Affirmations for Black Girls

Episode 444 | The Pain We Carry Quietly: Breaking the Silence on Pelvic & Reproductive Health
Host: Tyra The Creative
Guest: Dr. Janelle Frederick, Pelvic Floor Therapist
Release Date: December 3, 2025

Episode Overview

In this powerful episode—the first of a three-part series—Tyra The Creative sits down with Dr. Janelle Frederick to explore pelvic and reproductive health, focusing on why reproductive and pelvic pain is commonly ignored, especially by Black women. The conversation breaks taboos surrounding “what’s going on down there” and shines a light on the ways medical care and societal conditioning have led many Black women to suffer in silence. The episode is a call to action: listen to your body, ask questions without fear, and reclaim your health.

Key Discussion Points & Insights

1. Why We Ignore Pain: Social & Cultural Layers

[03:02, Tyra]

• Tyra notes the generational and cultural weight of being taught to be “strong,” avoid “making a fuss,” and keep personal health struggles quiet.
• She frames the episode as a safe space to break these habits, acknowledging both the trauma and the dismissal Black women face about reproductive pain, even from medical professionals.

Quote:

"We are uncomfortable with talking about what's going on down there. There's trauma. There's dismissive comments like 'you'll be fine' from people around us. And far too often, even doctors do not take our concerns seriously." — Tyra [03:02]

2. Demystifying the Pelvic Floor: What Is It, Really?

[09:43]

• Dr. Janelle explains that everyone has pelvic floor muscles, but one in three women experience pelvic floor dysfunction.
• The pelvic floor supports the bladder, rectum, and uterus, stretching from the pubic bone to the tailbone.
• Symptoms of dysfunction include:
  • Bladder leakage or urgency (e.g., needing to pee often or pushing out urine)
  • Bowel dysfunction (e.g., frequent straining, pain, or bleeding during bowel movements)
  • Pain with vaginal exams, tampon insertion, intimacy, or even sitting
  • Lower back pain, which is often actually pelvic in origin

Quote:

"Our pelvic floor muscles is something that everyone has, all genders. But as women, one in three women have pelvic floor muscle dysfunction." — Dr. Janelle Frederick [09:43]

Memorable Analogy:

"Imagine your muscles contracting or tightening when they should be opening. And so that can lead to constipation as well." — Dr. Janelle Frederick [11:26]

3. Recognizing & Reframing Symptoms

[18:55]

• Many women dismiss symptoms as “normal” or inevitable after childbirth or with aging.
• Dr. Janelle urges listeners not to write off:
  • Bladder control issues (especially post-partum)
  • Pain during urination, intimacy, or Pap smears
  • Pain that’s repetitive, not just a rare one-off
• She provides a guide to healthy bladder function:
  • Should be able to go 2-4 hours without urinating
  • No more than once per night
  • No pushing required to urinate and no pain

Quote:

"Bladder leakage after a baby or as we get older is common, but not normal." — Dr. Janelle Frederick [19:03]

4. Action Steps: Who to See & What to Do

[22:12]

• Pelvic floor therapists (not just OBGYNs or primary-care doctors) are the specialists for these symptoms.
• You can often go directly to a pelvic floor therapist; a referral isn’t always required.
• Initial treatment is non-invasive: no surgery, no medication.

Quote:

"The primary provider that will help you overcome it non-invasively...is us pelvic floor physical therapists...You can come straight to us. You don't actually have to wait on that referral." — Dr. Janelle Frederick [22:28–23:02]

5. Movement & Healing: Pilates, Yoga, and Muscle Tension

[23:16]

• Pilates is popular but can increase tension in the pelvic floor if you have symptoms or underlying dysfunction.
• For those with pelvic pain, Dr. Janelle recommends starting with “down training”: yoga, stretching, meditation, breathing exercises—before ramping up to strengthening routines like Pilates.

Quote:

"Pilates could potentially just add more tension...first work on down training...then, when your body is starting to open and lengthen and decrease pain, it may be more supportive to do Pilates at a later time." — Dr. Janelle Frederick [24:14]

6. What Does Pelvic Floor Therapy Look Like?

[24:59]

• Dr. Janelle’s practice is virtual, empowering women to use tools like dilators and wands at home.
• Therapy focuses on education, tools, guided exercise, relaxation strategies, and nervous system regulation.
• The ultimate aim: reduce “fight or flight,” release tension, and restore function.

Memorable Analogy:

"Pelvic floor tension is like your hand being in a fist all day long...It actually weakens the muscles too." — Dr. Janelle Frederick [25:24]

7. Healing Is Power: Final Reflections

[26:39]

• Tyra reiterates the need for these conversations, especially for Black women conditioned to “push through everything.”
• Empowerment lies in listening, learning, and questioning: “That is how we take our power back.”
• Dr. Janelle’s contact info and part two’s upcoming date are shared.

Quote:

"These topics aren't always easy to talk about. We've been taught to just push through everything, to dismiss our discomfort and sometimes even ignore our own bodies. But listening, learning and asking questions—that is how we take our power back." — Tyra [26:39]

Notable Quotes & Moments by Timestamp

• On breaking silence:

  “We're taught to be strong, not to make a fuss or just to keep it pushing…Far too often, even doctors do not take our concerns seriously." — Tyra [03:02]

• On muscle confusion:

  "Imagine your muscles contracting or tightening when they should be opening…that can lead to constipation as well." — Dr. Janelle Frederick [11:26]

• On pelvic floor therapy accessibility:

  "You can come straight to us. You don't actually have to wait on that referral." — Dr. Janelle Frederick [23:02]

• On Pilates and tension:

  “Pilates could potentially just add more tension…first work on down training.” — Dr. Janelle Frederick [24:14]

• On muscle tension:

  "Pelvic floor tension is like your hand being in a fist all day long." — Dr. Janelle Frederick [25:24]

• On reclaiming health:

  “Listening, learning and asking questions—that is how we take our power back.” — Tyra [26:39]

Key Timestamps

• [03:02]—Tyra’s framing of the episode’s purpose, addressing silence and dismissal
• [09:43]—Dr. Janelle explains pelvic floor muscles and dysfunction in detail
• [19:03]—Debunking “normalization” of bladder issues and other symptoms
• [22:12]—When and how to seek out pelvic floor therapy
• [23:16]—Discussion on the pros and cons of Pilates for pelvic health
• [24:59]—Breakdown of what virtual pelvic floor therapy looks like
• [26:39]—Closing empowerment message and preview of part two

Tone & Takeaways

• The conversation is warm, authentic, empathetic, and rooted in Black women’s lived experiences.
• Both host and guest emphasize self-advocacy, de-stigmatizing conversation, and the belief that wellness is not only possible but a right.
• This is a vital listen for anyone ready to break the cycle of silence around reproductive and pelvic pain—especially Black women conditioned to downplay their symptoms.

Coming Up

Stay tuned for part two (December 17, 2025), where Tyra and Dr. Janelle dive even deeper—how to interpret pain signals, the right questions to ask, and actionable steps to reclaim reproductive health.