SPOTLIGHT: Dr. Nicole Fleischmann - Rewiring Women’s Pelvic Health Through Neuromuscular Insight and Bold Advocacy

In the evolving world of women’s health, Dr. Nicole Fleischmann stands out as a disruptor—an advocate, healer, and visionary committed to transforming how we understand and treat pelvic floor dysfunction. As a board-certified urogynecologist and urologist with over two decades of clinical experience, Dr. Fleischmann merges surgical expertise with a progressive, neuroscience-informed approach that challenges conventional thinking.

At the heart of her philosophy is the belief that chronic pelvic conditions—such as pain, incontinence, and endometriosis—are not merely gynecologic or mechanical problems. Instead, they often stem from disrupted neuromuscular patterns, unconscious muscle guarding, and poor reflexive behaviors rooted in how we breathe, hold tension, and suppress awareness of our bodies.

“Our field is stagnant... and it shouldn’t be,” Dr. Fleischmann states. She is particularly critical of standard treatments like Kegels, which she sees as reinforcing improper pelvic mechanics. Rather than advocating for static strengthening exercises, she promotes a method of “reflex reeducation”—a process that helps patients retrain involuntary responses and reconnect with their physiology.

A central element of her therapeutic model is “sniff-enhanced respiration,” a simple but profound breathing technique that she uses to unlock and reprogram dysfunctional neuromuscular reflexes. “These are not just muscle problems,” she says. “They’re neurological. I’ve watched women regain bladder control simply by learning how to breathe differently.”

Her innovative perspective takes root in both clinical observation and anatomical understanding. As an MD trained in female pelvic medicine and reconstructive surgery, Dr. Fleischmann is cautious not to rely on theory alone—yet she’s unafraid to go where traditional medicine resists. Her long-term goal is to map physiological changes using tools like functional MRI, though she acknowledges that this level of research requires greater funding and a shift in medical mindset.

This shift is already underway through her work as an author. In her bestselling book, The Second Mouth: One Woman's Journey to Decode a Hidden Language for a New Era of Women's Health, Dr. Fleischmann brings readers into her world of discovery—blending professional expertise with a deeply personal exploration. More than just a guide to pelvic wellness, the book challenges cultural taboos and medical oversights. It also offers practical tools to identify and reverse habits that quietly sabotage women’s health, from poor posture and shallow breathing to dysfunctional toilet training.

The writing process, which she describes as “spiritual,” was a turning point in her career. “This book isn’t just for my patients—it’s for every woman who’s been told her pain is normal, or that leaking urine is just part of aging,” she explains. Her message resonates across generations, fueling conversations and attracting an audience eager for education and empowerment.

Dr. Fleischmann’s advocacy also extends into early intervention. She believes the seeds of dysfunction are planted in childhood, long before symptoms appear in adulthood. “What we see in menopause is often just the extension of uncorrected childhood problems,” she says. This insight has pushed her to speak out about rising neuromuscular disconnection and mental health issues in younger populations—especially in the post-COVID era.

To bring her vision into the mainstream, Dr. Fleischmann is actively collaborating with physical therapists, researchers, and fellow clinicians. Her mission: to build new, evidence-based protocols for pelvic care that address root causes instead of masking symptoms. She also embraces creative outreach, using humor, storytelling, and candid dialogue to engage broader audiences and dismantle the stigma around pelvic health.

“Sometimes the only way to wake people up is to hold a mirror they didn’t know they were avoiding,” she says, underscoring her belief in breaking through resistance with honesty and reflection.

Whether in the clinic, on stage, or on the page, Dr. Nicole Fleischman is forging a new path in women’s health—one that blends anatomical science with intuitive awareness, and compassion with clinical innovation. Her work is more than a career—it’s a movement aimed at helping women reclaim their bodies, their health, and their power.

For more about Dr. Fleischmann’s work and her book, visit thesecondmouthbook.com.

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AFTERMATH

From Silence to Science: Uplifting a Pelvic Health Trailblazer

By: Dr. Robert L. Bard

Women’s Health Digest believes in celebrating visionaries who challenge the status quo in women’s medicine—and Dr. Nicole Fleischmann is exactly that. As a board-certified urogynecologist and surgical urologist, Dr. Fleischmann has emerged as a bold voice and innovator in pelvic health, blending her clinical expertise with a neuroscience-informed, whole-body approach that is redefining the field.

Her work confronts one of the most overlooked dimensions of women’s health: neuromuscular dysfunction of the pelvic floor. Rather than relying on outdated or one-size-fits-all solutions like Kegels, Dr. Fleischmann champions a new paradigm of “reflex reeducation”—addressing unconscious muscle patterns, dysfunctional breathing, and early-life motor habits as the root cause of chronic issues like incontinence, pelvic pain, and prolapse. Through simple yet transformative techniques like sniff-enhanced respiration, she empowers women to restore control, awareness, and dignity to their bodies.

What makes Dr. Fleischmann’s voice so vital is not just her technical precision, but her fierce advocacy for change. In her bestselling book The Second Mouth, she exposes the silent epidemic of pelvic dysfunction and dismantles long-held taboos that have left too many women suffering in silence. Her mission is both revolutionary and restorative: to build evidence-based, collaborative care models that go beyond symptom management and truly heal.

We honor Dr. Fleischmann for her courage, candor, and commitment to educating a new generation—of clinicians, caregivers, and women—about what pelvic health should be: empowering, honest, and rooted in the mind-body connection. Her work is not just clinical innovation—it’s a social movement.

We are proud to spotlight Dr. Nicole Fleischmann as a featured thought leader in this issue. Her insights are not only changing medicine—they’re changing lives.