The Pelvic Health Problems Women Don't Talk About (And the Solutions That Actually Work)
February 16, 2026
How three women stopped letting issues, pain, and core weakness control their lives
Amanda's breaking point came during Emma's ninth birthday party at Sky Zone.
Forty-three years old, regularly attending Orange Theory, eating clean most days—she'd done everything "right" since having her two kids. But there she was, watching from the sidelines while other moms jumped on trampolines with their daughters, laughing without a care in the world.
She couldn't join them. Not anymore.
The stress incontinence had started small. A tiny leak during particularly intense workout classes. Then it progressed to sneezing, coughing, even laughing too hard at brunch with friends. By Emma's birthday, Amanda had developed an entire system of bathroom mapping and strategic positioning to avoid situations that might trigger an accident.
"I felt like I was 80 years old," Amanda told Dr. Nanos during her first consultation at KIND Health Group. "I'm in the best shape of my life everywhere else. I can run five miles. I can deadlift my body weight. But I can't jump on a trampoline with my daughter without worrying about peeing myself."
She'd tried Kegels. She'd bought the expensive Pilates reformer membership specifically for core work. She'd even done six months of traditional pelvic floor physical therapy in a depressing strip mall office with flickering fluorescent lights, doing the same three exercises while her therapist seemed surprised each week that nothing had improved.
The physical therapy helped a little. But "a little" meant she still couldn't do half the things she wanted to do.
When Your Body Stops Cooperating With Your Life
Lisa's story started differently, but ended in a similar place of frustration.
At 48, she'd been doing Kegels religiously since her first kid was born twelve years ago. Squeeze while brushing teeth. Hold during red lights. Release during commercial breaks. She'd read all the articles about pelvic floor health after pregnancy. She was being proactive.
But perimenopause hit like a freight train she never saw coming.
The urge incontinence started suddenly—that desperate, overwhelming need to find a bathroom immediately, followed by not quite making it in time. Lisa found herself planning her entire day around bathroom access. Long meetings at work became anxiety-inducing. Road trips with her family required multiple stops. A Saturday at her daughter's soccer tournament on those awful metal bleachers meant missing half the games to hover near the closest restroom.
"My husband kept suggesting I 'just relax' about it," Lisa said. "Like anxiety was causing the problem instead of being the result of it. He had no idea what it's like to be in a business presentation wondering if you're going to make it to the end without excusing yourself."
What made it worse was that none of her doctors seemed to take it seriously. Her primary care physician suggested drinking less water and "doing more Kegels." Her OB-GYN offered to write a prescription for bladder medication that came with a list of side effects longer than her arm.
Lisa wanted to scream. She wasn't asking for medication. She was asking for her body to work the way it used to work.
The Pain That Ends Intimacy
Jennifer's story was quieter. More private. The kind of problem you don't bring up at wine brunches or charity galas.
The painful sex had started gradually in her mid-40s. A slight discomfort that she initially ignored. Then burning sensations. Eventually, intercourse became so painful that she and her husband stopped even trying.
"I felt like I was failing at everything," Jennifer said. "Failing as a wife. Aging into someone I didn't recognize. My body was betraying me in this incredibly intimate way, and I had no idea how to fix it."
She'd seen three different doctors. One suggested lubricant, as if she hadn't already tried every brand at CVS. Another prescribed vaginal estrogen cream, which helped marginally but didn't solve the underlying tissue changes from menopause. The third basically shrugged and said, "This is just part of getting older."
Jennifer wasn't ready to accept that answer. She was 47, not 87.
By the time she found KIND Health Group, Jennifer had been avoiding intimacy for almost two years. Her marriage wasn't in crisis, but the distance was there. A sadness neither of them acknowledged but both felt.
The Connection No One Explained
When Amanda, Lisa, and Jennifer each arrived at KIND Health Group for their initial consultations, they came for different reasons. Amanda wanted to fix her stress incontinence. Lisa needed relief from her urge incontinence. Jennifer hoped someone could help with the pain that had stolen intimacy from her marriage.
None of them expected Dr. Nanos to start asking about their lower back pain.
"Wait, what does my back have to do with my bladder?" Amanda asked during her consultation.
Dr. Nanos pulled up a diagram on her tablet. "Your pelvic floor doesn't work alone. It's part of a team. Your diaphragm on top, your deep abdominal muscles in front, your back muscles behind, and your pelvic floor on the bottom. When one team member is weak or not communicating properly, the whole system breaks down."
She traced the connections on the screen. "Your chronic lower back pain, the core weakness you've been fighting since having kids, and your bladder issues are all related. Your pelvic floor muscles have been trying to compensate for weak deep core muscles for years. They're exhausted. And now that you're entering perimenopause, the hormonal changes are making everything worse."
Amanda stared at the diagram. In six months of traditional PT, no one had ever explained it like that.
For Lisa, Dr. Nanos drew different connections. "The urge incontinence got worse when perimenopause started because dropping estrogen affects the tissue quality in your bladder and urethra. But it's also affecting your vaginal tissue, which you've probably noticed. And the pelvic floor weakness is making it harder for your muscles to control those urges."
"So everything's connected?" Lisa asked.
"Everything's connected," Dr. Nanos confirmed. "Which is why treating just one piece rarely works. You need an integrated approach."
Jennifer's consultation revealed similar interconnections. The painful sex wasn't just about vaginal tissue changes from menopause. Her pelvic floor muscles had become constantly tense—partly from the pain and partly from years of stress and poor core mechanics. The tightness was making the pain worse, which was making the muscles tighter. A vicious cycle.
"The good news," Dr. Nanos told Jennifer, "is that we can address all of it. The tissue quality, the muscle tension, and the hormonal factors. Not one at a time across three different specialists' offices. All together, under one plan."
The Solutions That Actually Worked
Amanda's treatment plan combined three approaches simultaneously: Emsella for pelvic floor strengthening, Emsculpt NEO for deep core work, and targeted exercises Dr. Nanos designed specifically for her movement patterns.
The Emsella sessions felt almost too easy. She sat in what looked like a comfortable chair, fully clothed, while electromagnetic technology created thousands of pelvic floor contractions in 28 minutes—far more than she could ever achieve through Kegels alone.
"It feels like nothing," Amanda told her friend Sarah after her third session. "Maybe a slight tingling sensation. I literally answered work emails during the whole thing."
But the results weren't "nothing." By week four, Amanda noticed she could sneeze without panic. By week six, she made it through her entire Orange Theory class without needing to modify the jumping exercises. By week eight, she surprised herself during a hike with friends by laughing so hard she cried—and nothing leaked.
The Emsculpt NEO sessions targeted her deep core muscles—the ones that traditional crunches never reached. The treatment created intense muscle contractions while warming the tissue to support the strengthening process.
"I could feel it working in a way I've never felt from any core workout," Amanda said. "Like my muscles were finally waking up and remembering what they're supposed to do."
The unexpected benefit came three months in. The chronic lower back pain that had plagued Amanda since having her second child simply disappeared. She'd been so focused on fixing her bladder issues that she'd forgotten to track her back pain. One day she realized she'd gone two full weeks without that familiar ache.
"Dr. Nanos explained that my back pain was partly because my core wasn't providing the support my spine needed, so my back muscles were overcompensating," Amanda said. "Fixing my pelvic floor and deep core fixed everything."
Lisa's treatment took a slightly different path because her urge incontinence had different root causes than Amanda's stress incontinence.
She started with Emsella to retrain her pelvic floor muscles' communication with her bladder. The electromagnetic stimulation helped reset the pathways that had become dysfunctional, teaching her muscles to respond appropriately to bladder signals instead of overreacting.
But Dr. Nanos also addressed the hormonal component. Lisa's dropping estrogen levels were affecting tissue quality throughout her pelvic region. They integrated hormone therapy into her plan, carefully monitored through regular labs and check-ins.
"The combination made sense once Dr. Nanos explained it," Lisa said. "The hormones improved the tissue quality. The Emsella retrained the muscle function. Neither one alone would have solved the whole problem."
Dr. Nanos also recommended Lisa try MonaLisa Touch to support the vaginal tissue rejuvenation. Though Lisa's primary complaint was bladder-related, Dr. Nanos knew from experience that the vaginal tissue changes often contributed to urinary issues in perimenopausal women.
Lisa was skeptical. "I wasn't even thinking about that part. But Dr. Nanos said, 'While we're addressing your pelvic health comprehensively, we should probably take care of this too, because it's all connected.' She was right."
The MonaLisa Touch
treatments—gentle laser sessions that stimulated collagen production and improved tissue health—took about five minutes each. Lisa needed three initial sessions spaced six weeks apart.
"It was so quick I almost felt silly for being nervous about it," Lisa said. "And the changes were remarkable. Not just for the urinary issues, but for tissue health I didn't even realize had declined."
By month four, Lisa's entire relationship with her bladder had changed. The urgent, panicked feeling was gone. She could make it through her daughter's entire soccer game without bathroom trips. She stopped mapping her day around restroom locations.
"I got my freedom back," Lisa said simply. "I didn't realize how much mental energy I was spending on managing my bladder until I didn't have to anymore."
Jennifer's journey was the most complex because her issue involved not just tissue quality but also muscle dysfunction and psychological factors.
Her treatment plan integrated MonaLisa Touch for tissue rejuvenation, Emsella for pelvic floor muscle retraining (to address the overly tight muscles), and hormone optimization to address the root cause of her vaginal changes.
The MonaLisa Touch treatments made an enormous difference. By her second session, Jennifer noticed the burning sensation during intercourse had decreased. By her third session, six weeks later, she and her husband successfully resumed intimacy for the first time in nearly two years.
"I cried afterward," Jennifer admitted to Dr. Nanos during her follow-up. "Not from pain—from relief. I thought that part of my life was just over."
But the Emsella sessions addressed something Jennifer hadn't even known was a problem. Her pelvic floor muscles had been chronically tense for years—partly from the pain, partly from stress, partly from never learning how to properly relax them.
"Dr. Nanos explained that my muscles were like fists that had been clenched for years," Jennifer said. "They'd forgotten how to open. The Emsella helped retrain them to contract and release properly, not just stay tight all the time."
The combination of treatments had ripple effects Jennifer never anticipated. Her chronic hip tension eased. Her lower back stopped aching during long drives. Even her sleep improved, though she couldn't quite explain why until Dr. Nanos suggested that releasing years of pelvic floor tension might have reduced overall body stress.
Six months into her treatment plan, Jennifer told her husband the woman he married had finally come back.
Why This Approach Works When Others Failed
The traditional medical system treats pelvic floor issues the way it treats most problems: one symptom at a time, one specialist at a time, in isolated silos.
Stress incontinence? Try Kegels. Still not better? Here's a referral to urogynecology. Six-month wait for an appointment.
Painful sex? Use more lubricant. Not working? Try this estrogen cream. Still struggling? Well, there's always surgery.
Urge incontinence? Take this medication. Don't like the side effects? Try this other medication.
The problem with this approach is that pelvic floor dysfunction is rarely a single, isolated issue. It's almost always interconnected with core strength, hormonal status, tissue quality, muscle coordination, and sometimes even brain-body communication patterns.
Dr. Nanos treats the whole system because that's the only way to get lasting results.
"When Amanda came to me with stress incontinence, I didn't just see a bladder problem," Dr. Nanos explained. "I saw a woman with core weakness from two pregnancies, hormonal changes from perimenopause, poor muscle coordination patterns, and chronic back pain that was affecting her posture and movement. All of that was contributing to her bladder issues."
"When you treat the whole picture instead of just the symptom, you get better outcomes. And often, you solve problems the patient didn't even know they had."
What KIND Health Group Offers
The reason KIND Health Group can take this comprehensive approach is because they've invested in technology that goes beyond what traditional physical therapy or urogynecology offices offer.
Emsella
uses electromagnetic technology to create thousands of pelvic floor muscle contractions in a single 28-minute session. Patients sit fully clothed in the Emsella chair. There's no downtime, no pain, no recovery period. Most people schedule sessions during lunch breaks and return to work immediately after.
Emsculpt NEO
combines electromagnetic muscle stimulation with radiofrequency to strengthen the deep core muscles that support the pelvic floor. While it's often marketed for aesthetic body contouring, Dr. Nanos uses it to address the core weakness that contributes to pelvic floor dysfunction.
"Your pelvic floor can't work properly if your deep core isn't supporting it," Dr. Nanos explained. "It's like trying to build the roof of a house before the walls are strong enough to hold it."
MonaLisa Touch
uses gentle laser technology to stimulate collagen production and improve tissue health in the vaginal canal. The treatment takes about five minutes. Most patients need three initial sessions spaced six weeks apart, then one annual maintenance session.
Hormone Optimization addresses the root cause of many pelvic floor issues in midlife women. Dr. Nanos integrates hormone therapy when appropriate, carefully monitored through regular labs and ongoing check-ins.
What makes these technologies effective isn't just the devices themselves—it's how they're used together under a physician's guidance.
"Technology is only as good as the medical expertise guiding it," Dr. Nanos said. "I see a lot of med spas offering Emsella or Emsculpt with no real understanding of pelvic floor function or how to integrate these treatments into a comprehensive care plan. That's not medicine. That's just selling devices."
What About Your Story?
Three different women. Three different problems. One connecting thread: pelvic floor issues that traditional healthcare didn't solve.
Maybe your story includes all three. Along with chronic back pain. And declining energy. And brain fog from perimenopause. And weight that won't budge despite doing everything "right."
The traditional medical system would send you to five different specialists. Five different waiting rooms. Five different intake forms. Five different treatment plans that don't talk to each other.
KIND Health Group does it differently. Comprehensive care coordinated by a physician who sees how everything connects. Technology in an environment that feels nothing like a clinical office. Real medicine that treats you as a whole person, not a collection of symptoms.
Because when you treat the whole system instead of isolated symptoms, you get transformations that ripple through every part of life.
*Patient names and identifying details have been changed to protect privacy. All treatment outcomes reflect real patient experiences at KIND Health Group.*
Ready to learn more? Schedule a consultation
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