PODCAST & BLOG

PODCAST & BLOG

Kim Vopni, The Vagina Coach, joins me to talk about women’s pelvic health. Kim is a self-professed kegel maven and is a certified fitness professional who became passionate about spreading information on pelvic health after the birth of her first child. 

So, you may be wondering why we’re talking about things like vaginas and pelvic floors on a personal development podcast. Well, it is my belief that if your physical health is suffering, you won’t be able to appropriately focus on doing the hard work of personal development. But, if this isn’t your jam, don’t worry, we’ll be back to the good old fashioned self-help very soon! 

We explore ways to overcome pelvic floor dysfunction, vaginal dryness, and why we must normalize the conversation around talking about pelvic health. Some of the other topics in this episode include:

  • Kim answers, “Is it an overactive bladder or something else?” (8:56)
  • Pelvic organ prolapse: what it is, its symptoms, and healing (15:00)
  • Is it true that as we age we lose elastin in our vaginal walls? (20:38)
  • What causes vaginal dryness and how we can keep things moisturized (31:55)
  • Why doing kegels are important and when women should start doing them (38:59)

Resources:
Kim’s website
Maintenance Phase Podcast
MoisturizeYourVagina
HelloBonaFide
Repagyn
JoyLux
PelvicGuru

Book recommendations:
You know how I love a good personal development book, right? I’ve compiled a list of book recommendations, as mentioned in past episodes. Check out these amazing book recommendations here. Happy reading!

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Find a complete list of our sponsors and their offerings visit andreaowen.com/sponsors. Thank you for your support!

Kim Vopni is a self-professed kegel maven and is known as The Vagina Coach. She is a certified fitness professional who became passionate about spreading information on pelvic health after the birth of her first child. She is an author, a passionate speaker, and a women’s health educator. Her most recent book Your Pelvic Floor launched in March 2020 and was on the bestseller list since pre-orders launched in January. Kim is the founder of Pelvienne Wellness Inc – a company offering pelvic health programs products and coaching for women in pregnancy, motherhood and menopause.

Kim also certifies other fitness and movement professionals to work with women with core and pelvic floor challenges through her Core Confidence Specialist Certification and Pre/Postnatal Fitness Specialist Certification. You can find her on-line at www.vaginacoach.com and on social media @vaginacoach.

Right-click to download the episode.mp3

 


SHOW TRANSCRIPT  

Kim  00:00
We're talking about kids about sexual health and body education and menstruation, introducing the concept of this really important group of muscles in our body and how to care for it and because we menstruate, because we give birth, because we will all go through menopause, we deserve extra attention and awareness really.

Andrea  00:22
You're listening to Make Some Noise Podcast, episode number 487 with guest Kim Vopni.

Andrea  00:35
Welcome to Make Some Noise Podcast, your guide for strategies, tools and insight to empower yourself. I'm your host, Andrea Owen, global speaker, entrepreneur, life coach since 2007, and author of three books that have been translated into 18 languages and are available in 22 countries. Each week, I'll bring you a guest or lesson that will help you maximize unshakable confidence, master resilience and make some noise in your life. You ready? Let's go.

Hey, everyone, welcome to another episode of the podcast. I'm so glad that you're here. And before I forget, before I forget, the episode that we're going to be talking about today, and I will have a couple of guests in the women's health theme where you might be like, what on earth does this have to do with personal development, Andrea. And part of it is because I personally am interested in what these particular experts have to say because I have my own health issues as I’m guessing that many of you do or have in the past or will in the future. But here's the thing, I have noticed not just recently, but throughout the last decade and a half or so, if my physical health is not intact, if I don't feel good in my body because something's going on whether I know what it is, or I'm trying to find out what it is, I can't concentrate on doing the work. The other all the other stuff that we're talking about here, getting a handle on your trauma, learning new tools about you know how to let go of perfectionism and people pleasing and all of the things all the things that we talked about. So I wanted to kind of make sure that all of the themes were as well rounded as possible. Like I'm not going to have people come on talking about the easiest ways to change your oil. But basically, we're talking about how to change your oil in your own body, in your own vehicle, if you will. So today, this particular expert, we're going to be talking specifically about women's parts. I'm gonna read you her bio in just a second.

And recently on a on a personal note, also, I'm bringing you this episode for the first time this intro I should say, on my brand new computer. I told you guys last week about the woes I was having with my with my other iMac and so I have a brand new one. I swear getting a new computer is like getting a brand new pair of shoes, you're like this amazing, it's just fresh and new and empty and just ah, I love it. All right. But on a on a personal note. And another personal note, I recently just yesterday, as I'm recording this, got all of my lab results back from my doctor. I'm seeing a new doctor. I'm seeing a functional medicine doctor for the first time. I kept hearing, I needed to go see a functional medicine doctor because this autoimmune thing that I'm having. And I have a sneaking suspicion, I've had a suspicion for a couple of years that I have some inflammation going on in my body. But then do you guys ever do this? Where you kind of suspect that there's something going on physically and then you look into the remedy for it and it seems so difficult? You're like, is it okay, but is that really a thing? Where can I find the debunking of this particular ailment that I may or may not have? So for me, I suspected there was inflammation going on, because of a few different physical symptoms. A few different reasons. But thinking about what I might have to go through to get rid of the inflammation was daunting, but yet I didn't know if I had it or not. And then I'm like, is this pseudoscience? Is this really true? I love the podcast Maintenance Phase. If you guys don't listen to it, you really should. And they do a lot of debunking of different health fads and trends, and some of them are kind of ridiculous and when you hear about him you're probably like of course that is going to be debunked. But I like to has maintenance faced and did an episode on gut health. I don't think that they have I'm pretty sure I've listened to all of them and I don't think they have.

But anyway, I'm looking at all these test results, and she's going over all with me. And it turns out, I forget the name of it, whatever this thing is that points to the Candida in your body. Mine is very high. And I was like, dammit. So we are going to go through a thing to try to rid… And apparently it's not a one and done to kind of bad news bears things. It's not a one and done. It's not like you do this thing and then forever, you're just free of all the yeast in your in your gut. And then also, sometimes she's like, your symptoms will likely get worse before they get better. And I was like, I can't wait. I can't wait to have worse muscle and joint pain, or insomnia or sleepiness or gas and bloating. I'm sure my family can't wait either for the irritability that’s coming down the mountain. Anyway, I will keep you posted on how that is. I might have my doctor on here to talk about…because she deals with she a lot of her patients are people like us, women like us. At any rate, I did not foresee this intro being so long. My apologies for keeping you.

Let me tell you a little bit about today's guest. I can't wait for you to meet her. Okay, I had so many questions and here it is. Kim Vopni is a self-professed kegel maven and is known as the Vagina Coach. She is a certified fitness professional who became passionate about spreading information on pelvic health after the birth of her first child. She is an author, a passionate speaker, and a woman's health educator. Her most recent book, Your Pelvic Floor launched in March 2020 and was on the bestseller list since pre orders launched in January. Kim is the founder of Pelvienne Wellness Incorporated, a company offering pelvic health programs, products and coaching for women in pregnancy, motherhood and menopause. You can find her online at VaginaCoach.com and on social media @VaginaCoach. So without further ado, here is Kim.

Kim, thank you so much for being here.

Kim  07:06
Thank you for having me.

Andrea  07:07
The first thing I'm going to ask you is this is a question that just came to me. Like how excited were you when you were starting this project and you were like, is VaginaCoach.com available as a website?

Kim  07:21
I was very excited. I was pretty sure it would be but you know.

Andrea  07:25
Like, there's no one else. It's mine. That's awesome. I love a good niche. You know? Like I love learning about things. And you're like, you know what, there's a business for everything. And here we are. And so I was before this earlier this morning, I was looking at more of your social media posts and adding to the list of questions that I have. And so well actually, let me take a few steps back. Since you're the first of your kind who've been on my show. What exactly like when people ask what do you do like at a cocktail party, what do you say?

Kim  08:01
Usually what I say is I work in women's pelvic health and a lot of people mishear me and they say oh public health and I say no pelvic health and they go oh, and then I say my brand is the vagina coach. And then that usually, you know, a bunch of people start to laugh and haha, and but then they're also kind of like, well, what does a vagina coach do? And then I'll elaborate a little bit more from there. So if people don't ask that question, then they're just not quite comfortable with that and then we stop and it ends and then that's that, but most people do, they're curious by me using that word and have a few little giggles. So usually my conversation is around, I use fitness and lifestyle modifications to help women prevent and overcome pelvic floor challenges like incontinence and organ prolapse and chronic back pain and all the things that we are told from media and our health care professionals are a normal part of aging or just part of being a woman.

Andrea  08:56
Okay, okay. I can kind of relate to like that being like a little bit uncomfortable with it. So years ago, I started to have an overactive bladder, which I'm going to ask you about in a little bit here. And I was talking to a woman who does massage work, but it's the kind of massage work, it's like, more body work like rolfing and those types of things and she was saying, she's like, you need a pelvic floor expert. And so she was explaining what this person does, so it's like internal and I was like, Is this like a professional finger banger? She’s like yes. She's like… I never did get around to hiring anyone but, well let's start there. So, talk to us about overactive bladder and then also training your bladder because that was something that I was struggling with and my doctor said, stop going to the bathroom, just in case. Like I would do it before I would leave the house because I knew I didn't want to go when we were at target because it irritates my kids. And so talk to us about that.

Kim  09:58
Yeah, yeah, and first of all, I think it's great that your doctor said that because I think that there's also a lot of people who would be put on medication and or sent down the route of, you know, doing all this testing when overactive bladder is a term that a lot of people almost self-diagnose themselves as having. And a lot of, even sometimes care providers, we'll just assume that if somebody is going to the bathroom all the time, it must be because they have overactive bladder so let's see what medication we can put them on. People think they have overactive bladder, because they're going to the bathroom all the time. But a lot of the reason why they are going to the bathroom all the time can be diet related and it can also be behavior related. So you just nailed hit the nail on the head by saying, I went to the bathroom every time I left the house, and then I went to the bathroom, here and here. So I'm…I was filling that in, you didn't say that.

Andrea  10:4
I often half-joke like never, like I need a t shirt that says like, never pass up an opportunity to go to the bathroom even if you don’t have to go in that moment.

Kim  10:56
So you're interrupting the brain bladder communication. So usually the bladder sends messages and basically to say I'm full now and if we are interrupting that by voiding earlier than when those messages are being sent, then the bladder will start to basically like Pavlov's dog be trained to signal you when it's less full. And so you start to get into patterns. And it's also, you know, the sound of running water, or every time I go to my fitness class, because you always pee before your fitness class, because you always pee before you leave the house because you always pee as soon as you get home.

Andrea  11:36
I never thought about that. So it's like so every time I go to Target, I have to pee probably because I've trained myself to do that.

Kim  11:43
Yeah, so it's become a trained behavior, a response, and just like it's been trained to signal you there, you can also train for it not to signal either. So that's where the bladder training piece comes in. And something called the bladder diary is used pretty effectively for a lot of people, and it points out common bladder irritants. So sometimes it's food that's irritating your bladder, sometimes it's dehydration, sometimes it's constipation, sometimes it's the behaviors, and the bladder diary can help you identify those things. And it's just a matter of tracking your food intake and your liquid intake and also, you're avoiding habits and symptoms. Did you have urgency? Did you leak? What activity were you doing? How long in between voids. So two and a half to four hours would be considered normal voiding if you are staying hydrated throughout the day, and you're not having an irritant of some sort. And common irritants are caffeine, alcohol, spicy foods, chocolate, artificial sweeteners, dairy for many people, and so not to say that every single person will be irritated by all of those things, or their bladder will be. But if you do notice, a lot of people will notice, especially in the morning, after they have a coffee or a green tea, they have strong urges, they have to go more often. So it's also a diuretic. And then you can make a choice and you say, well, I'll just know that when I have my coffee, I have more stronger urges, or I can choose half-caf, or I can choose decaf and make your choices there. But at least you have that information.

Andrea  13:23
Yeah, it did help. Just waiting to go to the bathroom until I actually had to go to the bathroom. I will say that helped. But I've also heard somewhere that even though having to…whether it's like an official overactive bladder or not, that it's a common problem, but not a normal one. Is that correct?

Kim  13:44
Yeah, yeah. And I would say that about a lot of pelvic floor challenges, there's a lot of normalizing the dysfunction. So we want to normalize the conversation around pelvic health. We don't want to normalize, leaking. So leaking is presented to us through media that it's quote, unquote, just part of being a woman, or it's just what happens when you age or that's what happens when you get when you have kids. And that's also passed down through generations, it's talked about through friend groups. We laugh and giggle. I can't jump on a trampoline anymore. And so people think that it's normal, and they just accept it and they wear pads and they were will wear pads for the rest of their life. It's not a problem that will just go away on its own and will most likely worsen, especially as you're starting to approach menopause. So we want to normalize the conversation around talking about pelvic health, but it's a very common problem to leak urine or to experience pelvic organ prolapse and back pain. Back pain is very closely tied to the pelvis and there was one Canadian study 95% of women with low back pain have some form of pelvic floor dysfunction. So super common. Doesn't mean that these are normal and they're also doesn't mean that they're not treatable. So I want people to know that as well.

Andrea  15:00
Okay, what is a prolapse?

Kim  15:04
A prolapse is when the one or all even have the pelvic organs, so in the three most common would be the bladder, the uterus and the rectum, shift out of their proper anatomical position and they can start to bulge into or descend into the vagina. So in the case of the bladder and the rectum, they sort of nestled around the front and back wall of the vagina and so if the bladder starts to prolapse, it can belt into the front wall or the anterior wall of the vagina. When the rectum bulges, it bulges into the back wall or the posterior wall of the vagina, and if the uterine is displacing it will start to descend from the top down. So it's literally at the top like our cervix is the top of our vagina and our uterus will start to come down into it. So early stage… Well, let me just say this statistically 50% of women who have given birth at some point in their life, have some form of pelvic floor dysfunction, or sorry, of pelvic prolapse. Statistically, on the incontinence side, incontinence, statistically is usually somewhere between 35ish to 40ish percent. And we hear about that all the time but we never hear about pelvic organ prolapse. And there was another study that even looked at women at six weeks postpartum, over 80% of them have some degree of prolapse. So why are we not screening for and talking about this condition more because it arguably has a greater influence or impact on especially our emotional and our mental health.

So it can be asymptomatic early stage, not a big deal, and many doctors will consider a stage one prolapse almost normal after giving birth. But as it starts to progress, we can have symptoms of constipation and complete emptying, difficulty with inserting tampons, maybe tampons get pushed out or menstrual cups or whatever you're using, maybe some discomfort with sex, a feeling of heaviness and dragginess especially as the day progresses. Some people as it becomes more advanced, will have a bulge right at the entrance to the vagina or even outside of the vagina.

Andrea  17:12
Is it painful? Like I'm having like a physiological reaction just having you talk about it. Like is it or no?

Kim  17:20
Pain is actually often not talked about. It's more the discomfort of it. There can be some people can have pain, especially as it becomes more advanced, there can be irritation to because it's more exposed. But…so back pain, yes, but not so much of the bulge itself, it's more of the discomfort and the feeling like something is going to fall out or feel like you have something in your vagina all the time. It's a very vulnerable sensation.

Andrea  17:57
So I had the feeling… I’m having a flashback right now, because after the birth of my second child, and I was a runner. I don't run anymore, but I probably you know, shouldn't have been running. But I kept telling my doctor, I feel like my vagina, and this is these are the literal words that I was using, I said, I feel like my vagina is like gonna fall off. And I'm almost positive, they had to have done a pelvic exam to check for that. But it turned out that I had SI joint dysfunction, which I'm not sure if that's in the category of pelvic floor problems. Okay, so what they advise is to is to not run anymore. They're like, you can go on walks, but just don't run until you're totally healed. And I just wasn't far enough into like the postpartum phase to put that much pressure on my body.

Kim  18:46
Yeah, and that's also a big message that I have is, right now we have a six week green light and you know, so we wait to the six weeks and then we get this clearance and sometimes that doesn't even involve an internal exam anymore. And then it's like okay, go back to normal. And we haven't appreciated all of the change that has happened to our body over nine months. Plus the fact that we have given birth whether that's through vaginal birth or major abdominal surgery of a cesarian section, and to think that everything has gone back to quote unquote normal at six weeks to in my opinion is irresponsible and just crazy. So we need a a retraining phase basically, to be able to remind the pelvic floor of its job, to kind of get all the muscles reoriented again, to make sure that there's been the superficial tissue healing that we have to have. The pelvic floor is part of our core. It works with our diaphragm, it works with some muscles in our low back called the multifidus. It works with our transversus which is our deep abdominals and there's this I call it the core four unit on the inside and we need that synergy back in order to be able to do things like running or jumping or heavy lifting or, well, anything.

Andrea  20:20
Anything really, yeah. That’s what it sounds like

Kim  20:22
There needs to be some better communication around preparing for birth, recovering from birth, and retraining. And more and more research is highlighting that it's kind of like a, you know, it's can be upwards of a 12 month recovery. And before you're going back to the high impact, it's kind of like six monthsish. And it should also incorporate pelvic floor physical therapy. And they should be the ones that give us the green light. They are the ones that can tell us that yes, our muscles are now ready to handle the load of a run or a jump or heavy lifting or whatever it is that we want to go do.

Andrea  20:38
If I had to do it all over again, I would have I would be a lot more kind to my body. But yeah, it was it was a while ago, I kind of jumping around because I want to make sure I touch on a lot of different things with you. And is it true, and I can't remember where I heard this, I think it was a friend of mine who is postmenopausal and she was talking about that she was learning that, that and my mind might be using the words wrong incorrectly, but like that, just like we lose elastin in our face, you know, as we age, and she was saying that you also lose elastin in the walls of your vagina. Is this true or am I kind of getting it wrong? Can you talk about that?

Kim  21:18
Yeah. So post menopause is once we've reached menopause, the one day of menopause, which that one day is 12 months after not having a period. So it's like an anniversary.

Andrea  21:49
12 months in a row.

Kim  21:51
12 consecutive months, yes. Then we are considered post menopause for the rest of our life. Leading up to menopause. And post menopause is perimenopause and we can start to experience some changes, one of which is the loss of collagen, hyaluronic acid, muscle, you know, and that's happening throughout our entire body. And a lot of that has to do with the fluctuating levels of hormones and the gradual decline and eventual halt and production of estrogen. And the tissues in our pelvis, the tissues in our vaginas love estrogen. And when there's no longer circulating estrogen, the tissues start to thin and dry out, the walls of the vagina can start to narrow and that's also compounded by the collagen and the hyaluronic acid, and the loss of muscle mass as well. So it's all of it is being compounded and we often feel it because the pelvis is so central to so many things in our life. Along the way, we may have been able to just kind of say, well, you know, I'll just put a pad in and carry on. And, and again, we're told that that's normal. Pads can exacerbate dryness, you know, we've maybe avoided exercise now because we're afraid of leaking or we're afraid of making our prolapse worse. So now the already increased risks of our heart disease and bone is also now exacerbated by that. And so the pelvis is something we really need to be paying attention to along the way with pelvic floor exercise, pelvic floor, physical therapy, moisturizing our vagina, so hyaluronic acid inserted into the vagina, just like we put hyaluronic acid serums on our face.

Andrea  23:15
I was just gonna say we spend so much time figuring out and a skincare routine, especially like as we start to age, it's interesting that I have never in my life until just this moment, heard that they even make products for that.

Kim  23:31
MoisturizeYourVagina.com. I'm not affiliated with them, but it's a great product.

Andrea  23:35
MoisturizeYourVagina.com. You should be affiliated.

Kim  23:38
I know the person. I don't receive any royalties from it but… We deserve a lot more education much earlier in life. It's not really… And I found this when I was working really heavily in the prenatal world. That's really how I started my business was  with pregnant women. And I've always come from a place of prevention. So for me, it's just a natural thing to always be looking at what what's coming up and what should I be doing now. But what I learned and what I still see is people wait until there's a problem to overcome. And that's part of how our world has been set up. And I think that if we could start to plant seeds and educate people… We're talking about kids about sexual health and body education and menstruation, introducing the concept of this really important group of muscles in our body and how to care for it and because we menstruate, because we give birth, because we will all go through menopause we deserve extra attention and awareness really.

Andrea  24:41
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I didn't even take a mirror to see my vulva and everything down there until I was in my 20s. I had never seen it and like think about that. And I'm like, I want something different for my daughter. Like I want her to know her body. I want her to know what it looks like I want her to know all these things. I must have been in my 20s and I did do you remember those like three-day breast cancer fundraising walks that were really popular. I don't know if I think there's still do them. But they were all the rage 20 years ago. And I did one of those and the way that it was as they would set up these like tent cities, because it was a couple of nights that we would all spend the night on this very, very long three day walk. And in the tent, like two doors down, there was all this commotion and then the EMTs came and we're helping someone and then people are whispering that woman had had a prolapse. And I remember thinking that that was something super rare. Like this is you know, something that never happens. And it was like whispered about and it took until I was on social media, I mean, even just up until like a few months ago, like following accounts like yours to learn like, oh, this isn't all that rare. This is super common. And I met and I consider myself a well-educated woman who like, you know, like it just It blows my mind. And you're right. Like we don't we deserve more. We deserve more education on this. And not from not from a place of like, here's worst case scenario, like I'm gonna scare everybody. But…

Kim  29:12
If we could present it in a powerful way of this, like we have this incredible part of the body that is for pleasure. It helps you lift heavy things., it helps you move well, it helps you poop properly. All these reasons. And not because again, especially as we're dealing with a problem, it becomes this doom and gloom and it's very heavy, and they just think your life isn't doing anything right now. And you're often told things like, you can't run, you can't lift heavy anymore, nothing over 15 pounds, you can't do this. You can't do this and this huge, long I can't do list. And now people are thinking well, what can I do? And my life is ending and now I can't do this and you know and so… I just think that if we flip it and not present it as doom and gloom… And even periods right now are often presented, it's changing, but they're often presented in a way, like it's going to suck, you're going to have cramps, you're going to be moody, you're going to be… And so if we, if we flip that around and say, this awesome thing is happening, and this is why it's happening, and this is…

Andrea  30:23
Like magic. That's how I presented it to my daughter. She wasn't as on board with it as I was hoping. But I was like, it’s magic.

Kim  30:29
It really is. It really is. So I think messaging really needs to change and even for people who receive a diagnosis, also, if we could have like, definite referral to pelvic floor for physiotherapy, like that is not regularly happening yet. More and more doctors are getting on board. Because usually the first person that somebody sees if they have a problem is their family doctor. And we actually have some research that shows that women are waiting on average six and a half to seven years before they go seek help. Part of it because they're ashamed, part of it because they think it's normal and then they get to the point like I can't deal with this anymore, what's happening, and then we'll go to their family doctor, and then with all due respect to them, when we need pharmaceuticals. And when we need surgery, we absolutely want our medical providers on our team. But so much of pelvic health can be managed without drugs and surgery. Or even if surgery is required down the road, all of the work that we would be doing with lifestyle and bladder training and pelvic floor exercise will put us in a better position to go through that surgery and have better outcomes and also not given the impression that go have surgery and now you're all of your problems are fixed and oh, you don't need to do Kegel ‘s anymore. I think you actually need to do Kegel and pelvic floor exercise even more after you have surgery. And that message is simply not communicated.

Andrea  31:55
Well speaking of the, you know, the vaginal walls and just the vagina in general. So can you talk about vaginal dryness and what causes it and then I would love to continue the conversation about like how to keep things moisturize down there.

Kim  32:09
Yeah. So again, there's loss of muscle mass, lack of movement for a lot of people. So we have less blood flow and circulation hyaluronic acid.

Andrea  32:19
Is that usually just from lack of just not having sex that often?

Kim  32:24
Just like full body movement, even but also yes, sex. So because you are experiencing dryness and pain, now you're not going to have sex, right? So there can be a loss of libido as we're approaching menopause. There can also just be lack of interest because if something is not pleasurable, if something hurts, you're not going to want to do it. So when we can replenish and support hyaluronic acid, estrogen, and then maintain blood flow and circulation, we kind of reinvigorate things so to speak. And this is another thing that I feel so strongly about, don't wait for it to happen. Don't wait for you to start having painful sex and dryness. It is going to happen and over 80% of women will experience vaginal dryness and it does not improve with age. So hot flashes usually will start to subside. The mood side of things usually starts to improve. Vaginal dryness does not. So get on top of it early. Hyaluronic acid as I mentioned. There's lots of different products. HelloBonafide in the US is another great company. In Canada, there's a company called RepaGyn. So there's lots of different options with hyaluronic acid or creams or gels to be inserted into the vagina and you can use those nightly and then there's estrogen. So vaginal estrogen is again, to me, it's something that I believe that pretty much every single woman would benefit from being on as they're approaching that menopause transition for the rest of their life. And there's a lot of fear around estrogen. A lot of that came from the Women's Health Initiative. There is zero link to any cancers of any form with local vaginal estrogen and it can be transformative, especially when used in conjunction with high low hyaluronic acid. And that can then allow you to have comfort again and to be able to have sex again. And having insertive sex with or without a partner also plays a role in helping keep those tissues, preventing those tissues from starting to become so thin and the walls from becoming so narrow that we can't even have something inserted. So do your pelvic floor exercise, moisturize your vagina. Local vaginal estrogen is something I think that we all benefit from did I say pelvic floor physiotherapy? I think I said that too.

Andrea  34:53
Well, yeah, that's a that's a long list. That sounds very serious. But because I always looked at it anything that was in service of the vaginal walls and in terms of moisture. So those things that you talked about the hyaluronic acid or even lube. I always associated that with sex, like, you know, penetration sex, but it sounds like it's so much more than that. Like even if someone is choosing to not have sex, that it's important to stick just for the health of your that organ in general, and the organs around it.

Kim  35:27
So a lubricant is not a moisturizer, and it's not estrogen. So lubricant is kind of the third layer there where lubricant is used for, for sex again, with or without a partner with or without penetration.

Andrea  36:11
It sounds like a temporary solution.

Kim  36:14
Yeah, so it's just to just to help with slipperiness, basically. So hyaluronic acid will help improve the moisture within the tissues and can help heal already dry, irritated tissue, so it helps us retain more moisture. Estrogen helps replenish what we now no longer have circulating and estrogen plays a role in helping the walls of the vagina stay, I always say wrinkly and I just did a post on this why we want to wrinkly vagina we have folds in the walls of angina called rugae and we want those because it's what helps with juiciness and suppleness and allowing things to come in or out in the case of childbirth. Also, postpartum is a time when we also experience a loss of estrogen and vaginal dryness is something we can experience as well.

So even if we don't have a partner, we can still have something go inside. So it could be tampons, it could be a toy. One device that I love. Again, I'm not. I'm not sponsored by them. There's a company in the States called Joy Labs, and they make a device called the in Canada, it's called the viSculpt in the United States it's called the vFit, it's the same product. And it's so it looks like a white dildo in a way. And there's red light therapy, and infrared heat and vibration. And it helps with collagen, and it helps with circulation and it helps relax overactive muscles, and if you do your pelvic floor muscle activation, so your Kegel exercises against the vibration actually heighten the kind of the recruitment of pelvic floor. So it's a really multifaceted tool, and I think it's it puts so much control and prevention and again, even restoration. So people who do experience dryness, who are already experiencing atrophy, as long as they can still accommodate this currently, there's that there's dilators that could help them build up to it. But it's, I just think it's such an amazing self-help tool to help keep our vaginas healthy.

Andrea  37:41
If I was having a little bit of a moment after I was just talking and asking you that question, because I'm like, of course, I grew up in a culture that told me that the health of your vagina is really, you know, all about sex. And how it can serve other people and not necessarily us.

Kim  37:58
And you know, like sex part of the role of our pelvic floor is sexual response. It's, it's not the whole thing, continence organ support, pelvic and spinal stability. It plays a role with our diaphragm like a sump pump. Like there's all these other things that that it does as well. And we just don't even we don't even even things like constipation. Constipation can often be tied to the pelvic floor. So yeah, huh.

Andrea  38:22
Okay, I'm gonna I think I'm gonna walk away from this with like, maybe more questions than I even asked you. So I'll have to just dig in more to your to your content on social media. So I want to ask about Kegels. I admittedly, don't do them. So can you tell me tell me really like kind of what's your what's your spiel, if you will. And I know that because you talk about how this is really should be more of a proactive exercise. And it is like a reactive exercise to whatever ailment we might have.

Kim  38:59
Yeah, so Kegels… Dr. Arnold Kegel in the 1940s was recognizing that his women, patients after giving birth, were experiencing challenges with sensation and also their capacity to contract and relax their pelvic floor. And so he used a biofeedback device called a periometer to help them see what the pelvic floor was doing, even if they couldn't necessarily feel it right now and had great improvements. So that's essentially where the Kegel exercise came from. It was a voluntary contract, like activation and relaxation of the pelvic floor. And what has happened over time, like many things in fitness, people think more is better, people think I need to do it harder, people think you know that. It's really just the squeeze. And so there's a misinterpretation part of it also, because none of us have ever received Kegel training or pelvic floor muscle training. We have had pelvic exams with a speculum but…and none of us like those, and they're always uncomfortable. And so we always have, we have an ick kind of feeling when it comes to that. And pelvic floor physical therapy does not involve speculums. It's very, it's not IQ at all.

And again, we, if we had had the seed planted earlier that this becomes part of our life, just like, we go see the dentist every year even if we don't have a toothache, we should be using a pelvic floor physical therapist every year to help maintain the health of this vital part of the body. And part of the evaluation with a pelvic floor physical therapist is how can you contract and relax? What's your capacity? And a lot of people actually interpret some of the symptoms they have as their pelvic floor being weak. And by weak they think their pelvic floor muscles are lax. And oftentimes, they can be overactive. So we can have weakness from tight or overactive muscles. If that person did more activation, Kegel activation, and really forgot about and left out the relaxation component, they can actually make things worse. So So a Kegels are not the end all be all. But I do believe there's a place for them, we have evidence to support that they do work when they are done correctly, when they're done consistently. And I kind of take it a step further and say, again, key goals are great, we have evidence to support that they work but they're a static exercise. So a lot of times it's you know, to them at every red light or while you're brushing your teeth, that doesn't train the pelvic floor dynamically. So when we can incorporate Kegels into whole body movement, I think it becomes much more effective.

Andrea  41:35
Oh, I see what you're saying. Okay, how does one go about finding a pelvic floor…is it pelvic floor physiologist?

Kim  41:44
Pelvic floor physical therapist. If you're in the States, pelvic floor physical therapy if you're in Canada, it's physiotherapy. It's the same thing.

Andrea  41:50
Okay, that's right. So do you should someone just Google pelvic floor physical therapist or is there like a like… Psychology Today has like a site where you can find like, licensed therapist. Is that similar?

Kim  42:01
Yeah, so I usually recommend that you go to Google first and put in pelvic floor therapy, pelvic floor, physical therapy, physiotherapy and your town or city or wherever you are in the world. The American Physical Therapy Association does have a listing under Women's Health, Canadian Physiotherapy Association. There's also a site called PelvicGuru.com, where she is a pelvic floor physical therapist and she has also created a directory of not just physical therapists but other pelvic health professionals. And it is global. I wouldn't say it's the most it's not comprehensive for you know, not every single practitioner will be there but it can also be a place for people to start.

Andrea  42:42
So someone like me who like I don't, I'm not having any major quote unquote, problems, you know, I'm in perimenopause. I'm 47 and a half my bladder is better than it was but how could someone like me benefit from from that's the first part of my question. How can someone like me benefit? And also like, what does one expect at sort of like the intake appointment for this?

Kim  43:05
Yeah, so you bet you could benefit because you have a vagina and also because you've already told me that you have experienced SI joint pain and bladder challenges in the past. So , and you've given, I will, I shouldn't make that assumption. You have a child…

Andrea  43:18
Had a C section first and then a VBAC. So I had a VBAC with the second one.

Kim  43:22
And so you've given birth twice. And a lot of people say, well, I gave birth via cesarean. So my vagina is fine. But pelvic, you've had all the same accommodations and like all the same adaptations throughout pregnancy, the hormonal the weight of the baby on the pelvic floor. So you've already told me those things.

Andrea  43:42
I feel like that is like, in some ways, and I'm not a medical doctor, but like, in some ways that's more traumatic to your body I believe in of itself, then then giving birth.

Kim  43:53
Yep. Yeah. So thanks for all those reasons, even if you had said I've never been pregnant, I've never I would still say you have a vagina, you're approaching menopause and even if you were in your 30s I would still say go because people walk away from that appointment and they say how is it that I've lived this many years you know, with this body and I didn't know this or I just learned so much about this. What happens typically the first appointment is an hour and there'll be a detailed health history questionnaire, they will go through… And these are all people who have done the regular physiotherapy degree and training and then they have taken additional training specific to the pelvic floor. So they are licensed to evaluate and treat beyond the entrance to the vagina. Men do have a pelvic floor men can also see pelvic floor physical therapists. If they have an internal evaluation, it's through the rectum and in women we can also have a rectal evaluation as well but it's most commonly done through the vagina. In that appointment, there is a physical. So we they look at how you move, how you breathe, they might do some movement tests with you to see how you what your what are your recruitment strategies, and then they will also tie that to what you may have come in what sort of symptoms you might be having, or what's your health history.

Then there will be an internal evaluation and this may not always happen on that first appointment. But when the internal happens, you will then change into a hospital gown, you will be on a treatment table, the therapist will leave the room they will come back in and with your consent, they will do an internal evaluation. They will use gloved fingers, they typically sit beside you you're laying on the treatment table with your knees bent. They will kind of look externally at the vulva, the tissues surrounding if there's any scar tissue, maybe from childbirth or other surgeries. And then they will take one finger and inserted into the vagina if you can accommodate that. And if you can, then they will insert a second. And what they're feeling for is the tone of the muscles, is the tone balanced like is one side may be feeling more rigid or tight or the other side more lacks, or is it fairly balanced between the two sides. They'll feel for the position of the organs. And they may also ask you to cough or bear down to see if there's any dissent of the organs. They'll assess your capacity to do a Kegel so that contract and sort of upward lift and movement and relaxation. If they find any points of kind of tight tightness, like trigger points like we could have when we go see a regular massage therapist, they may do some release techniques, they could also do some scar mobilization work.

And then in a really ideal world, they would also assess you in standing so they take you off the treatment table. They sit or kneel on the floor, and you still have your hospital gown, they would again insert the fingers into the vagina. And now what they want to do is say okay, what's changed with the influence of gravity? Is the position of the organs different, is your capacity to contract and relax your muscles different. And then they may ask you even to do a squat. So they would feel as you squat down to bow. As you squat down they're feeling what's the pelvic floor doing? Is it going through as normal response? Is it reacting at the right time? Is it using the right amount of force because at the end of the day, that's what we need the pelvic floor to do. We need the pelvic floor to anticipate our movement. So we shouldn't have to be thinking about doing a Kegel every time we're doing something we it just happens. It should be able to react at the right time with the right amount of force for the task at hand. And so this evaluation helps determine, helps us develop an awareness, about whether or not that's happening and then what we need to do to get back to that capacity to anticipate the load react at the right time, have the endurance we need to have the strength we need but also have the capacity to let go and, and release when we're not working.

Andrea  48:07
I had no idea that it was that involved. But it all makes sense when you say it, you know and like all the different angles and… Well, you've sold me. I'm convinced and I know that there's a couple in my area. I've kind of seen them in like a moms group that I met on Facebook. And this has been seriously one of like the top 10 most informative interviews that I've ever done. Thank you so much. Before we close up Is there anything that you want to circle back tomake sure that you feel complete?

Kim  48:37
If you take away one thing is to see a pelvic floor physical therapist at least at least once in your life, but ideally once a year for the rest if your life.

Andrea  48:43
Okay, all right, just like you know, we're supposed to see our OBGYN once a year. Okay, so where do you want people like if people want to learn more about you and your lessons? Where do you want them to go? You said you're starting a podcast soon.

Kim  48:58
I am starting a podcast in January it'll be called…

Andrea  49:23
January 2023.

Kim  49:24
Yes, it'll be called Between Two Lips.

Andrea  49:29
Oh my god, that’s genious.

Kim  49:31
And it'll be mainly interviews so similar to you and I. The odd time it will be myself and it's just a way again to put this information out there. It’s free and whoever can listen wherever they are they can gain some knowledge and then be able to take action to improve their pelvic health. So VaginaCoach.com is where everything that I talked about an offer is his and the podcast will eventually live there as well.

Andrea  49:36
And your @VaginaCoach on social media as well, correct?

Kim  49:40
All my social handles are also @VaginaCoach.

Andrea  49:46
All those links will be in the show notes. Everyone listening and I just I really invite you to visit Kim's website and follow her on social media. I love the little like bite sized lessons that you have. It's been so informative to me and I appreciate you so much such important work. Thank you for coming on today and everyone listening, thank you so much for spending your time with us today. I appreciate you so much. And remember, it's our life's journey to make ourselves better humans and our life's responsibility to make the world a better place. Bye for now.

Hey, did you know there's free secret podcast episodes waiting for you that are not part of my regular podcast feed? Yes. AndreaOwen.com/free. And you just sign up, you get a link sent to you. It's very secret. It's like a secret club. We don't have a secret handshake. Don't worry about that. But it's these motivating podcast episodes that I made for you. They're under 20 minutes each. There's three of them there for wherever you are in your life. So head on over there and grab them. They range from really supporting you and seeing you where you are and being compassionate all the way to giving you a giant kicking your ass and telling you how amazing and gorgeous and phenomenal you are. So AndreaOwen.com/free and get your hands on that free podcast feed.

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