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The Staff of Femina Physical Therapy Blogs About Vaginismus, Pregnancy and Postpartum Best Practices, Treatments for Incontinence, and More


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Could Your Lube be Hurting You?

From Alleviating Vaginal Dryness to Improving Anal Play, Choosing the Right Lube is Important

Personal lubricant (lube) is something most people will use at least once during their sexual lifetimes, if not every time they are sexually active.

What are lubricants?

Lubricants are fluid or gel substances designed to offset genital dryness or inadequate natural lubrication which can be associated with discomfort or pain with sex or general activity. Lubes can be used for sexual activity, or just to alleviate dryness throughout the day.

Read more ...

Racial Bias and Women's Healthcare

Photo by Billie (unsplash)

What did you discuss with your healthcare provider at your last OB-Gyn appointment?

Hard truth – there’s a good chance your answer depends on your skin color.

The disturbing statistics about increased COVID risks for people of color shed much needed light on systemic injustice in our healthcare system; but you may not realize the problem extends to almost every facet of women’s health, from yearly check-ups to frightening mortality rates in pregnancy and childbirth. A recent survey of nearly 1,700 white and black, non-Hispanic women aged 18-49 pulls back the exam room curtain, indicating a double standard that often leaves women of color underserved and medically vulnerable to several risks.

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Federal Funding for Endometriosis DOUBLED!

On July 30th, the House approved to DOUBLE funding for Endometriosis.

This is a HUGE win for the 1 in 10 women across the US that suffer from this hidden disease.

Endometriosis can lead to missed days from work and school, chronic pelvic pain, infertility and many other chronic overlapping pain conditions.

The efforts were led by Rep. Abby Finkenauer of Iowa, who in March pubicly noted her own struggles with endometriosis. From her website:

Read more ...
Red Tomato sliced open to look like a vulva

Persistent genital arousal disorder (PGAD) is a condition that is poorly understood.

It is a rare disorder most commonly seen in those with female anatomy and is characterized persistent sensations of genital arousal in the absence of sexual desire or stimulation. These sensations typically stay after orgasm and are intrusive, unwanted, and can negatively affect quality of life.

The diagnosis itself is not well known among healthcare practitioners yet alone the general public. Those who experience its symptoms can be hesitant to talk about it with their healthcare practitioners even though it may be affecting their quality of life.

Read more: Persistent Genital Arousal...

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Woman with cat Photo by Maria Lupan on Unsplash

September is Healthy Aging Month! In recognition, this blog will talk about Menopause and how it can affect your genitals and sexual function.

What Happens During Menopause?

Menopause marks the end of the regular menstrual cycle and the transition to life beyond the reproductive period.

Babies born with female anatomy have a set number of eggs which are stored in their ovaries. The ovaries make the hormones estrogen and progesterone, which control monthly periods and ovulation. Menopause happens when ovaries no longer regularly release an egg every month and menstruation stops.

Read more: September is Healthy Aging...

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Hot flashes, insomnia, vaginal discomfort and more – hello, menopause!

If you’re experiencing any of those symptoms, your doctor may have recommended some form of menopausal hormone therapy. But is it safe? When should you start? And which therapy is right for you?

Researchers have been trying to answer those questions for decades, often with confusing and even conflicting results. Let’s take a look at the history of estrogen therapy, and how past studies are informing the latest recommendations.

A French physician coined the word ‘menopause’, and advanced the revolutionary idea that the health concerns of aging women deserved medical attention, in the 1800s. Throughout that century, doctors experimented – sometimes on themselves – with various animal hormones. The science was far from perfected; but by the 1890s, women were being treated successfully for symptoms of menopause with a powder or pill made from cow ovaries.

Read more: The History of Estrogen...

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September is Healthy Aging Month!

Do you need help navigating menopause?

You’ve probably already considered a visit to your primary care doctor and your gynecologist. But what about a women’s health physical therapist?

About 6,000 women enter menopause every day in the US, usually between the ages of 45 and 55; and as life expectancy increases, so does the number of years most women will spend on the other side of it. Approximately half of all women can expect to live 40% of their lives in the post-menopausal stage. It makes sense to develop a solid strategy for optimal health, the earlier the better – and just like hormone replacement, regular physical therapy can be an important component of that plan.

Read more: Menopause Considerations and...

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If you’ve trained for a marathon or half marathon, you’re well acquainted with the dangers of shin splints, pulled muscles, and joint injuries.

And you probably take deliberate care to avoid them.

But it may surprise you to learn female distance runners face a little-known health risk that can have serious, even permanent, consequences.

I’m talking about Female Athlete Triad (FAT).

A recent article in the Journal Of Women’s Health Physical Therapy defines the condition by its three components: “low energy availability, menstrual dysfunction, and low bone density”. Those components form a chain reaction of problems that build on each other. Unchecked, each one can lead to long-term health issues from hormonal imbalance to lowered metabolism and immunities, to osteoporosis. But it’s easily ignored by those who suffer from it, and misdiagnosed by their doctors.

Read more: Female Athlete Triad – The...

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Your Stress Levels Affect your Bowel Movements and Vice Versa

Psychological stress affects your bowels. Perhaps you know this through personal experience, but research in the past decade has strengthened the link between stress and bowel problems including IBS, nausea, vomiting, abdominal pain, and constipation (Chang et al., 2014).

Chang et al. (2014) found that heightened stress levels increased inflammation and permeability in the GI system, which were tied to increased IBS symptoms.

In 2018, Chan et al. found a dynamic relationship between bowel symptoms, stress, and emotional well-being. Study participants reported stress levels affected bowel function, and that also when they had were experiencing bad bowel function (loose stools, abdominal pain) that this affected their emotional well-being.

Read more: Stress, Bowel Movements, and...

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unsplash: Sabina Tone

You counted down the weeks until your baby’s arrival…

now you and your partner are counting down the days until your doctor gives you the green light to have sex again.

That’s a good thing; intimacy is an important factor in your relationship and your own well-being. But whether this is your first baby, or you’re sure it’s your last, your anticipation might be tinged with some anxiety. After all, your body has been through a lot since that positive pregnancy test result.

Sleepless nights, fluctuating hormones, and breastfeeding challenges can take a toll. Perhaps you’re still healing from a C-section or a physically challenging delivery. Even if giving birth was a breeze, and this is your easiest baby yet, you may worry that your expectations aren’t in sync with your partner’s.

When it comes to your postpartum sex life, what’s the new normal? And how soon can you get there?

Read more: Sex After Childbirth –...

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Getting back to activities like sex after a hysterectomy can be intimidating. 

Learn what a hysterectomy is, how it can affect your sexual function, and what pelvic floor physical and occupational therapy can do to help. 

What is a hysterectomy?

Acording to the American College of Obstetricians and Gynecologists (ACOG), a hysterectomy is surgery to remove the uterus. It is a common type of surgery for women in the United States.

  • Hysterectomy is used to treat many women’s health conditions including:
  • Uterine fibroids (this is the most common reason for hysterectomy)
  • Endometriosis (although it states this on ACOG, it is more correct for this to state Adenomyosis, which is endometriosis in the uterus. Please be clear -- a  hysterectomy is NOT a cure for endometriosis).
  • Pelvic support problems (such as uterine prolapse)
  • Abnormal uterine bleeding
  • Chronic pelvic pain
  • Gynecologic cancer

Read more: Return to Sex after a...

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If you’re facing a diagnosis of bladder cancer or a similar health concern, sex may be the last thing on your mind.

However, your sex life after a cystectomy (bladder removal surgery) should be a major consideration for any doctor who recommends it.

Sadly, research shows that’s much more likely to be true for men than it is for women. In fact – although sexual function after bladder removal is ‘routinely considered’ for male patients – surgeons in one study discussed complications that could affect pelvic health and sexual function with just 13% of female patients. Worse, the medical counseling those women got after surgery ignored the topic of sex altogether.

Read more: Sex After Cystectomy: What...

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How much do we really learn about intimacy, affection, sensual touching and sex while growing up?

A lot of our references for intimacy come from what we see in our families, movies, and for sex, a lot of the time porn. What we are individually exposed to will possibly become what we think is the norm, which can then possibly skew our views towards intimacy with a partner. For instance, if a woman watches porn for a sex reference she may think her vulva has to look a certain way or that she needs to attain an orgasm with penetration or to be intimate with her partner she has to have sex, when that’s not really the case. 

Read more: Did You Know There's More...

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During this time of "safer at home" orders, we have been having to find more creative ways to move at home.

If you are someone that experiences urinary incontinence and/or pelvic organ prolapse you may not be going out now to see a pelvic health physical therapist to guide you through a routine. In this blog post I’m going to go over a few mat pilates exercises I like to do with patients that experience urinary incontinence and/or pelvic organ prolapse (POP). A study done in 2018 by Lausen et al, found that in the group that did mat pilates with standard physical therapy had more positive outcomes with their urinary incontinence, as well as, quality of life. 

Read more: 3 Mat Pilates Exercises For...

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Photo by JESHOOTS.COM on Unsplash

Chronic pain doesn’t just happen to the body. It effects our thoughts and our feelings.

When pain persists beyond the body's normal healing range, 12-20 weeks (let alone over 6 months or even 6 years) it can make us worried and upset. That worry and upset can make the pain feel worse. In fact, studies now show that unchecked thoughts and feelings can hijack the body/mind setting off a vicious cycle of chronic pain.

Read more: Manage Stress, Mitigate Pain

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Check out these yoga poses you can do in your home office setup! Peform them at least 1-2x during your workday.

Many people working from home with the COVID-19 pandemic are finding themselves sitting hunched over a computer in non-ergonomic work setups -- kitchen counters, hard chairs or stools, or simply propped up in bed. Working for hours in these positions will lead to a stiff neck and shoulders, a sore lower back and tight hips, glutes,and pelvic floor muscles.

Read more: Yoga Poses for Working at Home

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Photo by Sincerely Media on Unsplash

What is Anal Incontinence?

Anal Incontinence is defined as the complaint of involuntary loss of liquid or solid stool or the involuntary loss of gas.

It is supposedly an underreported condition because of its stigmatizing nature. It occurs in approximately 50% of women at long-term follow-up after anal sphincter injuries (Gommesen et al., 2019; Haylen et al., 2010; Damon et al., 2006; Cotterill, 2008).

Read more: Postpartum Anal Incontinence

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Photo by Yuris Alhumaydy on Unsplash

A 2018 study by Bartley et al., showed that transvaginal trigger point injections helped reduce chronic pelvic pain, particularly when in conjunction with therapies including pelvic floor physical therapy.

What is Chronic Pelvic Pain and How Common is it?

Chronic pelvic pain affects 1 in 7 women in the United States and can have significant negative affects on quality of life, physical, emotional, and psychological well-being.  While there are various causes for pelvic pain, a common definition of chronic pelvic pain is pain that is noncyclical and occurring for at least 6 months (Bartley et al, 2018).

Read more: Chronic Pelvic Pain:...

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Woman singing Photo by Josh Rocklage on Unsplash

Did you know that when you sing you are not only using your vocal chords, but also the lungs, the diaphragm, the abdominal muscles, and also the pelvic floor?

It’s no surprise that the body is all connected, as in it’s one whole unit, but it’s easy to forget that an activity like singing is a dynamic and complex way we use our bodies. In a 2018 literature review, voice researchers Emerich Gordon & Reed refer to this YouTube video by osteopathic practitioner Roger Fiammetti which beautifully shows how the simple act of breathing involves not just the lungs, but the muscular system from the face and neck down to the bottom of our pelvic floor and the perineum, the video also outlines how the body has four diaphragms which help regulate air and fluid pressure throughout the body.

In fact, look at the structural similarities of the vocal chords and the pelvic floor:

Read more: How Singing Could Help Heal...

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    • Testimonial by Alexandra B.

      Heather is without exaggerating AMAZING! After years of trouble with a certain part of my body, in no time, she made everything change back to equilibrium and to what would be considered normal. She explains everything in detail and therefore gives you a better understanding of why things are the way they are, and how you can work towards turning things around. I would highly recommend Heather for any type of Physical Therapy. She has created her own "Method/Therapy" through years of studying...

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    • Testimonial by Jackie W.

      I was in multiple car accidents a decade ago, and I have been to many physical therapists through the years without success. They found the root of my lower back pain problems and after nearly a decade of barely being able to walk I finally can again without pain. They are also the best pelvic floor pts and the only ones who found the connection between my pelvic floor and lower back problems. If you need help with physical pain, they are your answer. -- Jackie W., 1/19/17 via Yelp!

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