Bladder Leaks, UTIs & Pelvic Floor Health with the Vagina Whisperer

Sara Reardon (0:00)

We've been told the narrative that diapers are our destiny, or that pelvic floor issues are just part of being a woman when they're not.

Mary Claire Haver (0:06)

68% of postmenopausal women who were surveyed didn't even know what a pelvic floor was.

Sara Reardon (0:11)

It feels very scary to hear your bladder's falling out of your vagina.

Mary Claire Haver (0:15)

She gets a 60-second exam, is told your bladder is falling out, just don't lift anything heavy.

Sara Reardon (0:20)

And dismissing it, which is complete gaslighting.

Mary Claire Haver (0:23)

Right now, she gets offered three things. Buy a device, get surgery, or live with it.

Sara Reardon (0:29)

And there's so much we could do. In every state in the United States, you can self-refer to physical therapy for your pelvic floor. And it's covered under insurance, like every other type of physical therapy. We're asking women to live half of their lives with these symptoms that are very treatable.

Mary Claire Haver (0:52)

The views and opinions expressed on unPAUSED are those of the talent and guests alone, and are provided for informational and entertainment purposes only. No part of this podcast or any related materials are intended to be a substitute for professional medical advice, diagnosis or treatment.

Nearly one in three women lives with a pelvic floor disorder, from urinary leakage and prolapse to sex that hurts. And in the United States, we spend over $20 billion a year just managing it, not fixing it, treating it. Liners, medications, surgeries, then repeat surgeries, because roughly 30% of women who have surgery to fix a pelvic floor problem end up needing a second one for the same condition.

You've heard the script your whole life. Leaking is just part of being a lady. Your bladder is falling out of your vagina, just don't lift anything heavy. Some pain with sex is normal. Try to relax. These are not medical answers. They are a system telling you to go home and manage it quietly. 68% of post-menopausal women said no one ever taught them what their pelvic floor even is. We are told more about erectile dysfunction than about pelvic organ prolapse, a condition that affects half of all women over 50 That is a decision about what medicine chose to study and to fund. My guest today, Dr. Sara Reardon, has spent two decades in the room where women finally get the truth. She's a board-certified pelvic floor physical therapist, the founder of The Vagina Whisperer, where she educates people about everything from pelvic health to menopause. And she's the author of Floored, a woman's guide to pelvic health at every age and stage. I'm Dr. Mary Claire Haver, a board-certified obstetrician and gynecologist and certified menopause practitioner and adjunct professor at the University of Texas Medical Branch. Welcome to unPAUSED, the podcast where we cut through the silence and talk about what it really takes for women to thrive in the second half of life.

Dr. Sara Reardon, welcome to unPAUSED.

Sara Reardon (3:02)

Thanks for having me.

Mary Claire Haver (3:03)

So tell me, I like to ask this question of everyone, how does menopause really show up in your practice?

Sara Reardon (3:08)

As a pelvic floor physical therapist, we see women of all ages and stages, particularly with perimenopause and postmenopausal patients, we see a lot of hormones starting to change. So some of the symptoms they may present with are urinary leakage, increased urgency and frequency, so peeing more frequently during the daytime and nighttime, pain with sex, it could be sex that's painful, uncomfortable, even causing tearing or irritation to the tissues, and then pelvic organ prolapse, which can feel like pressure or heaviness in the vagina. So they're all pelvic-related symptoms. We often think that this is something that's a normal part of aging, but menopause and postmenopause is over 40 years of our life, depending on how long we live. And we're asking women to live half of their lives with these symptoms that are very treatable.

Mary Claire Haver (3:53)

So let's break it down for our listeners because I said in the intro that 68% of postmenopausal women who were surveyed didn't even know what a pelvic floor was. So we brought a model today for those of us on video. What is the pelvic floor?

Sara Reardon (4:08)

Your pelvic floor is literally the floor of your pelvis. So you have this ring of bones that sits at the base of your spine. And at the bottom of this is a basket of muscles. And they attach from the pubic bone to the front to the tailbone in the back and side to side. So these muscles support your pelvic organs. They have the sphincters that hold in urine and stool throughout the day.