Affirmations for Black Girls

Episode 447 | The Body Keeps Score: Practical Tips for Taking Care of Your Pelvic Floor with Dr. Janelle Fredrick
Date: December 17, 2025
Host: Tyra The Creative
Guest: Dr. Janelle Frederick (Pelvic Floor Therapist)

Episode Overview

This episode is part two of a powerful series exploring Black women's reproductive health, with a special focus on pelvic floor care. Tyra The Creative welcomes back Dr. Janelle Frederick, who dives deep into how hormonal changes, everyday stress, and life experiences can manifest as pelvic floor dysfunction and pain. The conversation is affirming, frank, and intentionally centered on issues Black women face when navigating reproductive wellness—from misdiagnosis to shame to actionable lifestyle changes.

Key Discussion Points & Insights

1. Unpacking the Causes of Pelvic Pain (04:14–07:24)

• The Role of Hormones

  • Hormonal imbalances—like PCOS (Polycystic Ovary Syndrome)—may lead to irregular periods, excessive bleeding, and changes in libido, but don’t typically cause pelvic floor dysfunction directly.
  • "If it's just hormones...it may contribute to stress, which then could lead to the dysfunction. But directly, hormonal insufficiencies or hormonal imbalances don't necessarily cause pelvic floor dysfunction." — Dr. Janelle Frederick (05:24)

• Vulvodynia Explained

  • Vulvodynia is chronic vulvar pain, often described as stinging, burning, or aching, typically misunderstood or misdiagnosed—especially in Black women due to differences in the language used to describe pain.
  • "Vulvodynia is a condition that causes pain anywhere on the vulva...most women don't have the name for it, but they can't wear jeans, because there's stinging or burning sensations." — Dr. Janelle Frederick (06:08)

• Diagnosis & Treatment

  • Vulvodynia can have hormonal or muscular causes; pelvic floor tightness is a common culprit.
  • Discontinuing long-term birth control can reduce pain for some; more rare cases (proliferative vulvodynia) may need surgical intervention.
  • Vulvodynia is reported as the number one cause of painful intercourse. (08:26)

2. Why Black Women Are Often Misdiagnosed or Dismissed (10:12–13:22)

• Systemic Issues in Medicine

  • Misconceptions persist among physicians that Black women have higher pain tolerances ("black superwoman" trope).
  • "Doctors were actually taught...that Black women have a higher tolerance to pain—and that we cannot feel pain. Just a few years ago...a good 40% of [doctors] still believe that." — Dr. Janelle Frederick (10:25–10:51)

• Cultural & Personal Barriers

  • Cultural reluctance to speak openly about pelvic pain or sexual health, often influenced by upbringing, shame, or religious backgrounds.
  • "Most people don't even tell the doctor or their partner if they're experiencing pain, which is...sad. Because the person that is your soulmate...even they are not aware." — Dr. Janelle Frederick (11:55)

• The Power of Language

  • Black women tend to say "aches" instead of more clinical descriptors like "burning" or "stinging," contributing to misdiagnosis.

3. Reframing Normalcy in Reproductive Health (15:26–16:59)

• Pain Should Not Be Normalized

  • Many have learned to accept period pain, painful intercourse, or pelvic exams as normal.
  • "It should not feel like you're about to go into labor. If you feel you have to take off from work...be curled up for hours, that's a signal." — Dr. Janelle Frederick (16:59)

• Real Talk on Menstrual Health

  • Not all periods are supposed to be intensely painful—mild discomfort may be manageable with OTC medication, but severe pain is not typical.

4. The Role of Lifestyle & Nutrition (26:08–31:12)

• Foods Supporting Pelvic and Reproductive Health

  • Magnesium-rich foods (greens, almonds) help relax muscles and reduce pelvic pain.
    • "Spinach especially is rich in magnesium...anything magnesium-rich is going to relax muscles." — Dr. Janelle Frederick (27:34)
  • Zinc plays a role in menstrual regulation and conception ("zinc spark").
  • Omega-3 foods (salmon, walnuts, avocados) reduce inflammation and support hormone production.
    • "Walnuts actually have more Omega 3 than salmon...eight walnut pieces have a decent amount." — Dr. Janelle Frederick (30:22)

• Practical Tips

  • Incorporate leafy greens, nuts, seeds, and fatty fish for pelvic and hormonal health.
  • Vitamin D is essential; low levels linked to worsened period symptoms, mood disorders, and fibroids. (19:32)

5. Self-Advocacy & Breaking the Silence (13:22–14:03)

• Speaking Up With Providers
  • It can be difficult, but it's crucial to describe symptoms fully and push for answers.
  • "Open up and talk to your doctors, y'all." — Tyra the Creative (14:03)

6. Stress, Sleep & The Pelvic Floor (16:59–18:55)

• Stress and Hormonal Health
  • High stress and insufficient rest increase cortisol, which lowers progesterone, leading to heavier, more painful periods.
  • Simple interventions: prioritizing sleep, stress management, and overall emotional wellness.

Notable Quotes & Memorable Moments

• On the Power of Language in Diagnosis:

  • "We say things like, it aches down there...we're getting misdiagnosed because a lot of doctors are looking for specific descriptors of pain." — Dr. Janelle Frederick (08:27)

• Reclaiming Normal Pelvic Health:

  • "It's not supposed to hurt at all...not even on the first time." — Dr. Janelle Frederick (09:22)

• On Normalizing Discomfort:

  • "If you believe that it's supposed to hurt, when does it go away? When does it become normal for it to NOT hurt?" — Dr. Janelle Frederick (09:37)

• Addressing the Black Superwoman Complex:

  • "We don't want to look weak, we don't want to complain, we don't want to be a burden." — Dr. Janelle Frederick (10:51)

• Vitamin D’s Hidden Role:

  • "Vitamin D also is a hormone...if your vitamin D levels are low, you're at a higher risk for depression...mental health and pelvic health, even fibroids." — Dr. Janelle Frederick (19:32)

• On Self-Advocacy:

  • "I have to prep myself to say these types of things because I am not conditioned to say what is going on with me." — Tyra the Creative (13:25)

Timestamps for Important Segments

• 04:14 — How hormones and stress impact pelvic floor health
• 06:08 — Vulvodynia: Causes, symptoms, and why it’s overlooked
• 08:26 — Vulvodynia as a cause of painful sex and why Black women are misdiagnosed
• 10:25 — Myths about Black women's pain tolerance in medicine
• 11:55 — Cultural barriers and shame around pelvic pain
• 13:22 — Tyra reflects on why it’s hard to speak up at the doctor
• 15:26 — Conditions like endometriosis and how they mimic pelvic floor pain
• 16:59 — What’s normal and what’s not with periods
• 19:32 — The importance of vitamin D for Black women
• 27:34 — Foods that support pelvic and reproductive health (magnesium, zinc, omega-3)
• 29:00 — Best sources of omega-3 and practical eating tips

Final Insights and Takeaways

• Pelvic Pain Is NOT Normal: Any consistent pain in the pelvic region—especially with sex, periods, or exams—deserves to be investigated, not ignored or normalized.
• Self-Advocacy is Critical: Black women must intentionally speak up for themselves in medical spaces, despite barriers and stigma.
• Nutrition & Lifestyle Matter: Nutrient-rich foods, vitamin D, sleep, and stress management significantly impact reproductive and pelvic health.
• Knowledge Is Power: Learning the clinical language for what you're experiencing helps with accurate diagnosis and better care.
• Breaking Generational Silence: It’s healing to have open conversations about reproductive health with loved ones, partners, and providers.

Next episode: Part three will feature listener questions and real-life stories, continuing this powerful, affirming exploration of Black women’s reproductive wellness.

Want to connect with Dr. Janelle Frederick?
All her details are in the show notes. Stay tuned for part 3 in this essential health series!