Far 2 Fabulous

Guest Episode: Beyond the Taboo: Reclaiming Control of Your Pelvic Health

• Julie Clark & Catherine Chapman • Episode 61

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Episode 61

Pelvic floor health remains one of the most under-discussed aspects of women's wellness, yet affects one in three women. In this eye-opening episode, Julie and Catherine welcome women's health physiotherapist and nutritionist Chloe Stevens for a candid, myth-busting conversation about all things pelvic health.

Chloe swiftly dismantles common misconceptions, explaining that pelvic floor dysfunction isn't always about weakness—some women have overactive floors that don't relax properly. She skillfully navigates the complex relationship between childbirth, perimenopause, hormonal fluctuations and pelvic health, while offering practical, evidence-based solutions that go far beyond basic Kegel exercises.

Perhaps most refreshingly, Chloe challenges the outdated advice that women should avoid exercise or heavy lifting. Drawing from her MSc research and clinical experience, she advocates for a balanced approach that empowers women to stay active while managing symptoms effectively. "No one's going to die of a prolapse," she points out, "but if you don't exercise, you risk sarcopenia, osteoporosis, and fractures—that might ultimately kill you."

For women navigating perimenopause, Chloe explains how estrogen fluctuations directly impact pelvic floor function and offers practical strategies for managing symptoms, including the powerful combination of physiotherapy and topical estrogen. She compassionately acknowledges the shame many women feel while firmly rejecting the notion that incontinence or prolapse should be accepted as inevitable parts of aging.

Whether you're experiencing symptoms yourself or simply want to take preventative measures, this conversation provides the knowledge and confidence to advocate for yourself. As Chloe powerfully concludes, "We really shouldn't be accepting incontinence or prolapse as part of being a woman, and there are really simple things that can make a world of difference."

Make sure you connect with Chloe through Instagram HERE and find more information on her website HERE

Got a question or comment? Send us a text message here!

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Thank you for listening.

You can continue the conversation with us in the Far 2 Fabulous Facebook group. Come and connect with other women on a journey to empowered health.

For more information about Julie Clark Nutrition, click HERE
For more information about Catherine Chapman, click HERE

We look forward to you joining us on the next episode.

Speaker 1:

Welcome to Far Too Fabulous hosted by Julie and Catherine.

Speaker 2:

Join us on a mission to embrace your fabulousness and redefine wellness. Get ready for some feistiness, inspiration, candid chats and humour as we journey together towards empowered wellbeing. Let's dive in. Hello, hello everybody, and welcome to the Far Too Fabulous podcast. I nearly said Facebook group I'm gone already. We always start these laughing because I start this off sounding like we're introducing the Muppet Show and Julie starts it off making it sound like she's introducing the.

Speaker 1:

I'm like a newsreader, aren't I?

Speaker 2:

It all goes to hell from the minute we go on, but we're trying to behave ourselves because we've got a fabulous guest with us today we are welcoming chloe stevens.

Speaker 2:

She is a women's health physio and nutritionist. She is an educator of women and coaches. We're both here waiting to be educated, looking forward to pelvic floors, pregnancy and perimenopause and all that lovely stuff. Lots of experience within working with the NHS, and she's got some patients ready and waiting for her very soon, so we're going to get on with it today. If you're joining us, my pleasure. Thank you for having me. It's so great to have you here. You are doing such incredible work across social media. I know that you've helped us female older marathon runners. All of your tips have been coming through my sister, which is fantastic work.

Speaker 2:

She doesn't mind me outing her and yeah, and it's just, it's fantastic and it's so so well needed. So that was kind of a roundup. But, in your own words, who are you, what do you do, and and all that lovely things yeah.

Speaker 3:

So, um, I started out actually as a maternity care assistant. So I worked in maternity for a good five years, um, and then I became a women's health physiotherapist. So I work predominantly within the NHS doing women's health physiotherapy, um. And then I did a nutrition qualification, just because I think a lot of pelvic health needs knowledge around nutrition, because that can be really important for, like, bowel movements, things like that. And then I kind of started sort of educating PTs and personal trainers and coaches around women's health, because they don't really get much education into women's health and their qualifications, and so I have a consultancy that helps them to do that. I'm currently just finishing my MSc in women's health at UCL and my final project is like a narrative review on pelvic organ prolapse and exercise and pelvic organ prolapse, so hopefully I know quite a bit about this subject that can help your listeners.

Speaker 2:

Oh my goodness, if you could write down everything you need somebody to know, just for all of our listeners about this, I think that would be the list, don't you?

Speaker 1:

yeah, I think, talking about pelvic floor and this issue that a lot of us have, we don't often discuss it or talk about it, but it is so awful to experience and I've said on the podcast before that I don't generally have an issue until I've got a cold. And then the cough cough, cough cough. I just have no control and I don't really understand it, to be honest, because I can do gymnastics, I can jump on a trampoline, no problem. I'm in my 50s and I feel like I'm doing all right. But then I get a cold and I have this issue and someone said to me I think you've got an overactive issue rather than a you know the opposite. So I don't really know where do I start with that, chloe?

Speaker 3:

Yeah, so I think a bit of a misconception is that the only issue with a pelvic floor can be weakness, and that's a misconception in of itself, because a pelvic floor has to have four things really it has to have strength, it has to have endurance, so there'll be an ability to maintain strength over a time period. It needs to have coordination, so it needs to switch on when you need it to, when you're coughing, when you're sneezing, when you're laughing. And it also needs to have flexibility. So, like you said there, some women have high tone or we don't really call it that because tone is very difficult to measure but a non relaxing pelvic floor, a pelvic floor that doesn't relax properly and that can be just as problematic as a pelvic floor that is weaker. So, with regards to the problem that you're discussing, you know we're talking really about stress, incontinence. Stress incontinence is when there's an increase in intra-abdominal pressure and the pelvic floor can't respond. Now, unique to you is that you can do all these things like jumping, running, skipping. It's only when you're coughing, when you're unwell, that it's a problem.

Speaker 3:

And I'd say, you know, without assessing your pelvic floor, I can't really tell you what your pelvic floor is doing.

Speaker 3:

But what I would say is remember, when you are coughing and you are acutely unwell, that has an effect on your entire system, and so we often have like malaise, we might have weakness and that might be affecting your pelvic floor too. So I would say that might be the differentiating factor in your pelvic floor when you do have a cough, because you are fundamentally unwell and that will have an effect on all of your muscles in your body. If you did think that you had a non-relaxing or an overactive, as you said, pelvic floor, we might see other symptoms. So we might see things like coccyx pain. We might see things like painful sex. We might see things like constipation, where your pelvic floor won't relax so you can't open your bowels. We might see things like we call it like power peeing, like pushing out your urine, like you should just be able to relax and your pelvic floor should allow your bladder to empty. So in order to kind of diagnose a non-relaxing pelvic floor, there might be other symptoms that come alongside it.

Speaker 1:

What sort of percentage of people have this overactive versus a weak pelvic floor, would you say?

Speaker 3:

because overactivity is very difficult to be able to measure. I don't know the percentage of that right because everything has a bias. So if I do a pelvic floor examination with my finger, I'm not particularly good at assessing tone because it's not an objective measure of what a pelvic floor is. There's finger I'm not particularly good at assessing tone because it's not an objective measure of what a pelvic floor is. There's always going to be an element of bias.

Speaker 3:

If we think about pelvic floor dysfunction as a whole, one in three women have some form of pelvic floor dysfunction. That might be incontinence, that might be prolapse, that might be incontinence of wind or bowel problems. So as a whole, one in three women have some sort of pelvic floor dysfunction. When we narrow it down to like stress, incontinence, it's normally like 22 percent of women have some sort of stress incontinence or urge incontinence. And if we think about prolapse, you know I always say this statistic with hesitation 50% of women have some degree of pelvic organ prolapse. But I think if you say 50, 50% of women have a prolapse, everyone is like, oh my god, that's so high, that's like definitely one of us on this call having a prolapse, you know, and people kind of go into a flat spin, the the issue is, you know you can have something and have no symptoms, and so with prolapse, a lot of women will have no symptoms from a prolapse, but they have it right, and so it's not until it's symptomatic that it's really an issue. And we know that about 8.6 or 8.2 i't remember the exact statistic percent of women will visit primary care or a GP with symptoms of a prolapse. So, yes, 50% of women may have one on examination, but only 8% of women tend to have symptoms of that and thus are what may go to the GP with like a symptom of heaviness or dragging in their vagina.

Speaker 3:

So I think we have sometimes, I think prolapse is sometimes over pathologized, and you know I don't know about you two, but I am 35 now when I was 18 my boobs were not in the same place as they are now, and so you know like there's always changes in range of movement of tissues and to me, some degree of pelvic organ prolapse could just be a slight change in the range of movement of the vaginal tissues and we don't necessarily need to over pathologize that. We definitely don't need to push women down a surgical route without, you know, doing conservative measures like pelvic floor physiotherapy to help manage that. That comes with a whole host of other complications, doesn't it? Yeah, most definitely. You know, doing conservative measures like pelvic floor physiotherapy to help manage that.

Speaker 2:

That comes with a whole host of other complications, doesn't it?

Speaker 3:

yeah, most definitely. I mean, if we look at prolapse repairs, the re-operation rate is one in nine, which is very high, and there's.

Speaker 2:

Wasn't there something to do with the mesh, or something that we still use in the uk that's now banned in the us?

Speaker 3:

it's it's all very controversial so mesh is on a pause. In the UK you can only use mesh in some circumstances, so mesh was used. There's a TBT sling which kind of props the bladder up, and then there's mesh that is used for like pelvic organ prolapse. In my knowledge you can't use mesh for a prolapse anymore. They sometimes do use mesh for bladder and like leakage and dysfunction, but it's a lot rarer.

Speaker 3:

Because of all the litigation around the mesh, I think it was really successful for some women but unfortunately not very successful for others, and I actually wrote one of my MSC essays on mesh and it is quite astonishing that mesh was kind of allowed to be used and with regards to like medical devices, that it's a bit of a wild west. It doesn't have to go through the same rigor and testing as a pharmaceutical treatment and so you know there's a lot of gray areas of how the mesh got through, how it it was tested, and so it's definitely a tricky area and a lot of women are suffering a lot of chronic pain and issues off the back of the mesh.

Speaker 1:

Chloe, what do you think the triggers are for having these issues, because I think a lot of us know that after we've had a baby, we might have some issues in that area. And we're advised to do pelvic floor exercises and things, but even people that haven't had children but then go through their hormone changes also start to get issues. So what are the main triggers for having these issues in the first place?

Speaker 3:

Yeah, so you're right in saying that two of the biggest risk factors are childbirth. For every child that a woman has, she is 10 times more likely to have a pelvic floor related issue. For every decade that we go through as a woman, we are 10 times more likely to have a pelvic floor related issue, and so the other risk factors that are problematic are menopause. As you said, when we are going through perimenopause or menopause, the depletion of estrogen has an effect on the vaginal tissue, so we see something called vaginal atrophy, which is thinning of the vaginal walls, and we also see changes in plumpness and elasticity of the pelvic floor, and thus that can give rise to pelvic organ prolapse or incontinence. The other things that are lesser known are chronic constipation. Chronic constipation can have huge impacts on the pelvic floor, because you have imagined, if you're straining to open your bowels all the time, you're constantly putting downward pressure on that pelvic floor, and that can cause, to some degree, of pelvic floor dysfunction. Other things that they think might be an issue are chronic coughing, and so we don't know whether that is more likely to be associated with smokers. So smoking can have an effect as well, and potentially that is because of the chronic coughing. Obesity can have an effect on pelvic floor as well. And then the other thing that is kind of like a chicken and egg right is a lot of people will say like heavy lifting or high impact affects your pelvic floor. The data that that comes from is studies into cleaners and factory workers. So I think the problem when we look at that as advice iee heavy lifting and height or heavy lifting let's take that If we say, oh well, you shouldn't heavy lift because of your pelvic, it has an impact on your pelvic floor. But the data that we have that from comes from factory workers and cleaners who are lifting repeatedly throughout the day. That is different to a woman going to the gym for one hour a day and lifting weights. That's completely different, right.

Speaker 3:

And so this is where it becomes a really dicey, problematic area, because women will go to gynecologists, health care professionals, and they'll say stop heavy lifting. Well, to my mind, no one's going to die of a prolapse Right. Of a prolapse right. You will put your longevity and you're risking having lots of complications in later life. If you don't lift right, if you don't lift, if you don't do exercise, what then happens? You have sarcopenia, which is loss of skeletal muscle mass, you lose bone density, you have osteoporosis. You then fracture your hip by falling and then you end up in hospital. You may catch pneumonia and I know that sounds really morbid, but that might ultimately kill you. So I think that we have to be so careful around the messaging around prolapse or pelvic floor dysfunction. Telling women to stop exercising from old data that doesn't even really relate to women. Lifting weights for short periods of time a couple of times a week could eventually cause so much, so many more health problems for them later down the line yeah, I love how feisty Chloe is.

Speaker 1:

She's as feisty as I feel she is.

Speaker 2:

Indeed, I love that and and I like the way that really what she is saying is you need. It's the opposite way around, isn't't it?

Speaker 3:

You need to exercise and actually it may well help the muscle tone and everything deadlift and you're really symptomatic like you have a lot of heaviness or dragging because of a prolapse or you're leaking.

Speaker 3:

Whatever we can regress that and part of being a good pelvic health physiotherapist, I think, is basically helping women to understand how to manage pressure, not to stop them lifting. I think it's really lazy physio or lazy healthcare advice to tell someone oh, X is happening or just stop doing X. That's so lazy, right? You know you should be working with a patient or working with a PT or whoever it is, to find regressions and adaptations and allow that person to still exercise. And so, yeah, I think it is so dangerous to stop people exercising and, as I said, you know it can be wildly horrible to experience pelvic organ prolapse or incontinence, but it's not going to kill you. But we can work and manage that. Learn how to balance pressures throughout your body so that we can potentially get on top of that and help you to manage those symptoms potentially get on top of that and help you to manage those symptoms.

Speaker 2:

Yeah, yeah, I completely, completely agree. There is so much fear. I don't know whether it's it's a control or it's a litigation thing, I've got no idea but it's. There is a lot of fear that controls all of these, these blanket statements, and often I get a client will come into the studio and say, well, I can't do that or I can't do this, and, um, my eyebrows, raise my eyes, get a little bit wider and I kind of bite my tongue and my mouth and I go.

Speaker 3:

Well, you know, we'll see yeah, yeah, yeah, it's so true and and that's why, like especially in medicine, we have to be so careful with what we say, because you can really put a lot of fear into people and that's so problematic, and especially if it comes from a consultant, because consultants have like a status to them and if that's said by them, then me, as like a shop floor physiotherapist, trying to trying to go against what a consultant has said can be really difficult at times, really, really difficult.

Speaker 1:

Yeah yeah, I can relate, because I get people that have been to the doctor and then they come and see me for nutrition and, yeah, I often say something opposite to the doctor and then but the doctor said it.

Speaker 1:

It's really hard actually because, like, you said, there's a status and authority and an assumed power there, so it can be quite difficult, I think, with this problem. I think a lot of women just think they've got to get on with it and don't really know what to do. Or there's that aspect of you know, I've got to the age now where I'm not having to have my that area messed around with anymore and now I need to go and speak to someone about this and then it might be an exam. That's internal and do I want to do that? What's's your thoughts on?

Speaker 3:

that I would say that you know, just because you are aging as a woman, it doesn't mean that you have to accept certain things about your body changing. And I think that's really problematic in that we are already, as women, kind of told, dismissed and made to feel shameful about these things, and part of kind of changing society is talking about those taboo subjects or going to your GP and just expecting better for yourself. You know, knowing that you are worthy of being it should be worthy of going to do exercise without wetting yourself, or you should be able to go and do like some lifting and not feel your prolapse, or have sex and not feel your prolapse. You know, I see so many women who don't even go out anymore because they might have like bowel incontinence. And you know we should be, we should expect better for ourselves and be able to advocate for ourselves.

Speaker 3:

Now I'm not saying that's easy and I do recognize that there's so much shame and guilt caught up in, like pelvic floor dysfunction. But I would say the first thing I would say is think how is this affecting my quality of life and my ability to be able to do the things that I know are good for me or the things that I love. I need to do, like even going to work right, and if this is compromising your quality of life and your ability to be able to get on with a normal life, then I would most definitely make an appointment with your GP. There are like pelvic health physios out there. We're really well lucky in Whitstable area that we have the service that we do. I'm not sure if it's the same for everyone listening to this podcast, but you know there are lots of pelvic health physios within the NHS now, and getting a referral which might take a while, but getting a referral would be a step in the right direction.

Speaker 2:

Most definitely, yeah, and is it a realistic thought for herimenopausal women because that's who we're generally talking to on this podcast to expect to be fully continent if? Even if they're not now, are there lots of things that they can do to be able to expect that to continue later on into life?

Speaker 3:

yeah, I think most definitely, I think we should expect continents and work for continents. You know, I think it's really sad that, like, most of the adverts on the tv are like tenor ladies, when actually we should be talking about prevention rather than cure. You know, and and we do know, that pelvic floor exercises are highly effective for um incontinence, especially urgency um, and they are effective for pelvic organ prolapse as well, and they really are like small things that you can fit into your daily life. I would say, you know, there are cases where they don't work. There are cases where people need more, more intervention, like um the help of a gynecologist, or they might need surgery, or they they also might need topical estrogen.

Speaker 3:

You know, I think, really for a lot of perimenopausal women, the magic really happens when you use, like vaginal topical estrogen and do pelvic floor exercises that are guided by a physiotherapist. Quite often we see better outcomes in patients who have had a physiotherapy assessment and have been taught how to do them, not just by watching a youtube video or whatever, but also having like an internal examination and making sure they're doing them correctly. So I think that we should be promoting and expecting continence for ourselves and thinking that that, you know, that shouldn't be a luxury to be continent after, after menopause. Yeah, I mean for me all of the listeners know that shouldn't be a luxury to be continent after, after menopause yeah, I mean for me, all of the listeners know that uh, when and when I'm marathon training that it's a problem and it wasn't actually until, I think, that, because I've had three children, so I just expected that there was going to be a degree of incontinence.

Speaker 2:

And it wasn't until I was doing my marathon training and I was noticing that it was going in a cycle. So one week I didn't even have to, you know, run very far and I already felt like I've been incontinent. And then so, you know, a week and a bit later, and if I ran again, it was absolutely fine. And it wasn't until I realized it was more hormone driven that you start to think oh, actually, you know, we need to do something about this, as opposed to buying patterned leggings so that you can't see it fluctuating um or if you are having like um in perimenopause, where hormones are fluctuating, what we find is that when oestrogen drops, that's when we tend to see changes in pelvic floor function.

Speaker 3:

So if you think about the menstrual cycle, when you are going towards ovulation, oestrogen is rising. After ovulation oestrogen has a like quite a sharp drop down. So some women will notice symptoms then. Then estrogen slowly rises but doesn't really peak in that luteal phase and then just before your menstrual cycle, estrogen and progesterone drop down. And that drop in estrogen and progesterone just before you have your period for a lot of women is a very problematic time and that's when they have a lot of symptoms. So it tends to be related to the changes and fluctuations of oestrogen throughout your cycle, you know. Then we think about perimenopausal women and their hormones are literally up and down, bouncing up and down. So it can be a bit more unpredictable for perimenopausal women when they may have incontinence because of those very turbulent hormones that are going on for them. So it tends to be the changes in estrogen that affect the pelvic floor. So if you're in perimenopause and your estrogen is bouncing around all over the place, that can be an issue.

Speaker 1:

This goes back to us saying about you should know your cycle as well, because it does make a big difference. And you'd noticed that, even though you don't actually have a period because you've got a coil, you still know your cycle, don't you? So you know those times when that, then that's happening. If you've got a problem and you go and see someone like you, chloe, how long does it take normally to see a change in your symptoms?

Speaker 3:

does it take normally to see a change in your symptoms? I think we tend to say about three to six months of consistency tend to see the the best changes in pelvic floor function. But I think I see a lot of women who will leave my office and they'll you know what it's like. You get a new plan and you feel really motivated and you do it every day. And so I often see women about two to three weeks later and they would have been really really consistent with their pelvic floor exercises or whatever I've given them to do, whether that's some other exercise as well and they'll come back to me and they'll say, oh, it's, there's been a really big difference. And I'm like, okay, great, fantastic, that's great, you got to keep going.

Speaker 3:

And then ultimately, life gets in the way and you go from doing it three times a day, when you were super motivated, to two, and then you have days where you get in bed at night and you think, oh crap, I haven't done it. And I think there's always kind of what I've seen as a trend is that first follow-up consultation women will say, oh, things are a lot better. And then then they'll be like, oh, do you need to see me again and I'll be like, yes, because I I know that your, your motivation to do this is gonna wane and there will probably be a little bit of a trough and things might feel a bit um problematic again. And so I want you to come back and see me in another month's time just to kind of rally you and give you a bit more motivation and say, keep going.

Speaker 3:

Because I do think we tend to see, like, what I always say to any patient is that, like, rehabilitation is never a linear process. You don't just keep getting a bit better every day. There's always setbacks. And so I think you know, if I, if we look at the data, we're probably thinking about three to six months. So you can see, within that three to six months, it's not just going to get better all the time. There'll be days where you think, oh, my God, like I've just peed myself and that was why is this happening? What's gone on? And so there are always peaks and troughs in the process.

Speaker 1:

And then is it something that you do have to keep doing.

Speaker 3:

So once you've experienced an issue, you do have to keep doing the exercises forever there is no end point to exercise and this is just the gym for your genitals. I love that. You've got to keep going, right? You know you might not have to do it at the same frequency and if you did have a recurrence of your symptoms, you might go back and, you know, turn the volume up on it a bit more.

Speaker 3:

But I do think you know that they are a fundamental part of being a woman and being a woman that exercises you wouldn't just start neglecting your bicep or your glutes, like what's the difference with your pelvic floor, right? So I would say, yes, fundamentally they are a part of life, especially if you have had some form of dysfunction. But I would say, you know, even if you haven't had some form of dysfunction, it's probably a good thing to, every now and then, just check in and see if you can activate your pelvic floor and see how that feels to you, because I don't think there's an end point to them. Just as I said, they're gym for your genitals and you've got to keep going.

Speaker 1:

you don't move it, you lose it if you're someone who is like in their 70s and this has has only just been started, you know this conversation is only coming to the forefront for them and they're like I've had this issue now for like 30 years and now I'm hearing saying it's not.

Speaker 3:

It's harder, you know it is harder when we're over like a certain age, especially because of things like anabolic resistance, that's, our body responding to strength-based training and our body responding to like protein and synthesis of muscle. But you can still build it. You might have to do a little bit more frequency of them, um, but it's never too late and you know there are just starting pelvic floor exercises at that age can have a big difference and then maybe combining it with some other like hip based strength training, can really help that pelvic floor as well. So I don't think it's ever too late. You know I see loads of women who are in their 70s who start pelvic floor exercises and you know they have really good outcome.

Speaker 2:

That's amazing. And with regards to the estrogen pessaries, because that's that's why I started using. Unfortunately, I started using, I got prescribed almost the day I did the brighton marathon last year, which was really annoying and I am I'm horribly inconsistent remembering them, but they are. They're there as part of it. Is that something that, once the uh roller coaster of perimenopause settles down, is that something that is advised to keep going? Is that something that you can then maybe like, try without what's what's?

Speaker 3:

the trend with that. I think it's really person dependent and you know it really depends on the person sitting in front of us. But I know some women like I've got women who I still see who still use the topical estrogen or the pessaries way later than having unfinished menopause and they they continue to use it for like lubrication, their vaginal tissue health, and so you know, I would say I don't think there's any sort of blanket statement or one size fits all with that, but I'm pretty sure I've got women on my case load who are probably in their mid to late 70s who still use some form of like um, topical estrogen?

Speaker 2:

yeah, that's interesting. And what advice do you? So when you're training sort of pts and things, what advice do you tend to give them?

Speaker 3:

I tend to tell them that they need to learn about pelvic floors. It's not just this sort of misanoma that you ignore, because pelvic floor dysfunction can be a massive barrier to exercise and I don't think teaching pelvic floor exercises is that complicated. You know, pts are way better at programming exercises, in my opinion, than physios. You, you know we just work on like a short period of time and do rehab stuff, and so if you're good at programming as a PT and I I think neglecting that muscle group is is problematic.

Speaker 3:

And also you know, we know that a lot of PTs market themselves for women specifically, and if you won't talk about that subject or won't learn about that subject, I don't really think you should be coaching women. You know, we know the statistics are really really high. It's like a third of women having pelvic floor dysfunction. If you've got three clients, that means one of your clients has got a problem. I just don't see a world in where we we shouldn't talk about this issue and you know so much of women's health is shrouded in taboos and talking about the things tends to be the best way to reduce shame and reduce taboos. And so I think for PTs, it's a muscle group, it's fundamental, and if you're coaching women, it's fundamental that you learn about all muscle groups in the body, including your pelvic floor.

Speaker 1:

Howie, I know that you've got not long left with us now before your client turns up so just a quick question from me. If you're somebody listening to this and you're thinking, okay, I need to sort this out, but I know that one it's really hard to get in to see my doctor, then I know that a referral is going to take time and then I'm going to have to wait. But you've said, don't just look at YouTube videos. What can someone in that position do for themselves now whilst they're going through that process?

Speaker 3:

I would say, you know there are people privately.

Speaker 3:

You know, um, this is my private clinic, so I'm working privately in a minute and so there are, like women's health physios that you can go to see.

Speaker 3:

I I always try to encourage people to go through an nhs route because I think if you you pay, you pay, you should be able to, you should be able to access that, so I would maybe see someone privately alongside waiting for your NHS referral.

Speaker 3:

With regards to, like what I said about the YouTube stuff, I would say you know there's no problem just listening and starting pelvic floor exercises in that way, you know. But I would say you probably want something to be a little bit more individualized to you down the line and I think you know there's some really helpful information online and maybe follow some pelvic health physiotherapists because obviously they have a chartership and they can't give misinformation online, so it might be better to follow someone. You know there are some people who put some horrible stuff out there. But I would say, follow people who are like, have a chartership and maybe follow their advice around pelvic floor health and start them, and if you're not getting anywhere, then think I probably need something a bit more individualized, so I might wait for my NHS referral or go to see someone privately.

Speaker 1:

That's brilliant. Now we'll obviously put your contact information in the show notes, so you'd be a good person to follow, of course, because we know you're very good at putting across the importance of this. Have you got resources that we can point people towards as well for this kind of thing?

Speaker 3:

yeah, I have, I have resources, I have like pelvic floor videos and stuff. So if they want to contact me on Instagram or something, I can always send them like short videos and but you know, I would say one thing is that when we send videos like that, there is no nuance and there is no individualization. So you know it is, it is important to get yourself assessed, whether that is privately or through the NHL, okay fantastic, yeah, absolutely amazing.

Speaker 2:

Thank you so much. I know that I've learned lots here and I'm sure that everybody else has to keep up the great work.

Speaker 1:

It's really really fantastic what you're doing yeah, thank you, chloe, thank you is there anything you want to finish off that you just want women to know and understand yeah, I would say just don't suffer in silence.

Speaker 3:

I know it's a really difficult conversation to have with your GP, especially, you know, if they're male or something like that, but we really shouldn't be accepting incontinence or prolapse as part of being a woman and there are really simple things that can make a world of difference for a lot of women.

Speaker 2:

Yeah, brilliant, great thing to end on. Thank you so much. Thank you for keeping us company today. If you enjoyed the podcast, don't forget to subscribe and leave a review. Your support helps us on our mission to reach a thousand women in our first year, so share with your friends and family. You might just change your life. Connect with us on social media and make your life easier by joining our podcast mailing list.

Speaker 1:

You'll find the links in the show notes. Your weekly episode will be delivered straight to your inbox every thursday morning make it a fabulous week and we'll catch you in the next episode.