If we just listen to women, they will tell us what they need, like they know their bodies don't accept pain as anything normal in your life.
Welcome back to the show, everyone. Today's episode is one I've been so excited to record because we have the absolute queen of pelvic floor education joining us, we have Dr Sarah Reardon, better known to her almost 1 million followers as the vagina whisperer. Sarah is a board certified pelvic floor physical therapist with over 18 years of experience. She has built a wonderful app called the V hive pelvic floor workout app, and is the best selling author of the new book floored A Woman's Guide to pelvic floor health at every age and stage, she has taken what used to be a taboo and hush hush topic and turned it into something that's very approachable, bite sized and empowering, so that women can actually understand this material and use it, and she has done it with humor and hard and sometimes wearing a vulva costume. So what I love about Sarah is that she's not just educating in the clinic. She's in your comments, she's in your DM, she's on Tiktok and Instagram, and she is there real time, hearing what women are struggling with day to day. She provides a safe space that women can ask the hard questions, and then she provides that education and the answers that women are looking for to really just feel better and make sure they're not hiding these problems away forever. So today, we're diving into these real questions and her real perspective, working with so many women, one on one, in her clinic, but also on social media, working on her book, getting feedback from her app. This is going to be such a great conversation, and Sarah is a wealth of information. So Sarah, thank you for being here. I adore your content, and I'm so grateful you're doing what you're doing. So let's dive in and get started. One of the reasons I'm so vocal is because I still, after 18 years, see women getting pelvic floor therapy as an afterthought, or after months and years of suffering when I really want this to be the standard of care at every life stage.
Well, Dr Reardon, Sarah, thank you for coming on. It is such a pleasure to have you here.
Thanks so much for having me.
This is going to be a really fun episode, because you are very publicly in this space talking about women's health and pelvic health, and really bringing to light some things that have not been brought to light. Tell us a little bit about your journey as becoming kind of a voice in the field of pelvic floor physical therapy and really pelvic health in general. Tell us a little bit about your journey of how you became passionate about this area of women's health.
So I have been a physical therapist for 18 years. Right out of graduate school, I started practicing, and what was then called Women's Health is now called pelvic health, and I became interested in this because during my graduate school education, I had a professor who just gave us a couple weeks about pregnancy and pelvic floor health, and I thought, This is so interesting to learn about my own body as a woman. And then when I started doing some clinical rotations in the field, I was like, wow, this is really incredible to help other people understand their bodies better and to talk with them about really intimate issues that they had been dealing with, really privately experienced a lot of embarrassment or shame. And I was like, these are muscles, like every other muscle in your body, and there's help to relieve the symptoms of painful sex or pooping problems or urinary leakage or prolapse. So I started right away in this field 18 years ago, and then about 10 years ago, I was pregnant with my first son, and then second son a year later, and I started sharing tips with my girlfriends who were also kind of pregnant and postpartum, just about what I knew as a pelvic floor therapist to help them prepare for birth, or like how to heal postpartum. And I put it on Instagram under My Account, the vagina whisperer, that was their nickname for me, and so it was for my group of friends. So I use that, you know, handle, as the account name, and the account has organically grown. I mean, the first month, I had like 500 followers, and now I have over 700,000 and I think the growth of that is a real testament that we aren't getting this information from anywhere else in our healthcare system, and women really want it and they need it, and so it's just been amazing to see the awareness of pelvic floor therapy grow, to have the incredible opportunities that I've had to write a book and then create an app to help women at home And just to again, even share a platform with you to help women better understand their bodies and get care for what they need.
Well, this is one of the reasons I was so excited to talk to you, is because you do have a different perspective. As a women's health practitioner, you know, as a pelvic floor physical therapist, I think a lot of us as practitioners have experience working with one on.
One women, and you've been doing this a long time, so you have a lot of experience there working one on one, but you also have this slightly different perspective of being putting yourself out there and having people respond to that and saying, We want to hear more about that. What would you say? I think you're you're probably really popular at like, girlfriend parties, like, hey, what do I do about this? I think that's what I am. So glad that you're, you're doing the work that you're doing, because there are things that so many of us go through life and are just like, well, I guess this is just normal now. Like, I guess I pee my pants now and that's normal. Or I guess I have this pain and that's normal. Or I guess that I'm, you know, you think about people who like chronically have a difficult time going to the bathroom, and I guess that's just my normal. What do you think are some of the reasons that women seek you out? You know? What are the types of things that you're saying that resonate most with women who are hearing you talk about these really personal things? You know, I think the fact that I've been in this field for 18 years, and I've seen 10s of 1000s of women really helps people who are experiencing this feel less alone. I think we're not talking openly about painful sex or leaks of urine, or, you know, skid marks in our underwear and all of these things. So when I'm talking about it so publicly, I think people are like, Oh, wait, this is common. Like other women have this too, and there's an entire profession that's dedicated to helping people, you know, treat these issues that's not surgical or, you know, just medication based. So I think that that's really disarming for people that I talk about these issues so openly, and they yet seem so kind of embarrassing, but for me, this is my day to day work. I mean, I have, again, worked with 10s of 1000s of people, and this is kind of just, I have the same conversations over and over, which lets me know that a lot of people need this kind of education and support. But it's been interesting, because when I started in this field 18 years ago, I used to talk to my girlfriends, we were in our 20s, and somebody would say, like, we're at bachelorette parties. They'd like, what do you do? And I'd say, I'm a pelvic floor therapist, and I, you know, do intravaginal muscle exams. And they're like, what? And they're like, Oh, that's weird. And it was like, they would scoot two chairs over. And now that we're a lot of us are postpartum or perimenopausal, it's like, Hey, can I talk to you later? You know? And now it's like, they're really, like, Tell me more. And I think that we've just been living in the dark for so long about pelvic floor health. And it is not the fault of women. It's that medical providers haven't been trained on how to refer to pelvic floor therapy, that we aren't educated about pelvic floor health, you know, when we're taught about periods and sex, and so it's really helping the medical system understand the role that we can play and help women, and also help women advocate for themselves and give them a language to understand their bodies. And also know, like, oh, leaking isn't normal. Like, no amount of leakage is normal, no amount of pain is normal. And really help us take the steps to get the care that we need. What will you explain? Kind of the dynamic, kind of the range of things that you treat because I think one of the things, I think certainly it's not the fault of women, you know, I think we're we don't get enough research, we don't get enough language to our problems. I think a lot of times you bring something up, like even breastfeeding. If you say, like, breastfeeding in public, some some men will be like, Oh, can you like, not talk about that, right? So there's lots of reasons why these things are hard to talk about, but I think one of them is it is the area of our body that's particularly personal. So I think people are always afraid that they are going to bring it up, even to a medical practitioner, and that the medical practitioner will be like, Ooh, yeah, what like you have skid marks in your underwear. I don't want to hear about that. You help explain number one, I think what, what your experience will be, which is that no one can shock you right, like patients cannot surprise you with the issues they bring up, but help them understand kind of the the range of things that a physical therapist can help with and and re emphasize that idea of there doesn't need to be shame when you bring these things up to a pelvic floor physical therapist. Absolutely. So our pelvic floor muscles are a group of muscles that sit at the bottom of our bony pelvis. So we can imagine that ring of bones that we all see on skeleton pajamas or at, you know, the anatomy models at our doctor's offices, and at the bottom of that is this kind of hammock of muscles that you know, attaches from the pubic bone in the front to the tailbone in the back and sits like a basket those muscles support your pelvic organ so in the female body, the uterus, the ovaries, the bladder, which holds urine, the bowels, which hold stool, all rest inside of that basket of muscles and then the group of muscles, the pelvic floor muscles, has three openings, one for the urethra where urine exits, one for the anal opening for bowel movements, and then the vaginal opening for vaginal intercourse and menstruation and vaginal birth. And these muscles are also connected to our low back, to our diaphragm, to our abdominal wall and core.
Sure. So these muscles help with everything from, you know, holding in pee and poop to supporting your pelvic organs to supporting your spine to contracting and relaxing with breathing and movement. So they're they're so essential to our everyday life, and yet we don't even know they exist often until a problem arises. So if you have any challenges with urination, like incomplete bladder emptying, urinary leakage, frequency or urgency of urination, pain with urination, any issues with bowel movements, like constipation, hemorrhoids, fissures, fecal staining, fecal incontinence. Vaginally, it could be pelvic organ prolapse or pain or pressure in the vagina, discomfort with intercourse or tampon insertion, or even orgasms. I mean, more orgasms are muscular contractions of these pelvic floor muscles, so pain with orgasms, leakage with orgasms, the inability to orgasms, weak orgasms. So all of these things are connected to muscles. And yes, there are nerves and other tissues involved. But as a physical therapist, we specialize in the treatment and function of muscles, and so this is kind of how we are able to support all genders. I focus specifically on women with pelvic floor issues, kind of in the bowel, bladder, sexual health, reproductive space. You know, I think one of the reasons that it can feel really embarrassing to bring these up to medical providers is because they don't ask. The research is very clear, if medical providers don't ask specifically about these symptoms like leakage or pain with sex then or painful periods, patients likely aren't going to tell them. So I think part of it is we need to screen better. But then the other side is that, you know, I always say, people ask me oftentimes, like, if I go to my, you know, physician and I ask for a referral to physical therapy, or I say I have leakage with urine, like, oh, just give it six months. Or do Kegels, they're like, What should I do? If they, like, deny me treatment. And I'm like, you have to find a new medical provider, because it's ultimately gaslighting you. If you have the courage to bring up these symptoms, you should at least get a referral to somebody who can help you. If that's not the right doctor for you, they should have the resources, or find the resources to send you to pelvic floor training or suggest, you know, a home program or virtual therapy, because there's a menu of options. Now, I mean, even my book is like 30 bucks. You can buy it at home and just start learning. Start learning the normals for your pelvic floor and some quick treatment tips for home. So there's a lot of entryways into pelvic floor therapy now, and I think that these open conversations really help people start advocating for themselves, and medical providers to start asking the questions, yeah, I love that. I think too. It's important to point out that the idea of a referral is based on the insurance model, and so if you're going to a pelvic floor physical therapist that's covered by insurance, then you usually do need a referral from your primary care doctor or your gynecologist. But if you're going to see a cash pay pelvic floor physical therapist, to my knowledge, you don't need a referral like you can call them and they will happily see you. So if you're, if you feel like you want to bypass that step, or need to bypass that step, and you're, you're open to a cash based model. There are more and more pelvic floor physical therapy clinics that are just really open to taking women of all all needs, and all comers you know to just bring them in directly so that may bypass that that level of complication that shouldn't be there, right? It's a great point. I'm so glad you brought that up. And every state is different. So I live in Louisiana. I'm in New Orleans, and here we can see patients for initial assessments and ongoing care. As long as they're improving, we don't have to have a physician's referral. And I am one of those cash based practices, but in the state of Texas, even if you're a cash based practice, you can see anyone for an initial assessment, but you have to get a physician to approve more visits after the initial assessment. But once you have the assessment, and it's like, hey, we found this is what's going on, or we can refer you to a doctor who we know supports pelvic floor therapy, because often we're the ones referring out if you haven't had testing, or we we think that we need more care than just muscle therapy, so it's a really kind of fluid relationship now, versus like a doctor has to gatekeep therapy. And I think that even just the initial assessments really kind of just demystify this part of the body for people and help give them an understanding of, like, Oh, it's just like I need to work on relaxing my pelvic floor before sex, or do a little, you know, Scar massage on my C section scar to reduce, you know, straining with bowel movements or painful menstruation. So it's just really basic things that we're just not being taught until we see a pelvic floor therapist who specializes in this. Yeah, and I think the thing that's so awesome about pelvic floor physical therapy is that, you know, if you think about other parts of your body, you might only get pain when you're, like, throwing a ball, right? Maybe your shoulder hurts when you're throwing a ball. But all things pelvic floor are kind of, you know, you're using them.
All the time. And so when they get better, they get better all the time. I mean, it's, it's, I've seen a handful of pelvic floor physical therapists now, sometimes just in my work as an OB GYN, and I'm acquainting myself with them. And so I'll, they'll kind of use me as a model patient and do an evaluation sometimes, just like bending or looking at my hips, or, you know, things like that. But what's crazy is, I've had a couple different experiences where they fixed things that I didn't know, that I had a problem, like I didn't go there for a complaint. I was just going there to see their style. And this was an exam with clothes on. This wasn't even like an invasive exam. This was just them looking at things and saying, do you know you're a little bit out of whack here and fixing it, and then me seeing, on a day to day basis, that that little pain I had been ignoring that wasn't life altering, but it was still annoying, and it was gone. You know? Yeah, they were able to fix it just like that. So I think that the nature of physical therapy is so great in the pelvis, because we use these muscles all the time. Will you give us an idea of what kind of an initial exam looks like? Because I think that can be really scary and intimidating for women, absolutely. So you know, all of these pelvic floor examinations are one on one with a therapist. You're not in a big physical therapy gym. It's a private treatment room. They're one on one with a closed door. You can have a family member or friend or chaperone in there if you'd like, and everything is done with consent. So what that means is we're explaining to you along the way, like, what we want to do, what we think would be helpful. And you can say, I don't want to do that, or I'm not today, and we're like, you got it. This is absolutely like your journey, and we're going to walk through it with you at the pace that you're comfortable. What we do first is we just sit and talk for a bit about and ask you questions. So you may be there for tailbone pain, but I also want to hear about like, you know, discomfort with intercourse or your childbirth history. What do you do for exercise and work, you know, peeing and pooping habits, all of these things to get a good global picture of your pelvic floor health. And then I do an external assessment of your hips, your low back, your pelvis. I look at kind of muscle firing patterns, tension or weakness, if you have any abdominal scars, your breathing patterns, everything external, which we can do with clothes on. And then what we do, if you're comfortable, is an internal examination. So this isn't with stirrups or anything like that. You typically undress from the waist down, and we give you a sheet to cover up with, or a hospital gown, and you lay on a kind of comfortable, padded mat. It's, again, not like a clinical stir up room. And then we talk you through what we're going to do with a little pelvic model, like we're going to ask you to do what you would consider as a kegel contraction. Then you're going to push and bear down, and we're going to watch what you do for pushing during birth or pushing during bowel movements. And then we're going to kind of press externally along the muscles and look at the tissues of the vulva. And then we'll do an internal examination, if you consent. And this is how we test the muscles. So by inserting a glove lubricated finger into the vaginal opening, I can ask you to squeeze. Do a pelvic floor contraction. See how you contract, test the strength, see how you relax, see how you push your bear down, if there's any prolapse in the area, and then press on the side walls of the muscle to see if there's tension or tenderness or weakness. And then that's it. And all of that information we kind of put together to say, like, is this person, you know, maybe tense or overactive and they need to work on down training and relaxation first before, you know, doing tightening, or is this just purely a weakness issue to work on strengthening? Is this a coordination issue? And then we're able to guide you on what you need to do at home, whether it's, you know, learning how to pee or poop properly, or starting some strengthening, or starting some yoga and breathing work and again, to your point, it's a whole body treatment, because the nervous system is so connected to every muscle in our body, and 36 muscles attached to the pelvic bone. So, you know, a lot of it's kind of teaching folks how to be aware of this part of their body they don't know that they're tensing or, you know, not contracting, and then kind of just connecting with it, and then also how to bring it into day to day function with their lives. So it's, you know, we see people maybe once a week, once every other week. So it's not like three times a week for an hour, and it's I think you get so much from it, because it is so one on one and customized to you and your needs as well. I love that
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now back to the show. Well, take us back a little bit. I want to go back to your experience as
you know, a voice in this field, as an expert, voice in this field, what do you tell us about the interaction with your followers, with women who are coming to you and asking for more, or when they're giving you the feedback of, oh, this is so helpful. What are those things that they are most happy to be hearing from you? You know, it's funny, because I always go back to one thing, which is the reason why I started this account to begin with. And it was after 10 years of practicing I heard over and over again, I wish somebody would have told me this sooner. Why didn't anybody tell me about pelvic floor therapy sooner? And so when you hear those things and you're practicing, you're like, why aren't they hearing this sooner? Like, if I know this information, why am I the like, a lucky person who picked this field, who can have great pelvic floor health and understand my body and do preventative care? Or why doesn't every woman have access to that? So, you know, the reason behind my account was really bad. And so when I post something or share something, oftentimes it's a question My patient has come in with, like, Oh, hey. Like, I don't know how to use a menstrual cup. How should I do that? Or do menstrual cups cause prolapse, or, you know, this position is uncomfortable in sex, like, what should I do? Or is it a muscle problem? Or, you know, I can't pee, you know, first thing in the morning, how do I relax my muscle? So just like, little things like that make me think of, like, Okay, if this person has this question, probably other people have the question too. And then sometimes a lot of what we do is, like, questions that people are asking me via social media, you know, a lot about, like, how do I teach my daughter how to use a tampon? Or how do I prepare for birth? Or what do I do for a C section scar? So just everything, kind of in this arena. Or, you know, if I have vaginal dryness during perimenopause, is that a pelvic floor issue? So just a lot of things that people have questions about, and I'm really honored they feel safe to ask me that, and then I'm just responding. So, you know, I think that if we just listen to women, they will tell us what they need, like they know their bodies. We just need people to listen to them. We need people to do the research to support what they deserve in healthcare. And I think one of the reasons I'm so vocal is because I still, after 18 years, see women getting pelvic floor therapy as an afterthought, or after months and years of suffering, when I really want this to be the standard of care at every life stage of womanhood, whether it's getting your menstrual cycle, becoming sexually active, you know, preparing for pregnancy, pregnancy and postpartum, and now perimenopause and menopause. Like we know that at every transition, our pelvic floor health changes and has different things that it needs to support us, and we should be helping women navigate every season of that, instead of waiting until they're like, 65 or 70 and then there have significant incontinence and they're like, well, now this is just my destiny. I love that you brought up the idea of safety, because I think that is a huge part of what you do. And hopefully all of us as women's health practitioners are doing is just providing a safe space. And women are pretty good about, you know, if we give them that opportunity, they are pretty good about coming and saying, What do you think about this? So I love that you are and thank you for being that safe space online for people to answer these questions. Is there one thing or three things that all women can and should be doing for their pelvic health day to day? Are there some big things that you just want to shout from the rooftops? Yes, and I want to share those. They're actually there's a list at the end of my book, that's my top 10 things that I actually do as a pelvic floor therapist, which I think are my must haves. One is like learning how to pee properly, so you should not be pushing when you pee. I think that is the biggest mistake that I think women make, all genders make. I did a reel on this recently, and it got over 40 million views, and I'm like, wait this. Many people don't know that they shouldn't push when they pee, and it's such a basic thing. But when we I call us power peers, and we're always in a hurry, and we always want to be efficient, and we're moving on to the next thing. But when you pee, you should be sitting down, not hovering over a toilet. I get that some of them are really gross, so if that's the case, yes, hover, but, you know, try to sit down as a standard practice. And then when you pee, you should just, you know, lean forward onto your elbows. Legs are nice and wide, and just take some deep breaths and kind of quieting your nervous system actually helps your pelvic floor muscles relax. And then your bladder is a muscle that contracts to push the urine out. So you shouldn't have to push when you put.
When you pee, it actually can lead to incomplete bladder emptying, and it can also weaken your pelvic floor muscles and weaken the ligaments that support your pelvic organs over time, which can lead to weakness and prolapse and leakage. So if you're peeing six or eight times a day, and you're pushing every time, that's a habit that could be causing a pelvic floor issue. And I see women in their 20s who have prolapse because they Yeah, and they've never given birth, but it's like they're they're power peers, and they just were never taught differently. The other thing is, I think everybody should be pooping with a Squatty Potty. And a squatty potty is a little stool underneath your feet that you can keep in your home, or even if you're at a hotel, just turn a trash can on the sideways or lift your heels up, but getting into a squatting position is the physiological best position to relax your pelvic floor muscles for a bowel movement. And straining with a bowel movement puts more pressure so can weaken your pelvic floor more than running, jumping, coughing, things that we often think of can cause leakage, but if you're straining with bowel movements, which most people have, one once a day, that can cause significant weakness to your pelvic floor as well. So get a squatty potty, keep your poop nice and soft, stay hydrated, and that will help you empty the tank better. And
then the last thing is, you know, don't this is kind of a general one, but I'm like, don't accept pain as anything normal in your life, whether it's tailbone pain, pubic symphysis pain, sciatica, but vaginal pain and painful sex is probably one of the most common complaints that women come to me with, and it's can be the first time they have intercourse. It can be after giving birth. It can be both a vaginal and Cesarean birth. It can be later in life. It can be if you're a heavy muscle exerciser and you have tension in the muscles. And I think what happens is that we often just think of we need to push through the pain, like, I'll just deal with this. I'll just get this over with, but one that makes us not want to do something, like, when you don't enjoy something, or something's painful, we want to avoid it. And so we kind of start shutting down on this part of our body. Of our body. And two, pain sexual, sex should be pleasurable, not even just tolerable. It should be pleasurable. Pain is information from our body that something's not working well. And so it can literally be so easy as to just address a tight hip or tense muscles or some scar tissue or a dryness issue, and it can really help you feel better in this experience. And so I think we all deserve pleasurable sex well into our later years. And so I think it's something that I want women to know, that no amount of pain is normal, and it's very addressable many times to relieve that pain.
I'm glad you bring that. I mean, I think all of those are so great. And thank you for sharing with those with us. One of them things that you said was the idea of C section versus vaginal birth, yeah. And I think a lot of people, I've had many patients, say, Well, I don't need pelvic floor physical therapy because I had a C section. Like nothing came out there that wasn't a problem. And so much of it is actually the pregnancy and the carrying of the pregnancy. You know, the pregnancy had hormonal changes and torque changes, physics changes for eight months, nine months, you know, depending on when, I mean really it's 10 months, but depending on when those pressures hit of that uterus getting bigger and that baby getting bigger. I am about five weeks postpartum right now, and you say tailbone pain, and I'm like, trying to ignore it and convince myself I don't need to go to a pelvic floor physical therapist. So that's the other thing that I wanted to shout out, is we're just really good at convincing ourselves that we don't really need that, you know, like, it'll be fine, like, it's not that big of a deal. But when you get these things fixed, when you get them repaired, it really does affect more than that one little body part, right? Like, for me, it's my tailbone, only when I sit on a certain
type of surface, like a certain hardness of chair at a certain angle, like I have to be kind of slouched backwards for a prolonged period of time, like I was leaning on, sitting on the floor, leaning against the wall, talking to my kids, and after I got up, I was so stiff and almost couldn't move. And that's really easy for me to be like, well, I won't do that. That's okay. I'll fix it. Fixed it, you know, no problem. But this idea of like, I don't need PT because I had a C section, not a vaginal birth, I don't need PT because it's only if I do this and I'll just not do it. Like, just a shout out to all of us who are procrastinating taking care of ourselves, it really will get better. You'll be better off if you do get the help that you need. So I'm glad you said those things. Well, thank you for sharing that, and I think that it almost makes me emotional hearing you share that, because I think so often these symptoms start to infiltrate little areas of our life, like, oh, I only like pee when I, like, jump on the bounce house, in the bounce house with my kids, so I'm just not going to do that. Or when I'm playing on the ground with my kids, so I'm just not going to do that. Or when I have sex with my husband or other partner, it doesn't have to be, you know, male female partnership. So I'm just going to kind of avoid that position, or just do it less often. And.
And we realize that it starts infiltrating these little parts of our lives. But I'm like, why don't we deserve those moments of joy? Like, I kind of peel it back a little bit. I'm like, if my kid has a, you know, we think he broke his thumb. I'm like, I'm getting into the orthopedist the next day to get X rays. And I'm like, yet I won't, you know, I leak when I play tennis. I'm just going to quit tennis, which is something that brings me joy and gives me exercise and I socialize. So when we start thinking about the ripple effects of these symptoms, I think that's where we can boil it down in the medical system, where we're like, oh, it's just a little bit of leakage, but I'm like, but it's not because, one, these symptoms don't typically get better with time. They only typically get progressively worse. And two, it affects our quality of life. So we're saying I'm willing to kind of sacrifice my joy or my body, because this is just something I have to deal with. And I'm like, but we wouldn't want anyone else in our family or in our home to have to deal with that. And so I really think it's us taking a step back and saying, like, No, we do deserve this, and it is a little bit of work. It's a little bit of an investment in ourselves, but it absolutely we deserve it, and it's it's less complicated than we think. I think we're like, I don't need another thing on my list or but yet, I'm like, if my kid needs to go see a doctor, I'll go on a heartbeat. But if it's for me, I'm like, uh, I'll just wait a couple more months and see if it gets better. Yeah, okay. I'll go, I'll go, I'll go make an appointment. And I'm like, just don't slump. I think the thing with tailbone pain is we can't avoid sitting, but if you slouch backwards, it puts pressure at the right spot that causes discomfort. So if you kind of sit up and tilt your pelvis forward, you get more in your sit bones, in your sacrum. So that's kind of your short term remedy. But I hope that that's helpful for other people as well, and yeah, and also that we don't think of tailbone pain as a pelvic floor issue. And to your point about C sections, you know, pregnancy itself is what changes the pelvic floor, not just the way that you give birth, but a C section birth has its own separate list of challenges and side effects which people who have C sections have a higher frequency of having painful sex, painful periods, constipation and incomplete bladder emptying, which are all because people are like, but it's up here. It's on my abdomen. I didn't even go near the vagina with my baby. It's all connected and Yeah. And also, these scars can be sensitive. They can be painful, like, you can't have anybody lay in your chest. You can't lay in your stomach. You can't wear jeans, like, these are all treatable issues, and so I think it's just helping people, like, put the dots together again, not their fault. We haven't been taught this, so I think that's why I'm so vocal about it. Because I'm like, okay, whoa, let's put the pieces together. And there's totally a treatment, pelvic floor therapy that can help give you relief. And it's, it's really simple, yeah, well, tell us what, what is the most out there thing you've done in the name of getting these things out there, getting this information out there. I know that you you're not shy on your Instagram account, of bringing up the taboo things and making them even maybe a little silly, or joking about them, hopefully in an effort to soften the barriers around these. What's the craziest thing you've ever done? Right? So to kind of preface, this is the vagina whisperer was a nickname, and so I had no idea that any of this was going to kind of take off to where it has. But, you know, I think that the way I approach things, it's not to make light of them, it's to bring a little bit of levity to what can feel like a really heavy conversation. And I'm always like, we can laugh about the little leagues, but I also want us to get treatment for them, too. Yeah, you know, some of the most out there things. I mean, I have a closet full of vulva costumes that, over the years, I have worn on various one does. Yes, one does. And it's been fun to kind of see other pelvic floor therapists kind of get into that space too, and now they're like, who's your vulva costume maker? You know? So there's a market out there if anybody's interested, but I think that just dressing up like that, you know, to kind of like, do funny reels or videos and just educate people about our body in a way that's not so clinical. I mean, I use terms, like, in my book, there's a chapter called the scoop on poop, or, you know, keep calm and birth on and taming the Tinkler. And it's not at all to make light of an issue, but it's just to, again, like, lighten the medical heaviness and the scientific word so that people can understand what I'm talking about. I think if we get really technical, we lose people. And I think we just need to meet women where they are and help them kind of just understand their bodies. Like people don't necessarily know what incontinence is, but they'll know, like, I pee my pants. And then the other thing is, when the book launched in June, I was, you know, had the honor and pleasure of going to New York on NBC, and kind of the day of the book launch and being on, you know, national news. And it was like the first time they had ever had anybody say vagina on national TV. And I was like, Well, I am honored to be the first one. So that was really fun. And I think there were so many women, you know, newscasters and and journalists who were like, we want to have you on, because we want to talk about this. And.
You have the specialty, and you have the voice. And it was just really such a joy to have so many people open up their shows and their news stations to say, like, hey, let's say vagina, and let's say it loud. And like, if people are uncomfortable, that's on them, but women deserve this information. So those were all really, really big highlights over the past year. With the book launch, that's amazing. I also really respect and appreciate that what you do, I think it's easy to skate that line between like, bringing lightness to it and having it be crass or uncomfortable for people to talk about. And I think you do a really good job of keeping it light and keeping adding that levity like you're talking about. But that doesn't mean it has to be offensive or crass or, you know, where people are suddenly like, I'm not really comfortable talking about it that way. Some people are not going to be comfortable even with the word vagina. So there is a middle ground where you, you know, you want to bring that that level of, maybe get rid of some of those barriers. But there is also, I think, a sweet spot where we don't need to, I think you can. You can start to degrade women by by making it too light or too sexual or too out there. So I, as people are hearing that, you know, you're called the vagina whisperer, and you're talking about vagina. I think it can be done respectfully still, you know, I really try, and I'm sure that there are things that are still too out there for folks. I'm like, I get it. Like, if this, if I am not the right messenger for you, then like, please follow someone who is or get your education. So it's, this is kind of my style, and I don't think that everyone's style is for anyone, but I also think that me talking about it so openly and just being kind of authentically who I am has also helped just be like, Hey, this is normal. Like, I talk about this stuff all the time and so, but I do try to do it in a respectful way. But, like, there was a time that I was showing folks like, how to use a vibrator to massage their C section scar. And like, 1000s of people were like, This is too much. And unfollow and I'm like, I get it. I was shocked, but it goes to show me that, like, not everybody's ready for that. And I'm like, that's totally fine, but this is, these are the conversations I'm having in my clinic, and I just want people to know what their options are, and you you, I'll give you the options, and it's you decide what you like. But that's really I'm not saying everybody even has to go to pelvic for therapy. I just want folks to know that there are options, and you have the ability to kind of make those choices for you when
you're a women's health expert like I am, you get to talk about a lot of taboo topics for women, and that includes periods and how inconvenient they can be, among other things. I grew up in the era of only tampons and pads, and I am so glad that we now have better options. I switched years ago to using period underwear and a menstrual cup combined, and I will never go back. I've tried several brands, but the brand I'm really loving is salt that's s with two A's, LT, their cup. Discs and period underwear are not only comfortable and reliable, they also take extra steps to make sure that when you're using products in intimate places, that they're not going to release toxins like PFAs or other chemicals that we really don't want to be absorbing into our bodies, plus they're more sustainable and more cost effective compared to traditional products, which is a win in my book. We love that salts products are made with medical grade silicone, free of toxins and designed to actually fit real bodies and lifestyles. Whether you're brand new to reusable period care or looking to upgrade, we highly recommend checking them out. And please, if you have a teenager who's starting to have periods, please get them some period underwear. All of us who are older know what it was like to walk around with a sweatshirt tied around your waist. Let's get rid of that. Just get them some period underwear. Click the link in our show notes to shop salt and explore all of their options, and you'll see why so many of our patients are making the switch. Now, back to the episode. Well, I want to talk about your book, and I also want you to talk about the kind of the future of pelvic floor physical therapy a little bit, because I think, I think a lot of us think that you have to go to a pelvic floor physical therapist be evaluated in order to have any progress at all, and that's always a good idea, but you have now have several resources for people to get started and to start seeing these improvements. So tell us some of your other work as well. And then tell us a lot about your book, this wonderful book that you've published. Thank you. So you know, I think the beautiful thing about medicine now, which really, kind of, I think, has really shifted since 2020 is that there are options for how you can access care. So it used to be just the very standard, like, you have to wait to see somebody in person. It costs. You have to pay insurance. You've got to, like, take time off from work or get child care and travel. And that is still a number one option. And I don't think anything is going to replace in person care, and it shouldn't, because do having a physical assessment from a pelvic floor therapist is the best by a good pelvic floor therapist. However, there's not enough pelvic floor therapists to treat all of the women in the United States, specifically, even just the pregnant and postpartum women in the United States, so we need to have different avenues for.
Care, and there's not enough of us, even in certain areas of the country. And, you know, there's barriers to access. We can't all leave work. We can't all, you know, see an in person or even afford it. So I think you can do in person care. There's virtual therapy now. I have a therapist who works with me, and there's a lot of therapists who do virtual consults where, you know, the research is very clear, even one hour of pelvic floor education can help relieve some of your symptoms. So just the education itself can be really helpful. I created an app called the V hive that everybody gets to trial free for a week. But you know, the app was really again, just women saying, like, Hey, do you have online workout programs? I'm I'm having a hard time like doing my exercises that my therapist told me to do, or I'm on a three month wait list. Is there anything I can do right now to start dealing with my postpartum recovery or pro labs or painful sex? So again, it's just listening to what women want and saying like, Okay, let me think about how I can help address this. So my app has a ton of resources and workout programs and videos to help you just again, be able to access care from home. And then the book floored. It's called floored, a woman's guide to pelvic floor health at every age and stage. It was published and came out in June 2025
and it was a really incredible journey to create this book, because I had no goals of ever being an author, but I had an editor from Harper Collins who followed me on social media and said, hey, there are no books about this. I think that you've got a great voice. Like, would you consider writing one? And I was like, amazing. It was amazing. And I was like, Well, I've never thought about it. And so all the stars aligned where I was able to kind of do less clinical care and open up my schedule, and found an agent, and kind of started understanding the publishing world. And I spent a year, I mean, waking up at 5am every day, working on the weekends, missing vacations. I don't even really drink alcohol, but I like drank nothing for a whole year, and I just to focus on writing this book and combing through the research and really pouring what I knew in my, you know, 16 years of clinical experience when I was writing, and then all the research to see, like, where's the guidebook for women? To just get started, you could write an entire book on menopause, which there's tons of them now, there's you can write ton a book about pelvic floor health and birth, but we just need a baseline for pelvic floor health. So I wrote floored, and I focus specifically on women, just because that is where I have the majority of my experience. You know, we see all genders, trans folks, there's pediatrics, there's men's health, but I focus specifically on female bodies. So and it really walks you through everything from, you know, periods and peeing and pooping and sex and pain, and then also life stages like pregnancy and postpartum and perimenopause and menopause. So you could read the book in entirety, or you could go directly to the chapters where you feel like you most need support, and it gives you a great starting point. And you know, if there's ever things in there that you feel like you need more of them, like go see an in person therapist, or try some of the things in the app. But I just again, want women to have options for how they can really work on their pelvic floor health proactively, and also to address symptoms if they're having them. So what sets this book apart? What? What makes this I mean, obviously, like you said, there's not a lot of books or any on pelvic floor physical therapy. What tell us a little bit more about how this book, like I said, what you hope women to get from it, and some of the good responses that you've heard from it. So I think, you know, I open the book the first chapter in the last chapter, really my favorites. And I talk about, like, why do we need this book? And it really starts with, you know, when we were young, at least for myself, I'm 43 now, but when I was a young woman, it was like, you know, when you get your period, you're sneaking tampons up your shirt sleeve, like I was, it was like I got a book and a box of tampons and I went into the bathroom. I was like, Okay, let me try to figure this out. You know, it was like we were just so lost and not in the fault of my parents or my mom, it was like she didn't know any better. And there was no conversations openly about pelvic floor health. And it really starts even from young kids when we're potty training them, to becoming a young woman. And so a lot of it is just like opening up the conversations, helping people understand why pelvic floor health is so necessary. Because, as we've talked about throughout this conversation, it affects every part of our day when we're sitting here now, your tailbone, when you get up and go to the bathroom, when you go pick up your kids later, when you want to get an exercise or workout in postpartum. I mean, every part of our day, our pelvic floor is working or not working as well as we'd like it to. And I think when we can start understanding what it does, we can say, oh, what's normal? Like? Is it normal to have tailbone pain after giving birth? And what's not? And then I give you tips and resources to help it at home. So it's a lot of just understanding this part of the body why it's so necessary.
And also that, like women's health has been under researched, and we have to be the champions for our own bodies. We have to advocate for ourselves. Nobody else is going to do it for us. So it's really just also like, Hey, I hope that you better understand your body after this, and if you are having issues, I want you to get help from this book, from my app from a pelvic floor therapist. But you deserve this care, and I hope it continues to infiltrate areas of medicine where whether you're seeing an OB GYN or a primary care provider or a gastroenterologist or even a pediatrician, seeing a new mom like that, we can all start screening for these issues to help get women the care that they need. Well, thank you for saying that. I think I'm loving this point in history where so many practitioners are writing these books that really are so beautifully bridging the gap between patients and practitioners. You know, the books are really intended. They can be read by everyday women, but also can be utilized by practitioners to improve their care. It was always before, you know, there was the textbook and then there was the dumbed down, like, don't tell them too much, it'll be overwhelming. And I'm so happy for this blend where everyone is learning so much. I think there are some practitioners who worry about educating the public, you know, educating women that like they'll treat themselves, or they will, you know, go rogue. And I just think that's really unrealistic. I think for a woman to be empowered to come in and say, Hey, I read this in a book. This is what I think is going on. I love it as a practitioner. I love being able to say, This is so great. Talking from an educated person to another educated person you know to be able to hear where you're coming from, because you know something about your body. Why would we ever not want that? So I, I'm so grateful that you're doing what you're doing. Thank you. And, you know, I think it's one of those things that people used to kind of ask me, they still do, like, Oh, do you have a reel about this? Like, C section scars. I'm like, now it's like, it's in the book. Like, you have a book and you can, like, refer back to it, and, you know, I mean, I think you're an incredible practitioner for like, feeling like, you want people to feel informed about their bodies. You know, the interesting thing is that the way that I actually started kind of being more entrepreneurial and going out on my own is I was working for a local hospital here in New Orleans, and I had just moved back here after having my two kids. I was away for 17 years, and this is where I grew up, and I was working for hospital. I said, I think we should work with the childbirth educators and start talking to them about, like, pelvic floor therapy, so if women are having issues after giving birth, they know what we can help them with. And the medical director for the hospital said, We don't want to scare women, so we don't really feel like that's appropriate, and they don't really have those problems anyway. And I was like, what we don't want to scare when we all all quietly implode.
And I was like, Why do you get to make that decision for them? Like, let us figure out what we can handle. And if anything, again, I'm having women coming in telling me, I wish I would have known this sooner. So it was all about like we shouldn't be gatekeeping information from people. I think that women are going to Google and chat GBT and their friends to get health information. Now, why wouldn't we give them their own guide to their own bodies? There's hundreds of books on meditation and yoga and nutrition, and, you know, other other exercise so like, why wouldn't we have one on the pelvic floor? And so hopefully myself, and there's another PT friend who wrote a book on pelvic floor health as well. And I hope this really sparks just more people creating resources for women of every stage of life to have you know about their pelvic floors. Yeah, it's funny. You bring up the tampon thing, because I have a funny story about that that I when I was in residency. So I am an OB GYN. At this point, I'm in my OB GYN residency, and I was wearing scrubs, and you have, like, the breast pocket there, you typically put your pen in, and I was on my period, so I put a tampon in there, kind of tucked down. But through whatever I was doing, it had crept up. So it was now kind of climbing up my scrubs and very visually sitting there in my pocket. And we had our weekly kind of teaching meeting. So it was the whole residency gathers together, and I have a tampon, you know, hanging out of my pocket. And then after the meeting, I had a conversation with one of my male attendings, who's, you know, gray haired and tall, and just sat there talking to him the whole time with the tampon sticking out of my pocket. And I realized after the fact that that was the case, that here I am walking around with the tampon talking to all of these male, you know, attendings, and was kind of embarrassed about it, like, oh, I should have hidden my tampon so no one knew that I was on my period, right? But it didn't get to me so much. But I mentioned it to my roommate, and she was like, Oh my gosh, that's so humiliating. Like, you just you had that tampon out the whole time, and it's so it's such an interesting perspective on like, why are we so afraid to talk about women's health issues? Like, I.
Not like I was going into the gory details of being on a menstrual cycle. It was just acknowledging the fact that I was, in fact, a female having a menstrual cycle, as proven by a tampon sticking out of my pocket, right? I hope we can, kind of like, recognize that. I hope for my daughters, that I can reassure them that, like, That's okay if someone sees that you have a tampon. Is that? Is that really the end of the world? Like, is that something we should be ashamed of or scared of or disgusted by? And I'm, I mean, I was a doctor in a field of OB GYN, where we literally talk about menstrual bleeding all day, every day, yeah? So if one of those men didn't know that I was a cycling female, like, that would be weird, right? Yeah, wow. I mean, and I think that the way that you felt, and I think at the response of your roommate or whomever at the time, is not unusual. I mean, I think it's like, I would feel embarrassed, but I'm also like, Wait, why would I make my own self uncomfortable at the sacrifice of because I don't want to make them uncomfortable, like we're doing all of this so that other people don't feel uncomfortable yet. So we're all just gonna, like, live in shame and hide ourselves and sometimes that we're not having periods, right? I mean, and this is just like, it is what it is. And so I even challenged myself of, like, Okay, you're on the airplane, just hold that tampon out. Like, don't slip it, don't up your sleeve, don't hide it. And like, I even have to, like, unwind and unconditioned myself because I've grown up during this era and but I will say, like, I'm raising two boys, and I think that it's I'm curious to see how this goes, because, yeah, we're very open in our household. And like, they'll see blood, and they're like, what does that hurt, mom? And I'm like, No, it's a period, and it doesn't hurt. It happens when you know Mommy's not pregnant, and I bleed every month, and they're like, oh, and they're like, what's that string hanging out? And I'm like, I don't like, I'm sure I'm over sharing, but maybe I'm not like, maybe they'll still think it's gross, but I'm like, they'll at least know what a tampon is. They'll know that a woman has a female menstrual site, like a menstrual cycle. I just, I think some of this is just normalizing the things that are happening to our bodies. And again, we don't all have to go into the gory details, but it's also just the reality of what we're living with that on your mind, you're thinking, Am I bleeding through my underwear? Is anything showing through my pants? I have to make sure I get to the bathroom in time to change this before I over saturate it. I mean, these are the thoughts that we have to deal with as women that other genders don't. And so I think that it just goes into, like, the weight that we carry that is invisible, then we tack on making everybody else feel comfortable around us, and then, like, you know, we can just give that up and just actually just tackle what we need to tackle. Yeah, yeah. I'm just so grateful you're here. I think it's such an important you're such an important voice at this point in time. And I'm, I'm so glad that you're, you're comfortable enough and willing to put yourself out there and and talk about these things as we're wrapping up. Is there anything that you want to kind of shout from the rooftops just make sure that women are hearing from you? Yeah. Well, first, thank you for having me. It's just really an honor to be on and to have you share your platform and community with me to hear this. What I think is really important information. I think the two things I really want you know, folks to understand, is that, one, there's a lot that you can do to prevent pelvic floor issues. So I think just starting with like, whether you're trying to conceive or you're during pregnancy, or you're even perimenopausal, because heading into menopause, we know that your hormones are changing. We know that there's going to be drastic changes. There's a lot that you can do to build up muscle strength and tone and coordination and flexibility to help you with the next stage of life. So there's just like, I'm doing strength training now to help prevent osteoporosis later down the line. I can do pelvic floor training now to also help with incontinence and prolapse later down the line. So I want folks to really think about proactively caring for their pelvic floors. And the second thing is, I also want women to know it is never too late. If you had a C section 10 years ago, 15 years ago, if you are 80 and you're experiencing leakage, if you're 60 and you're having painful sex. It is never too late to address these issues. We have women coming into our clinics who are in their 80s and 90s, and I'm like, Yes. Like, it's almost like, going to the dentist. Are we ever going to like, Oh, I'm just going to give up on my teeth and just like, forget it and just see what happens. I'm like, No, we go religiously every six months to a year, and pelvic floor care should really be the same way integrated into our healthcare system, so that we can do preventative care and we can also do reactive care to help, you know, these symptoms from becoming chronic and longer term issues. But it's also never too late, and I think any stage you feel comfortable entering, whether it's a book, whether it's, you know, watching videos, whether it's seeing a person in person, like checking out the app, I think that it's just all great entryway points to start better caring for your body. Wonderful. Tell us where we can find you and where people can buy your amazing book. Thank you. Well, you can buy the book anywhere you like to buy books. So.
So it's offered many countries across the world and in the US, it's, you know, Amazon and Barnes and Noble and directly from my publisher, Harper Collins. So it's, it's really easy to access, and I hope that you love it. And if you do, please leave a review, and you can find me on social media at the vagina whisper it's the dot vagina dot whisperer on Instagram, and the vag whisperer on Tiktok, because Tiktok doesn't like the word vagina. And my website is the vagina whisper.com where you can learn a ton about my app, and I have tons of like, free guides and blog posts on there, and you can try the app for a week for free, and just, you know, really hoping people can just find resources to kind of answer the questions they may have that you know they haven't yet asked a provider, or they feel too embarrassed, but know that they're not alone, and there's, there's a lot of help out there for them. Well, thank you so much for being here. I'm going to make an appointment to get my tailbone looked at, and hopefully someone else listening feels motivated to go make their appointment to get those issues that they've been ignoring taken care of once and for all. Awesome. Thanks so much for having me. Thank you so much for tuning in to today's episode. A huge thank you to our guests for sharing their insights and time with us. We are grateful for the incredible support from our sponsors and to all of you listening. We couldn't do this without you. If you enjoyed this episode, please consider subscribing on your favorite platform. You can find us on our website, uplift for her, calm YouTube, Apple podcast, Spotify, or wherever you love to listen. And if you found value here today, please share this episode with someone who would benefit from it. Leave us a comment or give us a review. It really helps us reach more listeners like you. Thank you for being part of our community. Stay tuned for our next episode. Lastly, this information is for educational purposes only, and not intended to be medical advice.
