219 Breath, Bladder and the Brain: Rethinking Urination and Aging Gracefully with Dr. Nicole Fleischmann

Is your pelvic floor holding you back — literally? This week on the Growing Older Living Younger podcast, Dr. Nicole Fleischmann joins Dr. Gillian Lockitch to shatter the myths surrounding women’s pelvic health. Discover why “the second mouth” — your pelvic floor — is key to nervous system regulation, continence, and vitality as you age. Learn how pushing to pee could be damaging your body, why Kegels might not be the answer, and how a simple sniff can reconnect you with your core. This is a must-listen episode for every woman over 40 who wants to age with grace, strength, and confidence.

Dr. Nicole Fleischmann is a board-certified urologist specializing in female pelvic medicine and reconstructive surgery. She earned her MD from SUNY Downstate and completed her training in urology at Albert Einstein College of Medicine, followed by a fellowship at NYU. With over 25 years of clinical experience, she currently directs the FPMRS program at White Plains Hospital Center and serves as Assistant Clinical Professor at Albert Einstein College of Medicine. Dr. Fleischmann is the author of The Second Mouth: One Woman’s Journey to Decode a Hidden Language for a New Era of Women’s Health. Her integrative approach blends science and somatic awareness, helping women reconnect mind and body for lifelong pelvic health.

Episode Timeline

0:00 – Introduction
Dr. Gillian introduces the podcast theme of aging youthfully and welcomes Dr. Nicole Fleischmann to discuss pelvic health, aging, and the nervous system.

4:00 – Why Dr. Fleischmann Wrote The Second Mouth
Nicole shares her motivation: translating intuitive understanding into a narrative that reframes pelvic floor function as neurological and energetic, not just mechanical.

6:30 – Urinary Issues and Aging
Discussion of prevalence: incontinence affects up to 80% of women by age 80. Why pelvic floor dysfunction is universal yet misunderstood.

8:30 – What Is Embodied Awareness?
Nicole defines “interoception” — tuning in to how your body feels from the inside — and why it's critical to aging well.

10:40 – What is the Second Mouth?
How the pelvic floor functions like a jaw and why “opening” it via breath awareness is crucial to urination and defecation.

14:00 – Dysfunctional Urination Explained
Dr. Fleischmann describes the three common (and harmful) ways women urinate and how proper breathwork can retrain this system.

17:30 – Childhood Origins of Dysfunction
How toilet training ingrains habits of pushing, setting the stage for adult dysfunction — and what neurological milestones are missed.

21:30 – The Medical Establishment’s Blind Spot
Nicole explains why mainstream urogynecology hasn’t caught up and why breathwork offers a path beyond surgery and drugs.

23:30 – Why Not Kegels?
A passionate critique of Kegels and chest breathing — and how both disrupt pelvic harmony and nervous system regulation.

26:30 – The Sniff Technique
Demonstration of a simple sniffing maneuver to engage the diaphragm and drop the pelvic floor — a key to functional urination and core stability.

29:00 – Unconscious Behaviors and Structural Damage
Exploring how daily habits like pushing to urinate can lead to prolapse and why posture and breath matter more than strength.

33:00 – The One Habit to Build Today
Dr. Fleischmann’s no-nonsense advice: stop sucking in your belly. Let it out to free your diaphragm and align your body for healthy aging.

36:00 – Takeaway Message
Breath is the key to nervous system regulation. Awareness can’t be explained — it must be felt.

Learn more about Dr. Fleischmann's work

thesecondmouthbook.com

@drnicolefleischmann for TikTok, instagram, LinkedIn

Action Steps:

Download my EBook Guide: Guide to Building Back a Better Body

Schedule a CALL with Dr. Gillian Lockitch.

Join the GOLY Community: https://www.facebook.com/groups/growingolderlivingyounger

Growing Older Living Younger: About longevity, wellness, healthspan,

Where can you listen?

Episodes