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Today, we're talking with Kim, the one and only vagina coach about pelvic floor health and how it changes as we. Through menopause. I'm Natalie and you're listening to the resource doula podcast.

Natalie: 0:15

Hello and welcome. I'm Natalie. And I'm really excited to have Kim Botney on the podcast today. She is an incredible voice in the pelvic floor world, and I'm honored to call her a mentor as well. Kim Botney is a self-professed Cagle Maven, and is known as the vagina coach. She is a certified fitness professional who became passionate about spreading information on pelvic health after the birth of her first. She's an author, a passionate speaker and a women's health educator, her most recent book, your pelvic floor launched in March, 2020 and was on the bestseller list. Since pre-orders launched in January. Kim is a founder of pelvic and wellness, Inc. A company offering pelvic health programs, products, and coaching for women in pregnancy, motherhood, and menopause. Kim also certifies other fitness and movement professionals to work with women with core and pelvic floor challenge. Through her core confidence specialist certification and pre postnatal fitness specialist certification. You can find her online at www dot vagina, coach.com and on social media at vagina coach. So welcome Kim. Thanks so much for being here today.

Kim vopni: 1:28

Thank you for having me.

Natalie: 1:32

So let's go ahead and just kind of start to with your process and your journey and what led you to. Pursue a career in women's health, specifically publicly.

Kim vopni: 1:45

Um, I, I, it happened accidentally on purpose. I say. So, um, I have always been interested in health and fitness since I was a teen. And, um, uh, even earlier than that, I had seen a childbirth video. And that was in as part of our sexual wellness at school. And, and that sort of planted the seed. That childbirth was not something that I was interested in ever taking. Pardon? Um, Anyway, long story. Then I grew up and I decided I did want to start a family, but along the way, I had asked my mom about her experience and my mom wasn't a Werner. She was very open with information and all was taught my brother and I proper anatomy, which at the time was a little bit cringy. But now I feel grateful for the fact that she did. And so I was always asking her questions and I also was observing and knowing she had issues with. Her bladder, she stopped running. She had super heavy periods. Eventually had a hysterectomy. She had chronic back pain. She had a tummy that wouldn't flatten. And so this was all sort of, again, reaffirming that I didn't want to have a baby, but then when I did decide I wanted to start a family, I was really determined to do something different or have a different story than my mom. And I actually was thinking, well, I'll just have a scenario. I'll just see if I can find a doctor who will do a and so that was kind of my. With my limited view at the time, what would be the cure all? And it was actually quite difficult. I think it's a lot easier now to find physicians who will do elective Syrians, but at the time it was sort of, why would you want to do that? And, um, not everybody really appreciated the pelvic floor, cause it really that that conversation was not happening at all back then. So in this, so might just as reference. Um, my oldest is almost 18. So this is about 18 years ago when I was going through this process. And then I was using midwives and my midwives had told me about a product called the epi. No, which is a biofeedback device manufactured in Germany. And it designed to it's a biofeedback to help you connect with your pelvic floor and learn how to connect contract and relax the muscles. And also it does parallel massage and. So I looked at this and said, okay, this is a way that I could, like, my intention was really can I prevent tearing? And I associated tearing, which my mum had experienced in episiotomies. I associated that with postpartum and continent. So I thought if I don't tear, I won't have incontinence again at the time with my limited knowledge. That's what I was thinking. So I purchased one of these products. I used it. I was using midwives. I had done a little bit of research about childbirth, um, looking at different birth positions. I was in a sideline birth position. I had midwives, I had used the epi. No. So I had a few things that were working in my favor. I was able to prevent tearing at the time. All I really thought about was the superficial sort of the external tearing that we think about or that we know about. And later, like years later I found out I actually had some internal tearing that I didn't even know about because nobody checks for it. But anyway. So what happened is that I had this great experience with this product and I thought, how is it that the rest of the world doesn't know about this? None of my friends had heard of it. They, some of them had had some not so great birth stories. So I contacted the company and said, could I be a distributor? And I thought, yeah, I'll just have a little side business. And that's how it started. And that's what it was for a little while. And then in 2009, the financial world kind of fell apart. And I was working for a financial services company. I was laid off. And then I thought, okay, well, here I am. Let's see if I can turn this into a business. And I had already started a website and then I just started reaching out and trying to connect with others. And that's how I ended up meeting Samantha and Julia, who I know, you know, and we formed bellies, Inc. And then we were sort of juggling the two companies. We, we were educating other fitness professionals and. To wrap up my, my story as to how I got into this. That's how it started. And I was working primarily with pregnant women because I recognize a huge opportunity, missed opportunity to educate people about pelvic health in pregnancy. And then when we formed bellies, Inc, we were starting to focus on optimizing postpartum, recoveries. And then I started myself, all of us in Belize, zinc. We all started to transition more into peri-menopause and starting to approach menopause. And there's a whole other. Kind of realm of pelvic health challenges that come up. And we said, you know what? This conversation is not just pregnancy. It's not just postpartum. It's through all our life stages, even people who've never given birth before. And the term vagina coach came about when I had been speaking at a women's health, sorry, at a women's entrepreneur conference. The speakers were all some sort of a business coach. And when it was my turn to go up on stage, I said, well, you know, jokingly, you have a vagina coach for your business now. And it was, it was totally a joke. It just sort of came out of my mouth spur of the moment, but it was a light bulb because at the time I'd been the fitness doula and that wasn't really resonating with perimenopause and menopause women and vagina coach sort of summed it up. And, you know, also is pointing out that it's a word, no one likes to say, but we have. Say proper anatomical terms. And it was also doesn't matter what life stage you're in. If you have a vagina, you have considerations that need to be, need to be, need to be educated, need to be, we need to be informed about. So that's how it started. And here I am now.

Natalie: 7:19

That's an amazing story. I love it. And I found you when you were the fitness doula. And I was like, this girl is doing exactly what I want to do in my life. And so we connected that way and I got certified and Yeah. the rest is history.

Kim vopni: 7:34

Yeah. Yeah. I will always remember that email. I want to be you when I grow up.

Natalie: 7:40

It's true. It's still true. It's still true. Um, Okay. So as we age, as, as women, as females, our pelvic floor changes. When I kind of talk about what those changes might look like and what typical symptoms do we associate with aging that may not necessarily be, normal, common, but not.

Kim vopni: 8:07

So the pelvic floor is a group of muscles and they have a lot of different, really important jobs that we really, again, deserve more information about what we haven't been told. So I think if I reflect back when I was learning about that childbirth video, that would've been a great opportunity to talk about this group of muscles that faces a lot of change during pregnancy and childbirth. But even before that, we experienced changed during our menstrual cycle. We experienced change from fear and trauma and falls and sports activities, hormonal fluctuations. And then of course, if we, if you were born with a uterus and at some point you will go through menopause, whether it's surgical, chemical or a natural evolution into menopause, which also has significant influence to this group of muscles that, that the general function it should. Our pelvic floor is responsible for controlling our content. Keeping our organs in place supporting our pelvis and like contributing to spinal and pelvic control and stability. Part of our core sexual response, like really important jobs and some of the more common signs and symptoms when things are maybe not working as optimally and continents is a big one. So that's where we lose the capacity to control our urine or our gas or stool. So we can have urinary incontinence and we can have anal income. Anal is obviously much more life-altering much less common. Urinary incontinence is very common. So one that we would, would be most common that we hear about. Cause we see pat companies all the time telling us that it's just part of being a woman or it's just what happens when you get older. So super common, especially people who have given birth, that's a definite risk factor. Um, and then we have. Organ prolapse. So that's where the bladder or the uterus and the rectum. We can also experience prolapse of the urethra and our intestines, but the most common would be bladder uterus, rectum shift out of their proper anatomical position and start to bulge into our descend into the vagina. So symptoms would be low back pain. Difficulty starting the flow of urine, a sense of heaviness or fullness. Sometimes people talk about feeling like something's inside or something's going to fall out. They feel vulnerable. They may not have as much sensation during insertive sex. They might have discomfort during insert of sex. They may not be able to insert tampons, uh, or menstrual cups, or they notice that they fall out. They may experience constipation or feel like they can't completely empty their reckless. So, those are kind of more commonly associated with prolapse. Pelvic pain is common as well, so that again can have a multitude of contributing factors and it could be pain in and around the vulva pain with sex pain, with any kind of touch pain in the pelvic girdle. So in the bony structures, um, so those would be the most common, I would say that I see and help people or support people through and in terms of how that changes as we age. Uh, menstruation. So when we have fluctuations in our hormones, we also have fluctuations in our hormones. After we've given birth. We also have hormonal fluctuations when we are in perimenopause and, and moving beyond menopause as well. So tissues in and around the vagina, the, by the bladder, like all around her pelvis, we have estrogen rich that those tissues love estrogen. And when we are producing estrogen, we have it circulating in our body. And the tissues are happy. And when we are, for some reason, not producing or have declines in estrogen, such as just before our period, after we have given birth, as we were approaching menopause, those tissues can't find that circulating estrogen and that can influence sensation. The tissues can become dry. Um, they can start to think. It can be con contribute to sort of burning irritation type sensations for some people. And it doesn't even have to be with touch or in sort of sex. It could just be walking around or doing exercise and that then can also the thinning and drying out of the tissues can also exacerbate or potentially bring on urinary urgency, urinary frequency, frequency, and continents. Um, so. It's not, and as we age where we're losing muscle mass, so that can be a contributing factor. We may not move as much as we're getting older. And sometimes being working in this realm, sometimes the reason women and people born with a vagina and uterus are not moving is because they have pelvic floor dysfunction. So if they are. Stopping exercise because the symptoms get in the way or because they're afraid of making things worse. They then are at greater risk of that decline of the muscle mass that's already happening, but we're not counteracting it with exercise. Um, so those are kind of the, the main ones we're also, then we have an increase in. Adipose tissue that happens as well. So that's a whole other kind of conversation, but those would be there's there's age-related factors, there's hormone factors, there's lifestyle factors, um, that all play a role.

Natalie: 13:30

Wow. Wow. Yeah. that's a lot of information and, and I think people don't hear it. People don't hear it. Um, So, and to go back, I hear a lot of women talking about I'm going through menopause or I am experiencing menopause, and I think maybe we could benefit from it from a definition of perimenopause and menopause.

Kim vopni: 13:55

So there's there's, uh, as I'm still in this realm of learning about it, there are S there is, I think, an evolution that's happening with regards to the definition. So. Technically menopause is one day and it marks the one day that is 12 consecutive months without a period. So you could say menopause is one day, anything before that is perimenopause, anything after that is post-menopause. So there are some people that consider after that one day post-menopause there are some people that say you are in menopause after you reached that one day. So there's, that's a little. Still up for debate as to what that is. But essentially if you have not had a period for 12 months, you are considered to be in menopause or you have reached menopause peri-menopause is a bit newer of a term. And it is most people consider the six to 10 years prior to the onset of menopause and. There's also people who can go into menopause surgically. So if they have their uterus removed, if they have their uterus removed and their ovaries and fallopian, if they have everything removed, they immediately go through there they're immediately in menopause right away. As soon as they wake up from their procedure, they're in menopause, people that have just their uterus taken out, they, the ovaries are left in place and technically speaking. The ovaries would continue to produce the hormones, but we're now finding that usually within the first five years, after having the uterus removed, most people are starting to transition into menopause and the hormone levels are, are becoming dysregulated. And we don't quite understand why yet, but that seems to be the what's happening. And there are other people who may go into surgical menopause or sorry into chemical, which is. With the use of hormones and medications, for whatever reason that may, uh, that would halt the periods. Um, so you could technically, you know, have the periods stop and then you, if you stop those medications, you could go back into menstrual cycles again. Okay. So those would be kind of the types of menopause. And the definition again is a little bit, but a little bit uncertain in terms of, is it, are you post or are you in, or what have you, but I usually say you're you're menopausal or you've, you've reached menopause when you have 12 consecutive months without.

Natalie: 16:33

Okay. So if somebody restarts their menstrual cycle, then would they be considered not menopausal anymore?

Kim vopni: 16:42

Well that, so there are some people that could go 12, 15, 16, 20 months without a period. And then all of a sudden have a bleed and that's actually. That's something you do want to have investigated. It could potentially be benign and not a big issue, but it could also be signs of something a little bit more sinister. So anytime you have, if you have reached that 12 months, and if you experience any, any type of bleeding afterwards, you definitely want to get that checked out and make sure that the, the more sinister things like cancers would be, would be ruled out. Um, so there, and I hear lots of people who are. Days or weeks away from there, 12 consecutive months. And then they have a period and it's so frustrating cause you feel like you've been waiting and I'm in that situation right now. I'm like I'm four months away. And I plan on celebrating with a white pant party after, uh, after I reach it. And so I'm, I'm, you know, I'm, I'm hoping that I, that I stay the course, but yeah. So technically if it was a one Blake breakthrough bleed, I wouldn't consider me personally. I wouldn't consider that person is. No has to go through another 12 months, but if it, if it started to become a little bit more cyclical than yes.

Natalie: 17:53

Okay, that makes. Learned something new. So if somebody is going through menopause or aging, their muscle mass typically goes down and we worry about things like osteoporosis, osteopenia, all of that. So what would be your recommendation to that person? How best can, can someone like that gain?

Kim vopni: 18:18

In an ideal world, we are consistently building up our store. As, as we're aging, that, that we are always in opportunities where we are building bone mass and muscle mass. That isn't always the case. And again, not everybody is physically active for whatever reason. Sometimes there are sometimes it's just lifestyle habits. There's lots of different reasons why somebody may not be, it's never too late to. To step in and try to intervene. Ideally we don't want to get to the point where, you know, once you have osteoporosis, um, it can be a little bit more challenging and maybe some other considerations may need to, uh, need to be made with regards to the type of movement or the level of intensity, but it's never too late. So we can always intervene somehow with some sort of. Weight-bearing load-bearing exercise walking. Um, ideally a little bit of resistance training resistance training can be weight. It can also be with, uh, with, with resistance bands or, uh, dumbbells. But again, if we have people who feel like their organs are going to fall out, or they are afraid that they're going to leave. The intensity level at which they want to, or may be able to exercise that might be limited or hindered. And there's now more and more research and more and more people kind of pushing the boundaries with regards to what's possible when you have prolapse or when you have, um, no incontinence or what have you. I still think we need to respect some limitation in there. Um, but we do definitely benefit from. Some loading. So some sort of impact and impact does not have to mean jumping or jumping jacks or running or jumping off of a box. Like it. Walking can be an impact exercise stepping down and stepping up and down onto a step can be impact and bone loading type exercise. So it doesn't always have to be this high intensity. You know, bootcamp style or CrossFit style exercise that people think they need to do in order to achieve certain goals. So I would do some sort of weight-bearing activity every day, yoga in and of itself can be, can influence our bones. So when we, when we influence the tension, so what the, the pole on the bones by building muscle that can also help. So yoga is so beneficial in so many ways. I definitely recommend people, especially as we're approaching menopause. We need to consider also the, the well management of hormones, but also cortisol and cortisol can be kind of very high and constantly being produced in many people, especially this past couple of years. And we can, we can help mitigate that through exercise and we could also contribute to it with exercise. So really intense activity actually elevates cortisol. And so if we have people who. You know, thinking they need to, to exercise more intensely to build bone and to build muscle and to lose weight because gaining weight is also common in menopause. They sometimes may be working out more intensely than what is actually going to benefit them. So walking yoga resistance training twice a week for short periods of time. So I like high intensity interval where they're in like a 20 to maybe 30 minute time zone and they have intervals. Higher bursts of intensity. Again, that doesn't necessarily mean you have to jump. It could mean that you do a faster squat, for instance, a stationary squat, or you lift heavier weight for a period of time, but shorter periods of time for the workout. Many of us thought we had to work out for 45 minutes to an hour for us to actually have a good workout. And, we know now more that actually, especially during this time of. Shorter, but a little bit more intense workouts, not everyday, like two, maybe three times a week is actually more beneficial. So re so backing up the intensity can actually help mitigate some of those other things while still giving, still giving us the benefit. So we want to work on calming the nervous system. Controlling cortisol production, um, supporting hormones through movement as well, building up our muscle mass and making sure we get some sort of impact as well.

Natalie: 22:48

So I think everything in my life and everybody I've been talking to recently has been saying slow down. So I think it's a theme for the year, slow down, back off, and really be intentional about what you're doing.

Kim vopni: 23:02

Yeah. And I think. Like when you consider the work that you've done. And I I've done with pregnant women and other people who are working with postpartum, we were recognizing that the six week green light wasn't necessarily serving people and there's now still happening, but there's a lot more awareness about the need to recover, the need to be slower that, you know, forget getting back to the gym at two weeks postpartum and posting your selfie. Like we're recognizing that that's not. That's not okay. And myself I've now started to, so I went through a pelvic surgery about 15 months ago, myself and me through going through that process, recognize that it's similar to postpartum. And it's another one of those times that there's lack of information. People are not preparing for it, nor are they recovering because there's no information provided to people about how to recover. And so we have. People going through surgery whose symptoms get removed, which is amazing. We, we, that's the ultimate goal. These symptoms that have been so bothersome and interfering with quality of life are now gone, but symptoms can be teachers and symptoms can be guides and they can remind us to maybe slow down or to make certain choices. And when they're no longer there. And when we're given that six week Greenlight, which happens postoperatively as well as postpartum. Then all of a sudden we feel like hallelujah, I can go and I'm going to run again. And I'm going to do all these things that I haven't been doing, or haven't been doing as much. And we need just like postpartum that core retraining, that healing time, that transition that's more like a six month gradual progression back. And then once you reach that six months after you've been working with pelvic floor physical therapy, after you've been retraining the core, you then go through a gradual progression back to. Whatever it was you were doing before. So if you were running 10 K doesn't mean that it, even at six months postpartum or post-op that you're going to run 10 K, you're going to start doing a return to run. So I think in, you know, having been in the fitness industry for so long, harder, and more intense, everything has been getting harder, more intense for so long. It was th that was glorified. That's what was revered and celebrated. These people are going through really hard things. And, yeah, it's amazing to, to be able to do that, but not all the time and not for everybody and not for every phase of life, not for certain times in your menstrual cycle, not for, so, you know what I mean? Like there's, so I'm glad to hear you say that most people that you're interviewing are saying that, because I think collectively as a world, we need to. Slow down and we need to check in and we were sort of forced, our hand was forced over the last couple of years to, to do that. Um, but it'll be interesting to see if people adopt that as an ongoing practice.

Natalie: 25:50

Yeah, I found it so fascinated with my surgery as well. So excision of endometriosis, there was no information. I shouldn't say no information. There was a little information on the recovery aspect and I used what I knew from working with postpartum people that I. Recover. Well, that way. And I'm four months, five, four or five months. Post-op now and still working on some of those things. But I think about people who don't have my background, don't have our background and aren't in the pelvic floor world. They're not getting that information and it just, it blows my mind because you can have an ankle surgery. Okay. Everybody in the world says you need six to eight, Maybe a year, right. Six to eight months or a year. to recover. And you wouldn't think of going for a run at six weeks post surgery on your ankle. But with, with pelvic surgeries and, and childbirth, it's a different story.

Kim vopni: 26:52

Yeah. Yeah, yeah, for sure. And there's a period of being that we're talking about kind of perimenopause and menopause. It's a time of life. When there are a lot of changes in our hormones, a lot of people do experience heavy bleeding, and that's, there can be many contributing factors to that. And. Many of us put up with it for a long time. And then we find were like, okay, that's it I've had enough. And they go seek help. And typically our family doctors are the first line of defense that we go see. And with all due respect, they, they have seven, maybe 10 minutes to give us for time. And that's not enough time for them to do a full evaluation at full understanding to share, to instruct, to evaluate. And so oftentimes they're then sent to a specialist who then would a lot of people will say, well, why don't we just take your uterus out? You're done having kids, or maybe they've chosen not to have kids. And so the, the option of not bleeding anymore and not having to deal with these symptoms is, yeah. I remember being in that situation thinking, oh my God, I would love that I'm done. I'm not gonna have any more kids. I don't need my uterus. Now being a pelvic health professional. I knew that that I w the uterus plays a really vital role for, uh, for many things. And I wanted to keep my uterus, but not everybody knows that. And there are many people who have a hysterectomy during the perimenopause and menopause time could be for prolapse, could be for heavy bleeding, could be for endometriosis, could be for ed. No meiosis could be for fibroids. Could be. Cancer. Obviously they don't have a choice in that. Um, but there are many people who have it for benign reasons who haven't been completely educated or given all of the options to consider. Some of them may still choose hysterectomy. There's no shame in doing that at all. But I hear from so many people afterwards saying I wish I had known about hormone support. I wish I had known about hyper suppressives to help with my prolapse. I wish I'd known about pessaries. I wish I had all of these things. Uh, so it's a, it's a time of life when hysterectomy is, I say, I, I say, I think are presented as an option quite often. And I hope that as you know, as information gets shared in social media and people have become more aware that there are more people presenting all of the options first so that people can make a completely informed decision rather than thinking that that's the only way.

Natalie: 29:28

And I've even heard the uterus referred to as a disposable organ, which just makes me really sad. Yeah. So, so if somebody is considering surgery, whether it be hysterectomy or a prolapse surgery, what are some of the considerations that they should take into account prior to going into surgery? As far as, you know, prehab rehab, all of that, um, hormones.

Kim vopni: 29:52

I, I, I recommend that people. Get to the root cause of what it is that they're dealing with. So is it incontinence that they're looking for surgery for? Is it prolapse? Is it heavy bleeding? Is it whatever, what is it? Can you understand? Have you tried all the things to, to try to mitigate, so try to improve the symptoms to try to improve muscle function, to reduce a mint elimination in the body, to, you know, there's lots of things, lots of variables that we can address prior to. Not everybody wants to go through all those, but I want them to be presented as options and people can make the best choice for them. So generally I say, here's all the options to consider. Have you tried all of these? Yes. Great. Nothing's worked. Okay. Let's move to the next step or no, I don't have the time or don't want to find that's their choice. Let's move to the next step. Um, prior to surgery, I want people to also be informed in their procedure, so make sure they know all the questions that they should ask their doctor about the procedure about. The risk factors about the, um, success rates about the options is that the only type of surgery that I can have for my situation, what are the pros and cons of the different types? Um, I also want them to understand the, the recovery phase. So, um, actually let me back up in the, in that preparation point or preparation point of time, becoming informed as one piece. Calming the nervous system and reducing inflammation in the body is another. So, so surgery is scary. And part of, I think what contributes to that fear is because it's, uh, not a lot of information is shared and people are sort of just trusting that everything's going to be okay. But then they also hear horror stories. And while the Facebook support groups are amazing, they can also be really. Hard places to be. They can, they can really scare us. Um, so we need to come to a place where we feel calm and we feel centered and we feel confident in our decision. So that, so that we go into this without a ramped up nervous system. I think like when we have stress and anxiety, that's, you know, our hormones get dysregulated. Our heart's beating more like we, we just, you feel stressed. You feel stressed out. I want to do, I want to give them the information to help them feel confident in their decision, but then also take steps to, um, to help calm them and also reduce inflammation in the body, through diet and lifestyle. And then at that point now going into the procedure, what have you done to prepare for your recovery? So just like we do with postpartum, let's set everything up so that you're not scrambling. To try to do things when you should be resting, build your support team, prepare the meals, um, make sure you have your meds in place. Uh, talking about meds, a lot of people want to be heroes and not have to take pain medication, but pain medication can really help your, your recovery it and make sure that you're not going to get to a state of tension that can restrict blood flow that can restrict healing. So getting that the, um, the recap of the early recovery phase. Planned out. And then also look at that rebuilding, that retraining that needs to happen. So what exercise can we be doing? And that is, that is again like you and I have gone through our process, very informed various. We are not the norm. And a lot of people are not given instruction on core retraining. They're not given instruction on pelvic floor exercise, pelvic floor, physical therapy. They don't know how to return to normal. So they wait around at six weeks, they get their clearance and then they. I can run again. I can lift again and they go back too intensely, too soon. So giving them guidelines, giving people guidelines about that recovery phase, what that looks like pelvic floor initiated movement, retraining the muscles in and around the pelvis, the deep core system, the breath, um, and then a gradual rebuild and progressive loading from there. So those are, those are all things that, oh, and the other big one really big one is. The diet piece from an inflammation in the body, but also from constipation. I think that is another huge missing link for people that a lot of times constipation has contributed to the, to the challenge or the problem that person has, especially in with regards to prolapse. And if they go through surgery and having addressed the constipation, the likelihood that that problem will recur is very. Um, so I think we need a lot more awareness around gut health and bowel management and bowel health for people who are going through surgery.

Natalie: 34:34

Agreed and get a Squatty potty prior to surgery, start using it. Make sure you have all the, the stool softeners and the magnesium and everything prior to

Kim vopni: 34:43

Yeah.

Natalie: 34:44

I'm speaking from experience with my chronic conservation. Yeah. I think another thing that contributes to the thought process of I can just go back to what I was doing before is a lot of these surgeries are laparoscopic. And so we have teeny tiny little scars and we think, oh, it's not as big of a deal as like a total knee replacement. When in actuality it's more severe in my opinion, or more traumatic to the body to have the pelvis worked on then an appendage. I don't know if you'd agree.

Kim vopni: 35:20

Yeah. You're you're so right. There's it, there's a lot of advancements in surgeries. And I think that there there's good and bad to that. And, and exactly, as you said, the laparoscopic is deemed less invasive. So people think that their recovery time should be shorter than they should bounce back quicker. And, and that's again, not serving us. We still need to consider that's rather than one incision, we have multiple incisions and there's just because it's a smaller incision doesn't mean that it's any less invasive. We still have disruption to tissues and to, to the whole, again, to the whole nervous system, really. And, um, so regardless, any sort of. Any sort of incision is you could consider it's a strong word, but it's like an assault to the body. And I was very intentional going into my procedure. I, I had positive affirmations. I talked to my body even lying on in the operating room with all the lights beating down on you. They're just about to inject the anesthetic and, um, into me. And I just, I looked around, I said, I trust my doctor. I'm, you know, basically telling my body I have I'm going into. Consciously I have made this decision. I'm safe. I'm protected. I trust these people just to, just to be calm. I think that it sounds a bit woo, but it, I think it's an important factor. That's not considered.

Natalie: 36:46

Words are powerful. I tell clients that all the time, what we speak out loud, our body hears and, and manifests. So if we say constantly, oh, I have a bad back. I have a bad back. I can't do that. Or I have a bad knee. This one is my bad. So I have, a rule. I have I have several rules with when people work with me, I say, first rule. You can't say can't. So you can say that. is a challenge for me. Or I would like to be able to do that in the future. And second rule is you have to speak positively about your body. Like this is my healing, me or my knee. That's getting better, or my challenge knee, or my diva, knee, Whatever you want to call. it. But something that, something that's a little bit more positive than that's my, my bad.

Kim vopni: 37:31

Yeah. Um, something else I just thought of that I wanted to bring up with regards to surgeries. Um, when, when we have pelvic surgeries, a lot of people will have a catheter afterwards, and there's, there's many reasons for catheters and there's different lengths of time. So when may have them, it depends on the procedure. What have you. But when we think about the, the, the population that we're talking about today is mainly people kind of perimenopause menopause. Where we also have the changes to the tissues and the walls of the vagina. So we, we are, we have less estrogen circulating. So the tissues are becoming dryer. They're becoming thinner that already increases our risk of infections and UTIs. And then when we are again in a, in a surgical realm, and now we have catheters and some people have to self catheterize. We, if that tissue is also. Dry and thin already at an increased risk. And now we have to self Cass. There's also another additional risk on top of an additional risk, if that makes sense. Um, so, so UTI is, are a big factor for not just people going through surgery, but people in menopause, um, kind of perimenopause menopause. So a big something that I recommend that I think is really beneficial and more and more doctors that I follow who are active on social media. Uh, many of them are saying vagina, local, vaginal estrogen kind of, as we're getting close to menopause is something that is pretty much beneficial for every single person. And we would benefit for being on it for the rest of our lives. So if we are going through a pelvic surgery, especially if we're in that perimenopause menopause phase, if we are not already using local vaginal estrogen, I think it's something beneficial to start. In advance of the procedure to get those tissues in as best state as possible. And that will also help mitigate the risks of not just, not only UTIs, just because we're closer to menopause, but also with the surgery as well.

Natalie: 39:37

Fascinating. I've also heard a lot of people, um, having, having that prescribed to them during breastfeeding

Kim vopni: 39:44

Yes. Yep. Super common. So that, that sort of. That's kind of giving us a glimpse into what, what will happen is we approach menopause after if we've given birth. And we're in that early phase, we have a sharp decline in estrogen afterwards. And, um, and a lot of people experience vaginal dryness and painful sex as a result of the tissue, not having as much estrogen. So that's kind of a, a glimpse. And if we were to get, if we were, if we do that, then we can say, okay, I'm interested in this and I want to be proactive and I want to make sure that I'm me. I've always been proactive minded and I want, I'm not, I'm not okay with suffering. And, and I don't want to just go through, you know, this natural transition. It is menopause is a natural thing that happens, but I think we. We don't have to suffer. And I think we've been kind of felt made to feel like it's just something we have to suffer through. And, um, so I'm not okay with suffering. One of my two books actually that I recommend people read our estrogen matters and the estrogen fix. I think I wish that I had read those in my thirties. I wish not. And now, like I read them in enough time, I think like, Uh, you know, I wouldn't say that I'm late to the game, so to speak. I'm I'm I feel quite armed as I'm going into menopause. I still feel like I, that I would have benefited from that much earlier and also stuff, even like the auto-immunity connection, like you and I both experience as well, like

Natalie: 41:21

Yeah.

Kim vopni: 41:21

hormone education. I think people in their thirties, especially people who are giving birth, it would be amazing as part of prenatal education to talk about. Hormones to talk about vaginal dryness to talk about. Um, there was an amazing book called the postnatal depletion and talking about nutrients, talking about the increased risk of auto-immunity and hypothyroidism and hormone disruption in that population. Um, it, you know, we could, I think prenatal education with all that we want to say could probably last about five months.

Natalie: 41:57

Agreed.

Kim vopni: 41:58

Well,

Natalie: 41:59

Uh, I think advocacy in your healthcare is just a theme also. So slowing down is one of the big things that I've been hearing from everybody, but also. Advocating for yourself and getting the information that ahead of time. So you can make that informed decision or, or ask more questions about the decisions that you may be making in the near future.

Kim vopni: 42:21

Yeah. Yeah, exactly. And I think the other thing too, is that I also think COVID may be brought to light or maybe. People more aware of is we don't. We, we benefit from having a healthcare village. It's not just about my family. Doctor says we need a family doctor. I think we benefit from maybe Chinese medicine, naturopath, functional medicine, physiotherapy chiropractic. I think we have a lot of people that we can. Seek help from, and again, we can get the opinions and ask and then know what the best route for us is rather than just always relying on that one. That one thing, that the one with whatever my doctor says and, and I mean, no disrespect to the medical. I think that the medical community has also taken a lot of backlash over for, you know, as things have become, as we can, more aware of things. Which I mean, I want to feel badly, but there was also a lot of people who've started to choose other like who are going into functional medicine now because they've realized how broken the medical system is. It's, it's fantastic. When we have an emergency. It's fantastic. When we need things like pharmaceuticals and surgery, we are so fortunate to have that from a health management and preventive wellness perspective. I don't believe that they're our best allies. And so I want more people to be aware of all of the options we have to support our health. And if it comes to the point where we need pharmaceutical surgery, what have you, then we are fully armed. We have amazing practitioners.

Natalie: 44:01

I think it's also a paradigm shift for us because before, if you are feeling bad, you go seek out advice from the doctor. And now we are putting ourselves in the driver's seat for our own health. And picking all of the different practitioners we'd like with us and putting them in the, in the backseat with us as we go along on the journey. And so, um, that's sometimes is a hard hurdle to get over. Oh, I get to choose who I'm listening to and I get to choose these things that I maybe thought were just, I could just have to go along with prior to, um, Yeah. Ah, it's so good. Women's healthcare really needs an overhaul. So I think we're going into that through the pandemic. I think it's changing, I'm hearing a lot of good things from clients and what their providers are saying to them.

Kim vopni: 44:57

Yeah, I'm starting to hear a lot more even just today. So there's a pelvic surgery support group on Facebook that I'm part of. And somebody today asked the question about longevity and are there people who have long-term. Results and you know, is, does everybody surgery fail kind of thing? So lots of people added in their input and one person said my surgeon recommended pelvic floor physical therapy. He said that it would help improve the outcomes. And I do my pelvic floor exercise every day. And I, I wrote, of course, commented and said, hallelujah, this should be standard of care. Every single person should have that presented as this is what you're going to do prior to your surgery. And this is what you're going to do after your surgery. And I think it would transform. That like surgery surgery is obviously, but pelvic health and women's health in general, if there was more collaboration between healthcare providers and more appreciation for physiotherapy, um, I really truly think the world would change.

Natalie: 45:57

Hi. Great. And getting, getting PTs into the surgery room into the Orr, I think would be life changing as well because I've, I've talked to several PTs who talk about, well, if we were there, we could've seen, they were just tacking this tissue to this tissue, but we could have advised oh, that maybe will affect function. And so you could potentially change it this way. And just getting that, that community aspect of. Yeah, collaboration would be huge.

Kim vopni: 46:26

Yep. Yep. Totally agree.

Natalie: 46:29

Hmm. Okay. So lots of resources that you offer. I want to hear what you offer, um, for people who, who specifically want to do more research and get the information. So you have your books, you have a Facebook support group. Talk about.

Kim vopni: 46:49

Yeah, I think my, my book is, um, it's sort of a. Bible's not the right word, but it's sort of a, it's a good introduction to pelvic health through the different life stages. And I think is a good place to start for people to, uh, to have, uh, a level of awareness that they can refer back to that they can earmark that they can read the studies that they could bring into their care providers to ask more questions with. So I think that's a good place for people to. Um, in my Facebook group, it's called box talk and it's, it's a private group. I made it private because I want people to feel safe. Um, people need to apply to get in, they have answers specific questions to come in because it's, it's tough. It's tough to talk about some of these challenges that people are dealing with. And I wanted to create a space where people felt supported by. By myself, but also the others who are in the group and know that they're not alone in what they're dealing with. So a lot of conversation happens just, you know, learning from one another. This is what I did. This is what I did. And, and, uh, yeah, so that's, that's on Facebook. I have an app that I launched a couple of months ago that. It's available for both apple and Android, and it has a bunch of free resources for people. And then for those who want more, there is a paid option where they can get access to, um, more support for myself meal plans, workouts that are all pelvic floor, uh, friendly or support, obviously pelvic floor centric. That's my world. Um, so I give people ways to work out intensely. Still is mindful of the pelvic floor, lots of different options for, you know, different considerations, lots of different positions, just to, just to help get people moving again and moving with a level of intensity that will help their muscles and their bones and their brains and their hearts. Um, and doesn't make them feel like they can't, that they can't do this now because of their, their pelvic health. So that's called the Beth my app. Um, I have a few different online programs for people that just kind of like to move through at their own. Uh, they prefer, and then I offer one on one coaching as well for people who want a little bit more guidance who may not be as self-directed or self-motivated who need a little bit more guidance for their particular situation. Um, yeah, that's what I offer.

Natalie: 49:11

And speaking from experience, I'm in your group on Facebook. I have your app, I'm a bit of a groupie as you. know, so they're amazing. And I appreciate your approach to holistic. Body care. So looking at the body as, as a whole person, like our systems are connected, we don't move independent. And our muscles aren't separate from our bones. Aren't separate from our lymphatic system. And so you. do a good job of, of bringing that altogether and presenting a program that benefits the whole person. Yeah. One of my favorite questions to ask all of my guests is what is your number one piece of advice for our listeners? What do you want everyone to know?

Kim vopni: 49:53

Uh, I think this is a given most people that know me will know that I always say, I think we all benefit from seeing a pelvic floor physical therapist once a year. And. Uh, I always equate it to seeing the dentist. We have been told from a young age to brush our teeth twice a day and floss our teeth and go see a dentist once or twice a year. And we go, even if we have no toothache or no symptoms or no issues to talk about, we just go preventively. And if we were given that same messaging for our pelvic health, I think it would again transform the landscape of women's health. So if you were born with the uterus, you have a vagina, I would recommend that you see a pelvic floor, physical therapist, at least once a year. Even if you have no symptoms, but especially if you do.

Natalie: 50:38

Agreed. And I'll tell you a secret that won't be a secret anymore. I go to my pelvic vet more often than I see a dentist.

Kim vopni: 50:46

Yeah. Yeah. That's probably actually true with myself too. They're probably actually pretty equal if I, if I think about it. Yep.

Natalie: 50:52

Nice. I just dislike the dentist, but I can, I can handle pelvic beauty. Okay. What is your favorite wellness habit that you incorporate into your daily?

Kim vopni: 51:06

My non, I have two non-negotiables, but I would say the one that is, uh, definitely my favorite is hyper suppressives. Um, I learned hypo presses. I actually, I, I randomly, I don't even remember how I did this, but this is probably 12 ish years ago. Now I randomly came upon a woman who. Uh, I was working in pre post natal and she was doing this odd looking technique and I, she was speaking Spanish. So I didn't really know what she was saying, but I was watching her and start watching your videos. And I reached out to her. She had actually spoke English as well. That was my first introduction. And I wanted to invite her to Canada. And in the end, a friend of mine, um, who's now the founder of hyper-aggressive Canada. Trust is in, she actually flew to Spain to work with this woman after finding out she had her own prolapse and, uh, and learned the technique. And, and so she was, she sort of facilitated this woman coming to Canada and teaching the first course, which is about 10 ish years ago now, or maybe an 11 that I, that I took it. I have never in all of my years of working out and fitness and doing all sorts of programs, have I have never been as consistent with any program as I have been with hyper presses. I love, love, love the technique so much. It, it helped me overcome a uterine prolapse. It just it's calming. It's energizing at the same time. It is. I don't know. I just love it so much. I love the way that I feel doing it. I love how I feel. Um, I love that the protective kind of preventive element that exists there with regards to, you know, keeping my pelvic health in a, in a good state. So they, as they age. So I would say hypo presses, for sure.

Natalie: 52:49

And that's the thing that you have in your app and in your book as well. Right. So people can find that. Excellent. That's next on my list of certifications.

Kim vopni: 52:59

Yeah. It's uh, yeah. It's I love it. You will.

Natalie: 53:04

Awesome. What is your second non-negotiable habit?

Kim vopni: 53:06

Walking a little bit more boring, but, um, I, I would say unless like today is like heavy rainfall warning. Usually I would go to that heavy rainfall warning, but, um, but oftentimes it's my husband and I, sometimes it's just myself, sometimes it's myself and my girlfriends and I feel very fortunate to. In nature. We have, I live on the side of a mountain. We have lakes and paths in the forest right outside our doorstep. So I feel very fortunate to have that, but even if I didn't walking is, uh, you know, some of my biggest problems have been solved. Some of the, you know, the best conversations that my husband and I have are happening while we're walking. It's just, it's so cathartic and therapeutic and so beneficial for us. Um, Walking in, in minimal shoes

Natalie: 53:59

glad you said that I was going to say that anyways.

Kim vopni: 54:03

Yeah. I've been a minimal shoe lover for a long time. I've been again, probably like 14 years or so that I've been wearing minimal shoes and yeah, I, you and I were lovers of Katy Bowman and natural movement. And, uh, and she's also a big walk non-negotiable person as well.

Natalie: 54:21

Yeah. Yeah. I had minimal shoes. Most people know me as I will probably say the answer to most of their problems is to

Kim vopni: 54:28

Yeah,

Natalie: 54:29

their shoes.

Kim vopni: 54:31

I would agree.

Natalie: 54:32

Yes. Uh, well, thank you so much, Kim, for being here today and just spending, spending your time and energy with me and having this conversation. It's, it's been a.

Kim vopni: 54:42

Yes, it has. Thank you so much for having me. It's always lovely to chat with Kim and hear her wisdom and passion for educating people about. My top takeaways from this episode are number one, learn more about your body. Now. Information and education are powerful tools that you can use to help you advocate for your own health. You can start by reading Kim's book, your pelvic floor. Number two, find a village of healthcare professionals in number three, take your time to slow down and find some calm throughout your. Your nervous system will. Thank you. I will list all of the resources can mentioned in the show notes for this episode, and you can find her online@vaginacoach.com and on all social media channels at vagina co. Just a reminder that what you hear in this podcast is not medical advice. Remember to always do your own research and talk to your provider before making important decisions about your healthcare. If you found this podcast helpful, please consider leaving a five star review in your favorite podcast app. Thank you so much for listening.