
Dr. Sara Reardon, better known as The Vagina Whisperer, breaks down the importance of pelvic floor health and why it’s time to stop suffering in silence—and start getting the care and answers we deserve.
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Nicole Khalil
This episode is brought to you by Amazon Prime. From streaming to shopping, prime helps you get more out of your passions. So whether you're a fan of true crime or prefer a nail biting novel from time to time, with services like Prime Video, Amazon Music, and fast free delivery, prime makes it easy to get more out of whatever you're into or getting into. Visit Amazon.comprime to learn more. PMS, pregnancy, menopause being a woman is a lot. Ollie supports you and yours with expert solutions for every age and life stage. They just launched two new products exclusively at Walmart. Period Hero Combats Flow, mood swings and more during PMS and Balance Perimeno to support hormonal balance, mood and metabolism during perimenopause. Grab yours@ollie.com Ollie these statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any I am Nicole Khalil, your this Is Woman's Work Host here to talk about something that holds a lot together, literally and figuratively, but somehow mostly gets left out of the conversation. Unless it's about bleeding, birthing, or being used for someone else's benefit. And that is our pelvic floor Floor. Most of us weren't taught about it. We definitely weren't taught how to take care of it. And when something starts to feel off, like we experience leaking, heaviness, pain during sex or pressure, we're told it's just part of being a woman, part of aging, part of having babies. But I'm calling BS because pain is not something we should normalize. Leaking is not just a punchline. And peeing a little when you laugh, sneeze, or work out may make for hysterical conversations with your girlfriends, but doesn't have to be your new normal. Mostly, we've been misinformed and flat out ignored when it comes to our pelvic health. And that stops now. Because if you have a pelvic floor, and if you're listening to this, I'm guessing that you do, this conversation matters. Enter Dr. Sarah Reardon, better known as the Vagina Whisperer. Yes, that's her actual nickname. No, I don't think she made it up. And yes, she totally owns it. She's a board certified Pelvic floor physical therapist, TED speaker, and the author of Floored A Complete Guide to Women's Pelvic Floor Health at every Age and Stage. With nearly two decades of experience, she's on a mission to help women understand their bodies, advocate for their care, and stop suffering in silence. So Sarah thank you for being here. And I'm hoping to start with the basic of basics. What even is the pelvic floor?
Dr. Sarah Reardon
And.
Nicole Khalil
And what does it do?
Dr. Sarah Reardon
Thanks, Nicole, for having me. Your pelvic floor is a basket of muscles that sit at the base of your pelvis. So we all know that bony skeleton of pelvic bones we see on jammies or the anatomy medal at the doctor's office. And at the very bottom of that is a group of muscles called the pelvic floor, muscles that sit like a hammock, and they support the pelvic organs, including your uterus, which holds a growing baby, your ovaries, your rectum, which holds poo, and your bladder, which holds pee. These muscles also have three openings in the female body. One for urine, one for the anal opening where poop and gas exit, and then the vaginal opening for menstruation and childbirth and vaginal intercourse. So these muscles are super important. We're using them literally every moment of the day to help support our spine, to support our organs, to keep in urine and bowel movements until a convenient time. But again, to your point, we don't often even know they exist until a problem arises. And there's so much we need to do to take care of these muscles, to prevent issues and to overcome problems if we're experiencing them.
Nicole Khalil
Okay, so let's talk about some of those problems. What might be common pelvic floor problems that we might not even know that that's what they are, is my question makes sense.
Dr. Sarah Reardon
Like, yep. Okay, so some of the ones you mentioned, even in the intro. So urinary leakage, that often means that that sphincter where urine exits, that's in the muscle isn't strong enough or coordinated enough to prevent leaks when you cough, sphincter, sneeze, run, jump, laugh. Also, even common bladder issues like overactive bladder, where you feel like you have to pee every 30 minutes to an hour and you go and only a little bit comes out, or you're waking multiple times at night to pee, which can be disruptive to your sleep and make you fatigued or even a hard time starting your urine stream. You may sit down and feel like, gosh, I really have to strain or push to get it started. That means your muscles aren't relaxing well on other things, like constipation. You know, these muscles have to relax really well to empty your bowel movements, and often they're tight or tense, and your bowel movements feel like they're not complete or you have to strain or you're only going little bits at a time. Leakage of stool or staining in your underwear is also can be a pelvic floor issue, along with common things like hemorrhoids or anal fissures. And then one of the other bigger ones is pain. So painful intercourse, painful orgasms, pain with tampon insertion, spirit speculum exams, painful periods, tailbone pain. You know, pain is really information from our body that something's not working well or the way it should, so we don't want to ignore it. But if it's in this area of the body, it's often connected to your pelvic floor muscles, Whether it's, you know, the original area of issue or say something like painful menstruation can cause tension in the pelvic floor area that can cause other bowel or bladder or sexual pain issues. So, again, anything pretty much from your ribs to your knees, if there is a problem going on there, like hip pain or back pain, pelvic organ prolapse, all of that is connected to your pelvic floor.
Nicole Khalil
Okay, and I said in the intro, something along the lines of a lot of this is being dismissed as, you know, well, you just had a baby or you're just getting older. What's your reaction to that sort of thought process?
Dr. Sarah Reardon
I mean, major eye roll. You know, I think that, you know, it's really unfortunate because pelvic floor issues have been experienced by women since the dawn of time. Right. We know that the three biggest life stages that people develop pelvic floor dysfunction as women are pregnancy, postpartum, and menopause. And 100% of women will go through menopause. And everybody who gives birth, whether it's vaginal or C section, will go through pregnancy and postpartum. So this is. We're literally keeping the population going, yet we're not caring for women proactively or even after the fact when we know that pelvic floor issues could arise. So the narrative has been like, oh, this is just what happens after you have a baby, or, you know, wait until you're done having kids, and then we'll do surgery to fix it. Or, you know, you know, pain with sex or, you know, vaginal dryness or leakage is just like happens with aging. Well, yeah, these things can happen, but why aren't we helping women prevent these issues or treating them? I mean, there's more treatment for osteoporosis, diabetes, hypertension than pelvic floor issues. Yet pelvic floor issues are more common than all of those things. And it's really unacceptable because it impacts our quality of life so much, and yet we're just kind of living, you know, with these issues, avoiding things in our life like exercise or socialization or sex even. And it really impacts our quality of life. And it's pretty unacceptable to me.
Nicole Khalil
Yeah, I mean, it makes me feel kind of ragey, totally raging. Some of the other things related specifically to women's health, where it just feels so undervalued, so underserved, so under talked about, so under supported. I mean, it just. We are half of the population. It. It is infuriating to me. I'm going to put my rage to the side for a second and ask, what are some things that we can and should be doing to care for our pelvic floor?
Dr. Sarah Reardon
This is such a great question. And it's really kind of why I wrote the book Floored. Because, you know, I really went wide with it. I said, I can write a book about birth and the pelvic floor. I can write a book about menopause and the pelvic floor. But people don't even know what this muscle does, let alone every single life stage, how it's affected from your period to your monthly hormonal cycles, to having sex, to, we mentioned pregnancy, childbirth, postpartum, to, you know, pain and then menopause. So literally, from the time we become women to the time we die, your pelvic floor is changing. And there are some really simple things that we can do to just have, you know, minimize the risk of getting pelvic floor issues. So one of them is just daily stuff like how you pee and how you poop. You know, I tell people when they're peeing. We are notorious for this as, like, working women and moms. We're always trying to be efficient, but we push when we pee. And I tell people, like, do not push when you pee. When you pee, you should sit down on the toilet. Don't hover unless it's like, super gross. But sit down, lean forward, and just take some big deep breaths and don't push, because when you push or strain on the toilet, it weakens your pelvic floor. And I've seen young women in their 20s who've never had kids and they have pelvic floor weakness and leakage and prolapse just because they strain when they pee, because nobody's ever taught them how to do it properly or, you know, with menstruation, you know, learning how to properly use a tampon, how to properly insert a menstrual cup or a disc, like finding the vaginal opening, I mean, and also looking at the vulva and vagina. The vagina is the inside canal. The vulva is the outside. Like, teaching women about these parts of their body, because if they don't know what their normal is, they don't know what their abnormal is. Say their labia are disappearing, or they have, you know, redness or irritation in the area or something's kind of protruding or falling out. Like, they don't know what to look for because they've never even kind of visualized it. And then other things, like constipation or how to poop properly. So I tell people I take what's called magnesium citrate at night, then help soften your bowel movements. But, you know, none of us are getting enough hydration and enough daily exercise and enough grams of fiber. And often bowel movements can be hard. And when you strain for bowel movements, it also weakens your pelvic floor. So I tell everybody to get one of those little squatty potties or stool under their feet. And when you poop, you can push, but you need to exhale. So you don't want to hold your breath or strain. You want to exhale like you're blowing out a bunch of birthday candles. And that can help as well. And then when you're exercising. So the third thing is when you're exercising at the gym or in the workout, like, pull your pelvic floor in, like, activate your pelvic floor when you're exercising. So you get that pelvic floor workout and then things you're already doing throughout your day.
Nicole Khalil
Yeah, I was gonna ask that. Since it's a group of muscles, I would imagine there are things that we can do to strengthen. Like, we do all of our other muscles. So aligning that with our other workouts makes sense to me.
Dr. Sarah Reardon
Totally. You know, it's a muscle that contracts, but it also needs to relax completely. I think one of the other narratives about the pelvic floor is that we, like, only think of the vagina, where that's really one part of the pelvic floor. When we think about the vagina, we've always been told, like, do your Kegels and tighten your vagina and pull your core in, because that's gonna give you really awesome orgasms or a strong core. But these muscles need to relax, just like they need to contract. So often I see people, like, just tightening all the time. Or a lot of these exercise programs or, you know, Kegel exercises, exercisers that people use can tell people to just tighten their vaginas, but you need that muscle to relax and contract. So when you do a Kegel contraction or contract within a workout or just by itself, you need to relax it fully as well. And then also, some people don't need to strengthen at all. Some people have tension, and they really need relaxation and yoga and breathing. And so Kegels are the wrong thing. So you have to kind of figure out which avenue you need to walk down. And I go over kind of how to do this. In the book, there's a checklist of things you can look at to say, like, do we need to work on strengthening, or do you need to work on relaxation? And then kind of a menu of exercises to do to help that those issues.
Nicole Khalil
Okay. You mentioned pooping. My mom actually got me one of those squatty potties.
Dr. Sarah Reardon
Yeah.
Nicole Khalil
Yes, exactly. And I, like, rolled my eyes at her, but of course listened, because my mom always is ahead of the curve with these types of things. But my question is, what is once a day normal, or is it after every time you eat? Like, I've heard different things. What do we. What do we want when it comes to regular bowel movement?
Dr. Sarah Reardon
So the normal range is between three times a day to three times a week. So pretty much you can be going every other day, or you can be going three times a day, anything outside of that range. If you're going more than three times a day, you're going too frequently, and you might have something that's loosening your stool, something like that, or you're not emptying. Well, when you actually do go, and if it's less frequent than every other day, then you're not going often enough. And that's typically what we see more is the constipation lingering on for two or three or four days. And people don't always connect like, well, how is that even related to your pelvic floor? Well, when you have really hard bowel movements, like you're trying to, like, shit a baseball out of your butt, you're straining, right? You're straining, and you're bearing down. You can even tear sometimes and have a little bit of blood. And that straining weakens your pelvic floor. And you do that two or three times a week. And that is repetitive weakness and pressure on your pelvic floor. And that's what we really want to try to prevent. So, again, this is where you want to look into some things that could help, whether it's, you know, movement, nutrition, hydration, stool, softeners or again I use something called magnesium citrate that like has a natural kind of softening effect to the stool. But it's important. That's why this kind of pooping thing so important. I talk about it and what we see is a lot of kids have constipation. So if you have these issues when you're younger, you start to see them trickle into adulthood because you've never learned the right ways to manage it. And the other thing is you're really full of stool in your pelvis. It puts pressure on your bladder and when you're constipated, you're going to find that you have to go to the bathroom more, that you leak more often. And so you can see this kind of trickle effect about how if one of those systems is off, it really affects the whole pelvic health system.
Nicole Khalil
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Dr. Sarah Reardon
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Dr. Sarah Reardon
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Nicole Khalil
Over to warbyparker.com that's warbyparker.com you said earlier when you were talking about looking at our vulva and our vagina that when we look then we notice when something is abnormal. I would imagine the same is true with our poop and you know, all the other things, like probably everybody listening in. I've had everything from diarrhea to constipation. And a lot of times it just tells me something about what's going on, going on in my world, whether it be what I'm eating or not eating or drinking enough or not drinking enough or drinking too much alcohol or being really healthy or, you know, all the things, I guess, what would you say to the person who feels really Uncomfortable with the idea of looking at all of these things that we've, somewhere along the way, been taught are embarrassing or gross or whatever. I mean, wild to me because it is literally something that we all do. But what are your thoughts on that?
Dr. Sarah Reardon
Totally normal. I mean, we've. That's totally normal. To feel like it's. It's a big ask, and I know it's a big ask. And often in my clinic, you know, when women come in and I ask them, I'm like, hey, do you want to see what I'm doing? So they can actually see, like, how is Sarah in her pelvic floor assessment? By inserting her finger into my vaginal opening and pressing on the sidewalls. How is that connected to pain with sex? Or leakage or tightness from my C section scar, you know, So I think it's totally normal. And I don't think you have to jump from, like, not knowing your body to, like, this in depth exploration. But, yeah, you know, like, I don't.
Nicole Khalil
Have to invite other people to look at your poop. I mean, take it in stages, right?
Dr. Sarah Reardon
Well, and, you know, I think that, like, if you look at your pee, say, for example, if it's really cloudy or dark or odorous, like, that's probably a sign you either have an infection or you're not hydrating enough. Sometimes the first pee in the morning is a little bit more concentrated, but after that, it should be almost clear. Same thing with your poop. I mean, you kind of know if it's like, hard balls. You're like, I'm constipated. If it's super runny, you're like, okay, something's upsetting my stomach, right? One of my poop hacks, actually, is to eat a piece of corn on the cob and follow how many days it takes from the day you eat the corn to the day the corn is in your poop in the toilet. And that shows you how long it takes for poop to get through your body.
Nicole Khalil
And.
Dr. Sarah Reardon
And anything longer than, again, those two days is too long, which means your system's working really slowly. So check your corn poop. But then for your vulva and vagina, I'm like, start slow. Just like, look at the external. You know, you don't have to open the lips and kind of explore. It's like, can you see your mom's pubic, which is the area with the hair? Can you see the external labia, the labia majora, which has the hair? If you kind of just want to feel it in the shower, kind of just rinse the area with water in your hand and see if you can feel it. Like, you can take it really slow. You may not even know what you're looking at. I do have a diagram in the book that kind of shows you the vulva and the vagina and the clitoris and the muscles that are behind there. So I think work at your pace, but I do think it's an option for folks who want to see kind of what is going on. And, and it can help you if you don't know how to, you know where to put a dildo or a tampon or whatever. It's like you got to know where the hole is, right? And so I think it just helps you kind of see what's going on in this part of your body.
Nicole Khalil
So you mentioned a lot of things, but if we don't pay attention or we don't address some of these pelvic floor problems as we notice them, what happens? How do they evolve if left untreated?
Dr. Sarah Reardon
I mean, like most types of muscle pain or dysfunction, they don't typically get better on their own. So, you know, I think that maybe with postpartum, when sometimes there can be a little bit of leakage or some weakness right away after birth, there's a chance that could get better at three months or a year. But for the postpartum period, I typically tell people, if you're experiencing something at 12 weeks postpartum, leakage, pain with sex, back pain, hip pain, core weakness, prolapse, like that's your signal to go in and get it treated or start doing something. Because the research is very clear, if you experience something at three months postpartum, you're likely to experience it at one year postpartum as well. So it's not going to get better. And then you're going to say, why did I wait nine months to get this fixed? Right. What also happens is it starts to become chronic in nature. So say you have pain with sex. What happens when you have pain is you want to kind of. You guard up or tense your muscles when you're anticipating pain. So now you're developing muscle tension in response to that. And then your nervous system starts to get upregulated because you know it's going to hurt. And then you don't want to have sex at all. And it kind of starts evolving into this cascade of tension and anxiety and. And then sometimes just avoidance. And then, you know, outside of that, I would say muscles get weaker with time. Unfortunately, we lose a Little bit of muscle mass every year that we age, which is why we have to start strength training. You know, I see on Instagram, our social media, all these workouts that we need to do. And I'm like, why isn't anybody talking about the pelvic floor workouts we need to do? Because your hormones decline, your estrogen declines, your connective tissue decline. So we need to actively kind of build that up. I say perimenopause is. Is as much of a roller coaster as it is. It's a little bit of a yellow light. Like, hey, caution. Your body's going through changes, so you have an opportunity now instead of waiting until the lights red and everything stops over these next five to 10 years, start building your muscle mass, start using Evolvar moisturizer, start strengthening and kind of being aware of your body and make some of these changes so that when you hit menopause and you're hormones are kind of in the. In the dumpster, for lack of better terminology, you've done the work to make this, like, to ease this transition.
Nicole Khalil
Okay, so one of the things that I've noticed, and please challenge me if you feel I'm off base, but I've just sort of made up this story that we are not doing enough medically and with research and for women's health in general. I feel so far behind, and yet I see via capitalism and products and things that there are. It almost seems like they're ahead of the things that really matter. So we're seeing things like vaginal deodorant or all those types of things. What are your thoughts on products like that? Are they helpful? Are they leading the charge? Are they exploitive? Like something in the middle? Like, where are we?
Dr. Sarah Reardon
A little bit of everything, you know?
Nicole Khalil
Right. Okay.
Dr. Sarah Reardon
It's so funny because the first chapter of the book talks about. It's called the bit. I call it the, you know, the. The big business of vaginas. You know, we're kind of. Vaginas were kind of in the dark and they were not talked about and they were embarrassing and often thought of as like smelly or dirty. And like, now we're bringing them into the spotlight, which you think would be really positive. But what we're doing is with all these wellness products of just like, you know, scents and, you know, vibrating muscle stimulators or libido gummies or deodorants or whatever, you know, jade eggs and steaming. It's. It's a little bit half snake oil and half like trying to put like Fancy chandeliers in a house that doesn't even have walls. Right. So we're focused on wellness, but that's not true health. And wellness makes us like maybe feel good momentarily. Short term relief, it's something that makes us feel good in the very short term, but it's not true function. And I'm literally focused on like how do these muscles function and to, to really work on that in health. It's not just your vagina, it's not just your vulva, it's your pelvic floor. Your pelvic floor is the functional part of this body that helps with bowel movements and sex and birth and lifting and breathing. And we're not talking about that. We're talking about the things that are easy, the low hanging fruit we feel like we can do to like judge up our vags when you kind of need to start with the basics sometimes. So that's really the goal of this book. Do these things have a place? Some of them, some of them are like totally bogus and a waste of your money and time. Some of them, like some of the vaginal moisturizers I think are helpful. You know, we do need those options, especially people who don't want to take hormones. Some of there's like a red light therapy you can do that can be kind of a little bit of a boost for people. But a lot of the other stuff is pretty crappy, to be honest with you.
Nicole Khalil
This may be a repeat of what you've already said, but if we want to get down to the basics. I should have said get back to the basics. But for some of us, the basics were never given to us as a foundation in the first place. So I guess two part question. When should we start educating people about their or women about their pelvic floors? And then what are. Again, if it's repeat some of the basics that we should be focusing on before we even think about the products and the stuff and the chandeliers.
Dr. Sarah Reardon
Right. You know, it's a, it's a trickle effect. It's not like, hey, when you're 13, you got to learn this. And then when you're 25, you got to learn this. It's really a trickle that. I think one of the best things we are doing as a generation, I'm in my 40s, is we are educating ourselves so that we can educate the next generation. I have two sons and one of my girlfriends recently we were at a parade in New Orleans and her daughter was like, oh, you don't. You only have Sons. And I said, yeah, you know, I've got two boys. And she was like, that's a missed opportunity for a daughter, you know, because I can educate her about her body. I said, but I'm educating two sons about a woman's body. Like, they're going to know what a real body looks like, what breasts look like after you have kids, and what a tummy looks like. And like, they know what a tampon is. And they're like, what's that string hanging out of your. Your butt, Mom? You know, they're like, why? You know, they're like, the vagina looks like a butt from. But it's in the front. And I'm like, well, thanks. Like, you know, But I'm like, but it's a trickle effect where I think it really starts by naming our parts. I don't use kid kid names like cookie or cha Cha for our genitals. I do call them private parts. But I educate kids like, hey, this is what they are. This is when you can pull them out. This is when you keep them in you. This is what they do. Start really educating on the function and then answer their questions, you know, instead of saying like, oh, you're too young to ask about, like, what is that? You know, like. Or, why do you have blood every month, Mommy? Well, when mommy doesn't have a baby in her tummy, she gets what's called a period, you know, and the period happens because I'm shedding the lining of my uterus. If they ask more questions, you follow up, but sometimes they're just like, okay, and then they move on, right? So I think we want to trickle in the details that are age appropriate. And then I think menstruation is probably the first big landmark when we start to really educate young women because they may get a little bit of period education, maybe a little bit of sex, but they certainly don't learn about their pelvic floor. And over 40% of female athletes, high school and college, who have never had kids leak urine. So this is happening well before you even have kids. And yet they're ashamed. They're embarrassed. They're wearing dark, dark underwear, dark cheerleading skirts, dark yoga pants because they don't know where to go to get help. Women don't know how to insert tampons. They don't know that pelvic exams shouldn't be painful. They don't know that sex shouldn't be painful. So I think starting to trickle in these tidbits from periods to sexual health, all along, those like Teen years and twenties is run. A lot of it needs to happen. And then, of course, we need to proactively work with women during pregnancy and postpartum.
Nicole Khalil
Okay, couldn't agree more. And I don't know if this is true with the pelvic floor. I had a guest a while back and we were talking about, I think, menopause, and she said it was covered in one day during medical school. And I think a lot of us, rightly so, think we should be able to go to our gynecologist or doctors and ask these questions and talk about it. What do we do if we go to, and I put in air quotes, the expert, and do they say this is normal or it's just because you're getting older or it's just because you had a baby or what have you? And it doesn't sit right with us. Outside of reading your book, which is obviously phenomenal resource, what other recommendations would you have?
Dr. Sarah Reardon
You know, that's a great question. And unfortunately, I would almost say anticipate that it will be dismissed. Anticipate that they'll say, you're fine, it'll get better, deal with it later. I would find a different provider. You know, I think that that's why social media and online groups have really become, as much as there's a dark side, there's also a positive because it gives you information that you didn't even know was available. If you're experiencing anything in the pelvic health arena, again, peeing, pooping, sex, pain, prolapse, I would go see a pelvic floor physical therapist. You can access a pelvic floor physical therapist in every single state in the United States without a referral from a physician. So you can just walk right in like you're going to the chiropractor or the acupuncturist, which is important because they'll tell you, oh, your pelvic floor is an issue, or actually, you're doing great. It's like going to the dentist, like, oh, things are looking good, or oh, yeah, you got a little something going on here. We're going to need to kind of tune it up. So I would go there and then a gynecologist is a vagina doctor. Right. There's a urologist who's a bladder doctor. There's a urogynecologist who's a surgeon for female reproduction and bladder issues. You know, a GI doctor, Nicole Erectile. So I would go to, like, explore different physicians, but I would also go to a pelvic floor Therapist to get help. And, you know, the thing is, is that it's unfortunately not easy to access therapists sometimes. And there's just long wait lists. Sometimes they don't take insurance inside of pocket. And that's because insurance reimbursements are so crappy that we would only be able to see you for 15 minutes.
Nicole Khalil
Right.
Dr. Sarah Reardon
So I think that I would definitely just kind of keep pushing to explore options. But it's out there and you can get it in person. You can get it virtually. You can get it in a book, you can get it in an online program, but it's. It's out there.
Nicole Khalil
And I would imagine you share a lot via your Instagram and website as well. So let me just remind people or let people know that they can find you at the Vagina Whisperer on Instagram. The website is thevagwhisperer.com where you can also find her book Floored, which is coming out in the next couple days. Here. Sarah, thank you so much. Is such an important conversation. And as you were talking, I still recognize how much I don't know about my own body. And it's flat, frustrating, but also kind of exciting. Like, gosh, there's so much more to learn. And I so appreciate that you're out there doing this work on all of our behalf. So thank you.
Dr. Sarah Reardon
Thank you. And, you know, I think that that's. People asked, how did I come up with the title Floor? And I said, you know, I really think that when people read this book and learn about their bodies, they're going to be like, oh, wow, I had no idea. And that's, you know, really, if they walk away from it, just kind of having. Having understood their own bodies. And I'm like, this is success.
Nicole Khalil
Yeah. Okay. We're going to put all the ways to find and follow Sarah and a link to her book in show notes along with other related episodes. If you want to dive deeper into women's health topics like this one, and let me close us out by saying this, here's what I hope you walk away with after this episode. We deserve to understand our body, every part of it, not just the parts that are visible or palatable or convenient for other people. Your pelvic floor plays a critical role in your strength, your health, your sex life, and is not something to be ignored, dismissed, or quietly tolerated when it's not functioning as it should. We've been led to believe that suffering is just part of being a woman, that pain is the price we pay, that silence is strength. But what if. I mean, what if we started asking questions, speaking up, and actually taking care of ourselves and each other without guilt, shame or apology? I don't know about you, but that sounds like woman's work to me.
Podcast Summary: This Is Woman's Work with Nicole Kalil
Episode: Floored - Why Our Pelvic Floor Health Matters with Dr. Sara Reardon | 314
Release Date: June 2, 2025
In this empowering episode of This Is Woman's Work, host Nicole Kalil delves into a crucial yet often neglected aspect of women's health—the pelvic floor. The conversation aims to dismantle the stigma surrounding pelvic health, challenging the notion that issues like pain and leakage are just "part of being a woman." Introducing Dr. Sara Reardon, known as the "Vagina Whisperer," Nicole sets the stage for an in-depth exploration of pelvic floor health.
Nicole Kalil [00:01]:
"We explore the multifaceted experiences of today's woman, confirming that the new definition of 'woman's work' is whatever feels authentic, true, and right for you."
Dr. Sara Reardon provides a foundational explanation of the pelvic floor, highlighting its anatomical and functional significance.
Dr. Sara Reardon [02:51]:
"Your pelvic floor is a basket of muscles that sit at the base of your pelvis... These muscles support your pelvic organs, including your uterus, ovaries, rectum, and bladder."
She emphasizes that the pelvic floor is integral to everyday functions, from supporting the spine to controlling urinary and bowel movements.
The discussion shifts to the various issues that can arise when the pelvic floor is compromised. Dr. Reardon outlines symptoms and conditions that many women may experience without realizing their connection to pelvic health.
Nicole Kalil [04:07]:
"What might be common pelvic floor problems that we might not even know that that's what they are?"
Dr. Sara Reardon [04:11]:
"Urinary leakage, overactive bladder, constipation, painful intercourse, and pelvic organ prolapse are some of the common issues."
She describes how activities like coughing, sneezing, or exercising can trigger leaks due to weakened pelvic muscles. Additionally, conditions like constipation and painful sex are linked to pelvic floor dysfunction, highlighting the widespread impact on quality of life.
Nicole and Dr. Reardon express frustration over the tendency to dismiss pelvic floor problems as inevitable aspects of womanhood or aging, rather than treatable conditions.
Dr. Sara Reardon [06:04]:
"Pelvic floor issues have been experienced by women since the dawn of time... yet we're not caring for women proactively or even after the fact."
Nicole Kalil [07:28]:
"It makes me feel kind of ragey, totally raging. We are half of the population. It is infuriating to me."
They criticize the lack of proactive healthcare measures for pelvic health compared to other conditions like osteoporosis or hypertension, emphasizing the urgent need for better support and treatment options.
Dr. Reardon offers actionable advice on maintaining and strengthening the pelvic floor, integrating these practices into daily routines.
Dr. Sara Reardon [08:01]:
"Do not push when you pee. Sit down, lean forward, take deep breaths, and avoid straining to protect your pelvic floor."
She covers various aspects, including proper techniques for urination and bowel movements, hydration, fiber intake, and the importance of pelvic floor exercises. Additionally, she highlights the necessity of understanding one's anatomy to recognize abnormalities early.
The conversation delves into the balance between strengthening and relaxing the pelvic floor muscles, debunking the myth that only contraction exercises (like Kegels) are beneficial.
Dr. Sara Reardon [12:12]:
"The pelvic floor muscles need to relax completely as well as contract. It's not just about tightening."
She explains that overemphasis on tightening can lead to muscle tension and suggests a tailored approach based on individual needs—whether focusing on strengthening or relaxation through exercises and yoga.
Nicole and Dr. Reardon discuss the long-term consequences of neglecting pelvic floor health, including chronic pain, muscle weakness, and the escalation of related health problems.
Dr. Sara Reardon [18:54]:
"Pelvic floor problems don't typically get better on their own. They can become chronic, leading to increased tension, anxiety, and further physical issues."
She underscores the importance of early intervention, particularly postpartum, to prevent issues from becoming ingrained and affecting various aspects of a woman's life.
The episode addresses the challenges women face when seeking medical help for pelvic floor issues, including dismissive attitudes from healthcare providers.
Dr. Sara Reardon [27:44]:
"Anticipate that providers might dismiss your concerns. Find a pelvic floor physical therapist who can offer specialized care."
She encourages women to advocate for themselves, seek out specialists, and utilize available resources like pelvic floor physical therapists to receive proper diagnosis and treatment.
Nicole raises concerns about the proliferation of wellness products targeting the vagina and pelvic floor, questioning their efficacy and intentions.
Dr. Sara Reardon [21:56]:
"These wellness products are a little bit half snake oil and half trying to put fancy chandeliers in a house that doesn't even have walls."
She critiques how the market commodifies pelvic health, often prioritizing short-term wellness trends over genuine functional health solutions, while acknowledging that some products like vaginal moisturizers can be beneficial.
The importance of educating individuals about pelvic floor health from a young age is emphasized as a foundation for preventing future issues.
Dr. Sara Reardon [23:52]:
"Start by naming our parts and educating kids about their functions. This knowledge is crucial for recognizing and addressing problems early."
She advocates for age-appropriate education on anatomy and pelvic health, ensuring that both girls and boys understand the importance of pelvic floor function, thereby reducing stigma and promoting proactive health management.
In closing, Nicole reiterates the episode's central message: women deserve comprehensive understanding and proactive care of their bodies, including the pelvic floor. By breaking the silence, challenging societal norms, and seeking proper medical support, women can significantly improve their quality of life.
Nicole Kalil [30:16]:
"We deserve to understand our body, every part of it... What if we started asking questions, speaking up, and actually taking care of ourselves and each other without guilt, shame, or apology?"
She encourages listeners to prioritize their pelvic health and advocate for better education and medical support, framing this as a fundamental aspect of modern "woman's work."
Conclusion
This episode of This Is Woman's Work serves as a crucial reminder of the often-overlooked importance of pelvic floor health. Through candid discussion and expert insights, Nicole Kalil and Dr. Sara Reardon empower women to take control of their health, challenge societal taboos, and embrace a more informed and proactive approach to their bodies.