Heads up, this episode covers adult topics and isn't meant for little ears. So pop in some headphones if you've got kids around.
One of the main functions of the pelvis and pelvic floor is sexual satisfaction. And in fact, half of the population has an organ that is specifically for pleasure only, which is the clitoris. Mhmm. And we actually didn't even know until, I don't know, the last ten or fifteen years that the clitoris has in fact 10,000 nerve endings. And so I think if we talk about sex, we should be talking about pleasure. And what does that really mean? And what is that continuum? We are talking about pain during sex.
It is not normal, and you don't just have to live with it. I am here today with Christina Hansen, who is a pelvic floor physical therapist and founder of Uplift Pelvic Health and Wellness. No relation. Just sounds like it. She is here for a real and surprisingly hopeful conversation about what's actually going on when sex hurts.
We're also talking about what to do when connection feels hard with your partner or if your body just doesn't feel like it used to. We're talking about tension, trauma, hormones, physical changes, muscle changes, all of the things that can go on to make sex not feel like it used to. We also talk about childbirth and birth trauma and how that can be involved both emotionally and physically in the pelvic floor. She shares with us how pelvic floor physical therapy can help us feel safe in our bodies again, how we can improve intimacy, and how we can start healing in ways that go far beyond just doing some exercises. If you've ever felt like no one's listening or nothing's helped or you don't know what to do, this episode is a total game changer, so you don't wanna miss it.
Let's dive in. How do we create a safe space? How do we make it safe for each individual to go, okay, it's safe to touch myself. It's safe to have pleasure. It's okay to feel these things.
And maybe we need to go back to what was our upbringing and was there shame around that, or was there trauma around that that then could be leading to that inability to even allow yourself to get aroused or to receive pleasure or to feel safe with those sensations. Christina, welcome back. We're so happy to have you here. After last time, it was one of our listeners' favorite episodes. Oh, that's amazing.
Thank you for having me back. I had so much fun, and I'm excited for today's topic too. Yes. Well, everyone's excited for today's topic. So so without further ado, we are talking about sex today.
So if you have little ones in the car, this is not a good one to have on speaker. You wanna put your put your headphones in or listen to it another time because we're, we're not that shy. Right? No. Yeah.
No. Well, I I do think this is such an important topic because I don't think we talk enough about it. I think it still is quite taboo. It still is quite awkward for people to talk about, and, of course, within that, there's a massive range, a huge spectrum. You get some people who are so timid.
They don't wanna have any conversations with their partner about sex, much less about their own experience with sex. And because of that, I don't think they know what's, quote, normal or not normal or what should be the experience. And then you have all the way on the other extreme, people who have lots of experience with sexuality and who speak openly about it and maybe are a little more familiar with their bodies. So when we're talking about this, it's sort of tricky because you're talking all across the spectrum. But the part we really wanna focus on today is the part that you are particularly an expert in which is the anatomy and the physical alignment and the muscles and tissues that are really involved with female sexuality.
So tell us from your perspective as a physical therapist, what's the problem here? Why is this even worth talking about? Because isn't sex just sex? Like, isn't it just, like, I mean, quite simply anatomy? Right?
Like, where does this become something that is worth it for us to have careers based around and to have this conversation about? I think that's a great that's a very interesting starting point because what is sex? Yeah. What even defines that? And I think it depends on what kind of a partnership you're in.
Are you doing it on your own? Are you doing it with the same gender or the opposite gender? And so, and what is the goal? Is it procreation? Is it recreation?
And so from my lens point as a pelvic health PT, one of the main functions of the pelvis and pelvic floor is sexual satisfaction. And in fact, Half of the population has an organ that is specifically for pleasure only, which is the clitoris. And we actually didn't even know until I don't know, the last ten or fifteen years that the clitoris has in fact 10,000 nerve endings. We used to think it had about 7,500, but we were basing it off of cows. So once we actually looked at them in same clitoris as cows?
Shockingly no. But also that's really cool that we have an organ that is simply there for our own pleasure. And so I think if we talk about sex, we should be talking about pleasure and what does that really mean and what is that continuum. And so if somebody were to come in to me and have issues with their sexuality, it might be because of pain. It might be because of blood flow.
It could be because of hormones. It could be because of trauma, both small t trauma, big t trauma, and we can tease out what that means as well. So it can also be from prior diseases. Yeah. And that can lead to various degrees of pelvic pain.
So it's definitely on a spectrum, and we definitely help address many of those aspects. Okay. So start us off then in talking about what should the sexual experience be? Now that's obviously a massive question with a huge amount of range and variability, but but in terms of I'll give you the first one, which is not painful. So so what what should we be looking for as, like, this is acceptable?
You know? Right. Yeah. That's a great question. So right.
I guess first and foremost, we should say it shouldn't hurt. Mhmm. It should be consensual with both parties. Mhmm. There should be some level of ongoing consent as well.
And then, ideally, hopefully people are having fun. They're having pleasure there's arousal. And, and it depends on what the goal is between those two partners is an orgasm a goal. Yes or no. Is it a failure if you didn't have an orgasm?
Well, if you had a lot of fun and a lot of connection and a lot of pleasure, then maybe no. I dare to say though, for me, pleasure, then maybe no. I'd dare to say though, for me personally, that's like kind of a big deal part of it. But I think it can vary depending on what people are looking for. But I think it's also important to understand how you like to be touched.
What is pleasurable for you and for your partner having a dialogue of communication? Because I think that's also when we're talking about sex, sexuality, and pleasure. Now I don't know what everybody's upbringing is, but in the area that I grew up in, it was all about abstinence before marriage, disease prevention, and pregnancy prevention. I never learned either from my household or from my schooling anything about pleasure, nor did I learn how to dialogue that. And so not to be personal on this, but I do think that there are maybe a lot of people in that situation.
Yeah. A lot of patients and clients that I've worked with that have come to me and and maybe on that shy spectrum that you mentioned earlier that didn't have that language, didn't have that dialogue. And then once we've addressed maybe their primary reason that they can and they go, okay. So I have another question. Yeah.
I'm not sure if I've ever had an orgasm Mhmm. Which is so brave and so vulnerable and And pretty common. And very common, unfortunately. But the fact that there are people that feel safe enough to have the initiation of that conversation is huge. And then you get emails or you get phone calls and you're like, oh, they're having like, it just opens the door to a whole new experience.
And so I don't know where we need to go in that. How do we create a safe space? How do we make it safe for each individual to go, okay, it's safe to touch myself. It's safe to have pleasure. Yeah.
It's okay to feel these things, and maybe we need to go back to what was our upbringing and was there shame around that, or was there trauma around that that then could be leading to that inability to even allow yourself to get aroused or to receive pleasure or to feel safe with those sensations. I'm so glad you're saying this and bringing it up because one of the first things that I want to focus on is just how complex women's sexuality is. I mean, men's probably is too, but I don't know that much about it, and we're not talking about that. So we're gonna focus on female sexuality. One of the things that I see is people coming in and they're say they say, like, my sex drive is low, and they put it on one sentence on their intake form.
And I just want people to understand that your female sexuality deserves more. It's not just one line. It's not just one sentence like you've got it or you don't. Sex drive is an extremely complex. Orgasm is quite complex.
Female sexual pleasure is quite complex, and that's fine. There's nothing wrong with that. But I just don't want us to oversimplify by saying, well, if you fix this one little thing, it's all fine. This can be a journey and I think can be a really lovely intimate journey if we see it that way. But I think a lot of people don't see it that way.
They see it as, you know, not to be crude, but, like, the penis went in the vagina and that was sex. Like, that was my experience. And there's so much more to it. And if someone comes in and they say, well, that's what we do. Like, that's really the extent of my sexual experience is intercourse.
Right? If that's the extent of their experience and they say, and I don't have a sex drive, then you're like, well, I don't I don't think a lot of people would have much of a sex drive if that was the entire experience. Like, that's not very stimulating for many women. You know? That may not may not do it.
So we don't have to we can't go into every different direction, but the very first thing I would say is, like you're bringing up, female sexuality is complex, and it can go in many different directions. And that's a good thing because if you're struggling, then we have lots of things to think about. It's not just a matter of testosterone. It's not just a matter of estrogen, although those are great. It's not just a matter of whatever else.
It's complex, and that means we have lots of tools to help you get the the sexual pleasure and the sexuality that you're hoping for. So just a plug for complexity before we before we go too much further. Yeah. I I think that's a wonderful point because I think we should be thinking about not just our sexual wellness, but our overall wellness. I'm gonna be a little clinical here in a biopsychosocial model.
So what is going on biologically as you address, like is it testosterone, is it estrogen, is it declining, is it excessive, whatever's going on that way? Psychologically, do you feel safe? Do you feel valued? Are you stressed? Are you calm?
Are you in that mental state to be able to receive pleasure? And then social, like what is your social construct around sexuality and those lived experiences prior to that? And I think we could talk about that in health, and we we can talk about that in sexual health. Yeah. But I think if we think about it in those kind of buckets, and then I think to your point, for men, it is a little and I'm not trying to be crude here, but a little more like a light switch.
Mhmm. You see anatomy and you're like, woo. And then it's like, okay. Are the dishes done? Are the kids cared for?
Yeah. Have I slept enough? Am I bloated? Do I feel pretty? Do I look you know, it's there's so many other things, and maybe men have those same lived experiences.
I hear it from a majority of female clients and my own lived experience as well. Yeah. I'm glad you highlight that because the the lived experience from a psychosocial, the biological is also it's it's very complex, and we're gonna spend quite a bit of time on that talking about pain and tissue health and and how we kind of address the anatomical issues around sex. But but to highlight that psychosocial part, like, our brains are going a mile a minute. And not only that, I keep saying, like, I don't wanna be crude and maybe we're just gonna be crude here, but, you know, women have a lot going on down there.
There are fluids. There's changes that happen throughout the cycle. Like, you never quite know what that day is gonna bring down there. And so to be able to just be ready for sex at any time, especially for someone who's maybe more timid or maybe a little bit more self conscious about any sort of hygiene or cleanliness or smells or you know, like, that's gotta take a lot of planning. So now you take, like, oh, did I order the the kids' shoes online?
Did I remember to do the potluck? Did I remember their permission slip? And did I also shower and shave? Ah, shoot. You know?
Like, no. I didn't I didn't go to that depth. And so well, there goes sex for the day. Right? Because I didn't take the 18 steps that were needed to get to that level of complexity.
So when women come in and they say, like, something's wrong with my sex drive. Like, I just don't really wanna have sex. Like, well, who would wanna have sex when that's, like, going on in your mind when that's the whole context around it? Now if you take that psychosocial model and then you add to that lack of pleasure, like, I don't know how to orgasm. I don't I don't get it.
Or lack of, pleasure like I have pain or I have dryness or any other relationship issues. Like, yeah, that's not a broken sex drive. That's probably an appropriate sex drive for the circumstances. Right? So just highlighting what you say about that psychosocial model is very important for women to understand.
And there are some tricks. Do you wanna spend a little time just right there? Do you have any advice for kind of managing that side of, sex drive and sexuality before we dive into more of the biological physical side? Yeah. So I think getting yourself in a state of mind, so giving yourself that stepping away from life, almost like you're gonna go into a meditation.
Yeah. If you can give yourself even as little as three to five minutes to just drop in, you can use food, you can sit down and you can take a piece of chocolate or whatever your favorite food is, and just sit with it and look at it and use your five senses. Or if you want to go out into nature, same type of thing, using your five senses, dropping in, starting to connect. So when we look at our nervous system, we have, you know, their sympathetic nervous system and our parasympathetic, which is really, if we think about sympathetic it's fight flight, freeze, and fawn, It's like a lot of different categories with some positives within there. And then some other things that maybe are just keeping us in survival mode.
And then on parasympathetic, we just have relaxation. So if we're wondering why we're all walking around more in this sympathetic state, which the hormones that are being released are keeping us alive and surviving and thriving. But how easily can we toggle into that state of relaxation? So really that's what I'm addressing is how do we tap in to our parasympathetic or that rest and digest? Other times people will call it feed and breed Mhmm.
Type of nervous system. So maybe it starts in the morning where you're like, okay. I'm just going to go for a walk in nature, and I'm not gonna listen to anything, and I'm not gonna talk on my phone. And then maybe at dinner, it's okay. Maybe I'm gonna have some soft music on and my favorite drink, and I'm really going to sit across from my partner and stare at them in the eyes, or what's the most positive way I can have this connection with my whole family?
It doesn't have to be sexual, but just connection, calmness, finding that center, and I think that's priming the pump for our nervous system to be able to receive pleasure and to enjoy ourselves a little bit more. And I think a lot of us, whether it's sexuality or general life, we're maybe not allowing ourselves that time because we're too busy. But if we don't, we're missing out on all these other riches of life. So it's almost like I think there's like a Buddhist saying where if you don't have time to meditate, you should do twice as much. And so I think the same analogy goes.
If you don't have time for your sexuality, maybe you need to be spending twice as much time on it sort of analogy. I love that. I I think along those lines that sometimes as women, we have to be a little more proactive about it by saying, okay. Well, if I need to drop into this space, if I need to get myself into that space, then then it's not the worst thing to plan that, you know, and this is something that we talk about often with patients is plan it with your husband. Say Thursday night's sex night.
K? The other nights, I get to not think about it. I get to shave. If I if I don't wanna shave, I don't have to shave. Like but Thursday night, I will be ready.
And that means that you can plan around it. You can plan your your physical needs around it, but you can also tell your husband, like, it takes me a bit to kind of get my mind off of the daily tasks. So it would be awesome if you would send me some text through the day that compliment me and tell me what a great mom I am. Like, that would really help me be in the mood rather than not helping with the dishes and then me, like, magically being in the mood. Like, it's okay to and helpful to have that conversation to say, this is what's really gonna work for me for sex.
Another thing that can along those lines, which maybe is getting more into the physical side, but is being direct with what you like and and, you know, how you want to be touched and recognizing that role of foreplay. Anything else that you wanna add from that just psychosocial model of sexuality? I think it comes down to also the social aspect. So how do we relate to sex? Is sex something that was taboo as we were growing up?
And then getting the resources you can to have a healthy relationship with it and to see the positive benefits for yourself, for your partner, and for the two of you together or however you enjoy having pleasure. But I I think depending on how you were raised, there is a lot of shame surrounding our sexuality and self pleasure and touch. And so I think if you have those feelings, that's absolutely fine. And if you also wanna have a really healthy sex life, do you wanna do the work to address those issues? Yeah.
Will you take that a step further? Because I do actually think it it there is a a portion of the population that that's really common for, and I think some of the ways that it shows up is in embarrassment or kind of that ick factor of, like, I don't really like that stuff. Like, there's there's fluids and there's stuff going on, and, like, I don't even like being naked. I feel very vulnerable naked. What do you find helpful with your patients who kind of are just like, I I don't even know if I can get to what you're saying.
Like, I am so far from that. Like, I have sex with my husband because either we wanna have a baby or because it's pleasurable for him, but, like, I could literally pass on it and it would do nothing for me because I just have so many barriers. You know? How do you help someone kind of make those those first few steps? I think that's a great question.
I think it comes down to maybe taking the sex out of the picture Yeah. And then going, okay. How about we just hold hands? Yeah. Or how about I touch you in a way that I like and you touch me in a way that you like, and we start just having conversations.
There's a really fun drill that somebody taught me, and it involved, your hands. So you take your partner's hands and you spend the next couple of minutes just touching their hands in the way that you think you would like. Mhmm. And then they give you feedback. So you're starting to break down that conversation of, oh, I like this kind of touch.
Oh, I like this pressure. But it's on something completely separate from sex. Yeah. But it's opening a dialogue and creating a safe space. So I think, one, that communication.
Two, in terms of being comfortable in your own body Yeah. I think exploring how what feels safe. Okay. So if being naked is off the table, then how much clothing feels safe? Yeah.
And finding that place where I think it comes down to communication, and I think it comes down to finding that place of comfort for you and your partner. But if you're also not having pleasure and you're just doing it out of necessity, like, that sounds like a big conversation for people to have because it should be fun for everybody. Mhmm. But I think you have to believe that. You know?
Well, we'll figure that out. If that's not part of your operating system, then it's it can feel a little foreign. Like, I should be able to have pleasure here. Like, I'll have to sit with that for a minute. I love that you bring up the idea of intimacy and and nonsexual intimacy to start with because if we think of it as a spectrum, most people are going to love the idea of being intimate with your partner.
You know? Like, of course, I I love them. I want to be close to them. I want to be close to them emotionally and I want to be close to them in our relationship. And part of that is then moving along that that, depth of intimacy is then getting to physical intimacy and that can start with, like you mentioned, hand holding or kissing or or snuggling or just touching in any way and then that can be a more natural escalation if you will choose sexuality because otherwise, sometimes we skip that step and it's like nothing nothing nothing sex and people are like, I don't I don't know how to do that.
I'm 10 steps away from that step. Right. Exactly. I'm not I'm not there yet. Finding those baby steps along the way where it's like, oh, actually, I'm really close to my partner.
I want to be this close to them. But it's really easy in the hustle and bustle of busy woman life to kind of forget about those steps and just feel like, okay, on my to do list today is have sex with my husband because it's been a while. You check that box like, woah. What about all the stuff leading up to it? Like, maybe you focus for a week on finding other ways to be close to your partner and and and talking to him about ways that he would that you would feel closer to him if, like I said, if he compliments you or if he holds your hand or if he touches your back as he walks by, it doesn't just have to be straight to sex and and you should just love it and it should be part of your life and that's it.
Like, there can be a lot of intimacy that goes up to that. So I'm glad you bring that up. Yeah. And I totally agree that with that as well. Awesome.
Well, let's shift gears a little bit to then the anatomy. And by the way, there's, like, another four hours we could sit and talk about that. So if that feels like it's resonating with you and a struggle, certainly, there are sex therapists and there are you and I both help women with this, there are lots of resources out there for you. You almost just have to see a list of the tools and then feel like that one's uncomfortable for me. That one feels okay for me.
That one is awkward, but that one feels good. You know, there's so many tools out there. So shift gears then to for us to the sort of anatomical side of things. What are some of the biggest things that women come to you with around sexuality that you're addressing from that anatomical perspective? Pelvic floor area, it happens to both genders, and we do treat both genders with this for our I'm so glad you say that because most people don't know that men can receive pelvic floor physical therapy.
Yes. And men have pain with intercourse, and men have trauma, and they have shame, and I see all of it. And it manifests similarly, but not the same. And we all need to be able to create a safe space for those individuals to work through it. So for our females, there are varying diagnoses.
So some include inability to have anything penetrative within the vaginal canal, and that's called, vaginosis. And then there are some pain conditions that happen, say, after an STI or recurrent UTIs. Sexually transmitted infection. Yes. Oh, yes.
Thank you. Or like bacterial vaginosis or other things that can occur that change the tissue health and can lead to pain in both the dermatologic or skin areas, as well as then secondarily, the muscles tighten in response to that. Mhmm. So fun fact, 70% of the nerve fibers that innervate the pelvic floor are connected to your autonomic nervous system. Explain what that means.
Okay. So, Your autonomic nervous system is the part of your nervous system that does things without us thinking about them. Think heart rate, breathing, digestion, think stress response. People respond to stress in different ways. Some people, it manifests in tension headaches or clenching or grinding of their teeth and jaw, shoulder tension, or pelvic floor tension.
Mhmm. And that can even manifest itself in different ways. So think constipation, hemorrhoids, anal fissures, or pain in the vulvar area. Mhmm. And so those can span a whole spectrum.
So sometimes it's disease process. Sometimes it's trauma related. Sometimes it's more as a stress response to things that are going on in somebody's life. So if somebody comes to me with sexual dysfunction, oftentimes, it's secondary to some sort of pain, oftentimes, it's secondary to some sort of trauma. So it's really important to address, number one, those traumas that people have experienced and meeting them where they're at and what feels safe for them and working through that.
And that's oftentimes when I am partnering with mental health therapy because there's definitely a lot of therapy that happens, and I'm sure you're doing a lot of therapy in your sessions, but I'm not a therapist. Mhmm. And so I definitely acknowledge, like, okay. This is the end of what I can offer. Let's get you some more supportive help, and we're addressing it from a more physiologic and physical standpoint.
So making sure that you can connect into your pelvic floor, you can breathe into your pelvic floor. The pelvic floor muscles are moving well, and oftentimes, that can be extremely impactful in getting them out of pain. And then when you're not in pain, then you can start to explore pleasure again. Right. Because, I mean, if you think about chronic pain in any part of the body, you tend to wanna disassociate or separate from it or avoid the activities that create that pain.
Mhmm. And so it's very layered, and it's a little bit different depending on what the origin is for that person. Yeah. Yeah. Okay.
So let's unpack some of that a little bit. So when we're talking about pain, I guess the first question is, is it ever normal to have pain during sex? I think that is such a fantastic question. No. It is not.
However, the stats are up to seventy five percent of women will have pain with intercourse at some point in their life. Mhmm. It is not ever normal. It is not ever have a glass of wine and relax. Yes.
That to me is dismissive. I don't think they're wrong in the thought process behind it. It is tap into relaxation. Yeah. But I think that's have a glass of wine isn't enough to just Don't numb yourself so you don't mind the pain.
Right. Right. Right. Right. Exactly.
Exactly. Yeah. I will say you do have some people, and I think these are not the people you're referring to. You do have some people who will have funny twinges. I think certain positions, some people's cervix is a little more tender or a little more you know, when if the partner hits it just right, it'll be like, catching your throat a little bit.
So the cervix can be tender. I also think, like, constipation or gas bubbles sometimes will cause, pain. And the reason I bring this up is I do have patients who occasionally will be like, I don't know if anything's wrong, but this one time, I had this pain. And it's not necessarily something you need to be excited or or worried about. But just to recognize, there's a lot going on in the pelvis.
And if you get in a weird position and it does something weird one time or two times, that's legit. If it happens over and over and it pay attention to when it's happening. Are you constipated? Are do you have gas? Do you have a full bladder?
Do you have you know, is it just one position that you're having pain in? That can all be helpful information. But let's talk more about what what you are taking care of because those patients, I'm sure, don't usually make it to you. Correct. Tell us about some of the chronic pain.
Kind of walk us through where the different pain syndromes may manifest in the body. So some you mentioned would be just on the skin of the opening. Tell us a little bit about where different types of pain show up because I think it's helpful as a patient to kind of experience it and say, like, yeah. Where is that pain? I find women have a really hard time.
They're like, I don't know. It just hurts. So explain to us, like, how does someone differentiate where they're feeling the pain? I and I love that you're asking this question because I do think it's important for people to understand this. And I think it's also important to understand we're not very connected to our pelvic floor and all of the areas within there because though we have a lot of sensation, we don't have the type of sensation that tells us where we are in space.
The first is called proprioception. So typically I will categorize it. Do you have pain at insertion? Do you have pain throughout or do you have pain with deep penetration? And all three of those give me different pieces of information.
And so what I wanna know is, is there something dermatologic or is it something related to the skin either at the opening or within the vaginal canal? Or is it going to be like you had pointed out like pain at the cervix? So with proper arousal, the cervix actually lifts up and moves out of the way. So if you're getting pain with deep penetration, there's more than one thing that can be happening. One, you might not have enough arousal too.
You might have some restrictions. So the I'm going to get a little technical for a moment. You have a ligament that goes from your uterus and it goes back around either your sacrum or muscle really close to it. And it goes to your cervix since called your utero sacral ligament. But if there's restrictions in that, that might be limiting the ability for it to come up.
And it might actually be an orthopedic issue, meaning something going on bony or deeper with the pelvic floor muscles. And those things are very treatable. So I would say, By you. By us. By us.
Yes, by the right person. So and and that positionally can I say a position on this? Yeah. Okay. I don't care.
On on hands and knees is the most typical position. One, people enjoy it. It feels good for both parties, but that's where people oftentimes have pain, and that could be something secondary to some of those suspensory ligaments or ligaments that hold up the uterus. Mhmm. So that's really how I would divide, pain with intercourse on a simple, basic level.
So that's what they should pay attention to is pay noticing, like, okay. Where is this happening? I also think if it's happening with anything else, with fingers or with toys or anything like that, usually, that's the vaginal opening that's that's bugging them. Usually, it's the skin. Okay.
So now which ones of those do you how do you help? What do you do from there? Yeah. Great question. So it's gonna be an assessment.
I'm gonna be looking at them externally, their posture, their breathing, and then in terms of their pelvic floor, I'm looking at all of the muscles. Are they coordinated? What is the resting tone? And oftentimes not always, but oftentimes those individuals are holding extra tone. Now it's a chicken and egg game.
Was it, they had pain and so they tense their muscles and now they can't relax them or vice versa. Mhmm. And so really working on educating what does a relaxed pelvic floor feel like. Mhmm. And I do think it's really important that you pointed out there could be a full bladder or there could be constipation.
And constipation can lead to a lot of other issues, not just pain with sex, but also increased urinary urgency, which is that gotta go pee feeling. Yeah. Happens in both men and women, but it's three times more likely to happen in women than men. So making sure that you're having good bowel movements regularly. I know that's not the topic, but it's kinda related.
Well and I'll I'll chase that topic for a minute and say, if you have chronic constipation, even if we fix it medically, like, we we put you on the right supplements or we do gut rehab or whatever, chances are you should still see a pelvic floor physical therapist. Because if you're used to bearing down that hard to have a bowel movement, there's a really good chance your muscles are not coordinating and that you're gonna need retraining for that. Tell us anything else that you wanna add to that and how that contributes then to sexuality or to pain with sex. Yeah. Okay.
Love that. Okay. So the technical term is called fecal dissynergia, which is just a fancy way of saying it's like you're trying to push stool through a closed opening. Like you are bearing down and your muscles are tightening instead of softening, lengthening, opening, and relaxing. So pelvic PTs are a perfect resource for that muscular retraining.
And it's a game changer. Also, if you're pregnant and struggling with constipation, that's a great time to see a pelvic health therapist because those mechanics for both bowel movements and, bringing babies into world are very, very similar. And then in terms of how that can connect to, pain with intercourse, If you're holding something in, then you're gonna be guarding a lot more, and then that can be putting pressure in on the vaginal canal as well because the rectum or stool comes out of literally the walls touch with the vaginal canal. So if it's pushing or encroaching on it, that can increase pain. Mhmm.
Also with that muscle tightness, you can end up pushing on the nerves that go to the pelvic floor, which can also contribute to pain. Mhmm. But we can talk about that at another time. Hey. It's Mallory.
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Now back to the show. Anything else you wanna add about how you are treating pain during sex from your perspective? So one, it's getting them out of pain and then creating an environment where safe touch feels good. So, again, it's gonna depend on what that person needs. Oftentimes, if there's pain with sex or specifically vaginismus so that the vaginal opening is not opening, there's a trauma associated with it.
So it's setting up the environment for them, setting up the scene, and decreasing the expectation of the definition of sex. So maybe you take penis and vagina off the table and maybe it's all the other aspects of it that is pleasurable for both partners and can be very satisfying. Yeah. And just finding other ways to work around it while we're working on creating that safety within that body so they don't go into that fight or flight or freeze or fawning response, and they can feel safe and feel that pleasure. That's so, so important.
So I'm glad you say that. The idea of sex needing to feel safe, a lot of people will dismiss that if they have a good relationship with their husband. Right? Like, oh, that's not my thing. Like, I'm fine.
But if you've had chronic pain or if you've had pain with sex, your body, that autonomic, that reflexive system, why wouldn't it guard? Right? That's like if every time someone walks past me and they punch me in the arm, next time someone walks past me, I'm going to guard. Right? I'm gonna I'm gonna flex my muscles.
I'm gonna brace myself. I'm gonna get ready for that pain. So if every time you have a sexual experience, it's painful, it would be very normal for your muscles to clench up. And when you clench up, sex is not comfortable. You're not supposed to clench up and guard and be afraid of it hurting when you have sex.
That that makes it uncomfortable. We're gonna talk about trauma in a minute, but this isn't just for people who have, like, terrible, horrendous, sad, scary trauma. If you've had pain with sex, there's a decent chance you're guarding, and that can be retrained with physical therapy. Is there anything you wanna add to that? I think that was so beautifully said.
I think you're spot on with that. Yeah. It is it I will also put a plug in for OB GYNs like myself is we treat a lot of the the skin findings or surgical findings associated with pain during intercourse. But once we are done treating you, most people are going to need to go to a physical therapist to learn how to stop guarding, to learn how to let those muscles go. Because, like I said, why would you if someone punches me, why would I not guard?
Like, that's just a normal human response, and so we have to retrain that. So if you have seen a gynecologist and they've treated you, maybe you have long standing atrophy that now you're treating with vaginal estrogen, maybe you have vestibulitis or vestibulodynia and we're treating it with creams or surgeries, maybe you have chronic infection, even just the chronic infection aside from the changing of tissues, if it's chronically uncomfortable down there, right, you're gonna guard. You're gonna hold it in. You're gonna be really nervous about anything else down there, in the vaginal area. And so it's really important if you have, and I use down there not to be, like, not to use appropriate anatomical terms, but because it's everything down there, whether it's your your anus, whether it's your vaginal opening, whether it's your vulva, whether it's deep inside the pelvis, whether it's painful periods.
If you have something going on down there, there's a good chance that you need to see a pelvic floor physical therapist just to retrain yourself to cope with that chronic discomfort. I think that's beautifully said. And I and we have a lot of tools that you can also take home so you can continue to work on these things. So it's not just an in the clinic only moment. It's not just breathing strategies.
It's not just exercising. But literally, there are some tools and devices that you can use that can be really supportive and create sometimes pleasure if you wanted to or just decrease pain and create more safety. And there are tools that you can use to have fun with your partner. Yeah. So if you ever want to plug those, like, we definitely discuss those in our clinical setting of different tools and devices that are out there to help make intimacy and intercourse more pleasurable and enjoyable.
Tell us, what about things like things to help just bring more comfort, like, maybe not specific devices or tools, but other ways just to bring more comfort to to sex. Do you recommend any lubricants or any tools like that? We should all be lubricating, and I think there's lots of really good products. So Kokanoo is a great product. There's lots of different lubricants.
There's also really interesting suppositories that you can insert and apply vaginally that have, like, hyaluronic acid. And we know as we're getting more into that perimenopausal stage, which can start as early as age 35, we actually have not only decreased production of hyaluronic acid, but also collagen and other structures, so the tissues are getting thinner. So coconut vitamin, e oil or coconut oil or these hyaluronic acid or other suppositories, all can be really helpful. But I think have fun with lubricant. Like, I think it can really enhance an experience.
Yeah. I have a lot of patients who say, oh, yeah. We don't need lubricant. And I'd encourage you to try if you're looking for increased pleasure or increased comfort because sometimes you just forget that it's a thing and then you use it and you're like, oh, actually, that was better. So And there are some that have, like, different arousal components in it.
Yeah. And people have given me samples and they're actually quite fun. So those are the other options as well. Yeah. You mentioned breath work and teaching them how to breathe to relax pelvic floor, mindfulness to get out of their their fight or flight and and allow their body like, give their bodies permission to not approach sex in fight or flight.
Right? Mhmm. To approach sex in that relaxation state. I feel like this may just be my social media account, because of what I do as a gynecologist. But I feel like those pelvic floor physical therapy, like wands, the s shaped wands are having their moment on the Internet right now.
They really are. For better or worse. There's a there's a it's controversial. Yeah. Tell us what just any specific tools that would be interesting for people to hear that you can help people with.
So I would like to state my opinion on wands. I think that they are what they are first. Okay. So a wand is this curved device often made from medical grade silicone. Know what you're buying when you're buying them.
We do supply them at our clinic, and we teach people how to use them. They have two ends. One is more of a rectal end. One is more of a vaginal end. You can use them interchangeably, not at the same time.
But they are Sounds complicated. They're actually quite simple, which is but but I I mean the same time. Oh. Oh, no. Not literally at the same time.
You can interchange one end, the other end fashionally, one or the other. Got it. But I think it's really important to know that we can teach you to release specific muscles. So I would think of it as like trigger point release, very much like, Thera canes. It's like a Thera canes for your pelvic floor muscles.
So I do think there's a lot of value. Also, if you want to teach somebody to stretch, relax, and lengthen muscles, again, I think everybody should be trained properly and you shouldn't just go out and buy them if you have not had instruction. Yeah. Even people who have instruction from us, oftentimes we send them videos with it and we have follow-up sessions because you want to make sure you are using them correctly. Mhmm.
And so I know there's opinions on both sides of the fence. I think they're a great tool if you are trained to use them properly. Mhmm. Secondarily, another tool is a dilator. And so I don't think dilators are new at all.
I think that there are varying products of it. I know that people have come in and providers have given them plastic, lids for things to use as a dilator. I'm a big fan of them being medical grade and specifically for that purpose. But they can be a placeholder. So you can start with one that feels safe and comfortable.
You can do some breath work. You can do some therapeutic exercise that helps promote relaxation in those specific areas of the pelvic floor muscles and the associated hips and back and all of that, and it creates a nice, calming, relaxed environment that the patient can then use at home or the person who's struggling with pain so that, hopefully, it can calm that pain awareness down. So much of what this revolves around is fight or flight. The pelvis is so deeply ingrained in fight or flight. You think about from the animal side of things, like, us as mammals.
Right? Like, our fight or flight gets us ready to sprint. So I call it cave women. Right? Getting ready to run from saber tooth tigers.
And which what do you do which muscles are involved with getting ready to sprint or or guarding so that when the saber tooth tiger attacks you, like, you don't get knocked over. Right? It's like you what? Your thighs up to your your core. It's the entire area below, above, and including your pelvic floor.
So we just wanna understand that when you are in fight or flight, that pelvic floor is going to be overtense. Is that fair to say? I think that's very fair to say. Especially if your breath then is wrong and other things. We did a podcast episode a little while ago, and we talked a lot about breath work on that one.
So that would be a good episode to check out, to to kind of go down that road a little bit more. But I I wanna talk one of the tools that you mentioned earlier was just taking a break from sex. So tell us how that's utilized. Like, how does that really help? If the whole point is we're trying to fix sex, why don't I just power through?
Why don't I just, like, keep going, keep trying? Right? Like, maybe this is the time it won't hurt. I think you're just reinforcing a negative pattern. Yeah.
And so then the body is gonna keep having the same response. So if we wanna have a different response, we need to provide a different input. Yes. And so what is that input that is fun, safe, pleasurable, and can rewire that intimacy and connection so that when touch is down in that vulvar vaginal area, it's like, oh, this is actually nice. This doesn't hurt.
And maybe it's just working towards like the clitoris and not even going to the vaginal opening and just having fun and exploration without the expectation. And so I think if we can take that one act of penis and vagina off the table, but let everything else that feels good, that whatever's agreed upon. And if you and your partner have a conversation and you're like, okay, this, yeah, that feels good. Okay. How about this?
And you just come up with a list of, okay, here's the things on the menu for tonight. And we can change and we can go up now I'm full. I don't want any more. You know what? Just like if you were at a meal, like there's just those places where you have whatever the dialogue is.
But, yeah, I don't know if if obviously, many people, the goal is to have pain free sex. That's always what I'm working towards. But until we get there, what's that continuum to help support that journey towards that? You have to make it nonscary first once if you've been having painful sex. One of the things that you bring up is this idea of you've mentioned it a couple times, like self stimulation, like figuring out on yourself, touching yourself what feels good, and that can cause a lot of discomfort for a lot emotional, psychological discomfort for a lot of people.
But one of the things that is so important there, and I wanna hear your thoughts about this, is that so much of this, like I said, was fight or flight. So much of this is based on the idea of power and control, and women are deeply aware of the lack of control we have around us, whether that's our schedule, whether that's, you know, carrying mom burden, whether that's physical. I mean, women walk around, hopefully, not not pursuit not consumed by this thought, but women walking walk around knowing that there's a good chance that whatever man came up to them could physically overpower them. Right? Like, that's kind of the world that we live in, and that's not a very pleasant way to think about it.
But just saying that, like, so much of sexuality comes from control. And if you have ever been the victim of sexual assault, even if it wasn't that big, scary, horrendous sexual assault, if you've ever been part of what felt like a more forced sexual experience, our bodies are built to reject that. Everything in you will reject that. And if we're trying to help you enjoy sex, then we have to get to a point where you get to be the boss. You get to be in charge, not in, like, a weird way, like, in a really safe way that says, I know how I like to be touched, and that's not it.
It's an important part of sexuality to be able to have your boundary and say, I'm I'm not saying saying I'll never do that act, but, like, I'm not ready for that. And you have to have a partner who respects that. I think also that's part of then the taking a break from sex altogether, from penetrating sex. Right? You can still have other intimacy and other sexuality.
But by you saying, like, I get to take back my power here. I get to take back my own sexuality and my own intimacy. I think when we talk about self stimulation and people are like, oh, oh, oh, that's bad. That's yucky. That's like, it's I just ask people to kind of think about it.
You know? Think about what that really means from a standpoint of who are you in your sexuality? Who are you in your body? You know? How does your body feel to you?
If you are giving that to your partner and you're saying, I trust you enough to be intimate with me in the deepest ways possible, I give this to you to stimulate me and I feel safe and I can relax enough knowing that you're not gonna take advantage of this, how do we expect to get there if you feel so uncomfortable with your own sexuality, with your own touch of yourself? How could you how could you be super comfortable and safe with your partner touching you if you feel like it's disgusting to have any sort of intimate touch for yourself? Will you I know this is something you feel strongly about. Will you comment on that? Yeah.
So in the state of Utah, the stats are is that somewhere around seventy percent of women have had some form of unwanted sexual encounter, one in three by the age of 18. And so to the nervous system fight or flight, like, that is wired in a vast majority of us. And so I think if we can come from a place of acknowledging that whether you've had that experience or not, you're always thinking about it. You're always looking over your shoulder. You've been taught not to walk to your car at night by yourself.
Mhmm. And then also don't get pregnant and don't get an STD and then you get married and it's like, okay, you're supposed to just know- Yeah, you're supposed to be fine. Yeah. And everything's fine. And- And you should like it.
And you should like it and you should just be ready all the time. And so I think this is just where it gets to be really layered and really complex And then what your family beliefs were and what your your church beliefs were and what your societal beliefs were, what your peer group beliefs are, all of those layers get intertwined and create for an increased complexity to something that is already complex and intimate and vulnerable. Yeah. And a lot of us haven't even been taught the language to have what are those emotions around that complexity. Yeah.
Yeah. We're going real deep. Well, yeah, that went real deep. It's so important. I just think it's important to recognize when people come in and they say, like, I don't have any sex drive.
Have you ever had a sex drive? Nope. Let's start talking then. Let's start talking about it because the idea that, like, because you have penetrating intercourse, you should, like, love it and orgasm every time. Man, I will tell you the number of my patients who come in and say, I'm here talking about my sex drive because my husband is unhappy that I don't orgasm every time he penetrates.
Like, I there's so many thoughts there, but, like, number one, it's not your job to orgasm just because he thinks you should. Right. And number two, like, maybe you don't wanna orgasm that time. Like, maybe he didn't do it right. Like, maybe you weren't stimulated.
Maybe you had other stuff going on. Anyway, I I digress. But the idea being that, like, this this is it's so much more of a conversation, but it all really does stem around safety. And I I do I will go back to that plug of if you don't feel comfortable sexually with yourself, how on earth are you going to feel comfortably sexually with your partner? Now you have to decide from your own comfort level, like, like, what does that actually mean at that point?
Like, I'm not comfortable using a vibrator by myself in my, you know, bathroom. Like, okay. Fine. Don't. But figure out some way to figure out what your comfort level is sexually.
I do think you can do it with a partner if that's more comfortable by you guiding his hands or by you saying, like, will you try this? And and trying like, it's gonna be awkward at first if you have not had those conversations with your partner. But to be able to say, I I'm a little embarrassed to ask this, but will you try this tonight? Like, I don't know. I kind of feel like that might feel good.
And and letting it be awkward and letting it just be a thing. What are your thoughts on that level of awkwardness and sort of trying to kind of expand sexuality and and comfort, with feeling awkward? Totally. Well, I love what you just said, and I wanna I wanna go back to something you said a moment ago about my husband's disappointed that I didn't orgasm vaginally. Come As You Are by Emily, and I can't remember her last name, Nogalski.
Yeah. The stats are something somewhere around only 20% or so, depends on who you read. I've heard anywhere from fifteen to twenty five percent. I mean, how do they really know? How do they really know because it's underreported, having orgasms vaginally.
That means somewhere between seventy five and eighty percent of women, that is not the primary way that they have an orgasm. Not because they're they're broken. Not because they're broken. Absolutely. Just not their thing.
Exactly. And and then maybe they actually can, we just haven't explored it the same the right way, not the right way in a way that achieves that goal, if that is the goal. But there are, I mean, even just with vaginal penetration, you can have a G spot orgasm. You can have an a spot orgasm. You can have a cervical orgasm.
Like there's lots of different ways within there. And so maybe it's a positional thing, or maybe it's that plus the clitoris, or maybe it's that plus nipple, or maybe it's that plus talk or that plus anal, like it's, there's like so many different ways, like, more than 10 different ways to have an orgasm. So And then you add to that, like, the nervous system is calm and you trust your husband and he did the dishes that day. And he said you looked good in your pants. And, like, the it's it's there's a lot that goes into it sometimes.
It's so much. Meaty orgasm sometimes. Maybe we just need to be like, okay. The awkward thing is is that I need you to tell me I'm pretty. Yeah.
And I need you to put the kids to bed. Yeah. And then I need you to give me ready. Thirty minutes in the bath by myself, and then I'm ready. That's it.
That's all I need. Oh, and then I need to not be bloated. Whatever. It's we're complex. Yep.
And it's okay. And it's okay. And it's okay to be I think it's okay in that awkwardness to also just be honest. Yeah. And be okay in that vulnerability.
Yeah. Yeah. Okay. I and the last little bit here, I really wanna go back to this idea of trauma because it is so important, and it's not it is trauma that could have been, sexual assault from when we were younger, but it can also be trauma from a boyfriend in college. It can be trauma from the same partner that even if it's not a horrendous partner, but just feels like I was a little uncomfortable and you kinda pushed me harder than I than than I was comfortable going.
Right? Like, that can be small t trauma. Mhmm. Then we also have we haven't talked nearly enough about this, but childbirth trauma. And then we also have the trauma of painful periods and any chronic vaginal pain.
Will you comment on how this shows up in your practice, the idea of trauma, and then what on earth do we do about it? Because I just named things, and now we've named, like, ninety five percent of the population that has reason to have this chronic tightness or or reaction in the pelvis. So what do we do about it to you heard this phrase thrown around, like, release the trauma from from the system. Right. And I I mean okay.
So we've talked about how many of the nerve fibers are connected to the nervous system. So it's very intimately connected to our trauma response. And then you think almost energetically, if you look at the pelvis, it is a bowl. So you can think energetically it's holding emotions. You can think physiologically it's wired that way.
And I think also we need to talk, you said one specific thing there. So if we have painful periods, it might be endometriosis. We may actually have scar tissue or tissue that has painful lesions on it that could be contributing to it. And so it may not be those big t traumas, but it's literally that pain response trauma. Mhmm.
And then if we talk about birth and birth trauma and also that change in identity, And that is, like, a whole topic in and of itself, but you think psychological trauma and physical tissue trauma. Absolutely. Absolutely. And then tearing and then healing from tearing. And then it breaks my heart when women come in to see me, and they're so ashamed and embarrassed after they've had a child that they are destroyed or they are broken.
And when I do an exam and I'm like, your tissues look great and they look healthy, Totally. Like they look wonderful, like whatever it is for them. And to just see that whole body reaction. I've had women just crying on my table, which breaks my heart to think like you are still beautiful. You are still whole.
You might be a little different. You may not. Everybody's experience is different with that, but it's okay. And I would gather that most men are gonna be totally fine with it Mhmm. Because they're still having fun.
Mhmm. And I think we put more expectations on ourself than we need to, and maybe we're harder on ourselves than we need to be as well. And if we can maybe have those conversations with men, be like, what do you actually think about? What are you actually looking at for this? And we go, oh, that's it?
Oh, okay. Yeah. And then we might just maybe we'd have more fun if we knew that as well. So it comes back down to communication also. Yeah.
It I I wanna talk about birth trauma for a minute more. I've had a number of patients who will say, it couldn't be birth trauma causing my vaginal symptoms because I had a c section. So so that like, nothing came out of there. Will you talk about how I talk about it with them from a perspective of control, especially I get these patients with emergency c sections. They wanted the specific labor, and then it feels like it was, I mean, quite literally ripped out of them.
Right? They they're whisked back to the Operating Room. The doctors, and I've done it, ripped the babies out of them to save their lives. I'm not saying we shouldn't, but, like, that complete loss of control around your womb, around your uterus and your childbearing and your reproductive and your what we associate with, like, femininity, these are not conscious thoughts that women are having, like, oh, my femininity. You know?
Like, there it goes. Like, that's that's not what's happening. It's this raw, visceral, animal mama bear protective sort of thing that is just shattered for some women. Will you talk about that, what you've seen in your practice, and how that actually shows up in anatomy and how how that relates to sexuality? Yeah.
So specifically for our c section mamas, I think it's really great that you're talking about this. I think many women think, oh, I don't I there's no way I could have urinary leakage. There's no way I could have pain with sex. I had a c section. Furth this thing could be true.
You may not have any issues. Sure. That doesn't it's not a concern. Be afraid of a c section. Don't be afraid of it.
Yeah. But if you do still have symptoms, that's also not abnormal. Right. You've just had all of the tissue layers altered, either cut or moved around, all of that, and then it had to heal. Yeah.
And then, like, you're talking about that loss of control of the situation, and then there are some who schedule it. And I mean, there's all the varying things. But I think pain after a c section, I don't see it a lot, but I do see it more in the abdomen or more in, maybe bladder issues or even bowel issues or constipation or back pain type issues thereafter. But I think what you're talking about with that trauma and that lens is huge. I think there's and I think social media is wonderful, and I also think it can be harmful because if you don't have that perfect birth experience, oftentimes I hear women tell me that they feel like they failed.
You said that. Yeah. Yeah. Or that my body failed me Yeah. Or I failed.
You know? And it's like, no. Not at all. Yeah. Sometimes we cannot control the anatomy of our pelvis.
Like, that's not something that women should be blaming themselves for. I I don't know. I don't know if men are this hard on themselves. I think we're really hard on ourselves. Well, there's so many expectations of, like, it's when we do talk about how beautiful and glorious the female body is, and I will be the first one to say that, that it is amazing.
It is absolutely and utterly amazing. Having watched childbirth thousands and thousands and thousands of times, it is truly miraculous. And yet the more we talk about how amazing it is, if it doesn't go that way for you, then then all that's left for you is like, oh, well, it's not amazing for me because my body must have been screwed up. So it is difficult there. And then connecting the dots to the earlier part of our conversation, if that's kind of how you interpret your birth story, all your pelvis your your tissues are listening to your thoughts and your brain.
Like, I know that sounds weird. Like, no. It's not. But, like, literally, that's what happens. Like, you know, if I I use the example, if I slip on ice, the next time I go and see ice, my conscious brain is not the part that's like, oh, ice.
I should be careful not to fall. I'm gonna tense my muscles and reach for something. Right? Like, that's not our conscious brain. It's our deep reactive reflexive brain that's saying ice.
We tighten up. We we guard. We we get ready to fall. Right? That's because it's automatic.
And that's what I'm talking about with birth trauma is when we go through that level of trauma, we're not having this conscious talk about, like, there goes my femininity and there goes my, you know, perfect body. My body's a failure. It's happening deep within us. And if you're having thoughts wondering if your body screwed up and and mad at your body and resenting your body because it didn't work the way, you know, that influencer worked online and she was in her size two pants the next day after she delivered, must be my body that screwed up. If those are the thoughts you're having, your muscles will guard just the same way that they guard when you see ice knowing that there's a danger there.
They will guard and they will flex and they will or other things will guard and flex like your shoulders or your spine or and you'll get headaches or you'll get pelvic pain or you'll get constipated. Like, I'm not trying to freak women out and, like, we're all screwed. Like, that's not where I'm going at all. But it is just this issue of, like, recognizing the opportunity to be at one with our bodies and to release some of this so we're we're doing that. And such a big part of what you do is helping people in a hands on way actually see that tension Mhmm.
To say, like, see, it's right here. Let me help you in a hands on safe touch sort of way, which is hugely important with healing this area is there has to be touch involved, I think, but it has to be safe touch involved and and learning how to let go of some of that fear and that trauma that comes with it. That was a a bit of a detour, but any thoughts on that? I think it's really important for men to understand if they feel safe and comfortable enough to explore pelvic health therapy to solve these problems that find a provider that is trauma informed. Yes.
Find a provider that meets them where they're at and creates a safe space. Yeah. Because if not, then we're just gonna perpetuate the same issues they've already had. Yeah. And I I hate to even bring this up, but I do think it's helpful for people to know.
The insurance model does not give people enough time to do this. So as much as I'd say, like, go see a pelvic floor physical therapist that's covered on your insurance, Fine. But if this is really deeper and and you're dealing with a lot of these issues, you have to have more than a fifteen minute visit. You have to be able to build this relationship of trust and spend the time to allow your body to calm down. Your body is not just gonna relax because you told it to and this person's nice.
Like, you really do want to find someone who's going to do longer form visits, who's going to spend a little bit of time with you. And then it's so there's so much hope there. It's so doable. It's so healable and so, really, such a beautiful healing process because it heals those deeper parts of us that are that are traumatized or wounded as well. You're healing both at the same time because you're speaking safety, you know, to those muscles.
Yeah. And I think it's also and I I think I absolutely agree with that. I have the ability because I have chosen to be an out of network provider that I'm no longer defined by what insurance allows. And insurance really likes to put patients into you're an elbow, you're a shoulder, you're a knee. No.
You are a whole person. You have a nervous system, you have a story. And we need to have time to be able to listen to that story for people to feel heard, to feel seen, to feel valued, and to feel safe. Yeah. And the way that I operate absolutely allows for that.
And so I think that's a really, really, great point to bring up, because I I think health care is changing, and we need to change with it. And we and I think people are wanting more. Yeah. And they're wanting somebody who's it's not just a quick band aid on something. They want a full solution.
Yeah. Well, Christina, I've completely lost track of time, and I'm pretty sure we're way over time. But will you give us just your closing thoughts about this, what what you'd really like to make sure that women take from this? First of all, I loved your insight today. I thought that, I think that people as they hear this, they're really gonna feel like, oh, I feel heard or this is very relatable.
And I think it's really important to know that there are people out there in the community like you and I that really want to have a positive impact and really want people to feel good in their bodies. And we we recognize and understand that need for safety Yeah. And that need for addressing that nonconscious or unconscious responses that are happening in our body that can, impact the healing journey. Mhmm. Yeah.
Thank you so much. Tell people where they can find you and and work with you and get your excellent work. Thank you. So I own Uplift Pelvic Health and Wellness. It is a pelvic floor physical therapy practice.
It's located in Salt Lake City, Utah. It's actually about a half a mile from Uplift for her. Yeah. So if you're looking for Uplift, there's two Uplifts about a mile from each other. And we focus primarily on pelvic health, but that to me is just the center of the whole system.
So come in expecting to have your foot all the way up to your neck, taken a look at and along with your nervous system. I love it. Thank you so much for being here. Thank you for having me. I appreciate it.
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