The Hole Shebang

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.

Episode Overview

Dr. Daiana Castleman, naturopathic doctor and menopause specialist, joins Kristen to talk about Genitourinary Syndrome of Menopause (GSM)—a condition that affects up to 85% of women by 20 years post-menopause but remains dramatically underdiagnosed. This conversation goes beyond vaginal dryness to explore the full impact of estrogen decline on sexual, urinary, and overall health.

What You'll Learn

In this episode, we discuss the real symptoms of GSM including painful intercourse, recurrent UTIs, urinary urgency and frequency, and vaginal irritation. Daiana explains how estrogen loss changes the vaginal and urinary microbiome, increasing susceptibility to infection and why vaginal estrogen is a game-changer for prevention and treatment.

We also dive into sleep disruption during perimenopause and menopause—why waking up multiple times to urinate isn't normal aging, how sleep apnea presents differently in women (often without snoring), and what proper assessment looks like before reaching for supplements.

Finally, Daiana shares the incredible stat that over 90% of cardiovascular disease is preventable, making perimenopause and menopause the ideal time to focus on longevity, heart health, bone density, and cognitive function.

About Dr. Daiana Castleman

Dr. Daiana Castleman is a naturopathic doctor specializing in menopause, hormone therapy, and women's sexual health. She was inspired to pursue naturopathic medicine after her own transformative experience with an ND, and found her passion for menopause care through conversations with her own mother about perimenopause. Daiana was a keynote speaker at The Pleasure Principle Conference 2025 and is deeply committed to helping women get the evidence-based support they deserve during this life transition.

Theme Song: "Rise Up" by Andra Day

Connect with Dr. Daiana Castleman:

• Website: Dr. Daiana Castleman
• Instagram: @dr.daiana.castleman
• Newsletter: Subscribe through her website for expert menopause education

Additional Resources:

• Menopause Foundation Canada - Evidence-based menopause information and resources

Visit blueberrytherapy.ca to learn more about pelvic health physiotherapy and multidisciplinary care in Hamilton, Ontario.

Subscribe to The Hole Shebang Podcast for more honest conversations about women's health topics others whisper about.

Connect with The Hole Shebang on Instagram: @blueberrytherapypelvichealth

Episode Overview: When was the last time you actually looked at your vulva? If you're like most people, the answer is "never" or "I don't even know what I'm looking for." In this eye-opening conversation, nurse practitioner Kathryn Flanigan, Nurse Practitioner, breaks down everything we should have learned about vulvar health—but didn't.

What You'll Learn:

• The crucial difference between vulva and vagina (and why it matters for your health)
• How to talk to kids about their anatomy using correct terms without awkwardness
• Common vulvar conditions like lichen sclerosus and when to seek treatment
• Why the vagina is self-cleaning and what products to avoid
• How hormonal changes affect vulvar health across the lifespan—from postpartum to menopause
• Proper vulvar care practices (spoiler: ditch the scented soaps)
• How to recognize what's normal aging versus what needs medical attention

About Our Guest: Kathryn Flanigan is a nurse practitioner with over 25 years of experience in primary care. She's been recognized as Preceptor of the Year three times and specializes in vulvar health and pelvic conditions. After recognizing that her elderly patients lacked the vocabulary to describe vulvar changes, Kathryn dedicated herself to educating both patients and healthcare providers about this under-addressed area of health. She's passionate about giving women across the lifespan the language and knowledge to advocate for themselves.

Key Topics Covered: Vulvar anatomy 101 • Stigma and health literacy • Teaching children body autonomy • Vulvar skin conditions • Hormonal changes and vulvar health • Proper vulvar care practices • Patient advocacy • Canadian health resources

Resources Mentioned:

• GynQI.com - Canadian gynecologist-developed resource for vulvar care, lichen sclerosus, menopause, and more
• FemmeSense Balm
• The Body Book by Kathy Stinson

Connect with The Hole Shebang:

Instagram: @blueberrytherapypelvichealth

Visit: blueberrytherapy.ca

Subscribe to The Hole Shebang Podcast wherever you listen to podcasts

What if sex was supposed to feel good—but your body won't let you get there?

In this episode, Kristen sits down with Dr. Janelle Frederick, a pelvic floor physical therapist known as the Vagina Rehab Doctor, to talk about vaginismus, sexual pain, and how virtual pelvic health treatment is changing lives.

Dr. Frederick shares her journey from working in orthopedics to specializing in sexual dysfunction—and why she left her dream job at a top hospital to build a remote coaching practice focused on patient empowerment. If you've ever wondered how pelvic PT could possibly work over Zoom, this conversation will blow your mind.

What you'll learn in this episode:

• What vaginismus actually is (hint: it's a pelvic floor muscle disorder, not a psychological problem)
• Why early signs like difficulty with tampons or pap smears matter—and shouldn't be ignored
• How religious upbringing, cultural messaging, and even childhood constipation can contribute to vaginismus
• Why "just relax" is terrible advice when your pelvic floor is in overdrive
• The three first steps to take if you think you're dealing with sexual pain or vaginismus
• How Dr. Frederick's virtual model gives patients more agency and often leads to faster healing
• What "Vaj Stretch Labs" are (and why moving your body matters for pelvic floor release)

This episode is for anyone who's been told their pain is "in their head," who's tried treatment that didn't work, or who's just starting to realize that painful sex isn't something you have to live with.

About Dr. Janelle Frederick: Dr. Janelle Frederick is a Doctor of Physical Therapy who specializes in treating vaginismus and sexual pain. After completing her pelvic health residency at Loyola in Chicago, she built a thriving remote coaching practice that's helped over 300 people experience pain-free, pleasurable intimacy. Her approach focuses on patient empowerment, self-assessment, and addressing both the physical and mental aspects of healing.

Connect with Dr. Janelle Frederick: Instagram: @vaginarehabdoc

Visit Blueberry Therapy: blueberrytherapy.ca Subscribe to The Hole Shebang Podcast Follow us on Instagram: @blueberrytherapypelvichealth

Episode Overview

What if the future of pelvic health looks more like Invisalign than one-size-fits-most devices? In this episode, Kristen sits down with Derek Sham, biomedical engineer and founder of Cosm Medical, to explore how precision medicine is finally coming to women's pelvic health. Inspired by his grandmother's struggle with pelvic organ prolapse, Derek is revolutionizing vaginal pessary technology with custom devices designed using AI, digital scanning, and data from thousands of women.

What You'll Learn

• How custom pessaries work and why 1-2 millimeters actually matters for patient outcomes and comfort
• The shocking innovation gap between men's and women's pelvic health (hint: the prostate market is 10X larger)
• Why the same surgery gets reimbursed 30% less when performed on women versus men
• The future of postpartum recovery: "gynothotics" that could prevent prolapse through tissue remodeling
• How AI is transforming pessary fitting from an art based on experience to data-driven precision medicine
• What digital scanning technology could mean for moving beyond finger measurements in urogynecology

About Derek Sham

Derek Sham is a biomedical engineer and founder of Cosm Medical. He previously built the world's most utilized urodynamics system and brings over a decade of experience in medical device development to women's health. Driven by his grandmother's experience with pelvic organ prolapse, Derek is on a mission to bring precision, innovation, and digital technology to a field that has been underserved for decades.

Key Topics Covered

Custom pessary design and fitting • Postpartum tissue remodeling • Women's health innovation gaps • Healthcare reimbursement disparities • AI-assisted clinical decision making • Digital gynecology platforms • Access and affordability in pelvic health • The entrepreneurship journey in medical devices

Connect with Derek Sham and Cosm Medical

Website: COSM.care

Instagram: @cosm.medical

LinkedIn: Derek Sham

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

Subscribe to The Hole Shebang Podcast for honest conversations about women's health topics

Connect with The Hole Shebang on Instagram @blueberrytherapypelvichealth

Episode Overview

What's the connection between how you eat and how you experience intimacy? In this episode, Kristen sits down with Emily Arthur, a registered dietitian specializing in women's health, to explore the surprising intersections between nutrition, body image, sexual health, and endometriosis.

What You'll Learn

• How disordered eating patterns affect intimacy and sexual expression—not just with partners, but with yourself
• Why people with endometriosis are five times more likely to struggle with disordered eating, and how pain becomes tangled with attempts at control
• What interdisciplinary endometriosis care actually looks like, and why it's so effective (yet so rare in Canada)
• The spectrum of eating behaviors—from intuitive eating to eating disorders, and all the messy stuff in between
• How cultural expectations around gender literally shape what we put on our plates and how we relate to our bodies
• Practical approaches to addressing nutrition in pelvic health without falling into restrictive diet culture

About Emily Arthur, RD

Emily Arthur is a registered dietitian who specializes in nutrition for women's health "from first period to last period and everything in between." She completed a graduate certificate in sexual health education and has specialized training in endometriosis and pelvic health. Emily is part of the Endometriosis 360 interdisciplinary team, which provides comprehensive group programming combining nutrition, physiotherapy, and psychology for people with endometriosis. She also provides one-on-one nutrition counseling through Brandt Nutrition and is actively involved in endometriosis research.

Key Topics Covered

Disordered eating and its impact on intimacy | Endometriosis and nutrition | Body image and sexual health | Gender expectations and food | Intuitive eating | Interdisciplinary pelvic health care | The Endometriosis 360 program

Connect with Emily

Instagram: @emilytheperiodrd Website: emilytheperiodrd.ca

Resources

Visit blueberrytherapy.ca to learn more about pelvic health physiotherapy and comprehensive care.

Subscribe to The Hole Shebang Podcast wherever you listen to podcasts.

Connect with The Hole Shebang on Instagram @blueberrytherapypelvichealth