#93: The Fertility & Pelvic Floor Connection No One Talks About - with Mitali Mohanan

In this powerful episode of The Mindful Womb Podcast, I sit down with pelvic floor physical therapist Mitali Mohanan (she/her) to explore one of the most overlooked pieces of reproductive health: the pelvic floor. Often dismissed until postpartum, this essential group of muscles plays a foundational role in fertility, hormone regulation, emotional well-being, and more.

From her own journey after birth trauma to becoming a passionate advocate for this work, Mitali walks us through the misunderstood world of pelvic floor therapy. We dive deep into how tension (not weakness!) is often the hidden root of issues, and why breath—not Kegels—is often the first step in healing.

What You'll Learn in This Episode:

• Why pelvic floor therapy matters before you conceive

• How tight muscles can impact your hormones and fertility

• Breathwork as a tool to restore safety and connection

• Red flags you might benefit from therapy—even if you’re not postpartum

• How pelvic floor therapy supports emotional healing and trauma recovery

• Simple at-home practices to get started today

Listen to the episode now:

Welcome back to The Mindful Womb Podcast. In this Episode, we had the pleasure of speaking with Mitali Mohanan, a passionate and knowledgeable pelvic floor physical therapist, about something that isn't just important postpartum, but also before conception: the pelvic floor.

We dove deep into why this underappreciated area of the body holds the potential to dramatically impact not only fertility outcomes but also our broader emotional, hormonal, and physical health. Whether you’re a hopeful parent-to-be, a birth worker, or someone just beginning to explore their body’s deeper rhythms, this episode holds life-changing knowledge.

From Therapist to Advocate: Mitali’s Journey

Mitali's path to pelvic floor therapy started with personal experience. After the birth of her second child, she was diagnosed with a prolapsed bladder—a condition she initially felt confident managing on her own as a physical therapist. But her doctor urged her to see a pelvic floor specialist, introducing her to a field that, even as a trained PT, felt mysterious and misunderstood.

What she discovered was profound: pelvic floor therapy wasn’t just about treating dysfunction. It was about restoring dignity, improving the quality of life, and giving people tools to reconnect with their bodies. She committed fully, diving into extensive training and, in her own words, “found her calling.”

Let’s Talk About the Pelvic Floor (Because No One Else Is)

What Is the Pelvic Floor?

Your pelvic floor is a group of muscles, ligaments, and tissues at the base of your pelvis. It supports reproductive organs, assists with bowel and bladder control, and plays a key role in sexual function and core stability. In other words—it’s crucial, yet shockingly overlooked.

Mitali emphasized: “Everybody has a pelvic floor. And many of us have dysfunction—and don’t even know it.”

Fertility and the Pelvic Floor: A Hidden Connection

One of the most eye-opening parts of our conversation was the link between pelvic floor health and fertility.

While pelvic floor therapy is gaining traction postpartum, its role in the preconception phase remains under-discussed. Mitali shared how clients with conditions like endometriosis, PCOS, pelvic pain, and painful sex often benefit from targeted therapy to improve blood flow, reduce restrictions, and calm the nervous system—all of which support a healthier reproductive environment.

"Pelvic floor therapy isn’t a magic bullet," Mitali clarifies. "But when used as an adjunct to fertility treatments, it can make a significant difference."

Why Tension = Trouble (and Relaxation = Healing)

Many assume pelvic floor issues are about weakness—but tightness is often the real culprit.

What Causes Tension?

• Chronic stress and trauma

• Habitual muscle guarding

• Conditions like constipation, painful sex, or anxiety

  
  

This tightness limits blood flow to reproductive organs, affects hormone regulation (hello cortisol!), and perpetuates a feedback loop of dysfunction. Mitali explained how tight muscles overstimulate the nervous system, increasing inflammation and disrupting hormonal balance.

Enter Breathwork: The First Prescription

Pelvic floor therapy often begins not with internal exams—but with breathwork. Why? Because diaphragmatic breathing is the body’s first tool to regulate the nervous system and reduce pelvic tension.

As Mitali described it:

“Breath is your therapy. It signals safety to your body. Only then can true relaxation and healing happen.”

Signs You Might Benefit from Pelvic Floor Therapy (Even If You're Not Pregnant Yet)

Pelvic floor therapy is not just for postpartum. Consider seeing a therapist if:

• You experience pain during sex

• You struggle with chronic constipation

• You have unexplained back, hip, or pelvic pain

• You’re trying to conceive and feel like something is “off”

• You’ve been told to “just do Kegels,” but they don’t help—or make things worse

And don’t worry—you don’t need a dozen sessions. One to three visits can often provide the insight and tools you need to take control of your healing. Many don’t realize a tight pelvic floor may require relaxation, not contraction. Kegels can make it worse if done incorrectly.

Mind-Body Healing: Restoring Connection After Trauma

For those who have experienced birth trauma, infertility, or loss, pelvic floor therapy can be an emotional experience. Mitali highlighted the importance of building trust, listening, and reconnecting with a body that may feel broken or untrustworthy.

Through supportive conversation, guided breathwork, and gentle techniques, many clients experience not just physical healing—but emotional restoration.

“I help people learn to trust their body again. That’s where the magic starts.”

Gentle Practices to Start Today

If you’re not quite ready to book a session or are waiting for an appointment, here are some at-home supports:

• Practice 360-degree diaphragmatic breathing

• Explore gentle yoga poses like child’s pose, deep squats, and supported bridges

• Talk about it: Share your experience with a trusted friend, partner, or provider

• Challenge the “normal”: Leaking, pain during sex, and pressure are not inevitable

Advocate, Listen, Trust

If you take nothing else from this episode, let it be this:

• Advocate for yourself. If something feels off, it probably is.

• Listen to your body. It's always talking.

• Trust your inner wisdom. Healing often begins with awareness.

Pelvic floor therapy is more than treatment—it’s empowerment. Whether you’re trying to conceive, healing postpartum, or simply learning your body better, the journey inward is one of the most powerful you can take.

Resources

• Learn more about Mitali’s practice: Revitalize PT 

• Listen to Episode 82: Unlocking the Power of Your Menstrual Cycle with Julie Lipsett

• Explore pelvic floor yoga, breathing techniques, and fertility charting resources

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