Naturopathic Doctor Pelvic Floor Therapy — Integrative Treatment for Pelvic Health

The pelvic floor is a group of muscles, ligaments, and connective tissues that form a supportive hammock at the base of the pelvis. These muscles support the bladder, uterus, and rectum; control urinary and bowel function; contribute to sexual function and sensation; and stabilize the pelvis and lower spine. When the pelvic floor becomes dysfunctional — either too tight (hypertonic), too weak (hypotonic), or uncoordinated — it can cause a wide range of symptoms including pelvic pain, urinary incontinence, constipation, painful intercourse, and lower back pain. Pelvic floor therapy is a specialized form of rehabilitation that uses manual techniques, targeted exercises, biofeedback, and patient education to restore optimal pelvic floor function. Treatment is individualized based on thorough assessment of the pelvic floor muscles and contributing factors.

Most pelvic floor therapy is provided by physical therapists — and they do excellent work. However, seeing a naturopathic doctor who is also a certified pelvic floor therapist offers a uniquely comprehensive approach: • Root-cause investigation — Pelvic floor dysfunction rarely exists in isolation. Hormonal imbalances (low estrogen, progesterone deficiency), chronic inflammation, gut health issues, and stress all affect pelvic floor function. A naturopathic doctor evaluates and treats these underlying factors. • Hormonal support — Vaginal dryness, tissue thinning, and pelvic floor weakness often have hormonal components, particularly during postpartum recovery, perimenopause, and menopause. Naturopathic medicine can address these hormonal drivers. • Whole-person assessment — Instead of focusing solely on the pelvic floor muscles, a naturopathic doctor assesses how nutrition, stress, sleep, gut health, and hormonal status contribute to pelvic symptoms. • Integrated treatment plan — One provider managing both the manual therapy component AND the internal medicine component means better coordination, fewer appointments, and more cohesive care. • Reduced need for referrals — Rather than seeing separate providers for pelvic floor therapy, hormone management, and nutritional support, you receive integrated care from a single practitioner.

Naturopathic pelvic floor therapy can help with: • Pelvic pain — Chronic pelvic pain, vulvodynia, vestibulodynia, and coccyx pain. Treatment addresses both muscular tension and inflammatory/hormonal contributors. • Urinary concerns — Stress incontinence, urgency incontinence, overactive bladder, incomplete emptying, and recurrent UTIs. Pelvic floor rehabilitation combined with anti-inflammatory protocols can significantly improve urinary function. • Postpartum recovery — Diastasis recti, perineal healing, pelvic organ prolapse prevention, and return to exercise after childbirth. Naturopathic postpartum support also addresses hormonal recovery, nutrient repletion, and breastfeeding concerns. • Painful intercourse (dyspareunia) — Whether caused by hypertonic pelvic floor muscles, hormonal changes, endometriosis, or psychological factors, integrated treatment addresses all contributing components. • Bowel dysfunction — Constipation, fecal incontinence, and rectal pain related to pelvic floor incoordination. • Perimenopause and menopause — Pelvic floor changes during hormonal transitions benefit from combined manual therapy and hormonal support. • Pre- and post-surgical pelvic rehabilitation — Preparing for and recovering from gynecological surgeries.

At Soma Naturopathic, pelvic floor therapy sessions are conducted in a private, comfortable setting with a focus on patient comfort and consent at every step: • Initial Assessment — A comprehensive health history review covering pelvic symptoms, hormonal health, digestive function, stress levels, and relevant medical history. External and (when appropriate and consented) internal assessment of pelvic floor muscle tone, strength, and coordination. • Treatment Plan — Based on assessment findings, Dr. Sanika develops an integrated plan that may include manual pelvic floor techniques, therapeutic exercises, breathing and relaxation strategies, botanical and nutraceutical support, and dietary modifications. • Manual Therapy — Myofascial release, trigger point therapy, and stretching techniques to release hypertonic muscles or strengthen weak ones. Internal work is only performed with explicit patient consent and can be declined at any time. • Home Program — Targeted exercises, stretches, and lifestyle modifications to support progress between appointments. • Integration with Naturopathic Care — Hormonal testing and support, anti-inflammatory nutrition, gut health optimization, and stress management as needed based on root-cause findings.

Dr. Sanika Kshirsagar is a Certified Integrative Pelvic Floor Therapist and licensed naturopathic doctor at Soma Naturopathic in Kirkland, WA (12911 120th Ave NE, Suite J-3). She is one of few naturopathic doctors in the Eastside Seattle area who combines pelvic floor rehabilitation with naturopathic medicine. Pelvic floor therapy sessions are $95 per visit. In-person appointments are available on Tuesdays (9 AM–1 PM) and Wednesdays (2 PM–6 PM) at the Kirkland clinic. Dr. Sanika serves patients from Kirkland, Bellevue, Redmond, Bothell, Woodinville, Kenmore, Sammamish, and Issaquah. For patients who need naturopathic consultation (hormone testing, nutrition planning, supplement protocols) but not hands-on pelvic floor work, telehealth appointments are available for Washington and California residents. New patients can schedule a free 15-minute intro call to discuss their pelvic health concerns and determine if integrative pelvic floor therapy is appropriate.