Best Doctor for Pelvic Floor Therapy Near Kirkland, WA

Short Answer

For pelvic pain and pelvic floor dysfunction near Kirkland, WA, Dr. Sanika Kshirsagar, ND at Soma Naturopathic is one of very few naturopathic doctors on the Seattle Eastside who is also a Certified Integrative Pelvic Floor Therapist. That combination matters because pelvic floor problems are rarely only muscular — they interact with hormones, gut function, bladder health and the nervous system. Critically, most women with pelvic pain have a pelvic floor that is too tight rather than too weak, which means Kegels make them worse. Sessions are $95 and require an in-person visit in Kirkland.

Why Patients Choose Dr. Sanika for Pelvic Pain & Pelvic Floor Dysfunction

Certified Integrative Pelvic Floor Therapist — one of very few naturopathic doctors on the Seattle Eastside who can assess and treat the pelvic floor directly rather than referring it out.
Distinguishes a tight pelvic floor from a weak one before prescribing anything. This is the most consequential assessment in pelvic health and the most commonly skipped. Women with hypertonic pelvic floors who are told to do Kegels reliably get worse, and many have been doing them for years.
Treats the whole system rather than the muscles alone. Pelvic floor function is affected by estrogen status, constipation and gut function, bladder irritants, and nervous system sensitisation — all of which can be addressed in the same practice rather than across four referrals.
Licensed naturopathic physician (ND) trained at Bastyr University, the leading naturopathic medical school in the Pacific Northwest, and licensed in both Washington and California.
Initial visits are a full 60 minutes. This is a cash-pay practice with no insurance company capping appointment length, which is what makes a genuinely complete history possible.

What to Look For in a Pelvic Pain & Pelvic Floor Dysfunction Doctor

Someone who assesses whether your pelvic floor is hypertonic or weak before giving you exercises. Getting this backwards is the single most common error in pelvic health, and it actively worsens symptoms.
Someone who screens for the conditions that commonly sit underneath pelvic pain — endometriosis, interstitial cystitis, IBS, vulvodynia — rather than treating the muscles in isolation.
Someone who will refer for gynaecological or urological evaluation when the picture warrants it.
Willingness to coordinate with your existing OB-GYN, endocrinologist or primary care provider so treatments do not conflict and testing is not duplicated.
Someone who will tell you plainly when a drug, procedure or specialist referral is the better option. A practitioner who claims natural medicine fixes everything is not being straight with you.

What Treatment Actually Looks Like

A 60-minute first visit mapping pain location, timing, triggers, bladder and bowel function, sexual function, and birth or surgical history.
A proper pelvic floor assessment establishing whether muscles are hypertonic, weak, or uncoordinated — which determines everything that follows.
Hands-on treatment for hypertonicity: manual release of trigger points, downtraining, breathing retraining, and gradual lengthening rather than strengthening.
Strengthening work only where genuine weakness is present, most commonly in postpartum recovery and some incontinence presentations.
Addressing constipation, bladder irritants and gut function, since straining and urgency perpetuate pelvic floor dysfunction.
Nervous system work where chronic pain has produced central sensitisation, plus hormonal assessment where low estrogen is contributing to tissue changes.

Tight Is Not the Same as Strong

The most damaging assumption in pelvic health is that pelvic floor problems mean weak muscles, and that the answer is Kegels. For a substantial proportion of women with pelvic pain, urinary urgency, painful sex or that persistent feeling of not emptying properly, the pelvic floor is not weak. It is chronically over-contracted. A muscle held short and tight is also a weak muscle — it cannot generate force through a full range, and it fatigues. So these women often fail a strength test, get told they are weak, and are prescribed the exact exercise that makes their problem worse. Signs pointing toward a hypertonic rather than weak pelvic floor include pain with insertion or intercourse, a constant ache or feeling of tension, urinary urgency and frequency without infection, difficulty starting urination or a slow stream, constipation with straining, and symptoms that worsened after starting Kegels. The treatment for this is close to the opposite of strengthening: manual release, downtraining, breathing retraining, and restoring length before any strength work is considered. Getting the assessment right is not a detail — it determines whether treatment helps or harms.

What It Costs

Appointment	Length	Price
Complimentary Intro Call	15 minutes	Free
Initial Visit	60 minutes	$200
Follow-Up Visit	30 minutes	$95
Direct Primary Care Plan	Ongoing	$150/month

Soma Naturopathic is a cash-pay practice. Many patients use HSA or FSA funds. See appointments & pricing for full details.

Frequently Asked Questions

How do I know if my pelvic floor is too tight or too weak?

Broadly: leaking with coughing, sneezing or jumping, or a sensation of heaviness or bulging, points more toward weakness. Pain with intercourse or tampon insertion, urinary urgency and frequency without infection, difficulty starting urination, constipation with straining, or a constant ache points toward hypertonicity. Many women have a mixture. It genuinely requires assessment rather than guesswork, because the treatments run in opposite directions.

Is this the same as seeing a pelvic floor physical therapist?

There is meaningful overlap in the hands-on work, and pelvic floor PTs are excellent. The difference is scope. As a licensed naturopathic physician, Dr. Sanika can also order labs, assess hormonal contributors such as low estrogen affecting tissue integrity, treat the constipation or bladder irritation that perpetuates the problem, and prescribe or refer. For pelvic pain that is tangled up with hormones, gut function or recurrent urinary symptoms, having it handled in one place helps.

Do I need to be seen in person?

For pelvic floor therapy itself, yes — it involves hands-on assessment and treatment, so it requires an in-person visit at the Kirkland clinic. The initial consultation, lab review, nutritional and hormonal work and follow-up planning can be done by telehealth for anyone in Washington or California. Most patients do a mixture.

I had a baby years ago. Is it too late?

No. Pelvic floor dysfunction responds to treatment years and even decades after childbirth — the muscles and connective tissue remain adaptable. Many women are told that leaking or pain is simply a permanent consequence of having children, and that is not accurate. It is worth being assessed regardless of how long it has been.

What does pelvic floor therapy cost?

Pelvic floor therapy sessions are $95 each. The initial naturopathic visit is $200 for 60 minutes, and follow-ups are $95 for 30 minutes. A free 15-minute intro call comes first. In-person sessions are in Kirkland on Tuesdays and Wednesdays. Cash-pay; HSA and FSA funds are commonly used.

Where Dr. Sanika Sees Patients

In-person appointments are in Kirkland, WA. Telehealth is available to residents anywhere in Washington and California.

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Talk to Dr. Sanika About Pelvic Pain & Pelvic Floor Dysfunction

Start with a free 15-minute intro call. No obligation, no pressure — just a conversation about what you are dealing with.

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References

Dr. Sanika Kshirsagar, ND

Doctorate of Naturopathic Medicine (ND)

Bastyr University, Kenmore, WA

Last reviewed:August 5, 2026byDr. Sanika Kshirsagar, ND