Ageless and Outrageous

Delve into the intriguing history of vaginal pessaries and their use in treating pelvic organ prolapse. From ancient times to the modern era, discover the unconventional remedies and treatments that were employed, as well as advancements made through the centuries.

If you or a loved one has dealt with pelvic organ prolapse, you'll love hearing the colorful history of vaginal pessaries!

Key Moments in this episode:

01:16 What a pessary does and how we use it today

02:14 Origin of the word pessary

02:27 First recorded history of pessaries

02:55 Honey

03:21 Succussion

03:49 Hot oil and wool balls

04:40 Pomegrantes

05:29 Greek physician Soranus and "disagreeable odors"

06:41 Roman writer Celsus and bronze cones

08:33 Paulus Agena in the middle ages

10:05 Jonas Platerious

10:34 The first recorded vaginal hysterectomy

12:01 Perforated cork

12:35 The insane story of Faith Howard

13:49 18th and 19th century advances

Read information on prolapse from AUGS here:  https://www.augs.org/assets/2/6/POP.pdf

Find out AUGS information on modern pessaries here: https://www.augs.org/assets/2/6/POP.pdf

Today's episode discusses the various symptoms and changes that women may experience as they navigate the menopausal transition, specifically focusing on perimenopause. Many women have no understanding at all about the symptoms that can occur at the end of their reproductive life.  Dr J will explore:

My goal today aims to shed light on the often misunderstood and under-recognized symptoms of perimenopause, and provide valuable information and guidance for women going through this transformative stage.

Key Moments in the episode are:

01:18 Stages in a woman's life

02:14 The menopause transition

03:12 Changes to the menstrual cycle

05:07 Vasomotor symptoms

06:41 Differences in ethnicities with respect to vasomotor symptoms

07:25 Depression, anxiety and irritabililty

08:22 Sleep disturbances

08:38 Brain fog

09:08 Skin and hair changes

09:54 What to do about it

11:10 What to expect with a menopause specialist

12:15 What else could it be?

Read more about bioidentical hormone replacement therapy here: https://www.foundationsfl.com/bioidentical-hormone-optimization

Does your vagina feel dry, sandpapery, filled with paper cuts or ground glass? If so, you are not alone. While perimenopause and menopause are a major cause of this condition, there are also many other culprits.

By examining all the factors contributing to vaginal dryness, you can make an informed decision about  improving your quality of life.

Key moments in this episode are:

00:52 GSM, genito-urinary syndrome of menopause

03:12 Estrogen to treat GSM

03:22 Safety of vaginal estrogen

07:10 Non-estrogen treatments for GSM

08:07 Medications that cause vaginal dryness

09:02 Diabetes as a cause for vaginal dryness

10:12 Auto-immune disorders and vaginal dryness

12:00 Vaginal pain associated with dryness

15:35 Lubrication ingredients that may cause dryness

Read ACOG's statement on the safety of vaginal estrogen here: ACOG Clinical Guidance

Stress urinary incontinence, a condition characterized by urine leakage during activities such as coughing, sneezing, or physical exertion, can be both bothersome and embarrassing. Today's episode offers a comprehensive understanding of stress incontinence:

While stress urinary incontinence may be common, especially as we age, it is not normal and you should not just learn to live with it. Listen today to learn all of the treatment options so you can find one that best fits your lifestyle.

Key moments in this episode are:

00:52 Common does NOT mean normal

01:16 The cause of stress incontinence

02:30 Activities that worsen leakage

05:35 Can Kegels solve the problem?

06:37 Types of therapy to strengthen the muscle

08:59 Incontinece pessaries

11:52 Midurethral slings for SUI

13:08 Abdominal surgery for SUI

14:45 Are mesh slings safe?

16:58 Non-mesh sling options

18:06 Urethral bulking procedure

20:05 Types of bulking materials

Learn more about stress incontinence here: https://www.augs.org/assets/2/6/SUI.pdf

Find out about suburethral slings here: https://www.augs.org/assets/2/6/Mid-urethral_Sling.pdf

See the Emsella chair in action here: https://www.foundationsfl.com/btl-emsella

Menopause is a complex journey for women, but we hear all kinds of terms used to describe it--premenopause, postmenopause, perimenopaus.  Today we dive into what it all means, as well as the stages of the menopause transition as women enter midlife.

Understanding these stages is crucial so that both men and women can know what to expect, and be better prepared to manage the changes at this time.

Key Moments in this episode are:

00:28 The worldwide population of women over age 50

01:50 A basic division of the reproductive and menopausal stages

02:37 Menstrual changes during the menopause transition

04:09 Fertility during the menopause transition

04:31 Entering the postmenopause timeframe

06:07 Acronyms used to describe hormone replacement therapy

06:56 Understanding bioidentical hormones

08:18 Just exactly where Premarin comes from

09:17 The role of compounding pharmacies

Hair loss is a common and troublesome issue affecting millions of Americans. Today we look into the common cause of hair loss and how to improve hair growth, thickness and coverage.  Listen to discover:

If you're noticing thinning hair or a receding hairline, this is one episode you don't want to miss!

Key Moments in this episode are:

01:28 Stages of hair growth

04:35 Androgenic alopecia

05:47 Telogen effluvium

08:21 Alopecia areata

09:18 Other causes of hair loss

11:31 Can hair regrow on its own?

12:01 Simple changes to enhance hair growth

13:52 Minoxidil for hair loss

14:47 Finasteride for hair loss

16:55 Duasteride for hair loss

17:56 Spironolactone for hair loss

19:12: PRP (platelet-rich plasma) for hair loss

20:32 Exosomes for hair loss

24:59 Low level laser therapy for hair loss

27:10 Microneedling for hair loss

28:29 Hair restoration surgeries

For years, it has been believed that metabolism slows with age, leading to weight gain. However, new studies suggest that the decrease in metabolic rate is not as significant as previously thought. The control of our eating and weight is highly influenced by hormones like leptin and ghrelin. In today's episode, we look at:

While every woman will go through menopause, we don't have to accept the weight gain associated with it. Understanding the hormonal control of eating and making targeted interventions can help you combat weight gain during the aging process.

Key moments in this episode are:

01:41 How metabolism changes as we age

03:00 Leptin and ghrelin: hormones that control our appetite

03:43 Discovery of leptin

04:52 Discovery of ghrelin

05:11 Balancing these 2 hormones

06:41 Evolution not keeping up with our environment

07:02 Leptin resistance

07:50 How menopause affects leptin and ghrelin

10:20 The role of insomnia and weight gain

11:01 How treatment of hot flashes combats menopausal weight gain

13:05 Addressing insomnia to help with menopausal weight gain

14:33 Using Myplate for better eating habits

15:37 The difference between and apple and a glass of apple juice

Find out more about weight loss options here: https://www.foundationsfl.com/weight-loss

This episode delves into the basics of the pelvic floor, explaining its anatomy and function. It highlights how the pelvic floor is an essential support system for the organs in the pelvic region. Pelvic floor dysfunction, which can occur due to weakness or spasms in the pelvic floor muscles, is discussed along with its associated symptoms. The importance of pelvic floor therapy and the role of pelvic floor therapists are emphasized in improving pelvic floor health. The concept of prehab, which involves strengthening the pelvic floor muscles before childbirth or surgery, is introduced. The effectiveness of different interventions, such as Kegel exercises, weighted kegels, electrical stimulation, and biofeedback devices, is explored. The differences between electrical stimulation and electromagnetic stimulation for the pelvic floor are highlighted, with electromagnetic stimulation showing superior and longer-lasting results. The podcast concludes by emphasizing the importance of increasing awareness and taking steps to protect and repair the pelvic floor to maintain optimal function.

Key moments in this episode are:

00:51 Pelvic bones create a bowl

01:31 Pelvic floor as bottom of the bowl

01:45 Function of the pelvic floor

03:32 The under-recognized high tone pelvic floor

04:25 What a pelvic floor therapist does

06:54 Insurance coverage for pelvic floor therapy

07:28 The concept of "pre-hab" rather than rehab

08:19 The Kegel exercise

10:24 Dr Arnold Kegel

10:59 Ben-wa balls

11:57 Electrical stimulation to the pelvic floor

12:54 Evidence for benefit of vaginal weights and electrical stimulation

13:49 Limitations of studies on electrical stimulation

15:10 Animal studies of the pelvic floor

16:16 Biofeedback devices for pelvic floor

17:24 Which therapy is best for you?

18:40 Excessive marketing claims of over-the-counter devices

21:22 Electromagnetic therapy to the pelvic floor

22:07 Data about electromagnetic therapy

Here's the study comparing Kegels, electrical stimulation and vaginal cones: Castro RA, Arruda RM, Zanetti MR, Santos PD, Sartori MG, Girão MJ. Single-blind, randomized, controlled trial of pelvic floor muscle training, electrical stimulation, vaginal cones, and no active treatment in the management of stress urinary incontinence. Clinics (Sao Paulo). 2008 Aug;63(4):465-72. doi: 10.1590/s1807-59322008000400009. PMID: 18719756; PMCID: PMC2664121.

This study used vaginal biopsies to show beneficial effect from electrical stimulation: Sarmento ALC, Sá BS, Vasconcelos AG, Arcanjo DDR, Durazzo A, Lucarini M, Leite JRSA, Sousa HA, Kückelhaus SAS. Perspectives on the Therapeutic Effects of Pelvic Floor Electrical Stimulation: A Systematic Review. Int J Environ Res Public Health. 2022 Oct 28;19(21):14035. doi: 10.3390/ijerph192114035. PMID: 36360918; PMCID: PMC9658412.

And this one shows the deeper effects of electromagnetic stimulation to the pelvic floor: Sylantieva E., Zarkovic D., Soldatskaia R., Evgeniia A., Orazov M. Electromyographic evaluation of the pelvic muscles activity after high-intensity focused electromagnetic procedure and electrical stimulation in women with pelvic floor dysfunction. Sex. Med. 2020;8:282–289.

Let's take a journey through the history of personal lubricants, from ancient remedies to modern options. Today we explore the different types of lubricants, their ingredients, and when to use them. Discover the pros and cons of water-based, oil-based, and silicone-based lubricants.  Learn about the importance of choosing body-safe ingredients., and what ingredients are best to avoid.  Whether you're young or older, lubrication can enhance sexual pleasure and reduce discomfort. Dive into the world of lubricants and find the perfect one for you.

Key moments in this episode are:

00:21 History of lubricants

01:34 Water-based lubricants

01:54 Glycerin and osmolality of water-based lubes

03:38 Pros and cons of water-based lube

04:20 Parabens in water-based lubes

04:37 Capsasian in water-based lubes

04:56 Lidocaine or benzocain in water-based lubes

05:18 Oil-based lubricants

05:44 Pros and cons of oil-based lube

07:39 Silicone-based lubricants

08:39 Pros and cons of silicone-based lubes

09:04 Body-safe silicones

09:39 Testing your lube if you're sensitive

10:08 Hydroxycellulose in lubricants

10:24 Is lube safe in pregnancy?

11:01 Is lube safe when trying to conceive?

11:34 Are flavored lubes safe?

Body-safe silicones we discussed in this podcast:  

Cyclomethicone

Cyclopentasiloxane

Dimethicone

Dimethicone Crosspolymer

Dimethiconol

Phenyl trimethicone

Many women struggle to have solely have orgasms through vaginal penetration, and today's podcast episode dives into the reasons behind it. Through an understanding of female anatomy, it becomes clear that direct clitoral stimulation is often essential for orgasm. The podcast also discusses how the position of the clitoris relative to the vaginal opening affects a woman's likelihood of experiencing orgasm during penetration. Supporting data is presented, highlighting the significance of clitoral stimulation. Techniques such as double stimulation, using specific vibrators, and improving anterior vaginal wall stimulation are explored as well as ways to increase the chances of orgasm with penetration. The concept of the G-spot is examined, with emphasis on the need for more research. Lifting the pelvic floor and utilizing its strength during penetration is also discussed as a technique for enhancing stimulation. The episode concludes by suggesting that the best approach may involve combining multiple techniques to find what works best for each individual.

Key moments in this episode are:

01:01 Homology in male and female structures

02:30 Need for direct clitoral stimulation

03:39 Research on distance between clitoris and vaginal opening

04:42 Why women have differing distances between clitoris and vaginal opening

05:52 Our debt to Marie Bonaparte

07:05 First technique--double stimulation

09:02 Intro to the G spot

09:35 History of Dr Graffenberg

11:27 Research to identify the G spot subjectively

12:27 Research to identify the G spot with ultrasound

13:33 Second technique--improve G spot stimulation

14:42 Third technique--lift the pelvic floor