Dr. Stephanie Riley Hahn: Pelvic Floor Dysfunction, Leaks, Painful Sex, And Prolapse

Pelvic floor problems are not a “just do more kegels” issue.For a lot of women, kegels are either not specific enough, or they make symptoms worse.

In this episode, Dr. Stephanie Riley Hahn, pelvic floor physical therapist and founder of Longevity and Pilates, breaks down what pelvic floor dysfunction actually is, how to tell weakness from tightness, and why pressure management and breathing mechanics often matter more than squeezing harder.

Join the most comprehensive *female-specific community for health and longevity optimization.* After over a decade dedicated to human performance and women’s health, I created this space to share everything you need to know to optimize health and lifespan. Inside, you’ll get access to exclusive protocols, live Q&As, the latest female longevity science, and a private, supportive community of like-minded women.

https://kayla-barnes-lentz.circle.so/checkout/become-a-member

In this conversation:

  • Why pelvic floor tightness can drive pain, irritation and symptoms

  • The difference between weakness and tension, and how to tell

  • How breathing and pressure management change everything

  • What downtraining involves, and what tends to backfire

  • Prolapse support options, and when to seek help

  • Overactive bladder and constipation patterns that keep symptoms alive

Chapters:

00:00:00 Trailer / Cold Open

00:01:10 Stop Normalizing Leaks: Pelvic Floor Health Is Longevity

00:04:07 Incontinence Explained: Stress Vs Urge, And Why Women Wait Years

00:06:33 Pelvic Floor Basics: What It Is, And What Can Go Wrong

00:10:35 Why Weakness Happens: Hormones, Birth, Pressure, And Training Habits

00:15:13 The Breathing Fix: Pressure Management That Protects Your Pelvic Floor

00:21:52 Sex, Pain, And Pleasure: Why Tension Changes Everything

00:25:42 Kegels Done Right: Strength Without Making Symptoms Worse

00:32:03 Pelvic Floor PT: What To Ask, And When At-Home Tools Help

00:37:00 When Tightness Is The Real Problem, And Why It Happens

00:47:51 How Tightness Is Diagnosed: Internal Exam, Trigger Points, Pain Mapping

00:51:04 Downtraining Tightness: What Actually Works, And What Backfires

00:55:02 Prolapse Without Panic: What It Means, And What Helps First

01:01:33 Pre-Baby Prep And Core Training That Supports You (Transverse Abs)

01:07:08 Exercises That Spike Pressure, And Create Symptoms

01:09:46 Bladder And Bowel Reset: Constipation, Overactive Bladder, And Emsella

01:22:23 Postpartum Recovery: C-Section Scars, Diastasis, And Long-Term Strength

01:34:00 Final Takeaways, And Where To Find Dr. Stephanie

Next
Next

Dr. Aimie Apigian: The Biology of Trauma, Nervous System Safety and Somatic Healing