Culture Apothecary with Alex Clark - Leaks, Libido & The Pelvic Floor | The Vagina Whisperer Dr. Sara Reardon, DPT

Episode Date: June 10, 2025

Think pelvic floor health is just about doing a few kegels? LOL. Think again.I’m joined by Dr. Sara Reardon—aka The Vagina Whisperer—a total expert in all things pelvic floor to talk about what���s really going on down there: leaking when you sneeze, painful sex that’s not “in your head,” and how to have stronger orgasms.This episode is full of game-changing info every woman needs to hear 🙌Thank you to our sponsors!TAYLOR DUKES WELLNESS: Use code "ALEXCLARK" for 10% OFFPRIMAL PASTURES: Use code "ALEXCLARK" for 10% OFFPALEOVALLEY: Use code "ALEX" for 15% OFF your first orderJOOVV: Get an exclusive discount on your first red light therapy orderMASA CHIPS: Use code "REALALEXCLARK" for 25% OFF first-time ordersHARVESTRIGHTOur Guest: Dr. Sara Reardon, DPTSara's Links: WebsiteInstagramFacebookYouTubeTikTokBookSara's Favorite Book🌿 Top Tip: Look inward and not just outward. Right now there is a constant flood of information coming at you. Oftentimes if you read, listen and learn and then turn it all off and tune in, you can get a better sense of what you really need. FOLLOW ALEX:Instagram |⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠@realalexclark⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Instagram |⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠@cultureapothecary⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Facebook |⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠@realalexclark⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠X |⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠@yoalexrapz⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠YouTube |⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠@RealAlexClark⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Spotify |⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Culture Apothecary with Alex Clark ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Apple Podcast |⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Culture Apothecary with Alex Clark⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠🌿 ⁠Culture Apothecary WEBSITE⁠🗞️ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠WEEKLY NEWSLETTER SIGNUP⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Join the Cuteservatives Facebook group to connect with likeminded friends who love America and all things health and wellness!⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Join the CUTEservative Facebook Group!⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Subscribe to ‘Culture Apothecary’ on ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Apple Podcasts⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ and ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Spotify⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠. New episodes drop 6pm PST/ 9pm EST every Monday and Thursday.#PelvicFloorHealth #PelvicFloorPhysicalTherapy #PelvicHealth #IncontinenceAwareness #PostpartumRecovery #PelvicFloorExercises #MenopauseWellness #PelvicFloorFitness #PelvicPainRelief #WomenEmpowerment #CultureApothecary #AlexClark

Is it true that women should never push to pee? Yes, and thank you for saying that. You should not push to pee. You need to sit and chill. You can weaken your pelvic floor muscles over times. You're known as the vagina whisperer. Correct. So now you're my favorite guest who's ever been on the show.

Pregnancy changes the pelvic floor. Birth does as well, regardless of which method you birth, cesarean birth or vaginal birth, your pelvic floor changes. If you work on pelvic floor muscle training during pregnancy, you're less likely to have problems postpartum. What if everything you thought you knew about your body after giving birth, going through menopause, or experiencing pelvic pain was completely wrong? How did your body feel after childbirth?

Was it the way you expected? What if those normal issues like urinary leakage, painful sex, or prolapse didn't have to be a part of the deal? In today's episode, we're diving deep into the world of pelvic floor health, unpacking the mysterious and often overlooked area of your body that impacts so much more. more than you realize. From better orgasms to preventing tears in labor, we're revealing the secrets to stronger pelvic floors and why they matter more than you think. Joining us is Dr. Sarah Reardon, a board-certified pelvic floor physical therapist with over 18 years of experience. She's been

featured in top outlets like Time, Yahoo, and Harper's Bazaar, and as the founder of the Vehive, a game-changing platform dedicated to pelvic floor fitness. Dr. Reardon will explain why Strengthening your pelvic floor could be the key to unlocking your health and confidence and why it's critical at every stage of life from pregnancy to postpartum and even menopause. Watch this episode on the Real Alex Clark YouTube channel or Culture Apothecary on Spotify. Please pause really quick. Leave a five-star review. It's a free way to support the show.

Please welcome Dr. Sarah Reardon to Culture Apothecary. You're known as the Vigina Whisperer. Also a pee-pip-poo expert. Correct. So now you're my favorite guest who's ever been on the show. I love that. What does that mean? How did you become the vagina whisper? Well, I'm a pelvic floor physical therapist. So I went to physical therapy school. And, you know, right after physical therapy school, I started in pelvic floor therapy, which no one had any idea what it was 18 years ago. And when I started having kids, my girlfriends would call me and ask me questions about like, do I need to do perennial massage and what do I do for birth or what do I do for postpartum? And so they really coined me the vagina whisper because I was who they would come to to ask questions. about their vagina. And so when I started my Instagram account six or seven years ago,

it was for my group of girlfriends to share more pelvic floor tips. And so I called it the vagina whisper for them. And then here we are, you know, many years later with a book coming out and a brand. And so it's just really been exciting. And so what does it have to do with pee and poop? I mean, because you're, because I don't know much about pelvic floor, but like just that whole area and how strong it is can help with that. Well, your pelvic floor is a basket of muscles. So physical therapists work with muscles all throughout the body. I work. work with pelvic floor muscles in the pelvic region. And these muscles sit like a hammock at the base of your pelvis and they hold your uterus, your bladder, which holds pee, your rectum,

which holds poop. And they have the openings to eliminate those. So the opening for urine to exit, the opening for poo to exit, and then the vagina for vaginal intercourse, menstruation, vaginal birth. And so if there's any problems in that area, these muscles are likely affected. Why is the pelvic floor so important to our overall health? For so many reasons, One, we use it all throughout the day. So, Alex, when we're sitting here, our pelvic floor is supporting our core. It's keeping in pee and poop. You know, when we go to the restroom, it's relaxing.

It literally is contracting and relaxing with every breath that we take. And we don't really understand what it does until something goes wrong with it. And I think this is why I'm so passionate is because I see women in my practice for, you know, the past 18 years who have pelvic floor problems. And all of them said, I wish I would have known this sooner. why didn't anybody tell me about my pelvic floor sooner? Because there's so many things we can do to proactively take care of it. And so when typically in a woman's life does something go wrong with the pelvic floor for the first time? You know, you can experience pelvic floor issues at any time in your life, whether you're having your first period and you have a hard time inserting a tampon, whether you become sexually active and intercourse is painful or you're not able to have an orgasm.

But I would say some of the primary times that at first happens is during pregnancy. That is when the pelvic floor muscles, the hammock that supports the uterus, starts to really stretch. And this is when we see urinary leakage start occurring, weakness of the muscles where your pelvic organs aren't as supported. It can also lead to core weakness. There's a condition called diastasis recti when your core starts to really separate. Yeah, I've seen that in women who give birth and it is like their stomach looks loose. Yes, it looks like they're still pregnant, but they're not pregnant anymore. And it's unfortunate because, you know, pregnancy changes the pelvic.

floor, birth does as well, regardless of which method you birth, cesarean birth or vaginal birth, your pelvic floor changes. And there's no rehab or recovery afterwards. Women are just sent home with a baby. They maybe have a six-week appointment, which 40% of women don't even attend. And then their pelvic floor doesn't work for them as well anymore. And that's where we see a lot of changes really start to become chronic. You just said something that really shocked me. C-section moms need pelvic floor physical therapy? 100%. Explain that. Well, so pregnancy itself changes the pelvic floor. So regardless of what method of birth, okay, you know, almost 50% of women leak urine by their third trimester. Almost 90% have low back pain,

which is connected to your pelvic floor. You know, almost half can have pelvic organ prolapse. So even before you give birth, your pelvic floor has weakened. Now, post-birth, if you have a vaginal birth, you typically have perineal tearing where there's tissue tearing or cut at the opening of the vagina that has to heal. but for a cesarean birth, there's scar tissue at the abdomen. And your abdomen is connected to your pelvic floor. So women who have a C-section can have pain with sex, they can have painful menstruation, constipation, incomplete bladder emptying, all because of that C-section scar

that's causing pelvic floor tension and restriction and not relaxing well when we need it. You know, the pelvic floor is connected to so many parts of our body. It doesn't work in isolation. So, yes, C-section moms absolutely have to have pelvic floor therapy after birth. Would it be ideal to start pelvic floor therapy before pregnancy? Yes. Oh my goodness.

I mean, this is unfortunately not the way their health care system is set up. We, one, are working to get moms into pelvic floor therapy postpartum. So just when you go see your doctor or midwife at six weeks post birth, you should also be checking with a pelvic floor therapist. This is when you need to check your pelvic floor muscle strength, any scar tissue, any tension, look at a cesarean scar, a diastasis. all of these things can be addressed by a pelvic floor therapist. But during pregnancy, research is very clear. If you work on pelvic floor muscle training during pregnancy, you're less likely to have problems postpartum.

So you should absolutely see a therapist during pregnancy. And it can help you prepare for birth as well. When you say that pelvic floor therapy before giving birth can help with birth, like in what ways? Like it'll be easier to push the baby out vaginally. Yeah. So most women don't even know what these muscles do or how they work. And when you're giving birth vaginally, you have a room full of medical people under fluorescent

lights yelling at you to push, push, push. And if you've never learned how to relax your pelvic floor muscles, you don't know how to do that in that moment when there's so much pressure and performance and typically medicine. You know, if you have an epidural or different medications, those muscles just aren't going to work as naturally as if you have an unmedicated birth. Knowing what you know, did you have an unmedicated birth with your children? I had two unmedicated births with my kids. Because you just felt like you would have more control of your pelvic floor?

Because I felt like knowing the research that if you have an unmedicated birth, you're less likely to have a C-section, you're less likely to have perineal trauma or pelvic floor weakness, you're less likely to have postpartum complications. I opted to say, I want to do this because I know that I think we're overusing medicine and birth. And I think it's a wonderful thing to have to help protect babies and moms. but it's very clear that it's just birth is over-medicalized. And so for me, and it's a personal choice for everyone.

But my choice was to attempt to have a vaginal birth. And I had two vaginal birth and no perennial tearing. Interesting. Doing the pelvic floor physical therapy before birth can kind of help you know how to use those muscles correctly to prevent the tearing then and all that. That's what you were saying. To minimize the risk of tearing to also empower you. I think we're sending women into birth and we often give our, you know, autonomy over to a medical provider and say, I'm just going to do whatever the doctor says, which is fine. However,

the doctor isn't in the room, meant much of the time if you're in a hospital. But also it's like you're going through a huge physical event and you haven't trained for it. It's like going to run a marathon and you don't even know how to run a mile. Oh, wow. I mean, when you think of it that way, you know, pregnancy is 10 months. Birth can go on for days. Labor and birth can go on for days. And so how do we help educate and empower women about this part of their body so that they feel more and informed. So what we do in physical therapy prior to birth is we first in the first and second trimester, we teach you how to maybe modify things to prevent pelvic floor weakness and core weakness, how to get out of bed, how to change your workouts. If you're having hip pain or low back pain,

different supports to use. And then in third trimester, we really focus much more on pelvic floor relaxation, teaching you how to relax the pelvic floor muscles, how to push properly, different positions that you might want to try to push because it's different for everyone. And to give you stretches for labor and kind of going into birth. So really just helping you train for this physical event. And then birth is going to take whatever way it's going to take. It's, you know, it's a spontaneous event. We can't control everything. But at least you go into it feeling like, hey, I did everything I could to try to have the best birth experience I could have. How does the pelvic floor change throughout different seasons of life? I would say prior to pregnancy,

it's pretty standard. You have the pelvic floor muscles that are supporting you. You have the pelvic floor muscles that are supporting you, depending on your activity level. So if you are a high intensity female athlete, which means running, jumping, crossfit, cheer, tennis, volleyball, you can experience urinary leakage. So well before you've even given birth or had kids, you may have leakage, which is a pelvic floor problem. Activity will change it. The other thing we see outside of weakness is tension. I have a lot of young women who, again, have never had kids come in and they have pain. with sex. They have pain with pelvic exams at the gynecologists. They can't insert a tampon and they want to go to the beach and they are on their period and they, you know, they feel really limited in their lives.

And so we see some of those changes happen early. So I've always thought, because I have friends that have experienced this, especially growing up, I think for a lot of my audience, a lot of them grew up in very Christian homes, purity culture. It's like very, very hard for them. If they waited until marriage to have sex, that they get in that moment and it's like they can. cannot have sex. Right. I know people personally that it's taken years even after marriage to finally like relax enough to enjoy sex. So what you said is very interesting. I always thought that that was very mental. But you're saying if a woman is struggling to relax and be able to enjoy and have sex and achieve orgasm, it could really be pelvic floor related as well. Absolutely. It's,

there's a connection. Like, we know that there's a mind-body connection. And I think because we've always attributed it to it's in your head or it's mental or just relax, That really is putting the onus on the woman that it's their problem when it's really a physical condition. Muscle tension or muscle spasm. I mean, I get, you know, a lot of tension in my neck and shoulders because of my posture or stress. And then I get headaches and migraines. And so I get massage or acupuncture or physical therapy. It's the same thing in your pelvic floor.

If you get tension in an area because of workouts, because of stress, because of, again, a purity culture where you're told, like, this is off limits or we're kind of hidden behind shame. or, you know, even just lack of education. And then you get married and you're supposed to switch a flip, it's like, okay, all bets are off. Let's go. I mean, it's hard to switch that. And so I think helping women understand their bodies that, like, hey, nothing is wrong with you. This is literally a muscle spasm. Like, that's how simple we can boil it down to.

And then teaching them to relax their pelvic floor, which then in turn helps kind of calm their nervous system, which, you know, will help with relaxation during intercourse. So it's a whole process. You have to address mind and body, but you can't address to address mind. There has to be a physical component to addressing sexual pain. Okay, so that's pelvic floor in the season of life before birth. Yep. And birth, which we just touched on.

So we know the pelvic floor changes during pregnancy, typically gets weaker. And then depending on the method of birth you have, you're going to go through vaginal changes. You're going to go through abdominal changes. And post-birth, six weeks after giving birth, your pelvic floor is, 50% less strong and endurance than pre-pregnancy. When we get that six-week checkup from our midwife or our medical provider to go back to sex, go back to exercise, your pelvic floor is working at 50%. And because we don't have pelvic floor therapy integrated into our postpartum care,

then women are just going back to doing their day-to-day and their muscles are weak, and that could lead to prolapse, leakage, the diastasis recti, mummy tummy. But then you also have pain with sex as a component. Nine out of 10 women have pain with sex the first time they have sex after giving birth. There's no follow-ups after that. You don't go back to your doctor and say, like, hey, this happened, what do I do? You're just kind of expected to deal with it. And so postpartum is really a time where we need to kind of wrap our arms around moms and help them recover physically so that they can go on to have healthier pelvic floors and healthier future pregnancies in birth.

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regenerative meat delivered nationwide with code Alex Clark for 10% off. Primalpastures.com, code Alex Clark. Do you think that the six-week rule is accurate or do you think women need to wait longer or what are we doing wrong there so that we can avoid it hurting? You're saying you just have to do the pelvic floor therapy throughout pregnancy to avoid that or what? No, I mean, the six-week mark is really when your uterus has contracted back down, your cervix has closed, so you're at less risk of infection with inserting something in the vagina. That's it. It has nothing to do with your pelvic floor. Got it.

But medical providers don't even know what that six week is based on, let alone how the pelvic floor is functioning. You know, I think that we need to just educate women and say, like, hey, if you're going back to sex, like, you can wait longer than six weeks. Sometimes your sutures aren't even healed if you've had a vaginal birth. Sometimes you're still bleeding. So what are the things to look out for? Pain, bleeding, discomfort. Proactively use a lubricant because you typically have vaginal dryness after birth if you're lactating or breastfeeding because your estrogen levels are lower. And then if you do have pain that persists, that's when you should check in to see someone.

You shouldn't let it carry on for months on end. I remember seeing a mom who was 11 months postpartum. And she came into my office and she was like, I've been having pain with sex ever since I gave birth, you know, 11 months ago. And I feel completely broken. And it's affecting my marriage. It's affecting my self-esteem. We want to have another baby. And I can't even, you know, be intimate with my partner.

And after three sessions, she was completely pain free. Okay, so what did you tell her to do? I think one is just helping women understand like, hey, these are muscles or this is scar tissue, like, this is what's happening and really boil it down to like, this is how your body's working because they've never been educated on that. The second thing is we use in therapy, we do a lot of internal massage. It's like it's not as kind of racy as it seems, but literally like a patient's lying on the table. I like check their abdominal wall. They're back and their buttocks for muscle tension or trigger points, which are like little knots in the muscle. and then I do the same thing internally vaguely.

Oh, really? Yeah, like in the vagina, finger in the vagina, touch the muscles of the pelvic floor to see, like, is there tension, is there spasm? Let's work to relax those. Give them stretches at home to relax the pelvic floor. And I'm assuming you doing this is not as scary, invasive, and horrific as like gynecologist. No, you're not in stirrups. There's no bright lights. It almost feels, I don't want to say, like a spa-like experience, but it's much more relaxing and kind of intimate.

It's just, you know, there's real sheets and it's one-on-one, and it's not like just jumping right into the pelvic floor. We do a lot of external stretching and breathing and relaxation work as well. And then we give them tools to help them at home. There are these things called vaginal trainers, which look like tampons of different sizes for them to practice inserting in the vagina. There are little wands that you can insert that help release trigger points. So lubricant recommendations. I mean, there's so much that, you know, women just, there's so many tools out there to help. And yet they're suffering for 11 months when it literally could take three sessions.

Wow. Okay, I love that. So much hope. So much hope for people in my audience. I just know it. What are some of the most common pelvic floor problems that people don't even realize, oh, that's your pelvic floor causing that issue? First one's leakage. Like a little leak with a cough or a sneeze or a run or a jump. I mean, that's a pelvic floor problem. The other one is having to go to the bathroom a lot. So if you find yourself going to the bathroom every 30 minutes, every hour, multiple times before going to bed, what happens is that your either pelvic floor muscles aren't relaxing. well and you're not emptying your bladder or the pelvic floor muscles kind of quiet the bladder down. So typically, Alex, when you have to pee, your bladder fills and it sends a signal to your brain that like, hey, I have to go pee. And then your muscles tighten up and say, all right, bladder, chill out. Give me, I need to finish my show with Sarah and then I'm going to go after. Well, if these muscles can't contract well enough to tell the brain to chill out and tell the bladder to quiet down, then you have this constant urge to go. And then you start to contract. going all the time. And so bladder training really involves your pelvic floor muscles, making

sure they contract well and relax well. And so that's another common one. Another one is pooping problems, a favorite topic of mine. If you are straining with constipation, you have hemorrhoids, you can't clean well after bowel movement, you have fissures, you leak stool or standing in your underwear, that's likely a pelvic floor problem as well. And then another one we talked about is painful sex. Is it true that women should never push to pee? Yes, and thank you for saying that you should not push to pee. Okay, I don't know how to pee without pushing, Dr. Sarah. Like, I don't understand this. Yes, you're not alone. I would say that women and particularly moms, we are always on the go and we want to do everything as quickly and as efficiently as possible. However, you need to sit and chill for two reasons.

Our nervous system is involved in balum bladder function. So in order to eliminate well, you need to have a quiet sympathetic nervous system. It can't be really upregulated. That fight or flight response has to be kind of calm and relaxed. The other thing is your pelvic floor muscles need to relax. So your bladder, which is a muscle, pushes the urine out for you. If you're pushing when you're pee, you're almost like tightening your pelvic floor muscles and trying to then push the pee out against that force, which is not effective.

and you can weaken your pelvic floor muscles over time. Didn't you post this advice on TikTok and like everybody just freaked out? It went totally viral. Why were they freaking out just like me? Like I don't even understand how you would pee without pushing. Because nobody's taught us. You know, nobody taught us that like to pee, you just sit. Sit is the first one.

A lot of us hover over toilet. So unless it's totally gross, sit down, lean forward and just take some deep breaths. And your bladder is a muscle that pushes the urine out for you. If you push when you pee, you can really weaken your pelvic floor. And we do that eight to ten times a day. And then you end up with pelvic floor problems. Yeah. So my next question was going to be, what are the little things that we're doing unknowingly that is weakening our pelvic floor on a day-to-day basis?

So I guess pushing to pee would be one. Pushing to Pee would be one. Straining with bowel movements. So I'm a huge fan of this little stool you put under your feet when you're pooping called a squatty-potty. And you place it under your feet when you are pooping. And then you lean forward. And that kind of puts you into a squatting position, which is the most natural way to have a bobty. movement. If we look back in history or in Asian cultures, they all squat over the ground because

it helps relax your pelvic floor. So when you're giving birth, you're kind of in a squatting position. When you're pooping, you need to be in a squatting position because it relaxes your pelvic floor. So use a squatty potty and then don't hold your breath when you're trying to bear down to poop. You need to, you can push when you're pooping, but don't hold your breath, because again, that can weaken your pelvic floor. One of the other ones I tell people is they're holding their breath when they're working out. So if you are at the gym and you're lifting heavy, weights or you're, you know, doing something that requires a lot of exertion and you hold your breath that actually causes weakness on your pelvic floor. Okay.

Yeah. So I see all of these people at the gym and they're holding their breath trying to lift these heavy weights or they're, you know, have these weight belts on and they're just straining. And I'm like, oh my God, their pelvic floor is going kaput. Like it's just going to put all this pressure. And then people end up leaking. And it's almost become this like badge of honor. if you're in these high competitive weightlifting competitions to, like, pee your pants. It's like, people are cheering.

Yeah, it's like on social media. It's on YouTube that, you know, women are leaking when they lift weights. And people are cheering because they're like, oh, this is so amazing. Look how much she could lift. And oh, she had a, you know, empty your bladder to do it. But I'm like, oh, my gosh, this woman's pelvic floor, if she knows what's happening and she's cool with it, that's fine. But she doesn't know that later in life, I mean, she could have a complete prolapse of her organs and need surgery.

Ooh. How do pelvic floor issues affect mental health and why is that connection often overlooked? That's such a great question, Alex. And I think that, you know, what we experience in our bodies absolutely affects how we feel and it affects how we function. So let's take, for example, a mom who is leaking urine and she, you know, used to run with her run club. And now she can't run because she sweats her pants or she's afraid she's going to smell like urine or she can only wear black leggings because she's afraid that she'll, you know, wet her colorful ones. Well, if she can't work out, that's going to affect her mental health, right? Let's take it as another example of somebody

who wants to be intimate with their partner and they have pain with sex and it affects their relationship or they can't even have sex to get pregnant and they want to become a mom and start a family. That's going to affect your mental health. You know, there are studies that show that women who have urinary incontinence are at a higher risk for depression than those who don't leak. And so we really need to connect these pieces because, you know, I love that we recommend movement and exercise. And as a physical therapist, I'm such a huge fan of that for our long-term health. But if I look, step back and I say, okay, if you have back pain, if you have abdominal weakness, if you leak, if you have prolapse, you can't move and function the way that you want to and that's going

to affect your health. Okay, I have something to share that I've never ever shared before. Because it's so embarrassing and weird. When I was in seventh grade, I don't know what was going on with me, but like every single time I would laugh really hard, I would pee my pants. But it was like, it was in school. It was so embarrassing. And I was like, what is happening to me? I don't understand. We went to a urologist. Of course, they put me on Detral, L.A., which is for elderly people. And they couldn't believe there's like a 12-year-old girl in here. Why are we putting her on this? But now listening, do you say this? I'm like, oh, my gosh, I wonder if there was just something going on and it was like a weak pelvic floor for some reason. But I don't know, does that sound

possible for a 12 or 13-year-old? Totally possible. But it was also the time that I was starting my period for the first time. Interesting. So I just wonder if all that had to do with it now in hindsight, but they put me on that drug, of course. So I don't know. Yeah. I mean, it's hard to say without evaluating you. And there are a lot of kids who they come to us as adults. And so if I see an adult woman and they're like, I had childhood constipation and I was

straining or I was a chronic bedwet or I used to leak when I was, you know, playing sports, those are early pelvic floor dysfunction problems that just went unaddressed. And I think it's important for, you know, my generation and your generation to understand this part of our body and to know some of the red flags so that our kids don't have problems that go unaddressed. I think it's how we're really going to help change the narrative and the culture between or behind how women access care for their pelvic floor. So in that situation, I could be like there could be weakness. You could have been not emptying your bladder well because it was full a lot.

You could have had constipation. And if you have really full balls, it puts pressure on your bladder. It's actually a problem with bedwetting. A lot of the times bedwetting for kids is caused by constipation. Shut up. Yeah. Now this, now you're on to something because I was chronically constipated my whole life because all eight was ultraprone. processed food. And I didn't know until a couple years ago when I went on this whole health

journey and everything, I had no idea. I just thought I never pooped. I growing up would go like, I would poop like every week, week and a half. Oh my goodness. You just turned a massive light bulb on for me. That's crazy. But isn't that wild that all of this time, and again, childhood constipation, what's normal to poop is three times a day to three times a week. So if you're going longer than every two days, to your point, the what we eat, how much we move. the medications were taking in their side effects. All of those things affect our biofunction, which could affect your pelvic floor. But it's just so crazy to me, like, looking back, and this is a thing when you go down

these rabbit holes on all of this health stuff and how we've been so lied to in America and, like, over-medicalized and over-prescribed everything, like, all that was done was thrown a pill. Like, in 10 minutes, like, we probably could have figured this out with the right questions of what are you eating, the constipation stuff, you know, all this. Like, it's just mind-blowing. So, yeah, and I mean, I do get that all the time. that's crazy about kids and struggling with bedwetting is, I mean, because I've also heard about

mouth breathing. Oh, yeah. That could also play a part. But then to know that chronic constipation could also be affecting that as wild. Yeah. And it's, I mean, constipation is the number one GI complaint in our country. And there's a reason for that. But we don't think about how does that affect our pelvic floor or a bladder function

or like anything else. So it's pretty wild. It's all connected. I love when I learned something new for my guest. I love it. It's so fun. Summer always reminds me. spending entire weekends at the motocross track, watching my high school boyfriend throw whips in the

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use code Alex for 15% off. That's paleovalley.com slash Alex code Alex. Good snacks, zero compromise, and less miserable traffic jams. What are some of the most common myths about the pelvic floor that you wish people knew were false? I would say the first one is pregnancy that, you know, when giving birth, people think your pelvic floor pushes the baby out, and that is false. Your pelvic floor needs to get out of the way. It needs to relax and move aside. It's actually your uterus that

is contracting that pushes the baby out. And so this is why it's important when we're giving birth. The way that we give birth now is most women over 90% have an epidural, which kind of numbs the lower half of our body. And that's to help manage pain, which is wonderful. We want pain relief so that women can be comfortable. However, it also means you can't necessarily feel your contractions and you can't push as efficiently. And so I think understanding that you don't need to have these super strong pelvic floor muscles to push a baby out. You actually need to have really relaxed pelvic floor muscles. And so that's why I'm so passionate about educating women during birth that, you know, we want to teach you how to relax those muscles when pushing versus

tighten them and think you have to push so hard. How does the pelvic floor change in menopause drastically? And it actually changes prior to menopause during perimenopause. So menopause, by definition, is when you have not had a period for one year. And then you're officially in menopause and then after that you're considered postmenopausal. Prior to that, your menstrual cycles are changing for months and years. So you can be in perimenopause for up to 10 years before you hit menopause. So I'm 42 and say I go into menopause at 50 or hit menopause at 50.

I'm already in that stage where my hormones are fluctuating. I've got lower estrogen levels. I've got lower testosterone levels. The collagen in my skin is changing. So as those hormones are changing during perimenopause, we have less pelvic floor support. So all we see is maybe our hair changing or our skin changing or changes in our periods. But your pelvic floor is changing as those hormones change as well. You have more vaginal dryness because estrogen lubricates the vagina.

You have less pelvic floor tone during perimenopause and menopause because estrogen also tones the pelvic floor and plumps it up. You may have weaker orgasms because you have less pelvic floor muscle strength and kind of connection. And you have less pelvic floor support. So what that means is you're at a higher risk for what's called pelvic organ prolapse. So pelvic organ prolapse, it sounds really scary. but it's when your organs aren't as well supported by this hammock of muscles and they start to drop into your vagina. Yikes. I know.

So a lot of women experience this after birth and then in perimenopause and menopause because we don't have the same collagen and strength to support the organs and everything starts to drop down. Like all of a sudden there's just a rib coming out. I'm just joking. Or it's more like you feel a bulge in the vagina. It feels heavy. You feel like the tissue's rubbing against itself. I know. And so it's really common.

You know, over 50% of women, you know, after the age of, I think it's 50, can experience pelvic organ prolops to a really mild extent. But again, if we don't address strength training, if we don't strengthen our muscles, if we don't address the changes, then it will only get worse because postmenopausal, we have like no stores of estrogen, testosterone, and collagen. And then things are just like, you know, going down the drain. Do kegles work? They can.

Kegles are such an interesting thing. to discuss because I feel like growing up, it's all we heard about our pelvic floor. Yeah. Do kegles for better sex. Do kegles for a tighter vagina. Do kegels to stop leaks. And it's boiling down a complex part of the body to say, like, do this one thing to get a result.

It's like saying, oh, you have back pain, just do crunches, right? When we know that it's really how you move, how you breathe, how you relax, that's involved. Kegels are pelvic floor muscle contraction. So say you're going pee and you want to stop your, you know, you know, you're going to stop your urine stream and you tighten your muscles, that's a kegel. Or you need to pass wind in an elevator and you're trying to hold in a fart. That's a keegle. It's tightening the front and the back, contracting and lifting the pelvic floor up. However, what's equally important is relaxation of that muscle. You can't walk around doing a kegill all day to tighten your pelvic floor, right?

It's like you don't just bend your elbow and tighten your bicep to get strong biceps. You have to contract and relax and you have to use the muscle in different positions. So in sitting, in standing while walking, while lifting, all the functions we do throughout the day, because that's when we leak. We don't just leak sitting in a chair or sitting in the carpool lane in our car. So you want to use the muscle when you need it, work on quick contractions and longer hold contractions because it's an endurance muscle as well, but also make sure that you need kegles. A lot of women have tension and spasm and kegles could make their problems worse. How does the pelvic floor play a role in either giving you a weak orgasm or the best orgasm

of your life. A huge role. So, you know, arousal and orgasms are, they're definitely a mind-body connection. So in order for blood to start flowing and lubrication to occur in the vagina, there you need to have arousal, which could be, you know, physical touch. It could be watching something. It could be reading something. It could be thinking about something. So that is arousal. And then as blood starts to flow to the vagina and the vulva and the pelvic floor muscles, they kind of get to a heightened state of contraction. So that is where we start to think about having an orgasm. So the muscles are engorged with blood and then you reach a climax

and your muscles contract and relax during an orgasm. An orgasm is a contraction and relaxation cycle of your pelvic floor. So if you have weaker orgasms, it could be that your pelvic floor muscles are weak. This happened to me after giving birth. I had an orgasm, I was like, did that even happen? Like you can't even tell what's because it's like radio silence there. It was like blowing in the wind. It's like, well, that was over pretty quickly.

Sometimes if you can't have an orgasm, your muscles could be too tight or tense where they just can't get that blood flow there to get to that heightened state of climax. So, again, it really depends if you have tension or if you have weakness. Also, can you relax? Are you an environment where your nervous system is calm and relaxed if we're in a really heightened environment or our nervous systems are firing over time? Like, that's not going to help with orgasm. So it is a mind-body connection, but your pelvic floor muscles need to be in optimal shape to have great orgasms. Does posture have anything to do with pelvic floor? Yes, and we should probably uncross our legs now that we're talking about that.

Really? Okay. No crossing legs? I know. I know. I do it all the time, obviously. Yes, we are at a time in our culture where we sit a lot. And when we sit, we're stagnant. So you're not getting great blood flow to your pelvic floor. So people always say, like, what's the best posture for your pelvic floor? I'm like the next one because you want to be moving. I really tell people to get up every half hour, every hour to take a walk, to get a sip of water, to elevate their standing desk because we need blood flow to these muscles. The other thing is when we're sitting, we're like this, right? Yeah. Our pelvis is tucked under.

We're slout. Our back is rounded. Your pelvic floor muscles sit at the base of your abdominal cavity. So if they're crunched, you can't contract and relax those muscles really well to get relaxation of the muscles. And then also when you cross your legs, if you turn your knees in like this, if you twist your legs up in a pretzel like this. Oh my gosh, that's how I sit. I know. My team the other day noticed that for the first time because I wrap my legs twice around each other when I cross my legs.

And they're like, how are you even doing that? And I was like, I thought everybody could do this. And so, yeah, they'd never even seen that, but that's really bad. It's not bad, but it can contribute to pelvic floor muscle tension. Okay. You know, when you think about, like, if you have to pee and you squeeze your legs together or, you know, little kids have to go to the bath and they like turn their legs in. Turning your legs in or your thighs in helps contract your pelvic floor. So if you're sitting that way a lot and you have pelvic floor tension, it could be a

contributing factor. So I often look at how people are sitting, how they're standing. When we're moms, we just like have a baby on the hip all the time. And that kind of makes our thighs go in and can cause imbalances in our pelvic floor. Did you know that Americans throw away 100 billion pounds of food every year? That's billions with a bee. And most of it is stuff we meant to eat. produce that went bad, leftovers we forgot about, or things that expired too fast. That stat hit different once I got a Harvest Right home freeze dryer. Now I freeze dry fruits, vegetables, entire meals, even snacks, and keep them fresh for years. No more guilt over wasted food and no more sad bags of wilted spinach.

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Do men have a pelvic floor? Oh, my goodness. Yes. I'm so glad you asked this. Men, everyone has a pelvic floor. Every gender. And men absolutely have a pelvic floor because they are a gender that does not go through pregnancy, postpartum, and menopause, which are some of the three biggest times in our lives that our pelvic floor is affected. They often go kind of under-treated for pelvic floor problems.

The differences between males and females are men have two openings instead of three. Men have one opening for the urethra and one for the anus, so they don't have, you know, the vagina. but they often get affected with tension in the pelvic floor. So men who have crappy posture or have pooping problems or they think it's a prostate issue, but it's really pelvic floor tension. They can have pain with urination, incomplete bladder emptying, difficulty with erections and orgasms, pain with intercourse, pain with bowel movements, tailbone pain. So just a lot of tension can cause pelvic floor problems for males.

And then if they do have a procedure, like a prostate procedure, or they can have leakage or erectile dysfunction afterwards. So, but men don't talk about their pelvic floors a lot. I mean, if I go on a walk with a girlfriend, it's like 50% of our conversation. But because I think men don't talk about them and they also don't know where to get help, do they go to their urologist? Do they go to their primary care doctor? They don't even know where pelvic floor exists.

Yeah, so where would a man go? You would typically go to your urologist. You'd see a urologist, but you can also see a pelvic floor therapist. And a pelvic floor therapist will evaluate you, obviously not through the vagina. the assessment is through the anal opening. But they will tell you if you have a pelvic floor issue and they can help treat you as well. How can you differentiate between pelvic discomfort and something that is actually going to require professional treatment? It depends on how we define pelvic discomfort.

If pain is lasting longer than three months, then it becomes chronic. And I think one of the challenges, and that's where we really see a lot of changes in the brain when we start having chronic pain. If you experience something one time, like, oh, I'm, you know, playing tennis and I feel like a little jar in my knee. I'm like, okay, it's probably not a big deal. But if I start playing tennis or I'm continuing to play tennis and I feel it every time I play, it gets worse in intensity, the pain lasts for longer, it doesn't go away afterwards. These are signs that that's not going to get better by itself. Okay. I also say that there's no harm in just going to check him with the pelvic for a therapist to see if you have an issue.

It's almost like going to the dentist. We go into the dentist every six months, get our teeth checked, and we say, oh, you're doing great or like, oh, we see you could use a little tune up or fix here and then you get it addressed. I almost feel like pelvic floor therapy should be that way because there are so many times in our lives that it could be affected and we just don't catch it soon enough. Does breath work matter when it comes to pelvic floor health? 100%. Our breath is directly connected to our pelvic floors. So you'll find if you hold your breath a lot, your pelvic floor is locked up. And we are at a time in our culture and our society that's tense, it's stressful, And we do.

We find ourselves holding our breath a lot and tightening our jaws and tightening our pelvic floors. A lot of people who have TMJ also have pelvic floor problems. Really? Yeah. Wait. So you should also go get your pelvic floor looked at it. If you're like, oh my gosh, TMJ, it's killing me. Well, if you have pelvic floor issues, if you're like, you have TMJ and you're like,

oh, I have hip pain or back pain or, you know, sexual pain, then I'm like, you should, they're connected, right? Oh, my gosh. That's crazy. Yeah. There was actually a video that went viral of a runner who she was doing tongue stretches to release the fascia around her tongue. And it was also causing hip pain and pelvic pain. And it went viral because it was the connection between, you know, head to toe of like how is our body really connected. And so it was just a really great way to kind of bring awareness to this.

If you find yourself holding your breath, if you just need to relax your pelvic floor, the first place to start is your breath and not chest breathing. I really encourage people to do what's called diaphragmatic breathing, which is where you sit up nice and tall and you place your hands on your ribs and you inhale and you breathe into your ribs, almost like opening your ribs like an umbrella. You don't breathe into your chest. You don't puff your belly out. It's opening your ribs. And that helps your diaphragm contract and go down and that helps your pelvic floor relax.

So as you're breathing, it's like your pelvic floor is relaxing and contracting. But if you're holding your breath or you're breathing with your chest or your belly, you're not getting that same relaxation. What is the biggest mistake people are making when they're trying to fix their pelvic floor dysfunction at home? I think people aren't quite sure what their problem is. So they're just doing a bunch of kegles, to be honest with you. I think that even medical providers and even some physical therapists are overprescribing

strengthening. You know, they're like, tailbone pain, strengthen. I'm like, no. Your tailbone attaches to your pelvic floor muscles in the posterior backside. And if you have tailbone pain, your muscles are likely tight. tight and tense. And doing kegels could make that worse. Or you have to peeble all the time. They're like, do your kegles. I'm like, no, you might need relaxation. Or you have hemorrhoids. Do your kegels. Prolapse. Do your kegels. I think we're overprescribing strengthening,

when a lot of people really need to be focused on relaxation first. And if you relax your pelvic floor muscles, you may need strengthening after that, but you can't just jump right to this like tightening, tightening, tighten exercise. I think our fitness culture is so focused on like suck in and tighten it up and pull your core in where we really need to focus on the relaxation portion and it's just as important. What is the number one thing that women are getting wrong when we wash our vaginas using harsh chemicals? I am a huge fan of just using water. No soap only water. Well, I think let's talk about the difference between the vulva and vagina first. Okay. So the vagina is the internal canal. So that leads from the opening of the vagina

to the cervix of the uterus. And the vulva is everything outside. So it's the labia, the mon's pubis, the clitoris, kind of everything outside in the area. Now, you don't need to put anything inside of your vagina to wash it. You don't need to put duches or cleansers internally. The vagina itself is like a self-cleaning oven. And it just gets, you know, rinsed if you need it. However, externally on the vulva, I also recommend just using water and to get a

little graphic here. When you're in the shower, I say like kind of rinse water between the labia, pull the clitor or hood back. So kind of pull the clitor's back at water around. You want to make sure that there's no kind of whitish discharge or material or cream in the area. But some people do feel like they want to use more. If you're going to use a vulva wash, it needs to be pHed balanced, no sense. No fragrance. No fragrance. Anything that glitter, sparkle, smells, it's off limits for your vulva and it should just be really mild, like a mild rinsing cleanser. There's so many great products out there now that are specifically for the vulva that you can use if you want to wash. What do you think about people are calling it like the big vulva industry and they're

like selling things now like vagina deodorant or whatever? You know, I love that you brought this up. And I actually talked about it in my book because I talked about the big business of vulvas. Okay, yeah. And it's, you know, I think for me, vulvar care and is health care. Pelvic floor health is health care. I think that, you know, the way that our country works is that if there's something that could be a big industry, it's like we jump on it and we just blow it up and make it a big wellness thing. So I do think that some people feel like they need something to help the area smell better, to help the area feel better. But I'm always like, let's get to the root cause of what's causing that. Or is it, do you have an odor in the area because of products you're using

because of what you're eating or drinking from hygiene? Like, let's just back. back up a second instead of layering more on and kind of sometimes less is more. But, you know, there was a vagina-scented candle, which, you know, your vagina can have an odor, but it's kind of a benign odor. There was a vagina-scented candle that went on sale and, like, sold out, and it was $75 bucks a pop. I'm like, what does a vagina candle smell like? But it's just kind of kitsy. And I think that it can be fun and we want to bring levity to this topic. But I also think we don't want to capitalize on it because it's still health care. And I think if we just keep throwing things at people to fix problems, we still need to take a step back to be like,

what is the root cause of it? What are some of the weirdest and maybe even grossest things that happen after birth that nobody talks to women about? Because everybody only just says like, oh, well, you might poop during labor. But I mean, once you're home, yeah, once you're home, what's going on that, like, I have no idea as somebody who's never given birth. A lot of women poop during labor, and you won't even know. I mean, if you poop during labor, I'm like, good job. that your pelvic floor muscles should be relaxing and pushing out like gold star. After giving birth, a couple of nitty-gritty things to expect in the very early days are you might stand up and completely lose your bladder contents.

You could like just urine pours out of you because your pelvic floor muscles are just exhausted. You've got side effects from anesthesia if you use medication. The other one is constipation is terrible after giving birth. You have medications, you have blood loss, you have dehydrated, and you're sore in the area. So you're trying to squeeze out a poop the size of a baseball, and it's like you still have stitches in the area.

So so many women are like my first postpartum poop was worse than birth. And one of my most popular reels is the one where I teach you how to poop after giving birth. Oh, wait. There's a method to this madness? Yes. And I'm like, every labor and delivery unit should have this. So you put your feet on a stool or your luggage or a squatty potty. I'm like, bring your squatty potty to the hospital.

you should absolutely take stool softners after giving birth to keep your poop soft. You need to hydrate. And then you support the perineum. So the parame is the area between the vaginal opening and the anal opening. And if you take a piece of tissue paper and push up on that area as you bear down to poop, it's going to protect your vagina and vulva, which is really vulnerable post-birth or healing. And so I'm like, support the parinium, support the parinium. If you have a vaginal birth, if you have a C-section, I'd say put a pillow or like a roll towel over your C-section scar.

and exhale and bear down. And those are going to protect those really vulnerable areas after birth. The other thing is you're going to bleed for like a month. You'll have really heavy bleeding and blood clots regardless of which method you birth, vaginal birth and C-section. It's your uterus clamping down to heal. So you'll have really significant bleeding and that you might smell. What do you mean?

Yeah, you're going to smell. So after giving birth the pH levels of your vagina change, your estrogen levels drop, and you just smell. Your vulva and vagina are going to smell. Your armpits are going to smell. your whole body's going to smell. How long? And when does that go back to normal?

You know, within the first week, but it's, it's pretty bad. Really? Yeah, you're sweaty and you're hot and, like, your milk's coming in. And, yeah, you might smell. Okay, that's really good to know. Yeah, no one has ever told me that. Yeah. So that's important, I think.

Tell us where people can follow you on Instagram. So my handle is the vagina whisper. It's the dot vagina. And on TikTok, I'm at the Vaj Whisper. And I have a huge community there, which I really think. is a testament to how much women want this information. We're not getting it from our health care providers. We're not getting it, you know, in sex ed or period, you know, information when we're younger. And we're not getting it in pregnancy postpartum our menopause. So we've got a huge community

there. And I have a new book coming out called Floored, which is a woman's guide to pelvic floor health at every age and stage to help women like you and myself and my mom and my nieces just really understand this part of their body and how to care for it. And how can people work with you directly? Like, where is your practice? So I live in New Orleans, Louisiana, which is my hometown. I work at a practice there called Nola Pelvic Health. And I also have a team that does online consults. If you aren't in New Orleans and I have an online pelvic floor fitness platform called the Vehive, which is pelvic floor exercises for at home. And I really started it for my pregnant and postpartum moms. Like, you know, if you don't live in New Orleans or are close to a pelvic floor

therapist or you just kind of want to get started on your own journey at home, I walk you through pregnancy, postpartum, but now I have strengthening for, I have trying to conceive, I have post-surgical recovery, if you have a hysterectomy or an endometriosis surgery, I have perimenopause and menopause now, I have relaxation for painful sex. So just tons of programs to really help make this information accessible to women. This is such a good episode. This is so important. Okay, if you could give, I ask every guest this at the end, if you could offer one remedy to heal a sick culture, physically, mentally, or spiritually, and it could be anything, what would it be? As a from a pelvic health perspective, you have to really understand how this part of your body works.

Even if you don't do any of the recommendations I tell you today, I just want you to understand that this part of your body exists because it's literally involved with everything from peeing, pooping, sex, periods, birth, menopause, posture, exercise. And if anything in those arenas goes awry, your pelvic floor is likely affected and should be addressed. Thank you so much, Dr. Sarah, for coming on Culture Apothecary. Thanks for having me, Alex. This episode was truly Gorgina, as I like to say. Please leave a five-star review if you learn something new. Send this to every single woman in your life no matter what stage of life they are in. I think this is something that all of us need to know.

And I didn't know very much about pelvic floor, if anything at all, before this episode. So it's always fun when I get to learn something new. New episodes of Culture Apothecary come out every Monday and Thursday at 6 p.m. Pacific, 9 p.m. Eastern. We're on a mission to heal a sick culture twice a week, where every guest brings their own unique remedy to do just that. I'm Alex Clark, and this is Culture Apothecary.