned exercises to get my body back to normal. She also showed me correct ways to lift and carry my son as well as put him in/take him out of the carseat and stroller. This class was really beneficial and Heather is a wonderful teacher who made me feel very comfortable.

-- A.M.

Testimonial by J.B.

My husband and I were having problems with painful intercourse. My therapist recommended that I go and get a pelvic floor evaluation from a physical therapist. Having never been treated by a physical therapist, I wondered how this really was going to help me. My husband who is a physician was very supportive and agreed that a PT evaluation would be a great idea. So i made the appointment and was blown away by what I learned. I had no idea that pelvic floor muscles could get tight and have trigger points just like any other muscle in the body. I'm a massage therapist and very familiar with tight muscles, and this new thought really amazed me. Heather's program to help relax and strengthen these muscles made such a difference. I can say that I am 100% pain free during intercourse now. Yippee! Going to the PT appointments and doing the at-home exercises was definitely a discipline, but it's 100% worth it! The rewards are amazing.

-- J.B.

Testimonial by Lauren B.

Femina PT (née Fusion Wellness & Physical Therapy) has been such an answer to prayer, i'm so glad I found them! I've been struggling with vaginismus my whole life, but didn't have a name for it until about 6 or 7 months ago. Even once I did have a name for it though, I didn't know where to begin in getting help. My OB/GYN had me get a set of dilators, but I couldn't even insert the smallest one by myself. Most times I tried I just ended up frustrated and in tears. I felt really alone, like I was broken and didn't have the energy to keep trying. When I got engaged a few months ago though, I realized I needed to get answers so i wasn't dreading my honeymoon.

Read more: Testimonial by Lauren B.

Testimonial by M.N., age 28

A personal journey and testimonial from one of my patients:

I was diagnosed with vaginismus 4 years ago. I never heard of such medical condition until after I got married. At first my husband and I didn't know what to do, we didn't know what the issues were or how to overcome it. Being born and raised in Armenia and being Christian I wasn't that open about talking to sex with others and so it wasn't easy to seek help. But eventually I went to an Ob-Gyn and luckily she knew about the medical condition (not many doctors know). She referred me to a physical therapist and I couldn't believe it and thought it's something I can handle myself. I ordered a kit from vaginismus.com and started practicing with dilators. There was some small progress but wasn't much helpful.

Read more: Testimonial by M.N., age 28

Testimonial by J.H.

My last appointment with Heather was over 6 years ago but I still think of her every day. I don’t take for granted that I can easily get out of bed, care for my two active and busy young boys, run, play tennis, clean my house, or sit at a desk for several hours at a time. None of these tasks were easy for me before meeting Heather. Eight years ago my car was struck from behind by a tractor trailer that was estimated to have been speeding. I spent 3 years working with different PTs and Drs trying to heal and move on with my life. When I became pregnant and the hormone relaxin that “relaxes” all the joints of the body and the additional weight gain erased all my progress and I was suddenly in a lot of pain again. My OB sent me to Heather for one last try.

Read more: Testimonial by J.H.

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