Pelvic Floor Expert Sara Reardon

Sara Reardon, aka “The Vagina Whisperer,” has been very vocal online about the importance of women’s pelvic floor health since 2017. And with more than 680,000 followers and 13 million views on social media — people are listening.

“The account has organically grown, and I think that’s a real testament to how much women really want this information about their pelvic floor — and they aren’t getting it elsewhere,” Reardon said.

As a pelvic floor physical therapist, Reardon helps women strengthen, relax and rehabilitate the muscles and tissues in the pelvic region of the body. Problems with the pelvic floor and weakening of the muscles can cause a wide range of issues such as bladder leakage and the inability to orgasm. So, yeah — really important stuff.

Reardon talks all things pelvic floor in her new book, Floored: A Woman’s Guide to Pelvic Floor Health at Every Age and Stage. “The real mission behind The Vagina Whisperer and also writing the book was that everybody should know about the pelvic floor. We get period education and sex education — we should get pelvic floor education because we are more vulnerable to pelvic floor issues as women. So that’s really my goal — to help enlighten people and not normalize the problems, but normalize the conversation,” Reardon said.

We talked with Reardon about how to care for your pelvic floor (Hint: it’s more than Kegels) and the right way to pee. (Spoiler: A lot of us have been doing it all wrong.)

Our interview follows, edited for clarity and length.

HealthyWomen: We’re big fans of the name “The Vagina Whisperer.” Tell us how it started.

Sara Reardon: Every summer after graduate school, I would get together with my group of friends and we would hang out over the Fourth of July weekend. One summer, we were all hanging out and I ended up sitting in a hot tub with a bunch of my friends’ moms, and I was talking to them about aging and their bladder issues and vagina problems — and my friends were like, “Oh my gosh, Sara is the vagina whisperer!” And so they came up with the name.

A couple years later, I started my Instagram account, The Vagina Whisperer, and it was really for my group of girlfriends because we were pregnant and all having babies, and they would continuously ask me what they should do for pregnancy exercises. So I said, I’m just going to put it on Instagram so that everybody can see it, and it’s there whenever you need it. And that was the start of The Vagina Whisperer.

2024 (Photo/Sarah Becker)

HealthyWomen: Congratulations on your new book, Floored: A Woman’s Guide to Pelvic Floor Health at Every Age and Stage. What’s the most important thing women should keep in mind regarding pelvic floor health?

Sara Reardon: Although all genders have a pelvic floor, women go through different hormonal fluctuations every month and experience pregnancy, postpartum and menopause — and all those stages of life affect our pelvic floor and put women at risk for pelvic floor issues.

Pregnancy can stretch and weaken the pelvic floor, and we don’t have standardization for rehabilitation for women after birth like you would after other surgeries. In menopause, you have less estrogen, testosterone and collagen — all of those things put you at risk for more pelvic floor problems, typically weakness and sometimes even tension or pain.

HealthyWomen: Your TikTok post telling women not to push when you pee went viral with more than 10 million views. Were you surprised at how many people said they’ve been doing it all wrong? And what’s your advice to break the habit if you push to pee (asking for a friend)?

Sara Reardon: It does surprise me, but it also is exactly the reason why I’m doing what I’m doing. I think that it’s really important for people to know that. And I’ve posted don’t push to pee probably 50 times before, and then you see that millions of people are still learning. But we’ve never been taught — when do we teach people how to pee? My advice: Pee when you have the urge to pee — don’t go just in case. And don’t over delay. Sometimes people hold it for hours, but that can over tense your pelvic floor muscles.

Always sit down to pee so that you’re not hovering. That’s going to help your pelvic floor muscles relax better so you don’t have to strain or push. And when you are peeing, you don’t need to push — your bladder has a muscle that actually pushes the urine out for you.

I say put your feet flat on the floor and lean forward onto your elbows and just take some big deep breaths. Breathing can help your pelvic floor muscles relax.

Read: 15 Minutes With: Ashley Winter, M.D., Talks Urology, Sex and All Things Vaginas >>

HealthyWomen: I only recently learned that hovering is bad for you.

Sara Reardon: I can’t tell you how many people are like, “Sara, every time I pee, I think of you,” and I’m like, you know what that means? I’m doing my job alright and that’s really what I want. I just want people to be aware of what they’re doing because these small changes really go a long way. And it’s the same thing with pooping. Put a stool under your feet so that your muscles are more relaxed and you’re in a squatting position, and exhale when you’re pushing instead of holding your breath to have a bowel movement.

The thing is, many people know that women who are pregnant and postpartum are menopausal or at a higher risk for pelvic floor issues, but you can develop these problems at any age.

HealthyWomen: Another recent post of yours says to prioritize your pelvic floor now, so your organs don’t protrude out of your vagina later (pelvic organ prolapse). What’s your go-to exercise or tip for women to avoid this?

Sara Reardon: It’s actually more of a lifestyle. When you have pelvic organ prolapse, those pelvic floor muscles are not supporting your organs as well. So your bladder, your uterus, your cervix, your bowels can drop into the vaginal canal and it feels like something’s in your vagina or something’s falling out of your vagina. The biggest thing is not straining. You can do exercises and kegels until the cows come home but if you’re straining — pushing when you pee — or if you’re straining during constipation or pooping — all of that pressure just pushes down over and over and can create weakness of these muscles and prolapse.

Stop straining and start strengthening. These muscles are like any other muscle in your body — they need to be able to contract, and they also need to be able to relax.

HealthyWomen: Are Kegels good for your pelvic floor?

Sara Reardon: Yes, if you have weakness. But what’s interesting is that many, many women have tension. So, just like any other muscle or body, it can be weak and need strengthening, but it can also be really tight and tense. Think of how you get tension in your shoulders, and that makes you feel like you need a massage. It’s the same thing in your pelvic floor muscles. Those muscles can get tight and tense and they don’t relax well, and that can lead to a hard time starting your urinary stream or difficulty having bowel movements.

It can also cause pain with sex, hip pain and low back pain — a variety of things — because those muscles can even lead to issues like leakage and prolapse because if they’re tight and tense, they can’t contract well either.

What’s really important is, before you start a strengthening regimen, to know whether you have weakness and you need strengthening, or if you have tension and need to work on that tension first. Once that tension is relieved, then you may have some weakness underneath.

The other thing with Kegels — it’s not like a one size fits all prescription. There are different types of Kegels. So, there are quick contractions where you squeeze and relax, and then there’s longer contractions where you hold for five, 10 or 20 seconds. And those are the endurance muscle fibers that we really need to work as well. So, quick ones and longer Kegels and making sure that you’re relaxing completely and then also doing them in different positions.

HealthyWomen: What are your thoughts on the pelvic floor trainer devices?

Sara Reardon: I think they can have a role. For some people who struggle to know if they’re doing a pelvic floor contraction properly or relaxing properly, they can be helpful. But once you start working in standing or with movement and squats and lunges and lifting — you can’t really wear those devices. So, I think that they can be a helpful place to get started, but move away from them over time.

HealthyWomen: As a pelvic floor therapist, can you settle the debate: Is it OK to pee in the shower?

Sara Reardon: Yes, it is totally fine to pee in the shower. I think one of the misunderstandings here is that peeing in the shower is totally fine, but if you turn the shower on and it creates the urgency to pee, that’s a sign of overactive bladder, which can be helped with pelvic floor therapy. So, it’s fine to pee in the shower, and I think it’s actually really quite convenient.

2021 (Photo/Sarah Becker)

HealthyWomen: On the homepage of your website you’re wearing a vulva costume — we’re assuming it’s couture. Do you wear it around the French Quarter in New Orleans where you live?

Sara Reardon: I actually bought that costume online for $100 bucks in 2018! The store closed down and I’ve tried to contact them many, many times with no response. It’s the only one I have so I don’t wear it out in public — I don’t want anyone to spill beer on it or have something bad happen to it. So, it’s tucked away in my closet. My kids do pull it out from time to time and they’re like, “Here’s the hot dog costume, Mom!”