Hormones and the Pelvic Floor: What is Going on DOWN THERE?

Hormonal changes are an inevitable part of being a woman. Beginning with puberty, hormones are the driving force behind every phase of life…. affecting not only your reproductive organs (ovaries and uterus), but also the musculoskeletal system (muscles and joints), the cardiovascular system (heart and lungs), the brain (cognition and emotions), the immune system, and just about every process in the body.

Hormones reach their peak in the reproductive years (20’ and 30’s) then slowly start to slide chaotically downhill as you reach perimenopause and menopause (40’, 50’s, 60’s and beyond). Some research shows that women spend about 10 years in the perimenopausal phase ; reporting multiple physical, emotional, cognitive, and autoimmune changes in their bodies. Many women become over medicated with pharmacological remedies that act as a bandaid but do not really improve longevity or quality of life.

Many women experience major pelvic floor issues during this time including :vaginal dryness, atrophy, pelvic pain, chronic UTIs, interstitial cystitis, urinary/fecal leakage, constipation, prolapse, pain with intercourse and low desire. More often than not, these symptoms go untreated and undiagnosed for 2 reasons:

1. Women have come to believe that this is a normal part of aging so they do not talk to their doctor about it

2. Doctors do not know enough about hormone changes or pelvic floor dysfunction to offer viable treatments beyond pharmaceuticals

How do hormonal changes cause problems DOWN THERE? Vaginal tissues have a huge amount of hormone receptors, especially estrogen and testosterone. Hormones keep the muscles and tissues of the pelvic floor vibrant, juicy, and flexible so they can perform their many functions in the body. As hormone levels drop during perimenopause and menopause these muscles and tissues become weaker , making it difficult to function properly. This leads to organ prolapse , leakage, and many other symptoms.

The pelvic floor is actually 3 layers of muscles that form a bowl that supports the organs in the body as part of the core.

How do we manage these changes? The goal of optimizing health as a woman is to glide through this time of hormonal chaos with ease and grace. The way you eat, move, think, and sleep are the primary drivers to managing your health. You will find that the things you did in your 20’s and 30’s don’t work anymore. Finding the right lifestyle plan for your body is the key. Having a pelvic floor assessment is the best way to determine the root cause of your symptoms DOWN THERE. Health coaching is a great way to determine exactly where you are in your journey and determine a plan to move forward. Getting advice on menopausal hormone therapy to not only mitigate symptoms, but to protect your heart, muscles, bones, and brain from the horrible effects of low estrogen (yes- I’m talking about heart disease, muscle atrophy, osteoporosis, and dementia).

Scheduling your pelvic floor assessment is a great first step in your journey to reclaim your health and live a longer life with less dis-ease!

What is a pelvic floor assessment? What should I expect?? As a physical therapist with 30 years of patient care experience including orthopedics, women’s health and nutrition coaching, longevity training, and pelvic floor rehab…. I perform a holistic and comprehensive assessment of each and every patient. This includes evaluating posture and alignment, muscle asymmetries, and fascial restrictions in the whole body. We also discuss nutrition, life stressors, exercise, sleep habits, and family support. An internal assessment is performed to determine muscle tone and function of the pelvic floor muscles (this is optional depending on patient comfort level). All of this information is molded together to determine your specific pathway to healing. Recommendations may include: relaxation techniques, strengthening and stretching exercises, natural supplements and adaptogens, nourishing foods, hydration, and sleep hygiene.

If you have questions about hormonal balance and what is going on DOWN THERE then contact me today for a complementary 15 minute phone consultation :)

Could it be Menopause?

Menopause has been called “puberty in reverse” by many practitioners in the medial community. Just like puberty, menopause can be a confusing and often painful time in life, but we all get through it! There is a lot we still do not understand about women’s health, but there are some things we know FOR SURE!

EVERY WOMAN WILL GO THROUGH MENOPAUSE- EVEN IF YOU HAVE HAD YOUR UTERUS AND/OR OVARIES REMOVED

This transition begins slowly in the mid 40’s (perimenopause) then symptoms gradually progress over time until full menopause is reached and hormone levels drop to an all time low.

The average age of menopause is 51.

WOMEN LIVE WITH SYMPTOMS OF MENOPAUSE FOR 10 YEARS OR MORE!

Unfortunately for most women, the symptoms they report to their doctors during this time are not recognized as “menopausal” and they are treated with pharmaceutical drugs for multiple and various “diagnoses” (anti- anxiety meds, sleeping pills, statins, pain medications, etc). Before you know it, you wake up at age 65 and you’re taking handfuls of pills twice a day to maintain your low level of “health”. And yet, you can’t lose weight, can’t sleep, struggle with memory loss, and can barely walk up a flight of stairs without pain.

MENOPAUSE IS A FULL BODY EXPERIENCE… IT AFFECTS EVERY PROCESS IN THE FEMALE BODY INCLUDING: METABOLISM, REPRODUCTION, CARDIOVASCULAR, MOVEMENT, BRAIN HEALTH, DIGESTION

Could you be entering into menopause? You may recognize some of these symptoms:

1. Fatigue/ low motivation

2. Night sweats/ Hot flushes or flashes/ sweating

3. Osteoporoses / joint pain/ stiffness/ musculoskeletal pain

4. Difficulty going to sleep/staying asleep

5. Pain with intercourse

6. Vaginal dryness/ atrophy/ reduced sex drive

7. Anxiety/ heart palpitations

8. Memory loss/ brain fog

9. Irritability/moodiness

10. Weight gain/ belly fat/ weight lose resistance

Many women begin the transition slowly in their mid 40’s and may not even recognize that they are loosing sleep, loosing their mind, and losing their mojo until years later. Is a blood test required to diagnose menopause? No, not really. Would you do a blood test to diagnose your cranky, smelly, moody preteen kid to see it they were in puberty ? Probably not. Recognizing the signs and symptoms can help you to identify were you are in the process. Lifestyle and nutrition changes can go a long way to mitigate symptoms and optimize health and longevity!

IT IS HELPFUL TO DO SPECIALIZED TESTING TO MAXIMIZE ADRENAL AND THRYOID HEALTH

The million dollar question: What can we do about it? How can women lead a full, healthy, happy, joyful life while struggling through this unavoidable transition ?? What changes can we make to not only live longer, but improve our quality of life???

OPTIMIZE YOUR NUTRITION, GET THE RIGHT KIND OF EXERCISE, PERSONALIZED SUPPLEMENTS AND ADAPTOGENS , GET RID OF TOXINS IN YOUR BODY, MANAGE YOUR STRESS, AND ENHANCE YOUR SLEEP

I have been on the menopause struggle bus myself for 10 years. This has inspired me to learn more about the most updated information on women’s health and menopause…. and to share it with you!! I have been certified in Perimenopause and Menopause Health Coaching through the Integrative Women’s Health Institute and would be honored to help you navigate this transition with great health and improved quality of life. ~ Kaye Sharp MPT, WHC, ERYT

Contact Kaye for a health coaching session to learn how to make these changes in your life and feel great in your own body again!

Have We "Normalized" Urinary Leakage?

I hope not!! But then I saw an advertisement for underwear that you can actually pee in….. YIKES!

As a physical therapist who specializes in Women’s Health I hear this complaint over and over again. Bladder issues are prevalent in all stages of life . I have seen women of all ages who report leakage with jumping, lifting, coughing, sneezing, as well as before, during, and after pregnancy.

What do all of these women have in common? Pelvic Floor Dysfunction including:

• pelvic malignment

• muscular imbalances in the hips and abdominals

• low back pain and tightness

• pelvic floor muscle tightness/weakness

• food irritants/ intolerances

• poor bladder habits

• chronic constipation

• hormonal imbalances

Imagine the pelvic floor as a trampoline. It tightens and gives with pressure from above, providing support, stability, and flexibility all at the same time. If that trampoline was suddenly placed on an incline or has a broken leg, it would still function but would be less stable in some places, providing less support and may even be damaged from those forces from above. You may not even realized it is damaged until you started to see fraying and holes where it pulls away from it springs.

When you experience any type of leakage, pain, burning, and even pressure down below this is your sign that the pelvic floor is not being supported in some way. An experienced pelvic health therapist will be able to identify the exact structures that are not functioning properly.

With better alignment, the pelvic floor is able to contract and relax normally and stop the flow of urine. Retraining your body and managing pressure around your diaphragm is key to solving these issues.

Where do you start? Try some simple diaphragmatic breathing. Often times this is the first step to unlocking the pelvic floor and allowing the muscles to regain balance. Improving hip and core strength, pelvic alignment, and learning how to coordinate breath with everyday movements is the key to bladder control.

Contact me for a complete evaluation and plan to help you regain control of your bladder and stop urinary leakage!

How do I know if I have a pelvic floor dysfunction?

Pelvic Floor Therapy provides solutions that you may not know exist…to problems that you may not even realize you have.

How do I know if I have a pelvic floor dysfunction?

If you have one or more of these symptoms, then you likely have a pelvic floor dysfunction and would benefit from an evaluation from a Pelvic Health Therapist:

• I sometimes have pelvic pain (in genitals, perineum, pubic or bladder area, or pain with urination) that exceeds a ‘3’ on a 1-10 pain scale, with 10 being the worst pain imaginable

• I can remember falling onto my tailbone, lower back, or buttocks (even in childhood)

• I sometimes experience one or more of the following urinary symptoms

  • Accidental loss of urine

  • Feeling unable to completely empty my bladder

  • Having to void within a few minutes of a previous void

  • Pain or burning with urination

  • Difficulty starting or frequent stopping/starting of urine stream

• I often or occasionally have to get up to urinate two or more times at night

• I sometimes have a feeling of increased pelvic pressure or the sensation of my pelvic organs slipping down or falling out

• I have a history of pain in my low back, hip, groin, or tailbone or have had sciatica

• I sometimes experience one or more of the following bowel symptoms

  • Loss of bowel control

  • Feeling unable to completely empty my bowels

  • Straining or pain with a bowel movement

  • Difficulty initiating a bowel movement

• I sometimes experience pain or discomfort with sexual activity or intercourse

• Sexual activity increases one or more of my other symptoms

• Prolonged sitting increases my symptoms

Pelvic floor dysfunction is more common than you might think. Many symptoms that women struggle with DAILY have been normalized and often become chronic if not treated. If you have any of these symptoms please consider getting a consultation with a holistic women's health provider. You'll be surprised at how life changing pelvic floor therapy can be!!!

Contact Kaye for a complimentary 15 minute chat to discuss your symptoms and answer your questions

205-515-0258 kaye@sharpphysicaltherapy.com

What is the "Unlocking Your Pelvic Floor Workshop"?

I am so excited to be offering this deep dive into a VERY important aspect of women’s health….the PELVIC FLOOR! This workshop will be offered at several different locations in the Birmingham, Al area including:

Rest & Digest Wellness 10/15/23 2-3:30pm

Yoga Lab Bham 11/12/23 1:30-3:30pm (provides CEU’s for Yoga Alliance)

Essential Mvmt Pilates TBA

and more in the works…let me know if you have suggestions!!

Who is this workshop appropriate for?

Any person with a pelvic floor!

Actually, men have pelvic floors, too :) But, my particular passion and focus for this workshop is on the vagina-owning community.

In this workshop, you can expect a supportive and inclusive environment where you will feel comfortable discussing and exploring your pelvic floor health. The instructor, Kaye Sharp MPT, WHC, E-RYT, is trained in pelvic floor physical therapy and has extensive experience working with individuals with various pelvic floor conditions.

This workshop is suitable for individuals of all ages and fitness levels, including those who are pregnant, have recently given birth, experienced trauma, or are simply looking to improve their pelvic floor health. Whether you are a beginner or have some prior knowledge of pelvic floor exercises, this workshop will provide you with valuable tools to optimize your health and UNLOCK your pelvic floor!

What to expect:

1. Understand the anatomy and function of the pelvic floor highlighting the pelvic floor muscles and their role in supporting the pelvic organs, controlling urinary and bowel function, and maintaining sexual health.

2. Identify and address common signs and symptoms of pelvic floor dysfunction, such as pelvic pain, urinary incontinence, and pelvic organ prolapse. You will learn how to recognize these issues and explore strategies to address them effectively.

3. Many individuals experience tightness and tension in their pelvic floor muscles, which can contribute to pain and dysfunction. This workshop will introduce you to specific exercises and stretches that can help you release tension and improve flexibility, manage pressure, and calm your nervous system .

4. Building strength in the pelvic floor muscles is crucial for maintaining their function and preventing issues like urinary incontinence and pelvic organ prolapse. You will go through a series of exercises that target these muscles, helping you develop strength and control in the hips and pelvis.

5. Integrate mindfulness and breath work which plays a significant role in pelvic floor health. We will explore techniques that promote relaxation and improve mind-body connection, allowing you to develop a deeper understanding and awareness of your pelvic floor.

Physical Therapy for the Things Women DON’T Want to Talk About…but SHOULD!

Women’s health issues can be difficult to talk about. Discussing embarrassing symptoms with a partner, spouse, or doctor can be traumatic for a lot of women, causing many conditions to become chronic and difficult to treat. But that doesn’t need to be the case. Are you struggling with?

• Urinary or fecal leakage

• Constipation

• Pain with intercourse

• Bladder issues or interstitial cystitis

• Bowel issues including IBS

• Endometriosis

• Pregnancy related issues

• Postpartum pain/tearing/diastis recti/cesarian recovery

• Perimenopausal changes/dysregulated sleep

• Low back or hip pain

• Pelvic pain of any kind

If you are experiencing these symptoms you are not alone. Nearly every woman will experience at least one of these issues at some point. When this happens, the underlying issue is the health of the pelvic floor. The pelvic floor plays a crucial role in several bodily functions, including bladder and bowel control, sexual function, and stability in movement. However, issues such as pelvic pain, incontinence, and sexual dysfunction can have a significant impact on quality of life. Fortunately, physical therapy effectively and holistically addresses pelvic health symptoms and typically leads to a symptom free life.

Understanding Pelvic Health

The pelvis is a complex network of muscles, ligaments, and connective tissues that support the organs within it. When these structures become weakened, strained, or imbalanced, various pelvic health issues can arise. Common conditions include pelvic floor dysfunction, urinary or fecal incontinence (leakage when you laugh, cough, or sneeze is NEVER normal!), pelvic pain syndromes, and sexual dysfunction. These conditions can affect women of all stages of life including prenatal , postpartum , and perimenopausal. Other symptoms can manifest as IBS, chronic constipation, abdominal pain, lower back and hip pain, and other issues that don’t seem to resolve with conventional treatments.

How Can Physical Therapy Help?

Pelvic floor physical therapy focuses on assessing and addressing the musculoskeletal components of pelvic dysfunction as well as the nervous system. As a trained pelvic health physical therapist , I will perform a thorough evaluation to identify the root causes of your symptoms. Utilizing external and internal assessments to evaluate muscle strength, flexibility, and coordination within the pelvic region, together we will develop an individualized treatment plan tailored to your specific needs.

How are Pelvic Floor Issues Treated?

1. Pelvic Floor Muscle Training: Weak or tight pelvic floor muscles are often at the core of pelvic health issues. Breath work is used to affect the nervous system along with targeted exercises to strengthen or relax these muscles, depending on your condition.

2. Manual Therapy Techniques: Hands-on techniques, such as myofascial release or trigger point release, are used to address tight or painful areas within the pelvic region. Other treatments include dry needling and cupping to promote blood flow and healing.

3. Biofeedback: This technique helps you to gain awareness and control over your pelvic muscles by providing visual or auditory feedback on muscle activity. It aids in retraining the pelvic floor muscles to function optimally.

4. Education and Lifestyle Modifications: Learn valuable information regarding posture, body mechanics, dietary changes, and bladder/bowel habits. These lifestyle modifications can have a significant impact on pelvic health and overall well-being.

What are the Benefits of Pelvic Floor Therapy?

1. Improved Pelvic Floor Function: By targeting the underlying causes of your pelvic health issues, you will gain control over your pelvic floor muscles, leading to improved bladder and bowel control, decreased pain, and increased sexual satisfaction.

2. Enhanced Quality of Life: Pelvic health issues can significantly impact daily activities and personal relationships. Physical therapy offers a non-invasive and holistic approach to manage these issues, restoring your quality of life and overall confidence.

3. Prevention and Education: Pelvic health physical therapy is not only for those already experiencing issues; it can also serve as a preventative measure. By receiving proper pelvic health treatment and preventive exercises, women can maintain optimal pelvic health throughout their lives.

Pelvic health is an integral part of overall well-being, and physical therapy plays a vital role in addressing pelvic health concerns. By offering a comprehensive approach that combines education, targeted exercises, and lifestyle modifications, pelvic health physical therapy empowers individuals to regain control over their symptoms and return to the life they love! If you are experiencing any pelvic health issues, don't hesitate to contact Kaye Sharp MPT, WHC for a comprehensive evaluation and specialized care. Remember, investing in your pelvic health is an investment in your overall well-being!

Kaye Sharp MPT, WHC

Pelvic Health Specialist

What is Pelvic Misalignment?

Pelvic misalignment happens when the pelvis becomes tilted and /or rotated in an abnormal way. The pelvis is made of two separate bones that are joined together in the front by the symphysis pubis joint and in the back by the sacrum via the SI (sacroiliac) joints. These structures move as the hips and spine move. This movement is important during pregnancy to make plenty of room for baby. If the pelvis becomes abnormally aligned, it can cause symptoms such has:

• Constant dull lower back ache, even while laying down

• Hip pain especially after walking

• Pelvic floor pain

• Muscle tension in the lower back and neck

• Pain in the shoulders, buttock, and neck

• Foot pain

• Unbalanced gait (walking)

What causes the pelvis to become misaligned? Pregnancy, chronic muscle imbalances, leg length discrepancy, and certain types of trauma can all be causes. In pregnancy, oftentimes the baby is rotated in one direction which places unequal weight on the lower portion on the pelvis. This causes increased stress on the already tightened structures as the baby grows. During birth, the pelvis widens for the baby and should return to its normal resting place in the weeks following childbirth. Many times this doesn’t happen…. and mom may not have symptoms until the 2nd pregnancy:( YIKES!

How can you get your pelvis back into alignment? First, you need a full evaluation by a skilled physical therapist to determine what structures are involved. The bones of the pelvis need to be realigned and corrective exercises prescribed to maintain the correct alignment. Eventually, progressing toward strengthening the pelvic girdle to ensure proper stability and mobility.

Remember, it is impossible to diagnose your own pelvic asymmetry. If you have symptoms then get evaluated to prevent further injury and pain!

Give it a try!

Kaye