Transcript

Kylie: Hello ladies. Welcome back to the Hormone Hub. Now, today we are doing a bit of a U-turn and we are talking about your physical health and wellbeing. And [00:01:00] today I am, yeah, very happy to have a friend of mine, Kath Baquie, I hope I’ve said that right, Kath, join us. Now kath is the, Kathy’s a pelvic health physio. So she specializes in women’s health and all things pelvic floor, you know, and all things you know, that a physio would normally deal with as well. So she’s, she’s talking about our overall wellbeing. Kath is the owner of the Fitnest Mama, so you can find her website there. And we are gonna pop all of her details in the show notes of course.

But welcome to the show, Kath. 

Kath: Thank you Kylie, for having me. It’s great to chat today. 

Kylie: Yes, yes. Now Kath and I have been chatting away for 15 minutes before I was like, oh. Oh, we better hit record. Yeah. So Kath, would you like to tell us a bit about your background and you know what it is that you do? 

Kath: Yeah, so I’m a physiotherapist.

I graduated at school not knowing what I wanna be, and I just knew that I didn’t [00:02:00] want a desk job. So I went into physio. I think like all young students thinking they’d be drawn to the sports physio and all those really well known aspects of physio. And I soon discovered my first job on a footy field in the middle of winter, cold in Melbourne, massaging sweaty hamstrings.

I was like, no, this is not for me. I’ve got a few friends who are physios, and I got a placement in women’s health and I fell in love as a 20 year old, you know, bouncing around on fitballs with pregnant women. Helping women with their pelvic health. And eventually I ended up doing postgraduate training at university and specializing in

Kylie: this area.

Yeah. Beautiful, beautiful. And you know, like our pelvic floor is such a fascinating thing. It really is. And I think any, and I was gonna say, anyone who’s had a baby realizes the importance, but it isn’t [00:03:00] just women who’ve had children. Like I’ve had clients who, you know, haven’t had children and they still have pelvic floor issues.

So I think it’s just a massive design fault, to be honest. 

Kath: Well, absolutely, it’s a design fault, but also, We need that design like our pelvis compared to our male counterparts, they are wider. So there is, it’s like having a small trampoline versus a big trampoline. There’s obviously gonna be more movement in the base of the trampoline on a wider trampoline. So we do need that movement obviously to be able to have children. Plus we’re lucky enough to have all the hormonal changes, as you know. So those two combinations in particular, not even including the third combination, which is a childbirth. Yeah. Pregnancy and childbirth. Yeah. So, Even if you haven’t had babies, you’re still a female with a female pelvis and you’ve still got the hormonal changes.

Yeah, definitely. 

Kylie: Definitely. And it’s that drop in estrogen that, you know, as we go through peri menopause and [00:04:00] menopause, that seems to be the cause of many of our, you know, issues. 

Kath: Everything drops, doesn’t it? Uh, we’ve got some sags under our chin and eyes and our boobs. 

Kylie: It’s the Turkey neck. My daughter calls it She’ll, she was funny.

She grabbed my husband’s Turkey neck and she’s like, oh, you got a Turkey neck? And I was like, oh, thank God she’s leaving me alone for a change. The 10 year old girls, everyone needs one. Yeah. But Kathy, you know my, so I, we were chatting beforehand and I sort of realized for the first time, a, you know, the, the value of a pelvic floor specialist, and a pelvic floor physio when I was sitting in a menopause conference and, you know, this physio was up, she was speaking and she started talking about, you know, a lot of the things that actually hit home for me.

You know, and I’ve always been quite fit. I’ve always been healthy. I [00:05:00] did all the prenatal, all the postnatal Pilates, I did all the things, you know. You know, bounced on the Swiss ball, you know, forever, all the things, but she was talking about, you know, people who avoid, or women avoiding, you know, exercising in the afternoons because you know their bladders fuller and you know, they’re more prone to leaking.

And I was like, oh my God, that’s me. I deliberately don’t exercise in the afternoon because of that. And, you know, you know, just that cough that takes you by surprise or that sneeze that takes you by surprise. Laughing. It has caught me by surprise a few times, and she was sort of talking about, you know, it is sort of normal and, you know, what she was describing, you know, kind of I ticked the boxes for my sort of age and stage of life, you know, regardless of my fitness background, you know, it just didn’t even sort of seem to, to to matter, but she was sort of going through, you know, a lot of really practical things that we can [00:06:00] access and tap into with the support of a, a pelvic physio specialist, you know, to help us. Because, you know, in the back of my mind I was sort of thinking, oh, you know, Is, is this leading to a hysterectomy?

You know, and I was just in my head going, yeah, no. And that’s probably why I was in denial and kind of not being proactive about it. And generally I’m quite proactive about my own health and I certainly encourage women to be very proactive with their health. But yeah, I was in a bit of denial about this and yeah, she sort of took me by surprise, of, you know, some of the symptoms and some of the, the things I wasn’t even aware of. So maybe we can sort of go into like what are, you know, if we’ve got women in our, their forties and fifties and sixties, you know, what are some of the things that, you know, little warning signs or little symptoms that present that, you know, we can actually do something about? 

Kath: Yeah, great question Kylie. It’s a big question, but it’s a great [00:07:00] one. Because you’re right. I have friends in their forties, late thirties, forties, finished having children. And one friend in particular is really keen, well, she’s a big basketballer before having kids, and she loved playing with her a basketball team.

And so she started recently and she tells me about how before every game, A lot of her teammates are having to run to the toilet. They’re saying that they’re having to use pads for the game and they’re just accepting it. And you’re right, it is common, but I don’t think we should consider it normal because there is so much, and it’s exciting because there is so much we can do to help our pelvic health and our, this area. And as you said, it’s, you know, it’s an area we don’t talk about much, and then suddenly we’re pregnant. We have children and everyone hears about pelvic floor. We might then have our babies and sort of forget about it for a [00:08:00] while. And then in these perimenopausal years, it tends to rear its head again.

So there’s a, we know that there’s a spike of issues around pregnancy and childbirth, then it plateaus off and then the other spike happens around this time of our life. Perimenopause, menopause, and as you said, hormones are a big factor here, but, Some, so some red flags, some if you are listening to this today and you’re thinking, oh yeah, you know, I do leak.

Whether or not it’s when you’re coughing or sneezing or laughing or moving or exercising, that it in itself is a red flag. And don’t accept that it’s normal, because that could be something that you can do. Absolutely. Yeah. Another red flag is a pelvic organ prolapse symptoms, and these can be quite varied.

So this might be really obvious in terms of you are seeing a, a bulge, or you’re feeling a bulge when you have a shower or go to the toilet. Or you might feel a lump, like there’s something just [00:09:00] stuck in your vagina. Some women describe it as feeling like there’s a tampon stuck, even though they don’t have a tampon in.

 Some women describe it as a pelvic heaviness and a dragging sensation, and I know that’s what I experienced after the birth of my first baby. I went for a walk a few weeks later, and again, I felt really good physically. So I’ve been strong and active during pregnancy. You know, I was fit, so to speak, with quotation marks, but my pelvic health was my weakest link, and I’ve started to feel this massive heaviness, and I’ve said to my husband, I feel like I have a ton of bricks sitting on top of my pelvic floor. So that’s another red flag. Any of those sort of prolapsing symptoms. Then there’s bowel symptoms, is a red flag. So if you are having difficulty emptying your bowels, constipation, this might be related or any fecal incontinence, which is unfortunately also quite common and even less talked about the urinary [00:10:00] incontinence.

But it could be an issue with pelvic floor weakness or it could be an issue with pelvic floor overactivity or a combination of both. So if you’ve got overactive pelvic floor, they’re having trouble relaxing and that’s when you might have the issues with constipation, difficulty opening your bowels pain in the, your pelvis, like pelvic pain.

Women who’ve had a past history of endometriosis or any of those chronic pelvic conditions. Yeah, can sometimes have pelvic pain, painful sex is another indication of a red flag. Yeah. So if in doubt, check it out. 

Kylie: Yeah, a hundred percent. A hundred percent. And so what, you know, so let’s talk cause sex is something that, you know, we are not talking about.

And you know, a lot of women do experience painful sex and, you know, I think it’s a conversation that we need to have. And I sort of, with my clients sort of always look at it from a, like a [00:11:00] lubrication side, you know, do they feel uncomfortable wearing tight jeans? You know? So it’s more that hormonal, you know, that drop in estrogen, that dryness, you know, and I hate the term vaginal atrophy, like what , what male gorilla came up with that.

But it’s, you know, but so I sort of always think of it from a, you know, a, a dryness, hormonal sort of, but it can actually be pelvic floor issues too. 

Kath: Yeah. 

Yeah. So sexual discomfort is quite common. Again, as you said, I think that we don’t talk about it enough. And there are potential different causes of pain.

So I guess the big thing is identifying when it’s painful. Is it on penetration or is it more of a deeper pain? Your right vaginal dryness is it huge factor potentially. As you say the term atrophy, I think all of our [00:12:00] muscles as we get older become a bit thinner and our pelvic floor is one area we want a nice, plump, full muscle.

So rather than a thin, stretched muscle. So that can definitely Have an impact. But as you know, it’s not just a physical side, it’s the emotional, feeling tired. Yeah. All those sides. But in terms of the physical aspects, the first thing would be identifying where the pain is coming from. So you might need to see a pelvic floor physio for that.

 It might be a simple matter of trialing a different lubricant, and that in itself is a, there’s so many different lubricants around. Yeah. I have one, I, I’ll have to quickly bring up who it is. It’s, it’s called The Lover’s Brand and it’s a gyne, gynecologist who has created this, Dr Raelia Lew, it’s called Lover’s Products on Instagram.

And she’s got different types of lubricants based on different needs. So [00:13:00] she’s, yeah, I highly recommend her, because one’s one lubricant from the supermarket, a water based lubricant, potentially isn’t what you need. You might need an oil based lubricant or one. Yeah. So we highly recommend checking out. And I’ve done a podcast episode with Raelia too on my podcast.

Kylie: Yeah, great. Okay. Get those details, we’ll pop them in our show notes. 

Kath: Yeah, so the dryness is an issue. If it’s something like prolapse, which is causing pain, that can be really common too. So if your cervix is sitting a bit lower than normal, than it used to. You know, the penis could just be banging on the cervix and causing that discomfort, so yeah.

Yeah. Then sometimes we can discuss positioning or making sure you are in a, in the position of control so that you can gauge how deep penetration is. There’s something, oh, there’s so many. Do you want me to keep going with recommendations? There’s something called the [00:14:00] O-nut, which is amazing. An o-nut is this silicon ring that your partner can put on the base of their pelvis. And that helps to, pr helps to reduce the penetration depth. So if it is an issue with the cervical prolapse, an o-nut might be fabulous and apparently they feel really good for your partner too, so it doesn’t reduce the sensations.

Kath: So, pelvic floor muscle strengthening is huge. So there are, I guess at the, I guess to boil it all down, there’s so many different options depending on what your issue is. Yeah. So that’s where that individualized assessment can be really helpful. 

Kylie: Yeah. Yeah. Perfect. And I think, you know, it is important to, to get assessed and you don’t need a doctor’s referral.

You know, if you find a pelvic floor specialist. A physio who’s a specialist in pelvic floor. You know, go and see them. Book in, you know, you don’t need a doctor’s appointment, you don’t need to see a gynecologist, you don’t need, you know, and then you get that assessment done, you know, there could be exercises involved, there could be recommendations for certain products.

 You know, so it doesn’t have [00:16:00] to be surgery , which is, you know, like if you see a surgeon, they’re gonna recommend surgery. So, yeah. But there are steps that we can do before it gets to that. 

Kath: I tend to consider it in terms of four, four tiers. So the first like, easiest one to tackle, a lifestyle. So looking at, yeah, your daily lifestyle, how fit and strong and active are you, what’s your exercise program?

 What’s your diet like? Because we, we want the bowels to be functioning well because there’s a really close relationship between bowels and pelvic floor issues. So looking at those general lifestyle factors firstly, and then secondly, going onto pelvic floor muscle strengthening. Because that in itself can be if, if you’ve menopause, if you’ve had babies, you can probably most look, not everyone, but majority of the time it’s as a result of pelvic floor muscle weakness.

So this is when some [00:17:00] really beautiful strengthening around the pelvic floor muscles can be really helpful, but let’s face it, they are boring. I get it. They’re easy to forget. They’re easy to not prioritize. You forget to do them. We’re all busy. Yeah. Yeah. So it can be tricky to commit to a burst of pelvic floor strengthening, but can I just, you’re putting your hand up.

Kylie: Well, I’m putting my hand up for guilty of not doing them. Yeah. I’ll tell you what, when you start doing them, you, you, you kind of, I, for me, I didn’t notice how effective they were until I stopped doing them. You know, so while I was doing it, my pelvic floor felt great and you know, all those little leaks that I was having, stopped.

 And then I, you know, got slack, I stopped doing the exercises and then I would sneeze and I’m like, oh, oh, back to exercises. Yeah. And you know, I just got in the habit of, you know, it was the first thing I did when I woke up in the morning and it was the last thing I did before I went to bed. So I had, [00:18:00] you know, my, my rubber band and you know, I would just, you know, my husband just, you know, he just got used to it really.

Kath: Wait, you had your rubber band? 

Kylie: Yeah, so I, from my, uh, physio that I saw, you know, just on my knee, like around my knee, What are the bands called? TheraBand. Yeah. Yeah. So I had my TheraBand and I would do my exercises with my TheraBand before bed and after, you know, when I got up in the morning. So. 

Kath: Yeah. And that’s great. You found a habit like a, you were, habit for you and you were able to tack pelvic floor exercises into another activity like going to bed. And I think that’s key. Like I know with all my, I’ll do online workouts for yeah, exercise classes, and I’d never finish a workout without doing a set of pelvic floor exercises.

Yeah, because everyone’s already invested. They’ve already done 20 or 30 [00:19:00] minutes of exercise. What’s another two minutes? Just stay and do your pelvic floor exercises. So there are ways of weaving your pelvic floor into everyday activities or your exercise. So that it does get done. 

Kylie: Yeah, absolutely.

Absolutely. And that’s it. If it’s a commitment. But one of those things, you know, you notice how good they are when, when you’re not doing them. 

Kath: And if you are finding traditional pelvic floor exercises boring, there are other ways to jazz it up a bit. Yeah. You know, there’s devices out there, there’s these Bluetooth, there’s bio feedback solutions.

So we can put an a, an electrode or a probe, insert it into your vagina, you’ve, on an app on your phone and you can play sort of games. You know, you’re jumping over mountains and there’s all these like, really cool, apps and Bluetooth devices to help incentivize. Yeah. Keep it interesting.

So if you are finding traditional pelvic floor [00:20:00] exercises, just not doing it for you, there’s some other options, vaginal weights. So that’s, that would, when I’d go, that’s more the third tier. So we talked about lifestyle, then the good old traditional muscle strengthening and core exercises. And then the third tier would be what other devices are there?

So that’s, whether or not some vaginal weights or biofeedback, something to incentivize your pelvic floor muscle training or whether or not that’s pessaries. So I dunno how much you wanna talk about pessaries, but if you’ve got. 

Kylie: Talk us through the pessary. Yep. 

Kath: Yeah. Okay. So if there’s a, if you’ve got a pelvic organ prolapse or even some types of urinary incontinence, there are different types of pessaries. So pretty much what it is is a silicone, nice and bendable, it’s an insert that you can put into your vagina, you, it might be a ring, it might be a cube. There’s lots of different shapes and sizes depending on. what we’re trying to do. Yep. So it, a pessary is something that could hold [00:21:00] up a prolapse.

So you pop it in like a tampon and it stays inside and it might support your prolapse so that you don’t feel symptoms. Yep. And some women might use a pessary just before they go for a run or before they do exercise or they go out and about. So like they pop it in in the morning and then they take it out before bed.

 Whereas other women might have a longer term pessary that a gynecologist would put in and keep it in for a certain period of time. Yeah. But again, that’s something that you’d need to be assessed either by a gynecologist or a pelvic health physio that specializes in pessaries, but that could also be an amazing one just for keeping your symptoms at bay.

It might be all that you need. It might fit in really well with your lifestyle. And then there’s some women would hate the thought of putting in pessary. And then the fourth tier would be perhaps surgical intervention. 

Kylie: Yeah. Well I [00:22:00] think it’s good to, good to know that there’s so much we can do before we get there, you know?

Kath: Yeah, absolutely. And surgical intervention isn’t necessarily gonna be an option for you or you know, that’s something to talk to your doctor about. There’s always pros and cons of any of this sort of stuff, so it’s a matter of talking through the pros and the cons. And I really do think we want to have trialed the first three before even thinking about the fourth, because the first three are very low risk. Like, you know, they can only be the potential benefit, so why not consider these three first? And then even if you do have surgery, we still need to consider that, the lifestyle and the exercise. You know, the post-surgical rehab is super important and that’s something that also gets neglected.

I think sometimes doctors might say, okay, let’s have surgery, rest for six weeks. Have that six week checkup. It’s like having a baby, isn’t it? Have that six week checkup looking [00:23:00] great. See you later. Whereas that rehab, and this is why I developed my program, whether or not it’s postnatal rehab or post gynecological surgical rehab. Like there’s so much we can do to help support our pelvic health, to help support our, strengthen this area. And help us feel more confident and feel good. 

Kylie: And I think a sort of pretty scary sort of statistic is, you know, like the second biggest reason for women being admitted into nursing homes is incontinence.

 So, you know, the first reason is dementia. The second reason is incontinence. So if we can do something about it now, In our forties, fifties, sixties, you know, it’s gonna help us when we’re in our eighties and nineties. A hundred percent. We get this one body. And the more we can be proactive about our health, you know, including our gynecological health, the more we can do now, the better off we’re gonna be in the long term.

A hundred percent. 

Kath: Oh, preventative health. 

It’s so [00:24:00] good. Yeah, it’s like it, but it’s also, you know, there’s a lot of treatment options that sound a lot more sexy. Help reduce pain with this and help yeah, lose weight by doing this, whereas to sell prevention or like, you know, this sort of stuff is so life changing, but it’s just, it’s not as sexy to say, come and do this so that you don’t get x, Y, Z, whatever it might be, so Yeah. Yeah, yeah. It’s certainly, it takes it, I think there is a big shift happening at the moment. People are becoming more aware of the power of prevention. And it’s amazing. But still, our private health insurance doesn’t usually, It doesn’t usually cover this preventative stuff, but Sure, it covers you after. And same with our healthcare system. Healthcare backwards. I know it’s backwards, so yeah, you and me are both on the same page here about that. Yeah. 

Kylie: Alright, [00:25:00] well thank you so much for, for coming on the show. I think this is gonna be really helpful for a lot of ladies and you know, if your take home message, you know, for those who who are listening, your take home message is you do not have to put up with this. You know, there, there is so much we can do. Get yourself assessed by a pelvic floor, you know, physio. You don’t need a referral, you don’t need, you know, Google one or you know, Kath’s got programs online.

So, you know, there’s so much support out there. But get assessed. Don’t just suffer in silence. You don’t wanna be the nana who ends up in the nursing home because she wees herself. Telling it to you straight. So, so, yeah. So thank you Kath. And I think it’s, yeah, definitely something, an area, another area of women’s health that we need to be talking more about and you know, bringing awareness to so we can, you know, be proactive and do something for ourselves.

Kath: Yeah, that’s great. And often it is that first step of [00:26:00] becoming aware of it. And if anyone wants to send me a question, if you’re not sure about the next step for you or who to go and see, feel free to send me a message on Instagram at FitNest Mama. So I, I’m happy to help. Yeah. 

Kylie: Fantastic. Thanks, Kath.

That’s very generous, and we’ll pop all of Kath’s details in the show notes for you. 

Kath: Great. Thanks Kylie. 

Bye.