Rethinking the Menstrual Experience in Pelvic Rehab A look at Menstruation and Pelvic Health, with Nicholas Gaffga, MD, MPH, FAAFP and Amy Meehan, PT, DPT, MTC

Half the world's population experiences a menstrual cycle, yet social stigma, clinical discomfort, and gaps in provider training often leave patients without the information, tools, or permission they need to manage it well. Pelvic rehab clinicians frequently find themselves on the receiving end of questions no one else has been willing to answer. What is a normal period? Why does my cycle affect my pelvic floor symptoms so much? What products actually work, and how do I choose the right one? Is this amount of pain something I should just live with?

These are the questions Nicholas Gaffga, MD, MPH, FAAFP and Amy Meehan, PT, DPT, MTC set out to address when they built the Herman & Wallace remote course Menstruation and Pelvic Health. The course is designed for pelvic rehab providers who want to go beyond treating isolated symptoms and instead help patients reshape the menstrual experience itself through non-hormonal, non-prescription, and non-surgical interventions.

What the Course Covers

The curriculum is organized into four parts. Part 1, Cultural Aspects of the Menstrual Experience, examines how historical and cultural narratives shape the way menstruation is discussed, clinically managed, and personally experienced. Part 2, Menstrual Structures and Processes, covers the hormones, anatomy, and physiology of the cycle, including the HPO axis and the organs involved in preparing the uterus throughout each phase. Part 3, Menstrual Symptoms and Disorders, addresses dysmenorrhea, heavy bleeding, off-cycle spotting, emotional concerns, and vaginal discharge, along with common disorders including premenstrual disorders, endometriosis, adenomyosis, PCOS, and fibroids. Part 4, Menstrual Interventions, focuses on holistic strategies clinicians can introduce in practice today.

The second edition of the course includes new interviews with expert pelvic floor practitioners Ramona Horton, Jenna Ross, and Beth Kemper, whose clinical experience adds depth to the discussion of how the menstrual cycle intersects with pelvic floor dysfunction across the lifespan. Provocative topics run throughout, including chronobiology, interoception, menstrual mindfulness, menstrual molimina, cultural milestones, prostaglandins and period symptoms, and what a normal period actually looks like.

Why It Matters for Pelvic Rehab

In the live remote session, Dr. Meehan demonstrates yoga and stretch poses tailored to different phases of the cycle, along with a detailed walkthrough of menstrual products from liners and tampons to cups, discs, period underwear, overnightwear, activewear, and swimwear. Participants learn to build a flow management plan with patients, identify when to refer for physician evaluation, and help patients develop an individual action plan to reduce negative symptoms and work with the natural rhythms of their cycle.

Past participants describe the course as one that changes how they practice. Clinicians leave with a deeper understanding of their patients' experience, a broader set of tools to offer in the clinic, and language that makes a historically taboo topic feel approachable in the treatment room.

Upcoming Dates

The next live remote session of Menstruation and Pelvic Health is May 9, 2026. Additional dates are offered throughout the year for clinicians who want to schedule the course alongside their summer and fall continuing education plans.

Register for the Course

Menstruation and Pelvic Health

Next Session: May 9, 2026

Remote Course via Zoom

Additional dates available throughout 2026

Register here: https://hermanwallace.com/continuing-education-courses/menstruation-and-pelvic-health