Cardiovascular disease is the number one cause of death in women, yet most women don't realize that menopause itself is now recognized as a cardiovascular risk factor. In this episode, Dr. Daiana Castleman returns to The Hole Shebang to break down what's really happening to women's hearts during midlife—and the sex-specific risk factors that standard screening tools completely miss.

What You'll Learn:

Dr. Daiana Castleman explains why the menopause transition is such a critical window for cardiovascular health. During perimenopause and menopause, women commonly experience increased cholesterol levels, changes in blood pressure, insulin resistance, and worsening cardiometabolic health—changes driven by hormonal shifts that don't happen in men's bodies the same way.

We discuss traditional cardiovascular risk factors that affect both men and women (smoking, high blood pressure, high cholesterol, physical inactivity, poor diet, obesity, diabetes, and psychosocial stress). These traditional factors account for 80-90% of cardiovascular disease risk. But here's what's crucial: three of these factors—smoking, diabetes, and psychosocial stress—have significantly heightened impact in women. Women who smoke are twice as likely to experience a heart attack compared to men who smoke.

Then we dive into sex-specific risk factors that most doctors never ask about:

Pregnancy complications carry significant cardiovascular risk: preeclampsia increases heart failure risk 4-fold and cardiovascular disease risk 2-fold; gestational diabetes increases cardiovascular event risk by 1.5-2x; preterm birth before 37 weeks carries 1.4-2.5-fold higher risk; stillbirth increases risk 1.5-2.2-fold; and placental abruption carries 1.8-fold higher cardiovascular disease risk.

Lipoprotein(a) is a genetic marker that affects about 1 in 5 people (20% of the population) and is 6x more atherogenic than LDL cholesterol. It's more than 90% genetically determined and can increase during menopause while remaining stable in men. Everyone over 40 should have it tested at least once, yet most women have never heard of it.

We also discuss premature or early menopause, PCOS, and autoimmune conditions like lupus and rheumatoid arthritis as additional sex-specific risk factors.

Daiana explains why the Framingham Risk Assessment—while valuable—has serious limitations for midlife women. It only calculates 10-year risk and doesn't account for any sex-specific factors, meaning many women receive "low risk" scores that don't reflect their actual cardiovascular risk profile.

The empowering news? 80-90% of cardiovascular disease is preventable when you know your risk factors and advocate for yourself.

Theme Song: Put a Little Love in Your Heart by Annie Lennox and Al Green

The Decads Ahead Summit (Apr 25, 2026):

Information about The Decades Ahead Summit (Oakville) covering heart health, osteoporosis, hormone therapy, sleep, and nutrition for long-term health.

Register Here: Decades Ahead Summit Registration Link

Connect with Dr. Daiana Castleman:

Website: Dr. Daiana Castleman Instagram: @dr.dianacastleman

More from The Hole Shebang:

Visit blueberrytherapy.ca Subscribe to The Hole Shebang Podcast Connect with The Hole Shebang on Instagram @blueberrytherapypelvichealth

What does proactive relationship care actually look like? In this conversation, Dr. Jessica O'Reilly breaks down the simple daily practices that prevent relationship breakdown and explains how cancer survivors can rebuild intimacy when bodies and identities have fundamentally changed.

What You'll Learn:

• Why relationship quality (not just having a partner) is what impacts cardiovascular health, mental health, and longevity
• The 1-5-30 formula for maintaining relationships proactively: one minute daily, five-minute weekly check-ins, and thirty-minute monthly dates
• How to start intimacy conversations after cancer diagnosis without jumping straight to "what will sex look like?"
• Why practicing clinical and pleasure language out loud matters for healthcare providers
• Communication strategies for couples when one partner is navigating chronic illness or cancer treatment

About Dr. Jessica O'Reilly:

Jess O'Reilly (@SexWithDrJess) is a sex and relationship expert with a background in education and behavioural and organizational psychology. Her research and passion involves teacher training in sexual health and she works primarily with business leaders to improve relationships from the boardroom to the bedroom. Jess is also a television personality, author, podcast host (@SexWithDrJess Podcast) and award-winning international speaker who has facilitated hundreds of corporate workshops and retreats in 45+ countries from Lebanon to Switzerland.

Theme Song: "All Over the World" by Proteje and Lila Iké

Key Topics Covered:

• Dr. Jess's journey from high school teacher to relationship expert
• The gap in sexual health education for teachers (only 15.5% of Canadian teacher education programs had mandatory sex ed training)
• How Western culture centers intimate partnerships and why that makes relationship quality even more critical
• The protective health mechanisms of quality relationships
• Why couples wait too long before seeking support
• Using popular culture (Netflix, TikTok, streaming content) to start difficult conversations
• The sexual values interview as a foundation for rebuilding intimacy
• Teaching children anatomical language for safety and empowerment

Resources & References Mentioned:

• Book referenced by Kristen: Women's Anatomy of Arousal by Sheri Winston
• Weekly relationship check-in questions (available through Dr. Jess's resources

Connect with Dr. Jessica O'Reilly:

• Website: Happier Couples
• Instagram: @sexwithdrjess
• Podcast: Sex with Dr. Jess Podcast

Keynote Speaker Announcement:

Dr. Jessica O'Reilly is the keynote speaker at The Pleasure Principle Conference on May 8, 2026 in Hamilton, Ontario. Her session, "Pleasure as Practice: Eroticism, Desire, and Connection After Cancer," will provide healthcare professionals with practical strategies for supporting cancer survivors' sexual health. Learn more at blueberrytherapy.ca.

Visit blueberrytherapy.ca | Subscribe to The Hole Shebang Podcast | Connect with The Hole Shebang on Instagram @blueberrytherapypelvichealth

Episode Overview

Natalia, founder of Dott, joins the podcast to discuss why clitoral vibration should be considered healthcare for menopause—not just pleasure. As an industrial designer who experienced Premature Ovarian Insufficiency in her thirties, Natalia breaks down the physiology of estrogen loss, decreased blood flow to pelvic tissues, and how vibration therapy supports tissue health, natural lubrication, and nervous system regulation during hormonal transitions.

What You'll Learn

• Why blood flow to your vulva and vagina decreases during perimenopause and menopause—and what that means for tissue health
• How vibration therapy prevents the thinning, dryness, and sensitivity loss that many people accept as "normal aging"
• The three-phase ritual (regulate, release, restore) and why nervous system regulation comes before addressing the vulva
• The difference between using vibration therapy preventatively versus therapeutically once symptoms have started
• Why standards matter in the intimate wellness industry—and what Health Canada licensing actually means

Guest Bio

Natalia is an industrial designer and founder of Dott, a Health Canada licensed intimate wellness company focused on perimenopause and menopause care. After watching her mother suffer through menopause in silence and experiencing Premature Ovarian Insufficiency herself in her thirties (which led to bone density loss before diagnosis), she founded Dott to treat vibration therapy as real healthcare for women's bodies. She designs tools and education that support hormone balance, pelvic floor health, nervous system regulation, and sexual comfort during hormonal change. Natalia collaborates with menopause clinics and pelvic floor therapists to integrate evidence-based vibration therapy into treatment protocols.

Theme Song: The Chain by Fleetwood Mac

Key Topics Covered

• The physiology of estrogen depletion and decreased pelvic blood flow
• How vibration therapy increases circulation to vulvar and vaginal tissues
• Nervous system regulation as the foundation of the three-phase protocol
• Why preventative care matters before symptoms become severe
• The lack of standards in the intimate wellness industry
• Partnering with healthcare providers to integrate vibration therapy into pelvic health treatment

Connect with Natalia

• Website: Dott Wellness
• Instagram: @dott.wellness
• LinkedIn: Natalia B.

Visit blueberrytherapy.ca and subscribe to The Hole Shebang Podcast.

Connect with The Hole Shebang on Instagram @blueberrytherapypelvichealth

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Episode Overview

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Dr. Jordin Wiggins is a naturopathic doctor, author of The Pink Canary, host of The Pleasure Principles podcast, and an intimacy coach for high-achieving women. Her journey into women's sexual health started in grade 10 with debilitating pelvic pain that felt like "somebody was shoving a knife in between my vagina and my rectum." Doctors dismissed her pain as psychological, offering antidepressants because they couldn't see the problem on imaging. It wasn't until naturopathic medical school that she learned about pelvic floor physiotherapy—the answer she'd been searching for.

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That experience of being dismissed by healthcare, combined with horrible reactions to birth control, shaped her mission: understanding why 50% of women globally suffer from sexual dysfunction and why so many successful women have everything they thought they wanted but feel completely unfulfilled.

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In this conversation, Jordin introduces super traits—personality strengths like empathy, loyalty, tolerance, and hard work that make you extraordinary in your career and relationships. But when there are no boundaries around these traits, women build their entire relationship around their partner's moods and comfort, carrying all the emotional labor while their own needs shrink smaller and smaller. What happens in the bedroom becomes a mirror of what happens outside the bedroom.

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What You'll Learn:

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How being gaslit about pelvic pain shaped Jordin's approach to women's health, why she ran a successful 7-figure women's health clinic that almost swallowed her whole, what super traits are and why conventional advice doesn't work for women who have them, the four hidden patterns that destroy intimacy in relationships, why "just communicate better" doesn't address power dynamics, the difference between desire that's gone versus desire buried under resentment, how to start examining your relationship without making things worse, why accountability requires checking for safety first, what it means to come home to your head, heart, and body, and why sex being "for him" while connection is "for us" keeps women stuck.

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Resources Mentioned:

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Super Traits Research: Sandra Brown's original research on super traits as personality strengths

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Free Resource: Super Traits Quiz — Take the quiz to discover your super traits. Jordin notes the quiz sends your top trait, but she can send all results profiles if you DM her on Instagram, as most women have three or four super traits.

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Theme Song: River by Bishop Briggs

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Connect with Dr. Jordin Wiggins:

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Website: Dr. Jordin Wiggins Instagram: @drjordinwiggins Podcast: The Pleasure Principles Book: The Pink Canary by Dr. Jordin Wiggins

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Visit blueberrytherapy.ca and subscribe to The Hole Shebang Podcast.

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Connect with The Hole Shebang on Instagram @blueberrytherapypelvichealth

When cancer treatment forces you into menopause overnight, the experience is drastically different from natural menopause. Your hormones don't gradually decline—they stop. And the symptoms? They hit hard and fast.

In this episode, I sit down with Dr. Ashley Chauvin, a Naturopathic Doctor and Menopause Society Certified Practitioner who has built her practice around cancer survivorship and menopause support. Ashley shares her journey from radiation therapy intern to naturopathic doctor specializing in integrative cancer care, and why she's passionate about helping patients feel like themselves again after treatment.

What You'll Learn:

• The physiological differences between medical menopause and natural menopause—and why symptoms are more intense when treatment shuts down your hormones overnight
• What to ask your healthcare providers before cancer treatment begins, and why establishing your baseline matters
• Ashley's non-restrictive approach to nutrition for cancer survivors (spoiler: it's not about eliminating gluten, dairy, and coffee)
• Why muscle mass is critical for cancer survivorship, longevity, and bone health
• The truth about hormone therapy for cancer survivors—including when vaginal estrogen might be an option
• How to collaborate with your oncology team without feeling like you're asking for permission to feel better
• What gives Ashley hope in this work, and why her patients inspire her to try adult gymnastics at 40

This conversation challenges the narrative that cancer survivors just have to suffer through menopause symptoms. You don't. There are options, and quality of life matters.

Theme Songs:

• Can't Stop by Red Hot Chili Peppers (family friendly)
• Till I Collapse by Eminem (non-family friendly version)

Connect with Dr. Ashley Chauvin:

• Website: Clarity Health Burlington
• Instagram: @ashleychauvin_nd
• Practice: Clarity Health, Burlington, Ontario (Virtual and in-person appointments available across Ontario)

Visit blueberrytherapy.ca and subscribe to The Hole Shebang Podcast.

Connect with The Hole Shebang on Instagram @blueberrytherapypelvichealth

Why Muscle Is Your Longevity Organ with Barbara Birke

When your body stops responding to the same old strategies, it's not because you're broken—it's because your hormones are changing, and your body needs something different now.

Barbara Birke is a German sports scientist and nutritionist who specializes in supporting women through perimenopause, menopause, and beyond. She studied sports science with a focus on psychology and motivation, managed an orthopedic rehab center, and has spent years teaching women how to build strength, optimize nutrition, and thrive through hormonal transitions. But her most powerful lesson came from her own body in her 40s, when she realized that muscle wasn't just professional advice—it was personal survival.

In this episode, you'll learn:

• Why muscle loss accelerates when estrogen declines (and why muscle quality degrades if you don't actively work against it)
• How strength training acts as metabolic medicine—pulling sugar from your bloodstream, releasing protective myokines, and improving blood work markers
• The connection between strength training and bone health, brain health, and mood
• Why managing stress becomes harder in perimenopause and how to set better boundaries
• What "strength training" actually means for women who've never lifted weights before
• How building outer strength creates inner strength and empowerment

Theme Song: "Unstoppable" by Sia

Connect with Barbara:

• Website: Optimum-U.com
• Instagram: @strongwithbarbara
• Programs: Power & Balance (strength training), Clean Up (nutrition), Thrive Formula (12-week holistic program)

If you're feeling dismissed by conventional medical advice or struggling with a body that suddenly won't cooperate, this conversation will give you the framework to understand what's actually happening—and what you can do about it.

Subscribe to The Hole Shebang Podcast wherever you listen, and visit blueberrytherapy.ca for more resources on pelvic health and wellness.

Connect with The Hole Shebang on Instagram @blueberrytherapypelvichealth

In this powerful episode, Kristen sits down with Michiko Tsukada Caringal, a pelvic health physiotherapist in British Columbia who brings both clinical expertise and deeply personal experience to her work. Michiko spent three years recovering from vulvodynia before becoming a physiotherapist, and that journey shapes everything about how she treats patients today.

What You'll Learn:

Michiko opens up about her non-linear recovery from pelvic pain, including the moments she gave up hope and how she eventually found her way to being symptom-free for over 10 years. She shares the golden nuggets from her journey—particularly the critical role of hope, finding your own advocate, and believing recovery is possible even when the path isn't clear.

You'll hear about Michiko's unique approach to gender-inclusive pelvic care, her work as a subject matter expert with TransCare BC, and how she navigates the tension between maintaining professional boundaries while creating genuine human connection with patients. She explains her "detective cap" approach to understanding each person's unique story and why relationships are the foundation of all healing.

The conversation also covers practical topics like post-prostatectomy incontinence recovery, functional pelvic floor training that makes sense in real life (not just on a treatment table), and why the best healthcare professionals can be both your cheerleader and your source of evidence-based facts.

About Michiko Tsukada Caringal:

Michiko is a pelvic health physiotherapist with a master's in bioethics who treats people of all ages and genders at two clinics in BC: Inner Circle Physio in Burnaby and Kaia Health Care Center. She specializes in gender-inclusive care, works as a subject matter expert for TransCare BC, and is passionate about empowering anyone with a pelvic floor to understand and heal their bodies.

Theme Song: I'm a Believer by The Monkees

Connect with Michiko:

• Website: Happy Down There
• Email: Available on her website
• Clinics: Inner Circle Physio (Burnaby) and Kaia Health Care Center (BC)

Visit blueberrytherapy.ca to learn more about pelvic health services in Hamilton, Ontario.

Subscribe to The Hole Shebang Podcast and connect with us on Instagram @blueberrytherapypelvichealth

Dee Hartmann is a pelvic health physical therapist who spent nearly three decades specializing in chronic vulvar pain. After treating thousands of women in her Chicago practice, she discovered that conventional approaches were missing critical connections - between old injuries and current pain, between visceral tension and pelvic floor dysfunction, and between pain elimination and pleasure cultivation.

In this conversation, Dee shares her journey from treating incontinence to becoming a leading voice in vulvar pain treatment. She explains why pelvic floor dysfunction is a symptom rather than a cause, how seemingly unrelated issues throughout the body contribute to vulvar pain, and why her approach now centers on pleasure as a pathway to healing.

What you'll learn:

• How Dee's own experience having five children in six years led her to specialize in pelvic health
• Why treating just the vulva or just the pelvic floor isn't enough
• The five exercises that can decrease vulvar pain before penetration of any kind
• How pleasure and arousal fit into physical therapy treatment
• What to look for (and avoid) when seeking pelvic health care
• Why a multidisciplinary approach matters for chronic pain

Dee retired from clinical practice in 2017 and co-authored "The Pleasure Prescription" with Elizabeth Wood. She now travels internationally teaching her approach and speaking about the intersection of physical therapy, sexual health, and pleasure.

Theme Song: Don't Stop by Fleetwood Mac

Connect with Dee Hartmann:

Dee Hartmann Physical Therapy Website: Dee Hartmann Physical Therapy

Book: The Pleasure Prescription on Amazon:

Find Dee on Facebook and LinkedIn

Connect with Blueberry Therapy:

Website: Blueberry Therapy

Instagram: @Blueberrytherapypelvichealth

Subscribe to The Hole Shebang Podcast on your favorite podcast platform

Episode Overview

Breathwork facilitator Jenn Mansell joins The Hole Shebang to talk about how intentional breathing can shift everything from chronic illness to pelvic floor dysfunction to trauma patterns. If you've ever felt trapped in your body or caught in stress loops that keep you stuck, this conversation offers both the science and the hope you need.

What You'll Learn

In this episode, we explore how breathwork actually works in your body and why it's become such a foundational practice across healthcare disciplines. Jenn breaks down the physiology of breathing, from oxygen as your brain's primary fuel to how breath shifts your nervous system state and creates space for tension release. We discuss practical applications for pain management, pelvic health, and accessing emotions that live in your body beyond cognitive memory.

You'll hear Jenn's powerful story of growing up chronically ill with severe eczema, allergies, and asthma, and how she moved from fear and disconnection to becoming a facilitator who's breathed with thousands of people. We talk about the moment she realized her body wasn't the enemy, how breathwork bridges the gap between feeling trapped and feeling wild, and why this simple practice keeps showing up in conversations with neuroscientists, physiotherapists, and trauma specialists.

About Jenn Mansell

Jenn Mansell is a breathwork facilitator and mentor who has been guiding people through intentional breathing practices for eight years. Her work combines breathwork with somatic therapy, internal family systems, and nervous system healing. She also DJs conscious dance spaces and has recently expanded her practice to include low dose cannabis and ketamine work for trauma and attachment healing. Based in Toronto, Jenn runs regular events and works with clients privately to help them reconnect with their body's innate intelligence.

Theme Song: "Keep Going" by HRRTZ SHELLS

Key Topics Covered

• The physiology of breathwork and nervous system regulation
• How stress is held as tension in the body
• Breathwork for chronic illness, pain management, and pelvic floor dysfunction
• Shifting from the default mode network (survival brain) to the limbic system
• Trauma release and accessing nonverbal body memory
• The role of oxygen in brain function and energy
• Somatic therapy and body intelligence

Connect with Jenn Mansell:

• Website: jenmansell.com
• Instagram: @jenmansell
• Find Jenn's guided breathwork sessions on Insight Timer

Ready to explore more?

Visit blueberrytherapy.ca and subscribe to The Hole Shebang Podcast wherever you listen.

Connect with The Hole Shebang on Instagram @blueberrytherapypelvichealth

Episode Overview

Dr. Margie Davenport is rewriting the rules on exercise during pregnancy and postpartum—and the outdated advice about waiting six weeks or avoiding heavy lifting is officially being replaced with actual evidence. As an exercise physiologist at the University of Alberta and the lead researcher behind the 2025 Canadian Postpartum Exercise and Sleep Guidelines, Margie shares the groundbreaking research that's changing how we support people through this massive life transition.

What You'll Learn

• Why the six-week postpartum checkpoint has been completely removed from the new guidelines and what replaced it (hint: it's way more individualized and actually useful)
• How the Get Active Questionnaire for Postpartum helps you determine when YOU'RE ready to start moving—not when some arbitrary timeline says you should be
• The shocking research showing that people who lifted heavy (>80% of their 1RM) throughout pregnancy had a 51% reduction in adverse pregnancy outcomes
• Why the "don't lift more than 20 pounds" advice during pregnancy is based on occupational lifting literature and doesn't apply to intentional strength training
• How to gradually and safely progress toward 120 minutes of moderate to vigorous physical activity per week postpartum using symptom-based cues
• Why starting exercise during pregnancy is beneficial even if you've never been active before

Resources Mentioned

• Get Active Questionnaire for Postpartum - Use this self-screening tool to determine when you're ready to start your postpartum exercise journey

About Dr. Margie Davenport

Dr. Margie Davenport is an exercise physiologist and researcher at the University of Alberta, where she founded the Program for Pregnancy and Postpartum Health in 2013. A former national team athlete, Margie has dedicated her career to pushing the boundaries of what we know about exercise during pregnancy and postpartum. She led the development of the 2019 Canadian Pregnancy Exercise Guidelines and the groundbreaking 2025 Canadian Postpartum Exercise and Sleep Guidelines.

Theme Song: Survivor by Destiny's Child and My Way by Frank Sinatra

Connect with Dr. Margie Davenport:

• Website: Exercise in Pregnancy
• Instagram: @DrMargieDavenport

Visit blueberrytherapy.ca and subscribe to The Hole Shebang Podcast wherever you listen. Connect with The Hole Shebang on Instagram @blueberrytherapypelvichealth.