Menopause Guide Podcast, with RhondaNP

029: Pelvic Floor Puzzle: Incontinence, UTIs, Prolapse and More


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“Incontinence” and Other Words Women Fear

As if pregnancy and menopause weren’t enough fun for women, there are a special set of challenges that are associated with the pelvic floor.

As women age, gravity, childbirth and the loss of estrogen do a number on our delicate lady parts.

Many of these challenges are hidden, secret and often times not discussed for years, even with our healthcare practitioners.

But, that avoidance needs to STOP.

Our guest in this podcast is Melanie Schlittenhardt, NP and Doctor of Nurse Practice.  Her 15 years of clinical expertise, safe and gentle approach make her the perfect practitioner to share information with you on this topic.

Listen to the podcast or watch the video below.
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Episode Time Stamps

1:00 Melanie’s intro and the funny thing her mom told her when she let her know her career choice!
3:42 On average, it takes an individual 7 years to gain the courage to seek help with incontinence.
5:06 (Rhonda) Incontinence is a common problem in perimenopause/menopause.
6:40  What to expect during a practitioner visit?  What type of leaking are we dealing with? The practitioner will determine if it is “stress” (exert and squirt) or “urge” incontinence (overactive bladder).
8:36 Overactive bladder explanation – our storage unit (may lose the entire contents of the bladder).
9:34 Treatment options range from surgery to over the counter to exercise; but none of them are “awesome”.  That’s why we have a entire toolkit of options because everyone is unique.
11:05 Impressa Device – pros and cons
12:20 Overactive bladder strategies – natural and prescription (side effects may limit longevity of use)
13:30 Listen to Melanie’s excellent description of how to do the Keagle exercise.  60% of women  do them incorrectly.
15:15 (Rhonda) Why urinary tract infections may happen more during menopause.
16:22 UTIs – the best treatment is prevention.
17:00 The fear of using estrogen.  Cream, tablet or ring? What’s the reality?
19:00 Lack of cleanliness is NOT a factor in increased UTIs.  In fact – women are OVER cleaning themselves!
21:00 Pelvic Organ Prolapse (POP)– Melanie’s “House” explanation nails what is going on!
23:00 What are the options for (POP)?  (Prolapse is subjective – the question is…how much does it bother you or affect your lifestyle?)
26:26 Bowel disorders – this topic is tough to talk about for so many!   We’ve underestimated the scope of this challenge.
28:00 Melanie shares the options – dietary and surgical.   InterStim II Neurostimulator  (pace maker type unit for the bladder). She’s been working with this device for more than 9 years and sees good results.
31:00 What type of healthcare practitioner should you look for?  Consider a multi-pronged approach – do your homework.

  • Physical Therapist – look for someone trained in pelvic floor therapy.
  • OBGYN – research a practitioner who specializes in incontinence.
  • Urogynecologist – there is a shortage in the US, so if you have one available to you – go for it!
  • Nurse Practitioners – identify those who have specific training in incontinence management issues.
  • 32:29 Work to find the right fit for you!  Don’t be afraid to have the conversation and keep at it until you find the alignment with the right practitioner.
    33:03 A safe and awesome website: education, providers, tools – NAFC.ORG
    35:35 Final thoughts from Rhonda – there is help available, there are options, and you’re not alone.
    38:00 Final thoughts from Melanie – “You cannot find peace by avoiding life.” (Michael Cunningham) Melanie’s favorite quote – don’t miss out on life!

    Melanie Schlittenhardt, NP, Doctor of Nurse Practice


    Learn more about Melanie’s Practice

    Discover FREE resources, education and information on these subjects and more
    at the National Association for Continence.


    Discover FREE Resources

    Looking for a safe/private place to ask your questions about perimenopause and menopause?
    Check out our PRIVATE Facebook group.
    Click on the image below to get started.


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