In this episode, I'm diving into a topic that comes up often in midlife: urinary incontinence during menopause. If you've started noticing new bladder symptoms—like leaking, urgency, or increased frequency—you're not imagining things, and you're definitely not alone.

I'll walk through:

• The different types of incontinence and why they matter
• The crucial role of estrogen—and how vaginal estrogen can improve symptoms like dysuria and urge incontinence
• How weight gain in midlife can affect your bladder (and how even modest weight loss can help)
• Why changes in medications or recent surgeries might be affecting your bladder control
• The power of pelvic floor training (yes, it works—and I'll explain how)
• A clear overview of treatment options for both stress and urgency incontinence

Whether you're just starting to notice changes or you've been managing symptoms for a while, this episode is full of practical, evidence-based guidance to help you take charge of your bladder health—without shame or confusion.

Tune in and get the clarity and confidence you deserve.

For more information: a. https://journals.lww.com/menopausejournal/abstract/2023/06000/menopause_hormone_therapy_and_urinary_symptoms__a.14.aspx

b. https://pmc.ncbi.nlm.nih.gov/articles/PMC3038422/#:~:text=Effect%20of%20weight%20loss%20on,of%20noninsulin%2Ddependent%20diabetes%20mellitus.&text=In%20this%20article%2C%20we%20examine,women%20in%20the%20PRIDE%20study.

Timeline:

00:28 Introduction to Menopause and Urinary Incontinence

00:50 Understanding the Prevalence and Types of Incontinence

01:24 Role of Estrogen in Managing Incontinence

02:47 Vaginal Estrogen: Benefits and Usage

05:21 Impact of Weight on Urinary Incontinence

07:42 Medications and Surgeries Affecting Incontinence

08:46 Diagnosing Types of Incontinence

09:09 Pelvic Floor Muscle Training

11:33 Advanced Treatments for Incontinence

12:19 Conclusion and Encouragement

This episode tackles a common concern: urinary incontinence after childbirth. This can affect about a third of women, so you're not alone. I dive into what you can do to minimize urinary leaks after your first delivery with insights from a major 2020 Cochrane Review. The big takeaway? Pelvic floor muscle training, like Kegels, can make a huge difference! I'll cover how to do these exercises, why they work, and the benefits they offer, including reducing the risk of severe tears during childbirth. I'll discuss risk factors such as multiple pregnancies, higher maternal weight, and age, as well as why maintaining a healthy weight and understanding your delivery options are essential. I also talk about how long recovery might take and what to expect. Importantly, if you're experiencing symptoms, there are strategies that can help. Join me for a friendly, informative chat about keeping those leaks at bay and feeling your best postpartum! 

https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD007471.pub4/full

Timeline:

00:28 Introduction and Podcast Series Overview 

00:43 Understanding Urinary Incontinence Post-Delivery 

01:03 Pelvic Floor Muscle Training: Evidence and Benefits 

02:41 How Pelvic Floor Muscle Training Works 

03:45 Theories Behind Pelvic Floor Muscle Training Benefits

06:41 Risk Factors for Postpartum Urinary Incontinence 

07:35 Prevention and Management Strategies 

08:58 Post-Delivery Incontinence: What to Expect and Do 

11:04 Conclusion and Key Takeaways

In this episode, I’m drawing from over 20 years of experience—as a physician and a woman navigating this journey myself—to share real, actionable strategies for aging well, inside and out.

We’ll explore the core pillars of healthy aging, including the power of movement, nourishing your body with the right foods, getting quality sleep, staying socially connected, and being proactive with your healthcare. These are evidence-backed strategies inspired by the National Institute on Aging and other trusted resources—but made personal, practical, and doable. I’m also shedding light on a topic that often gets left out of the aging conversation: urinary incontinence. It’s more than an inconvenience—it can limit your physical activity, impact your confidence, and quietly chip away at your social life. We’re going to talk about it openly, and I’ll show you how addressing bladder health can support your overall well-being as you age.

Whether you’re already noticing changes or just want to feel prepared for what’s ahead, this episode is full of guidance you can start using today. 

For more information on today's topic:
www.nih.gov
www.cdc.gov
https://pubmed.ncbi.nlm.nih.gov/38383092/
https://www.nia.nih.gov/

Timeline:

00:28 Introduction to Aging Gracefully

01:34 Key Recommendations for Healthy Aging

02:56 The Importance of Staying Active 

08:46 Healthy Eating Habits 10:36 The Role of Quality Sleep 

13:31 Social Connections and Mental Health 

14:47 Proactive Healthcare and Final Thoughts 

15:54 The Impact of Bladder Health on Aging

I've compiled insightful clips from interviews with three leading pelvic floor physical therapists. The focus is on the benefits of pelvic floor physical therapy, with the first clip featuring MJ Strauhal discussing what to expect in the initial therapy visit and the importance of a therapeutic relationship. Prof. Chantale Dumoulin from the University of Montreal emphasizes the effectiveness of pelvic floor exercises, the advantages of group training, and the importance of starting therapy early. Finally, Kari Bo from Norway discusses the specifics of pelvic floor strength training, the impact of high-impact exercises, and recommendations for pelvic floor training during pregnancy. The episode underscores the significance of individualized treatment plans and the benefits of group and one-on-one sessions.

To hear these episodes in their entirety or for more information:
S1E25: PT at Providence Portland with MJ Strauhal DPT
https://www.buzzsprout.com/2112419/episodes/13143516

S2E9: The Path to Aging Gracefully with Chantale Dumoulin
https://www.buzzsprout.com/2112419/episodes/14653291
For information on Prof. Dumoulin: https://www.womenhealthaging.ca/

S2E19: Empowering Women Through Pelvic Floor Strength with Dr. Kari Bo
https://www.buzzsprout.com/2112419/episodes/15087635

Timeline:

00:28 Introduction to Pelvic Floor Physical Therapy
01:13 Interview with MJ Strauhal: First Visit Insights
04:48 Interview with Prof. Chantale Dumoulin: Research and Group Training 
15:39 Interview with Dr. Kari Bo: Strength Training and High-Impact Exercises
23:50 Conclusion and Encouragement

In this episode, I dive into various non-surgical treatments for stress urinary incontinence. The show features clips from four different interviews. We start with Mandy Pulliam, CMO of Leva Health, who explains how their device assists in strengthening the pelvic floor. Next, Lauren Barker, CEO of Uresta, discusses her company's over-the-counter pessary. Allison Watkins, CEO of YoniFit, explains the benefits and study results of their prescription-only pessary. Finally, we hear from a woman named Jane, who shares her positive experience with a urethral bulking procedure known as Bulkamid. This comprehensive episode provides valuable insights and options for women dealing with stress urinary incontinence, offering them the tools to make informed decisions about their treatment options.
Looking for more information on these episodes and treatments:

S2E10:Leva Device with Mandy Pulliam
https://www.buzzsprout.com/2112419/episodes/14690011

S2E40: Uresta CEO Lauren Barker on the Transition to Over-the-Counter Availability
https://www.buzzsprout.com/2112419/episodes/16185663

S2E38: Innovating Women's Health: The Story Behind Yoni Fit
https://www.buzzsprout.com/2112419/episodes/16093774

S2E13: Jane's Decision - The Urethral Bulking Procedure
https://www.buzzsprout.com/2112419/episodes/14799586

Timeline:
00:28 Introduction to Stress Urinary Incontinence
01:06 Overview of the Episode Structure
02:21 Interview with Mandy Pulliam on Leva Health
08:08 Interview with Lauren Barker on Uresta 1
13:17 Interview with Allison Watkins on YoniFit
19:54 Personal Experience with Urethral Bulking
28:07 Conclusion and Encouragement

This episode explores various neuromodulation devices designed to help women manage overactive bladder. I talk about the symptoms of overactive bladder and the common treatments such as pelvic floor exercises, behavioral changes, and medications. The episode features clips from interviews with leaders in the field discussing devices like Vivali, Zyda Control Sock, Revi, Ecoin, and sacral nerve stimulators. Each device has its unique approach and benefits, ranging from non-invasive wearables to implantable stimulators, offering patients multiple options for managing their symptoms. The episode aims to provide an overview of these technologies to help listeners make informed decisions about their treatment options. 

Timeline:

00:28 Introduction to Overactive Bladder 

01:46 Exploring Vivally: A Wearable Solution 

08:31 ZIDA Device: Simplifying Bladder Control 

14:59 Revi: Implantable Tibial Nerve Stimulator 

20:14 E Coin: Long-Term Implantable Solution 

27:39 Sacral Nerve Stimulation: A Long-Standing Solution 

34:25 Conclusion and Further Resources

In this episode, I address the challenges many women face when traveling with bladder issues, particularly around the holidays. With comprehensive advice on managing urge incontinence and stress incontinence while traveling. For those with urge incontinence, I offer three key tips:

• Identifying bladder irritants and avoiding them on travel days
• Practicing urge suppression techniques
• Consulting a physician about short-acting bladder medications

For women with stress incontinence, I suggest using over-the-counter pessaries such as Impressa or Uresta. Additionally, I highlight the importance of having a backup plan, like wearing incontinence pads or underwear and using bathroom finder apps to alleviate travel anxiety. The overall goal is to help women travel confidently and enjoyably without being hindered by bladder issues.

Timeline:

00:28 Introduction to Traveling with Bladder Issues

01:18 Understanding Your Type of Incontinence

01:30 Tips for Managing Urge Incontinence

06:20 Tips for Managing Stress Incontinence

07:25 General Travel Preparation Tips

09:05 Conclusion and Final Thoughts

In this episode, I spoke with Lauren Barker, CEO of Uresta, about the transition of Uresta's pessary from prescription-only to over-the-counter status. Uresta treats stress incontinence, commonly caused by physical activities like coughing and exercising. Lauren discusses the rigorous FDA approval process, safety studies, and the extensive user data gathered from Canada, reinforcing the product's safety and effectiveness. She explains the broad target audience, including women in their 20s to 80s, and details the purchasing process, including the starter kit and pricing. Additionally, Lauren teases upcoming complementary products, such as a natural cleaning gel and hyaluronic acid vaginal moisturizer, aiming to enhance user experience and accessibility.

You can find more information on the Uresta:
Website:  www.uresta.com
Instagram @myuresta
Facebook: Uresta
Pinterest: My Uresta
TikTok: myuresta

Timeline:

00:28 Introduction to Uresta and Guest Lauren Barker

00:57 Transition to Over-the-Counter Availability

01:46 Safety and Clinical Studies

04:12 Target Audience and Usage

07:32 Purchasing and Fitting Uresta

10:10 Customer Feedback and Effectiveness

13:45 Future Developments and Conclusion

In this episode, I spoke with Susan Stover, Director of Marketing and Sales at HYIVY, a company focused on improving female pelvic health through innovative solutions. Susan discusses the company's origins, founded by Rachel Bartholomew due to personal struggles with pelvic issues such as Endometriosis and radiation-induced vaginal stenosis. Susan introduces HYIVY's groundbreaking device, Floora, which offers controlled, automatic dilation and heating. We dive into the significance of integrating clinical feedback, leveraging patient data, and the potential future enhancements for Flora. Susan highlights the importance of addressing chronic pelvic pain, a pervasive yet often overlooked issue that affects many women. We also discuss ways for viewers to participate in focus groups and stay updated on the product's development.

For more information, check out: https://hyivy.com/

Timeline:

00:28 Introduction to HYIVY and Susan Stover
01:02 Rachel Bartholomew's Journey and the Birth of HYIVY
02:11 Understanding Pelvic Health Challenges
03:02 The Problem with Traditional Dilators
07:04 Innovative Solutions by HYIVY
11:11 The Floora Device: Features and Benefits
17:38 Future Prospects and Clinical Trials
23:24 How to Get Involved and Final Thoughts

In this episode, Allison Watkins joins the podcast to discuss Yoni Fit, an innovative incontinence pessary she developed. Watkins shares her personal experiences with stress urinary incontinence following childbirth, leading her to create Yoni Fit as a solution. She talks about the challenges she faced, including unsuccessful pelvic floor rehabilitation, and how her active lifestyle inspired the design of her device. The conversation covers the practical aspects of using Yoni Fit, the importance of self-sizing for comfort and efficacy, and the prospects of making the product available through pharmacies and telehealth. This episode emphasizes how important it is to handle incontinence problems tactfully and successfully.  

For more information, be sure to check out her 

website at: https://yonifit.com/

Instagram: @yoni.fit_bladder_support

Facebook: Yōni.Fit Bladder Support

Timeline:

00:28 Introduction to the Podcast and Guest 

00:52 Allison's Personal Journey with Incontinence 

02:08 Challenges and Initial Solutions 

03:17 The Birth of Yoni Fit 

05:46 Development and Testing of Yoni Fit 

08:26 Efficacy and Comfort of Yoni Fit 

15:18 Target Audience and Availability 

18:52 Conclusion and Final Thoughts