The Vagina Whisperer: What Every Woman Over 40 Needs to Hear

Have you ever been told that bladder leaks, painful sex, or pelvic floor problems are “just part of getting older”?

In this eye-opening episode, I’m joined by pelvic floor expert and “Vagina Whisperer” Dr. Sarah Reardon to talk about the symptoms so many women experience… but hardly anyone talks about.

We discuss:
• Why pelvic floor issues are incredibly common — but not something you simply have to put up with
• The huge impact perimenopause and menopause have on vaginal and pelvic floor health
• Why topical vaginal estrogen can be life-changing for many women
• How pelvic floor exercises really work (and why Kegels alone aren’t the whole story)
• What women can start doing today to feel stronger, more confident, and more comfortable in their bodies

This conversation is empowering, practical, and full of hope — especially if you’ve ever thought:
“Is this just what happens as we get older?”

Spoiler alert: no, it isn’t.

If you’re a woman over 40 who wants to feel strong, healthy, confident, and informed about your body, this episode is a must-listen.

Connect with the Vagina Whisperer:

Youtube: https://www.youtube.com/@thevaginawhisperer 

IG: https://www.instagram.com/the.vagina.whisperer/ 

Website: https://thevagwhisperer.com/ 

Vhive app: https://thevagwhisperer.com/membership/ 

Watch Stop Dieting Start Thriving: https://www.drorlena.com/stop-dieting 

Sign up for the Stop Dieting and Start Thriving Video: 

https://www.drorlena.com/stop-dieting

Looking for support? Book a free call with Dr Orlena: 

https://www.drorlena.com/book-a-call-dr-o 

Transcript

Dr Orlena: [00:00:00] Hello, and welcome to Fit and Fabulous with me, Dr. Orlena. I'm super excited today because we are talking to the Vagina Whisperer, Dr. Sarah Reddon. Welcome, welcome

Dr Sara Reardom: Thanks for having me

Dr Orlena: Do you want me to start a little bit? First of all, let me back up and tell people why I thought it'd be really interesting to talk to you.

I know that women of our age get so many symptoms of problems in our vagina, and I found you on the internet and thought, "Hooray, you'd be a perfect person to talk to." My own personal story is that I had twins. I have four children, so I had twins at the age of 38. And after I had twins, I really developed discomfort with intercourse, and I went to my midwife at the time, that was the person who was supposed to see me, and I mentioned this so many times.

I went back so many times over a period of years, and basically, they told me to take lubricant, and I, at the [00:01:00] time, didn't really know much and said, "How about estrogen?" And they fobbed me off. Now, years later on, when I know so much more about menopause and things like that, I look back and I think, "Oh, my goodness," that was such a missed opportunity, and I went through literally seven or eight years of discomfort for no particular reason.

I know, it's awful, isn't it? So that's why... That was my reasons of inviting you, thinking if somebody could avoid that would be amazing. But let's kick off, and you just tell us about who you are and what you do.

Dr Sara Reardom: Yeah. I'm Dr. Sarah Reardon. I'm a board-certified pelvic floor physical therapist. I'm located in New Orleans, Louisiana, in the United States. I'm also an author of a book called Floored available across the UK and Spain Floored: A Woman's Guide to Pelvic Floor Health at Every Age and Stage, and I'm the founder of the Beehive app, which offers at-home pelvic floor training for women during pregnancy, postpartum, perimenopause, and also experiencing painful sex.

So I've been in this field for [00:02:00] about twenty years, and it's really incredible to see the rise in conversations around pelvic floor health, but I still think there's so much that we need to understand about our own bodies as women, but also to help medical providers understand when could there be a pelvic floor component that needs to be addressed through therapy

Dr Orlena: Yes, entirely. And first of all, thank you so much for coming. But actually I talk about my discomfort during intercourse, but actually also I had really awful stress incontinence at that time as well, and I didn't realize that it was so amazingly common and that so many other people had it, but nobody ever talks about it.

Luckily my midwife did help me with that actually, and so I fixed that. But let's start by thinking about all the things that can go wrong, all the symptoms that women have

Dr Sara Reardom: I think what's helpful is to also just introduce folks to what the pelvic floor is. So what does it m- do day to day? So when you start having a problem, oh, this is a pelvic floor issue. So these muscles are [00:03:00] a basket of muscles that sit at the bottom of your pelvis. So you can envision that bony ring of that pelvic bone that we see on skeleton models or even, little skeleton jammies.

And at the bottom of that is an opening that in our bodies is covered by a floor of muscle. So it's literally the floor of your pelvis, and these muscles support your pelvic organs. So in the female body, there is support for the uterus and ovaries, the bladder which holds urine, the bowels which hold stool.

In male bodies, you have-- it supports the bladder and bowels, but then the prostate in males. So it's like a hammock supporting everything. And then you also have openings in, again, the female body for urine to exit the body through the urinary sphincter, for the anal sphincter for bowel movement, and then the vagina for vaginal intercourse, menstruation, and birth.

So these muscles are holding in pee and poop throughout the day. They're relaxing when we go to have a bowel movement. They're contracting and supporting us [00:04:00] through all throughout the day when we get out of a chair, when we lift weights, when we cough or sneeze. And so often when we see things go wrong, you may start to experience like leaks of urine, like little bladder leaks difficulty starting your stream or feeling like you're not emptying completely, frequent urination of of pee.

And then sexually, you may have painful sex, as you just mentioned difficulty having an orgasm, decreased sensation. We often think of sexual symptoms like somebody's, like loose or weak, but actually they can be quite tense, and that can be a source of pain with sex. And then bowel symptoms include like constipation, hemorrhoids, fissures, fecal leakage, staining in the underwear, things like that.

And then supportively, pelvic pain and then a condition called prolapse, which is when that hammock of muscles isn't supporting your organs as well, and they start to push into the vaginal canal, and it feels like there's pressure or heaviness in the vagina or something's falling out. So these muscles are integral to our day-to-day [00:05:00] function, yet we don't talk about them.

We're never educated, and then not until something goes wrong, and maybe if somebody says, "Oh, that might be your pelvic floor muscles," do we start to pay attention like, oh is there something I can do to train these muscles better?

Dr Orlena: Yeah, sure. And I think the thing about like now, we're so much more thinking about our muscles in general and becoming aware that we need to look after our muscles, so we happily go off to the gym, but that's not a muscle that we pay attention to unless we have a problem

Dr Sara Reardom: When, and so my goal was really to help us... with my book Floor it was, when people say, "Why did you read this?" And I said "Women deserve to understand their bodies. We deserve access to this information." I think depending on where you live or where your kids go to school, you might get, a health class on periods or maybe a health class on sex.

But we're never talked, taught about our pelvic floor. We're never given a health class on the pelvic floor. And so even from a young age of having a period, playing, being a female [00:06:00] athlete, starting to become sexually active, these conversations should be happening about the role of these muscles so that if you have pain with sex, painful periods, leakage during cheer or dance or running, you understand that your muscles are a component

Dr Orlena: Yeah, and it's totally fixable because I think a lot of times when these things happen, they're often embarrassing symptoms. We don't wanna talk about "Hey, you know what? I wet myself or pooped myself," or something like that. And then so we don't wanna talk about it, and then there's this really big fear that perhaps that's it.

I remember my poor grandmother when she was 80 and had horrible fecal incontinence and urinary incontinence, and I suspect that actually if she'd done talk to you, that wouldn't be the case. So knowing that there are things that we can do I think is really reassuring

Dr Sara Reardom: It is, and I think it also gives us a lot of hope. The narrative, I think for me growing up was do your Kegels for a tight vagina and better sex, which is not, again, always necessary. And two, that diapers are [00:07:00] your destiny. You walk down the aisle of the grocery store or the market, and it's tons of incontinence pads, and our grannies are in, pads and diapers because our m- muscles get weaker with aging.

But all-- everyone's muscles get weaker with aging, but what do we tell them to do? Strength training, do your exercises for bone health and heart health. But again, we need to train our pelvic floors for pelvic floor health to prevent that incontinence later down the line

Dr Orlena: So what are the main problems that people experience?

Dr Sara Reardom: I think it all depends on the season of life that you're in. If you're a young woman say, or if you have young children menstruating, painful periods are not normal. So if you have a young daughter and she's experiencing painful menstruation, that is a red flag that something more serious could be going on, like endometriosis or adenomyosis, which is something that needs to be treated.

If you have like light cramping, some bloating, that's normal. But if the pain is so severe that you're having to miss work or school or socializing, taking [00:08:00] pain medications, those are all red flags. So painful menstruation. Other things are if you are-- if you have a young female athlete or if you're an athlete or exerciser, leakage, if you leak with jumping jacks or jumping in the bounce house or lifting weights or even coughing and sneezing, any type of leakage is information that the muscles are not holding in urine as well as they should and need to be treated.

You may need pelvic floor strengthening, or you may need pelvic floor relaxation first and then strengthening. No amount of leakage is normal, and unfortunately, it doesn't get better. After the age of thirty-five, we lose two percent of our urinary sphincter muscle strength every year. So you have to really start proactively strengthening these muscles, even if you don't have problems, to help combat the muscle changes with time.

And then again, we talked about sexual health symptoms like painful sex. Again, no amount of pain is normal. It's information from our bodies that something's not working [00:09:00] well. Orgasm issues like, leakage during orgasms, the inability to have an orgasm. You'd be surprised, almost ten percent of people aren't able, have never had an orgasm, and that's a muscular contraction of the pelvic floor.

So it's important to be able to recognize that, oh, that could be either they have an-another a pelvic floor issue or, we wanna train their pelvic floor muscles so they can achieve that. And then we talked about prolapse, pooping problems as well. So really, I always say anything from ribs to knees, your pelvic floor could be a component.

Dr Orlena: Wow, that's amazing. I hadn't really considered so many different things. And then I think as well, thinking about things that make it worse. So for me, the incontinence definitely came. I had twins, and I was enormous when I had twins, and I think all that extra weight on my poor pelvic floor did not help it.

So I presume that's the same with actually if you're overweight as well, that losing weight is gonna help the situation

Dr Sara Reardom: That's a great point. Pregnancy birth, and menopause are the three biggest [00:10:00] risk factors for developing a pelvic floor issue. 100% of us will go through menopause, like all of us. Not a single woman who lives long enough will go through menopause. So unfortunately, that means we have to take care of our pelvic floor in the second, in midlife and beyond.

Vaginal birth make you more susceptible because the muscles are being stretched and lengthened. There could be nerve injuries, there could be tearing at the base of the vaginal opening, which can compromise how the muscles are functioning. But pregnancy itself, as changes the pelvic floor. So whether you have a C-section, a singleton, a birth of multiples, your pelvic floor is stretching and lengthening and getting weaker just through pregnancy.

So I really encourage women to start seeing a pelvic floor therapist during pregnancy to proactively train their muscles and then help prepare them for birth, and then they're already comfortable to return postpartum. But having more than so with every vaginal birth, your risk goes up of a pelvic floor issue.

So you had three births and you had singleton, multiples, which I'm a twin as [00:11:00] well, and I'm the fourth baby. So I love that you have a big family and that your caboose is a set of twins because that's me. I always say we weren't a mistake, we were a surprise, but I... So anyways, those are all risk factors.

And then aging, again, you had your babies later in life when your muscles are already muscle tone is decreasing. But even things if you've never given birth, lifting heavy weights while holding your breath, straining with bowel movements, chronic constipation even stress.

Dr Orlena: just ask about the-- well, number one, I just wanted to make the point as well, you talked about menopause, and I'd like to just go into that a little bit more. But actually, what happens to a lot of people at menopause is they put on abdominal weight, and we talk about this quite a lot, like all the reasons why the drop in estrogen leads to abdominal weight.

But now you find you've got a drop of estrogen, and you've got this extra abdominal weight.

Dr Sara Reardom: it's true. So

Dr Orlena: But I was gonna ask you... Yeah, go on

Dr Sara Reardom: I'll say that, so there's actually research to say that five pounds of abdominal weight can make someone incontinent versus [00:12:00] and leak urine. So you're very right. Having more abdominal weight and weight in general puts more pressure on your pelvic floor. So I'm not like, "Hey, everybody get on medicine and lose it."

But we do have to think about the influence that all of these physical changes have on our bodies and our pelvic floor and weight gain is one of them

Dr Orlena: And so going back, you said weight, lifting weights and holding your breath. How does-- is that increasing the abdominal pressure?

Dr Sara Reardom: That's correct, Orlena. When you hold your breath, it kind of locks that pelvic floor in place and doesn't allow you to contract and relax it. So I always tell people to exhale with exertion. If you're lifting weights, exhale when you're lifting. Exhale when you're lifting a kid, lifting a stroller, lifting a heavy box, pushing a piece of furniture.

That pressure, if you hold your breath, is gonna find a way out of your body because you're not exhaling it out. So it can go towards your abdomen. It can go, you can have, get a hernia, you can get a hemorrhoid, or you can get pelvic floor issues, particularly in people with vaginas, because that's an area of weakness.

So that pressure's [00:13:00] just gonna find its path of least resistance

Dr Orlena: And so coming back to menopause, is the issue with menopause just in terms of all muscles, we lose all muscle strength, we lose that ability to strengthen our muscles? Is it the same or is there another thing that's going on with menopause?

Dr Sara Reardom: So some of it is muscle weakness over time, and obviously another one is hormonal changes. You have fluctuating levels of estrogen during perimenopause, so the time period before menopause, which can last up to ten years and can start in your thirties. And that lower estrogen levels, which is-- the low estrogen, which is gone.

You have no estrogen after menopause, which is menopause is, twelve months of no period. You have no estrogen. And estrogen is a hormone. I call it our fertilizer for our lawn. Estrogen helps plump everything up and keep it lush. It keeps our skin lovely. It keeps our hair thick.

It keeps your vaginas lubricated, and it plumps up the muscles and tissues in the vagina and the pelvic floor. So [00:14:00] when you have less estrogen, we see it externally in our skin and our hair, but in the pelvic floor you have thinning vaginal walls that can cause dryness painful sex risk of infections.

You can have itching 'cause the skin around the labia and the vulva gets dry and itchy. W-more incontinent, so more leakage because you don't have as much muscle mass and estrogen in the area. And then also more bladder irritation, so frequent urination, urinary tract infections, urgency to pee, all of those things.

So your bladder health your sexual health, your vulvar health, all of those things are affected because of the estrogen changes and the muscle weakness. So when we-- A lot of menopause providers are getting more comfortable with the thought of prescribing local topical estrogen. And I say this is important because local topical estrogen, so a cream or a tablet that you put in the vagina or on the outside, is different than systemic estrogen.

So systemic estrogen is [00:15:00] what we call hormone replacement therapy or menopause hormone therapy. It's a pill, a patch, a gel that goes into your bloodstream, right? Local vaginal estrogen just goes on the vulva and vagina and just targets those tissues. So if you're doing one, you're not doing the other.

If you're taking systemic estrogen, you still need to be doing the local cream on the vulva and vagina. They're very different things, and every woman should be on local vaginal estrogen. Everyone. The absorption...

Dr Orlena: day? So I 100% agree with you, and I'm taking HRT, and we have a gel here actually. But init- initially they prescribed it once a week. Now I take it twice a week. I don't know. Does it make any difference? I guess it depends on the formulation

Dr Sara Reardom: So the typical recommendation is every day for two weeks to get started, to flush the tissues with a lot of that kind of juicy hormone, and then twice a week ongoing forever. Some doctors will say do it three times a week, but you wanna make sure that you're really getting it inside of the vagina and on the [00:16:00] outside, on the labia and the clitoris, and all of those external tissues because estrogen receptors are everywhere.

I'm a pelvic floor physical therapist, so I do not prescribe estrogen, but I see a lot of vulvas and work with a lot of vaginas, and so I'm often sending people back to a nurse practitioner or a midwife or doctor and saying, "We can do strengthening till the cows come home, but you have to be on this topical estrogen to help those tissues stay really healthy."

Dr Orlena: Okay, perfect. I'm just gonna repeat that again. You said that everybody needs to be on this, full stop. Yeah

Dr Sara Reardom: Correct. And, I know that there's concerns with obviously, a risk of estrogen-driven cancers, endometrial, ovarian, breast cancer. And so the absorption into the bloodstream of this local estrogen on the vulva and vagina is so low it doesn't even show a change in your blood levels of estrogen.

So it's such a low dose it doesn't even show up. But if you're not comfortable taking it, then don't take it. There-- I am-- I think we need to meet people where they are, and we can [00:17:00] say, it's safe," but if they don't feel like it's safe for their bodies, then we should respect that. But there are other things that you can do for the area and for moisture that I recommend as well.

Dr Orlena: And in terms of if you're taking HRT, are you still not getting enough to give that area the amount that it needs?

Dr Sara Reardom: Correct. You are not. It needs to go directly on the tissues

Dr Orlena: Perfect. Yes, and I have to say since I've started taking it, which has been a few years now, I've really noticed a significant difference. And as I say, I don't quite understand why they didn't give it to me 10 years ago. But there we are. And as I-- as you say, I think it is partly education. I think over the years I think the difference is I am now menopausal, whereas at the time I was clearly just starting perimenopause, and perhaps that wasn't recognized.

But these things can also be given in perimenopause as well, can't they? You don't have to wait until

Dr Sara Reardom: I'm 43 and I've been taking it-- I use topical vaginal estrogen for the past two years, and I-- one of the things that's interesting is that I actually got introduced to it when I was postpartum because [00:18:00] I was breastfeeding my kids for, practically till they were driving. They're-- I was just a long-term breastfeeder.

And I could notice something is not right down there. The tissue felt frail and thin and, I just was like... So I went to see my gynecologist and she was like, "Oh, these are low estrogen changes," which when you're breastfeeding, you have high prolactin, which is the hormone that helps produce milk, which means you have low estrogen.

That's why you don't get your period back oftentimes for a long time if you're breastfeeding or pumping. So low estrogen, same thing. It's like your vagina's in menopause when you're postpartum. And so I used topical vaginal estrogen and I was like, "Huh." So one, postpartum moms can be on this if they have similar issues, and two it dramatically improved the health of my vagina and vulva.

So now when I was 40, 41, I was like, I'm-- I need this. I could already start feeling the changes. I need more lube during sex. I'm having to pee more frequently. I do a vulva check every month with a mirror, and I'm like, my labia is getting thinner. And these are all signs that [00:19:00] estrogen is getting lower and that you need to start using the topical cream in

Dr Orlena: I used to get little cracks and I could feel them. They were quite painful. The skin had just cracked for no apparent trauma

Dr Sara Reardom: And as a pelvic floor physical therapist, the way that we evaluate your pelvic floor muscles is by doing an intravaginal muscle exam. So it's similar to going to a midwife or gynecologist, but there's no stirrups, there's no speculum. We use a gloved lubricated finger, and I will do internal exams and assessments on people's muscles, and I pull my glove out and there's like pink, pink on it, like they're bleeding because they have these little micro tears.

And this is where I'm like, "I can't even do the pelvic floor training because the tissues are so thin." And that's when I say "We've got to get you on some topical vaginal estrogen because the therapy can't even be beneficial if we're not addressing the tissue health."

Dr Orlena: Perfect. So I think we've addressed medications, and then there is some work that we need to do, so we do need to do some strengthening. Do you wanna tell us how we do that?

Dr Sara Reardom: Absolutely. We've all probably [00:20:00] heard of a Kegel, which is a pelvic floor muscle contraction. A Kegel got its name by a gentleman, a gynecologist, Arnold Kegel, in the '70s, who was testing the strength of a woman closing her vagina after birth. And of course, he named the exercise after himself.

And so we now call them Kegels, but they're really pelvic floor muscle contractions. And that's like you're stopping your urine stream or kind of holding in gas. So I don't want you doing Kegels when you're peeing, but it's that same maneuver where you're, like, closing the sphincters and lifting up. My favorite cue to teach people to do this is think...

Sit up nice and tall, so don't be slouched. Take a nice deep breath to kind of inhale and exhale, make sure that you're not holding any tension, and then think about your vagina sucking up a thick smoothie. And it's a funny cue, but if you actually think about a sucking up, it's like your muscles pull up.

You don't tighten your butt, you're just pulling those muscles up, and that's a pelvic floor contraction. [00:21:00] So that's really the basis of strengthening your pelvic floor, but you can't just do these pelvic floor contractions when you're sitting in the car or sitting at your desk because that's not when you're leaking, right?

That's not when you need that strength. So you take this contraction and you start learning how to do it with squats and lunges and weighted workouts, and then you build it into the other exercises you're doing, whether it's Pilates or barre or weightlifting. So by strength training your pelvic floor, you can also be strength training your whole body.

My app that has pelvic floor workouts, it's not just like sitting in a chair doing Kegels. It's learning to use these muscles during the day-to-day functions that we need them to work, like holding your bladder so you can get to the bathroom jumping running, laughing. We need these muscles to be working during all of those activities.

Dr Orlena: Perfect. And I suspect everybody who's listening to this now is busy doing kegels as you talk about this

Dr Sara Reardom: It's good for us. We're never taught to connect with this with this [00:22:00] muscle. And I think what's important, because you need to contract the muscle, but you also need to relax the muscle. So many of us just walk around with our muscles so tight, and that's not gonna strengthen your pelvic floor.

It's like holding a bicep curl all day and thinking that's gonna strengthen your bicep. No, it's just gonna cause it to be tight. So you wanna contract and relax when you're doing these con-- pelvic floor contractions. You also wanna hold them for endurance, so not just a squeeze and release, but like squeezing and holding for five or ten seconds and then relaxing and then doing them in different positions.

Do them in standing. Do 'em when you're walking. Pre-contract before you're lifting a weight. Those sort of things to really get the muscles stronger

Dr Orlena: And I don't know, when I first went to my midwife and they did that pelvic floor assessment, they said, "You have zero out of five." And I was like, "Great." that kind of meant I really couldn't do a Kegel. I would try and do a Kegel, but I couldn't. Actually, here in Spain, I don't know if you do these things or if they have made their way [00:23:00] to America, but we did things called hypopressive exercises.

I don't know if that's something that you use or

Dr Sara Reardom: more popular in Canada and in Europe, but there, there is an exercise called hypopressives, but it my understanding of that, it creates this like vacuum inside, like a negative pressure environment to help engage that pelvic floor

Dr Orlena: Yeah, and I found them very... So I had to go off and, they said, "Go and do these exercises." And it got me up to I can't remember whether it was two or three. But I did find them useful. But I think w- you could use both

Dr Sara Reardom: You can, oh, you can use... There's so many different ways to do this. It's not, but I think the goal is like, we want people to be thoughtful about it. We want it to be top of mind because these muscles don't strengthen themselves, they don't, after birth, postmenopausal, they don't just get stronger on their own.

And so we have to be very thoughtful about how we're doing it. And then, the other thing is some people don't need Kegels. Many women have pelvic floor tension, and they need to work on relaxation. So if you have pain with sex, deep hip pain, back [00:24:00] pain constipation, incomplete bladder emptying, even sometimes leakage the muscles may be too tight or tense, and we have to relax the muscles first with yoga and stretching and breathing before we do a bunch of strengthening

Dr Orlena: what about those little balls? I don't know, I just presume you're aware of them, but those little balls that you, they're weighted little balls and you're supposed to... Do they help?

Dr Sara Reardom: weights or Kegel balls. They can absolutely be helpful. If you use them, don't use a lot of lubricant when you use them because they can fall out, slide out pretty easily. If you have prolapse, it may be initially hard to use them because they'll not stay in.

But I like to do a couple things with them. You can insert them into the vagina and you do some contractions with them. You can do movement with them, like squatting and sidestepping, and they come in different weights. So you can start with the lowest weight and then gradually sh- like increase your strength to get up to a higher weight.

And then I also even like to do a little bit of what we call resistance training. So they have a string on the end of them, some of these weights, and you can pull the string and your muscles f- it's like a tug of war, [00:25:00] and then your muscles try to squeeze tighter to hold it in.

So these are all different ways you can use them. So I think weights are great. Especially some folks they can't tell if they're squeezing around properly, so it gives them something to squeeze around, and that can be a good feedback mechanism for them to get started.

Dr Orlena: Definitely something you need to do at home then, not at the gym

Dr Sara Reardom: Absolutely do it at home. And all of these things, eventually we wanna use them, but we also want to just have our muscles working for us when we're working out. So if you are, doing hypopressives or doing again, other workouts, like eventually you... These muscles are strengthening when you're doing, when you're lifting weights and doing other workouts.

You don't have to be so thoughtful about it. But like every other muscle, if you don't do a maintenance program to keep them strong, they'll get weaker over time. Just, I always say this, it's every other muscle, it'll get weaker if you don't use it, and it will get stronger if you continue to train it

Dr Orlena: Perfect. So before I ask you about your app, is there anything else that we've left out that you feel we should mention?

Dr Sara Reardom: I think just more than [00:26:00] anything I just want folks to know that it's never too late. If you've had symptoms for, like yourself, 10 years, it's never too late to get help. Don't feel like, "Ugh, I've just had this for so long, I have to deal with it." Because, in the second half of our lives when you've raised your kids and you've got a lighter workload or...

We deserve to have active, fun, fulfilling lives. And over 50% of women stop exercising because of bladder leakage or bowel leakage. So if-- Yes. And so if we're kinda saying "Hey, exercise for bone health and heart health and osteoporosis and blood pressure," a lot of women can't do that. So we have to really think about the importance of this foundation.

And there are different ways to access this care. It could be in person, it could be virtual visits, it could be reading my book, it could be using my app. So I don't want people to think the only way to get care is one-on-one, because we have a lot of options now, and I just encourage you to find something that works for you

Dr Orlena: Perfect. That is a very good cue into tell us about your app, please

Dr Sara Reardom: Yeah. So I've had online workout programs for [00:27:00] years since, post-COVID era when everybody was, at home. And then in 2025, I launched my app called The V Hive, which is a mobile app that is-- You can get it on Google or iPhone devices, and it's got over 300 pelvic floor workouts. It's everything from, pregnancy to postpartum for strengthening, for painful sex.

We have yoga. We have barre. I just added, like-- I'm adding a chair yoga because I had some, women who were older and they're like, "I can't get on and off the ground, but I need to do pelvic floor relaxation." So I really-- I respond to what people are asking for. Everything in there people have said I need this.

I'm having a hysterectomy. What can I do afterwards?" So I have a post-surgical program. So all of these are at-home pelvic floor ex-- workouts for either strengthening or relaxation, minimal equipment. The workouts are, like, 10 to 20 minutes. They're not 30 to 45 minutes. I don't have 30 to 45 minutes, so I'm always like, "What can I do?" And and you can try it for free. So every... There's a seven-day trial, so try it. I'm, like, a big [00:28:00] try before you buy person. Try it, download it, see if you like it, and then there's so much in there for you and even just a ton of pelvic floor tips. If you just have a whole section, if you put in menopause, you'll get a ton of tips on menopause and perimenopause and all the pelvic floor changes that can happen and things you can do to address them at home

Dr Orlena: Perfect. I am definitely gonna try. To be honest, I have to confess, I think I did know about your app, but it hadn't really got into my radar. And so if I'd been really organized, I would've done that a week ago.

Dr Sara Reardom: No, that's fine. That's fine. That's why, I think that there's always new things coming out and different resources to support people. And my goal is to really get this app into birthing centers and, with menopause providers, because I think that, again, nobody's telling us this stuff, and we're not finding out about it until we like have a problem or listen to a podcast or our girlfriend tells us.

So I just really want this to be integrated into healthcare, just like going to the dentist or getting a mammogram. Like these should be things that we're just proactively educated to, on how to do.[00:29:00] 

Dr Orlena: Yeah, and I think you talk about dentists. I think that brings up a really good point. All of this, a lot of the stuff that we do that you teach is really like brushing your teeth, and it's like we're so trained to brush our teeth, and we don't really want to find out what happens when we stop brushing our teeth.

And it's exactly the same thing, like eating healthily, doing our exercises. We don't really want to find out what happens when we stop doing these things. And it almost feels I do all these exercises and there's no results, or it feels a bit invisible. But if you stop doing them, then you start seeing the negative impact, like urinary incontinence, perhaps not now, but in 10, 20 years' time.

And now is the time we can really think about avoiding that and never getting there

Dr Sara Reardom: Yeah. And I think that we also don't even realize what is a pelvic floor problem? Like pain with sex, is that a pelvic floor issue? Hip, deep hip pain, is that a pelvic floor issue? Constipation. But again, I'm like, if it's between your ribs and your knees, like just get your pelvic floor checked or kind of start using some of the tools and things [00:30:00] you can do at home and see if you can get some relief.

Dr Orlena: Yeah. So what I'm really hearing is estrogen, vaginal estrogen for everybody, and exercises for everybody. Here's another question for you quickly before you go. If you're looking at somebody who's just really thinking they just want to maintain their strength, how much exercising do you think they need to do per week?

If they're somebody who's

already exercising

Dr Sara Reardom: yeah, I love it. Typically we say three times a week, 10, 10 to 20 minutes. But if you're already lifting weights, you just pull that pelvic floor contraction into your weightlifting. If you are doing Pilates, you're just more thoughtful about pulling your pelvic floor in versus not.

The recommendation from the, in the US, the National Academy of Sports Medicine it's, three times a week, 10, 20 minutes a day. But these are small muscles,

Dr Orlena: And then also what I'm hearing you say is if you've got a routine, you just incorporate it into your routine. So it's not extra, it's at the same

Dr Sara Reardom: Correct. It's like it's, you're getting more bang for your buck, right? You're already doing this.

And but I think that's what the V [00:31:00] Hive app does, is it trains you to know how to engage those muscles, and then you can bring it into the world that you live in to make it easy and accessible

Dr Orlena: Perfect. Thank you so much for spending some time with us. It's been really enlightening and really inspiring

Dr Sara Reardom: Thanks for having me