The Hole Shebang

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In this engaging conversation, Kristen Parise speaks with Jill Mueller, a pelvic health physiotherapist, about her journey into pelvic health, the complexities of endometriosis, and the importance of understanding sensitization in chronic pain. They discuss the connection between endometriosis and gastrointestinal dysregulation, the evolution of diagnostic methods, and the innovative Endometriosis 360 program that takes a holistic approach to treatment. Jill shares practical tips for managing pain and emphasizes the need for a comprehensive understanding of the patient's experience.

• Jill's journey into pelvic health was influenced by her own fertility struggles and endometriosis diagnosis
• Sensitization plays a crucial role in chronic pain, affecting how the nervous system responds
• Endometriosis is complex and can manifest in various ways, including outside the pelvis
• GI dysregulation is common among endometriosis patients and can exacerbate symptoms
• Diagnosis of endometriosis is evolving, with less invasive methods like ultrasound gaining traction
• Endometriosis 360 offers a holistic, interdisciplinary approach to treatment involving physiotherapy, psychology, and nutrition
• Understanding the patient's life context is crucial for effective care
• Pain management should consider both physical and psychological factors
• The tissue is just one aspect of understanding pain; the brain's role is significant

• 00:00 - Journey into Pelvic Health Physiotherapy
• 03:20 - Understanding Sensitization and Chronic Pain
• 05:37 - Exploring Endometriosis: Definition and Perception
• 10:17 - The Connection Between Endometriosis and GI Dysregulation
• 14:50 - Diagnosis of Endometriosis: Traditional vs. Modern Approaches
• 23:25 - Introducing Endometriosis 360: A Holistic Approach
• 27:14 - One-on-One Client Care: Addressing Sexual Pain
• 32:44 - Cutting Edge Care for Endometriosis
• 35:51 - Practical Tips for Managing Pain and Sensitization
• 41:46 - Future Directions and Resources for Patients

• Natasha Orr - Researcher focused on sensitization and endometriosis - natashaorr.com
• "Healing Pelvic Pain" by Dr. Peta Wright
• "Tame the Beast" - Educational video on YouTube about pain science
• Endometriosis 360 - endometriosis360.ca
• Endo Together - endo-together.com

Jill Mueller has been a physiotherapist since 2001 and is the founder of Endo Together and a lead physiotherapist at Endometriosis 360. After her own experiences with endometriosis and fertility challenges, she shifted her focus to pelvic health. She practices at Healthy Balance Physiotherapy and Wellness in Oakville, Ontario, and is dedicated to empowering people with pelvic health conditions.

• Clinic: Healthy Balance Physiotherapy & Wellness, Oakville, Ontario
• Instagram: @endotogether, @endometriosis360, @oakvillephysio
• Websites: endotogether.com, endometriosis360.ca, hbpw.ca

• Instagram: @blueberrytherapypelvichealth
• Website: blueberrytherapy.ca/podcast

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In this powerful episode of The Hole Shebang, host Kristen Parise sits down with Dr. Arielle Buch-Frohlich, a clinical psychologist specializing in perinatal mental health, sex and couples therapy. Together they explore the often unspoken challenges of pregnancy, birth, and postpartum life. Dr. Buch-Frohlich shares insights from both her professional expertise and personal experiences, offering valuable guidance for couples navigating the complex emotional terrain of new parenthood. From redefining intimacy after baby to processing birth trauma and managing postpartum emotions, this conversation breaks the silence on topics many suffer through alone.

Dr. Arielle Buch-Frohlich is a Clinical Psychologist licensed with the College of Psychologists of Ontario and Quebec. She completed her doctorate in Clinical Psychology (Psy.D) from the Université du Québec à Montréal (UQAM) and clinical training at the Sex and Couple Therapy Service at the Allen Memorial Institute. Dr. Buch-Frohlich provides inclusive Sex and Couples Therapy using a combination of Emotionally Focused Therapy (EFT), Cognitive Behavioural Therapy, and Acceptance and Commitment Therapy (ACT). She specializes in helping couples navigate communication challenges, infidelity, and transitions into parenthood, from fertility to perinatal and postpartum care.

• Perinatal mental health issues are far more common than most people realize
• The postpartum period should be treated as a survival period before thriving can begin
• Both partners may experience birth trauma, though often in different ways
• Self-care is essential for new parents and should not be viewed as selfish
• The pressure to "bounce back" after pregnancy is unrealistic and harmful
• Intimacy can be redefined beyond sexual intercourse through emotional and physical connection
• Communication is key to maintaining intimacy and navigating challenges in relationships
• Processing emotions like anger is healthy; it's the behaviors that need to be appropriate
• Prioritizing your relationship during parenthood is vital for long-term success

• 00:00 Introduction to Perinatal Mental Health
• 03:04 The Journey of a Clinical Psychologist
• 05:57 Navigating Emotional Changes in Pregnancy
• 09:04 Creating a Supportive Environment for Couples
• 11:48 Surviving the Postpartum Period
• 14:57 The Pressure to Bounce Back
• 17:59 Self-Care Strategies for New Parents
• 21:03 Resuming Intimacy After Baby
• 24:02 Communication and Intimacy in Relationships
• 26:41 Creating Safe Spaces for Vulnerability
• 27:34 Understanding Birth Trauma and Its Impact
• 30:03 Preparing for Birth: Communication and Expectations
• 32:10 Processing Trauma Together: The Partner's Perspective
• 33:53 Navigating Anger and Reconnection Postpartum
• 35:56 Self-Care Strategies for New Parents
• 39:34 Emotional Regulation and Healthy Expression
• 43:14 Resources for Postpartum Support
• 45:29 Prioritizing Relationships in Parenthood

• Big Little Feelings (Instagram and podcast)
• Dr. Becky Goodenstein
• Fertility Oasis/The Oasis Network (support groups for Ontario)
• Dr. Arielle's website: drarieltherapy.com
• Coming Soon: Anna and Solomon's Sex and Couples Health (launching May 2025)

• Website: Dr. Arielle website
• Coming soon: Anna and Solomon's Sex and Couples Health
• Instagram: @annaandsolomon (launching May 2025)

• Host: Kristen Parise, Pelvic Health Physiotherapist
• Clinic: Blueberry Therapy Pelvic Health and Pediatrics
• Website: The Hole Shebang
• Instagram: @blueberrytherapypelvichealth

This episode contains discussions about birth trauma, mental health challenges, and intimate relationships. While we aim to provide helpful information, this podcast is not a substitute for personalized medical or psychological care.

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In this enlightening episode of The Hole Shebang, host Kristen Parise sits down with Dr. Stacey Ritz, Associate Professor at McMaster University, to challenge our understanding of hormones and their roles in health across all bodies. Dr. Ritz shares her expertise on how cultural narratives have shaped our misconceptions about hormones like estrogen and testosterone, and explains why moving beyond binary thinking is essential for both healthcare and scientific research.

• The myth of "male" and "female" hormones and why this framing is scientifically inaccurate
• How testosterone and estrogen function in all bodies, regardless of gender
• The reverse relationship: how behavior can influence hormone levels
• Why hormonal levels vary throughout life stages and aren't as dimorphic as commonly believed
• The complex feedback mechanisms between different hormones
• How gender diversity research enhances our understanding of hormonal health
• Practical approaches to discussing hormones with children without reinforcing stereotypes

• Testosterone and estrogen are present and important in all bodies
• There's significant overlap in hormone levels between different sexes
• The relationship between hormones and behavior is bidirectional
• Cultural narratives often misrepresent the roles of hormones in behavior
• Understanding hormonal complexity helps dismantle harmful stereotypes
• The social and biological aspects of hormones are deeply entangled

00:00 - Introduction to Dr. Stacey Ritz and Her Journey 02:50 - The Intersection of Sex, Gender, and Health Research 05:47 - Myths About Hormones: Understanding Testosterone and Estrogen 08:55 - The Reality of Hormones in All Bodies 12:03 - Cultural Narratives and Hormonal Stereotypes 15:11 - Talking to Children About Hormones 18:01 - The Reverse Relationship: Behavior Influencing Hormones 26:53 - Understanding Hormones and Their Interactions 32:30 - The Complexity of Hormonal Balance 36:43 - Hormones and Female Sexual Health 40:37 - Evolving Perspectives on Gender and Hormones 45:42 - The Interplay of Biology and Society 48:31 - Future Directions in Hormonal Research

Dr. Stacey Ritz is an Associate Professor in the Department of Pathology and Molecular Medicine at McMaster University. Her research focuses on how sex and gender should be considered in health research, particularly developing approaches that account for the nuance, complexity, diversity, and dynamicism of sex and gender-related factors beyond binary comparisons.

• Dr. Ritz's research on hormones associated with gender and sex (HAGS)
• The concept of sex contextualism in biomedical research
• The understanding of hormone receptors and their function across different bodies

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To connect with Gillian Linkedin, website or email [email protected]

In this engaging conversation, Kristen Parise and Gillian Stovel Rivers explore the intricate relationship between financial wellness and personal health. They discuss the importance of understanding financial stability, the mindset shifts necessary for overcoming financial anxiety, and the unique perspectives women bring to financial discussions. The conversation also delves into practical steps for building long-term financial security, particularly in the context of education savings for children. Through personal anecdotes and professional insights, the episode aims to empower listeners to take control of their financial futures.

Guest Bio

Gillian Stovel Rivers is a Senior Wealth Advisor at Assante Wealth Management and the creator of The Muscle Money Mindset. With over twenty years in wealth management, Gillian acquired her wealth business from her father in 2007 and tripled it before partly monetizing it to her fellow founding partners at SurroundWealth.com in 2020. She holds CFP® and CEA designations, is certified as a CF-L2 Level 2 Coach in CrossFit, and is also a Certified High Flow Coach through the Flow Research Collective. When not advising clients, Gillian competes as a Masters CrossFit athlete and Olympic weightlifter, and is the mother of two teenage sons and two dogs.

Gillian Stovel Rivers is a Senior Wealth Advisor with Assante Financial Management Ltd. The opinions expressed are those of the presenter and Financial Advisor and not necessarily those of Assante Financial Management Ltd. Please obtain professional financial advice or contact Gillian Stovel Rivers at (905) 335 - 1950 or visit https://www.surroundwealth.com/ to discuss your particular circumstances prior to acting on the information presented.

Episode Chapters

• 00:00 Introduction to Financial Wellness
• 05:57 Understanding Financial Stability
• 10:54 Mindset Shifts Around Money
• 16:32 Unique Perspectives of Women in Finance
• 20:32 Building Long-Term Financial Security
• 24:50 Concrete Steps for Education Savings
• 27:07 Starting Over Financially: Navigating Life Changes
• 30:20 The Importance of Advisors and Networking
• 32:35 Building Resilience Through Financial Challenges
• 38:36 Practical Budgeting for Everyday and Long-Term Goals
• 46:31 Practical Tips for Increasing Savings
• 51:48 Tax Efficiency in Saving and Investing

Resources Mentioned

• The Muscle Money Mindset by Gillian Stovel Rivers
• DIY financial planning software: Optiml– there are literally few if not no other personal financial planning programs available to Canadians, everything else is a budgeting app!
• Ray Dalio Principles for success: an ultra mini-series adventure on You Tube

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For more information about Right At Home Sharlene Louden

In the podcast interview Kristen Parise speaks with Sharlene Hogeterp Louden, a dynamic serial entrepreneur and registered kinesiologist with a passion for movement as medicine. Sharlene's journey began as a gymnastics coach and developed through her work in a multidisciplinary clinic setting, where she emphasized the importance of movement for all ages. Her entrepreneurial spirit led her to create Louden Kinetics, focusing on rehab and health promotion, alongside other ventures.

In 2018, Sharlene sought a legacy project and partnered with Right at Home, a franchise providing in-home care services, especially valuable during the COVID-19 pandemic. Sharlene's approach is grounded in building compassionate, client-centered care teams by hiring individuals with personal caregiving experiences. Her leadership philosophy is to create a supportive work environment, celebrating staff achievements and fostering a spirit of connection and respect.

Sharlene is committed to volunteering and community building, often seen leading initiatives like women's health summits and advocating for mental health services through the Canadian Mental Health Association board. Her belief in taking risks and her love for community interaction have been instrumental in her success.

Sharlene has faced personal health challenges, including navigating a total hysterectomy, but she advocates for self-care, movement, and being one's own health advocate. Her passion for movement continues through her longstanding fitness group, Louden Kinetics, which she started to support and connect with other mothers.

Throughout the interview, Sharlene emphasizes the importance of building networks, volunteering, and taking risks. Her life motto, underscored by songs like "Courage" by The Tragically Hip, reveals her dedication to continuous personal and community growth, making a meaningful impact wherever she can.

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For more information on Dr. Sari van Anders van Anders Lab

In this engaging episode of The Hole Shebang podcast, host Kristen Parise welcomes Dr. Sari van Anders from Queen's University. Dr. van Anders shares her impressive academic journey, which began with a passion for teaching sex education to younger students and evolved into a career as a Canada 150 Research Chair at Queen's University. She specializes in social neuroendocrinology, sexuality, and gender sex, weaving these interests into a complex tapestry of research that includes feminist and queer science perspectives.

Dr. van Anders discusses her groundbreaking Sexual Configurations Theory (SCT), which aims to address gaps in traditional understandings of sexual orientation. SCT provides a framework that separates identity, orientation, and status, capturing the complexity of human sexuality beyond binary definitions. This theory is particularly useful for individuals whose identities do not align with conventional labels. Dr. van Anders and her team are developing materials for clinicians and educators to help them utilize SCT in practical settings.

Another significant topic covered in the interview is the societal impact on women's sexual desire, particularly in heteronormative relationships. Dr. van Anders challenges the notion that low desire in women is primarily due to biological factors like testosterone levels. Instead, she posits that gender inequities and cultural expectations play a significant role, affecting women's sexual experiences and desires. This perspective shifts the focus from individual issues to broader societal structures that influence intimate dynamics.

The conversation also explores Dr. van Anders' research on orgasms, revealing how these experiences are often viewed as achievements tied to gender roles rather than purely personal pleasure. Her work suggests that cultural expectations can distort relationships and sexual satisfaction.

Regarding pornography and sexual norms, Dr. van Anders acknowledges the branched nature of sexual fantasies, desires, and real-life experiences. Her research emphasizes that what arouses in fantasy or pornographic content doesn't necessarily align with in-person desires, highlighting the importance of recognizing and respecting these differences.

Throughout their discussion, Kristen and Dr. van Anders emphasize the power of open communication in relationships to navigate and challenge outdated sexual norms. Dr. van Anders is working on developing pragmatic tools and language around these issues for clinicians and educators to improve understanding and acceptance in various sexual and relational contexts.

For those interested in learning more about her work, Dr. van Anders' research and resources on Sexual Configurations Theory are accessible online, promising fresh insights and practical applications for those looking to deepen their understanding of sexuality and gender dynamics.

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For more information on Dr. Carly King Dr. Carly King

Dr. Carly King, a passionate and experienced naturopathic doctor, joins me on the Podcast to share her remarkable journey and insights into perinatal health. With a background as a high-level athlete at McMaster University, Dr. King's personal health challenges led her to explore naturopathic medicine after conventional treatments failed to alleviate her severe migraines.

Dr. King's passion for perinatal health was ignited by her personal experiences during the perinatal period. Her challenging pregnancy, including being diagnosed with kidney failure and undergoing close monitoring, taught her the importance of being proactive. Researching ways to improve pregnancy outcomes through lifestyle, nutrition, and holistic approaches became her mission.

In this episode, Dr. King discusses the significance of early intervention in pregnancy and emphasizes the proactive measures that can be taken to ensure a healthy outcome for both mother and child. She highlights the importance of addressing nutritional deficiencies early in pregnancy, particularly focusing on iron, vitamin D, and omega-3s, which are crucial for placental and fetal development. Dr. King shares valuable tips on maintaining health through a Mediterranean diet, known for its benefits in reducing risks like gestational diabetes and enhancing fertility.

Listeners will be captivated by Dr. King's inspirational story of resilience through her medical challenges, including a recent kidney transplant. Her dedication to combining naturopathic practices with conventional medicine offers a comprehensive approach to perinatal care, and her insights are sure to resonate with those seeking a more informed and holistic path through pregnancy.

This episode promises to be a beacon of knowledge and a source of empowerment for expecting mothers and healthcare providers alike. Whether you're interested in holistic health approaches or captivated by Dr. King's journey, this episode is a must-listen.

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For more information on Dr. Carolyn Best Dr. Carolyn Best

In this engaging episode of The Hole Shebang, Kristen Parise welcomes Dr. Carolyn Best, a seasoned urogynecologist, for an in-depth discussion about pelvic organ prolapse (POP), surgical options, and the misconceptions surrounding these conditions. Dr. Best shares her journey into urogynecology and her passion for impactful, tangible results in women's health. Her experience ranges from Mount Sinai Hospital in Toronto to her current position at Halton Healthcare, where she continues to perform surgeries and educate others in the field.

Throughout the conversation, Dr. Best emphasizes the importance of understanding the symptoms of pelvic organ prolapse, such as a feeling of pressure or bulging in the vagina, which can significantly impact a person's quality of life. The discussion highlights that while these symptoms are common, they often remain misunderstood, leading to unnecessary distress among those affected.

Dr. Best provides clarity on the causes of prolapse, pointing to pregnancy, gravity, chronic constipation, and heavy lifting as potential contributors. While hormones play a role, the exact mechanism remains under study, with changes in estrogen levels affecting tissue integrity and muscle tone more than directly causing prolapse.

Listeners will gain insight into how Dr. Best approaches treatment, considering surgery only when prolapse significantly affects a patient's life and when non-surgical options prove insufficient. She explains the nuances of grading prolapse, focusing on quality of life rather than numerical severity. This approach ensures that treatment is highly personalized, acknowledging the diversity of patient experiences.

Prolapse surgeries, as Dr. Best describes, are typically done through the vagina, minimizing recovery time and the need for invasive procedures. She elaborates on the steps involved in these surgeries, including vaginal hysterectomy and repairing the vaginal walls, while emphasizing non-surgical measures like pelvic floor exercises and pessaries when appropriate.

Dr. Best addresses common concerns about the longevity of surgical outcomes, explaining that while prolapse can recur, each case is unique. She reassures listeners that treatment options remain open, even if prolapse returns, providing a balanced perspective on surgical success rates.

The episode concludes with Dr. Best's theme song choice, "Get Up, Stand Up" by Bob Marley and the Whalers, reflecting her advocacy for women's health and the continuous fight for improved awareness and care.

This episode is a must-listen for anyone interested in women's health, providing expert insights and practical advice on managing pelvic organ prolapse with warmth, humor, and a wealth of experience.

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In this episode Susan Alexander, a registered psychotherapist and Kristen's cousin discuss Caregiving. They discuss Susan's journey into psychotherapy, starting from her personal experience with therapy at 18 after a high school betrayal. Susan's career began in massage therapy, where she noticed clients opening up about stress and anxiety. Her interest in psychotherapy deepened after her son was diagnosed with leukemia, leading her to connect with professionals in the field during his treatment.

The conversation shifts to caregiving, highlighting the challenges faced by the "sandwich generation" managing care for both children and aging parents. Susan emphasizes the importance of recognizing and addressing caregiver burnout, which can manifest as exhaustion and stress. She shares strategies for setting healthy boundaries and the significance of self-awareness in preventing burnout. Mindfulness techniques, such as the 5-4-3-2-1 grounding exercise, are suggested as methods to manage stress and stay present.

Kristen and Susan discuss the societal pressures on women to balance caregiving and other responsibilities, often resulting in guilt. They stress the importance of communication and self-compassion, encouraging women to ask for help and prioritize their well-being. Susan mentions the benefits of seeking psychotherapy and support networks, particularly in times of caregiving challenges. The podcast also touches on self-talk and reframing thoughts towards self-compassion and kindness. Susan concludes by sharing her theme song, "Hallelujah" by Leonard Cohen, as a representation of her journey, symbolizing hope and resilience.

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In this engaging episode of The Hole Shebang Podcast, Dr. Maureen Macdonald hosts an insightful conversation with Kristen Parise, a pelvic health physiotherapist specializing in women's health issues, particularly pelvic organ prolapse and pessaries. Pelvic organ prolapse, a common condition affecting up to 50% of women, involves the descent of pelvic organs due to weakened support structures. Kristen emphasizes that this condition is prevalent but often unaddressed, partly due to a lack of awareness and conversation.

The discussion starts with a detailed introduction to vaginal pessaries, devices used to support pelvic organs, much like how a knee brace supports a weakened knee. Pessaries are presented as a versatile solution for women of all ages, from those in their twenties postpartum to women over 100 years old. Kristen highlights their effectiveness not only in managing symptoms but also in potentially preventing further progression of prolapse by providing necessary structural support.

Kristen and Maureen explore the anatomy and function of the pelvic floor, emphasizing its vulnerability to gravity and life's physical demands. They discuss how prolapse can manifest differently in women, with varying symptoms such as the sensation of heaviness, urinary difficulties, and bowel issues. Kristen explains the grading of prolapse severity and underscores that even minor prolapse can significantly impact a woman's quality of life, making day-to-day activities challenging.

The podcast delves into the assessment process for pelvic floor health, demystifying what might seem an intimidating experience. Kristen describes a comprehensive approach that includes lying and standing assessments to understand the true extent of prolapse and ensure effective treatment planning. Emphasizing a holistic approach, Kristen talks about collaborating with other healthcare professionals to provide well-rounded support for women, acknowledging the role of teamwork in optimal pelvic health management.

Preventive measures are also a critical component of the conversation. Kristen advocates for early education and pelvic floor health awareness, suggesting that pelvic health assessments should be as routine as annual physicals, especially before childbirth. Proper understanding and strengthening of the pelvic floor, managing constipation, maintaining healthy weight, and mindful physical activity are recommended to minimize the risk of prolapse.

Another key point of discussion is the innovation in pessary design. Kristen shares her excitement about new developments in custom pessaries, which offer more comfortable, personalized fits compared to standard models. This innovation provides hope for those who previously struggled with standard pessary discomfort.

Overall, this episode is a valuable resource for anyone seeking to understand pelvic organ prolapse better and explores the role of pessaries as a supportive, effective solution. The key takeaway is clear: there is hope and help available, and conversations like these are the first step in lifting the veil on women's pelvic health issues.