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E212
October 20, 2026
Bladder Leaks, UTIs & Pelvic Floor Health with the Vagina Whisperer
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In this episode of unPAUSED, Dr. Mary Claire Haver sits down with board certified pelvic floor physical therapist Dr. Sara Reardon, known on social media as The Vagina Whisperer, to take on a belief many women carry into midlife: that bladder leakage is just part of getting older. Pelvic floor dysfunction affects roughly one in four women, and that number climbs with age, yet most women in perimenopause and menopause have never been taught what the pelvic floor is or that pelvic floor physical therapy can help.

They begin the conversation with the basics, from what these muscles do every day to what actually happens at a first pelvic floor therapy visit. They also get into why simply being told to do Kegels so rarely works, how a pelvic floor that is too tight can cause many of the same symptoms as one that is too weak, and where biofeedback fits in. Dr. Haver shares her mother’s decades of living with urinary incontinence, while Dr. Reardon recalls the moment she leaked on a tennis court and understood the mental load her patients carry.

From there they turn to the bladder in midlife, including waking up at night to pee, the difference between stress incontinence and urge incontinence, a simple technique for preventing leaks when you cough or sneeze, and why recurrent urinary tract infections and genitourinary syndrome of menopause (GSM) so often call for vaginal estrogen. They also cover practical ways to cut down on nighttime bathroom trips and lower the risk of a fall on the way there.

They close with pelvic organ prolapse, when the bladder, uterus, or rectum presses into the vaginal wall and causes pressure or a bulge. It is far more common than most women realize. Dr. Reardon explains what causes it, why surgery alone does not strengthen the muscles underneath, what women with transvaginal mesh should watch for, and what to ask before agreeing to any prolapse repair.

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Chapters

00:00:00 – Why pelvic floor problems shouldn't be accepted as normal
00:02:58 – How menopause changes your pelvic floor
00:04:03 – What your pelvic floor actually does
00:05:27 – The hidden impact of urinary incontinence
00:09:14 – How to access pelvic floor physical therapy
00:10:48 – What happens during a pelvic floor assessment
00:13:23 – Why surgery and Kegels aren't your only options
00:16:23 – Why Kegels aren't working for some women
00:18:31 – Weak vs tight pelvic floor muscles
00:21:07 – What research says about pelvic floor training
00:22:32 – How biofeedback therapy works
00:24:05 – Why women wake up at night to pee
00:27:13 – Stress vs urge incontinence explained
00:29:41 – How to reduce nighttime bathroom trips
00:31:24 – The knack technique to prevent leakage
00:32:31 – Why nighttime urination increases fall risks
00:35:18 – Recurrent UTIs and vaginal estrogen
00:40:30 – Pelvic organ prolapse symptoms and causes
00:43:57 – The boat analogy for understanding prolapse
00:45:20 – Vaginal mesh surgery and its complications
00:48:11 – Different types of pelvic organ prolapse
00:49:43 – What to ask before prolapse surgery

About the guest

Dr. Sara Reardon

Dr. Sara Reardon is a board-certified pelvic floor physical therapist, CEO and Founder of The Vagina Whisperer, and creator of The V-Hive App that's helped over 18,000 women with at-home pelvic floor training during pregnancy, postpartum, menopause, pelvic pain, and strengthening. Sara has been featured in The Washington Post, Time Magazine, NPR, Harper’s Bazaar, The Today Show, and numerous other podcasts, publications, and professional conferences for her advocacy and educational work as pelvic floor physical therapist. She is a TED presenter on Rethinking Postpartum Care and the author of the national bestselling book, FLOORED: A Woman’s Guide to Pelvic Floor Health at Every Age and Stage. You can follow her on social media as The Vagina Whisperer on Instagram and TikTok.