Normalizing the Unspoken: Addressing Incontinence, Constipation & Sexual Dysfunction in Women's Health

In this episode, I welcome pelvic health pioneer Ingrid Harm-Ernandes, PT, DPT, author and international speaker, to discuss her four-decade journey in physical therapy and nearly 30 years specializing in pelvic health. Ingrid shares how the field has evolved—from obscurity in the U.S. to structured residency programs—while underscoring the critical need for early education, interdisciplinary teamwork, and advocacy. She reveals the inspiration behind her book A Musculoskeletal Mystery: How to Solve Your Pelvic Floor Symptoms, outlines practical strategies for mentorship and collaboration across healthcare disciplines, and calls listeners to champion pelvic health as a public health priority throughout women’s lifespan.

Guest Bio
Ingrid Harm-Ernandes, PT, DPT

Background:

• 40 years as a physical therapist; 28+ years in pelvic health
• Co-Director & Mentor, Women’s Health PT Residency Program, Duke University
• Course Development Director, International Women’s Health Courses
• Author of A Musculoskeletal Mystery: How to Solve Your Pelvic Floor Symptoms
• International speaker, educator, and illustrator
• Areas of Expertise: Pelvic floor rehabilitation, orthopedic integration, interdisciplinary care, women’s health through life stages

Key Topics & Timestamps

00:00 – 05:00 | Origins of Pelvic Health PT
Ingrid recounts the early 1990s landscape—scarce training in the U.S., skepticism from physicians, and her orthopedic foundation that shaped today’s best practices.

05:00 – 12:00 | Building Residency & Education
How Duke launched one of the first pelvic PT residencies, the slow but steady growth of programs, and the power of “book clubs” and clinical mentoring to integrate pelvic health into standard curricula.

12:00 – 20:00 | Mentorship Beyond the Discipline
Strategies for new grads: start generalist, shadow diverse providers (OB-GYN, urogynecology, cardiopulmonary PT, even acupuncturists and sex therapists) to build confidence and referrals.

20:00 – 30:00 | Writing A Musculoskeletal Mystery
The pandemic-sparked book project: filling the education gap for patients and practitioners, demystifying pelvic floor anatomy, evaluations, treatments, and including a self-help toolkit.

30:00 – 40:00 | The Continuum of Life & Menopause Care
Reframing women’s health as a lifelong continuum—pregnancy, perimenopause, menopause, and postmenopause—and the alarming statistics: 50% of life spent in menopause transition, rising cardiovascular risks, and the need for strength training over cardio.

40:00 – 50:00 | Interdisciplinary Teamwork & Advocacy
“Teamwork, teamwork, teamwork”: integrating PTs with physicians, nurses, nutritionists, mental health professionals, and corporate stakeholders. How education fuels advocacy—from clinic in-services to writing senators for research funding.

Major Takeaways

• Education Is Foundation: Early exposure in PT, medical, and nursing curricula prevents decades of untreated symptoms.
• Mentorship Matters: Seek out and sustain relationships with both pelvic PT and cross-specialty mentors to refine skills and referrals.
• Interdisciplinary Care: Pelvic health thrives when PTs collaborate with OB-GYNs, urogynecologists, acupuncturists, PAs, and beyond—breaking silos boosts patient outcomes.
• Lifelong Lens: Women spend a large portion of life in menopause transition—with implications for bone, cardiovascular, and pelvic health; prevention through strength training and pelvic floor awareness is key.
• Advocacy Amplifies Impact: Armed with education, practitioners and patients can lobby for research funding, insurance coverage, and workplace policies that support pelvic health.

Resources & Guest Links

• Ingrid Harm-Ernandes on LinkedIn:
  https://www.linkedin.com/in/ingrid-harm-ernandes-5057773b/
• Book: A Musculoskeletal Mystery: How to Solve Your Pelvic Floor Symptoms
• Duke University Women’s Health PT Residency Program (search DukePT.edu for details)