Sober Vibes Podcast
Welcome to Sober Vibes, where sobriety meets empowerment! Hosted by sober coach, author, and mom Courtney Andersen—who’s been thriving in her alcohol-free life since 8/18/2012—this podcast is your go-to space for real talk, proven strategies, and inspiring stories from women who are redefining what it means to live without alcohol.
Each week, Courtney dives deep into the topics that matter most—from conquering cravings and navigating social settings to rebuilding confidence and finding joy in sobriety. Whether you’re newly sober, in long-term recovery, or simply curious about life without alcohol, the Sober Vibes Podcast delivers the support, insights, and encouragement you need.
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Sober Vibes Podcast
Pelvic Floor Health during Perimenopause and Embracing Sobriety w/ Dr. Christine Klein
Episode 212: Pelvic Floor Health during Perimenopause and Embracing Sobriety with Dr. Christine Klein
In episode 212 of the Sober Vibes podcast, Courtney Andersen welcomes Dr. Christine Klein to the show. They discuss pelvic floor health and its significance during perimenopause. They also discuss the often-unspoken struggles women face related to their pelvic floor post-pregnancy or during menopause, emphasizing the importance of seeking help and advocating for one's health. Christine also shares how she quit drinking alcohol and her sober journey!
Christine Klein is a doctor of physical therapy and a board-certified women’s health clinical specialist specializing in Pelvic Floor Physical Therapy. She owns and operates a private practice pelvic floor physical therapy clinic in Florida where she treats women, men, and children in person and virtually.
What you will learn in this episode:
- Understanding the pelvic floor and its functions
- Common misconceptions surrounding pelvic floor issues
- Impact of hormonal changes on pelvic health
- The importance of advocacy in seeking pelvic floor therapy
- Practical tips for strengthening the pelvic floor
- Dr. Christine's sober journey
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Hey, welcome back to the Sober Vibes podcast. I'm your host and sober coach, courtney Anderson, and I'm also your go-to guide just in case you did not know for navigating life without booze. Welcome, welcome. If you're new here, I appreciate you pressing play and discovering this episode and if you like it so much, go back and to listen to more or share with friends, or even to. If you haven't yet done so, leave a rating and review, because those help the show you are listening to, episode 212.
Speaker 1:This is a great episode for the ladies today. Now, men, because we have men listeners, you can continue to listen, and if you just want to take this as an educational piece, feel free. But today's episode is going to be about the pelvic floor and perimenopause and why I wanted to conversate and discuss this, especially with the pelvic floor, because this is something I had to deal with after I gave birth to the dictator. My pelvic floor was fucked up after that. Women actually don't know that they can get physical therapy for this and that they can have that area back. So it's important, okay, and I want to get more into a little bit of some women's health here in season six, especially, too, with the majority of the age group who tunes into this show on a weekly. I want you all to have a great perimenopause. I want to have a great perimenopause. I want to have a good menopause experience. Right, we want to be as optimized as possible. But also, going back to the PF, which is pelvic floor, you shouldn't be like peeing when you laugh, okay, ladies, especially after having kids.
Speaker 1:So great guest today Dr Christine Klein. And Christine Klein is a doctor of physical therapy and board certified women's health and clinical specialist. She's been working in the orthopedic and pelvic floor physical therapy for the past 18 years. She has her own practice down in Central Florida and what also, too, that I like is that she also offers online services, so you can find her information in the show notes below. Also, too, dr Christine will share with you her sober journey, and she was in the sobriety circle and I did some business coaching with her. So I really, really adore Dr Christine Klein and she shares a wealth of knowledge in this episode today, so I hope you enjoy it. As always, feel free to slide into my DMs and let me know how this episode helped you today. And that's all. Keep on trucking and kicking ass out there. Hey, christine, welcome to the Sober Bygy Podcast. I'm very excited to have you on the show today.
Speaker 2:Hi, courtney, it's nice to be here. Thank you.
Speaker 1:And it's nice to see you again because it's been a minute since we saw each other. I know it's been a while, so let's dive in. Before you, give us your expertise, knowledge about the pelvic floor, because I wanted to have you on to talk about that specifically, because the time I met you, I think it was a year after I had the dictator. It was around that time and then I was like, oh my God, because that's when I had to go to pelvic floor therapy and all of that. So I did ask you some other questions about the pelvic floor, but during that time I had learned through my pelvic floor, through the physical therapist, that a lot of women didn't know that they could fix their pelvic floor. Yes, yes, right, yeah. So then you came into my life and I was like, oh, this is funny how I dealt with that. And then I met you. So, but I first want you to tell the good people of the world when you got sober.
Speaker 2:Okay, so the date was April 19th. 2023 is my date, yeah, and then I used to count. I guess you kind of start counting hours at first and then you count days, and then it was weeks and months, and now I'm like lost track of months and so soon I'm sure it'll be years, but it's the best thing I've ever done for myself.
Speaker 1:Yeah, do you feel like after that first year, after you got, it's like the first year? Then it's not so much the like I said, it's not so much like the hours and the days and the months, it's just okay. This was a part of my lifestyle.
Speaker 2:Yeah, and it to me is kind of like I don't know if you felt this way when you were pregnant, but at first nobody knows you are. So it's like you have this little secret that you keep to yourself and like you wake up excited and happy, and so that's kind of how I felt about my sober journey. It's, yes, another day done, and I feel so much better and I'm so happy to not wake up with a hangover and not be a bad example for my kids and all that.
Speaker 1:Yeah, so you're at a year and a half at this point. A year and a half, and what would you say is the biggest difference from then to now?
Speaker 2:I know I have more energy, for sure, and then I know I can just channel my all the things I want to do in my life. It's getting easier, if that makes any sense like work is getting better, family life is so much better, and my kids are now 12 and 13 and I can openly tell them, because they remember I would drink wine every evening and they would pick up on that even though they were little, and now I can just tell them openly and honestly yeah, I used to drink alcohol and that's so bad for you, and now I've stopped, and so hopefully that'll be a positive in their life for when they are exposed to that really soon in a few years and will help them not want to drink either.
Speaker 1:For you too, though how has that been after being sober? Have you noticed the mommy wine culture? I mean cause you have. You have kids in that middle age? Right, it was after quitting drinking. Did you notice the mommy wine culture was a lot bigger than you thought it was.
Speaker 2:Yeah, and I've been. I've been off and on with trying to stop drinking for a long time before that actual day when I really did stop and I found you and your community and everything which was such a big help to me. So I was extremely a parent of the mommy wine culture and that it's there and just how we're being marketed to and sold to and it's just a whole bunch of crap in my opinion, and I can go on about that and how that applies to what I do now with pelvic floor and hormones and all of that.
Speaker 1:Oh, yes, we'll go there for sure.
Speaker 1:Okay, Because I had another hormone specialist on the podcast a couple months back and even, too, she was just talking about alcohol and hormones. But I even was out to breakfast with two girlfriends last week and they drink from time to time, right, which is it's all good. And my one girlfriend, she was like Court, I can barely drink anymore and she is 46. And she was like it has now come to the point because, due to love some IPAs, she's like I can't even drink the IPAs anymore. She's like I legit will wake up at 3 am in a sweat and then start having anxiety about my life from 20 years ago.
Speaker 2:Yeah, it does crazy, crazy stuff to you.
Speaker 1:Right. She was like I'm at the point now where it's like I like a beer from time to time. She's like I will now drink like an ultra. Like she's cause I like a beer from time to time, she's like I will now drink like an ultra. She was like, just because it's just so crazy how in the past two years, alcohol has it's completely different on how I react to it now. Yeah, but I told her I was like that's fucking perimenopause, like that is hormones and just how your body processes it now.
Speaker 2:Yeah, and I think you start to kind of notice that even in your 30s, yeah, it hits you differently, that alcohol starts hitting you differently.
Speaker 1:What After life?
Speaker 2:I guess Don't really pay too. Didn't pay that much attention and I think I even had an allergy to it and I just didn't care. I just kept on drinking.
Speaker 1:Just kept on drinking, right, right, I'm very proud of you for a year and a half. That's amazing, and that yeah cause. Did you listen to the podcast or did you just come in straight into the sobriety circle? Oh, when. I yeah, it was called the fix when you were in there. But I did a name change, I did a rebrand. I love that. So much.
Speaker 2:I don't know. I probably just saw you on Instagram because there's a couple of other sober influencers that I follow and I've read so many books and the book by Annie Grace I just love so much. And then you have your Sober Vibes book. But I think I probably found you through Instagram and then listened to your podcast. Yeah, so I think Instagram is how I originally found you.
Speaker 1:Yeah, and I do like to ask what was so for you that final time of drinking? How did you know that that was your final?
Speaker 2:I don't think I did know. I think I took it one day at a time Because I would still and I still now will have dreams about it. I'll dream that I drank and then I'll be so upset and then I'll think, oh, that was a dream and the my company name is called embrace health Cause this really did have a lot to do with it. I opened it really in 2021. And I just kept thinking to myself I can't be drinking like this and telling other people not to and live their healthiest life when I need to walk the walk. So I had that in the back of my mind for a while and so that really stuck with me and I think I really like accountability and challenges and stuff. And I feel like just being able to go into your group every day and tell the other members hey day, whatever. Blah, blah, blah was very encouraging and then I just kept going, yeah.
Speaker 1:I mean that accountability and support helps when you are in a group of people who get it. Yeah, friend again, like my friend Dudu is her nickname but like talking to her of trying to quit drinking alcohol while she is still drinking, which, again, no shade. Not everybody who drinks has a drinking problem, but there's just. Even with friends who casually drink, they don't understand what that struggle is. So definitely, being around people who get it and who are in the same boat with you is like the number one thing that I think a lot of people should get more help of, of reaching out and getting that help and being around a community.
Speaker 2:And it's so nice too. Like I have some mom friends that I didn't know very well but we'd go out with our kids and I'd say, oh, that's like their wine area over there. And then she'll just randomly be like, oh, that's cool, I don't there. And then she'll just randomly be like, oh, that's cool, I don't drink. And I'm like, oh see, see, it's always nice. But yeah, I never shove it down anybody's throat that I don't drink. I just don't Like at family parties, whatever it's, I don't make a big deal out of it.
Speaker 1:Yeah, yeah, and I think a lot of other people for the most part won't make a big deal out of it if you're not drinking. I think that a lot. There's a couple who will, who will push boundaries and be like what the fuck? But I think we put that into our heads that more people will care than they actually do.
Speaker 2:Oh absolutely.
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Speaker 1:All right, let's now chat about the pelvic floor, all right. So, going into this, I just want to share the story. And that's when. So during this time I was going after I had the dictator. I then, after three months, I then went back and bartended for a little bit and during time I was bartending, on a Saturday, there were two ladies sitting there, and it's not like I was intentionally listening to their conversation, but I was hearing things that they were saying. So this woman and and again at this time I'm going to pelvic floor therapy for, obviously for physical therapy for my pelvic floor, because being pregnant, being on bed rest, fucked me up. I also had a fourth degree tear. I don't know if that played any part of it, right, so the dictator out, hot.
Speaker 1:So I'm listening to this woman who, if I were to guess, was in her early 50s and she was telling her girlfriend where she was like I, every time I go to this exercise class, I pee. She was like I can barely jump up anymore, like jumping. She was like I pee, and then that's Like jumping. She was like I pee. And then that's when I had to step in because I had already gone to physical therapy for the last couple months and I was like have you ever tried PT for your pelvic floor? And she was like no, because she was saying too that this had to do with after giving birth for kids, right. And I was like I said this is a thing.
Speaker 1:Because at that time the physical therapist told me it was like what is it Like? One in three, one in four women have pelvic floor issues, something like that. Yeah, right. So I told this woman and she was like I cannot believe. Even my gynecologist has never recommended this to me. And I was like I said I had to ask for it. I was like, just because I felt like something wasn't right in that area, right. So she's like, all right, I'm going to ask my gynecologist. But that is what I'm saying and what I said in the beginning of this. It's like women don't know, so explain to us the pelvic floor.
Speaker 2:The pelvic floor muscles are a group of muscles in the pelvis. It's like a bowl of muscle, if you think about it, and it's in between our upper body and our lower body, and then usually we kind of think of your arm or your back or your neck or your foot, and you don't take into consideration what connects us, which is just the middle of our body, is our pelvic floor and how those muscles are part of our deep core system. And so that's the pelvic floor in a nutshell. But they do so many things for us. It's bladder and bowel control, it's sexual appreciation, it is sphincteric control, so bladder and bowel organ support, so it supports our organs. It does so much for us.
Speaker 2:And so, yeah, so many people because we really don't learn this stuff anywhere else they just assume that as we get older, this is what's going to happen I'm going to leak, or if I'm pregnant and have kids, I'm going to leak when I run and jump, or sex is going to be painful, and I should expect that and just deal with it and not seek help for it, because there is no help for it, but there's so much help for it, and so these are things that we don't have to live with and suffer through, and even if your doctor doesn't say anything about it, like you said, you, number one, ask for it. But, number two, a lot of physical therapists have what's called direct access, so you don't need a referral in most states, so you can just go and then your therapist will tell you what they need, based on the state they live in and the laws.
Speaker 1:Yeah, yeah, fantastic, see. And I didn't know that that was also tied into sex. Because again, being a new time mom, I was like again it wasn't just the sex part of where I was like this doesn't feel fucking right. This doesn't feel like it once used to. Is this because of the kid Right? Is this because of a fourth degree tear? Is this because of all the pressure, what happened here? So I didn't know that until I went through that process too, that sex. It shouldn't be painful.
Speaker 2:It really shouldn't be and it is painful for so many people. And then especially postpartum or at least postpartum. But lactating, breastfeeding, pumping, what have you? It's like you're in a state of menopause. Your cycle doesn't come back for a while, so your estrogen in your tissues is pretty depleted. So using a topical estrogen cream in that postpartum time can really help to decrease pain with intercourse Right.
Speaker 1:So when does the? Okay? Because we have to talk about two parts here, because there's women who've had kids, or there's women who have not. So what, though? Besides pregnancy? Obviously that's going to weaken that muscle, correct, but even to during if you're pregnant, because that was the thing too. I was trying to do Kegel exercises to prevent, right, because that's what I've heard of. Do your Kegel exercises because it will help, and I didn't feel like it helped.
Speaker 2:Yeah, so not everybody needs to be doing Kegels and pregnancy does automatically weaken your pelvic floor muscles. Oh okay, so not everybody needs to be doing Kegels and pregnancy does automatically weaken your pelvic floor muscles. Oh okay, so I'm trying. Was there a specific question?
Speaker 1:in there. I think I was probably just stating something, so so okay. So then let's go back. What starts to weaken your pelvic floor? Let's just let's just put the the, since you just said it where. It's not always that pregnancy weakens it. Yeah, how does it start to weaken your pelvic floor? Let's just put the, since you just said it, where. It's not always that pregnancy weakens it. How does it start to weaken?
Speaker 2:So here's the thing about the pelvic floor. I like to try to keep things simple and I like to think of the muscles as like a pendulum where we have they could be weak, they could be just normal doing what they're supposed to do, and they can be super tense and tight and shortened, and so being tense and tight can have the same symptoms as being weak. So that's where it really is helpful to go see a pelvic floor therapist to be assessed, to figure out what's going on with you, okay. But if you're doing Kegels number one it's okay. Are you doing them correctly? And then do you really need to be doing them, okay?
Speaker 2:So some people, like some people, have issues that start in childhood. So there are people who work with kids and pelvic floor issues. Men have issues too. So it's every single human being can have dysfunction in their pelvic floor. So pregnancy is definitely not the only thing. For people who strain and bear down a lot or have a chronic cough, chronic constipation, jobs where they have to lift heavy things a lot and to do that they're holding their breath and bearing down, that can lead again to a weakness in those muscles, or a reason for constipation could also be tension. So it's figuring out what those muscles are doing and then working on it from there. Okay, okay.
Speaker 1:And then as we age, especially in women, how does perimenopause take place? Like how, how does that? Yeah, what does that do to the pelvic floor when women start to enter in perimenopause?
Speaker 2:so that's basically, and just to simplify it again, five to ten years before you enter in perimenopause.
Speaker 2:So that's basically, and just to simplify it again, five to 10 years before you're actually in menopause, where menopause just means you haven't had a cycle for 12 months and then that one day of not having a period for a year means you're in menopause and then you're in post-menopause after that.
Speaker 2:So perimenopause is the crazy hormone fluctuations for five to 10 years before you're actually in menopause. So with those hormone fluctuations we have estrogen receptors from our brain to our toes. So that's where we start to see not only changes in the vaginal canal and the vulvar tissue and the bladder, but also like depression and anxiety and, of course, hot flashes for some and all of the other symptoms that come along with it. So in the vulvar tissue and the bladder tissue that because estrogen is going wild and starting to decrease, it leads to urinary urgency, frequency, less support of the organs. So people might start to notice prolapse a bit more More leaks because the muscles aren't working as well as they did before. Tissue thinning which can lead to pain with sex, which can then lead to muscle clenching and tightening. So that's like a vicious cycle and that can lead, obviously, pain with sex intercourse, whatever it is that you're doing, and then UTIs are more prevalent.
Speaker 1:Nothing's worse than a UTI.
Speaker 2:So as physical therapists, we can do as much as we can physically with you to help overcome these symptoms. And it's not just all physical, it's also looking at your diet, watching you exercise, look at how you're breathing, seeing what else in your body's going on, but then also changing some bladder habits and behavioral management type things, and tweaking your diet a little bit here and there and then educating as much as we can about hormones and estrogen cream and the benefits of it and how not. We shouldn't be so scared of it. So we can't prescribe anything as physical therapists, but we can tell you about it and how not we shouldn't be so scared of it. So we can't prescribe anything as physical therapists, but we can tell you about it and help you advocate for yourself to your doctor.
Speaker 1:How do you control the bladder then, or bladder management?
Speaker 2:I mean bladder management. Okay, first thing that I do is teach people what's considered normal habits for the bladder, okay and like. Frequency should be every about every two to four hours. We shouldn't be rushing to pee the bladder contracts as we relax the pelvic floor muscles, so we don't want to be forcing or pushing urine out. We want to sit down and relax and not hover over the toilet seats. So all these things I go over with people. We look at diet, like how much water are you drinking? Or here we go with alcohol again, like alcohol makes you have to pee more, but so does coffee, so do just things with higher acid content in them. So education, education, education. And then, if your muscles, if it's appropriate for you, like being able to do a Kegel with certain activities like coughing and sneezing, lifting stuff like that.
Speaker 1:Okay, I do have to say you did tell me about not rushing when you pee, like even in the morning time. I remember you telling me that and ever since you did tell me that I chill I'm not saying chill, but I don't try to hurry this pee out Like I just take my. I take my precious time now when I pee to help my pelvic floor, but also too. So that's the thing. So really, with the urinary, the frequency, it should just be two to four hours. So if somebody, if you are peeing more than that time, that's where you have to what dial back some fluids or get that checked out.
Speaker 2:Yeah, it depends, because there's certain conditions that lead to frequency specific bladder issues like painful bladder syndrome, where the once the bladder starts to stretch a little bit it hurts. So you really want to get that urine out. So physical therapy can be helpful for that, but you also want to be managed by a physician as well. But I had somebody come in and I'll never forget it. I just thought it was the funniest thing. She's I, I can't wait six hours to pee and I'm like what do you mean? She thought that it was normal to be able to hold your bladder for at least six hours during the day. So it's like this general information that is so helpful. Oh, this is going to be pretty easy, because every two to four hours is typical.
Speaker 1:Yeah, Did that. Poor patient had a bunch of UTIs Like that poor. She was holding her pee for six hours.
Speaker 2:I don't remember, I don't think so I mean.
Speaker 1:I used to have to be in a bartender. Just when you're so busy, it's just it's. And then after a couple years, like of towards the end of my career, I was like fuck you, god, I'm going to pee, I'm not giving myself Right.
Speaker 2:Nurses, surgeons, teachers. First response you can't just stop and pee when you need to, but you can try to make little changes here and there.
Speaker 1:Yeah, when I worked in the medical field, if I had to go into, when I worked at the pain clinic, if I had to go in and help with the x-ray machine, I would pee after every procedure. And one of the nurses was like you need to get that checked out. I said no, this is just a psychological thing, because I don't want to be stuck in here for an hour and having to pee. Thank you very much.
Speaker 2:And that's another thing. We call it a just-in-case pee, yes, yeah, which is something to definitely try to stop doing.
Speaker 1:Yeah, no, I actually did do that a couple times at Disney because I don't want to have to be stuck on a line, but I did do it. But I don't want to have to be stuck on a line, but I did do, but I don't do it anymore of, because that was just in that situation.
Speaker 2:But when she told yeah, every now and then, fine, whatever, but some people do it every single time they leave the house and then every single time before they leave, wherever they were, like it's just, and then they see me for overactive bladder and it's. You've done this to yourself.
Speaker 1:Oh, by conditioning yourself to pee all the time. What's that Overactive bladder comes from? What Conditioning yourself to pee all the time?
Speaker 2:I believe that's a part of it. And then the bladder is a muscle and it works. There's a delicate reflex between the brain and the bladder and the pelvic floor muscles. So I tell people your bladder right now is stronger than your pelvic floor. But that's definitely where behavioral training and management comes in and just education Super helpful.
Speaker 1:Yeah, I mean, I love this conversation. I could talk about the human body and all of this stuff for days upon days, so I really appreciate you talking and giving your expertise on this. So what would be three things you would recommend for a person to strengthen their pelvic floor right, especially during perimenopause?
Speaker 2:Yeah, and if it's appropriate for them to be strengthening.
Speaker 2:I think one of the most important things is to engage the pelvic floor, which a lot of us call that a Kegel, to engage your pelvic floor muscles.
Speaker 2:With increases of pressure, like a cough sneeze, laughing, lifting something that's heavy, instead of just letting that pressure push down on the pelvic floor. I'd say you're fighting back against that pressure with your muscles, you're closing those sphincters so that that pressure is not pushing down into your pelvic floor, which could cause a leak and which could lead to prolapse over time. That's number one. Learning how to breathe with your diaphragm muscle can be super helpful because the diaphragm and the pelvic floor work together. So when we take a deep breath in with our breathing muscle, the pelvic floor muscles relax and then as we exhale and we do consciously squeeze the pelvic floor, you'll get a better squeeze and it's just better for your body overall to be able to coordinate that deep core muscle system and, I guess, just not letting yourself feel like, oh, I'm getting older or I'm a woman, so it's expected to that these things will happen, don't. Don't think that. Go get the help that you need.
Speaker 1:Yeah, and if something doesn't feel right, go go ask for the help. So I like that. I mean that goes back to the mindset of just this isn't the help. So I like that. I mean that goes back to the mindset of just this isn't.
Speaker 2:yes, it's normal, but it doesn't have to be normal for you. You don't have to live through that right.
Speaker 2:Yes, oh my goodness, yeah, it's. Oh, I have a cavity in my tooth. Oh right, let's not go treated, give me a break, yeah, so recognize that a lot of doctors aren't that well educated when it comes to perimenopause and menopause. And so I worked with a woman who I was like oh my gosh, you really need to be using estrogen cream. Go talk to your urologist about it. And she came back and she said to me my doctor said I'm not sexually active, so I don't need it. I'm like you're 79 and you have recurrent UTIs and frequency urgency you need it. I will call your doctor right now and talk to her. This is ridiculous. So, yeah, you might need to see several different providers before you get the answer that you need.
Speaker 1:Isn't that? I mean, I think what? What'd you say in the last, within the last 10 years years? There's starting to be more talk in education about perimenopause and menopause. Right like when. Do you think that the medical field in teachings and educations are going to catch up with this?
Speaker 2:I feel like they're starting to catch up with it now, because there's a lot more vocal people on social media who are physicians yeah talking about it more and more celebrities talking about it more. So I feel like last two years it's becoming more well-known and more spoken about. A lot of these doctors are going through it themselves.
Speaker 1:And that was like going back to when I was pregnant and I saw my doctor after, right, like I was like I don't know, at the six week checkup maybe, and I was like I said, am I ever going to stop sweating? And what she said to me she goes, courtney, I never knew this type of stuff happened to women until I went through it and like my jaw just was like dropped because I'm like it's wild Right, and I'm just thinking to myself, respectfully, bitch, you are a guy in a car, you are an OBGYN. What do you mean? That you don't know that women go through this postpartum. So like that I was. Just like that was when I was like, oh wow, like this education has any, there's not much of the postpartum experience that these doctors can provide you know what I mean.
Speaker 2:It blows my mind that it's like if they're not going to give you a referral for pelvic floor therapy, at least tell your patients that it exists so they can go find the help they need on their own.
Speaker 1:And this is the kicker Even though I knew something was not right down there, I asked for the physical therapy script specifically for my back, because the bed rust fucked me up on my back. I mean I would be standing up rocking the dictator, I'm like, because the bed rest fucked me up on my back, I mean I would be standing up rocking the dictator. I'm like I'm so weak I can barely stand up right. So I initially went for my back and then it was in the physical therapist when she did the intake and I really loved this office and this woman and her team and it was the intake that then specifically got more to the questions about the pelvic floor.
Speaker 2:Good, it's not like we'll do that Right, right and not every pelvic floor therapist is the same, like it sounds like yours maybe didn't go over bladder health and education with you, not that I remember. Yeah, so we all do things differently, yeah.
Speaker 1:Right, right, so yeah, all right. Any tips that you have for somebody also to just cause you are as well as a hormone specialist, but any tips that you have for just to help women with the perimenopause, menopause, the change, any tips you want to suggest to them just to make it a little bit smoother.
Speaker 2:I know for myself. So I'm 42. And when I turned 40, I was like, what the hell can I do to help myself here with everything? So I got my eyebrows done, all nice. I got my face lasered because I'm like, oh my God, facial hair is a thing for women as they get older, so let's go take care of this now. And then, really, before I needed it, I asked my gynecologist for a prescription per topical vaginal estrogen cream, and so it can be very much used preventatively, number one. But then also finding somebody somebody in your area who can prescribe menopause hormone therapy for when you possibly need it, I would say can be super hormone replacement therapy, yeah, which we're now calling menopause hormone therapy for when you possibly need it.
Speaker 2:I would say can be super hormone replacement therapy. Yeah, which we're now calling menopause, hormone therapy instead of therapy. Yeah, and just figuring out what else you might need in that regard, because you can use that type of therapy plus the estrogen cream, do both, and then just work out, exercise, move your body and lift weights. Stay strong.
Speaker 1:Yeah, stay strong. I always have to give it back too. I always have to give a shout out to RIP Suzanne Summers, because I remember when she was talking about hormone replacement therapy and people thought she was nuts and that was the start of like, how I heard about hormone replacement therapy and this was what I think it was a long time ago, because you and I, we are the same birthday, same age, so this was probably I mean, I think she died in.
Speaker 1:I think she was 80 or maybe late 70s, so this had to have been like 30 years ago. I almost want to say, too she might've done some infomercials about, because I think she had her own supplement line. I'm going to have to look this up, I'm going to have to Google this after we're done, but I just remember her speaking about hormone replacement therapy and all this jazz and how it made her it made a world.
Speaker 2:Well, it was more widely used and then that study came out that claimed that it led to cancer and all sorts of other risks. So everybody stopped, and now doctors feel wary to prescribe it because of that study. That has since been basically debunked. So I highly recommend following along, if you're interested in that the physicians on Instagram who all they do is talk about the latest research as it relates to perimenopause and menopause.
Speaker 1:So that original study now they're saying was horseshit.
Speaker 2:Yeah, and there's an excellent book called Estrogen Matters that has so much good information in it. There's a lot of good books out there, but that one's very good. I feel like every doctor and every woman should read it.
Speaker 1:I'm going to link that in the show notes below. So where can people find you if they want to work with you? How?
Speaker 2:can they work with you Through my website's probably the easiest way. So the website is embracehealthandrehabcom, and so from there you can book an appointment, either in person or a virtual appointment, because we do that too. Oh nice, yep. And then I have an email newsletter that goes out weekly that I try to put tons of goodness into and lots of free guides. And then my course is also available. So through a link on my website, you're able to find that, which is basically pelvic floor physical therapy at home. So everything I teach my in-person clients, it's all together in that course.
Speaker 1:And do you with your in-person clients also to tell them what to be doing at home. You need to be doing exercises at home, yeah so, yeah, that's great that you have a course like that and such a great resource so people can be doing that at home. Because I mean, also too, I don't it all depends on your insurance. Okay so, I don't know everybody's insurance, but insurance will only cover so much physical therapy right Before it starts having to come out of pocket. That's what I know to be true in Michigan because of what I had to do. So I'm just saying your course could also be great in case your insurance is not able to cover all of that in-person stuff.
Speaker 2:Absolutely, and so many pelvic floor therapists have their own clinic where it's usually considered what's called cash-based, where we just don't even take insurance. Oh okay, and so I could really go into that into detail. But in my clinic we take Medicare and then we're just self-pay for the rest. But you can still submit it to your insurance company for reimbursement. It just doesn't go through us. And then, like health savings accounts, flexible spending accounts that can be used for visits with us, and that's just how a lot of clinics are, because that gives us more time with you. I have an hour with each person, where in an insurance-based clinic, they try to get more people in in less time, and that's kind of ridiculous. With what we're working on in pelvic floor therapy, we really need that extra time, and then you don't have to see us as often.
Speaker 1:Yeah. Do you then feel like a lot of clinics are starting to go the route that you have gone? I mean, which is great yes.
Speaker 2:Yeah, and that's basically how I modeled my clinic, after other clinics who have done that, because you need that time, and I started off in a hospital-based system where they wanted to cut the visits down to 30 minutes. I think I had 45 minutes and even just 45 minutes really wasn't enough time because there's so much to learn to really get the most bang for your buck out of each visit, and even those people with their in-network benefits they were paying hundreds and hundreds of dollars per visit because of their deductibles.
Speaker 1:So that's a whole other podcast. Yeah, that's a whole other thing of just talking about the insurance companies, because it's nuts.
Speaker 2:So hopefully that course is a cost savings for people for sure.
Speaker 1:Yes, and that is what I was trying to say is that it could be more cost effective for somebody to do that and just start doing it at home themselves and have that guide, because it's the same stuff that you're going to need to learn to keep on doing it. So thank you so much for sharing all of your knowledge and I appreciate you taking the time to speak to the good people of the world. And again, on another note, I'm very, very proud of you on your sobriety journey and kicking ass this last year and a half.
Speaker 2:Thank you and I appreciate you and I'm so thankful for you. So thank you.
Speaker 1:Thank you, all right, thank you for again talking today, and I will put all of Dr Christine's information down in the show notes. Thank you.