# Women's Health Pathway This file contains structured content from Women's Health Pathway for language model processing. Generated on: 2026-09-04T01:33:28.737Z Total pages: 96 --- ## "We don't really know why this happens": what I wish someone had told me about vulvodynia and painful sex URL: https://www.womenshealthpathway.com/blogs/what-i-wish-someone-had-told-me-about-vulvodynia-and-painful-sex/ Description: Told at 25 that painful sex was just something some women live with, she later learned how treatable vulvar pain often is — and why the answers rarely reach the women who need them. Metadata: - intro: Told at 25 that painful sex was just something some women live with, she later learned how treatable vulvar pain often is — and why the answers rarely reach the women who need them. - metaDescription: Vulvodynia, vestibulodynia and vaginismus have different causes and different treatments. What one woman wishes she'd known about painful sex, and how to advocate. - publishDate: 2026-08-06 - author: Mathilde Olstad - authorSlug: mathilde-olstad - featuredImage: mathilde-olstad-feature.jpg - tags: pelvic-health,sexual-health - draft: false - hcp: false - headingTitle: "We don't really know why this happens": what I wish someone had told me about vulvodynia and painful sex - headingSubtitle: - headingDescription: Told at 25 that painful sex was just something some women live with, she later learned how treatable vulvar pain often is — and why the answers rarely reach the women who need them. At 25, I started having pain during sex. It arrived without warning. No injury, no infection I could point to, no explanation. What followed was years of appointments, swabs and creams, and a feeling I now recognise in almost every woman I speak to: that I was making too much of something ordinary, and that the problem was probably me. The sentence I heard, in various forms, from more than one clinician, was this. We don't really know why this happens. Some women just experience this kind of pain. There isn't much we can do about it. I believed it for a while. Then I found out how common these conditions are, and something in me snapped. How can this many of us be handed the same shrug? Here is what I want every woman reading this to know. "We don't know" is not the truth. It is the edge of one clinician's knowledge, and those two things are not the same thing at all. ## Vulvar pain is an umbrella, not a diagnosis Vulvodynia, vestibulodynia and vaginismus are not single conditions with a single cause. Pain can be driven by an overactive pelvic floor. It can be hormonally mediated, often linked to combined hormonal contraception. It can be neuroproliferative, where the vestibule carries an excess of nerve endings, sometimes present from birth. It can involve inflammation and mast cell activity. It can be neuropathic, as in pudendal neuralgia. It can sit alongside a skin condition such as lichen sclerosus. Very often it is more than one of these at once, layered on a nervous system that has learned to expect pain. These distinctions are not academic. They lead to completely different treatments. Hormonally mediated pain often responds to topical hormones. Muscle-driven pain responds to pelvic floor physical therapy, not another cream. Neuroproliferative pain may eventually need surgery. Getting the driver wrong does not just waste time. It teaches a woman that treatment does not work for her, when in fact she was given someone else's treatment. Do we have all the answers? Not remotely. We need far more research before anyone can promise a clean diagnostic pathway. But there is an enormous distance between "we do not yet know everything" and "we do not know anything", and women are routinely handed the second when the first is true. ## The gap is geographic as much as it is clinical The knowledge exists. It just does not travel. Findings presented openly at international conferences can take years to reach clinics a few countries away, and terminology used routinely by specialists in one country is unfamiliar to well-regarded clinicians in another. That is not a failure of individual doctors. It is a structural problem with how knowledge moves between countries, specialisms, and the people actually living with these conditions. ## What advocating for yourself actually looks like Ask what is driving your pain, not just what it is called. Ask whether your pelvic floor has been assessed, and by whom. Ask whether hormonal contraception could be a factor. Ask for a cotton swab test that maps where the pain actually is. Ask for a referral to a pelvic health physiotherapist. If you are told nothing can be done, you are allowed to ask who else might know more. You should not have to arrive at an appointment armed like this. But until the system catches up, vocabulary is power, and the vocabulary is available. ## Why I built The World's Tightest Community I left a career in finance to build the resource I needed at 25, when I was convinced I was the only person in the world dealing with this. The podcast brings leading clinicians and researchers in vulvovaginal and pelvic pain into plain-language conversation, because the answers that do exist should not stay locked inside conference halls and paywalled journals. That is why Raelene's work here matters, and why the two of us found each other. None of us closes this gap alone. But together we can make sure the next 25-year-old with unexplained pain gets a name for it, a reason for it, and somewhere to belong while she works it out. --- ## Alexandra Clay URL: https://www.womenshealthpathway.com/resources/telehealth/alexandra-clay/ Metadata: - name: Alexandra Clay - authorSlug: alexandra-clay - role: Accredited Practising Dietitian - businessName: Alexandra Clay Dietitian - url: https://www.alexclaydietitian.com - country: Australia - metaTitle: Alexandra Clay | Alexandra Clay Dietitian | Telehealth Provider - metaDescription: Alexandra Clay is an Accredited Practising Dietitian who supports women to navigate health changes across the lifespan, including perimenopause and menopause, PCOS and endometriosis, through practical, evidence-based nutrition care. - publishDate: 2026-01-22 - featuredImage: alex-clay.jpg - tags: nutrition,menopause - draft: false Alexandra Clay is an Accredited Practising Dietitian who supports women to navigate health changes across the lifespan, including perimenopause and menopause, PCOS and endometriosis, through practical, evidence-based nutrition care. Alexandra has experience working with a diverse range of clients, including those managing chronic health conditions, mental health concerns, neurodivergence, and complex relationships with food. She takes a highly personalised approach, working collaboratively with each client to develop sustainable strategies that respect their lifestyle, culture, and individual needs. Her areas of clinical interest include: * Women’s health, perimenopause and menopause, PCOS, endometriosis * Mental health * ADHD and Autism (ASD) * Eating disorders and disordered eating * Gut health and IBS * Weight-inclusive care and body image support * Sports and performance nutrition * Rehabilitation and recovery Alexandra’s practice is weight-inclusive and informed by neuro-affirming and trauma-aware care. She believes health is not defined by numbers on a scale, but by how you feel, function, and live day-to-day. She is committed to creating a safe, supportive, and non-judgemental space where women feel heard, understood, and empowered to make meaningful changes that support long-term wellbeing. --- ## Amanda Curry URL: https://www.womenshealthpathway.com/resources/telehealth/amanda-curry/ Metadata: - name: Amanda Curry - authorSlug: amanda-curry - role: Doctor of Physical Therapy, Certified Oncology Specialist, Breathwork facilitator - businessName: The Somatic DPT - url: https://linktr.ee/thesomaticdpt - country: USA - metaTitle: Amanda Curry | Telehealth Provider | Breathwork facilitator - metaDescription: - publishDate: 2025-09-11 - featuredImage: amanda-curry.jpg - tags: healing - draft: false Doctor of Physical Therapy, Certified Oncology Specialist, Trauma Informed, Training Camp for the Soul™ Master Facilitator, Level 1 David Elliot Breathwork Facilitator Amanda has a fierce commitment to supporting those who struggle with feeling they are “too much” and are tired of living in shame and denial of their true essence. She walked the path of the rigid minded overachiever for the better part of two decades and had all the degrees and awards to show for it. She was shining on the outside while slowly rotting within. The statement, "There has to be more." pivoted her focus from self-help books and cognitive behaviour therapy to somatic healing. There, she found the root of what had kept her stuck, overwhelmed, and lacking contentment ……SHAME. Now with that root unearthed, she has been able to extend love, grace, and presence to herself and others in a way she never knew possible. Her connection to her husband of 17 years and two children has felt more solid and intimate. Even the care and attention delivered to her pediatric cancer patients and their families has been impacted. As she has transitioned out of full-time physical therapy work, she now has opened herself up to hold space for women and especially moms to unearth their own deep limiting beliefs that are keeping us stuck, disconnected, and overwhelmed. Through this space holding, these individuals have been given space to feel more, accept all parts of themselves, and step into their full authentic self. --- ## Anal Cancer in Women: Let’s Talk About It URL: https://www.womenshealthpathway.com/blogs/anal-cancer-in-women/ Description: To the surprise of many clinicians, women make up the single largest group of people diagnosed with anal cancer — yet it sits almost entirely outside the women's health conversation. A colorectal surgeon explains why. Metadata: - intro: To the surprise of many clinicians, women make up the single largest group of people diagnosed with anal cancer — yet it sits almost entirely outside the women's health conversation. A colorectal surgeon explains why. - metaDescription: Women make up the largest group diagnosed with anal cancer. A colorectal surgeon explains the HPV link, the real risk factors, and who should be screened. - publishDate: 2026-07-22 - author: Dr Matt Marino - authorSlug: matt-marino - featuredImage: matt-marino-feature.jpg - tags: sexual-health - draft: false - hcp: true - headingTitle: Anal cancer in women: Let’s talk about it - headingSubtitle: Women Are the Largest Group Diagnosed — So Why Is No One Talking About It? - headingDescription: To the surprise of many clinicians, women make up the single largest group of people diagnosed with anal cancer. Yet it sits almost entirely outside the women's health conversation. Here's what every woman should know about the risk, the HPV link, and when screening is worth discussing. Whilst not particularly glamorous, anal cancer doesn't get the airtime it deserves. It's not part of the standard women's health conversation, and most people, understandably, have never given it a moment's thought — which is part of the problem. To the surprise of many, including many clinicians, **women make up the single largest group of people diagnosed with anal cancer**. In the United States, where the data is most comprehensive, women account for around two-thirds of all new anal cancer diagnoses each year, a pattern seen consistently across high-income countries. Reassuringly, anal cancer remains uncommon in absolute terms and is considered a rare cancer. It is, however, increasing in incidence and is under-recognised in women's health settings. For certain women, such as those with a history of gynaecological cancers or precancers, the risk is real enough to warrant a conversation. So, let's have it! ## So, what is anal cancer, and how does it start? Anal cancer arises from the skin around or lining the anal canal. Like cervical cancer, the overwhelming majority of cases, around 90% in fact, are caused by human papillomavirus (HPV), particularly the high-risk strain HPV 16. If you've ever had a cervical smear or been told about HPV as part of your gynaecological care, you already understand the basics. HPV is extremely common — most people encounter it, usually during sex, at some point in their lives. They don't develop any symptoms and clear it without ever knowing they had it. But in some people, high-risk HPV can persist and, over years or decades, cause cellular changes that if left undetected, can progress to cancer. In the cervix, we screen for this routinely with Pap smears and HPV testing. In the anus, the same process takes place, but screening and awareness are considerably lagging. For more information on HPV and its association with cancer, have a read of [this blog on HPV and anal cancer](https: ## What puts women at higher risk? For most women, the risk of anal cancer is low. But for some, it's significantly elevated, and it's worth knowing if you're in that group. The most significant risk factors for women are: - **A history of vulvar precancer (HSIL) or vulvar cancer** — this is classified as a high-risk category by the International Anal Neoplasia Society (IANS), the leading global body on anal cancer screening.[^1] - **A history of cervical or vaginal precancer (HSIL) or cancer** — a 2025 study published in *JAMA* confirmed that women with a history of cervical cancer have a significantly elevated rate of anal cancer diagnosis over time, with risk increasing the further out from their original diagnosis.[^2] - **Persistent gynaecological high-risk HPV, particularly HPV 16.** - **Smoking**, which impairs the immune system's ability to clear HPV. - **Immunosuppression** from any cause, including autoimmune conditions or immunosuppressive medications. The underlying reason is HPV. If HPV has already caused disease in one part of the genital tract, it's easy for it to affect neighbouring areas too, including the anus. Women with a history of gynaecological precancer are, in a sense, an overlooked group: screening is easiest and tends to focus on the highest risk groups where the risk is most dramatic, and that has historically meant other populations. So why do women make up the majority of anal cancer diagnoses overall, given that the overall number of women with these specific risk factors is low? It comes down to anatomy and HPV biology. The cervix, vagina and vulva sit close to each other and share the same HPV exposure risk, meaning HPV can spread between these sites without anal intercourse ever occurring. Studies suggest that around half of women with anal cancer have never had anal sex. Interestingly, even wiping technique may play a role — an Australian study found that front-to-back wiping after toileting was associated with a significantly increased risk of anal HPV and precancerous changes in women with a history of gynaecological precancer, presumably by mechanically transferring HPV from the vulva to the anal region.[^3] In contrast, heterosexual men without specific risk factors have very limited pathways for HPV to reach the anal canal, so their rates are lower. Most men who develop anal cancer are overwhelmingly men who have sex with men, and men living with HIV. In short, women without specific risk factors are not at dramatically elevated risk, but because female anatomy creates more opportunities for HPV to spread to the anal region, women collectively account for more cases across the general population than men do. ## What about symptoms? Most women with anal pre-cancer have **no symptoms at all**. That's why screening is so valuable for those in high-risk groups. When symptoms do occur, these often represent anal cancer itself (and not the pre-cancer). Symptoms include: - Bleeding from the anus - Persistent anal itch or irritation - Pain or discomfort in the anal area - A lump or swelling near the anus - Changes in bowel habits and narrow stools If you're wondering whether rectal bleeding is something to worry about, [this blog on the causes of rectal bleeding](https: **Not all anal symptoms are from haemorrhoids!** The key message is that patients frequently assume or are told that their anal symptoms are attributed to something common and harmless. And whilst most symptoms *are* benign, it is crucial that you get it checked out if something doesn't feel right or if symptoms persist despite treatment. Outcomes are always better if sinister problems are discovered early. ## Should I be screened? Not every woman needs anal cancer screening, but for women with specific risk factors, screening is recommended and worthwhile. Consensus guidelines published in 2024 by IANS,[^1] the organisation leading the way in anal pre-cancer, recommend the following groups get screened: - **Women with a history of vulvar precancer (HSIL) or cancer** within one year of diagnosis. - **Cis women over 45 and trans women over 45 living with HIV.** - **Cis and trans women who have received a solid organ transplant,** 10 years after transplantation. **Women aged 45 and over with a history of cervical or vaginal precancer (HSIL) or cancer** are at a slightly lower risk, and so it is recommended that they discuss screening with their doctor (or get a referral to an HRA provider for this discussion). Screening is simple and familiar. It involves an anal swab, which is essentially the same technique as a cervical Pap smear, to look for the presence of high-risk HPV or abnormal cells. If results are abnormal, the next step is a procedure called high-resolution anoscopy, or HRA. ## So, what's an HRA? If you've ever had a colposcopy after an abnormal Pap smear, HRA is basically identical, but obviously looking in a different spot! A small plastic scope (similar to a speculum) is placed in the anus, and a colposcope (an instrument that provides magnification) is used to examine the lining of the anal canal. Abnormal areas can be identified, biopsied, and if this confirms pre-cancerous changes (known as HSIL), that area can be treated before it has a chance to progress to cancer. The landmark ANCHOR trial demonstrated that treating anal HSIL reduces the risk of progression to anal cancer by around 57% in people living with HIV.[^4] While this was in a specific population, it is reasonable to assume this reduced risk of cancer extends to women more broadly. We also have the benefit of knowing from decades of cervical screening that identifying and treating HPV-related precancerous change before it becomes cancer works. The anal canal is basically no different. When HSIL is found, several treatment options are available, ranging from topical creams to ablative procedures performed under HRA guidance. A systematic review I co-authored this year concluded that, while recurrence is common, treatment is overall safe and effective, with no single treatment option clearly better than any other.[^5] For more details on what HRA involves and what to expect on the day, [this blog on HRA](https: ## Let's talk about the stigma Farrah Fawcett, actress, icon, and one of the most recognised faces of the 1970s and 80s, died of anal cancer in 2009. Before her death, she documented her diagnosis and treatment publicly, at a time when few people were willing to say the word "anal", let alone "anal cancer," out loud. She founded a foundation named after herself, dedicated to funding anal cancer research and raising awareness. Part of the reason this disease receives so little attention in women's health spaces is that it sits at an uncomfortable intersection of stigmata — around the anus as an erogenous zone, cancer, and the misconception that anal cancer only affects certain people. Many women who are diagnosed describe feeling isolated, sometimes feeling as if they can't share their diagnosis with others out of embarrassment or shame. That silence has consequences. This stigma exists amongst clinicians, too. Research I have been involved in shows that surgeons rarely ask patients about anal intercourse or its role in their lives and well-being, even when it is directly relevant. Despite being a common sexual practice, reported in 28–34% of cis women in some studies,[^6][^7] women are the least likely of all patients to be asked. Discomfort around the topic, on both sides of the consultation, means important conversations don't happen. That needs to change. So let's normalise it! Anal health is part of overall health. An anal swab is no different from a Pap smear. Just as we've made remarkable progress in reducing cervical cancer deaths through the cervical screening program and HPV vaccination, we have the knowledge and tools to do the same for anal cancer. But we must be willing to have the conversation, so spread the word! ## What about the HPV vaccine? Australia's school-based HPV vaccination program has been running since 2007 for girls and 2013 for boys. It protects against 9 strains of HPV, including the main ones that cause anal cancer (and other types of cancer), and those that cause genital warts. If you haven't been vaccinated, adults can still receive it, though at their own cost. It's worth noting that vaccination is primarily preventive — the current evidence does not support any benefit in people who already have anal (or vulval) pre-cancer, with a high-quality recent study finding no reduction in HSIL (pre-cancer) recurrence when the vaccine was given after treatment.[^8] Vaccines, though, are safe, and can help prevent you from getting strains of HPV you may not yet have. The real benefit of vaccination is in prevention, not treatment, and that benefit will be enjoyed most by the generations vaccinated at school age, before any exposure to HPV. Remarkably, Australia is projected to effectively eliminate cervical cancer by around 2035, largely on the back of the vaccination program. It is entirely reasonable to anticipate a similar trajectory for anal cancer over the coming decades, though the timeline will be longer than for cervical cancer. In the meantime, screening for those at elevated risk and early detection for those with symptoms remain the most important tools we have. ## What to do if you have concerns If you have a history of vulvar, vaginal, or cervical precancer or cancer, or if you're experiencing anal symptoms that concern you, it's worth having a conversation with your GP. Anal cancer is rare, and there's no need to be alarmed, but symptoms deserve proper assessment, and if you fall into one of the higher-risk groups discussed above, screening is worth discussing. Your GP can do an initial assessment and refer you to a colorectal surgeon. If HRA is recommended, it's worth doing a little research on who performs it. Very few colorectal surgeons are trained in high-resolution anoscopy, so look for someone with specific training in HRA. You may come across the term "anal mapping," but it is an older, considerably less accurate technique that has largely been superseded. HRA specialists are still relatively few and far between in Australia, which is something the field is actively working to address. Remember, if something just doesn't feel right, trust your instinct, and see a specialist. For a broader overview of anal cancer, risk factors, and the screening pathway, [this blog](https: *This blog is for general information only and is not a substitute for professional medical advice. Please consult your GP or treating clinician if you have specific concerns.* [^1]: Stier EA, Clarke MA, Deshmukh AA, Wentzensen N, Liu Y, Poynten IM, et al. International Anal Neoplasia Society's consensus guidelines for anal cancer screening. Int J Cancer. 2024;154(10):1694-702. [^2]: Damgacioglu H, Curtis C, Sonawane K, Clifford G, Palefsky JM, Chiao EY, et al. Anal Cancer Incidence Among Women With a History of Cervical Cancer by Age and Time Since Diagnosis. JAMA Netw Open. 2025;8(9):e2531362. [^3]: Simpson S, Blomfield P, Cornall A, Tabrizi SN, Blizzard L, Turner R. Front-to-back & dabbing wiping behaviour post-toilet associated with anal neoplasia & HR-HPV carriage in women with previous HPV-mediated gynaecological neoplasia. Cancer Epidemiology. 2016;42:124-32. [^4]: Palefsky JM, Lee JY, Jay N, Goldstone SE, Darragh TM, Dunlevy HA, et al. Treatment of Anal High-Grade Squamous Intraepithelial Lesions to Prevent Anal Cancer. N Engl J Med. 2022;386(24):2273-82. [^5]: Marino MJ, Jones S, Caldwell NR, Cartwright C, Blacket B, Turner RC. Efficacy and Safety of Anal High-Grade Squamous Intraepithelial Lesion Treatment Modalities: A Systematic Review. ANZ J Surg. 2026. [^6]: Zaliznyak M, Walton AB, Stelmar J, Isaacson D, Gaither TW, Knudson G, et al. Anal sex practices and rectal erogenous zone maps among men and women of diverse sexual orientations: an anatomic-map based questionnaire study. Sexual Medicine. 2025;13(3). [^7]: Sturiale A, Fabiani B, Dowais R, Porzio FC, Gallo G, Martellucci J, et al. Does Proctologic Surgery Really Influence Sexual Behaviors? Rev Recent Clin Trials. 2021;16(3):322-8. [^8]: Stankiewicz Karita HC, Magaret AS, Doody DR, Schouten JT, Mao C, Huh WK, et al. Nonavalent HPV vaccine to prevent recurrent anal or vulvar high-grade squamous intraepithelial lesions (VIVA trial): A randomized, double-blind, placebo-controlled trial. Int J Cancer. 2026;158(11):2983-94. --- ## Anna Scammell URL: https://www.womenshealthpathway.com/resources/telehealth/anna-scammell/ Metadata: - name: Anna Scammell - authorSlug: anna-scammell - role: Women's Health Physiotherapist - businessName: The Whole Mother - url: https://www.thewholemother.com - country: Australia - metaTitle: Anna Scammell | Telehealth Provider | Women's Health Physiotherapist - metaDescription: - publishDate: 2025-09-11 - featuredImage: anna-scammell.jpg - tags: continence,childbirth,vaginal-vulva-health - draft: false Anna Scammell is a Masters-trained Women's Health Physiotherapist in Sydney, Founder of The Whole Mother and mum to a beautiful little girl. Anna specialises in pregnancy, postpartum & the pelvic floor, offering home visits, clinic consults and Telehealth. She is also the Founder of Academy and [The Postpartum Academy](https: --- ## Anne Jordan URL: https://www.womenshealthpathway.com/resources/telehealth/anne-jordan/ Metadata: - name: Anne Jordan - authorSlug: anne-jordan - role: Menopause Practitioner and Coach - businessName: Kaha Mna - url: https://www.kahamna.nz - country: New Zealand - metaTitle: Anne Jordan | Telehealth Provider | Menopause Practitioner and Coach - metaDescription: I am dedicated to helping women navigate the challenges of all things menopause including both Peri and Post Menopause - publishDate: 2025-09-11 - featuredImage: anne-jordan.jpg - tags: menopause - draft: false Welcome to Kaha Mna, my name is Anne Jordan, and I am your trusted Menopause Specialist and Coach in New Zealand. I am dedicated to helping women navigate the challenges of all things menopause including both Peri and Post Menopause, with confidence so they don’t just survive, they thrive from it. I empower women, guiding and encouraging them to take control of their own health and wellbeing. Are you ready to take control of your symptoms? Let’s talk! --- ## Arvinder Virdi Eleveld URL: https://www.womenshealthpathway.com/resources/telehealth/arvinder-virdi-eleveld/ Metadata: - name: Arvinder Virdi Eleveld - authorSlug: arvinder-virdi-eleveld - role: RTT Hypnotherapist and Founder of Healing Minds Therapy - businessName: Healing Minds Therapy - url: https://www.healingmindstherapy.com.au - country: Australia - metaTitle: Arvinder Virdi Eleveld | Telehealth Provider | RTT Hypnotherapist and Founder of Healing Minds Therapy - metaDescription: Arvinder is passionate about helping women navigate the complexities of mental, emotional, and cultural wellbeing. - publishDate: 2025-09-11 - featuredImage: arvinder-virdi.jpg - tags: hypnotherapy,healing - draft: false Arvinder is passionate about helping women navigate the complexities of mental, emotional, and cultural wellbeing. As the founder of Healing Minds Therapy, she offers a safe, stigma-free space for women to heal from the weight of depression, anxiety, trauma, and the quiet struggles of self-worth. Through Rapid Transformational Therapy (RTT), a powerful method that combines hypnotherapy, neuroscience, and psychotherapy, Arvinder supports women in uncovering and rewiring the subconscious beliefs that quietly shape their lives. So often, these beliefs are formed in childhood — influenced by cultural differences, parental expectations, or critical voices that leave lasting imprints on how women see themselves. Over time, these patterns distort not only how we think but how we feel, act, and even relate to others. Arvinder's work helps women gently release these old narratives and create new, empowering ones. The transformation touches every part of life: building self- confidence, reclaiming self-worth, strengthening self-belief, and cultivating the ability to finally feel good enough — just as you are. Neuroscience pioneers have shown that our subconscious mind and the beliefs we carry shape not only our emotional well-being but also our physical health. When we shift the inner programs that keep us stuck, we unlock the brain’s extraordinary ability to heal, adapt, and rewire. Arvinder's approach is warm, deeply empathetic, and culturally sensitive. She understands that trauma doesn’t have to be “big” to have a big impact — and that healing is possible for every woman. Each session is an invitation to step into your power, embrace your wholeness, and create a life grounded in clarity, self-compassion, and possibility. --- ## At Your Cervix URL: https://www.womenshealthpathway.com/resources/podcasts/at-your-cervix/ Metadata: - subtitle: - author: Grainne Donnelly - publishDate: 2025-09-16 - tags: prolapse,vaginal-vulva-health - category: podcast - image: /images/reviews/podcasts/at-your-cervix.jpg - infoLink: https://absolute.physio/podcasts/ - purchaseLink: - draft: false - spotifyLink: https://open.spotify.com/show/4DgaWNgwGm8o7aHMhDYM9M - appleLink: https://podcasts.apple.com/au/podcast/at-your-cervix/id1530617581 - googleLink: - youtubeLink: At Your Cervix – The Podcast is a biannual series of weekly podcasts where co-hosts Grainne Donnelly and Emma Brockwell aim to lift the lid on all things pelvic health. Listen on your favourite podcast channel. --- ## Awfully Hilarious URL: https://www.womenshealthpathway.com/resources/books/awfully-hilarious/ Metadata: - subtitle: Stories We Never Tell: 1 - author: Heather Hendrie - publishDate: 2026-08-08 - tags: sexual-health - category: book - image: /images/reviews/books/awfully-hilarious.jpg - infoLink: https://awfullyhilarious.com/ - purchaseLink: https://www.amazon.com.au/s?k=heather+hendrie&crid=3GTNRLIV6SWLL&sprefix=heather+hendrie%2Caps%2C93&ref=nb_sb_noss_1 - draft: false - spotifyLink: - appleLink: - googleLink: - youtubeLink: This anthology brings together a group of emerging writers sharing true personal stories about dating, drinking, embarrassing moments, and the everyday mishaps most people are told to keep private. The pieces range from online dating experiences — Tinder, Bumble, and bad dates — to the kind of honest, funny, and sometimes awkward situations many readers will recognise from their own lives. The project was created by Heather Hendrie and two close friends, who came up with the idea while consoling her after a bad date. The goal was to offer that same sense of support to other readers through shared writing. Heather is a clinical counsellor and writer who has travelled widely on a tight budget and drawn on her own life experiences — including plenty of dating misadventures — in her work. Her earlier jobs included leading bus tours in Calgary. She uses an intimate, self-deprecating writing style to connect with readers over the ordinary, universal experience of navigating life and relationships. --- ## Awfully Hilarious Period Pieces URL: https://www.womenshealthpathway.com/resources/books/period-pieces/ Metadata: - subtitle: - author: Heather Hendrie, Katherine Matthews, Lindsay Harrington - publishDate: 2026-08-08 - tags: sexual-health - category: book - image: /images/reviews/books/period-pieces.jpg - infoLink: https://awfullyhilarious.com/ - purchaseLink: https://www.amazon.com.au/s?k=heather+hendrie&crid=3GTNRLIV6SWLL&sprefix=heather+hendrie%2Caps%2C93&ref=nb_sb_noss_1 - draft: false - spotifyLink: - appleLink: - googleLink: - youtubeLink: Awfully hilarious: period pieces is an anthology of poems and short prose about menstruation, written by 26 girls and women across every age and stage — from a first period through to post-menopause. It's the second book in the award-winning awfully hilarious series, this time focused on the menstrual cycle and the topics that surround it: puberty, monthly periods, PMS, ovulation, fertility, birth control, pregnancy, perimenopause, hot flashes, and menopause. The collection is organised into four seasonal sections that follow the menstrual cycle and the maiden–mother–crone archetypes. Spring covers first periods, youth, and the follicular phase between menstruation and ovulation. Summer covers ovulation, fertility, birth control, and pregnancy. Autumn covers the luteal phase, when many people experience more pain and premenstrual distress. Winter covers perimenopause and menopause. Written from a range of gender expressions and experiences, period pieces is aimed at any reader with an interest in menstrual health. It treats a common human experience — one often kept private — as something to talk about openly. --- ## Biggest Secret in Women's Health URL: https://www.womenshealthpathway.com/resources/books/the-biggest-secret-in-womens-health/ Metadata: - subtitle: Stigma, Indifference, Outrage, and Optimism - author: Sherrie Palm - publishDate: 2025-10-04 - tags: prolapse - category: book - image: /images/reviews/books/the-biggest-secret-in-womens-health.jpg - infoLink: https://www.amazon.com/stores/author/B003GFS3UU - purchaseLink: https://www.amazon.com/Biggest-Secret-Womens-Health-Indifference-ebook/dp/B0CM4Z4J2W/?_encoding=UTF8&pd_rd_w=eZOuZ&content-id=amzn1.sym.a7785aa2-ac28-4769-b3eb-cff7b9738627&pf_rd_p=a7785aa2-ac28-4769-b3eb-cff7b9738627&pf_rd_r=140-6939266-6892363&pd_rd_wg=fN1FF&pd_rd_r=f063913e-35fc-4fe5-a1ac-7bd41f0accc4&ref_=aufs_ap_sc_dsk - draft: false - spotifyLink: - appleLink: - googleLink: - youtubeLink: Women suffer in silence with below-the-waist symptoms they find too embarrassing to share with doctors, intimate partners, family, or friends, such as vaginal tissue bulge, urinary incontinence, fecal incontinence, chronic constipation, or pain with intimacy. Pelvic organ prolapse is The Biggest Secret in Women’s Health. Award-winning author, patient advocate, vaginal and intimate health activist, Sherrie Palm addresses the most significant underacknowledged, underscreened, and underdiagnosed pandemic in women’s health, frequently research estimated to impact 50% of women worldwide. Palm shares her personal POP experience, illuminates patient quality of life perceptions, and clarifies practitioner perspectives, paving the path to the next notable evolution of women’s health awareness, screening, practice, and policy. Palm’s book ignites a long-overdue revolution in women’s wellness best practice. Here is what you will discover in The Biggest Secret in Women’s Health: - Explanation of five types of pelvic organ prolapse. - Symptom, cause, and treatment breakdown. - How to prep for surgery. - Clarification of mesh repair. - What to expect after surgery. - Vaginal and intimate health empowerment insights. Aids included in The Biggest Secret to guide your journey: - Tips and tools. - POP Risk Factor Questionnaire. - POP Questions to ask your doctor. - Where to find POP support. - A must-read for all women. - A valuable adjunct to diagnostic practitioner curriculum. - A beneficial patient reference tool for the practitioner’s consult desk. --- ## Bladderly URL: https://www.womenshealthpathway.com/resources/apps/bladderly/ Metadata: - subtitle: Smart bladder diary app - author: Soundable Health - publishDate: 2026-09-04 - tags: continence - category: app - image: /images/reviews/apps/bladderly.png - infoLink: http://bladderly.com - purchaseLink: http://bladderly.com - draft: false - spotifyLink: - appleLink: https://apps.apple.com/us/app/bladderly-smart-bladder-diary/id1523268654 - googleLink: https://play.google.com/store/apps/details?hl=en-US&id=com.soundable.diaryandroid.us - youtubeLink: If your doctor has ever asked you to keep a bladder diary, you'll know how quickly the pen-and-paper version becomes a chore. Bladderly turns that task into something you can manage from your phone, quietly and without fuss, so the record you take to your next appointment is complete and accurate rather than half-remembered. ## What Bladderly does Bladderly is a bladder diary that lives on your phone. It keeps track of how often you go, how much you pass, and how much you drink, then pulls those numbers together into a clear picture of your day and night. Rather than jotting figures on a scrap of paper you have to remember to carry, everything sits in one place and builds up over time. The app records the details that matter for making sense of urinary symptoms: single-void volume, your 24-hour total, your daily maximum and average, the gaps between visits, and a separate count for daytime and night-time trips. That last distinction is useful if you're waking to use the bathroom, since nocturia is often assessed differently to daytime frequency. ## How the sound measurement works The feature that sets Bladderly apart is how it measures volume. Traditional diaries ask you to urinate into a measuring cup and read off the amount, which is awkward, unhygienic, and easy to skip. Bladderly instead listens. Its sound-based analysis estimates how much you've passed from the audio alone, so there's no cup, no tools, and nothing to rinse out afterwards. Using it is straightforward. When you feel the urge, take your phone to the bathroom, rest it on your thigh or hold it, and tap start. Tap finish when you're done, and the app logs the measurement for you. The volume estimate is drawn from an analysis model trained on a large bank of real-world samples, which is what allows it to work from sound rather than a physical reading. Your recordings are processed privately, which is worth knowing given the personal nature of the data. ## Logging on your own terms Automatic tracking is the headline, but life doesn't always cooperate. You might leave your phone in another room, or only remember a trip after the fact. Bladderly lets you add entries by hand at any time, so a missed measurement doesn't leave a gap in your records. Between the sound-based and manual modes, you can keep the diary complete however the day unfolds. ## Keeping fluids in balance Volume out only tells half the story, so Bladderly also lets you log what you drink. Recording fluids alongside output helps surface patterns you might otherwise miss, such as which drinks or times of day precede urgency. Over a week or two, that balance of intake and output becomes genuinely informative, both for you and for anyone helping with your care. ## Why a bladder diary is worth keeping A bladder diary is one of the most useful tools for understanding urinary problems, which is why clinicians ask for one so often. It shows how much you drink, how frequently you go, and whether you're experiencing urgency or leakage across a normal few days of your life. That record helps put a number on how severe symptoms are, gives a baseline to measure any treatment or lifestyle change against, and gives your doctor concrete information to work from rather than a rushed recollection in the consulting room. Doing this consistently on paper is hard. Keeping it on your phone, with the measuring handled for you, makes it far more likely you'll actually stick with it long enough to get a meaningful picture. ## Who might find it helpful Bladderly is aimed at anyone monitoring their bladder habits, whether that's because of urgency, frequent trips, night-time waking, leakage, or simply a wish to understand their own patterns better. It's also handy if you've been asked to complete a diary before an appointment, or if you want to see whether a new treatment or change in routine is making a difference. The app supports both women and men, with guidance tailored to each. If bladder symptoms have been nagging at you, an accurate diary is one of the simplest first steps you can take, and Bladderly removes most of the friction that usually gets in the way of keeping one. --- ## Bronwyn's story - My body is resilient and so am I URL: https://www.womenshealthpathway.com/blogs/bronwyns-story-my-body-is-resilient-and-so-am-i/ Metadata: - intro: - metaDescription: Bronwyn Ford's inspiring journey with pelvic organ prolapse after birth injuries. A story of resilience, diagnosis challenges, and finding empowerment through acceptance. - publishDate: 2025-08-01 - author: Bronwyn Ford - authorSlug: bronwyn-ford - featuredImage: bronwyn-ford-feature.jpg - tags: prolapse,continence,vaginal-vulva-health - draft: false - hcp: false - headingTitle: Bronwyn's story - My body is resilient and so am I - headingSubtitle: - headingDescription: Bronwyn Ford’s journey with pelvic organ prolapse has been emotional. She describes frustration, sadness, anger and disbelief but on the other side - acceptance, resilience and empowerment. Research shows prolapse can run in families. Bronwyn says she wishes someone had told her that she was in a higher risk category for prolapse because of her family history, heavy lifting for work, and use of forceps and injuries during childbirth. She says her knowledge of prolapse was “virtually non-existent” before being diagnosed with it. Bronwyn’s first diagnosis of prolapse occurred during a routine check-up. At 46 years old, she went to the GP for a pap smear where the doctor told her she had a Grade 1 (mild) to Grade 2 (moderate) uterine/vaginal prolapse. “There was never any major dialogue,” Bronwyn says. Looking back, Bronwyn thinks because she was lying down for the pap smear, the full extent of her prolapse couldn’t be noticed. “Lying down, prolapses can go back into a more normal position. Standing up, being examined from below can be more accurate,” Bronwyn says. ### The diagnosis journey Over the next few years, Bronwyn saw several health professionals and learned about a number of other bladder, bowel and pelvic health issues. “That same year I had a colonoscopy for a diagnosis of another problem and was told by the specialist that I had irritable bowel syndrome (IBS), a rectal prolapse, a uterine prolapse and haemorrhoids. By the time I turned 48 I was perimenopausal and suffering symptoms from my prolapses,” she said. Bronwyn’s experience is common. Many women experience an onset or worsening of prolapse symptoms during perimenopause and/or after menopause. “At the age of 49, after suffering severe prolapse symptoms and a period that had lasted a month, my new GP referred me to an obstetrician gynaecologist and a urogynaecologist. After multiple tests, I was diagnosed with a Grade 3 (severe) bladder prolapse, a Grade 3 leading to a Grade 4 (very severe) uterine prolapse, and complete bilateral avulsions (pelvic floor muscles torn from the pubic bone),” she said. The first time I can recall that I ever heard about prolapse was from my mum,” Bronwyn says. “She used to say to me that her doctor said she had a prolapsed “pee-hole”, in her words. After she passed away, I was going through her medical records and saw they mentioned prolapse. Unfortunately, I never got to discuss any of this in detail with her as she had passed away before my own symptoms became quite bothersome." This extremely serious set of diagnoses were somewhat unexpected for Bronwyn. Her torn pelvic floor muscles would have occurred as a result of childbirth but weren’t detected until more than 17 years later. She recalls her experience after childbirth as “suffering silently”. “There was so much going on, I didn’t attribute it to prolapse. I didn’t know who to talk to about it. I didn’t know I should be talking about it,” she says. Bronwyn is passionate about ensuring other women don’t feel as alone or unaware as she did. She dedicates much of her spare time to raising awareness of prolapse and supporting others through Facebook groups for women with prolapse. Bronwyn also recently shared her experience as a guest on SBS Insight’s episode on birth trauma, [‘Giving birth better’ (Episode 6, 20 April 2021)](https: In 2012 after receiving her diagnosis, Bronwyn’s symptoms were getting worse. “My prolapses greatly affected every aspect of my life and the quality of my life. First thing in the morning I would feel quite good, however as the day progressed the symptoms would worsen and by the afternoon and evening all I would want to do was lie down to ease the pressure and discomfort. Unfortunately, gravity, being on my feet all day and heavy lifting for work, and everything that comes with looking after a household, worsened the symptoms.” Thankfully, she would soon experience relief. Bronwyn underwent major repair surgery and a hysterectomy which were successful in treating some of the symptoms. Unfortunately, the pelvic floor muscle avulsions couldn’t be repaired. “The surgery greatly reduced the symptoms I had been suffering, including a heavy dragging sensation, a visible bulge at my vaginal opening, difficulties with urination and bowel movements and lower back pain. It’s now been nine years since my surgery, which greatly reduced my symptoms; however, it could not repair all the damage.” Today, Bronwyn manages her mild bladder prolapse and mild rectocele (rectum bulging into the back vaginal wall) symptoms with extra bladder and bowel care and a diet to avoid constipation. Over the years, she has also sought the guidance and support of physiotherapists who specialise in women’s health, particularly pelvic floor health. Together they worked on increasing her pelvic floor muscle strength and managing her symptoms. Bronwyn credits the work of these practitioners, who educated her further about prolapse, and recommends this as an integral part of symptom management and improvement. ### Bronwyn's feelings on the past and future “During my journey with pelvic organ prolapse I have experienced a variety of emotions: good and bad, “says Bronwyn. I have felt frustration, sadness, anger and disbelief as well as acceptance, resilience and empowerment. I have accepted that this has happened to my body. I can’t go back and change what occurred, but I can change my thoughts and feelings about it and how I deal with it. My body is resilient and so am I. Even though I suffered injuries during birthing, my body was able to compensate for this for many years and enabled me to continue functioning in day-to-day life. This resilience has also helped me cope emotionally with other health issues I have dealt with in recent years including non-invasive breast cancer and treatment and acute onset rheumatoid arthritis. I am empowered. I have educated myself about prolapse and all its aspects to enable me to understand why and how I developed it. I know I can still live a full and active life whilst living with the day-to-day symptoms and hurdles that it throws at me. I would like everyone to know that prolapse affects many women, from mid-teens through to end of life. Giving birth and menopause are two of the main risk factors for development of prolapse, however there are other risk factors as well. Even women who have not had children can develop prolapse. It can also vary significantly from person to person, ranging from mild through to severe, with symptoms not always an indication of the severity of the prolapse. Bronwyn says, "I am excited and looking forward to a future where awareness of pelvic organ prolapse is widespread. My hope is that three main things can be achieved in the future: - Information and support are readily available and easy to access - treatment options are varied and effective over the long term, and - individual care is a focus, where each person is looked at on an individual basis and is offered treatment options to suit their needs and circumstances.” ### Get support Phone the free National Continence Helpline 1800 33 00 66 to speak to a nurse continence specialist about bladder and bowel health (Australia). First published in the Bridge Magazine ([Continence Foundation Australia](https: --- ## Closer to fine URL: https://www.womenshealthpathway.com/blogs/closer-to-fine/ Description: After 27 years of misdiagnosis, Heather discovered that PMDD had quietly steered her whole life. She's sharing her story so others find answers sooner. Metadata: - intro: After 27 years of misdiagnosis, Heather discovered that PMDD had quietly steered her whole life. She's sharing her story so others find answers sooner. - metaDescription: It took Heather 27 years to be diagnosed with PMDD. She shares her honest story of misdiagnosis, nature and hard-won hope so you can find answers sooner. - publishDate: 2026-08-08 - author: Heather Hendrie - authorSlug: heather-hendrie - featuredImage: heather-hendrie-feature.jpg - tags: sexual-health - draft: false - hcp: false - headingTitle: Closer to fine - headingSubtitle: - headingDescription: After 27 years of misdiagnosis, Heather discovered that PMDD had quietly steered her whole life. She's sharing her story so others find answers sooner. I've got all the resources in the world, come from a family of physicians, and still, it took 27 years to diagnose the medical condition that's largely steered my life. That's because it only impacts folks who menstruate (and oops! [we haven't been studied much in medical research](https: The condition is called [PMDD (Premenstrual Dysphoric Disorder)](https: Living with PMDD is like having an awful roommate (that you didn't know was there and who never pays the rent). Over the years, I've had some pretty shitty roommates. There was the one in Boulder who had homicidal thoughts and the one who snuck up on me in the kitchen and always smelled sour. There was also the bully who kicked me out and blended smoothies by my bedroom at 5am. (Not to mention the one who walked in while I was masturbating and just stayed there.) None of them though, had anything on the PMDD roommate that's lived with me for three decades. With the others, I was always free to move out. PMDD empties my home of Kleenex, eats all my chocolate, trashes my kitchen, and, on occasion, breaks up a friendship or leaves a Dear John letter for my boyfriend. For a couple weeks, she'll leave and my house will be in order. I'll start to make plans with friends, feeling strong and resilient. I may even apply for a new job. In these brief lulls, I've felt great joy. But then she strides back in without knocking, blowing the door off its hinges. I dread her return, tensing when her tires crunch the gravel driveway. Over the years, I've become so afraid of my roommate's return that my life has begun to feel like a house of cards. It makes it scary to start school, a job, a new relationship, or even a project, because I don't trust that she won't show up and ruin everything. She has a way of pulling the rug out from under me, leaving me sobbing in bed, or so anxious I struggle to breathe. ## I went to the doctor "I'll give you a moment to collect yourself," says the latest kind doctor as I lie sobbing on the crunchy cold paper of the examining table, having received yet another mental health diagnosis. I feel shattered, my alphabet of diagnoses growing longer. I had the ABCs with Anorexia, Bipolar II and Cyclothymia, and now she's pronounced atypical Depression. I'd gone in asking for a prescription for birth control, "I really think the issue is my hormones," I'd said, after scratching out my symptoms in red ink on my calendar for a year. She's not the only one who missed my PMDD diagnosis. Four psychiatrists, three psychics (regrettably), two naturopaths, six counsellors, five MDs and one traditional shamanic healer from the Amazon all missed it too. To her credit, the Amazonian healer came the closest when she said that I had to come to terms with being a woman by embracing my sacred, divine life force. Though I didn't love her suggested method — finger painting with my own period blood — I gave it a try, because I was just that desperate. ## 14:41 When I got my first period at 14 years old, wishing I hadn't, my mom said it was like a switch had flipped. "You were like a different person." That's when I started counting to five before walking through a door (if I didn't do it, something bad might happen, like one of my parents could die). I ate less and less and swam more and more. My brain caught fire and I couldn't put it out. I survived one of the most fatal mental health diagnoses: Anorexia, which I now know often presents as comorbid with PMDD. (As does Seasonal Affective Disorder – and, go figure, [ADHD](https: In my 40s now, I've had to grieve not getting to the root of this sooner. It wasn't for want of digging, nor for lack of support from loving family and kind, skillful practitioners. It's that we were all operating under the same flawed and false assumptions. When I first felt its physiological pinch, PMDD had not yet been considered, much less understood. It wasn't until, "…a landmark decision in May 2019", that The World Health Organization finally added Premenstrual Dysphoric Disorder to the International Statistical Classification of Diseases and Related Health Problems. They say it was complicated because the condition straddles different disciplines: does it belong in the field of endocrinology? Gynaecology? Is it a mental health issue? The truth is that it requires a multi-disciplinary approach. But first you have to care. (Dig for one minute into this and you'll see that it stems from the same reason that more women than men die of heart attacks. I suggest reading [Invisible Women by Caroline Criado Perez](amzn.to/40mYBIH).) ## I went to the mountain At 19, I quit university and moved to the mountains. (I'd missed so many morning classes lying weeping in my dorm room that it only made sense.) With my bare feet on the earth, I simply felt better. Outdoors I could simply be me, freed of rules, expectations and all the "shoulds" shouted by society (except for the ones I'd accidentally swallowed). I skied and paddled, and in seeking out snow, rivers, and awe, I regained perspective. In nature, there is only beauty and survival. Nothing else matters. Gender, time, and the patriarchy are abstract concepts out there, not crushing us into tiny boxes the way they do indoors. I got a degree in outdoor pursuits, and later went on to specialize in [wilderness therapy](https: ## That's me in the corner In the middle of July, at 2am, I lay crying in our family cottage. I'd holed up there to weather the first few months of the pandemic with my parents, my sister and her family. They slept just down the hall from me, as I soaked the pillow and stifled my sobs. "I can't believe this is my life," I thought, 41 and jobless, single without prospects. Up to that moment, I'd always thought I'd be ok, that I'd meet someone in the end, that I wouldn't spend my life alone, and that one day, things would get better. But that night, I realized they might not. Hope dies hard, I think they say. It sure does. I've always prided myself on being hopeful and used to operate as though I'd die trying. Whether it was what I learned at the Buddhist school I attended, or more likely, that I just got too exhausted to try any longer, something shifted that night. I surrendered. I think that's when I first let go, and began to grieve all those things that didn't or hadn't yet happened: falling in love, choosing a home, becoming a mother… So I sobbed into my pillow all night long, and then I leaned in to ask PMDD what she'd been trying to tell me all along. And in the morning, I walked over to my mom and asked her for help. ## Me & PMDD **Me:** Wow, you waited 27 years to tell me, eh? **PMDD:** Yeah, well, you're the one who wrote that piece, "Ripe" about how things can only happen once it's time. It had to be now. **Me:** But you hurt me! I've suffered for so long. *(a tear falls.)* **PMDD:** I know honey. But I didn't come here to hurt you. I'm only here to wake you up. **Me:** Wake me up? What's that supposed to mean? **PMDD whispers softly:** It's time for you to reclaim your power. *(I start to sob softly.)* **Me (quieter now):** I'm getting older. There's so much in life I may have missed. Why did it have to take so long? **PMDD:** Honey, you can't peel a cocoon off a caterpillar. You'll fly in time. Rest now. Rest. And so I do. I sleep. And each morning dawns a little brighter than the morning before. *(~~the end~~. the beginning.)* ## Post script: pitching a red tent With a first degree in outdoor pursuits and a second in wilderness therapy, I've spent a lot of years pitching tents. Here's my final pitch: it's time to put up a lot more red tents. We need spaces where we can step into caring community, and feel held and heard and heal. We need to start to speak about that which was once sacred but that power has made taboo: dreams and blood and babies, and we need to celebrate and grieve together. PMDD is just another word, even a label if used poorly, but the great thing about it is that it is leading me to community, and I believe that it's in wild community that we heal. As I blaze my trail forward and step closer and closer to fine, you can bet your bottom dollar that I'll be leaving trail markers as I go. Because honeys, it shouldn't have to be so hard. I think it all starts with story. And I'm telling you, now that I've got language for this, I'm not shutting up. --- ## Community is an Evidence Infrastructure URL: https://www.womenshealthpathway.com/blogs/community-as-an-evidence-infrastructure/ Metadata: - intro: - metaDescription: Long before clinical trials, women spot the patterns science misses. Here's why lived experience belongs at the start of health research, not the footnotes. - publishDate: 2026-07-28 - author: Voni Nyamazana - authorSlug: voni-nyamazana - featuredImage: voni-nyamazana-feature.jpg - tags: menopause - draft: false - hcp: false - headingTitle: Community is an evidence infrastructure - headingSubtitle: Rethinking where evidence begins - headingDescription: We tend to treat community as women's health's support act. But long before a study is funded, women are already spotting the patterns science hasn't caught up with. Community isn't where the evidence gets discussed. It's where it begins. We have long misconceived the role of community in women’s health, seeing it first and foremost as a sphere of emotional and practical support. Indeed, community spaces, online forums, local groups, churches, salons and kitchens, are where women rally after difficult diagnoses, cope with pregnancy loss or chronic illness, navigate fertility challenges or transition into menopause. Here they share stories, offer encouragement and find solidarity when coping alone feels impossible. That supportive function remains invaluable. Yet community’s contribution extends far beyond consolation. It is where evidence begins, well before a woman checks into a clinic or researchers secure funding. Long before journal articles appear and clinical guidelines evolve, women are already talking, describing symptoms that disrupt their lives, comparing experiences, spotting patterns, asking questions and sharing remedies. Through these interactions, they craft explanations and language for bodily changes that often arrive without warning or medical validation. This communal exchange does not replace scientific research; rather, it fertilizes it, generating the questions that research must address. Rigorously conducted studies, randomised trials, systematic reviews and clinical guidelines, remain the bedrock of safe, effective care. Yet every study starts with a question, and every important question arises when someone perceives an unexplained phenomenon. In women’s health, that “someone” is very often women themselves, noticing shifts in energy, mood, menstrual cycles or other systems that science has not fully explored. For generations, women have recognized bodily patterns long before formal investigation. Around kitchen tables and over coffee, in churches and community centres, at hair salons and in late-night WhatsApp chats, they have compared notes on overwhelming fatigue, sudden anxiety, brain fog, joint pain, heart palpitations and digestive distress. These conversations may lack the structure of a clinical trial, but collectively they form an informal dataset—an early warning system, indicating symptoms that warrant scientific scrutiny. All too often, lived experience is relegated to a supporting role in research, presented as the human-interest piece that follows the “real” evidence. What if we flipped that paradigm? What if lived experience were not a footnote but one of the primary sources from which research questions emerge? When one woman describes unrelenting postpartum anxiety, and ten more report similar symptoms, those individual stories become signals that can guide study design, ensuring research focuses on issues that matter most to women’s daily lives. Listening to community conversations at scale allows meaningful patterns to surface. These signals generate hypotheses and shape research agendas, leading to investigations that might otherwise be overlooked. Integrating lived experience into the earliest phases of research does not undermine evidence-based medicine; it strengthens it by ensuring scientific inquiry aligns with the real-world needs of the population it seeks to serve. In many ways, community networks perform the earliest stages of public health intelligence: observing trends, recognising anomalies and sharing insights. Women do this work around kitchen tables, at park benches, in support groups, workplaces and digital spaces. The problem isn’t a lack of data, but our failure to listen systematically, ethically and meaningfully to these grassroots observations. Sometimes discussions of lived experience are framed as competing with peer-reviewed evidence, as if narratives and data cannot coexist. In reality, healthcare needs both. Scientific research tells us what works under controlled conditions; lived experience reveals how those findings translate into everyday life. Research quantifies outcomes; communities contextualize those outcomes for diverse populations. The most resilient healthcare systems embrace both scientific rigor and human insight. Qualitative studies have long shown that women’s experiences of menopause are shaped not only by biology, but also by relationships, culture, work environments, identity and access to support. These dimensions influence how symptoms are managed and communicated, highlighting the need to couple quantitative measurement with qualitative listening. The same interplay of factors shapes experiences of fertility treatments, endometriosis, polycystic ovarian syndrome and postpartum mental health. If society views infrastructure as anything we depend on, roads, water, electricity, then healthcare must also recognize infrastructure that supports learning, communication and adaptive improvement. Community is part of that infrastructure. It is where trust is built, unmet needs surface and emerging health trends are first spotted. It is a collaborative space where partnerships between women, clinicians, researchers and policymakers can flourish. Moving toward truly person-centred care means embedding community voices at the earliest stages of decision-making. Communities should not be consulted only after research agendas are set; they should help set those agendas. Instead of asking merely, “What does the evidence tell us?” we should also ask “Whose experiences shaped the questions we decided to investigate?” This dual perspective broadens our understanding of where and how evidence begins. Over the past decade, raising awareness of issues like menopause and women’s cardiovascular health has been critical. But awareness alone is not enough. The next step is building systems that listen deliberately, collaborate authentically and value lived experience as much as scientific evidence. By doing so, we ensure research priorities reflect the realities of women’s lives and that care improvements are both meaningful and impactful. This is not about lowering standards of evidence; it is about expanding the boundaries of what we consider the starting point for evidence. When community is acknowledged as the foundation where questions first arise, we create a more responsive, inclusive and effective health research ecosystem—one better equipped to serve the needs of all women. --- ## Dr Sinéad Dufour URL: https://www.womenshealthpathway.com/resources/telehealth/sinead-dufour/ Metadata: - name: Dr Sinead Dufour - authorSlug: sinead-dufour - role: Physiotherapist specialising in perinatal care, pelvic health and pain science - businessName: - url: - country: Canada - metaTitle: Dr Sinead Dufour | Telehealth Provider | Physiotherapist - metaDescription: - publishDate: 2025-09-11 - featuredImage: sinead-dufour.jpg - tags: continence,vaginal-vulva-health - draft: false Dr. Sinéad Dufour is an academic clinician who shares her time between clinical and academic pursuits. Sinéad is an Associate Clinical Professor at McMaster University holding a faculty position within the Faculty of Health Science for over a decade. For the last two years she has added to her research portfolio through her work with FIFA (Fédération Internationale de Football Association) serving as a perinatal and pelvic health expert on the FIFA Female Football Project. Clinically, Sinéad has been a practicing physiotherapist for over 20 years the last decade of which her focus has been related to perinatal care, pelvic health and pain science. She is a founding partner of The WOMB , a family of perinatal care centres in Ontario, Canada and also Compass Rose , a company dedicated to delivering exemplar virtual pelvic health care. Sinéad has led and authored a multitude of clinical practice guidelines spanning perinatal care and pelvic health and is a well-recognized speaker at international conferences. LinkedIn www.instagram.com/dr.sinead --- ## Dr. Colleen Lind URL: https://www.womenshealthpathway.com/resources/telehealth/colleen-lind/ Metadata: - name: Dr. Colleen Lind - authorSlug: colleen-lind - role: Certified pelvic health physical therapist - businessName: The Vagina Whisperer - url: https://thevagwhisperer.com/consultations/ - country: USA - metaTitle: Dr. Colleen Lind | Telehealth Provider | Certified pelvic health physical therapist - metaDescription: Dr. Colleen Lind (She/Her/Hers) specialises in pelvic health and related orthopedic conditions as a certified pelvic health physical therapist - publishDate: 2025-09-11 - featuredImage: colleen-lind.jpg - tags: vaginal-vulva-health - draft: false Dr. Colleen Lind (She/Her/Hers) specializes in pelvic health and related orthopedic conditions as a certified pelvic health physical therapist through the American Physical Therapy Association’s Academy of Pelvic Health. She graduated with a Bachelor of Science in Human Health Science from the University of Kentucky and a Doctorate in Physical Therapy from Washington University in St. Louis. Dr. Lind has always been fascinated by the human body and all that it is capable of, and with an extensive background in sport and orthopedic care and her certifications in pelvic health, she integrates this knowledge to treat individuals from head to toe, the pelvic floor included. She has special interests in sport and fitness, as well as pregnancy, postpartum, and far beyond. She strives to provide optimal care by educating, empowering and emphasizing the importance of prevention and wellness through providing virtual consultation via The Vagina Whisperer. --- ## Early Menopause, Missed Bone Health & The Cost of Delayed Care | Case Report URL: https://www.womenshealthpathway.com/blogs/early-menopause-missed-bone-health-and-the-cost-of-delayed-care/ Metadata: - intro: - metaDescription: A case report on a uterine cancer survivor who developed severe osteoporosis after early menopause and delayed hormone therapy. A reminder that prevention must come before insurance approval. - publishDate: 2026-03-10 - author: Dr Pany Nazari - authorSlug: pany-nazari - featuredImage: pany-nazari-feature.jpg - tags: menopause - draft: false - hcp: true - headingTitle: Early menopause, missed bone health & the cost of delayed care - headingSubtitle: - headingDescription: When a patient's journey includes cancer, radiation, surgical complications, and decades without adequate hormonal support, the consequences compound quietly until they can't be ignored. Case Report: 57 year old female, small frame. At age 28, she was diagnosed with uterine cancer and after a complete hysterectomy, she was treated with radiation. It’s important for this case to know that menopause began following the hysterectomy, much earlier than usual. She was never consistently prescribed hormone therapy… let’s talk about it. Two bowel obstructions and surgical interventions throughout her treatment led to the formation of significant scar tissue and more surgeries. She self-referred to me for urinary and bowel incontinence. Grateful to have all the time that we need to take a thorough history (a rewarding benefit of our private clinic setting), she tells me that she had “stopped thinking” about any type of sexual activity since she never thought “it would work” anyways. As part of my intake, I asked her about all other health conditions, including bone health. The decline in estrogen during and after menopause accelerates bone loss, and loss of sufficient bone density leads to osteoporosis, a condition that increases fracture risk. She said her PCP told her that her insurance won’t pay for bone density assessment until she’s 65! Outraged, I called a GYN friend who managed to see her and send her off for her first Dexa scan (a bone mineral density test). Important to note—Dexa index scores of -2.5 or lower indicate osteoporosis (weak bones/high chance of fractures), while scores of -1.0 or higher indicate normal bone density. This patient’s Dexa score? -3 Adequate estrogen levels promote bone formation and maintain bone mineral density; since she went into menopause so early, her chances of having osteoporosis is that much more significant. The lack of action in her 20s/30s that led to this is so troubling. After these results, the doctor and I confirmed the treatment plan (also considering her pelvic-related issues) and got her started with hormone therapy. While hormone therapy isn’t always for everyone, her care team should have thought about assessing her bone health many years ago. That association is very clear—no estrogen bone density loss. The key takeaway here is that interventions could have been done to help her bone health and other subsequent complications. As medical professionals, our responsibility is to our patients—not insurance companies. It is our duty to use the investigative skills we were trained in to make our patients’ outcomes better, focusing on prevention as much as possible! --- ## Enterocele, Rectocele, or Both? URL: https://www.womenshealthpathway.com/blogs/enterocele-rectocele-or-both/ Description: Little talked about, often overlooked; enterocele is like the distant cousin who is a bit misunderstood compared to common cystocele and rectocele. Metadata: - intro: Little talked about, often overlooked; enterocele is like the distant cousin who is a bit misunderstood compared to common cystocele and rectocele. - metaDescription: Understanding enterocele vs rectocele: expert guide to prolapse types, symptoms, and diagnosis. Learn about these often misunderstood pelvic conditions. - publishDate: 2025-08-14 - author: Sherrie Palm - authorSlug: sherrie-palm - featuredImage: sherrie-palm-feature.jpg - tags: prolapse,continence - draft: false - hcp: false - headingTitle: Enterocele, rectocele, or both? - headingSubtitle: - headingDescription: Little talked about, often overlooked; enterocele is like the distant cousin who is a bit misunderstood compared to common cystocele and rectocele. Articles about pelvic organ prolapse can be vague when it comes to enterocele; this POP is sometimes undiagnosed or misdiagnosed when other types of POP are recognized (that was my scenario; a large enterocele was discovered during surgery). Let’s shine a bit of light on the difference between rectocele, intussusception, rectal prolapse, and enterocele. A rectocele is a bulge in the anterior (front) or posterior (rear) rectal wall. During a bowel movement when a rectocele is present, stool typically remains trapped in the bulge. The most significant symptom of a rectocele is chronic constipation or incomplete bowel movements despite fingers inserted into the vagina to assist evacuation, or bridging to assist bowel movement (two fingers shaped like a V pushing up against the labia and/or perineum during defecation). Bowels may still feel full after a movement. Intercourse may be uncomfortable or painful because of pressure of full bowel. Women who’ve been diagnosed with rectocele will gladly share the difficulties they have navigating constipation-it haunts them daily. Intussusception is the rectum pushing back inside itself (partially inside out), similar to a rubber glove finger pushed into itself when you pull them off. It may appear as finger-like protrusions that branch off of the rectum. Stool becomes trapped in these pockets. An intussusception can be intra-rectal (inside along the rectum), intra-anal (inside along the anus), or extra anal (outside the anus). With the straining that accompanies constipation, these folds sometimes progress and deepen and or reach downward through the anal canal to form rectal prolapse. Common symptoms are chronic constipation, incomplete emptying, pain with bowel movement, blood loss upon defecation, incontinence of gas or feces, or mucus discharge. Upon hard straining, obstructive sensation may increase. Enemas may be ineffective. Rectal prolapse occurs when rectal walls have prolapsed to the degree they protrude through the anus and are visible outside the anal canal. Patients' with rectal prolapse may experience faecal incontinence. Rectal prolapse sensation may seem similar to an obstacle preventing defecation. Enterocele occurs when the intestines (small bowel) protrude through a fascial defect or weak tissues, typically at the apex (top) of the vagina. Women who’ve experienced birth trauma or had prolonged deliveries or forceps deliveries may have a higher risk of enterocele. Patients with previous pelvic surgery may have a predisposition to an enterocele as well; particularly a hysterectomy. An enterocele can develop in the posterior wall (back side by rectum) or anterior wall (front side by uterus), basically wherever the small bowel (intestines) fall through defects in the vaginal wall. The size and “degree of drop” of enteroceles may vary considerably, from halfway down the vaginal length, all the way down to the perineum (tissues surrounding the urogenital and anal openings), or even protrude out of the anal canal to form rectal prolapse. An enterocele may be distinguished during pelvic examination as a bulge that occurs during the valsalva maneuver (deep held breath while bearing down). It may also be necessary for a physician to request you perform the valsalva maneuver while you are standing with one foot on a stool. Symptoms of an enterocele may be sensation of a mass bulging into the vagina or pushing against the perineum or pain with intercourse. They may also include a pulling sensation in the pelvis or low back pain that eases up when you lie down, vaginal discharge, or a feeling of pelvic fullness, pain, or pressure. There may be a rapid return of bowel movement urge shortly after evacuating bowels (gotta go, gotta go again). ### There are 4 types of enterocele: - Pulsion: Caused by continual pressure in abdomen from chronic cough or extreme physical exertion like repetitive heavy lifting - Traction: Caused by pregnancy, childbirth and estrogen loss which contribute to weakening and stretching of pelvic tissues. Additionally other prolapsed organs may put pressure on tissues contributing to enterocele - Latorgenic: Cause is not fully known but assumed to be related to hysterectomy or some cystocele repair procedures - Congenital: Birth defect. An additional and more definitive diagnostic tool utilized for enterocele is called DRE or defecography (also called proctography). During this test, the act of defecation is assessed by recording expulsion of barium paste that is the consistency of feces. This test can evaluate pelvic floor and rectal function, how well the rectal sphincter works, and the effectiveness of rectal evacuation. Barium is both swallowed (to highlight the intestines) and injected as a paste into the rectum. The patient is sitting on a test commode to mimic normal body language which enables screening of the function of both rectum and pelvic muscle tissue during the procedure. This test facilitates diagnosis of rectocele, enterocele, intussusception, and function of the anal sphincter. On a more personal note (how much more personal can it get than discussing our bowel concerns, something we ladies do in the [APOPS forum](https: individual quest for answers), I’d like to share a few insights. I pay particularly close attention to my body, the signs, symptoms, flags. When something occurs that is the slightest bit left of normal in my pelvic cavity, the wheels are clicking away in my brain, trying to assess whether it is something I need to be concerned about, or share with women navigating POP. My backdrop was transvaginal mesh repair of grade 3 cysto/rectocele; large enterocele discovered during surgery and repaired without mesh. Years ago when I noticed a subtle but palpable loss of sensation front to back as well as a feeling of fullness, I thought to myself, hmmmm, what’s going on in there? Could it be my enterocele is back? Could it be as simple as bloated days related to IBS coupled with scar tissue or adhesions? We all need to recognize that as time keeps ticking away and we move forward with our lives, we must continually monitor change to enjoy continuing quality of life. No one gets a “free health pass” post surgery; we need to remain pro-active. I do my best to utilize self-awareness along with fitness techniques to address continual shifts in my body. I recognize a distinct difference in how my bowel acts when I eat a healthy low sugar diet with lots of produce, and how it acts when I shove 6 pieces of Dove dark chocolate in my face in one sitting or knock back a few gin cocktails - I’m only human! Every time women with rectal POP issues have a bowel movement, I encourage them to try the following steps to make bowel movements a bit more user-friendly. Lock the bathroom door and "go deaf" to activities and voices outside that door, to assure no one and nothing can disturb you - it will make it easier to relax. And “V-brace” the labia with your first two fingers, pushing against the labia gently, creating some structural support for the pelvic floor, prior to bearing down to have a bowel movement. --- ## Experiencing Both Sides of the Stethoscope URL: https://www.womenshealthpathway.com/blogs/experiencing-both-sides-of-the-stethoscope/ Description: A doctor who spent years undiagnosed with endometriosis reflects on navigating a healthcare system that repeatedly dismissed her symptoms—even as she worked within it. From six miscarriages and failed IVF to surgical menopause at 34, this is a deeply personal account of how lived experience reshaped her understanding of medicine, patient advocacy, and what it means to finally be heard. Metadata: - intro: A doctor who spent years undiagnosed with endometriosis reflects on navigating a healthcare system that repeatedly dismissed her symptoms—even as she worked within it. From six miscarriages and failed IVF to surgical menopause at 34, this is a deeply personal account of how lived experience reshaped her understanding of medicine, patient advocacy, and what it means to finally be heard. - metaDescription: A doctor shares her personal endometriosis journey—from dismissed symptoms and miscarriages to surgical menopause at 34, and the advocacy work that followed. - publishDate: 2026-06-01 - author: Dr Liz Murray BCA, MBBS, DipMedSci - authorSlug: liz-murray - featuredImage: liz-murray-feature.jpg - tags: sexual-health - draft: false - hcp: true - headingTitle: Experiencing both sides of the stethoscope - headingSubtitle: - headingDescription: A doctor who spent years undiagnosed with endometriosis reflects on navigating a healthcare system that repeatedly dismissed her symptoms, even as she worked within it. The day I began training to become a doctor, little did I know my journey as a lifelong patient had already begun. Like many people, I had visions for my future life; my career, family plans, ambitions. I had never had what would be considered a ‘healthy period’ and like many women was put on the pill at 17 and there I remained in blissful ignorance until my mid 20’s, totally unaware (even as a doctor) that I was harbouring an incurable gynaecological disease that would one day drastically change the trajectory of my life. Then, after I decided to stop the pill and ‘go natural’ I, like too many other women have also experienced, entered a whole new world of suffering. Miscarriages, disabling period pains, joint pains, fatigue. Doctor’s appointments sitting in the patient chair, struggling to advocate for myself. A complete lack of answers, being told ‘everything was fine’ and trying to struggle on working as a doctor whilst it felt like my body was betraying me. Like many women, my symptoms were initially minimised, normalised, or fragmented across different appointments and specialties. I experienced firsthand how exhausting it can be to live in a body that is struggling while simultaneously trying to convince people that something is genuinely wrong. At the same time, I was continuing to work within medicine - balancing hospital shifts, professional expectations, family life, and increasingly poor health. There is something uniquely disorientating about understanding medicine clinically, yet still finding yourself lost inside the system personally. After 6 miscarriages, failed IVF (that I now know was always destined to fail) I was early 30’s when I finally heard the word ‘endometriosis’ directed toward me from the end of my bed after an emergency laparoscopy. No explanation, no follow up, no treatment started. This from a team within the same hospital I was working at as a doctor at the time. And this is the true tragic irony – if I as a doctor struggled to advocate and receive the correct care, what chance do other people have without the medical ‘language’ and experience? I was fortunate to finally find a specialist gynaecologist who came in right before I was close to losing my bowel, and somehow I fell pregnant whilst waiting for a hysterectomy. A complicated pregnancy because of the endometriosis and fibroids ensued, but I was lucky to experience motherhood before I had to have all my gynaecological organs removed. Surgical menopause at 34, five years on and I am facing further surgery and very much aware I may still require a stoma because of the extent of my endometriosis. What struck me most was not just the physical impact of illness, but the emotional and psychological toll of delayed diagnosis and feeling unheard. Over time, I realised that many patients weren’t simply struggling with symptoms - they were losing trust in themselves, in their bodies, and in healthcare altogether. That experience fundamentally changed me. It changed how I communicate with patients. It changed how I think about healthcare systems. And ultimately, it changed the direction of my career. What began as personal frustration evolved into advocacy, public speaking, charity work, and eventually writing my book, Not Just Painful Periods. The book was never just about periods or specific diagnoses. It was about validation. About helping people feel seen earlier. About giving patients language, confidence, and understanding in a system that can sometimes leave them feeling invisible. Alongside this, I founded the charity Mortal And Strong, developed the Diagnosis Spiral and Thrive Arc framework, and began focusing my work on the intersection between medicine, lived experience, and systems change. Ironically, some of the hardest experiences of my life became the very thing that clarified my purpose. I still believe deeply in healthcare and in the extraordinary people working within it. But I also believe we need to listen differently. Because behind many delayed diagnoses, there are people quietly adapting to levels of pain, exhaustion, and fear that should never have become normal. If there is one thing I hope my work contributes to, it is this: That fewer people feel dismissed. That fewer people lose years of their lives searching for answers. And that patients no longer have to become experts in suffering before they are finally taken seriously. --- ## Floored URL: https://www.womenshealthpathway.com/resources/books/floored/ Metadata: - subtitle: A Woman's Guide to Pelvic Floor Health at Every Age and Stage - author: Dr. Sara Reardon - publishDate: 2025-09-16 - tags: continence,prolapse,menopause,vaginal-vulva-health - category: book - image: /images/reviews/books/floored.jpg - infoLink: https://thevagwhisperer.com/floored/ - purchaseLink: https://thevagwhisperer.com/floored/ - draft: false - spotifyLink: - appleLink: - googleLink: - youtubeLink: Dr. Sara Reardon is a board-certified pelvic health physical therapist, educator, and fierce advocate for destigmatizing intimate health. Known globally as The Vagina Whisperer, she founded The Vagina Whisperer platform to offer accessible, evidence-informed pelvic floor education and virtual workouts for women at every life stage. With over 15 years of clinical experience, Sara specialises in postpartum recovery, incontinence, painful sex, prolapse, and menopause. Her work blends clinical precision with warmth and humour, making pelvic health approachable and empowering. She’s a trusted voice across social media, podcasts, and public health campaigns. Floored is an empowering guide offering clear, compassionate support for women navigating pelvic floor challenges across every life stage. From postpartum recovery and painful sex to prolapse, incontinence, and menopause, Floored blends clinical expertise with emotional safety and zero shame. --- ## Foreplay URL: https://www.womenshealthpathway.com/resources/books/foreplay/ Metadata: - subtitle: An awfully hilarious tease - author: Heather Hendrie, Angelina Jimenez - publishDate: 2026-08-08 - tags: sexual-health - category: book - image: /images/reviews/books/foreplay.jpg - infoLink: https://awfullyhilarious.com/ - purchaseLink: https://www.amazon.com.au/s?k=heather+hendrie&crid=3GTNRLIV6SWLL&sprefix=heather+hendrie%2Caps%2C93&ref=nb_sb_noss_1 - draft: false - spotifyLink: - appleLink: - googleLink: - youtubeLink: Foreplay is a chapbook created as a companion to the award-winning anthology [Awfully Hilarious: Pillow Talk](/resources/books/pillow-talk/), functioning as both a prequel and a sequel to it. It's a short collection of poems, reflections, stories, and essays that lead into deeper conversations about sex, desire, intimacy, trauma, pleasure, vulnerability, healing, and the body. The writing is short-form — poetic reflections and narrative fragments — covering desire and longing, sexuality and self-trust, pleasure and embodiment, trauma and tenderness, intimacy and consent, and humour and healing. It works as an introduction to the Awfully Hilarious series for new readers and as a companion read for existing fans. Foreplay will suit readers interested in feminist storytelling, sex-positive and body-positive writing, trauma-informed and queer-affirming literature, intimacy and relationships, mental health and healing, and honest, memoir-style personal essays. It also works as a gift or a conversation starter. --- ## From 39 to now URL: https://www.womenshealthpathway.com/blogs/from-39-to-now/ Description: After experiencing a sudden wave of brain fog so intense she couldn’t remember her own name, Kirsty began a journey of rediscovery that transformed her life. Metadata: - intro: After experiencing a sudden wave of brain fog so intense she couldn’t remember her own name, Kirsty began a journey of rediscovery that transformed her life. - metaDescription: Kirsty Dixon's honest perimenopause journey from brain fog confusion to empowered self-discovery. A transformative menopause story of hope and resilience. - publishDate: 2025-08-11 - author: Kirsty Dixon - authorSlug: kirsty-dixon - featuredImage: kirsty-dixon-feature.jpg - tags: menopause - draft: false - hcp: false - headingTitle: From 39 to now - headingDescription: After experiencing a sudden wave of brain fog so intense she couldn’t remember her own name, Kirsty began a journey of rediscovery that transformed her life. I describe myself as a postmenopausal woman since 17 March 2023, following an 11-year perimenopause rollercoaster. My story is not unusual, but it’s one I share to help others navigate this stage with awareness and empowerment. At 44, I was diagnosed as perimenopausal. My symptoms were so mild I didn’t think much of it—mistake number one. Like many, I believed the outdated school narrative: menopause happens in your 50’s, brings a few hot flushes, mood swings, and weight gain, and that’s it. Oh, how wrong I was! ### The first warning signs I ignored At the age of 39 (now 57), my Personal Trainer first mentioned the word menopause to me as I had love handles appearing which would not shift. Now at this point, I was super fit with more fat on a chip. He told me that it was natural because of the way our bodies store fat with menopause (the peri word had not arrived then) and I was getting to ‘that age’. Did I believe him? No!! Bloody cheek. “What does he know?" I thought. So I did nothing and carried on slogging away to get rid of those handles. Once I hit 40, I started to notice that despite doing more exercise in a week than ever, I really struggled to maintain the same level of fitness. I accepted I wasn’t 26 anymore (when I started being a regular gym goer) and was pleased that I was still fit and healthy. ### My first GP visit and official diagnosis At 44, I went to see the GP (male GP may I add). About what I can’t remember. I think it was because I was getting moments of blankness, like a camera shutter. I was told it was menopause (still no peri word) and offered antidepressants. “Give over”, I thought and turned them down as I wasn’t depressed. Whatever it was, it wasn't that bad. Five years passed with the only real change being that I pulled a muscle just looking at a dumbbell and the joints definitely ached a bit more. Was menopause in my thoughts? Not one little bit. ### The day everything changed Then. At 49. BANG. What felt like overnight: - The anxiety - The stress - The brain fog - The memory problems - The heart palpitations - The dizziness - The emotions, mostly tears - The complete loss of confidence in my ability to do anything - The disorganisation - The trouble making the simplest decision Etc. Aaaaagh. "What the fu!k is happening to me" I thought. Apologies for the swear word but I am being honest. ### My mental health crisis I spoke about it, but no one mentioned menopause. Other conditions yes, but not menopause. After two months of the symptoms getting gradually worse, I crashed and burned. I was stressed and anxious about the most stupid little things but didn’t know why. I had told myself I could not do my job anymore and was useless. In floods of tears, I spoke with my line manager and was sent home. Off sick from work for 18 days. ### HRT and continued struggle The GP did blood tests which showed it was hormonal and again the word menopause (still no peri word) was used. I was put on HRT which for me, was never a wonder drug. It helped, but in the four years I took it, it only dampened my symptoms at best. Now wouldn’t you think that at that point I would look into what this ‘menopause’ thing was all about? Nah. The GP must be wrong. My mum had sailed through it (or so I thought) and I spent the next four years fighting it with every ounce of energy I did not have. I cried. I lost myself. In my head I was useless and so, so down in the dumps. Still I didn’t know why. The brain fog and memory problems were just so debilitating. My husband said to me one day while I was in floods of tears, not knowing why. “I want my old Kirsty back”. So did I!! I felt lonely inside. I thought it was only me. I thought I was totally losing the plot. Sound familiar? May I add that my husband, big shout out to John, has been the most wonderful support to me all the way through my journey and still is. The temper, the tears, the snappiness, the forgetfulness, the brain shutters coming down, the words that I think I have said that change by the time they reach his ears, and so on. I cannot express how important having a support network is but that’s another Blog. ### Fighting for answers So, fighting away, I went back to the GP quite often! Again I was told it was menopause. I remember the day I went back, the last time before my ‘lightbulb’ moment, and told her I was not leaving the room until she had referred me for a brain scan AND, I would pay privately with no idea where the money would come from! I said to her “This cannot JUST be menopause”. JUST. I giggle now that I said that word. There is no JUST about menopause, regardless of what stage you are at. Anyway, she humoured me and referred me to the Mental Health team, ‘as that was the first course of action’. I got my appointment and went along. Hoping that at last, I would find out how early onset my dementia was or how large the tumour that must be in my brain. I took all the tests and guess what? I passed with flying colours. Now did I then say, ‘ok, perhaps there is something in what the GP has been telling me, so go and read up on this thing called menopause’. NOOOOOO. I said to them “But this is today. I bet if I came back tomorrow, the results would be totally different”. Again, I think I was humoured, and the lovely lady went away to ask her colleagues if anything else could be offered. I was settling for nothing less than a brain scan!! ### The final HRT chapter My next ‘thing’ was the mammoth three-month long bleed which would not stop. It went on and on. Despite trying different HRT’s, including one which apparently should have stopped me bleeding, the flow continued. Eventually the only solution was to come off HRT and see what happened. Within three weeks, the bleeding finally stopped. That was my last time taking HRT. I take a number of medications for COPD/Asthma and acid reflux (which started during perimenopause. The gift that keeps on giving), and had never been happy taking HRT as ‘another medication’ so I chose to self-manage. To be honest, I didn’t really notice any difference other than hot flushes and night sweats became a thing for me. I still felt down, anxious etc and I still blamed the brain rather than menopause. ### Career change during menopause By this time and in full swing of my menopause fight, I decided to change career. At the age of 51, I applied for an apprenticeship to be a Learning and Development Practitioner. I smashed the interview and got the job, woohoo, and I took on this complete other change in life. In a classroom with the other apprentices who were all 30+ years younger than me, with their fabulously functioning brain, I felt a bit out of place. How on earth could my brain learn all this new information? Saying to my husband “Why have I done this to myself when I am so emotionally unstable, and with no answer as to what is wrong”. Roll on to Covid and I ended up ‘off sick’ with depression following an 18 month awful time with a very poorly dad, who we lost in January 2020. Grief on top of my menopause struggles were just too much. I went off sick just before Covid hit and this time I very reluctantly accepted the antidepressants for my depression (this is relevant in a later part of the story. Probably a different Blog). ### My lightbulb moment So here comes the really good bit! One day, sitting in the garden in the sun, hearing nothing but birds and the quietness that was Covid, I opened an article on menopause on my phone. I thought to myself, “What is all the fuss about menopause”! It had started to hit the tabloids and magazines. BOOOM! At last, I read something which I could relate to. “Hmmmm” I said to myself “Perhaps there is something in this menopause malarkey”. So I read more and I read more. “WOOOOOOOOOW. It is menopause AND it is all perfectly normal. Yippee. It is not just me. I am not alone and I am most certainly not going mad.” I NEED TO EDUCATE MYSELF AND UNDERSTAND WHAT IS GOING ON IN MY BODY. How could I help myself and even be proactive? ### Transformation The almost instant relief was amazing. I realised I needed to own my journey. Had menopause robbed me of me? Yes. But only because I let it. I realised I didn’t know what my values and beliefs were anymore. What was my purpose in life? Who was I and who did I want to be? Once I embraced it I went on the most WONDERFUL year of rediscovery. It was so enlightening and uplifting. I found ‘me’ again and do you know what? I really love this ‘me’. Am I different to the pre-menopause Kirsty. No. I am still here but I am a bit tweaked and I looooooove those tweaks. I can honestly, hand on heart say, that if I could live my life again without menopause, I would say no. It has helped to shape me into the beautiful butterfly I am today. Flying awake into an awesome, period free future. I am going to leave it here as for a Blog. I am told this is a bit long! I will write others on more specific topics but wanted to get the nuts and bolts down. If you made it to the end. Thank you for reading this far and just remember, if you are struggling at all, you are bloody awesome and you are not alone. Not while I live and breathe anyway. ;-D --- ## Georgia Hartmann URL: https://www.womenshealthpathway.com/resources/telehealth/georgia-hartmann/ Metadata: - name: Georgia Hartmann - authorSlug: georgia-hartmann - role: Naturopath - businessName: Hormone Health Studio - url: https://hormonehealthstudio.com - country: Australia - metaTitle: Georgia Hartmann | Telehealth Provider | Naturopath - metaDescription: - publishDate: 2025-09-11 - featuredImage: georgia-hartmann.jpg - tags: menopause - draft: false Georgia is a university qualified Naturopath, professional member of the Australian Traditional Medicine Society, accredited member of MTHFR Support Methylation & Genomics Institute, Honorary Adjunct Lecturer at Newcastle University, co-host of Hormone Health Podcast, and founder of Hormone Health Studio. Hormone Health Studio was founded by Georgia Hartmann. After being diagnosed with Premature Ovarian Insufficiency (POI) in her early 20s, she became a Naturopath to better understand her body and hormones. Through years of study, functional testing, and a holistic approach, she went on to naturally conceive three children - despite being told it may not be possible. Her experience is at the heart of everything we do. Hormone Health Studio exists to support women through every stage of hormonal health - with compassion, clarity, and evidence- based care that works. We are your go-to naturopaths for all things hormones. Endometriosis, PCOS, PMS/PMDD, gut issues, skin conditions like eczema & acne, perimenopause/menopause, sleep, stress & anxiety, thyroid dysfunction, period problems, infertility, recurrent pregnancy loss, IVF support, preconception, pregnancy, postpartum, fatigue, mood & energy problems, weight & everything in between. We are largely focused on women's health but we also help men and children too. ### Types of appointments offered We offer online only initial and couple's initial fertility consultations. We then offer online follow up and couple's follow up fertility consultations. Hoping to have another in person clinic again soon but currently just digital. We also have online self paced programs too like our [Feel Good program](https: --- ## Get cliterate! This is how your clitoris works URL: https://www.womenshealthpathway.com/blogs/get-cliterate-this-is-how-your-clitoris-works/ Description: Discover how the clitoris really works, its anatomy, function, and role in sexual pleasure. Evidence-based information to help you understand your own body. Metadata: - intro: Discover how the clitoris really works, its anatomy, function, and role in sexual pleasure. Evidence-based information to help you understand your own body. - metaDescription: - publishDate: 2026-03-28 - author: Dr Suzanne Belton PhD - authorSlug: suzanne-belton - featuredImage: suzanne-belton-feature.jpg - tags: vaginal-vulva-health,sexual-health - draft: false - hcp: true - headingTitle: Get cliterate! This is how your clitoris works - headingSubtitle: You have a clitoris. Great, it’s not a button for a start! The clitoris is part of female genitals whose primary function is sexual pleasure. When it is stimulated, it can lead to orgasm but that doesn’t mean pleasure is only physical or limited to one area. Your thoughts, emotions, context, and sense of safety all play a role too. - headingDescription: You have a clitoris. Great, it’s not a button for a start! The clitoris is part of female genitals whose primary function is sexual pleasure. When it is stimulated, it can lead to orgasm but that doesn’t mean pleasure is only physical or limited to one area. Your thoughts, emotions, context, and sense of safety all play a role too. ## So, what is the clitoris? The clitoris is a specialised organ made mostly of erectile tissue and nerve endings. Its only known function is to create pleasure. Research shows that the clitoris contains thousands of nerve endings—more than any other part of the human body—making it highly sensitive to touch, pressure, vibration, and temperature.[^1][^2] ## What does it do? The clitoris responds to sexual stimulation. When touched or aroused, it fills with blood, becoming engorged and more sensitive. This is sometimes described as the clitoris "ripening." Stimulation—such as stroking, pressure, licking, vibration, or warmth—can create pleasurable sensations that may build toward orgasm.[^3] Orgasms are rhythmic, involuntary muscle pulsations that are felt in the pelvis, vagina, anus, and across the body. They are not just localised; they are whole-body experiences influenced by the nervous system. During orgasm, the body releases hormones such as oxytocin, which promotes feelings of relaxation, bonding, and wellbeing.[^4] Importantly, orgasms originate from the clitoral network. Even when pleasure is felt deeper inside the body, it is typically due to stimulation of the internal parts of the clitoris. ## What does it look like? The clitoris is shaped like a wishbone and is an internal and external organ. Many people think the clitoris is just a small "button," but that's only the visible part, called the glans. The glans is at the top of the vulva, where the inner lips meet. It is highly sensitive and often covered by a fold of skin called the clitoral hood. The shaft of the clitoris extends inward from the glans and is usually about 1 to 2 cm long on the outside. Internally the clitoris branches into a larger structure known as the clitoral complex. This includes two long "legs" (called the crura) which attach to the pubic bone and two bulbs. Altogether, the clitoral complex is on average 9 cm in size.[^1] ## Where is it? The clitoris is found at the top of the vulva, above the urethral opening (where urine comes out) and the vaginal opening. While the glans is external, most of the clitoris is inside the body. The internal bulbs "hug" the vagina and urethra. This means that stimulation of the vagina can also stimulate the internal clitoris, particularly the bulbs. This helps explain why some women experience pleasure (or orgasm) from vaginal touch, pressure or stretch, even though the vagina has fewer nerve endings compared to the clitoris.[^2] (The easiest way for women to orgasm is by stimulating the external clitoris and vulva lips.) ## Why isn't it mentioned in most sexual health information? For a long time, the clitoris was ignored in medical research, education, and public discussion. Historically, books either censored it or described it inaccurately. Negative cultural attitudes toward sexuality—especially women's pleasure—also played a role. Topics related to pleasure were considered taboo or unimportant compared to reproduction. As a result, women and girls grew up without accurate information about their own bodies. Even today, some sexual health education focuses heavily on risk (like pregnancy and sexually transmitted infections) and leaves out pleasure and anatomy.[^1][^5] However, this is changing. Recent research and education efforts are recognising the importance of the clitoris and providing evidence-based information about bodies and pleasure. ## Understanding your body The best way to understand your body is through curiosity and exploration. Learning what feels good to you—start by yourself. It is safe and does not cause harm. Everyone's body is different, and there is no "right" way to experience sexual pleasure or orgasm. Think about how you talk about your vulva, labia, and clitoris. Using clear, respectful language helps build confidence and makes it easier to communicate with others. You are the expert on your own body! Knowing what you like—and being able to express it—is an important part of sexual wellbeing. [^1]: O'Connell, H. E., Sanjeevan, K. V., & Hutson, J. M. (2005). Anatomy of the clitoris. *Journal of Urology*, 174(4), 1189–1195. [^2]: Puppo, V. (2013). Anatomy and physiology of the clitoris, vestibular bulbs, and labia minora with clinical implications. *Clinical Anatomy*, 26(1), 134–152. [^3]: Levin, R. J. (2006). The physiology of sexual arousal in the human female: A recreational and procreational synthesis. *Archives of Sexual Behavior*, 35(2), 129–151. [^4]: Komisaruk, B. R., Beyer-Flores, C., & Whipple, B. (2006). *The Science of Orgasm*. Johns Hopkins University Press. [^5]: Wade, L. D., Kremer, E. C., & Brown, J. (2005). The incidental orgasm: The presence of clitoral knowledge in sexual health education. *Sex Education*, 5(1), 59–72. --- ## Hormone Health Studio URL: https://www.womenshealthpathway.com/resources/podcasts/hormone-health-studio/ Metadata: - subtitle: - author: Georgia Hartmann and Chloe Sheehan - publishDate: 2025-08-15 - tags: menopause - category: podcast - image: /images/reviews/podcasts/hormone-health.jpg - infoLink: - purchaseLink: - draft: false - spotifyLink: https://open.spotify.com/show/1R7s1XLSnWMp6fjkkqVFnK - appleLink: https://podcasts.apple.com/au/podcast/hormone-health-podcast/id1694631245 - googleLink: - youtubeLink: Hormone Health Podcast is a vibrant, evidence-based series hosted by naturopaths Georgia Hartmann and Chloe Sheehan, founders of the Newcastle-based Hormone Health Studio. It’s designed to demystify hormonal health and empower listeners with practical, holistic insights. Topics include: - Perimenopause, fertility, and menstrual health - Gut-brain-hormone connections - Birth preparation and physiological pain - Mental health, fatigue, and functional medicine --- ## How does strength training impact your pelvic floor? URL: https://www.womenshealthpathway.com/blogs/how-does-strength-training-impact-your-pelvic-floor/ Metadata: - intro: - metaDescription: Expert advice on how strength training affects your pelvic floor. Learn about dysfunction signs, proper lifting techniques, and evidence-based rehabilitation strategies. - publishDate: 2025-08-14 - author: Dr Grainne Donnelly - authorSlug: grainne-donnelly - featuredImage: grainne-donnelly-feature.jpg - tags: prolapse,continence,vaginal-vulva-health - draft: false - hcp: true - headingTitle: How does strength training impact your pelvic floor? - headingSubtitle: - headingDescription: If you are a female engaging in any form of strength training from high intensity interval training to hyrox or power lifting, you may have heard conflicting messages about what this could mean for your pelvic floor. There is a plethora of misinformation and pseudoscientific messages online and in social media platforms. This can make it difficult to understand what the right thing is to do or not do. This article will break down the current scientific and clinical understanding of strength training and the pelvic floor. First, we will discuss what the pelvic floor is and what it does. The we will look at signs of a dysfunctional pelvic floor and what to do about it. Lastly, we will specifically focus on strength training and what it means for the pelvic floor. ## What is the Pelvic Floor? First and foremost, the female pelvic floor is an incredibly important muscle group. It represents a group of muscle spanning the base of the pelvic outlet in layers with its attachments suspended around the bony perimeter of the pelvis and not one, not two but three intersections compromising it in the form of the urethral, vaginal and rectal openings. It serves to support the pelvic organs, facilitate bladder and bowel control and emptying, and facilitate reproduction. I like to think of the pelvic floor as a trampoline, a structure that needs to be flexible enough to accept and absorb load with enough integrity and strength to give back and respond. Therefore, if the pelvic floor “trampoline” is too stiff, too lax or compromised in its attachments around the perimeter, it may not function as intended. ## What are the signs and symptoms of Pelvic Floor Dysfunction? If the pelvic floor is not functioning as intended, any and all of the roles it is involved in can be compromised (Donnelly and Moore 2022). These include: - Urinary frequency, urgency and or incontinence - Bowel frequency, urgency or incontinence - Difficulty emptying the bladder or bowel fully - Straining to empty the bowel - Heaviness, pressure or dragging in the vaginal area - Pain anywhere in the saddle region or “inside” - Recurrent urinary tract infections - Pain with intercourse - Inability to tolerate intravaginal products e.g., tampons, menstrual cups, smear tests The presence of one or more of these signs and symptoms need not scare you – across the female lifespan they are actually very common. At least 1 in 3 women will leak from the bladder (Lawrence et al, 2008; Sims et al, 2022) and 1 in 2 women will experience pelvic organ descent (with varying degrees of awareness and symptoms) (Donnelly and Moore 2022). However, they are not to be accepted or suffered either. Like any sports related niggle or injury, we address the presenting symptoms and rehabilitate the driving area. Did you know that there is a dedicated specialist physiotherapy profession who solely deal with pelvic floor dysfunction. That’s right – that is how many people need pelvic floor rehabilitation. ## Why might strength training influence symptoms of pelvic floor dysfunction? Firstly, strength training is not harmful or risky. It is a fundamental component of staying strong and protecting muscle mass and bone density throughout the lifespan. This includes the beneficial effect that strength training will have on building pelvic floor muscle strength and endurance as it trains to meet the demands of the load placed upon it. However, like any area in the body, the level of resistance that we can tolerate depends on the load capacity of the tissues (Gabbett, 2023). This means that while you may be ready to lift a certain barbell weight or kettlebell in terms of your lower limb, upper limb or trunk strength, you may not have the necessary load tolerance in the pelvic floor. This will ultimately lead to exposing symptoms of pelvic floor dysfunction on a lift/exertion. Just like you strengthen the other muscle groups around the body so that you can progress your deadlifts or bench press or any other strength training exercise, you need to engage in targeted strengthening for the pelvic floor too. For some women, it isn’t so much that their pelvic floor is weak or lacking structural integrity - it could be more to do with the strategy they employ during resistance training. For example, some women breath hold and brace their abdominal wall and trunk in order to lift heavy. This bracing and breath hold places additional load and abdominal pressure down onto the pelvic floor (Prevett and Moore 2024). This may be enough to tip the balance from being able to tolerate the load to not being able to tolerate it with signs of load intolerance represented in symptoms such as pain, leaking urine or a heaviness or bulge sensation in the vaginal region. Altering strategies to try to “blow as you go” (breath out of the effort of the strength exercise) or brace the abdominal muscles less intensely may be enough to reduce or alleviate symptoms. Check out this podcast for more information on [resistance training and the pelvic floor](https: ## What should I do if I have signs and symptoms of pelvic floor dysfunction? You can speak with you GP or primary care physician to ask for a referral to your local pelvic health specialist or if you prefer to access healthcare privately there will be a local private pelvic health physiotherapist in your region. Generally speaking, most people benefit from engaging in pelvic floor muscle training – the difficulty is that it can be hard for everyone to know how to do them. If you are unsure they best option is to get assessed and access guidance from a specialist physiotherapist – however typical cues to locate and train the pelvic floor include: - Imagine you are stopping wind escaping from the back passage - Imagine stopping the flow of urine mid-flow - Imagine closing a zip from back passage to front passage - Close the vagina No one cue suits everybody therefore consider the cues above and whether you feel a tightening and lifting in the pelvic floor region. It isn’t clenching your glute muscles or squeezing your legs together, it is specifically the muscles in and around the saddle region. Aim to do 3 sets of 8-12 repetitions of close to maximum contractions (Donnelly and Moore 2022). For women who wish to continue strength training while they seek help and rehabilitate their pelvic floor, or after they have reached their rehabilitation potential, several adjunctive products can help with pelvic floor function and support (Giagio and Donnelly 2025). These include compression shorts – which direct compression up towards the pelvic floor. I am researching these in my PhD and they are showing significance in mechanical support, symptom reduction and user perception. Other adjuncts include pessaries (which support the pelvic organs), urethral support devices (support the urethra/bladder) and vaginal weights which can help you progress pelvic floor muscle strengthening. ## References Donnelly GM, Moore IS. [Sports Medicine and the Pelvic Floor](https: Gabbett T. [Load Management: What It Is and What It Is Not!](https: Giagio S, Salvioli S, Innocenti T, et al [PFD-SENTINEL: Development of a screening tool for pelvic floor dysfunction in female athletes through an international Delphi consensus](https: Giagio, Silvia PhD1,2; Donnelly, Grainne M.3. [Persistent Pelvic Floor Dysfunction in Female Athletes: A Commentary on Postconservative Management](https: Lawrence JM, Lukacz ES, Nager CW, Hsu JW, Luber KM. [Prevalence and co-occurrence of pelvic floor disorders in community-dwelling women](https: Prevett C. & Moore R. (2024) [Nuances of the Valsalva manoeuvre and bracing with regard to resistance training performance and its effects on the pelvic floor](https: Sims L, Hay-Smith J, Dean S. [Pelvic floor exercises and female stress urinary incontinence](https: --- ## How hypnotherapy can support women living with health challenges URL: https://www.womenshealthpathway.com/blogs/how-hypnotherapy-can-support-women-living-with-health-challenges/ Metadata: - intro: - metaDescription: Discover how hypnotherapy supports women with health challenges like prolapse, incontinence, and menopause. Evidence-based mind-body healing approach. - publishDate: 2025-08-29 - author: Justine Daly - authorSlug: justine-daly - featuredImage: justine-daly-feature.jpg - tags: continence,prolapse,menopause - draft: false - hcp: true - headingTitle: How hypnotherapy can support women living with health challenges - headingSubtitle: - headingDescription: Mindset is more than positive thinking. It’s the lens through which we experience health and illness, influencing resilience, wellbeing, and how fully we live despite a diagnosis. I once supported a dear friend whose strength continues to inspire me. A few years ago, she was diagnosed with ovarian cancer, a diagnosis that changed everything for her and those who loved her. We spent many hours together talking openly about what her illness meant—the silent fears, the constant “what ifs,” and the invisible weight of worrying about her family’s future. Her physical symptoms were mirrored by emotional ones: a racing mind, sleepless nights, and the dark cloud of uncertainty about what lay ahead. She had an exceptional medical team and explored several complementary therapies, each offering its own value. Among them were her hypnotherapy sessions with me. She often told me that these sessions gave her a sense of lightness, calm, and space to breathe more deeply. Sometimes, that meant a better night’s sleep. Other times, it brought relief from the relentless anxiety and a little more energy to face the day. These were not magical cures, but they were tangible changes—small but significant moments of peace in a time of intense challenge. When we face health conditions that affect our bodies, the medical approach often focuses on the physical, on treatment options and symptom reduction through surgery and medication. Whether reproductive cancer, pelvic organ prolapse, incontinence, or the changes of menopause, the impact extends beyond the physical. There can be a loss of confidence, a shift in identity, and an overwhelming sense of responsibility for our loved ones’ wellbeing. Even with the best support, it can feel isolating. Hypnotherapy offers a safe, natural space to address both the physical and emotional toll of these experiences. It works alongside medical care to ease anxiety, improve coping, and restore a sense of control. Research shows that hypnotherapy can reduce symptom severity and lessen psychological distress, which in turn can lower the perception of discomfort. For women living with prolapse or incontinence, for example, releasing feelings of embarrassment and shame can help restore confidence in daily life. For those navigating menopause, hypnotherapy can reduce hot flushes, improve sleep quality, and ease mood fluctuations. The benefits extend further than symptom relief. Hypnotherapy can help you feel calmer before medical procedures, manage pain and fatigue, and release feelings of guilt about “being a burden” to loved ones. It can lift low mood, build resilience in the face of physical change, and reignite a sense of optimism. The mind and body are deeply connected; when your mind is calmer, your body has more space to heal, and when you cope better, life feels more manageable. Living with a health challenge does not have to mean losing your sense of comfort or hope. Hypnotherapy works gently and powerfully, helping you reconnect with your body’s own capacity for balance and repair. Wherever you are in your journey, whether newly diagnosed, in recovery, or living long term with your condition, it is possible to feel more at peace, more in control, and more connected to the life you want. If you are navigating a health challenge such as prolapse, incontinence, menopause, or a serious illness, know that there is support for your whole self, mind and body. You do not have to carry the weight alone. --- ## How Perimenopause Impacts Physical Health and Muscle Pain: An Osteopath’s Perspective URL: https://www.womenshealthpathway.com/blogs/how-perimenopause-impacts-physical-health-and-muscle-pain/ Metadata: - intro: - metaDescription: Discover how perimenopause impacts muscle pain, joint health and overall physical wellbeing. Learn how a Women’s Health Osteopath in Newport supports women through this transition with evidence-based care and holistic treatment. - publishDate: 2025-12-15 - author: Dr Ashton Wilson - authorSlug: ashton-wilson - featuredImage: ashton-wilson-feature.jpg - tags: menopause - draft: false - hcp: true - headingTitle: How Perimenopause impacts physical health and muscle pain: an Osteopath’s perspective - headingSubtitle: Discover how perimenopause impacts muscle pain, joint health and overall physical wellbeing. Learn how a Women’s Health Osteopath in Newport supports women through this transition with evidence-based care and holistic treatment. - headingDescription: Discover how perimenopause impacts muscle pain, joint health and overall physical wellbeing. Learn how a Women’s Health Osteopath supports women through this transition with evidence-based care and holistic treatment. [Perimenopause](https: and musculoskeletal health. As a Women’s Health Osteopath working with women across all life stages, I see firsthand how perimenopause affects the body, daily function, and overall wellbeing. While hot flushes, irregular cycles, and mood changes are commonly discussed, the physical symptoms — particularly muscle pain, joint stiffness, and reduced recovery — often go unnoticed or unvalidated. Yet for many women, these are some of the most impactful changes. Let’s break down why this happens, and how an Osteopath can support you through this stage with personalised, holistic care. ## 1. Hormonal Changes Affect Muscles, Joints & Fascia During perimenopause, [levels of oestrogen fluctuate](https: - Muscle mass and tone - Collagen production (affecting ligaments, fascia and skin) - Joint lubrication - Bone density - Inflammation regulation As these hormones shift, many women begin to experience: - Widespread muscle aches - Joint stiffness, especially in the morning - Increased tendon irritation (common in the Achilles, rotator cuff, hips, Frozen Shoulder) - Reduced flexibility - Greater sensitivity to pain This isn’t “in your head” — your body is responding to real physiological changes. ## 2. Increased Systemic Inflammation Oestrogen has an [anti-inflammatory](https: - Soreness after light workouts - Feeling “old” or stiff when getting out of bed - Slower recovery after physical activity - Heightened muscle tension As an osteopath, I often see women in perimenopause who suddenly feel like their usual exercise routine is becoming harder or more painful. The culprit is usually this shift in inflammatory response. ## 3. Sleep Disruption Worsens Pain & Healing [Sleep quality](https: - Increased muscle soreness - Slower tissue healing - Heightened pain perception - Reduced energy for activity or rehab Addressing sleep — whether through lifestyle strategies or coordinated care with other health professionals — is a key part of effective osteopathic support. ## 4. Stress, Mood & the Nervous System Perimenopause can amplify [stress responses](https: - Increasing muscle tension (particularly neck, shoulders, jaw) - Heightening pain sensitivity - Reducing your ability to “switch off” or relax - Causing postural changes from bracing or tension As osteopaths, we consider nervous system balance just as much as structural function, because they are deeply connected. ## 5. Why Osteopathic Treatment Helps During Perimenopause A Women’s Health Osteopath focuses on the full picture: hormones, nervous system, lifestyle, movement patterns, stress, and musculoskeletal health. Osteopathic care during perimenopause may include: **Gentle hands-on treatment** To reduce muscle tension, improve joint mobility, and support circulation. **Individualised exercise programs** Targeting strength, flexibility, bone health and load management. **Education on pacing, recovery & exercise adaptation** Because your body may need a different approach now — but you can still move and train with confidence. **Support for stress & nervous system regulation** Breathing techniques, mobility drills and lifestyle strategies to help reduce tension. **Collaborative care with women’s health professionals** Including GPs, pelvic health physios, dietitians and mental health practitioners. The goal is not just symptom relief, but helping you feel strong, supported and informed throughout this transition. ## 6. When You Should See an Osteopath Seek help from an Osteopath or a [Women’s Health Osteopath](https: - New or unexplained muscle or joint pain - Stiffness that doesn’t improve with movement - Tendon pain that keeps returning - Fatigue or slower recovery from exercise - Heightened stress or tension through the neck, back or pelvis - A sense that your body is “different” or not functioning the way it used to Early support can make a huge difference — not just for pain, but for long-term mobility, bone health and confidence in your body. ## Final Thoughts Perimenopause is a chapter of transition — not decline — and with the right support, you can continue to feel strong, capable and empowered in your body. Osteopathic care provides a holistic, personalised approach that honours the full complexity of what women experience during this time. If you’re navigating perimenopause and want guidance, gentle treatment, and a clear plan forward, our team of [Osteopaths at Alpha Sports Medicine in Newport](https: --- ## How Recurrent Thrush Causes Vulvodynia: A Preventable Disability URL: https://www.womenshealthpathway.com/blogs/disabled-by-thrush/ Metadata: - intro: - metaDescription: Severe thrush infections can cause permanent vulval nerve damage (vulvodynia), yet women receive no warning. Learn the symptoms, prevention strategies, and why medical guidelines must change to protect women's health. - publishDate: 2025-12-07 - author: Phillipa Baines - authorSlug: phillipa-baines - featuredImage: phillipa-baines-feature.jpg - tags: vaginal-vulva-health - draft: false - hcp: false - headingTitle: Disabled by Thrush - headingSubtitle: Why wasn't my life worth saving? - headingDescription: Recurrent thrush can cause permanent vulval nerve damage, yet women receive no warning. Medical bodies have known about the link between severe thrush infections and vulvodynia for years, but prevention strategies remain non-existent. This is one woman's story of preventable disability and why the healthcare system must do better. Why wasn't my life worth saving? Is a question that rattles around in my mind a lot. In October 2022, I had my 10th thrush infection. It was drug-resistant. Lasted 2 months and gave me nerve damage of the vulva. I now live with a burning feeling in my genitals 24/7. The level of pain averages out at 6/10 and my career dreams are over, along with my hope for having a baby and starting a family. Almost daily, I regret being born. Specifically, being born a woman. They've known a severe thrush infection causes vulval nerve damage for quite some time. ‘They' being The British Association of Dermatologists, who list thrush as a trigger event for ‘vulvodynia': ‘Secondary vulvodynia may follow inflammation in the vulva, such as that caused by thrush or the overuse of topical and vaginal anti-thrush treatments.' And the Vulval Pain Society knows, to quote: “a commonly recognised event is a severe attack of thrush followed by anti-thrush treatment. Once the attack of thrush settles following treatment, soreness and burning may persist as vestibulodynia.” It was also listed as a predisposing factor to developing vestibulodynia in the 2015 meeting on the definition of vulvodynia held by ISSVD, ISSWSH and the IPPS – 'Some women …have a genetic predisposition to developing this condition …: genetic polymorphisms that increase the risk of candidiasis” And so I sit here holding an ice pack to my groin and wonder – why no prevention strategy? Why no warning to women prone to thrush before the nerve damage develops? Two sentences on the NHS website warning of the link could have saved my life. Here is what I'm suggesting: "There is an association between thrush and vulval nerve damage, a chronic pain condition called vulvodynia. Women prone to thrush should take all reasonable measures to bring their rate down and consult a vulval clinic if they have any concerns." This could have saved my life. As I could have taken my thrush predisposition seriously. I wouldn't have had the coil fitted, which significantly increases your risk of thrush (Marcos et al 2010). I could have stopped drinking beer, which was a known trigger for me. I could have gone immediately to a vulval clinic when the thrush lasted more than two weeks. And they'd have been able to help me tackle the infection using treatments sensitive to the nerve-packed vulval vestibule. The current guidelines to treat severe thrush with clotrimazole pessary after cloterimazole pessary after clotrimazole pessary (14 to be precise), irritates the vestibule even further according to the British Association of Dermatologists. So why haven't they updated the guidelines? When the pain first started for me, I made a full recovery. From October 2022 to March 2023 - my nerves calmed down and I got better. But because I was never diagnosed, as I was never referred to a vulval clinic. My GP didn't know they existed and the GUM clinic where I was being cared for said the waitlist was so long for gynaecology departments that there was no point in going to see them if I was improving anyway. And indeed gynaecologists aren't taught about the vulva. So they wouldn't have helped. Despite 51% of the population having a vulva, vulval pain syndromes are seen as a niche speciality within medicine. Despite 1 in 4 women developing vulvodynia in a lifetime, only vulval clinics have any understanding of the vulval tissues. The nerve-packed hormone-dependent vestibule that gets irritated so easily, located at the entrance of the vagina. Medicine should serve the needs of the population. But women are let so severely down. Thrush is not something that pharmacists should roll their eyes at. But a condition that can cause disability via chronic pain. And can increase a woman's chance of suicide by over 300% due to the impact of chronic pain. In the absence of any medical entity wanting to drive change and protect women's lives - I set up [www.thrush-support.com](https: A resource hub to help thrush-prone women bring down their rates and get to the right doctors in time to stop nerve damage before it starts. I raise awareness on [Instagram](https: Despite this, I've had no Doctors or governmental health bodies approach me saying – we really should be doing something about this. Let's collaborate. Every woman's life is worth safeguarding. And that starts with taking their health issues seriously. And listening to their voices. I thank Women's Health Pathway for really appreciating the magnitude of this issue and allowing me this platform to warn others. No woman should be made disabled by a thrush infection. Every woman's life is worth saving. --- ## InVisible URL: https://www.womenshealthpathway.com/resources/podcasts/invisible/ Metadata: - subtitle: - author: Dr Ashton Wilson - publishDate: 2025-08-15 - tags: menopause - category: podcast - image: /images/reviews/podcasts/invisible.jpg - infoLink: - purchaseLink: - draft: false - spotifyLink: https://open.spotify.com/show/6PBTSEhANoW3DOcuIMKLto - appleLink: https://podcasts.apple.com/au/podcast/invisible/id1807698698 - googleLink: - youtubeLink: InVisible is a bold, stigma-breaking podcast hosted by Dr Ashton Wilson, an osteopath, business owner, and passionate advocate for hypermobility and invisible illnesses. This podcast shines a light on conditions that are often misunderstood or overlooked in mainstream healthcare, like hypermobile Ehlers-Danlos syndrome (hEDS), lipedema, autism, ADHD, and chronic pain. Ashton blends clinical insight with lived experience, creating a space for education, empathy, and advocacy. --- ## Justine Daly URL: https://www.womenshealthpathway.com/resources/telehealth/justine-daly/ Metadata: - name: Justine Daly - authorSlug: justine-daly - role: Clinical Hypnotherapist, Childbirth educator, Midwife - businessName: You Hypnotherapy / A Focused Birth - url: https://www.youhypnotherapy.com - country: Australia - metaTitle: Justine Daly | Telehealth Provider | You Hypnotherapy - metaDescription: - publishDate: 2025-09-11 - featuredImage: justine-daly.jpg - tags: hypnotherapy,childbirth - draft: false Justine Daly is a registered midwife, clinical hypnotherapist, and educator based in Melbourne, Australia. She offers telehealth consultations across a wide range of health and wellbeing concerns, with a particular passion for supporting women through significant life transitions such as conception, birth, and menopause. With over 25 years of clinical experience, Justine combines evidence-based healthcare with advanced hypnotherapy and psychotherapy techniques. Her approach draws on the science of neuroplasticity, helping clients reframe unhelpful patterns, build resilience, and create lasting change. Clinical hypnotherapy is increasingly recognised as an effective approach for managing anxiety and depression. Research also supports its benefits for chronic pain, phobias, irritable bowel syndrome, migraines, and trauma-related symptoms. During sessions, Justine works collaboratively with clients to clarify goals, identify strengths, and guide them into states of focused relaxation where therapeutic change can take place. Each consultation includes practical strategies to reinforce progress, ensuring clients feel supported between appointments. Many report feeling calmer, clearer, and more in control after working with her. ### Antenatal and Hypnobirthing Education Alongside her therapeutic practice, Justine provides both telehealth and in-person education for expectant families through her [A Focused Birth hypnobirthing programme](https: Her classes cover evidence-based information about birth physiology, practical comfort measures, and relaxation methods including breathing and self-hypnosis. Justine creates a supportive space for discussion, answering questions and addressing concerns so families feel informed and empowered in preparing for parenthood. --- ## Kirsty Dixon URL: https://www.womenshealthpathway.com/resources/telehealth/kirsty-dixon/ Metadata: - name: Kirsty Dixon - authorSlug: kirsty-dixon - role: Menopause advocate, Educator - businessName: Feel Good Menopause - url: https://www.feelgoodmenopause.co.uk - country: UK - metaTitle: Kirsty Dixon | Telehealth Provider | Menopause advocate, Educator - metaDescription: - publishDate: 2025-09-11 - featuredImage: kirsty-dixon.jpg - tags: menopause - draft: false At 51, I embarked on a new career as a Learning & Development Practitioner, specialising in menopause workshops and talks. I’ve never felt more fulfilled. It’s why I started Pause for Thought Consultancy in 2022, which has now become Feel Good Menopause: to raise awareness, share knowledge, and help others have a better journey. Starting my own business has been a leap of faith, but it’s the best decision I’ve made. --- ## Kristen Parise URL: https://www.womenshealthpathway.com/resources/telehealth/kristen-parise/ Metadata: - name: Kristen Parise - authorSlug: kristen-parise - role: Registered Pelvic Health Physiotherapist, Podcast Host, Conference Creator - businessName: Blueberry Therapy - url: https://blueberrytherapy.ca - country: Canada - metaTitle: Kristen Parise | Telehealth Provider | Registered Pelvic Health Physiotherapist - metaDescription: Kristen Parise has dedicated over 25 years to transforming pelvic health care through evidence-based treatment and fearless conversation. - publishDate: 2025-09-11 - featuredImage: kristen-parise.jpg - tags: continence,vaginal-vulva-health - draft: false Kristen Parise has dedicated over 25 years to transforming pelvic health care through evidence-based treatment and fearless conversation. With graduate degrees in Exercise Physiology and Physiotherapy from McMaster University, she founded Blueberry Therapy in 2017—a multidisciplinary clinic in Dundas, Ontario, that has grown from a small practice to a thriving hub serving families throughout the Golden Horseshoe. Recognized with the 2020 YWCA Women of Distinction Award for Small Business, Kristen specializes in treating bladder, bowel, and sexual dysfunction for people of all ages. Her approach combines clinical expertise with refreshing honesty about topics many find too awkward to discuss. In 2024, Kristen launched The Hole Shebang Podcast, which has spent a full year breaking down taboos around pee, poop, pain, and sex. The podcast has reached thousands of listeners seeking real answers about pelvic health without the shame. Building on her mission to advance women's sexual health conversations, Kristen created The Pleasure Principle Conference. After its successful debut in 2025, the expanded 2026 conference returns on May 8th at McMaster Innovation Park, bringing together healthcare professionals from around the globe to tackle the topics that matter most to women's wellness. Kristen continues teaching at McMaster University and remains committed to making pelvic health care accessible through Blueberry Therapy's comprehensive services, online resources, and community education programs. [The Hole Shebang Podcast](https: --- ## Lichen Sclerosus URL: https://www.womenshealthpathway.com/blogs/lichen-sclerosus/ Metadata: - intro: - metaDescription: Emma Norman's powerful story living with lichen sclerosus from childhood. Breaking the silence around vulvar conditions and advocating for awareness. - publishDate: 2025-08-19 - author: Emma Norman - authorSlug: emma-norman - featuredImage: emma-norman-feature.jpg - tags: vaginal-vulva-health - draft: false - hcp: false - headingTitle: Lichen Sclerosus - headingSubtitle: - headingDescription: I want medical professionals to have training on Lichen Sclerosus and Vulva Cancer. I want leaflets in all surgeries and hospitals. I want children to be taught about Lichen Sclerosus in Sex Education lessons at school. Hi, My name is Emma Norman and I have Lichen Sclerosus. I was diagnosed at 22 years of age but my symptoms started during childhood (my first recollection was being 5 yrs old and screaming in a classroom) I stayed away from boyfriends and sexual intercourse because inside I knew something wasn't right but I was too embarrassed and ashamed to go to the Dr. I figured he would just tell me it was in my head or something similar. I decided to go see my Dr when I was 22 years old following a discussion with a boyfriend at the time. I had tried to have intercourse but was never able to have penetration due to the excruciating pain. He had a look at my Vulva and decided to send me for a smear. This was when I heard the sole shattering words from the nurse "were you abused as a child? I can't even get the smallest speculum in as your too small" I went home and broke my heart, sobbing uncontrollably. I plucked up the courage that night to get a mirror and look at my Vulva. I was bruised purple, red, white, crinkly, had lost my labia minora where it had fused to my labia majora, my clitoris was buried under skin, I was itching and burning like I was on fire. It was the most horrific sight I had ever seen. My Dr referred me to a gynaecologist at my local hospital where I met the most amazing consultant. He biopsied me and within a couple of weeks I had my diagnosis, Lichen Sclerosus. He didn't know enough about it to treat me and so I was referred to a specialist at a well-known London hospital. This is where things took a turn for the worse. The ladies treating me (one with large pointed false nails whilst doing internal checks) decided to admit me for 3 days and start a dialator treatment to widen the opening of my Vagina. Now Dialators come in packs of 8 sizes. Size 1 being as small as a little finger - size 8 being as big as an 'average' penis. At no point was I in control of any of these dialators being inserted into my Vagina!! On the first day she started with size 1, then size 2, then size 3. I was bleeding and in agony and crying. I was burning trying to urinate and it took me a good hour at least to urinate once. On day 2 she used size 3, size 4 and went to try size 5 with me begging for mercy. This was when I contacted my consultant back home and told him what was happening. To say I was being discharged with an apology within an hour would be pretty accurate. In fact he used my ordeal with all female patients using dialators to educate and ensure it was never repeated again. From there on I was referred to a Gynae oncologist who knew very little about Lichen Sclerosus but was very experimental. I had 3 clitoral hood separations, which never lasted long as the skin always grew back over within a few months, 2 skin grafts with a plastic surgeon which I have to say lasted years so was a better treatment long term as well as countless biopsies for pre cancer cells. I was put on Dermovate from the first appointment with her and have used it ever since (approximately 12 years now). I must point out that there were some very dark times during the early stages of diagnosis. Times when I felt like a freak, like I wasn’t good enough, worthless, suicidal, in a deep depression and that I would never be able to have a child of my own due to this incurable condition. Flash forward to 5.5 years ago when I welcomed my beautiful daughter into the world via c section and things couldn't be more different now. I won't lie, sex is unbearably painful still so I still avoid it. But those thoughts and feelings of hopelessness, of not feeling worthy or not wanting to live have gone. Now I have turned those feelings into passion. A passion to make a difference to many women, Men and children who have Lichen Sclerosus, the ones who have been diagnosed but aren't getting the help they need and the ones who are still being mistreated for Thrush time and time again, the ones who don't yet know they have Lichen Sclerosus and need immediate treatment starting. That is why I run support groups for women and men with Lichen Sclerosus, it's why I have started the awareness website, Facebook, Twitter and Instagram pages. I want to spread the word and get the symptoms out to as many people as I possibly can so they can get the diagnosis they need. I want medical professionals to have training on Lichen Sclerosus and Vulva Cancer. I want Leaflets in all surgeries and hospitals. I want children to be taught about Lichen Sclerosus in Sex Education lessons at school. I want more research and better treatments. To have stem cell treatments available on the NHS. These are my goals and i hope you will join me in making these things happen. --- ## Lichen Sclerosus Podcast URL: https://www.womenshealthpathway.com/resources/podcasts/lichen-sclerosus-podcast/ Metadata: - subtitle: - author: Kathy Ruiz-Carter - publishDate: 2025-12-15 - tags: vaginal-vulva-health - category: podcast - image: /images/reviews/podcasts/lichen-sclerosus.png - infoLink: - purchaseLink: - draft: false - spotifyLink: https://open.spotify.com/show/0kJYre8rVCLP7IHaJ8kvRu - appleLink: https://podcasts.apple.com/au/podcast/lichen-sclerosus-podcast/id1499515188 - googleLink: - youtubeLink: https://www.youtube.com/c/lichensclerosuspodcast Our journal of learning about and living with Lichen Sclerosus from a patient's point of view. Bringing community and awareness to a disorder that hardly anyone knows about. Join me as I research Lichen Sclerosus from every angle and share my struggles living with it. My hope is to build a community of survivors so we can affect change in our lives and the research. --- ## Live Well Be Well URL: https://www.womenshealthpathway.com/resources/podcasts/live-well-be-well/ Metadata: - subtitle: - author: Sarah Ann Maklin - publishDate: 2025-09-16 - tags: continence,prolapse,menopause - category: podcast - image: /images/reviews/podcasts/live-well-be-well.jpg - infoLink: https://lnk.to/niJn7C - purchaseLink: - draft: false - spotifyLink: https://open.spotify.com/show/4KzOtx55wRngyeKC9raJDn - appleLink: https://podcasts.apple.com/au/podcast/live-well-be-well-with-sarah-ann-macklin-health/id1508380100 - googleLink: - youtubeLink: https://www.youtube.com/channel/UCASEE6WVp31E3FNeM-Mk_bw Sarah Ann Macklin is a distinguished force in health, nutrition, and wellness advocacy, renowned for her dynamic approach and groundbreaking initiatives. As the founder and host of the top health podcast "Live Well Be Well," she has spent the last three years interviewing some of the world’s greatest minds, exploring the true essence of living well. --- ## Making Menopause Matter URL: https://www.womenshealthpathway.com/resources/books/making-menopause-matter/ Metadata: - subtitle: The Essential Guide - author: Diane Danzebrink - publishDate: 2025-08-15 - tags: menopause - category: book - image: /images/reviews/books/making-menopause-matter.jpg - infoLink: https://menopausesupport.co.uk/ - purchaseLink: https://www.sheldonpress.co.uk/titles/diane-danzebrink/making-menopause-matter/9781399812672/ - draft: false - spotifyLink: - appleLink: - googleLink: - youtubeLink: Diane Danzebrink is a psychotherapist, menopause educator, and founder of the #MakeMenopauseMatter campaign a grassroots initiative that’s reshaped public discourse around menopause in the UK. After experiencing a life-altering surgical menopause, Diane became a fierce advocate for better menopause education in schools, workplaces, and healthcare. Her work blends emotional intelligence, policy advocacy, and lived experience, making her one of the most trusted voices in menopause support today. Through her writing, speaking, and campaigning, she continues to break stigma and build safer, more informed spaces for women everywhere. Making Menopause Matter; this book is both a practical guide and a powerful call to action. It offers clear, compassionate insights into the physical, emotional, and social realities of menopause, it covers everything from hormone therapy and mental health to workplace support and medical care. With personal stories, expert advice, and advocacy tools, this book helps women feel seen, heard, and empowered. It’s not just a book, it’s a movement toward better education, healthcare, and dignity for all women navigating menopause. --- ## Making Menopause Matter URL: https://www.womenshealthpathway.com/resources/podcasts/making-menopuase-matter-podcast/ Metadata: - subtitle: - author: Diane Danzebrink - publishDate: 2025-08-15 - tags: menopause - category: podcast - image: /images/reviews/podcasts/making-menopause-matter.jpg - infoLink: - purchaseLink: - draft: false - spotifyLink: https://open.spotify.com/show/2BsTBPH4LjNHPNXUWsV3b5 - appleLink: https://podcasts.apple.com/gb/podcast/making-menopause-matter/id1818079720 - googleLink: - youtubeLink: Making Menopause Matter is the powerful podcast by Diane Danzebrink, founder of Menopause Support UK and creator of the #MakeMenopauseMatter campaign. - Honest, stigma-breaking conversations about menopause - Deep dives into symptoms, treatments, and emotional wellbeing - Self-care strategies, workplace support, and relationship insights - Episodes aligned with chapters from [Diane’s book Making Menopause Matter](/resources/books/making-menopause-matter/) --- ## Margo Kwiatkowski URL: https://www.womenshealthpathway.com/resources/telehealth/margo-kwiatkowski/ Metadata: - name: Margo Kwiatkowski - authorSlug: margo-kwiatkowski - role: Pelvic floor and orthopedic physical therapist - businessName: p4moms - url: https://www.p4moms.com - country: USA - metaTitle: Margo Kwiatkowski | Telehealth Provider | Pelvic floor and orthopedic physical therapist - metaDescription: - publishDate: 2025-09-11 - featuredImage: margo-kwiatkowski.jpg - tags: continence,prolapse,vaginal-vulva-health - draft: false Margo Kwiatkowski, PT, DPT, CSCS,PCES is a pelvic floor and orthopedic physical therapist based outside of Ojai, California. Her career began in professional sports, including time with the Los Angeles Dodgers, before transitioning into outpatient practice where she discovered her passion for pelvic health—especially in supporting postpartum athletes returning to peak performance. She holds certifications as a Strength and Conditioning Specialist, Pregnancy and Postpartum Corrective Exercise Specialist, and Body Ready Method Pro, with advanced training in pelvic organ prolapse management, including pessary fitting. Margo has helped thousands of women worldwide through both in-person and virtual care. In addition to clinical practice, she teaches continuing education courses for physical therapists on the management of prolapse and has created online programs designed to empower women living with prolapse to better understand their bodies and restore quality of life. ### Pelvic Health Coaching In addition to in-person physical therapy I offer virtual physical therapy to patients in California and wellness coaching to people world-wide. During sessions we speak in depth about your medical history, birth history, current symptoms (how they are evolving), what treatment you have tried so far, medical tests done (if any), what has been working and what seems to not be helping at this time. We go into detail about your bowel and bladder health/habits and break down your pelvic symptoms. I’ll take the time to educate you on certain topics along the way as they pertain to your situation. We look at your posture, spine motion, breathing, core contraction/stabilization, squats, hip hinges, lunges etc. I then select exercises for you that will help improve your functional movement, core and pelvic floor strength/coordination. After our session I send you a detailed email summary of what we talked about during the session. You will also receive individualized exercises in video form to help address your unique impairments. --- ## Menopause and vaginal health: The effects of low oestrogen and what to do about it URL: https://www.womenshealthpathway.com/blogs/menopause-and-vaginal-health/ Metadata: - intro: - metaDescription: Understanding low estrogen's impact on vaginal health during menopause. Natural and medical solutions for dryness, infections, and intimate wellness. - publishDate: 2025-09-16 - author: Sarah Henschel - authorSlug: sarah-henschel - featuredImage: sarah-henschel-feature.jpg - tags: menopause,vaginal-vulva-health - draft: false - hcp: true - headingTitle: Menopause and vaginal health: The effects of low oestrogen and what to do about it - headingSubtitle: - headingDescription: Menopause is a natural part of life, but it brings changes that aren’t always easy to talk about - especially vaginal health. Low oestrogen can impact the vaginal microbiome and tissue, causing dryness, irritation, and sometimes painful intimacy. The good news? There are both naturopathic and medical ways to support vaginal health and comfort during this transition. ## Why oestrogen matters for vaginal health Oestrogen does more than regulate periods - it keeps your vaginal tissue healthy and your microbiome balanced: - **Maintains moisture and elasticity** – helping prevent dryness and thinning. - **Supports healthy bacteria** – Lactobacillus thrives with estrogen, keeping the vagina slightly acidic and protected from infection. - **Boosts blood flow** – which helps tissue repair and overall comfort. When oestrogen drops during menopause, the vaginal walls can thin, the microbiome may shift, and dryness or discomfort can occur. ## Signs low oestrogen is affecting your vaginal health - Vaginal dryness or itching - Pain during sex - Recurrent infections - Recurrent UTI´s - the urethra changes as oestrogen levels drop, making it easier for bacteria to stay around causing UTI´s – good news is, we can treat this issue with vaginal oestrogen creams or pessaries safely and easily - Increased vaginal pH (less “friendly” environment for healthy bacteria) ## Naturopathic tips to support vaginal health 1. **Eat for your microbiome** – probiotic foods (yogurt, kefir, sauerkraut) and phytoestrogens (soy, flax, chickpeas) can help. 2. **Stay hydrated and nourish tissues** – omega-3s from fish, chia, or flaxseed support vaginal elasticity. 3. **Use gentle moisturizers** – hyaluronic acid gels, aloe-based lubricants, or coconut oil can relieve dryness. 4. **Keep tissues active** – sexual activity or pelvic floor exercises improve blood flow and tissue health. 5. **Avoid irritants** – skip scented soaps, douches, and harsh detergents. ## Medical options - **Topical oestrogen** – creams, tablets, or rings restore tissue thickness and moisture. \*It can take a 3-12 months to notice the full effect as the vaginal tissue needs time to recover and repair itself - **Oral HRT** – helpful if you also have hot flashes or other menopausal symptoms. - **Non-hormonal therapies** – prescription moisturizers and gels if estrogen isn’t an option. ## Takeaway Vaginal health doesn’t have to suffer in menopause. Combining naturopathic strategies with medical support can help maintain comfort, intimacy, and confidence. Listen to your body, nourish your tissues, and seek guidance when needed—your vaginal health matters at every stage of life. --- ## Midlife desire – Where did my sexual self go? URL: https://www.womenshealthpathway.com/blogs/where-did-my-sexual-self-go/ Metadata: - intro: - metaDescription: A clinical psychologist unpacks the real reasons so many midlife women experience low libido—biology, psychology, and relationship quality all play a role. - publishDate: 2026-06-01 - author: Dr Nadia Boscaglia - authorSlug: nadia-boscaglia - featuredImage: nadia-boscaglia-feature.jpg - tags: sexual-health - draft: false - hcp: true - headingTitle: Midlife desire – Where did my sexual self go? - headingSubtitle: - headingDescription: Nearly half of midlife women report sexually related personal distress. A clinical psychologist and somatic sexologist unpacks the real picture: the hormonal, psychological, and relational factors driving low desire at midlife, and what it actually means for how you approach it. As a clinical psychologist who later completed training in somatic sexology, I've sat with countless women who ask, almost apologetically, if this is the right space to talk about sex, followed by: I just don't feel like it anymore, the lack of sex is straining my relationship, is there something wrong with me? There's nothing wrong with her, or you. In this post, I'll use a biopsychosocial framework to explore the changes in sexual response and desire that can occur in midlife for women. These changes do not occur for all midlife women of course, but the statistics are compelling. In a large-scale study published in *The Lancet* in 2025, almost 5,500 women aged 40 to 69 were surveyed; nearly half reported sexually related personal distress. Not a niche subgroup, not a clinical outlier. Half. Of those, low desire affected around 25% and low arousal 21.5%. An important distinction here: desire is the cognitive and emotional motivation to seek sexual experience, whereas arousal is the psychophysiological response to stimulation – feeling sexually excited, blood flow to the genitals, lubrication, etc. Desire and arousal can, and often do, operate independently. A woman can want sex but not get wet, and vice versa. What are the factors that are driving half of midlife women to report sexually related personal distress? The answer is a complex mix of biological, social and psychological factors, and the interaction between them, hence the biopsychosocial framework. The hormonal landscape of midlife can have a significant influence on desire and arousal. Oestrogen and progesterone begin their chaotic decline during perimenopause, up to a decade before the final menstrual period. As oestrogen drops, vaginal walls thin, lubrication decreases, and vulval tissue becomes fragile and easily irritated. This is part of the Genitourinary Syndrome of Menopause (GSM) and it is very common. GSM makes sex uncomfortable and sometimes genuinely painful; some women with GSM describe penetrative sex as feeling like barbed wire. Testosterone, a key driver of libido, also declines steadily from the mid-reproductive years. Add in the sleep disruption and fatigue that accompany midlife hormonal fluctuation; not to mention the sexual side effects of medications such as antidepressants, plus the onset of health conditions that typically begin in midlife and affect sexual function (e.g., Type 2 diabetes), and…. the biological conditions for desire and arousal are not ideal. Biology alone, however, doesn't explain why two women with similar hormonal profiles can have profoundly different experiences of sexual desire and arousal. A woman's psychology and social context matter, and enormously so. The Dual Control Model of sexual response is helpful in explaining the psychosocial factors that influence how women (and men, but focusing on women here) respond to sexual cues. According to the model, there are two neurological processes running simultaneously: the Sexual Excitation System (SES) or the sexual accelerator, and the Sexual Inhibition System (SIS) or sexual brake. The accelerator picks up on sexually relevant cues and pushes the system toward desire and arousal, whereas the brake scans for reasons not to proceed with sex, such pain, threat, anxiety, & distraction. The balance between brake and accelerator determines how she feels about sex at any given time, and brake pressure is far more powerful than accelerator pressure. Some women naturally have a more sensitive brake, but this is not a wholly fixed setting. Both systems are flexible, and heavily influenced by context, life stage, and circumstances. In midlife, the brakes get a lot of pressure. Pain anticipation. Body image concerns. Exhaustion. Partner resentment. Cognitive overload. A room full of scented candles and champagne isn't going to do much when she's just finished a phone call about her ageing parent's continence products, the house is a mess, sex was cut-glass painful last time, her joints ache, and she's navigating weight redistribution, brain fog and wondering why she just doesn’t feel like herself. In that case, the brake is firmly applied. Beyond the brake pressures already named, the research literature points to several additional SIS activators at midlife: mood disorders and sexual dysfunction are highly comorbid, with up to 75% of women with depression reporting sexual problems; a history of sexual trauma, affecting close to half of all women, carries risk that is not fully explained by anxiety or PTSD alone; and medications increasingly prescribed at midlife, particularly antidepressants, can quadruple the odds of sexual dysfunction. The brake is rarely being pressed by just one thing. The Dual Control Model also helps explain the difference between spontaneous and responsive desire, a difference that is not spoken about anywhere near enough by general practitioners and other first port-of-call healthcare professionals. Spontaneous desire is the out-of-nowhere wanting that popular culture treats as normal, she's doing the dishes and suddenly feels like a romp. It's more common in younger people, new relationships, and men. Responsive desire emerges in response to sexual stimulation and context; it's the desire that can show up after sexual activity has begun. Many midlife women, especially in long-term relationships, have shifted to a predominantly responsive pattern, which is perfectly healthy and normal. Just an explanatory note here: responsive desire is emphatically not a prescription nor encouragement for women to push through disengagement or nonconsent and hope for the best. It’s more about understanding that desire may not arrive as a spontaneous spark, so that she can stop pathologising herself for not wanting sex out of nowhere, and can choose, on her terms, whether the conditions are right to let desire emerge. The social context a woman inhabits at midlife can be as inhibitory to desire as anything happening in her body. Research consistently identifies relationship quality as one of the strongest predictors of sexual desire and satisfaction in midlife women. After two decades with the same partner, familiarity, accumulated resentment, and unresolved conflict are potent brake activators. Esther Perel, whose work on relationships and sex is world renowned, argues that eroticism, the erotic charge and aliveness that gives sex its fire (as distinct from desire, which is the wanting), requires a degree of separateness, novelty, and unknowability to survive. It is difficult to fetishise someone whose bathroom noises have been part of her morning routine for the past 20 years. Desire needs space; eroticism needs it even more. Then there is midlife caregiving. Many women at midlife find themselves providing care for the people who shaped their earliest ideas about bodies and sex. That contact can activate early trauma and sexual shame. Add in full-time work, the exhaustion of having spent decades meeting everyone else's needs, and inhabiting a world that has few realistic models of sexual, sensual women beyond 45, and it is no wonder that the brakes are floored for so many women at midlife. Once we take a nuanced view of midlife sexual function, it becomes clear that for most women with a flattened libido, it is a complex interaction of biological, psychological, and social factors that are at play. Despite what Instagram would have one believe, a testosterone prescription alone is often not the whole answer. Effective support for midlife desire problems might comprise a mix of self-education, a GP who takes it seriously, a psychologist with a good understanding of sex, and a sexologist or somatic sex therapist who works with midlife women. The reference list at the end of this article has a few starred references which are an excellent place to start. ### References Calabro, R. S., Cacciola, A., Bruschetta, D., Milardi, D., Quattrini, F., Sciarrone, F., Rosa, G., Bramanti, P., & Anastasi, G. (2019). Neuroanatomy and function of human sexual behavior: A neglected or unknown issue? Brain and Behavior, 9(12). https: Cleland, L., Schluter, P. J., & Arnold, E. P. (2022). Childhood maltreatment and the menopause transition in a cohort of midlife New Zealand women. Menopause, 29(5), 565–573. https: Faleschini, S., Tiemeier, H., Rifas-Shiman, S. L., Rich-Edwards, J., Joffe, H., & Perng, W. (2022). Longitudinal associations of psychosocial stressors with menopausal symptoms and well-being among women in midlife. Menopause, 29(11), 1247–1253. https: Faubion, S. S., Sood, R., & Kapoor, E. (2021). Genitourinary syndrome of menopause: Management strategies for the clinician. Journal of Obstetrics and Gynaecology Canada, 43(8), 976–987. https: Wang, Y., Islam, R. M., Bond, M., Skiba, M. A., & Davis, S. R. (2025). Sexual dysfunction in women at midlife: a cross-sectional study of data from the Australian Women’s Midlife Years study. The Lancet Obstetrics Gynaecology & Women S Health, 1(3), e198–e208. https: ‌Janssen, E., & Bancroft, J. (2023). The dual control model of sexual response: A scoping review, 2009–2022. The Journal of Sex Research, 60(7), 948–968. https: Nagoski, E. (2015). Come as you are: the surprising new science that will transform your sex life. Scribe Publications. Perel, E. (2006). Mating in captivity: Unlocking erotic intelligence. HarperCollins. Sarmento, A. C. A., Costa, A. P. F., Vieira-Baptista, P., Giraldo, P. C., Eleuterio, J., & Goncalves, A. K. (2021). Genitourinary syndrome of menopause: Epidemiology, physiopathology, clinical manifestation and diagnostic. Frontiers in Reproductive Health, 3, 769950. https: StatPearls. (2024, October). Genitourinary syndrome of menopause. NCBI Bookshelf. https: Thomas, H. N., Neal-Perry, G. S., & Hess, R. (2018). Female Sexual Function at Midlife and Beyond. Obstetrics and gynecology clinics of North America, 45(4), 709–722. https: Tremblay, A., Mbuagbaw, L., & Wolfman, W. (2025). Treatment patterns for genitourinary syndrome of menopause: A TriNetX analysis. Sexual Medicine Reviews. https: Ussher, J. M., Perz, J., & Parton, C. (2024). Women's experiences of their sexuality during the menopausal transition and the support offered to them by healthcare providers: A systematic review and meta-synthesis. BMC Women's Health. https: --- ## Midlife Matters URL: https://www.womenshealthpathway.com/resources/books/midlife-matters/ Metadata: - subtitle: Feel Empowered and Confident Every Step of the Way - author: Katie Taylor - publishDate: 2025-09-16 - tags: menopause - category: book - image: /images/reviews/books/midlife-matters.jpg - infoLink: https://www.penguin.com.au/books/midlife-matters-9780241674451 - purchaseLink: https://www.penguin.com.au/books/midlife-matters-9780241674451 - draft: false - spotifyLink: - appleLink: - googleLink: - youtubeLink: With significant female figures breaking down taboos around menopause and opening up the discussion, women are in a stronger position than ever before to insist on a better midlife experience – a real cause for celebration. But while these discussions around menopause are brilliant and empowering, it’s vital that we don't let the conversation stop there. Because midlife for women is a multifaceted experience, one in which our changing bodies and minds play an enormous part, but that’s far from the only thing going on. MIDLIFE MATTERS is an all-encompassing guide for midlife women, exploring the key areas of HEALTH, WELLBEING, NUTRITION, BEAUTY, SEX & RELATIONSHIPS, WORK LIFE, and FINANCES with warmth and honesty. In this much-needed book, menopause campaigner and founder of the award-winning platform for midlife women, The Latte Lounge, brings together renowned experts to inform and empower you through every step of your midlife journey. With comprehensive advice from leading doctors, psychologists, dermatologists, dieticians, athletes, journalists, lawyers and more, this midlife manual will help you to make your middle years the best ones yet. --- ## Mind Over Bladder URL: https://www.womenshealthpathway.com/resources/books/mind-over-bladder/ Metadata: - subtitle: A Step-by-Step Guide to Achieving Continence - author: Rabin M.D., Jill Maura, Stein, Gail, O'Shaughnessy M.D, Danielle - publishDate: 2026-04-23 - tags: continence - category: book - image: /images/reviews/books/mind-over-bladder.jpg - infoLink: https://www.amazon.com.au/Mind-Over-Bladder-Step-Step-ebook/dp/B08H6T6QQ4 - purchaseLink: https://www.amazon.com.au/Mind-Over-Bladder-Step-Step-ebook/dp/B08H6T6QQ4 - draft: false - spotifyLink: - appleLink: - googleLink: - youtubeLink: Mind Over Bladder is a trusted and informative guidebook for bladder control, written with respect and humor by a nationally known urogynecologist, revised and expanded for the 21st century woman. Urinary Incontinence plagues millions of women worldwide, vastly more women than men. The reasons for this are many, including we have children, go through menopause and our anatomy is pretty different. Since these issues affect approximately 30-40% or greater of all women, can include issues with prolapsing organs (bladder, uterus, rectum) and can limit a woman’s freedom and ability to live a full and active life, an actual guidebook seemed not only necessary but overdue. Mind Over Bladder answers this need. Informative, respectful and written with humor by a leading urogynecologist, Mind Over Bladder asks and answers the question of “What is incontinence and what can I do about it?”. This unique approach begins at the beginning takes women through basic bladder and pelvic plumbing to getting a diagnosis and formulating a treatment plan. Mind Over Bladder arms women with information and practical solutions to help lead better, drier and happier lives. --- ## My journey with levator avulsion URL: https://www.womenshealthpathway.com/blogs/my-journey-with-levator-avulsion/ Metadata: - intro: - metaDescription: Lyn Leger's honest journey with levator avulsion after childbirth. From diagnosis challenges to mental health support and finding community healing. - publishDate: 2025-09-06 - author: Lyn Leger - authorSlug: lyn-leger - featuredImage: lyn-leger-feature.jpg - tags: prolapse,continence,vaginal-vulva-health - draft: false - hcp: false - headingTitle: My journey with levator avulsion - headingSubtitle: - headingDescription: In 2017, I sustained injuries while giving birth to my first child. At the time, I knew things didn’t feel right. I went to see a few different medical and allied health professionals in the hope of someone telling me why I felt the way I did, but no-one did. This should have been a special time getting to know my new baby. Instead, I found myself slipping into a dark and confusing period, not knowing what was wrong with me. Among other things, it impacted my ability to parent and to bond with my baby. I got pregnant again quite quickly, through painful sex, and had a second child in 2018. Five weeks after the birth of my second child I discovered a bulge (pelvic organ prolapse) at the entrance of my vagina. I was horrified and scared! This began six months of MANY appointments with my obstetrician, multiple GPs, four different pelvic floor physios and a urogynecologist. It took me a while to find a GP who understood it wasn’t only older women who had prolapse, and a pelvic floor physio who could palpate to diagnose avulsion. During this time I was told by more than one practitioner to ‘stop catastrophising’. The imaging by the urogynecologist finally confirmed it all for me… I have bilateral avulsion of the levator ani muscle, as well as three compartment prolapse. The diagnosis was devastating. For a long time, I couldn’t speak to anyone openly about the injury, except for my husband. This was because I couldn’t see it and couldn’t understand it. I couldn’t understand what all the impacts were to my life as I was still discovering them daily. If anyone asked how I was, I would either lie and say “good thanks” or burst into tears trying to tell them. I felt so isolated, and so alone. Over the following months, I started to get a better picture of the impacts and how I would need to manage the levator avulsion and prolapses for the rest of my life. These impacts – both current and future – became so overwhelming that I began experiencing suicidal thoughts. This was a deeply distressing and unexpected moment in my journey, and I’m grateful that I was able to reach out for help and am still here today to share my story. After this event, I realised I needed serious and urgent help for my mental health. I saw my GP and was prescribed antidepressants, and while these aren’t for everyone, they helped me immensely in this time of crisis. Also, I found a psychologist and began regular appointments, including the use of EMDR. After one of my early appointments with the psychologist, I drew a ‘mind map’ of the many impacts that levator avulsion and prolapse had already had on my life. It shows how my birth injury, which cannot be seen, impacts EVERY aspect of my life; everything from the physical aspects of the injury, managing a pessary, fitting in the required ongoing rehabilitation, to my work, home and social life, mental and physical health and well-being, my relationship with my husband, children and extended family, and my ability to look after my own children. Making this mind map helped me to recognise the many layers of impacts, how they are interrelated, and why I felt so overwhelmed. I want to share this image so that others may be able to better understand their own injuries and impacts, and hopefully feel less overwhelmed by them. Additionally, I reached out to speak to others with levator avulsion. I went to a face-to-face session held by [Birth Trauma Australia](https: same injury as me. We discussed which practitioners they were going to, their struggles, and the things that had helped them overcome various challenges. However, the thing that helped me the most was just knowing there were other women out there dealing with the same injury and similar challenges. Online communities helped me in this way too, including Facebook groups such as an [Australian pelvic organ prolapse group](https: [Birth Trauma Australia support group](https: women with lived experience, who understood what I was going through. My journey with levator avulsion continues. One thing is for sure, as I age and go through menopause, things will get worse. I have tried to set myself up with good friends and professional support networks, and despite my anxiety about the future, I will just have to take each day as it comes. Since I was diagnosed with levator avulsion and prolapse, I have read many articles from peer-reviewed journals in an effort to understand my injury. - Approx 1 in 5 women sustain levator avulsion during their first delivery (with the incidence of avulsion reported at 13–36%, or up to 1 in 3 in some studies) - Avulsion has been found in up to 66% of women after forceps deliveries - 36% of women with prolapse have underlying avulsion Realising how common this injury is, I thought surely there is a surgical fix for me and searched for more information. However, I discovered there is no surgical solution for avulsion. At best, surgery for avulsion is considered experimental. Additionally, while prolapse surgeries are relatively common, they have a high re-operation rate, around 30%, and my urogynecologist explained to me that for women with avulsion, the failure rate of prolapse surgery is much higher, around 70- 80%. To say these statistics are shocking to me is a gross understatement. It was even more shocking to me that NOTHING big is being done to help women with birth injuries when the scale of the problem is obviously HUGE! Listening to the news on the radio one day, hearing about endeavours to send spacecraft to Mars, and establishing communities on the Moon, I got incredibly angry. How is this fair? Somehow, millions, probably billions of dollars are poured into R&D for these activities in space, but we can’t fix a woman’s vagina after she gives life to another. Birth injuries are a major public health issue, with long-term physical and psychological effects that severely impact the lives of thousands of women every year. I believe that immediate action is required to secure funding for the diagnosis, treatment and rehabilitation of birth injuries, which are often overlooked in discussions about women's health. I shared my recommendations for action, as well as my mind map, with the [2023 NSW Parliamentary Inquiry into Birth Trauma](https: ### I really want the Government to implement my recommendations - Ensure that funding can be allocated to research on diagnosis, treatment and management of levator ani avulsion, commensurate to the economic burden of avulsion - Address gender bias in the health system and health research by focusing on issues that impact women’s health and quality of life. - Improve the lives of women with birth injuries by ensuring access, early diagnosis, affordability of medical and allied health services, and long-term treatment and management options. - Provide a positive impact on the economy and society as women with avulsion will more likely be able to participate fully in society again. --- ## NAFC Life without Leaks URL: https://www.womenshealthpathway.com/resources/podcasts/life-without-leaks/ Metadata: - subtitle: - author: NAFC - publishDate: 2025-09-16 - tags: continence - category: podcast - image: /images/reviews/podcasts/life-without-leaks.jpg - infoLink: - purchaseLink: - draft: false - spotifyLink: https://open.spotify.com/show/70fTcG8SgNAf6BsoaorbHx - appleLink: https://podcasts.apple.com/us/podcast/life-without-leaks/id1623821953 - googleLink: - youtubeLink: https://www.youtube.com/playlist?list=PLP8kIB1vMVysG107iQVYNPY83LTKyHU1O Life Without Leaks is brought to you by the National Association for Continence, America's leading advocate for patients with bladder and bowel disorders. We discuss important topics for those living with incontinence, including hints and tips for better management, insights on state-of-the-art medical care and stories offering hope and guidance for those on the path to drier days. Remember, there's no shame in being human. --- ## old hope, delivered despair: The new menopause marketplace URL: https://www.womenshealthpathway.com/blogs/sold-hope-delivered-despair-the-new-menopause-marketplace/ Metadata: - intro: - metaDescription: The menopause wellness industry is booming — but who is it really serving? We cut through the marketing noise to explore what evidence-based menopause care actually looks like. - publishDate: 2026-03-20 - author: Raelene Ristevski - authorSlug: raelene - featuredImage: raelene-feature2.jpg - tags: menopause - draft: false - hcp: false - headingTitle: Sold hope, delivered despair: The new menopause marketplace - headingSubtitle: - headingDescription: The menopause wellness industry is booming but who is it really serving? We cut through the marketing noise to explore what evidence-based menopause care actually looks like. For decades, menopause sat in silence — unspoken, misunderstood, and often dismissed. Walk into any pharmacy and you'll see it: an aisle overflowing with hope, glossy labels, soothing colours, promises of balance, and yet so many women walk away with nothing but disappointment. Now, suddenly, menopause is everywhere. Not because the world finally decided to care about women's health, but because corporations realised there was money to be made. A natural life stage has become a multi‑billion‑dollar "market opportunity." And women — exhausted, confused, desperate for relief — have become the target. ## The rise of the menopause gold rush In the past few years, we've seen an explosion of: - supplements promising "hormone balance" - powders claiming to "fix" menopause - creams marketed as miracle solutions - devices with no clinical evidence - influencers selling hope in a bottle - corporate campaigns wrapped in empowerment language but driven by profit The messaging is polished. The branding is beautiful. The science is often… absent. Behind the scenes, global companies are pouring millions into marketing — not into research, not into clinician education, not into improving access to evidence‑based care. Marketing. Because fear sells. Confusion sells. Silence sells. ## Why women are so vulnerable to this messaging Menopause symptoms can be debilitating. Sleep disruption, anxiety, vasomotor symptoms, joint pain, cognitive fog — these are not minor inconveniences. They affect work, relationships, identity, and quality of life. When women can't access timely, evidence‑based care, they turn to whatever is available. And corporations know this. They know women are: - underserved - under‑diagnosed - under‑supported - and often dismissed in clinical settings This creates the perfect environment for predatory marketing. ## The problem isn't women seeking relief — it's the system exploiting them Women deserve relief. Women deserve options. Women deserve to feel better. But they also deserve truth. They deserve to know: - what is evidence‑based - what is unproven - what is harmless but ineffective - what is potentially harmful - and what is simply expensive hope When companies blur these lines, women pay the price — financially, emotionally, and possibly medically. ## What evidence‑based care actually looks like Menopause care is not mysterious. We have research, clear guidelines, and effective treatments. Evidence‑based care includes: - appropriate assessment - lifestyle support - non‑hormonal options where indicated - hormone therapy when clinically appropriate - management of comorbidities - ongoing review and shared decision‑making It does not include: - miracle claims - detox language - "hormone balancing" supplements - products that promise what physiology cannot deliver ## The call for transparency Women don't need more products. They need clarity. They need: - honest information - access to trained clinicians - culturally safe care - support that isn't tied to a sales funnel - education that isn't sponsored by a brand And they need advocates — clinicians, educators, researchers, and platforms such as Women's Health Pathway — who refuse to participate in the commercialisation of their vulnerability. ## A better way forward Menopause deserves visibility, but not commodification. Women deserve support, but not exploitation. And the global conversation deserves to be led by evidence, not advertising budgets. We can do better. We must do better. Because women's health is not a market trend — it's a lifelong, human reality. --- ## Painful orgasm: Understanding and overcoming Dysorgasmia URL: https://www.womenshealthpathway.com/blogs/painful-orgasm-overcoming-dysorgasmia/ Metadata: - intro: - metaDescription: Understanding dysorgasmia: causes of painful orgasms and treatment options. Expert guide to pelvic floor therapy and sexual wellness solutions. - publishDate: 2025-08-30 - author: Dr Sara Reardon - authorSlug: sara-reardon - featuredImage: sara-reardon-feature.jpg - tags: vaginal-vulva-health,sexual-health - draft: false - hcp: true - headingTitle: Painful orgasm: understanding and overcoming Dysorgasmia - headingSubtitle: - headingDescription: Orgasms can be the very welcome grand finale of an intimate experience. But if you’re someone who feels pain instead of pleasure at the peak moment, you’re not imagining it — and you’re not alone. Orgasms can be the very welcome grand finale of an intimate experience. They’re your body’s way of saying, “Hey, great job down there!” But if you’re someone who feels pain instead of pleasure at the peak moment, you’re not imagining it — and you’re not alone. A condition in which you experience a painful orgasm, also called dysorgasmia, is more common than people realize. ## What actually is an orgasm? Before we tackle the complexities of painful orgasms, it’s important to understand what an orgasm entails. Although similar in their pelvic floor contractions, they are experienced differently from person to person and from moment to moment. An orgasm is a moment of intense pleasure that lends to a brief feeling of both physical and mental euphoria.[^1] The most common symptoms are involuntary contractions in the pelvic floor muscles — particularly around the vagina and uterus (in female bodies), prostate (in male bodies) and anal opening. ## Different kinds of orgasms (and why that matters) Orgasms aren’t one-size-fits-all. According to research, women can experience orgasms triggered by a variety of both genital and non-genital touch — and the type of stimulation may affect the physical sensations and even emotional impact of an orgasm.[^2] ## Some main types of orgasms include: - **Clitoral orgasms:** This is the most commonly reported, “easiest” to reach, type of orgasm. Your clitoris is jam-packed with nerve endings and external or internal clitoral stimulation can lead to rapid, intense pleasure. - **Vaginal orgasms:** These happen from internal stimulation, especially the front vaginal wall — often linked to the “G-spot”. Vaginal orgasms often feel deeper and may trigger more full-body sensations. - **Cervical orgasms:** Triggered by deep penetration or direct stimulation of your cervix (the opening to the uterus), cervical orgasms may feel deeper or more emotional. Not everyone finds cervical stimulation comfortable, but for those who do, the sensation is often said to be the most pleasurable. - **Blended orgasms:** This happens when multiple areas are stimulated at once — like your clitoris and vagina. Often, people report combined sensations for a more intense or longer-lasting orgasm. - **Non-genital orgasms:** Yes, really! Some people report orgasms from stimulating non-genital areas like the nipples or ears. Non- genital orgasms may even be achieved while sleeping, like during a dream, or while exercising.[^3] Why does this matter? Because the type of stimulation involved can activate different muscles and nerves — and that can affect whether you experience a painful orgasm. For example, deeper orgasms involving your cervix or pelvic floor may trigger more discomfort if you have tight pelvic floor muscles, a condition like endometriosis, or a history of a gynecological surgery.[^4] Understanding your own orgasmic pain patterns can help you identify triggers and get the right kind of support if you’re experiencing pain. ## Causes of painful orgasm Experiencing pain during or after orgasm can be attributed to various things. Here are some of the more common culprits. ### Pelvic floor muscle dysfunction The pelvic floor muscles play a huge role in orgasm. These muscles contract rapidly to help create pleasurable sensations. However, if these muscles are overly tight or in spasm, then these contractions can be painful. Too tight pelvic floor muscles is a type of pelvic floor dysfunction, not only can they lead to pelvic floor pain during sex, but they can lead to painful orgasm as well. ### Endometriosis Endometriosis is a condition where tissue that is similar to the lining of the uterus (the endometrium) grows outside the uterus. This misplaced tissue can cause pain and inflammation throughout your body, which can be especially bad when you’re on your period and during sex.[^5] Some research suggests that 14% of people with endometriosis also have dysorgasmia, which is linked to their pelvic floor pain and chronic centralized pain.[^6] ### Pelvic inflammatory disease (PID) PID is an infection of the female reproductive organs, often caused by sexually transmitted infections (STIs). This condition can lead to inflammation and scarring, causing pelvic pain and painful sex that may get worse during orgasm. Think of it as trying to dance with a sprained ankle — the movement aggravates the injury. ### Ovarian cysts Ovarian cysts are fluid-filled sacs that develop on your ovaries.[^7] While many are harmless, some can cause pain, especially if they rupture. If you experience sharp pain on one side during orgasm, an ovarian cyst might be the culprit. ### Uterine fibroids These noncancerous growths in the uterus can lead to discomfort during sex and orgasm. Depending on their size and location, fibroids can press against surrounding tissues, making muscle contractions during orgasm painful. It’s akin to having an uninvited guest taking up too much space on the dance floor. ### Gynecological surgery Surgeries like hysterectomy, fallopian tube removal (salpingectomy), or endometriosis treatment can lead to painful orgasms due to nerve changes, scar tissue (adhesions), or pelvic floor dysfunction. Nerves may become overly sensitive, and tight pelvic muscles can add to the discomfort — especially without proper post-op rehab like pelvic floor therapy. ### Sex guilt Painful orgasms aren’t just physical — they can be deeply emotional, too. Feelings of guilt, shame, or anxiety — especially if tied to cultural, religious, or societal pressures around sex — can actually contribute to pelvic floor tension and amplify pain.[^8] With sex guilt you may even unconsciously brace or tighten your muscles during sex due to internalized beliefs or past trauma, leading to or worsening orgasmic pain.[^9] ## How to find relief from pain when orgasming Experiencing painful orgasms isn’t something you have to endure silently. There are several approaches to alleviate the discomfort: ### Pelvic floor physical therapy If you have painful orgasms, work on your pelvic floor to address issues like muscle tightness, trigger points, and spasms. You can learn to unwind chronic pain which can improve your sexual health and physical emotional well-being with treatment that includes manual therapy, biofeedback, and tailored exercises. ### Medical interventions Depending on the underlying cause, medical treatments may be necessary. Common medications include antibiotics to treat infections like PID or pain relievers for more chronic conditions. In cases of significant uterine fibroids, ovarian cysts, or endometriosis, surgical intervention might be recommended to remove problematic tissues. If you have orgasmic pain, let your healthcare provider know to help you rule out any medical conditions that could be causing your pain and determine the most appropriate treatment plan. ### Emotional support for painful orgasm Talking to a licensed sex therapist or a mental health professional who specializes in sexual dysfunction can help untangle the emotional layers of dysorgasmia. Therapy can provide a safe space to explore how past experiences or beliefs may be affecting your body’s responses. And don’t underestimate the power of open communication. Sharing what you’re going through with a trusted partner can reduce anxiety, build intimacy, and help you both explore new ways to experience pleasure without pain (or pressure). This can be especially important for sexually active couples navigating discomfort together. ## You are not broken — your body is talking A painful orgasm doesn’t mean you’re broken. Your body is trying to tell you something. Painful orgasms can be fixed, managed, or dramatically improved. In the [V-Hive](https: exercises and stretches designed to relieve painful orgasms and provide support for your pelvic floor and your sex life. [^1]: Meston, C.M., et. al. (2004). [Women’s orgasm](https: [^2]: Weitkamp K., et. al. (2023). [Women’s Experiences of Different Types of Orgasms-A Call for Pleasure Literacy?](https: [^3]: Cronkleton, E. (2023). [Coregasm: Why it Happens, how to have one, and more](https: [^4]: Giovannetti O,. et. al. (2023). [The contribution of the cervix to sexual response: an online survey study](https: Medicine. [^5]: World Health Organization. (2023). [Endometriosis](https: [^6]: Ding, A., et. al., (2024). [Pain with orgasm in endometriosis: potential etiologic factors and clinical correlates](https: Medicine. [^7]: Beerten S.G., et. al., (2024). [Dysorgasmia in women: Case report and preliminary assessment guide](https: [^8]: Ley, D.J., (2017). [Overcoming religious sexual shame](https: Today. [^9]: Azim, K.A., et. al., (2021). [Exploring relationships between genito- pelvic pain/penetration disorder, sex guilt, and religiosity among college women in the U.S](https: --- ## Pelvic Floor Pro URL: https://www.womenshealthpathway.com/resources/apps/pelvic-floor-pro/ Metadata: - subtitle: Pelvic Floor Exercises - author: Lake City Physical Therapy, P.A. - publishDate: 2025-09-16 - tags: continence,prolapse - category: app - image: /images/reviews/apps/pelvic-floor-pro.jpg - infoLink: https://pelvicfloorpro.com - purchaseLink: https://pelvicfloorpro.com - draft: false - spotifyLink: - appleLink: https://apps.apple.com/us/app/pelvic-floor-pro/id6737835957 - googleLink: https://play.google.com/store/apps/details?id=com.lakecitypt.pelvic_floor_pro - youtubeLink: Strengthen your pelvic health with Pelvic Floor Pro! Personalized plans, expert-guided exercises, and progress tracking. Take control of your wellness today! Struggling with pelvic floor issues? Pelvic Floor Pro is your ultimate companion for strengthening and maintaining a healthy pelvic floor. Whether you’re looking to improve bladder control, recover postpartum, or simply prevent future concerns, this app provides guided workouts, personalized plans, and tools to track your progress—all in one convenient place. ### Why Pelvic Floor Pro? Pelvic floor health is essential for overall well-being, yet it’s often overlooked. Pelvic Floor Pro offers easy-to-follow exercises tailored to your needs, empowering you to take control of your health and feel confident. ### Key Features: - **Tailored Exercise Plans:** Explore a variety of exercises designed by professionals to suit your unique needs and fitness level. - **Progress Tracker:** Monitor your improvements and celebrate milestones with our intuitive tracker. - **Daily Reminders:** Stay consistent with gentle nudges to complete your exercises. - **Educational Resources:** Learn more about pelvic floor health with expert tips and articles. - **Easy-to-Use Interface:** Navigate through the app effortlessly, whether you're at home or on the go. --- ## Pelvic Floor Recovery URL: https://www.womenshealthpathway.com/resources/books/pelvic-floor-recovery/ Metadata: - subtitle: Physiotherapy for Gynaecological and Colorectal Repair Surgery Edition 5 - author: Sue Croft - publishDate: 2025-09-16 - tags: prolapse - category: book - image: /images/reviews/books/pelvic-floor-recovery.jpg - infoLink: https://pelvicfloorrecovery.com/ - purchaseLink: https://suecroftphysiotherapist.com.au/book-shop/ - draft: false - spotifyLink: - appleLink: - googleLink: - youtubeLink: Sue Croft is a pioneering Australian physiotherapist specializing in pelvic health. With over three decades of clinical experience, she’s helped thousands of women and men manage pelvic floor dysfunction with dignity and clarity. Sue is known for her warm, accessible writing style and her tireless advocacy for destigmatising intimate health issues. Through her books, blogs, and Brisbane clinic, she continues to educate, empower, and uplift, making pelvic health care more inclusive and informed. Pelvic Floor Recovery offers women a clear, empowering roadmap through pelvic surgery recovery. With gentle language and practical strategies, it demystifies pelvic anatomy, explains common procedures, and provides safe, physiotherapy-based exercises to support healing. Whether you're preparing for surgery or navigating post-op care, this book is a trusted companion. --- ## Pelvic Health for Active Women: What Every Runner and Lifter Should Know URL: https://www.womenshealthpathway.com/blogs/pelvic-health-for-active-women/ Metadata: - intro: - metaDescription: Leaking during training isn't something you have to accept. Pelvic health physiotherapist Zain Oher explains what active women need to know about pelvic floor health. - publishDate: 2026-04-01 - author: Zainab (Zain) Oher - authorSlug: zainab-oher - featuredImage: zainab-oher-feature.jpg - tags: continence,prolapse - draft: false - hcp: true - headingTitle: Pelvic health for active women: what every runner and lifter should know - headingSubtitle: - headingDescription: If you've ever quietly wondered whether a little leakage during a run is 'just normal,' or why your lower back pain keeps coming back despite consistent training, you're not alone. Pelvic floor dysfunction affects a significant number of active women. The good news is, it's treatable. As a pelvic health physiotherapist, I often meet strong, capable women who can deadlift impressive weights, run half marathons, and train consistently each week, yet quietly wonder: “Is it normal that I leak a little?” “Why do I feel heaviness after long runs?” “Why does my hip or back pain keep returning?” Let me say this clearly. Pelvic floor symptoms are common in active women, but they are not something you have to accept as part of training. ## What is the pelvic floor, really? The pelvic floor is a group of muscles that sit at the base of your pelvis. They support your bladder, bowel, and uterus, help control continence, contribute to sexual function, and play a critical role in core stability. They do not work alone. Think of your core as a coordinated pressure system: - The diaphragm manages breathing and pressure from above. - The abdominal muscles provide front support. - The glutes and back muscles generate power and stability. - The pelvic floor responds and supports from below. When this system works well, you feel stable and strong. When coordination or strength is reduced, symptoms can develop. ## Common pelvic floor issues in active women Research shows a high prevalence of pelvic floor dysfunction in physically active women, particularly in high impact and strength sports. You may experience: - Stress urinary incontinence: leakage with coughing, jumping, running, or lifting. - Urge incontinence: sudden strong urges to urinate. - Prolapse symptoms: heaviness, dragging, or a bulge sensation in the vagina. - Persistent hip, groin, pelvic, or lower back pain. More than 30 percent of women who lift heavy weights report leakage during intense sets. Endurance runners often report symptoms that worsen with fatigue or longer distances. Impact forces challenge the pelvic floor’s ability to absorb load, especially when technique or breath control is not optimal. ## Life stages matter Pelvic health changes across the lifespan. Pregnancy and birth increase load and stretch on the pelvic floor. Postpartum, the system needs rehabilitation just like any other muscle group after strain. Menopause brings hormonal changes that can affect tissue quality and muscle function. However, pelvic floor dysfunction is not limited to postpartum or menopausal women. It can occur in adolescents, young athletes, and nulliparous women as well. ## What contributes to symptoms? Several factors increase risk: - High impact exercise without adequate recovery - Poor lifting mechanics - Breath holding during heavy lifts, increasing intra abdominal pressure - Chronic constipation - Low energy availability in athletes - Hormonal shifts - Stress and high muscle tension Holding your breath during squats or deadlifts significantly increases pressure within the abdomen. A controlled brace with coordinated exhalation often reduces strain and leakage risk. ## It is not just about Kegels Pelvic floor training is not simply stopping your urine midstream or doing endless Kegels. Effective rehabilitation includes: - Individualised assessment - Strengthening or relaxing the pelvic floor as required - Breathing retraining - Load management and impact modification - Glute and deep hip rotator strengthening - Education on toileting posture, hydration, and bowel health - Recovery planning, including sleep and deload weeks Just like any muscle group, the pelvic floor can be overtrained. It also needs recovery. ## When to seek help You should seek assessment if you experience: - Leakage during exercise - Vaginal heaviness or bulging - Pain with intercourse - Persistent pelvic, hip, or back pain - Symptoms that limit your training Pelvic health physiotherapy is proactive. It is not a “wait and see” approach. With structured guidance, women can move through a clear rehabilitation pathway: addressing symptoms, rebuilding strength and coordination, and returning to high level activity with confidence. Pelvic floor symptoms are not a sign that you need to stop exercising. They are a sign that your system needs support and smarter training. Strong women deserve strong support, at every level of the body. --- ## Pelvic Organ Prolapse URL: https://www.womenshealthpathway.com/resources/books/pelvic-organ-prolapse/ Metadata: - subtitle: The Silent Epidemic - author: Sherrie Palm - publishDate: 2025-08-15 - tags: prolapse - category: book - image: /images/reviews/books/pelvic-organ-prolapse.jpg - infoLink: http://sherriepalm.com/home - purchaseLink: https://www.booktopia.com.au/pelvic-organ-prolapse-sherrie-palm/book/9781622124046.html - draft: false - spotifyLink: - appleLink: - googleLink: - youtubeLink: There are more than 300,000 surgeries for POP annually. Due to various causes such as menopause, estrogen loss, genetics, childbirth or heavy lifting, a woman's pelvic organs can shift or drop. This can lead to POP symptoms, including some painful and embarrassing ones, as well as impacting a woman's sexuality. The condition has probably always existed, but has received little press or public acknowledgement so women could learn about the condition and treatment options. This book on POP fills an unfortunate void in women's health awareness. Sherrie Palm writes about her own personal experiences in Pelvic Organ Prolapse: The Silent Epidemic. She had never heard about the condition until she needed surgery for it. Palm explores the subject from all angles, providing the information women need to recognize the symptoms of POP and to become advocates for their own health. Pelvic Organ Prolapse: The Silent Epidemic named the winner for Women's Health in the USA Book News National "BEST BOOKS 2009" Awards. --- ## Perimenopause doesn’t just change her. It can change your relationship URL: https://www.womenshealthpathway.com/blogs/perimenopause-doesnt-just-change-her/ Description: The woman you love is changing and neither of you has the language for why. Here's what perimenopause does, why it's so often missed, and how to be the ally she needs. Metadata: - intro: The woman you love is changing and neither of you has the language for why. Here's what perimenopause does, why it's so often missed, and how to be the ally she needs. - metaDescription: Perimenopause can begin a decade before menopause and quietly strain a relationship. Understand what she's experiencing and how to be the ally she needs. - publishDate: 2026-08-31 - author: Mardi Lucich - authorSlug: mardi-lucich - featuredImage: mardi-lucich-feature.jpg - tags: menopause - draft: false - hcp: false - headingTitle: Perimenopause doesn’t just change her. It can change your relationship - headingSubtitle: What happens when the person you love is changing, and neither of you has the language to understand why. - headingDescription: What happens when the person you love is changing, and neither of you has been given the language to understand why. Here's what perimenopause does, why it's so often missed, and how to be the ally she needs. It's 2am and she's staring at the ceiling again. Not for the first time this month. In the morning she'll snap at something small, apologise for it an hour later, and neither of you will quite know what happened. Later that week she'll cancel plans she was looking forward to, or forget a word mid-sentence that she's used a thousand times, and laugh it off like it's nothing. You might think it's stress or that she's simply exhausted. She may think the same thing, while quietly wondering if she's losing it. Nothing about her life has changed enough to explain it, yet her sleep, her patience, her focus and her body all feel unfamiliar. Neither of you may think to connect it to hormones. Both of you are probably familiar with the word menopause. And you may think of it as something that happens later, usually in a woman's 50s or 60s. What you may not know is that there's a whole transition before it, called perimenopause. It starts years earlier, sometimes a decade before menopause, and can affect far more of her life than either of you realise. So when these changes start showing up in a woman's late 30s or early 40s, they can feel completely out of left field. Perimenopause probably isn't on her radar. Her doctor may not recognise the pattern, and her mother may never have had the information to make sense of it either. Meanwhile, she's in the middle of her career, family, relationships, maybe raising kids or caring for ageing parents. Life is already full. So she does what most women do: keeps going, pushes through, and wonders why everything suddenly feels harder. She may not even realise how much it's affecting her day-to-day life. She's just not feeling like herself. That uncertainty doesn't stay contained to her. It affects how you both navigate what's changing, and it can quietly put strain on the relationship. Understanding what's happening gives you a chance to be the ally she needs, rather than letting confusion decide how you respond. ## It's more than a change in her periods Hot flushes, sleep disruption, brain fog, mood shifts, headaches or migraines, and changes in sexual interest can all occur during perimenopause. Then there are the things most people would never think to connect to hormones: sensitive teeth or painful gums, dizziness, ringing in the ears, joint and muscle aches, changes in skin and hair, palpitations, crawling or prickling sensations on the skin, or a sudden increased sensitivity to alcohol. The experience can be remarkably varied. None of it follows a neat pattern. Symptoms can come and go, appear together, ease off, then return. One week can look completely different from the next. That unpredictability is part of why perimenopause is so often missed. There is no single checklist, and no single test that can confirm it. What looks like a handful of unrelated problems can be part of the same hormonal transition, showing up in different parts of her body at once. And this isn't a short phase, either. Perimenopause typically unfolds over several years, on average around 4 to 7. Menopause itself is a single point in time: the final menstrual period, confirmed after 12 consecutive months without another one. After that, a woman is in postmenopause. ## When everything feels harder Oestrogen and progesterone are deeply connected to the brain and nervous system. They influence mood, memory, focus and how the body responds to stress. During perimenopause, these hormones can fluctuate significantly, affecting how she thinks, feels and functions. And then there's sleep. Hormonal changes can disrupt it, and poor sleep amplifies almost everything else: irritability, brain fog, mood, all of it. And the demands don't disappear. The same job, kids, ageing parents, relationships and mental load are still there. It's rarely one thing that makes everything harder; it's the accumulation of several changes at once. She's not less capable. She's just running on less: less resilience, less in the tank. The people closest to her feel that shift too. She may feel more overwhelmed, be quicker to snap, more anxious, suddenly weepy, or find herself pulling back from things she usually enjoys. ## The body changes, and so do the numbers you can't see Some of this shows up in the mirror. Her body may start to feel unfamiliar: clothes fitting differently or weight settling somewhere new. Muscle mass and energy expenditure naturally change with age, while hormonal changes during perimenopause can influence how much fat is stored, where it settles, and the type of fat that accumulates. That combination can be genuinely frustrating: the same effort, a different result. It isn't a failure of willpower. Her physiology is shifting. And some of what is happening can't be seen at all. Cholesterol and triglycerides can change, insulin sensitivity may be affected, and bone turnover rises sharply in the years leading up to the final menstrual period, with bone density loss accelerating around menopause. There may be no obvious sign that any of this is happening, but these changes still matter. This is a health inflection point for her, not just a difficult stretch of life. What she's experiencing matters now, but it also has implications for her health in the years ahead. ## And then there's intimacy Desire is never one thing. It's a mix of physical, psychological and relational factors. How she feels in her body, how she's sleeping, stress, what's happening between you, how you communicate, and whether sex is painful can all play a role. As oestrogen fluctuates and eventually declines, vaginal and vulvar tissues can become drier and less elastic, making sex uncomfortable or painful. She may also be dealing with things she never expected to connect to hormones: needing to pee more often, a sudden, hard-to-hold urge to pee, leaking when she coughs or jumps, vaginal itching or irritation, or recurrent UTIs. These are part of the genitourinary syndrome of menopause, or GSM. They're common and treatable. From your side, a change in sex or affection can feel personal. You may wonder if she's lost interest in you, or if something between you has changed. Ask her rather than assuming. What's feeling different for her? What does she need right now? Intimacy may look different during this transition, but it doesn't have to disappear. ## What support actually looks like You don't have to have all the answers. What matters is understanding what she's experiencing and knowing that how you respond matters. - **Listen first, fix later, if at all.** Most of the time she isn't looking for a solution. She wants to say the hard thing out loud without you immediately trying to make it go away. - **Take one real thing off her plate.** Not a vague offer to "help more." Something specific: you cook Tuesdays, handle the school pickup, or become her gym partner on Saturdays. - **Protect her sleep like it's a shared project.** Take it seriously. A run of bad nights can affect far more than her energy. - **Be her advocate.** Go with her to appointments if she wants you there. Help her prepare questions beforehand and take notes in the room. There's a lot to absorb when you're the one this is happening to. If she's not being heard, speak up alongside her. Having someone in her corner can be the difference between leaving with a plan and leaving with more questions than answers. - **Stay connected.** If she pulls back, don't quietly decide what it means about the relationship. Check in instead. - **Keep learning.** This transition lasts years. One article, one conversation or one appointment won't cover it. The more you understand, the better you can support her decisions and encourage informed care when she needs it. ## It doesn't stop with your partner What you learn here doesn't stop with her. It changes what you notice in the women around you: a sister who keeps saying she's exhausted, a friend who's stopped making plans, a colleague who doesn't seem quite herself. You don't need to diagnose what's going on. You just know enough not to dismiss it. You might listen differently. Share something you've learned when she brings it up. Point her toward good information or menopause-informed care when she's looking for it. Sometimes being the person who says, "I've heard this can happen during perimenopause," is enough to open a door. Perimenopause can be a long, difficult transition, and women don't always have the information or support they need. Having people around them who understand what's happening, and don't make them feel like they're imagining it, can make the whole experience a little less isolating. ## A different way forward Perimenopause is a pivotal transition for women. It can be one for relationships too. Having the language for what's happening can change how you both navigate it. Neither of you was taught this. Now you're learning about it, together. Pay attention to what changes, and don't assume yesterday's answer is today's. Know when something's beyond what the two of you can work out alone, and don't be afraid to ask for help. You can't fix perimenopause, and you don't need to become a menopause expert. Be her ally. Understand what's happening, stay curious, and keep showing up for her. The goal isn't to get through perimenopause without it affecting your relationship. It's to understand it well enough that it doesn't come between you. --- ## Perimenopause: What You Were Never Told URL: https://www.womenshealthpathway.com/blogs/perimenopause-what-you-were-never-told/ Metadata: - intro: - metaDescription: Most women weren't told about perimenopause. It starts years before periods stop and reshapes brain, bone, metabolism, and heart health. Here's what to know. - publishDate: 2026-06-01 - author: Mardi Lucich - authorSlug: mardi-lucich - featuredImage: mardi-lucich-feature.jpg - tags: menopause - draft: false - hcp: true - headingTitle: Perimenopause: What you were never told - headingSubtitle: - headingDescription: Most women were told one thing about menopause, that it starts when their periods stop. What they weren't told is that perimenopause, the multi-year hormonal transition that precedes it, can begin a decade earlier and reshapes brain function, bone density, metabolism, and cardiovascular health Most women were told one thing: when your periods stop, that’s menopause. What we weren’t told is that there’s a long, complex phase before that — more involved, and far more consequential. Perimenopause. A word that, until recently, wasn’t part of our vocabulary. It isn’t a moment or a sudden change, but a multi-year transition in how the ovaries function and how the body responds. To understand it, you start with the ovaries, the workhorse organ of the female body. Inside them sit follicles, each containing an oocyte and the cells that produce your hormones. You begin life with millions, by birth far fewer, and over time that supply declines, accelerating in your late thirties and forties. How many follicles you start with and how quickly you lose them help determine when menopause will happen for you. As ovarian aging progresses, the ovaries begin to function less consistently. Hormone production starts to shift. Ovulation becomes less reliable. Progesterone declines because it depends on ovulation, and estradiol begins to fluctuate before eventually decreasing. For years, your hormones followed a monthly rhythm your body could rely on. Now that rhythm is changing. ### Your cycles may still be coming, but the system behind them has altered. That is perimenopause. It often begins while everything seems “normal.” Cycles are regular and nothing obvious signals change. Yet subtle shifts have already begun. Sleep becomes less reliable. Mood feels less stable. Focus and patience are harder to hold. ### These are typically the earliest signs because hormones act through the brain; they shape how you think, feel, sleep, and function. At the same time, the body starts to reflect these changes. Weight becomes harder to regulate, muscle recovers more slowly, and physical resilience feels different. As those hormonal signals start to fluctuate and fade, the body responds alongside them. What once felt steady now requires more effort. Energy, stamina, and stress tolerance begin to change even though your routine has not. For many women, these mind and body changes appear before cycles show visible variation. When periods eventually shift, arriving earlier or later, it is the confirmation that something deeper has been underway for some time. ### Your internal rhythm is recalibrating. Recognizing it clarifies what you feel and why it matters. This often unfolds during a stage of life filled with competing demands — work, family, responsibility — in a world that refuses to slow down. We call it stress, but beneath it is the physiology of hormonal change. Without proper context, many women start to question themselves. That persistent sense of not feeling like yourself can be confusing. And when there is no clear framework — or no doctor with a solid understanding of female hormones — the frustration intensifies. The deeper issue is how narrowly hormones have been understood. They have been defined almost exclusively around cycles and reproduction. In reality, estradiol, progesterone, and testosterone are essential to nearly every aspect of female physiology: brain function, immune regulation, metabolism, cardiovascular health, and the maintenance of bone and muscle. ### When these hormones shift, everything shifts. There isn’t a single test that clearly defines this phase. Perimenopause isn’t diagnosed by a number; it shows up in patterns — changes in sleep, mood, cognition, metabolism, and body composition. Not all at once, not the same for everyone, but rarely in isolation. It often begins in the forties, sometimes earlier, and lasts on average seven to eight years. This is not menopause. Menopause is a point in time, twelve months without a period, typically around fifty-one. Menopause ends periods. It doesn’t begin or end the story. Ovarian aging is already reshaping bone, metabolism, brain, and cardiovascular health long before that final bleed. Perimenopause is where the trajectory is set. This is a health inflection point. How the body transitions now dictates how it will age. Calling this process “natural” doesn’t make it insignificant. It simply means it happens to all of us. For decades, women were told to endure it, with symptoms minimized or dismissed as inevitable. That perspective no longer holds up to the evidence, and continuing it costs women their health and vitality. This isn’t just a communication gap; it’s a failure in how women’s health has been taught and practiced. For over fifty years, research has shown this transition can be supported safely and effectively, easing symptoms while protecting long-term health. Yet much of that knowledge remains buried in a culture that normalizes female suffering and fails to act on the science that could better protect women’s health. ### Hormones are not optional or peripheral. When they decline, it is not a benign health event. Their influence extends far beyond cycles and reproduction, shaping cardiovascular, metabolic, cognitive, and bone health. Supporting hormonal function during perimenopause is not only about symptom relief. It is about sustaining vitality, resilience, and healthspan. Perimenopause is not just the prelude to menopause. It is an active physiological transformation. Understanding it changes how you move through these years and what comes next. --- ## Pillow Talk URL: https://www.womenshealthpathway.com/resources/books/pillow-talk/ Metadata: - subtitle: - author: Angelina Jimenez, Heather Hendrie - publishDate: 2026-08-08 - tags: sexual-health - category: book - image: /images/reviews/books/pillow-talk.jpg - infoLink: https://awfullyhilarious.com/ - purchaseLink: https://www.amazon.com.au/s?k=heather+hendrie&crid=3GTNRLIV6SWLL&sprefix=heather+hendrie%2Caps%2C93&ref=nb_sb_noss_1 - draft: false - spotifyLink: - appleLink: - googleLink: - youtubeLink: This anthology, part of the Awfully Hilarious series, collects personal writing about sex and sexuality. The contributors — writers of different ages, cultures, sexual orientations, and gender identities — share their own experiences with honesty and humour. The pieces span first sexual experiences through to long-term relationships, and cover topics including asexuality, masturbation, and polyamory. Alongside difficult or embarrassing encounters, the collection includes stories of pleasure, self-discovery, and desire, presenting a wide range of experiences without judgement. --- ## Pregnancy-related Pelvic Girdle Pain: it is time to LEARN a NEW tune! URL: https://www.womenshealthpathway.com/blogs/pregnancy-related-pelvic-girdle-pain/ Metadata: - intro: - metaDescription: Understand pregnancy-related pelvic girdle pain beyond outdated beliefs. Expert physiotherapist explains evidence-based approach to PGP management and pain science. - publishDate: 2025-09-14 - author: Dr Sinead Dufour - authorSlug: sinead-dufour - featuredImage: sinead-dufour-feature.jpg - tags: vaginal-vulva-health - draft: false - hcp: true - headingTitle: Pregnancy-related Pelvic Girdle Pain: it is time to LEARN a NEW tune! - headingSubtitle: - headingDescription: Why do tunes get stuck in our head? We like the tune or maybe we just heard it recently! For the same reason, we get stuck into treatment patterns because they are comfortable and familiar. When it comes to pregnancy-related PGP the long-standing familiar narrative is reflected in this case study. The problem is that this narrative is outdated, untrue and actually harmful. We all need to do better evolve our narrative a reframe our understanding of pregnancy-related PGP. It is a pain experience that has nothing to do with relaxing, pelvic mechanics or even the pregnancy itself. It has everything to do with the context of the pregnancy, factors of which for some people are making their systems more protective and sensitive (fear, worry, and previous births trauma are some of the key culprits of a protective system). Despite mounting evidence of the role that psychosocial and physiological factors play, PGP continues to be mainly understood and treated as a purely biomechanical issue. However, congruent with broader literature examining lumbopelvic pain more globally, PPGP must be understood along with the evolution of contemporary pain science regarding the multifaceted nature of pain and the context of each pregnant person’s unique lived experience The factors at play for each person are a bit different so working with a pelvic health physiotherapist who has training in pain science can be very helpful. [PDF Available for download in multiple languages](https: The key aspects of our reframed approach to pregnancy-related PGP are explained in the infographic below and to learn more about this topic you can tune into the podcast below. [At Your Cervix podcast Season 2 Ep 1 - Understanding Pregnancy Related Pelvic Girdle Pain with Dr Sinead Dufour](https: Women deserve updated evidenced-based care – if you are someone who needs help navigating pain you are experiencing in pregnancy or post-partum, you can do a virtual consult with me. If you are a health care provider who needs a tune up in your clinical skills on the topic of pregnancy- related PGP, come learn with me. Use code PGP25 to get 25% off my course: [Reframe Pelvic Girdle Pain: A 21st Century Approach](https: --- ## Prolapse Exercises Inside Out URL: https://www.womenshealthpathway.com/resources/books/prolapse-exercises-iniside-out/ Metadata: - subtitle: Physiotherapy Guide For Women - author: Michelle Kenway - publishDate: 2025-09-16 - tags: prolapse - category: book - image: /images/reviews/books/prolapse-exercises-inside-out.jpg - infoLink: https://www.pelvicexercises.com.au/pelvic-exercise-products/books/prolapse-exercises/ - purchaseLink: https://www.stressnomore.co.uk/products/michelle-kenway-prolapse-exercises-inside-out-10000 - draft: false - spotifyLink: - appleLink: - googleLink: - youtubeLink: The highly anticipated new book from physiotherapist and pelvic health expert Michelle Kenway has arrived! Known as a global advocate for women’s pelvic health, Michelle’s work has been followed and supported by Kegel8 for years. Her expert guidance has helped countless women regain their confidence, and now her latest book, Prolapse Exercises Inside Out, is set to revolutionise how women manage pelvic organ prolapse (POP). ### What Is Pelvic Organ Prolapse? Prolapse occurs when the pelvic floor muscles become too weak to support the pelvic organs, causing the bladder, uterus, or vaginal walls to drop into the vaginal canal. It’s a condition that affects many women, particularly after childbirth, menopause, or surgery. The fear of worsening prolapse often leads women to avoid exercise altogether, but Michelle’s book empowers women to exercise safely and effectively to manage prolapse, improve fitness, and regain confidence. ### Why Prolapse Exercises Inside Out Is a Must-Have Michelle Kenway provides comprehensive advice for managing prolapse, with guidance tailored to women at all stages of their pelvic health journey. Whether you're recovering from prolapse surgery, looking to strengthen your core, or seeking safe ways to stay active, this book covers it all: - **Pelvic Floor-Safe Exercises:** Learn the types of movements that support your pelvic floor and avoid those that strain it. - **Post-Surgery Recovery:** Gentle exercises to help you rebuild strength and support healing. - **Core Strengthening:** Safe abdominal workouts that avoid overloading your pelvic floor. - **Weight Management Tips:** Reduce pressure on your pelvic floor with sustainable weight-loss exercises. - **Bone Health:** Improve osteoporosis while protecting your pelvic floor. With Prolapse Exercises Inside Out, Michelle demystifies pelvic floor health with easy-to-follow instructions, step-by-step photographic guides, and clear diagrams. --- ## Rare disease, common problems.. How Hirschsprungs shaped my life URL: https://www.womenshealthpathway.com/blogs/how-hirschsprungs-shaped-my-life/ Description: I was born with a rare bowel disease called Hirshsprung's Disease. Despite it's hard to spell name, the concept is pretty simple: I couldn’t poo. Metadata: - intro: I was born with a rare bowel disease called Hirshsprung's Disease. Despite it's hard to spell name, the concept is pretty simple: I couldn’t poo. - metaDescription: I was born with a rare bowel disease called Hirshsprung's Disease. Despite it's hard to spell name, the concept is pretty simple: I couldn’t poo. - publishDate: 2025-11-20 - author: Louisa Shapton - authorSlug: louisa-shapton - featuredImage: louisa-shapton-feature.jpg - tags: continence - draft: false - hcp: false - headingTitle: Rare disease, common problems.. How Hirschsprungs shaped my life - headingSubtitle: - headingDescription: I was born with a rare bowel disease called Hirshsprung's Disease. Despite it's hard to spell name, the concept is pretty simple: I couldn’t poo. I was born with a rare bowel disease called Hirshsprung’s Disease. Despite it’s hard to spell name, the concept is pretty simple: I couldn’t poo. To spare you the scientific jargon, my large intestine didn’t work properly, meaning my body was unable to “relieve itself” the way most people’s body does. I was the 1 in 5000 newborns to have this condition and it gave my parents a fright, to say the least! I was rushed to a specialist children’s hospital where I had more tests from inside a state-of-the-art incubator. I cried in pain every time my parents held me and had to be fed through tubes. At just 2 weeks old, I had my first surgery to try and fix my faulty digestive system. What a welcome to the world, right? The first surgery removed 80% of my large intestine, leaving me with a poop-bag attached to my body (or a colostomy bag, if you want to be technical) for the next few months. At 3 months old, I had my second surgery to reverse my colostomy surgery and restore “normal” intestinal function – just with much less intestine that I originally had. Since this traumatic entrance to the world, Hirschsprung’s hasn’t posed any risk to me, but it’s far from a distant memory. Every time I look in the mirror whilst getting changed, I see the reminders of my ordeal with HD. Two scars, and irregular bathroom habits, are all that reminds me of what I went through. But it wasn’t always like this. During my school years, I was laughed at, tormented, and outright bullied for having these scars on my stomach, I was called ‘disgusting’ and “weird” because I needed to poo so often – which is just one of the perks of having just 20% of your colon left I suppose! I quickly learnt, to my detriment, how to “hold it in”. I believed that needing to go to the bathroom was a bad thing and that my scars were something to be embarrassed about, especially as a female. I was wrong on three accounts. For years, I was afraid that my scars were ugly or would open a conversation I didn’t want to have. Someone even suggested I should pretend I’d had my appendix taken out because of where my scars are? (The audacity) I didn’t wear crop tops for fear of being shamed, and I always felt awkward going swimming. Throughout my teenage years especially, I struggled with the anxiety around going to the bathroom. What if people heard me? What if I took too long? What if….? There were times I would hold it in until I was doubled over in pain, or I vomited. This wasn’t healthy, and I knew it. I’d literally had surgery to allow me to achieve this basic function and now I was forcing myself not to? Something had to change. I’d started doing working on myself and I became increasingly proud of my Hirschsprung’s Disease. I realised that other people’s lack of understanding doesn’t take away from what I faced as a baby. The prouder I became, the more confident I became to go to the toilet in public. I started realising that I don’t record how long other people spend in the bathroom so why on Earth would they time me? If they do, they are the odd ones - not the girl in the bathroom doing the one thing everyone else does. Societal judgement had deprived me of the confidence to perform one of the most natural functions, and I wasn’t prepared to give away that power anymore. Somehow, we’ve created a society where needing a poo is often seen as ‘rude’ or ‘dirty’, even more so in females. So now, I advocate for all women who feel they need to hold it in, and for those who have been shamed for their bathroom habits relating to conditions like IBS, IBD, and menopause. I speak up for all the ladies who just want to poo in peace and have been subject to the same torment I once faced. We have come so far in tackling the stigma around periods and that “time of the month”, but our other bathroom habits have lagged. So, come on ladies – now is the time to stand up. We shouldn’t be ashamed of our bodily functions, and we shouldn’t feel like we should have to hold it in. Together, we can have a world where no women or girl is made to feel disgusting by her body. A world where no daughter is afraid to go to the toilet in school. A world where no sister is embarrassed to talk about her bowel condition. A world where no girlfriend is afraid to poo in a 10mile radius of her partner. But it only works if we do it together. --- ## Remembering the Whisper Within URL: https://www.womenshealthpathway.com/blogs/remember-the-whisper-within/ Metadata: - intro: - metaDescription: Mic tap. Tap.. Tap tap.. tap.. I curiously look around a room that could be empty or packed full. …Overhead lights blinding my eyes. 'Is this thing on? - publishDate: 2025-09-29 - author: Amanda Curry - authorSlug: amanda-curry - featuredImage: amanda-curry-feature.jpg - tags: - draft: false - hcp: true - headingTitle: Remembering the Whisper Within - headingSubtitle: - headingDescription: Mic tap. Tap.. Tap tap.. tap.. I curiously look around a room that could be empty or packed full. …Overhead lights blinding my eyes. 'Is this thing on?' Mic tap. Tap.. Tap tap.. tap.. I curiously look around a room that could be empty or packed full. …Overhead lights blinding my eyes. “Is this thing on?” Thud thud thud. A louder test to this thing that's supposed to project my message louder… Finally the squeal of feedback hits my ears. “Oh. Ok. There we go.” Staring straight into the abyss, I ask again. “Are you ladies ok out there?” No response. “No seriously. I know this thing is on.” I can feel their energy rustling. The uncertainty of their ability to respond. The fear of what’s to come in holding this question in their mind's eye and hurting hearts. The house lights drop and I can see every one of their faces glowing in front of me. Mom’s with babies on their hips. Women holding their womb. Angry scowls and fixed jaws. Darting eyes and legs braced to exit. Women wearing Jimmy Choos and Vera Wang clutching Prada purses. Others with worn hand me downs and their latest discount snag. Those that struggle with disconnection to themselves, their partner, their kids, and/or their family. Those that have a severed relationship to their body, their heart, and their womb. Those that feel lost and confused in the washing machine that is life as a modern day woman. I HEAR YOU, I whisper. Your inner dialogue of inquiry, hypercriticalness, and helplessness reverberating in my ears. I SEE YOU, I offer. Reading the books, skimming blogs, watching youtube videos, and confiding in friends. I FEEL YOU, I finally scream. The tossing and turning at night, clenching your teeth and pelvic floor during the day, your whole body tensing with anger, despair, and confusion at where you’re at. I can do all this because I have experienced parts of what you have experienced. Held women in what you are experiencing. And hold a tenderness for the tiny little girls staring back at me attempting to navigate this wild wild world as adult women. I want you to know this tenderness I feel. That I have found, cultivated, and gifted to myself and others is REAL.. And It’s available for you too. But you can’t find it in stores, a manual, or pill bottle. It can only be found WITHIN YOU. And with so much gentleness, I want to remind you…. You are the gatekeeper of all the sensations and emotions within. You are the knower of all that you need to feel safe and whole. You are the permission giver to all of the things you desire and dream about. So let this be my message of remembering both the simplicity and complexity of life as one that may consistently hurt on a physical, emotional, and energetical level. Of your ability to hold safety in the unknown. Of the permission to let yourself unravel. Of the gift that is advocating for what you know, what you need, and lengths you will go to get it. Let this be the re awakening of the whisper that grows to a roar. “Just keep going. You know the way.” --- ## Restoring the Pelvic Floor for Women URL: https://www.womenshealthpathway.com/resources/books/restoring-the-pelvic-floor-for-women/ Metadata: - subtitle: - author: Dr Amanda Olsen - publishDate: 2025-09-16 - tags: prolapse - category: book - image: /images/reviews/books/restoring-the-pelvic-floor.jpg - infoLink: https://www.amandaolsondpt.com/ - purchaseLink: https://www.amandaolsondpt.com/ - draft: false - spotifyLink: - appleLink: - googleLink: - youtubeLink: Dr. Amanda Olson is a pelvic health physical therapist, entrepreneur, author, and global educator with a passion for empowering men and women and advancing conversations around pelvic health. With over a decade of experience, she has dedicated her career to breaking stigmas around pelvic health, supporting patients with conditions including incontinence, pelvic pain, cancer, pelvic organ prolapse, endometriosis, and MRKH, and developing innovative solutions to improve quality of life. Dr. Olson is the President & Chief Clinical Officer of Intimate Rose, a successful pelvic health device company, holds multiple patents, and has authored three peer- reviewed journal articles as well as the book Restoring the Pelvic Floor for Women. Restoring the Pelvic floor offers clear, compassionate support for women navigating pelvic floor dysfunction. Blending clinical expertise with emotional safety, the book covers conditions like pelvic organ prolapse, incontinence, pelvic pain, and sexual health. It introduces evidence-based exercises, lifestyle strategies, and therapeutic tools to help women restore strength, function, and confidence. With its accessible tone and stigma-breaking approach, Restoring the Pelvic Floor is a trusted companion for anyone seeking healing and hope. --- ## Rethinking Comfort in the Speculum Exam URL: https://www.womenshealthpathway.com/blogs/rethinking-comfort-in-the-speculum-exam/ Metadata: - intro: - metaDescription: Dr. Emily Fitch explores improving speculum exam comfort for patients and providers. Advocacy tips, modern innovations, and respectful healthcare. - publishDate: 2025-09-23 - author: Dr. Emily Fitch - authorSlug: emily-fitch - featuredImage: emily-fitch-feature.jpg - tags: vaginal-vulva-health - draft: false - hcp: true - headingTitle: Rethinking Comfort in the Speculum Exam - headingSubtitle: - headingDescription: Speculum exams are a vital part of women’s health care, but they’re often remembered with dread rather than comfort. Patients deserve agency, providers deserve better tools, and both deserve an exam experience that feels respectful. In this blog, Dr. Emily Fitch explores how comfort can be improved on both sides of the exam and how innovation is helping to reimagine the process. No matter the stage of life, speculum examinations are uncomfortable. Over the years, I patients have echoed these exams are cold, painful, simply something you just “have to deal with”. I’ve also spoken with providers who feel limited by the tools they use, wishing the process could be smoother for both sides of the exam table. The truth is, comfort in a speculum exam is not a luxury, it’s a necessity. Comfort directly impacts the quality of care delivered through patient trust and test efficacy. Improving that comfort requires collaboration from both patients and providers. ## How patients can advocate for themselves Your voice matters. Here are some tips on how to be more active in shaping your experience: - Before the exam, sharing past experiences, asking for the smallest available size, or requesting that the speculum be warmed or lubricated are all reasonable ways to help increase comfort. - During the exam, communicate openly. Ask the provider to explain each step, or to request quiet if that feels more grounding. You can pause or stop the procedure if needed, request adjustments to positioning, or even insert the speculum yourself in certain cases. - After the exam, feedback matters. Letting the provider know what worked well, asking about alternatives for the future, or simply voicing questions about findings helps ensure the visit ends with clarity and respect. ## What providers can do to support comfort For providers, reducing discomfort is part of delivering quality, compassionate care. Here are some examples on how that can be achieved: - Clear communication builds trust: explaining steps, offering reassurance, and responding openly to patient concerns or preferences. - Thoughtful technique matters: using the right size, warming the instrument, or applying lubricant when appropriate can reduce discomfort significantly. - Creating space for agency gives patients control: by encouraging feedback, respecting a request to pause, or guiding the process. - Being open to innovation improves care: clinically tested modern designs can reduce exam time, improve visualization, and support a more comfortable experience. ## A shared responsibility When patients are empowered to advocate for their needs and providers respond with openness and care, healthcare improves. What once caused dread and avoidance can become a moment where women reclaim their autonomy. Comfort isn’t just about easing discomfort; it’s about creating a foundation of trust that strengthens care and protects our health. Innovations in women’s health are beginning to reflect this shift. [The Bouquet Speculum](https: For sales enquiries, please contact [Pioneer Medical Europe](https: --- ## Sarah Henschel URL: https://www.womenshealthpathway.com/resources/telehealth/sarah-henschel/ Metadata: - name: Sarah Henschel - authorSlug: sarah-henschel - role: Naturopath & Nutritionist, Women's Health Advocate - businessName: Natology - url: https://www.natology.com.au - country: Australia - metaTitle: Sarah Henschel | Telehealth Provider | Naturopath & Nutritionist | Women's Health Advocate - metaDescription: - publishDate: 2025-09-11 - featuredImage: sarah-henschel.jpg - tags: menopause,vaginal-vulva-health,nutrition - draft: false With over 20 years of experience, I’ve dedicated my practice to supporting women through life’s transitions. I understand the challenges that come with hormonal shifts, energy changes, and mood fluctuations, and I’m here to help you feel balanced, confident, and supported. My approach blends evidence-based testing with the gentle wisdom of natural medicine. Together, we’ll look at the whole picture—your body, lifestyle, and unique story—to create a plan that feels realistic, nourishing, and sustainable. I offer support for: - Menopause & hormonal balance - Thyroid and gut health - Skin, mood, and energy concerns - Nutrition and lifestyle guidance Above all, my goal is to create a safe, compassionate space where you feel heard and understood. Many women tell me they finally feel “seen” when we work together—and that’s the heart of what I do. If you’re ready to feel more like yourself again, I invite you to start with a free 15-minute call so we can talk about what’s going on for you and how I can help. --- ## Sex with Dr Jess URL: https://www.womenshealthpathway.com/resources/podcasts/sex-with-dr-jess/ Metadata: - subtitle: - author: Dr Jess - publishDate: 2026-07-22 - tags: sexual-health - category: podcast - image: /images/reviews/podcasts/sex-with-dr-jess.png - infoLink: https://happiercouples.com/ - purchaseLink: - draft: false - spotifyLink: https://open.spotify.com/show/0sL5FqZrxCAa94DhntIm5M - appleLink: - googleLink: - youtubeLink: https://www.youtube.com/user/SexWithDrJess Want richer relationships from the boardroom to the living room to the bedroom? Dr. Jess has you covered. Whether you want to let go of resentment, find your long lost libido or simply explore multiple orgasms, Jess, Brandon and their brilliant roster of guests explore all things relationships and pleasure in this practical, solution-focused podcast. [Happier Couples](https: --- ## Sex Without Pain URL: https://www.womenshealthpathway.com/resources/books/sex-without-pain/ Metadata: - subtitle: A Self-Treatment Guide To The Sex Life You Deserve - author: Dr Heather Jeffcoat - publishDate: 2025-08-15 - tags: vaginal-vulva-health,sexual-health - category: book - image: /images/reviews/books/sex-without-pain.jpg - infoLink: https://www.amazon.com/dp/1631100084/?mr_donotredirect - purchaseLink: https://www.amazon.com/dp/1631100084/?mr_donotredirect - draft: false - spotifyLink: - appleLink: - googleLink: - youtubeLink: Heather Jeffcoat (she/her/hers) is the author of Sex Without Pain: A Self-Treatment Guide To The Sex Life You Deserve and a recognized expert in the field of Pelvic Health Physical Therapy. She is also a recent past President of the Academy of Pelvic Health Physical Therapy from 2021-2024, and she served many years on the Advisory Board of the International Pelvic Pain Society. With her expanding mission to provide access to the specialized pelvic health services her office offers, she also launched the Empower Health Fund in 2019, a nonprofit with 501(c)3 status, providing no-cost care to low-income, marginalized populations. She has also been a featured guest on CNN, Cosmopolitan, Glamour, Livestrong, the award-winning Sex With Emily podcast and Sirius XM show, Mom.me, ABC Radio and many others. Sexual pain is not a life sentence. It’s a signal, one that deserves compassion, clarity, and care. In Sex Without Pain, pelvic health expert Dr. Heather Jeffcoat offers a groundbreaking, stigma-breaking guide for women navigating conditions like vaginismus, vulvodynia, and painful intercourse. This book is more than a treatment plan—it’s a reclamation of agency, pleasure, and self-trust. Through gentle exercises, trauma-informed tools, and validating insights, Heather empowers readers to reconnect with their bodies and rewrite their intimate narratives. --- ## Sheree DiBiase URL: https://www.womenshealthpathway.com/resources/telehealth/sheree-dibiase/ Metadata: - name: Sheree DiBiase - authorSlug: sheree-dibiase - role: Physical Therapist - businessName: Lake City Physical Therapy - url: https://www.lakecitypt.com - country: USA - metaTitle: Sheree DiBiase | Telehealth Provider | Founder Lake City Physical Therapy, - metaDescription: Meet Sheree DiBiase, PT - founder of Lake City Physical Therapy & Pelvic Floor Pro app. 42 years helping women with pelvic health, breast cancer recovery & quality of life. - publishDate: 2025-12-01 - featuredImage: sheree-dibiase.jpg - tags: continence,vaginal-vulva-health - draft: false I’m Sheree DiBiase, PT, the founder Lake City Physical Therapy, with 7 clinics in the USA providing PT/ OT care. We are located in Washington and Idaho. I am also the founder of [Pelvic Floor Pro](/resources/apps/pelvic-floor-pro/), a science-backed, medical App on Apple and Google Play. A third of all women have pelvic floor disorders and often tell no one and over 2.3 million women have breast cancer that affects their daily lives. Over 30 years ago, I had my own pelvic floor issues after the birth of my first son. I saw five physicians, and no one knew how to help me. Since then, I became a certified pelvic health practitioner. At that time, I also saw a care gap continuum for women with breast cancer as well. Due to improved medical care, they were living longer as survivors and needed help having higher quality of life. Because of that, I became certified in the management of oncology and lymphedema care. The “Pelvic Floor Pro” App offers easy access for women: education, specific exercise plans, Telehealth visits with a provider, “Ask Amy-AI” and community support, for everything “below the belt” bladder, bowel and sexual health. Globally over 1.6 billion women suffer from some form of pelvic floor disorder, and data points to only 20% of women are seeking help. Our pelvic floor app will allow accessible, affordable and accurate care for the 80% of women who are lost in the care gap. I started [FemTech Health, a podcast](/resources/podcasts/the-fem-tech-health-podcast/) 3 years ago, because I wanted to talk to the people all around the world, who were developing new technologies and had innovative ideas about how to help women have a better life. Take a listen and hear these brilliant people tell their stories. I have been a PT for 42 years and was an Adjunct Professor at Loma Linda University PT/ PTA/ OT School for 7 years. I taught kinesiology, biomechanics and gait training. Education is my passion, the more we know, the better we live. All that being said, my number one goal is to help women have the life they choose. ### Links - Facebook: [Sheree DiBiase](https: - YouTube Channel: [Sheree DiBiase](https: - Tic tok: [Sheree DiBiase](https: - Instagram: [Sheree DiBiase](https: - LinkedIn: [Sheree DiBiase](https: - Podcast: [Fem Tech Health on Apple and Spotify](/resources/podcasts/the-fem-tech-health-podcast/) ### Websites - [www.lakecitypt.com](https: - [Pelvicfloorpro.com](https: --- ## Sheren's journey part 1: My decade living with vulvodynia URL: https://www.womenshealthpathway.com/blogs/my-decade-living-with-vulvodynia/ Description: For ten years, Sheren's life was measured in pain levels and cancelled plans. This is how she moved from bedbound and hopeless to the beginning of real recovery. Metadata: - intro: For ten years, Sheren's life was measured in pain levels and cancelled plans. This is how she moved from bedbound and hopeless to the beginning of real recovery. - metaDescription: Sheren spent a decade living with vulvodynia. She shares her story of misdiagnosis, isolation, and the unexpected turning point that started her recovery. - publishDate: 2026-08-01 - author: Sheren Gaulbert - authorSlug: sheren-gaulbert - featuredImage: sheren-gaulbert-feature.jpg - tags: vaginal-vulva-health - draft: false - hcp: false - headingTitle: Sheren's journey part 1: My decade living with vulvodynia - headingSubtitle: Living with vulvodynia - headingDescription: One woman's decade-long path from chronic pelvic pain toward recovery. Ten years is a long time, and for most people it will be marked by milestones: careers built, relationships formed, memories made, and new chapters begun. For me, those years were measured in pain levels, cancelled plans, missed opportunities, and days when my bedroom became both my refuge and my prison. My journey didn't begin with a single dramatic moment when everything changed. Instead, what started as discomfort and a burning sensation, was treated as thrush, but the treatments seemed to make things worse. It took a year before I heard the word “vulvodynia” for the first time, and that was only because I kept advocating for myself. I knew my body. I knew something wasn’t right. I was in my early twenties, studying law, and trying to understand how this could be happening to me. At the time, there was a perception that vulvodynia mainly affected postmenopausal women. That didn’t match my reality, and I felt helpless with the uncertainty and lack of answers. I dropped out of law school and started an easy part-time job because I couldn’t function as I once had. I started on Amitriptyline, which made me feel disconnected, my world fuzzier. As the dosage increased, the drowsiness worsened. A few years later, I moved to the less sedating Nortriptyline, eventually increasing to 95mg with zero relief. Occasional appointments with no answers. The pain worsened. One consultation impacted me hard. A leading consultant at the time suggested reducing my work hours, or stopping completely and taking bedrest. She also said, “This is your life from now” and “You do realise you’re not going to see me again, don’t you?” Now, I understand how these messages can become part of the illness experience, adding to hopelessness. The nocebo effect - the negative impact a clinician’s words or demeanour can have on symptoms and recovery. I eventually stopped work and started taking that “bed rest.” The pain became all-consuming. I tracked pain levels daily because I had been told it might help. The pattern was 8, 9, or 10 out of 10, keeping my focus on the severity and ramping things up further. There were moments when the intensity became so overwhelming that I would black out. The hardest part was not only the physical pain. It was the isolation. People around me cared. But there's a taboo around pelvic pain. Plus, pain that cannot be seen is difficult for others to truly understand. Even healthcare encounters sometimes left me feeling more alone. I wore a mask of pretending I was ok (we can get so good at that right, when living with persisting pain)! For years, I followed the advice I had been given. I rested. I avoided things that might make the pain worse. I spent so much time in bed because I believed I was protecting myself. I was referred to a sex therapist who didn't seem to understand that sex was the last thing on my mind. I just wanted the pain to disappear. I went through some dark times. Eventually, something inside me shifted. I reached a point where I decided enough was enough. I could not spend my entire life waiting for someone else to find the answers or give me permission to live again. I tried diets, therapies, techniques, and ideas that promised relief. I spent energy and money, but gained nothing. Almost 10 years in, came a turning point from an unexpected place. A friend suggested self-hypnosis. At first, I dismissed it. I’d tried it before and it felt like a silly fad. However, this time I found a script focused on values and self-compassion, not pain. I recorded myself reading it in what I thought was a ridiculous hypnotic tone of voice! I listened each night before sleep. Seven days later, I went outside on my own. To some people, that may sound like a small thing. For me, it was enormous. A new routine began once or twice a week. With Google still in its infancy, I would slowly walk to the library to access the internet, explore what else I could do with my life, and find answers. The pain had not magically disappeared. My body had not suddenly returned to how it was before. But something had changed. I had started to reconnect with myself and see that my life could become bigger than my pain. It was the beginning of my recovery journey. No instant cure or simple solution. Chronic pain is complex, and every person’s experience is different. But what changed for me was my relationship with pain. I began to recognise that although pain was part of my story at the time, it did not have to be the whole story. When I was in the depths of that dark tunnel, I made a promise. When I found a way out, I would retrain, learn as much as I could about pain, and start helping others out of the tunnel. Part two gets into the next part of my recovery and what followed. --- ## Sheren's journey part 2: Out of the vulvodynia tunnel & beyond URL: https://www.womenshealthpathway.com/blogs/out-of-the-vulvodynia-tunnel-and-beyond/ Metadata: - intro: - metaDescription: Part two of Sheren's vulvodynia story: pain science, cognitive hypnotherapy and self-compassion, and why the best care treats the person, not the body part. - publishDate: 2026-08-22 - author: Sheren Gaulbert - authorSlug: sheren-gaulbert - featuredImage: sheren-gaulbert-feature.jpg - tags: vaginal-vulva-health - draft: false - hcp: false - headingTitle: Sheren's journey part 2: Out of the vulvodynia tunnel & beyond - headingSubtitle: - headingDescription: Seven days after recording a self-hypnosis script, I left the house on my own for the first time. The pain hadn't gone but there was finally a light at the end of the tunnel. This is what I found on the way out. Seven days after recording a self-hypnosis script, I was able to go out of the house on my own. Pain hadn’t disappeared, but there was now a light at the end of the tunnel. I was curious. Self-hypnosis hadn’t worked previously, and this script had nothing to do with pain. What had made the difference? I dove into pain science and reflected on people deemed "hopeless cases" I’d coached in the past. I began volunteering to help others who had long term health problems. I now responded with self-compassion to negative thoughts, rather than impatience and frustration. I realised the script had been about compassion for others and myself, and focusing on doing things that were meaningful to me. A year later, I began training in Cognitive Hypnotherapy, a framework underpinned by evolutionary biology and neuroscience. I worked through my own trauma, reprocessing memories connected to sadness, shame, anger and out-of-date beliefs that had shown up as tension and anger throughout my life. A pattern I recognise now: adrenaline - cortisol - tension - health problems - pain. Pain dissipated, and I slowly tapered medication. I qualified and started as a generalist, wanting more depth before helping people with pain. I trained further in pain science with the Neuro-Orthopaedic Institute, and attended monthly meetings with pain scientists. I noticed overlapping principles across cognitive hypnotherapy, pain science and best practice care. The most important: **Treat the person, not the body part**. There is little correlation between pain severity and tissue damage. What else is happening in a person's life, support, beliefs about pain, meaningful things in their life pain prevents them from enjoying, anticipation of pain, nocebic messages from clinicians, emotions such as fear, shame, guilt, can all amplify symptoms, as can some comorbidities, and past trauma. That doesn’t mean pain is "all in the head." Humans are complex and unique. The biopsychosocial model: biology, psychology and social context are constantly interacting. Just treating a body part misses the bigger picture of what else may be contributing. I tentatively began working with people living with vulval pain. Unsurprisingly, when a person living with persisting pain feels like they’re not being heard or supported, a cycle of hopelessness, helplessness, anxiety or depression can fuel worse pain. I was told by a GP "Just get married and have children and you'll be fine" and a sex therapist told me “You’re avoiding finding a boyfriend." Sex was not my priority, but this was the supposed care pathway. Even when two people have the same diagnosis of vulvodynia, treatment plans need to be individualised, taking into account the factors that amplify their pain and working toward a life that’s meaningful to them. A good outcome-focused question: **“What’s the first small thing you’d like to be able to start doing?”** The nervous system can be primed for sensitivity over time during periods of stress and more adrenaline. A question to uncover key factors: **"What was going on in your life in the 1-2 years before the pain started?"** For some there's something obvious, like the death of someone close, but more often it's prolonged background stress or overdoing things. In 2013, I presented at the [Vulval Pain Society](https: I had not forgotten the promise made in that dark tunnel: if I found a way out, I would retrain and help other people. Even now, for those who persist, diagnosis takes two years on average. Half give up, and many self-diagnose. In 2019, I became a Trustee of the VPS, organising webinars and livestreams with clinicians and researchers. Our YouTube channel now has more than 50 videos for patients and clinicians. After a period of stress in 2016, every pain I’d ever had returned at once - vulvodynia, sciatica, back pain, sore joints, and migraine. I’d take one step then breathe for a bit before taking the next. But this time, I had knowledge, therefore the unshakeable belief that I’d recover within 2 weeks and possibly sooner. I took myself through a deep therapy session and went to sleep… The next day, I could walk fine. 48 hours later, everything had eased and I could run! This may seem like a miracle but really, I knew pain science plus what I had to do and knowledge meant power. My journey out of the dark vulvodynia tunnel had taught me determination, patience, self-compassion, how to advocate, and how patients and clinicians must work better collaboratively. I now divide my time - guiding people with chronic pain through the tunnel with tailored programs, and coaching multidisciplinary clinicians in ethical, pain-science-based, trauma-informed care, therapeutic language, addressing imposter syndrome and burnout. How we show up as clinicians matters. There is no one-size-fits-all or quick fix but my journey was needlessly long. Multidisciplinary care is best practice, addressing the interconnected biopsychosocial elements. My personalised path out was self-hypnosis, cognitive hypnotherapy (the big piece), physiotherapy, yoga, pain science, trauma work, and time. "Out" looks different for everyone: full resolution for some, less frequent or decreased pain for others. Regaining a sense of agency must be the focus so people can start doing more of what matters to them, rather than pain being in charge. Despite my knowledge, I am still amazed by neuroplasticity and bioplasticity - the capacity for change. The journey has taught me so much, and it is a privilege to now guide others. I am profoundly differently now, in a good way. The way I practise, how I advocate, how I guide clinicians to facilitate change rather than hinder it - the promise I made in that dark tunnel has shaped the life I live now, and for that I am forever grateful. --- ## Squeeezy URL: https://www.womenshealthpathway.com/resources/apps/squeezy/ Metadata: - subtitle: Pelvic Floor Muscle Exercises - author: Living With Ltd - publishDate: 2025-08-15 - tags: continence,prolapse - category: app - image: /images/reviews/apps/squeeezy.jpg - infoLink: https://squeezyapp.com - purchaseLink: https://squeezyapp.com - draft: false - spotifyLink: - appleLink: https://apps.apple.com/gb/app/squeezy-nhs-pelvic-floor-app/id700740791?at=10lta2 - googleLink: https://play.google.com/store/apps/details?id=com.propagator.squeezy - youtubeLink: Pelvic floor muscle exercises are incredibly effective as a first-line treatment for a variety of bladder, bowel and pelvic floor issues. Your pelvic floor muscles also play an important role in your sex life too! All women should perform pelvic floor exercises on a daily basis, preferably three times a day. There is excellent research to show that this can help keep your pelvic floor healthy, and prevent problems such as stress incontinence and pelvic organ prolapse. For women who experience problems—such as bladder or bowel leakage, or pelvic organ prolapse—pelvic floor muscle exercises should be practised up to six times a day. --- ## The Day My Vagina Broke URL: https://www.womenshealthpathway.com/resources/books/the-day-my-vagina-broke/ Metadata: - subtitle: What They Don't Tell You About Childbirth - author: Stephanie Thompson - publishDate: 2025-09-16 - tags: childbirth,vaginal-vulva-health - category: book - image: /images/reviews/books/the-day-my-vagina-broke.jpg - infoLink: https://www.booktopia.com.au/the-day-my-vagina-broke-stephanie-thompson/book/9781925921342.html?srsltid=AfmBOopPQUq-EdydM2Bm0IPJwxk_wnWyfqP0ahrg3djUCuB-YJdcg3B- - purchaseLink: https://www.booktopia.com.au/the-day-my-vagina-broke-stephanie-thompson/book/9781925921342.html?srsltid=AfmBOopPQUq-EdydM2Bm0IPJwxk_wnWyfqP0ahrg3djUCuB-YJdcg3B- - draft: false - spotifyLink: - appleLink: - googleLink: - youtubeLink: The Day My Vagina Broke' follows one woman's journey to becoming a mumma and how she had no idea childbirth could break your vagina… and you. Once you're pregnant the rest is easy right? No. Knowing parenting wouldn't be easy, Stephanie Thompson never thought too much about how the baby would actually arrive, and how that was, in fact, the hardest part of the journey so far. Many women feel foolish for not knowing what they didn't know; they found out the hard way. 'The Day My Vagina Broke' is about breaking the silence on the secret women's code around childbirth and empowering mums-to-be at their most vulnerable time. After going through her own tough childbirth experience, Stephanie wants other mothers to be informed about all birthing methods and be empowered to decide which method is best for their individual needs, not what they hear or read as being the ‘best'. This book builds a sisterhood of support by taking away the pressure and judgement so many women place on themselves and others. While this is a tough subject, ‘The Day My Vagina Broke’ also provides hope for those who have been through a difficult birth and shows that you can still enjoy that wonderful moment you meet your baby for the first time. --- ## The Fem Tech Health Podcast URL: https://www.womenshealthpathway.com/resources/podcasts/the-fem-tech-health-podcast/ Metadata: - subtitle: - author: Dr Sharee DiBiase - publishDate: 2025-09-16 - tags: continence,prolapse,menopause - category: podcast - image: /images/reviews/podcasts/the-fem-tech-health-podcast.jpg - infoLink: - purchaseLink: - draft: false - spotifyLink: https://open.spotify.com/show/4hne4TiEdsuOOegT6srv3u - appleLink: https://podcasts.apple.com/us/podcast/femtech-health-podcast/id1603325503 - googleLink: - youtubeLink: Femtech and women's health podcast. We talk to leading experts in endometriosis, prenatal postpartum, pelvic floor, biotech and more. Join us weekly for conversations your OBGYN didn't even know existed. --- ## The Giant Vibrator in the Room URL: https://www.womenshealthpathway.com/blogs/the-giant-vibrator-in-the-room/ Metadata: - intro: - metaDescription: When a pelvic floor therapist suggested a vibrator for my endometriosis pain, unexpected shame surfaced—revealing how sexual conditioning shapes our care. - publishDate: 2026-08-26 - author: Spencer Moore - authorSlug: spencer-moore - featuredImage: spencer-moore-feature.jpg - tags: sexual-health - draft: false - hcp: false - headingTitle: The giant vibrator in the room - headingSubtitle: - headingDescription: How a routine suggestion in pelvic floor therapy surfaced the shame I thought I'd left behind. I recently had a consultation with a pelvic floor therapist. I have endometriosis, and these past few months I've been struggling with increasing pelvic pain, especially when sitting. My endo specialist recommended that I try pelvic floor therapy to find some relief. The session was wonderful, I learned so much, and felt hopeful that the therapy would help manage my pain as I also pursued other options for treatment. The therapist recommended weekly sessions, but since Barcelona (and Europe) largely shut down in August, she would be leaving for holidays. We wouldn’t be able to begin our sessions until mid-September. As we were winding down, I asked whether there was anything I could do during the next four to six weeks to get the ball rolling as I waited to begin the therapy. "Do you have a vibrator?" she asked. Instead of an enthusiastic yes, I found myself speechless, unsure how to answer or even whether I wanted to. I am a 43-year-old woman who consciously believes there is nothing shameful about owning a vibrator, which, by the way, I do. Yet in those first few seconds, I felt embarrassed and exposed, as though acknowledging it revealed something I should have kept private. My body reacted before my conscious beliefs could catch up. She had asked for an entirely practical reason. She explained that there were certain pressure points where I could place the vibrator so that the vibration around the pelvic region could help release some of the tension in the muscles, which evidently I had been keeping extremely tight. She discussed it without awkwardness or judgment, because that was precisely what it was within the context of our conversation: a therapeutic tool. Walking out of the appointment, I found myself shaking my head. Not out of shame, more toward bewilderment. It had been a knee-jerk reaction, something that moved before I could intercept it, and I couldn't quite account for why that one question had landed the way it did. We were not talking about sex or pleasure. We were talking about endometriosis and the tension my body had been holding. Yet that one word brought an entirely different set of associations into the room. The shame I felt was connected to sexuality, but it surfaced in an appointment where I was seeking treatment for pain. That distinction is important because sexual conditioning does not remain neatly contained within our sex lives. It can emerge in medical appointments, conversations about our bodies, and the language we use when describing our health. It can influence what we are comfortable admitting, what we hesitate to ask, and which parts of ourselves we instinctively keep private, even when that information may be relevant to our care. I had believed that being open-minded and comfortable with female sexuality meant I had moved beyond that kind of shame. My reaction showed me that consciously rejecting a message does not necessarily erase every trace of it. We absorb ideas about women's sexuality, pleasure, respectability, and judgment throughout our lives. Some are obvious enough to challenge. Others settle more quietly into the body and only reveal themselves when an unexpected question touches them. During that appointment, mine was the giant vibrator in the room: the shame attached to owning a vibrator, even for a woman in her forties who consciously believed otherwise. Recognizing it didn't make it disappear. But there is something that shifts when you can finally name what has been quietly occupying space. You can begin to ask where it came from, whether it was ever really yours to carry. Awareness doesn’t instantly undo a lifetime of conditioning, nor does one conversation resolve every feeling it brings to the surface. But listening to my body's reaction made that giant invisible vibrator visible. And once I could see it, I could begin to understand it, shrink it enough to fit through the open door, and let it vibrate itself out of the room. --- ## The GP Show URL: https://www.womenshealthpathway.com/resources/podcasts/the-gp-show/ Metadata: - subtitle: - author: Dr Sam Manger - publishDate: 2025-08-15 - tags: general - category: podcast - image: /images/reviews/podcasts/the-gp-show - infoLink: - purchaseLink: - draft: false - spotifyLink: https://open.spotify.com/show/5pZZqmYqrvFoxpwrKfAl9N - appleLink: https://podcasts.apple.com/au/podcast/the-gp-show/id1267681502 - googleLink: - youtubeLink: The GP Show is a respected, evidence-rich podcast hosted by Australian GP and medical educator Dr Sam Manger. It’s designed for health professionals and curious minds alike, offering deep dives into medicine, wellness, and the social determinants of health. - Interviews with global health leaders, psychologists, and researchers - Topics like trauma-informed care, ADHD, lifestyle medicine, and - Practical tools for inclusive, whole-person healthcare --- ## The Hairy Chin URL: https://www.womenshealthpathway.com/resources/podcasts/the-hairy-chin/ Metadata: - subtitle: - author: Spencer Moore - publishDate: 2026-04-23 - tags: prolapse,vaginal-vulva-health,menopause,continence,sexual-health - category: podcast - image: /images/reviews/podcasts/hairy-chin.png - infoLink: https://www.thehairychin.com/ - purchaseLink: - draft: false - spotifyLink: https://open.spotify.com/show/7BTlKLaFBhdTa0pqFVXoUD - appleLink: https://podcasts.apple.com/us/podcast/the-hairy-chin-podcast/id1761208157 - googleLink: - youtubeLink: https://www.youtube.com/@thehairychin The Hairy Chin is a women's health advocacy podcast focused on the mechanics behind self advocacy. Because here’s the truth: women are told they must advocate for their health, but rarely they are explained how. This show breaks down the practical skills women can learn to navigate medical systems more clearly, from preparing for appointments and communicating symptoms in usable language, to organizing health information and understanding how decisions are made inside the room. Hosted by Spencer Moore, a patient turned advocate with over thirty years of experience navigating complex health systems (in the US and Spain), this podcast is built on lived experience, interviews with medical professionals, and the patterns that repeat across women’s stories. This is not a wellness trends podcast. It’s not about biohacking or chasing root causes. It’s about learning how healthcare actually works, and how to participate in it without minimizing yourself, over explaining, or leaving unsure of what just happened. Through structured advocacy series, conversations with women telling their advocacy in real life stories, and expert interviews, you’ll learn how to show up prepared, communicate clearly, and walk out of appointments with next steps you understand. Self advocacy is not a personality, it’s is a skillset. And skills can be learned. [The Hairy Chin](https: --- ## The Hole Shebang URL: https://www.womenshealthpathway.com/resources/podcasts/the-hole-shebang/ Metadata: - subtitle: - author: Kristen Parise - publishDate: 2025-09-16 - tags: prolapse,vaginal-vulva-health,sexual-health - category: podcast - image: /images/reviews/podcasts/the-hole-shebang.jpg - infoLink: https://example.com/pelvic-floor-talks-info - purchaseLink: https://podcasts.apple.com/pelvic-floor-talks - draft: false - spotifyLink: https://open.spotify.com/show/3Qjlm6VuV0rqvqwmJlGl0t - appleLink: https://podcasts.apple.com/ca/podcast/the-hole-shebang/id1766397933 - googleLink: - youtubeLink: Brazenly and unashamedly exposing the truth about all things pelvic health including pee, poop, pain and sex and shining a light on our holes in knowledge to help empower us to be healthier, wealthier and wiser. Kristen Parise is a Pelvic Health Physiotherapist and owner of Blueberry Therapy a multidisciplinary clinic that specializes in the treatment of pelvic health issues. Kristen’s goal has always been to make sure her clients understand their own bodies and and they have all the tools and information they need to reach their goals. Her passion is the rehabilitation of the pelvic floor and she provides treatment for men and women and children with incontinence, chronic constipation, pelvic pain and women pre and postnatally. Kristen is an avid podcast listener and is excited to bring forward the latest research and information to The Hole Shebang audience. Kristen has a deep interest in research and evidenced based practice and continues to teach at McMaster University in Hamilton, Ontario to stay current with evolving practice trends. --- ## The midlife strength solution: staying upright, active, and independent URL: https://www.womenshealthpathway.com/blogs/the-midlife-strength-solution/ Description: As we get older, our muscle health naturally declines, and as a result, muscle strength and power decrease significantly. At the same time, many people develop more body fat, and in the pursuit of staying fit and well, often turn to restrictive diets in an attempt to lose it. Metadata: - intro: As we get older, our muscle health naturally declines, and as a result, muscle strength and power decrease significantly. At the same time, many people develop more body fat, and in the pursuit of staying fit and well, often turn to restrictive diets in an attempt to lose it. - metaDescription: Combat midlife muscle decline with evidence-based strategies. Learn about protein needs, strength training, and healthy aging for women over 50. - publishDate: 2025-08-15 - author: Rebecca Thompson - authorSlug: rebecca-thompson - featuredImage: rebecca-thompson-feature.jpg - tags: menopause - draft: false - hcp: true - headingTitle: The midlife strength solution: staying upright, active, and independent - headingSubtitle: - headingDescription: As we get older, our muscle health naturally declines, and as a result, muscle strength and power decrease significantly. At the same time, many people develop more body fat, and in the pursuit of staying fit and well, often turn to restrictive diets in an attempt to lose it. But here’s the problem: research has shown time and again that crash dieting doesn’t work. Once we stop dieting, we often regain the fat — but more importantly for women in midlife, we lose muscle during dieting and don’t regain it afterwards. That loss of muscle has long-term consequences. ## Why Is This So Important? We need strong, healthy muscles and bones to keep us upright, active, and independent. This becomes even more critical as we age. One in three women over the age of 50 will suffer a hip fracture — a rate far higher than that seen in men. Poor bone health plays a significant role here. The outcomes can be serious: 40% of women never walk unaided again after a hip fracture Women are five times more likely to fracture the other hip within two years[^1] ## What can we do? There is so much we can do to support healthy aging: - Weight-bearing and resistance exercise to strengthen muscles and bones - A healthy diet, such as the Mediterranean diet - Ensuring you’re not deficient in vitamin D, calcium, or iron - Quitting smoking - Reducing alcohol intake - Considering Menopausal Hormone Therapy (MHT) to replace hormones lost during menopause. ## How much protein do we actually need? According to evidence presented at the International Menopause Society Conference in Melbourne (October 2024), women going through the menopause transition require 1.2 to 1.5 grams of protein per kilogram of body weight per day. Example: A woman weighing 70 kg would need 84 to 105 grams of protein per day. This is significantly more than general guidelines, and many women simply aren’t getting enough — especially if they’re eating smaller meals or skipping them entirely. ## Tips to boost protein intake - Include protein with every meal (think: eggs, Greek yoghurt, legumes, lean meats, tofu, tempeh, fish) - Add protein-rich snacks like nuts, hummus, or boiled eggs - If needed, consider a protein supplement. ## Community-recommended protein supplements Based on feedback from our Embrace Change private Facebook community, some popular protein supplements include: - True Protein - At Health - Mirrabooka Protein These have been tried and tested by women in our group who are prioritising their midlife health. [^1]: Falchetti A., Mohseni M., Tramontana F., Napoli N. (2021), ‘[Secondary prevention of fragility fractures: where do we stand during the COVID-19 pandemic?](https: --- ## The Mind/Body Connection: Why what's happening in your head is happening in your body too URL: https://www.womenshealthpathway.com/blogs/the-mind-body-connection/ Description: When you think about sex (before anything erotic or arousing has even happened), what's the first word that comes to mind? Because, for a lot of the women I work with, the honest answer I hear is… Obligation. Pressure. Stress. I should. Boring. Metadata: - intro: When you think about sex (before anything erotic or arousing has even happened), what's the first word that comes to mind? Because, for a lot of the women I work with, the honest answer I hear is… Obligation. Pressure. Stress. I should. Boring. - metaDescription: If sex feels like obligation, your body is already listening. Why the mind-body connection drives women's arousal, and how feeling safe changes everything. - publishDate: 2026-07-22 - author: Lauren Cummings - authorSlug: lauren-cummings - featuredImage: lauren-cummings-feature.jpg - tags: sexual-health - draft: false - hcp: true - headingTitle: The mind/body connection: Why what's happening in your head is happening in your body too - headingSubtitle: - headingDescription: If sex feels like obligation, your body is already listening. Why the mind-body connection drives women's arousal, and how feeling safe changes everything. When you think about sex (before anything erotic or arousing has even happened), what's the first word that comes to mind? Because, for a lot of the women I work with, the honest answer I hear is… Obligation. Pressure. Stress. I should. Boring. This is not desire, curiosity, excitement, or pleasure, but rather a low-level and pervasive sense of duty. To be clear with you right now, that's not a relationship or libido problem. This is your mind and your body in direct conversation with each other using high-speed 5G Wi-Fi, and your body is responding exactly as it should. Our bodies are so so wise! In many online spaces now, people often talk about the mind-body connection as if it were a wellness concept, something soft and abstract. However, in my work, I know this to be physiologically literal, and understanding it changed how I work with every single woman who comes to my practice. Dr Anita Elias from Monash University, Australia provides us with an amazing framework called the Mind/Body Model. Her model explores that enjoyable and pleasurable sex needs to be **FREE**. It needs to be free of duty, a chore, a should, something you're doing for someone else. Because if the sex you’re having isn’t free, then your mind is not free, and this creates an inevitable (and often chronic) anxious mental state. This can feel like being worried, feeling stressed, pushing through or overriding your body's internal no to “get it over with.” When this happens, the body responds to that mental state immediately and directly by bracing and tensing muscles as part of your bodies evolutionary and well-tuned threat detection system. From that contracted and tense place, arousal is physiologically inaccessible. This doesn’t happen because desire has disappeared; instead, the nervous system has prioritised protection over pleasure. ## So what does alternative look like…? Free → Safe → Relaxed → Aroused → Enjoyable. **Free** is a mental state. It means that all the types of sex you’re having are released from obligation, chore, a should, a performance, and mental monitoring. This includes how you're coming across, whether you're taking too long or whether your body looks okay. Freedom is a precondition, not a bonus! **Safe** is a nervous system state. It means the body has enough information (from the environment, from your partner, from its internal cues) to lower its guard. Safe means being able to say no, stop, and slow down at any point and this is respected and heard. **Relaxed** is not passive. It is an active physiological shift in which the nervous system genuinely downregulates, the pelvic floor relaxes, and the muscles soften. This is the body following the mind into a different state. And **ONLY** from these states does arousal become available to the body. And I am referring to actual physiological arousal (not just the mind being turned on), which includes engorgement of your vulva, lubrication, increased blood flow and increased sensation. Then, and only then, does enjoyment become possible. Women come to my practice with a huge range of presentations, including pelvic pain, vaginismus, vulvodynia, low or absent desire, difficulty with arousal or orgasm, disconnection from their bodies, and sex that has become something they endure rather than experience. The work I do is about understanding and interrupting this pattern because we don’t (and literally can’t) bypass the mind to have “enjoyable” sex when the body isn’t open and receptive. Instead, I help women explore their mind/body erotic landscape: understanding ingrained sexual scripts and pleasure anatomy as a way to discover what conditions they actually need to feel free, building a genuine felt sense of safety in the body, and giving the nervous system evidence that something different is possible. Dear reader, if you’ve read this blog and felt a quiet or loud knowing that duty, obligation, anxiety, and tension are familiar territory for you, I want you to know that there is another way. Unfortunately, it’s not going to be about trying harder or wanting it more – I know you’ve probably already tried that. The work is in exploring and understanding what your mind and body are saying together, listening and responding in ways that respect and honour your body's truth. --- ## The Pelvic Floor Project URL: https://www.womenshealthpathway.com/resources/podcasts/the-pelvic-floor-project/ Metadata: - subtitle: - author: Melissa Dessaulas - publishDate: 2025-09-16 - tags: prolapse,continence - category: podcast - image: /images/reviews/podcasts/the-pelvic-floor-project.jpg - infoLink: - purchaseLink: - draft: false - spotifyLink: https://open.spotify.com/show/7Ge32yNEhc4rnOxsIgcTVv - appleLink: https://podcasts.apple.com/au/podcast/the-pelvic-floor-project/id1556324013 - googleLink: - youtubeLink: https://www.youtube.com/channel/UCIhu0Oqqse1zYnjdShLVdug This podcast is for anyone with a pelvic floor. Pssst….. everyone has a pelvic floor. The pelvic floor is a group of muscles responsible for controlling our bodily functions. I refer to myself as a physiotherapist for embarrassing issues. I routinely help clients address symptoms like incontinence, prolapse, diastasis, pelvic pain, intimacy issues and the list goes on. A theme that stands out to me is how little we learn about our private parts and the muscles surrounding. This podcast is for you if you are interested in learning more about your body. Focused on the female, I cover topics pertinent to puberty, athletics, pregnancy, birth, postpartum recovery, menopause, surgery and so much more.I promise to share evidence based information through discussion with other health care experts in their field with the goal to showcase a holistic and empowering approach to taking care of the only body you will ever have. I hope you enjoy! --- ## The power of mindset in women's health: how hypnotherapy can transform your journey URL: https://www.womenshealthpathway.com/blogs/the-power-of-mindset-in-womens-health/ Metadata: - intro: - metaDescription: Discover how hypnotherapy and mindset transformation support women's health. Evidence-based approach to anxiety, depression, and chronic conditions. - publishDate: 2025-09-03 - author: Arvinder Virdi Eleveld - authorSlug: arvinder-virdi-eleveld - featuredImage: arvinder-eleveld-feature.jpg - tags: continence,prolapse,menopause - draft: false - hcp: true - headingTitle: The power of mindset in women's health: how hypnotherapy can transform your journey - headingSubtitle: - headingDescription: When it comes to women's health, every journey is deeply personal. Whether you are navigating hormonal changes, fertility challenges, chronic illness, or the emotional toll of balancing life's many roles, one truth remains: your mindset matters. The way we speak to ourselves and the beliefs we hold about who we are can have a profound effect on both mental and physical health. Many women struggling with health concerns also experience anxiety, depression, sadness, or a loss of engagement with life and others. These feelings can make an already difficult situation feel even heavier. ## Why Mindset Matters in Health Research shows that the mind and body are inseparably linked. The American Psychological Association notes that chronic stress and negative thinking patterns can weaken the immune system, increase inflammation, and worsen mental health outcomes. A 2016 study published in Frontiers in Psychology highlighted that 75–98% of mental, physical, and behavioral illnesses come from thought life alone. This means our inner dialogue, beliefs, and subconscious patterns directly shape our emotional and physical wellbeing. For women, cultural pressures, family expectations, and internalized self-criticism can amplify this. Many feel they must "push through," dismissing their emotional needs, which can intensify anxiety and depression over time. ## How Hypnotherapy Helps This is where Rapid Transformational Therapy (RTT) and hypnotherapy can be life changing. Rather than only addressing symptoms, hypnotherapy works with the subconscious mind, the place where limiting beliefs and emotional wounds are stored. In hypnosis, the brain naturally shifts into relaxed states (theta and alpha brainwaves) where old, unhelpful patterns can be accessed and gently rewired. This allows women to release deep-seated feelings of "not enoughness," grief, or fear, and replace them with empowering beliefs that support resilience and healing. ## Benefits of Hypnotherapy for Women's Health Issues - Reduces anxiety and depression by calming the nervous system and reshaping thought patterns - Improves emotional regulation, making it easier to cope with stress, sadness, or change - Restores self-worth and self-belief, helping women feel more confident in themselves and their choices - Promotes physical wellbeing, as the mind-body connection supports reduced stress responses, better sleep, and improved overall health A growing body of research supports this: - A 2017 study (International Journal of Clinical and Experimental Hypnosis) found that hypnotherapy significantly reduced symptoms of anxiety and depression in patients undergoing medical treatment - Harvard Medical School research showed that hypnotherapy can create measurable changes in brain activity, improving emotional regulation and stress resilience ## A Personal Journey of Healing What women often discover through RTT is that trauma doesn't have to be "big" to leave an impact. Even subtle messages in childhood — such as criticism, cultural expectations, or feeling invisible — can create patterns of self-doubt that show up later in life as anxiety, depression, or loss of joy. By addressing the root cause rather than just the surface symptoms, hypnotherapy provides a path to not only feel better in the present but to create lasting change for the future. ## Closing Thought Whatever your health journey looks like, it is uniquely yours. And while challenges like anxiety or depression may be part of it, they don't define who you are or what is possible. With the right support, including tools like hypnotherapy, you can rebuild your mindset, reclaim your self-worth, and reconnect with life in a new, empowering way. --- ## The stigma of faecal incontinence URL: https://www.womenshealthpathway.com/blogs/the-stigma-of-faecal-incontinence/ Description: We come into this life incontinent, we go out the same. We acknowledge it, we accept it, this is the circle of life. We don’t talk about poop, except when using the word in a moment of anger or frustration in its more popular slang terminology. Metadata: - intro: We come into this life incontinent, we go out the same. We acknowledge it, we accept it, this is the circle of life. We don’t talk about poop, except when using the word in a moment of anger or frustration in its more popular slang terminology. - metaDescription: Breaking the stigma around faecal incontinence. Sherrie Palm's honest story about pelvic organ prolapse and the importance of open conversation. - publishDate: 2025-07-20 - author: Sherrie Palm - authorSlug: sherrie-palm - featuredImage: sherrie-palm-feature.jpg - tags: continence,prolapse - draft: false - hcp: false - headingTitle: The stigma of faecal incontinence - headingSubtitle: - headingDescription: We come into this life incontinent, we go out the same. We acknowledge it, we accept it, this is the circle of life. We don’t talk about poop, except when using the word in a moment of anger or frustration in its more popular slang terminology. I can’t remember ever hearing a mom say she was totally creeped out by poop in her baby’s diaper (we don’t “love” it, we simply recognize it’s a normal part of child development). I can’t remember anyone talking about the graphic end of life process in a way that was disrespectful. But what about when something happens in between those two stages? Heaven forbid we talk about faecal incontinence, much less admit it has happened to us. Fecal incontinence absolutely occurs, more frequently than you would imagine - it simply doesn’t get talked about. Way too much stigma. As a pelvic organ prolapse (POP) advocate, incontinence is one of those layers that come with the turf. I’ve written about FI (fecal incontinence) a couple of times, discussed it during radio interviews, had multiple communications over the years with practitioners as well as women in various stages of POP navigating awkward symptoms. I’ve always wondered “what’s the big deal”? Poop is a normal bodily function. Faecal incontinence is the body signalling that something is a bit off kilter. No different than snot when you have a cold. No different than throwing up when you have the flu. No different than bad breath when you have periodontal disease. While we don’t like any of these other bodily functions, we don’t avoid talking about them like they are the plague. So what’s so different about poop? Why can’t we talk about incontinence out loud? Why do we worry so much what others will think of us if it happens to us? Why can’t we discuss poop in open conversation? STIGMA has kept this topic off-limits. That has to change. Someone has to talk about poop out loud and what happens when everything “lets loose” in public. The unmentionable stuff. So let me start the conversation…. My life as a POP advocate means I talk about the unmentionable stuff all the time; it’s necessary in order to generate change. I freely initiate conversations when opportunities present themselves about the aspects of POP that make others squirm, not because I enjoy making others feel uncomfortable, I’m simply trying the lift the veil that has covered POP for thousands of years in order to enable the world to recognize and address it. I look at my body as a “lab rat”, available for experimentation to better understand not only my own dynamic, but also to increase my ability to better recognize the needs of women navigating POP. When I experience something I feel is relevant to my ladies, I can’t wait to share. This is one you’re going to be a bit surprised to read. But not nearly as surprised as I was to experience. For the past year or so I’ve been noticing a subtle loss of contraction both vaginally and rectally. I do all the right stuff, exercise (both internal and external muscles), I have a pretty healthy diet, I check my posture regularly, use bio-identical hormones to optimize both estrogen and testosterone. I monitor MS flags to keep the condition in check. I’ve mentioned my contraction concerns to research connections, I’ve mentioned it to practitioners, I’ve spent a considerable amount of time digging through neurologic pelvic floor research. No one seems to have an answer (I confess I haven’t tried biofeedback yet; I need to fit an appointment into my sideways schedule). My “gut” says my weakened vaginal/rectal contraction has something to do with internal adhesions; I was shocked the last time I had internal MFR (vaginal myofascial release therapy), the improvement in pc contraction was significant and I'm hopeful a treatment or two will do the trick for me again. So…..now onto the part of my story that will get your attention. I went to the airport, excited to leave for Nepal, a vision I’ve had since 2009, but exhausted from the trip and meeting prep I’d worked on in the prior weeks. A few blocks from the airport my stomach started to warn me I’d need to find a bathroom as soon as I got go there; I wasn’t concerned. We parked the car at the curb and my driver helped carry my suitcases inside and then it hit me - I was not going to make it to the bathroom on time. I could feel a tiny bit of poop leaking out; and then while I scanned the room looking for the bathroom, I felt everything bust loose. And I do mean everything. It just kept coming and coming, poop sludge. I quickly mentioned I was pooping my pants and ran for the bathroom. The shoes I’d been breaking in the past week apparently stretched out a bit too much, they kept slipping off my feet threatening to make me fall like a ton of bricks with a load in my pants. Yikesville to say the last. I made it to the bathroom, hit a stall, pulled my dress up and pantyhose and undies down (thank God for pantyhose, my new favorite travel companion) and realized this was not going to be an easy fix. Everything had to come off except my bra. I put my pantyhose into the stall paper garbage bag used for tampons (throwing out runless pantyhose about killed me) then put my undies in the toilet to wash then out (they were brand new), and the automatic flusher kicked in and snatched them right out of my hand and down the toilet. I wish I had a picture of the look on my face (I’m cracking up now just thinking of it, I must have had such a funny shocked/ticked off expression, they were BRAND NEW). At that point all I could think of was get cleaned up, you’ve got a plane to catch to fulfill a dream you’ve been waiting five years to explore. So I stood by the sink in the bathroom, naked from my bra down, cleaning poop from every crevice imaginable. A woman walked in to use the bathroom; I apologized to her for the smell and told her I had an accident in my pants and she said don’t worry about it, that’ll happen sometimes. After she left another woman came in; I again apologized for the mess and she also said don’t worry about it. When she came out of her stall and washed her hands, she asked me there was anything she could do to help. I thanked her profusely and described the person with my suitcase and his location and asked her to have him bring my suitcase with fresh clothes. (Turned out he had followed me to the bathroom and was waiting right outside the door.) He handed me the suitcase; I finished cleaning up, got dressed, and popped an Imodium prior to registering for my flight, asked an attendant to please empty the garbage in the bathroom where I’d used up every paper sanitary garbage bag to contain paper towel washcloths, and was on my way for a two day flight to Nepal. Here’s the important part of the story. Not once during this event was I embarrassed. I was rattled when my bowels first let loose, I was frustrated when my shoes threatened to trip me on the way to the bathroom, I was ticked off when the toilet sucked my brand-new underwear down the toilet, I was grateful the women who came into the bathroom were so understanding. But I was never embarrassed. I’m going to assume it’s because I talk out loud about all aspects of POP every day and feel we all should in order to bring the condition into the 21st century. It confirmed what I’ve been feeling for the past six months-the stigma that drapes the symptoms of POP women find embarrassing is shifting. Yes, incontinence may be a bit easier for me to navigate than others because my life is embedded deeply in the POP arena, but the fact that I responded the way I did tells me that the energy which surrounds me is evolving as well. Change is not coming; it’s already here-we move forward together. --- ## The untapped women's health market hiding in plain sight URL: https://www.womenshealthpathway.com/blogs/the-untapped-womens-health-market-hiding-in-plain-site/ Description: Lisa Taylor set out to build a period underwear brand. Instead, her customers revealed an overlooked market: women over 50 living with light bladder leaks. Metadata: - intro: Lisa Taylor set out to build a period underwear brand. Instead, her customers revealed an overlooked market: women over 50 living with light bladder leaks. - metaDescription: One in three women experience incontinence, yet products for light bladder leaks overlook mature women. Lisa Taylor on the market hiding in plain sight. - publishDate: 2026-08-01 - author: Lisa Taylor, Founder of Wicks Intimates - authorSlug: lisa-taylor - featuredImage: lisa-taylor-feature.jpg - tags: continence - draft: false - hcp: false - headingTitle: The untapped women's health market hiding in plain sight - headingSubtitle: An Overlooked Market - headingDescription: How listening to customers revealed an underserved women's health need. I didn't set out to build a brand for women over 50. In fact, prior to launching, they weren't the customer I thought I was designing for. When Wicks launched, I expected our customers to be women looking for an elevated take on period underwear. Instead, from day one, the women who connected most strongly with the brand were in their forties, fifties, sixties and much beyond. They are women who need functionality in their underwear for light bladder leaks, but have been left feeling infantalised by what’s on offer – namely either period underwear designed for teenaged bodies, or products that yes, are designed for LBL, but with uninspiring designs that don’t reflect their vibrant, sophisticated selves. Very early on we knew we'd uncovered something much bigger than a new product. We'd uncovered a demographic that has been largely overlooked. Around one in three women experience urinary incontinence during their lifetime, yet it remains one of the least talked about areas of women's health. While absorbent underwear has become increasingly mainstream over the past decade, much of the category is still designed and marketed around menstruation. For women navigating light bladder leaks after childbirth, during perimenopause or following menopause, there are surprisingly few products that feel like they were created with a mature woman in mind. The more women I spoke with, the more their stories echoed one another. Some told me they packed spare underwear whenever they left the house. Others had quietly stopped wearing light-coloured trousers or dresses. Many were wearing disposable pads and liners every day, horrified at the amount of waste they were creating, but without a real alternative. Several admitted they thought carefully about where the nearest bathroom would be before agreeing to go for a long walk or meet friends for coffee. Most had simply accepted that this was part of getting older. What struck me most wasn't that these women wanted more absorbency. It was that they wanted more dignity. They wanted underwear that looked beautiful. They wanted fabrics that felt soft against their skin. They wanted products that reflected who they were, rather than constantly reminding them they were managing a health issue. Those early conversations completely changed the direction of Wicks. Instead of asking how we could make absorbent underwear more functional, we began asking a different question: how could we make women feel like themselves again? That shift influenced every decision we made, from the choice of premium fabrics to the fit, comfort and aesthetic of new styles. Building Wicks has reinforced something I believe is true across women's health: some of the biggest opportunities for innovation exist in the areas women have been quietly managing on their own for years. It’s common knowledge that women's health has historically been under-researched, underfunded and, too often, overlooked. Yet women have always understood their own experiences. Once those experiences are shared openly, patterns begin to emerge, unmet needs become impossible to ignore and meaningful innovation can follow. Looking back, I don't think customer feedback refined Wicks so much as completely redirected it. It changed my understanding of who needed our products and gave the business a much clearer sense of purpose. As Australia's population continues to age, the number of women experiencing light bladder leaks will continue to grow. They deserve products that acknowledge this stage of life with the same care, quality and respect that other areas of women's health are increasingly receiving. The real turning point wasn't launching Wicks. It was listening to the women who bought it. They showed me there was an overlooked need hiding in plain sight. I just had to listen. --- ## The woman menopause introduced me to URL: https://www.womenshealthpathway.com/blogs/the-woman-menopause-introduced-me-to/ Metadata: - intro: - metaDescription: One woman's honest account of perimenopause: the silence, the cultural stigma, the frightening symptoms, and the purpose she discovered on the other side. - publishDate: 2026-08-22 - author: Voni Nyamazana - authorSlug: voni-nyamazana - featuredImage: voni-nyamazana-feature2.jpg - tags: menopause - draft: false - hcp: false - headingTitle: The woman menopause introduced me to - headingSubtitle: - headingDescription: Menopause changed my body, my confidence, my sense of who I was. What I didn't expect was that it would also introduce me to a braver, more purposeful self. Menopause didn't diminish me. It revealed my deepest strengths. There are moments when you realise you'll never be the person you once were. For some, it's illness. For others, grief or loss. For me, it was menopause. If you'd told me ten years ago that perimenopause would become my life's work, I would have laughed. Back then, all I felt was exhaustion, sleepless nights, aching joints and a creeping "brain fog" that stole words mid-sentence. Anxiety arrived without warning. I no longer recognised the woman I'd always known. ## Who I thought I was Before perimenopause, I saw myself as strong, reliable, deeply capable. I balanced marriage, motherhood, multiple jobs, housekeeping, even a law degree. I'd built a new life in a foreign country. I took pride in solving problems, caring for others, pushing through every challenge. But perimenopause quietly dismantled all my certainties. The competent woman I trusted vanished, replaced by fear and self-doubt. ## When silence became the loudest symptom My cultural background taught me to keep personal matters private. You endure in silence. You pray. You stay strong. So I carried my confusion alone, never having had a single conversation about menopause in forty-plus years. No one warned me that hormonal shifts could disrupt sleep, concentration, joints, emotions, identity. Blindsided by symptoms I couldn't name, my mind filled in terrifying explanations: Was I dying? Did I have cancer? Dementia? Was I cursed? Without language or support, my fears escalated. The physical symptoms were hard enough, but the silence around them made the experience unbearable. ## Caught between two worlds As a Black African woman in the diaspora, I felt split in two. One world offered Western medicine and clinical data but often lacked cultural sensitivity. The other prized strength, endurance and faith-qualities that made it hard to admit vulnerability. Neither side alone could contain my experience. I needed care that honoured both my heritage and my individual needs. Research confirms this: women's menopause journeys are shaped by relationships, culture, social circumstances and personal meaning. We don't experience menopause in a vacuum. ## Evidence of inequality The [Study of Women's Health Across the Nation](https: Telling every woman "menopause is natural" isn't enough. We must acknowledge that symptom burden, barriers to care and information gaps vary across communities. Equity means listening to each woman's story-not handing out identical leaflets. ## "I thought it was just me" When I finally learned my symptoms were perimenopause, relief washed over me. I wasn't losing my mind. But relief shifted to anger: Why had no one prepared me? Why was this transition still shrouded in silence? Knowledge didn't erase every hot flush or sleepless night. But it stripped away the fear. Women deserve timely, accurate, culturally relevant information long before they reach crisis point. ## What menopause gave I believed menopause stole my predictability, my sleep, my confidence, my clear thinking. Yet I've come to see it also made space: for deeper compassion, an honest redefinition of strength, community, shared stories, purpose. Purpose seldom arrives fully formed. For me, it unfolded through hundreds of conversations. One woman would share her story; another would say, "That happened to me too." What began as isolated talks became a community. I listened to women who felt dismissed, frightened, ashamed. From these conversations, the Ketura Woman Movement was born-not from a business plan, but from conviction: women need knowledge, language, culturally sensitive support and safe spaces to speak their truths. ## Lived experience as qualification Clinical expertise matters. But lived experience teaches lessons no certificate can: how to recognise fear beneath a question, how to listen without rushing to fix, how validation restores dignity, how empathy transforms pain into purpose. My suffering became wisdom only when I used it to clear the path for another woman. That is the true power of lived experience. ## Midlife is not decline Too often we view women's ageing as loss. [Menopause](/health-conditions/menopause/) is portrayed as an ending. I reject that. Menopause can be hard, and we shouldn't romanticise suffering. But difficulty does not equal decline. Midlife can be a season of refinement, when we ask: What matters most now? What have my experiences taught me? What legacy will I leave? There is no single "right" way to experience this transition. Some women feel liberated; others are destabilised. Many feel both. Our stories deserve that complexity. ## I am more than I was Menopause was not easy, but knowledge made it manageable. Community made it less lonely. Purpose made it meaningful. Menopause changed my body, my confidence, my self-understanding. But above all, it revealed a purpose I never knew I carried. Menopause didn't diminish me. It introduced me to a braver, more purposeful self. I can say with confidence: I'm not the woman I was before menopause. I'm more. --- ## The Worlds Tightest Community URL: https://www.womenshealthpathway.com/resources/podcasts/worlds-tightest-community/ Metadata: - subtitle: - author: Matilde Olstad - publishDate: 2026-07-22 - tags: vaginal-vulva-health,sexual-health - category: podcast - image: /images/reviews/podcasts/tightest-community.png - infoLink: https://theworldstightestcommunity.com/ - purchaseLink: - draft: false - spotifyLink: https://open.spotify.com/show/71vUACTM1dI4au9ebDevpW - appleLink: https://podcasts.apple.com/gb/podcast/the-worlds-tightest-community-a-podcast/id1791430816 - googleLink: - youtubeLink: https://www.youtube.com/@theworldstightestcommunity The World's Tightest Community is a weekly podcast about chronic vulvovaginal and pelvic pain, hosted by patient advocate Mathilde Olstad. Each episode brings a leading clinician, researcher or advocate into an honest, jargon-free conversation about the conditions that too often go unnamed: vulvodynia, vestibulodynia, vaginismus, pudendal neuralgia, pelvic floor dysfunction and painful sex. It is made for two audiences at once. For patients, it is the resource Mathilde wishes she had had at the start of her own journey. For clinicians, it is a way to stay current with the latest research and clinical best practice in a field that moves faster than most training keeps up with. New episodes every week. Listen on Apple Podcasts, Spotify, YouTube and wherever you get your podcasts, or visit [The Worlds Tightest Community](https: --- ## Two Changes, One Journey: Living with HIV Through Menopause URL: https://www.womenshealthpathway.com/blogs/living-with-hiv-through-menopause/ Metadata: - intro: - metaDescription: Menopause can arrive earlier and hit harder for women living with HIV. Here's why the two overlap, why symptoms get missed, and how to get the right care. - publishDate: 2026-09-01 - author: Dr Nneka Nwokolo - authorSlug: nneka-nwokolo - featuredImage: nneka-nwokolo-feature.jpg - tags: menopause - draft: false - hcp: true - headingTitle: Two changes, one journey: Living with HIV through menopause - headingSubtitle: - headingDescription: Millions of women with HIV are now reaching menopause for the first time, often earlier, and with symptoms so overlapping that even clinicians struggle to tell the two apart. Here's how they interact, and how to get care that treats both. Menopause conversations are everywhere, and rightly so. For generations, menopause was something women whispered about, or didn’t mention at all, expected to just get on with things. No more. Women are speaking up, and it's becoming clear how much we still need to learn about how women experience menopause differently, depending on ethnicity, country, gender identity, and more. One thing that isn't on many people's radar: how women living with HIV experience menopause. Is there a difference? It seems so. Picture a woman in her late 40s. She's been living with HIV since she was 20, her viral load has been undetectable for years, and life has settled into a rhythm of six-monthly clinic visits and a single daily pill. Then the night sweats start. Her mood swings without warning; she snaps at her family for no reason; she cries all the time. She can't remember where she put her keys — again. Is this menopause? Is it the HIV? Is it the meds? Nobody warned her about this. Thanks to modern antiretroviral therapy, HIV has evolved from a life-threatening emergency into a manageable long-term condition. People with an undetectable viral load can't pass HIV on to sexual partners, and their babies are born without HIV. Because treatment is so effective, for the first time since the pandemic began, millions of women worldwide are now living long enough to go through menopause. Research suggests menopause may arrive earlier, on average, for women with HIV, and cause more severe symptoms. We don't fully know why — likely a mix of chronic HIV-related immune activation, the virus itself, and other factors we're still working to understand. Women with HIV are also more likely to be diagnosed with advanced disease, since they're less often offered testing than men, and prevention options aren't always designed with them in mind. That means many already have HIV symptoms by diagnosis — symptoms that overlap heavily with menopause. Night sweats. Fatigue. Low mood. Trouble sleeping. This is how they felt when their HIV was diagnosed. Then menopause arrives, and it feels like it's all starting again. Is the tiredness hormonal, or the treatment? Is the brain fog "meno-brain" or something else? And if women are confused, their HIV clinicians are too! An undetectable viral load and unchanged medication rule out the obvious causes, and primary care clinicians, often unsure about managing HIV, worry about missing something HIV-related, and no one thinks “this could be natural; she’s 49; could it be menopause?” ## How HIV and menopause interact Menopause brings hormonal changes that affect bone density and heart health — both already concerns for people with HIV, since the virus and certain HIV medicines can raise the risk of osteoporosis and cardiovascular disease. Women with HIV also tend to have poorer mental and sexual health than women without HIV, and menopause worsens both. For many, it's a double whammy — and one both women and their care teams need to anticipate. ## The power of peer support Despite progress, HIV remains shrouded in stigma and silence — and menopause, in many communities, isn't far behind. HIV activism pioneered something menopause support is now embracing too: peer support - turning private, stigmatized symptoms into shared language and collective advocacy. Women showing up for each other with hard-won knowledge is exactly what can make the menopause transition less isolating for everyone, living with HIV or not. No one should carry the burden of HIV or menopause alone. Whether it's an HIV support group, a menopause community, or ideally people who understand both, connection helps more than most of us expect. ## Getting the care you need * Talk to your HIV specialist and a menopause professional; if you’re lucky, they might be one person! If not, make sure they're talking to each other. * Don’t be afraid to ask direct questions - fracture risk, bone density screening, cardiovascular risk, and menopause hormone therapy are all worth raising. * Track your symptoms. Even a quick note — what happened, when, how intense — turns "I've just been feeling off" into something a clinician can act on. ## The bottom line Going through menopause while living with HIV isn't a rare medical mystery — it's an increasingly common part of aging well with a condition that, not so long ago, didn't offer people the chance to grow older at all. Asking questions, tracking symptoms, and pushing for coordinated care is exactly what navigating two major transitions with clear eyes looks like. --- ## Understanding perimenopause anxiety URL: https://www.womenshealthpathway.com/blogs/understanding-perimenopause-anxiety/ Metadata: - intro: - metaDescription: A husband's guide to understanding perimenopause anxiety and supporting your partner. Real insights into mood swings, symptoms, and relationship impact. - publishDate: 2025-08-01 - author: G.S - authorSlug: g-s - featuredImage: g-s-feature.jpg - tags: menopause - draft: false - hcp: false - headingTitle: Understanding perimenopause anxiety - headingSubtitle: - headingDescription: I never thought I'd be writing about menopause. But here I am, sharing my journey because, honestly, men need to understand this better. When my wife started showing early signs at 33, we were both lost. If you’re a woman reading this, consider sharing it with your male partner—it might help him understand what you’re going through and how he can support you. Menopause isn’t just a “women’s issue,” it impacts relationships, families, and daily life. The more we know, the better we can navigate it together. Every doctor brushed it off, saying, "You are too young.” But with menopause running early in her family, we knew something was up. Doctors asked her about stress and depression, offering her antidepressants and “the pill,” which actually made her feel worse. Her grandmother and mother both experienced menopause early, becoming fully menopausal by 40. It wasn’t until years later that we finally began getting some answers. Now, at 40, she’s in the midst of navigating hormone replacement therapy (HRT) to help with her symptoms of menopause, with all the trial and error that comes with it. What I’ve learned through this journey is that menopause isn’t just something that happens to women—it affects relationships, too. From menopause mood swings to sleepless nights, it’s been tough watching someone I love go through something so challenging, feeling powerless at times to make it better. But I’ve also realised that with understanding, patience, and effort, this phase can bring you closer together as a couple. If you’re reading this, you’re probably in a similar place—trying to figure out what’s happening and how you can help. I’ve written this guide to share what I’ve learned and help other men understand how menopause affects relationships and what you can do to support your wife going through menopause. ## What is Menopause and how does it affect women? Menopause is a natural biological process that marks the end of a woman's reproductive years. It occurs when the ovaries stop releasing eggs and significantly reduce the production of reproductive hormones, particularly estrogen and progesterone. For most women, it starts in their 40s or 50s, but for some, like my wife, it can begin much earlier. Menopause is not an illness and is a natural part of aging, but it can cause various physical and emotional changes, some of which may require attention and management. As women age, the number of eggs in their ovaries decrease, and the production of hormones that stimulate their menstrual cycle declines. Understanding the stages of menopause—when it starts and what happens in the body during each period—will help you know what to expect and how you can help your partner with their symptoms. ## Common symptoms women experience Not everyone experiences the same symptoms of menopause, but they can vary widely in both intensity and duration. What men should know about menopause is that, while some women may have mild symptoms that are barely noticeable, others may experience more profound effects that significantly affect their daily lives. ### Physical symptoms: - A sudden feeling of warmth in the face, neck, and chest - Red, blotchy skin - Rapid heartbeat - Sweating, especially on the upper body - A chilled feeling when the hot flush ends - Feelings of anxiety - Hot flashes, episodes of sudden feeling of warmth in the upper body and are usually most intense over the face, neck, and chest, hot flashes can happen 1 to 10 or more times a day, lasting from 30 seconds to 5 minutes and can start a few months or years before a woman’s period stops. In my wife’s case, it started at an unusually early age of 33. ### What can menopause hot flashes cause? Fatigue, irritability, forgetfulness, and disrupted normal functions ### Emotional symptoms: Menopause mood swings, anxiety, and even depression are common experiences. However, in my wife's case, the depression may have been present as a consequence of menopause, rather than being the underlying cause of her irregular periods and other symptoms. Hormonal shifts can also significantly impact sexual desire, often leading to a decline that can affect intimacy and relationships. It's worth noting that men experience these challenges too—after all, a billion-dollar industry was built around a little blue pill by Pfizer to address male sexual health. Yet, despite this, discussions about libido, especially among women, remain taboo. While men’s issues in this area are addressed openly and even commercialised, women’s struggles with libido often receive even less attention or acknowledgment. How is that fair? This imbalance reflects a broader societal tendency to sideline women’s health concerns, leaving many women to navigate these changes in silence. It's time to break the stigma and start conversations that normalise and prioritise women’s sexual health. For years, my wife struggled with menopause fatigue and menopause mood swings, often feeling isolated because no one acknowledged her symptoms. Now that we understand what’s happening, I can approach it with empathy instead of frustration. ## How Menopause affects relationships Let me be honest: menopause hasn’t just been hard on my wife—it’s been hard on us. The mood swings hit like a storm, and sometimes, it felt like I couldn’t do anything right. There were days when I thought, “Is this anger directed at me? Am I failing her somehow?” The more I learned about how menopause affects relationships, the more I realised that her emotions weren’t something I needed to “fix.” Instead, I needed to understand and support her through this transition. For husbands, dealing with menopause means learning to navigate mood swings, emotional changes, and physical symptoms with patience, empathy, and understanding. ## Key challenges we faced Menopause Mood Swings and Anxiety: Sudden bursts of anger or sadness were confusing at first, but I learned these were symptoms of menopause and anxiety, not something my wife had control of. Menopause Fatigue and Stress: Her energy levels dropped, making even simple tasks feel exhausting. Changes in Physical Intimacy: Hormonal shifts affected her libido, which sometimes led to feelings of insecurity on my part. By acknowledging these challenges and working through them together, we’ve been able to strengthen our bond rather than let these changes drive us apart. ## How I’ve learned to help my wife through Menopause Over the years, I’ve made plenty of mistakes, but I’ve also learned how to better support my wife. Here are some things that worked for us: 1. Be Patient and Empathetic Sometimes, different emotions like frustration, stress, sadness, or even anger toward husbands can arise during menopause, and when that happens, it can be easy to take things personally. But I’ve learned to step back, remind myself it’s not about me, and respond with patience. 2. Encourage Open Communication We’ve created a safe space where she feels comfortable sharing what she’s going through. I make it a point to listen without judgment and ask how I can help. 3. Help Manage Physical Symptoms From lowering the thermostat during menopause night sweats to encouraging healthy routines, small adjustments have made a big difference. 4. Support Her Emotional Health I’ve encouraged her to seek professional help when symptoms like menopause and depression or menopause and anxiety felt overwhelming. These actions, though small, have helped us navigate this phase with more ease and understanding. ## Taking care of myself What most menopause tips for husbands usually don’t say is that it’s important to prioritise your own mental and emotional wellbeing, too. After all, you can’t pour from an empty cup. Think of it like the instructions on an airplane: when the oxygen masks drop, you’re told to secure your own mask first before helping others. The same principle applies here—taking care of yourself is not selfish; it’s essential. Whether that means carving out time for your hobbies, seeking advice from friends or professionals, or simply finding moments to recharge, prioritising your wellbeing ensures you have the capacity and energy to support your partner effectively. By being at your best, you can offer the patience, understanding, and compassion your partner needs during this transformative phase of life. **Educate yourself:** Understanding what husbands need to know about menopause, including common symptoms like hot flashes or fatigue, has helped me approach her experiences with more empathy. **Talk to Others:** Joining online forums or talking to friends who’ve been in similar situations has been a great source of support. **Practise Self-Care:** Taking time to recharge has made me a more present and patient partner. ## Why supporting your partner through Menopause matters At first, menopause felt like something that was happening to her. But I’ve come to realise that it’s something we’re going through together. Helping your partner manage symptoms like menopausal mood swings or menopause and depression isn’t just about helping her—it’s about strengthening our relationship. This phase has taught me patience, resilience, and the importance of communication. While challenging, it’s also an opportunity to grow closer and show up for your partner in ways that truly matter. ## Final thoughts Menopause is a natural transition, but it can feel overwhelming for both partners. By educating yourself about symptoms like menopause hot flashes and menopause fatigue, practising empathy, and offering support, you can help your partner navigate this phase with confidence. For me, the hardest part has been watching someone I love go through something so difficult. But it’s also been a privilege to stand by her side, learn how to support her and grow stronger as a couple. If you’re in this phase with your partner, remember it’s not about fixing things. It’s about listening, understanding, and being there every step of the way. Together, you can come out of this stronger and more connected. ## Reach out for professional help If you and your partner need professional support, don’t be afraid to reach out for help. Speaking to a healthcare provider or a therapist can provide valuable guidance during this transition. --- ## Vaginal health: How to support your body naturally and effectively URL: https://www.womenshealthpathway.com/blogs/vaginal-health-how-to-support-your-body-natually-and-effectively/ Metadata: - intro: - metaDescription: Vaginal health is a key part of overall wellbeing, yet it’s often misunderstood or ignored until something feels wrong. Recurrent infections, discomfort, odour, or irritation are not just “bad luck”, they are signs that the vaginal ecosystem is out of balance. - publishDate: 2026-01-19 - author: Sarah Henschel - authorSlug: sarah-henschel - featuredImage: sarah-henschel-feature.jpg - tags: vaginal-vulva-health,sexual-health - draft: false - hcp: true - headingTitle: Vaginal health: How to support your body naturally and effectively - headingSubtitle: - headingDescription: Vaginal health is a key part of overall wellbeing, yet it’s often misunderstood or ignored until something feels wrong. Recurrent infections, discomfort, odour, or irritation are not just 'bad luck', they are signs that the vaginal ecosystem is out of balance. Vaginal health is a key part of overall wellbeing, yet it’s often misunderstood or ignored until something feels wrong. Recurrent infections, discomfort, odour, or irritation are not just “bad luck”, they are signs that the vaginal ecosystem is out of balance. Understanding that ecosystem and how to support it can make a huge difference to a woman´s wellbeing. Let´s me explain how… ## The vagina your personal ecosystem Your vagina isn’t just a body part, it’s a living ecosystem made up of bacteria, yeast, and protective bacteria called the vaginal microbiome. When this microbiome is healthy, good bacteria such as Lactobacillus, keep the vaginal pH acidic to protect us from infections. Usually this system is pretty stable but every now and again it can become imbalanced by antibiotics, hormones, stress, diet, sex, or hygiene products. What we notice when the vaginal microbiome is imbalanced: * Yeast infections * Bacterial vaginosis (BV) * UTIs * Irritation ## Why many women get “stuck” in a cycle of infections Usually when we notice symptoms like this we get a prescription for antibiotics and thrush medication. While this can bring short-term relief, it is mainly focused on killing all of the vaginal bacteria, good and bad. If the good bacteria are not replenished it can cause a viscious cycle, where the vagina doesn´t have enough good bacteria to protect itself, so infections happen more often. ## This is where naturopathic medicine can really help you out. A naturopath looks at vaginal health as part of your whole-body system. That includes: * Gut health (healthy gut = healthy vaginal microbiome) * Hormones (low oestrogen can impact your vaginal microbiome) * Immune function (low immunity overall can make you more susceptible) * Blood sugar (hello thrush!) * Sexual and hygiene practices Instead of just suppressing symptoms, the goal is to restore the terrain so infections are less likely to return. ## Vaginal & Microbiome Testing One of the most helpful tools naturopaths use is microbiome testing. These tests go far beyond a basic swab and can identify: * Which bacteria and yeast are present * Whether protective Lactobacillus species are low * Whether BV-causing organisms or yeast are present * Whether the vaginal pH and microbiome need balancing Sometimes we test the gut microbiome too, because many vaginal imbalances begin with poor gut health. The bacteria in your gut often migrate to the vaginal area, especially after antibiotics or hormonal changes. ## How do naturopathic treatments work? Based on your test results and health history, a naturopath may recommend: ### Specific probiotics Specific probiotics can be taken in capsule form or even locally in pessary form to build the good bacteria back up as quickly as possible. #### Herbal antibiotics A gentle and safe treatment solution without destroying healthy flora the way antibiotics often do. ### Diet changes Sugar, refined carbs, alcohol, and food sensitivities can flare up yeast infections. A few dietary changes can make a huge difference. ### Hormone support Low estrogen, the pill, or perimenopause can make the the vaginal walls thinner and affect the microbiome. Naturopaths can help rebalance this naturally using herbs and nutritional medicine. ### Immune and gut healing A strong immune system and healthy gut are essential for long-term vaginal health. ## When to use both naturopathic and medical care If you have severe pain, fever, heavy bleeding, or suspected STI, you should always see a medical doctor. But for recurrent, stubborn, or unexplained vaginal symptoms, naturopathic support can be the missing piece that stops the cycle for good. ## A few words from me on the way: Your vagina knows how to repair itself naturally. A symptom is always just a message from your body to say it needs your support. Sometimes it´s just a quiet whisper but when we do listen, our bodies give us so much more back. --- ## Vaginal pessaries: a game-changing solution for pelvic organ prolapse URL: https://www.womenshealthpathway.com/blogs/vaginal-pessaries-a-game-changing-solution-for-pelvic-organ-prolapse/ Metadata: - intro: - metaDescription: Discover vaginal pessaries: effective prolapse treatment with 70-90% success rates. Conservative, reversible alternative to surgery with immediate relief. - publishDate: 2025-08-15 - author: Kristen Parise - authorSlug: kristen-parise - featuredImage: kristen-parise-feature.jpg - tags: prolapse,continence - draft: false - hcp: true - headingTitle: Vaginal pessaries: a game-changing solution for pelvic organ prolapse - headingSubtitle: - headingDescription: Discover how this simple, effective device could transform your prolapse symptoms and give you back control over your pelvic health. If you've recently been told you have pelvic organ prolapse, you're probably feeling overwhelmed with questions and concerns. The good news? You have more treatment options than you might think, and one of the most effective solutions might surprise you with its simplicity. Let's talk about vaginal pessaries – a conservative treatment that's helping women worldwide reclaim their comfort, confidence, and quality of life. ## What exactly is pelvic organ prolapse? Pelvic organ prolapse happens when the muscles and tissues that support your pelvic organs (bladder, uterus, and bowel) become weakened or stretched. This causes one or more of these organs to drop down into the vaginal space, creating that uncomfortable feeling of "something coming down." You might experience: - A bulge or pressure in your vagina - A dragging sensation in your pelvis - Difficulty emptying your bladder completely - Bowel movement challenges - Lower back or pelvic pain - Changes in sexual comfort Here's what's important to know: **you're not alone**. Research shows that up to 65% of women may experience some degree of prolapse during their lifetime, with symptoms becoming more noticeable as we age or after childbirth. While only about 21% find their symptoms truly bothersome, if you're reading this, you're likely in that group seeking solutions. ## Enter the vaginal pessary: your conservative treatment champion A vaginal pessary is a removable device made of medical-grade silicone or plastic that's inserted into your vagina to support your prolapsed organs. Think of it as a personalized internal support system that holds everything in its proper place. Why pessaries are such excellent news: - Immediate relief: Unlike surgery, pessaries can provide symptom relief right away - Reversible: You can try it without any permanent changes to your body - Highly effective: Research shows that 70-90% of women experience significant symptom relief - Long-term success: Most women who report successful pessary use at 4 weeks continue using them at 5 years - May prevent progression: Some studies suggest pessaries might actually help prevent your prolapse from getting worse over time ## Myth-busting: let's set the record straight **Myth #1: "You have to be old to use a pessary"** **Truth:** Women of all ages successfully use pessaries! Whether you're 35 or 75, if you have prolapse symptoms, a pessary could be right for you. **Myth #2: "Anyone with incontinence or prolapse can automatically use a pessary"** **Truth:** While most women can be successfully fitted with a pessary (up to 75% according to research), it does require proper assessment and fitting by a trained healthcare provider to ensure the right type and size for your specific anatomy. **Myth #3: "Pessaries are just a temporary fix while you wait for surgery"** **Truth:** Pessaries can absolutely be used as your primary, long-term treatment! Many women choose pessaries instead of surgery and use them successfully for years. Remember, surgery has a 30-50% failure rate, while pessaries offer immediate, reversible relief. **Myth #4: "You can't manage a pessary yourself"** **Truth:** This is one of the biggest misconceptions! While some women prefer clinic-based care, many can learn to remove, clean, and reinsert their pessaries themselves. Self-management gives you complete control over your treatment and eliminates the need for frequent clinic visits. **Myth #5: "Pessaries will ruin your sex life"** **Truth:** Many women actually report improved sexual satisfaction after starting pessary use! Ring pessaries can often be left in place during intercourse, and research shows that 79% of sexually active women report improvement in sexual symptoms or enhanced relationships with their partners after using a pessary. ## What to expect during your pessary fitting appointment Knowledge is power, so here's what typically happens during a pessary fitting: ### Before your appointment: - Your healthcare provider will assess your prolapse type and severity - They'll discuss your symptoms, lifestyle, and treatment goals - A pelvic examination will determine the best pessary type for you ### During the fitting: - Your provider will try different pessary sizes and types to find your perfect fit - You'll learn how the pessary should feel when properly positioned - Don't worry if it takes more than one visit – getting the right fit is crucial! - You'll be taught how to check if the pessary is in the correct position ### Testing your fit: - You'll be asked to walk around, cough, and bear down to ensure the pessary stays in place - The pessary should feel comfortable and shouldn't cause pain or significant pressure - You should be able to urinate normally with it in place ### Follow-up care: - Initial follow-up appointments help ensure everything is working well - You'll learn about care and maintenance (and possibly self-management!) - Regular check-ins help optimize your treatment ## Types of pessaries: finding your perfect match **Ring Pessary:** The most commonly used type, perfect for mild to moderate prolapse. It's comfortable, easy to insert and remove, and can often be left in place during intercourse. **Cube Pessary:** Excellent for women who have difficulty retaining other types of pessaries. It uses suction to stay in place and is particularly good for more advanced prolapse. **Gellhorn Pessary**: The go-to choice for advanced uterine prolapse. It provides excellent support for more severe cases and has a high success rate. Your healthcare provider will help determine which type is best based on your specific prolapse, anatomy, and lifestyle needs. ## The life-changing benefits you can expect Research consistently shows remarkable improvements in quality of life for pessary users: - **90% of women** experience relief from that uncomfortable bulging sensation - **70% improvement** in pressure symptoms - **Significant reduction** in urinary difficulties (40-97% improvement in obstructive voiding) - **Better bowel function** with 28% improvement in difficult evacuation - **Enhanced daily activities** – you can exercise, work, and care for your family comfortably - **Improved sleep and energy** when you're not dealing with constant discomfort ## Taking control: self-management is possible One of the most empowering aspects of pessary treatment is that many women can learn to manage their pessary independently. Self-management means: - Removing your pessary at home for cleaning - Reinserting it yourself when ready - Having complete control over your treatment schedule - Reducing the need for frequent clinic visits - Greater flexibility for travel, intimacy, and daily activities Recent research shows that women who self-manage their pessaries report excellent outcomes with minimal complications – giving you the freedom to take charge of your own pelvic health. Your next steps: taking action If you're intrigued by the possibility of pessary treatment, here's how to move forward: 1. **Talk to your physician** about pessary options during your next appointment 2. **Consult with a pelvic health physiotherapist** who can assess your pelvic floor and discuss conservative treatment options 3. **Ask for a referral** to a healthcare provider experienced in pessary fitting if your current provider doesn't offer this service 4. **Don't accept "surgery is your only option"** – pessaries are a valid first-line treatment for pelvic organ prolapse ## The bottom line: you have options Pelvic organ prolapse doesn't have to control your life. Vaginal pessaries offer an effective, conservative treatment that can provide immediate relief while giving you complete control over your care. With success rates of 70-90% for symptom relief and the possibility of preventing prolapse progression, pessaries represent hope, empowerment, and a return to the activities you love. Remember, most women who find success with pessaries at 4 weeks are still happily using them 5 years later. That's not just treatment – that's transformation. Ready to explore pessary treatment? Reach out to healthcare providers experienced in pelvic health, such as specialized pelvic health physiotherapists at clinics like Blueberry Therapy, who can guide you through your options and help you reclaim your pelvic health. ## Want to learn even more? Check out [Episode 21 of The Hole Shebang podcast](https: The evidence is clear: you don't have to live with prolapse symptoms, and you don't have to rush into surgery. Pessaries offer a proven, conservative path to relief – and your journey to feeling like yourself again could start with a simple conversation with your healthcare provider. --- ## Viva la vulva URL: https://www.womenshealthpathway.com/blogs/viva-la-vulva/ Metadata: - intro: - metaDescription: Kath Mazella's powerful advocacy story after vulvar cancer survival. Breaking taboos around vulvar health and promoting accurate medical terminology. - publishDate: 2025-08-12 - author: Kath Mazella OAM - authorSlug: kath-mazella - featuredImage: kath-mazella-feature.jpg - tags: vaginal-vulva-health - draft: false - hcp: false - headingTitle: Viva la vulva - headingDescription: At the age of 39, I faced the diagnosis of vulvar cancer, an uncommon cancer usually described as affecting postmenopausal women. Surviving a radical vulvectomy 30 years ago was just the beginning of my journey. This surgery involved removal of my clitoris, vulva, and groin lymph glands due to vulvar cancer, an experience that profoundly altered my life. The subsequent six weeks of pelvic radiation therapy induced menopause at the age of 42. I cannot begin to describe those first two years and discovering the taboos and stigmas associated with the word ‘vulva’. ## Finding connection Coincidentally, I met with a woman who experienced the same diagnosis and journey eight months previously. I remember this meeting so well, she lifted her dress, and I lifted mine and there we realised, we were on the same page. We had both requested our medical professionals to connect us with others battling vulvar cancer, but we had both been advised against doing so because ‘it would be too depressing’. There were no support groups for women navigating the post-operative journey after radical vulvectomy. This was my turning point. Feeling all alone and ostracised by society I placed an advertisement in a women’s magazine seeking others with whom I could talk. I received 38 responses, from women all over Australia, facing the same sense of isolation and embarrassment that I was experiencing. This compelled me to try to understand what made women fearful of speaking out about their symptoms and diagnosis. At the time, most women did not know the difference between ‘vagina’ and ‘vulva’. How could they, when even gynaecological cancer brochures did not include a diagram or picture of a vulva. In 2005, I presented my story to the New South Wales Cancer Council questioning the absence of a diagram of a vulva in their brochures. They took my feedback on board and have since updated their brochure to include a vulva that is appropriately represented. Other states followed suit. Sadly though, even today, reproductive health brochures, aimed at women, often have diagrams of the uterus, cervix and vagina but they do not include a vulva. I have made it my mission to increase awareness of vulvar cancer, among both women as well as health professionals, by destigmatising the use of correct terminology. ## Misdiagnosis and medical gaps I have been told that vulvar cancer is rare and often diagnosed late because of its ‘intimate’ nature. 1 Of these, many are young, like I was when I received my diagnosis, and many die of this devastating cancer because of the late diagnosis. And it is not just vulvar cancer. It is also other vulvar conditions like lichen sclerosus, another condition that gets overlooked despite one in 80 women suffering from it. Women themselves feel embarrassed to ask for help for vulvar issues. Medical professionals can also be reluctant to examine the vulva. When they do, they often lack the knowledge and experience to accurately diagnose vulvar conditions. I often hear from women how they were misdiagnosed as having thrush instead of lichen sclerosus or cancer of the vulva. ## Campaigns for change My entire life, since my diagnosis, has been focused on empowering women to embrace their bodies, especially their vulvas, and have open conversations about vulval symptoms like itching, discharge, skin discolouration, and lumps and bumps, and to seek help early. I want health professionals to take women’s symptoms seriously, to expand their knowledge of vulval diseases and educate women on vulval health. I feel we can only do this if we use accurate terminology, hence my insistence on using the word ‘vulva’. Not vagina, vulva. When I first started to talk about the vulva, I was told it was an offensive word, and that it would be better to say ‘vagina’. That made no sense to me. The vagina and vulva are two different parts of the body. One is internal, the other is external. We do not call a man’s penis his testicles! How can women talk about their body accurately if they do not know the correct words to use? Hence, I started my ‘Red Knickers’ campaign with the tagline ‘Viva la Vulva’ and advocated for 10 September to be celebrated as International Gynaecological Awareness Day (IGAD). King Edward Memorial Hospital in Western Australia has celebrated IGAD for the past nine years. My advocacy has been recognised with many awards, but awards are superfluous in the absence of action. In 2018, I was selected as Western Australia Senior Australian of the Year. This only spurred me to continue my advocacy. Despite the challenges, and being a multiple award recipient, I remain steadfast in my mission to ensure that women with vulvar health issues receive the attention and care they deserve and that research into vulvar cancer receives the same funding as breast cancer or ovarian cancers. My journey is a testament to the resilience and determination necessary to effect change in this critical area of women’s health. This is a new world with women demanding old stigmas and taboos be broken. It is time to shine a light on this silent suffering, and I will continue to be the voice of women who are afraid to speak out about vulvar issues. ## Viva la vulva --- ## Vulval cancer URL: https://www.womenshealthpathway.com/blogs/vulval-cancer/ Metadata: - intro: - metaDescription: Clare Baumhauer's courageous journey through vulval cancer diagnosis and treatment. A story of resilience, misdiagnosis, and raising awareness. - publishDate: 2025-08-19 - author: Clare Baumhauer - authorSlug: clare-baumhauer - featuredImage: clare-baumhauer-feature.jpg - tags: vaginal-vulva-health - draft: false - hcp: false - headingTitle: Vulval cancer - headingSubtitle: - headingDescription: Clare Baumhauer is a courageous UK-based advocate who co-founded Lichen Sclerosus & Vulval Cancer UK Awareness alongside Emma Norman. Her story is one of deep resilience, having endured decades of misdiagnosis before finally receiving a diagnosis of lichen sclerosus and vulval cancer in her 30s. In March 2016 I was told I could have Vulval Cancer. I walked out the surgery to my husband who was waiting in the car with my son, I was trying really hard not to cry. I needed to get home. I remember feeling sick and holding back the tears so my son didn’t ask what was wrong, he is only 11 and has autism so wouldn’t understand, hell I didn’t understand! I had never heard of vulval cancer, I didn’t even know the outside area was called your Vulva. I got home and then told my husband what the doctor said, he looked shocked. I had to wait for a call for an appointment to see a gynaecologist and have a biopsy. I was told it should be within 2 weeks. I was sure it was cancer and as I had the symptoms and ulcer nearly a year so thought that it must of spread! I told myself I had weeks maybe months to live. I came to terms with death quite easy, until I thought about my family, I wouldn’t see my son and daughter grow up, get married or have kids. Help them in life. I then thought back to how I felt when I found out my mum had cancer and what it was like when she died. I realised how scared she must of been and how I felt when I was told. I didn’t want my kids to go through that. The next few weeks were a blur! I decided to sort all my stuff out so my daughter and husband didn’t have to. I packed up most of my stuff in my bedroom and sorted through all my clothes. My poor husband made about 4 trips to the tip. I took my daughter shopping and brought her lots of things, I nearly brought a couple things for myself then thought what’s the point I won’t be here to use them. I had my biopsy which was a day before my birthday. Only my husband knew, which was hard to act normal around others. I thought that would be my last birthday. I arranged my funeral in my head, found flowers and a coffin I liked and saved them on my phone. I would go for a bath most nights and just sit and cry as that was the place I didn’t hold it all in. I got my biopsy results of Lichen Sclerosus (again I had never heard that condition before either) and squamous cell carcinoma (Vulva cancer). I then had to have PET scans and MRI and wait for the results to see if it had spread. I had convinced myself it had and was having symptoms of bladder and bowel cancer. The next couple weeks seemed to go so slow but finally got the results that it hadn’t spread and surgery was in 2 weeks time to remove the tumour and sentinel nodes biopsy to test if it had gone to my lymph nodes as scans were unclear in seeing cancer in nodes. What a relief! It hadn’t spread and was stage 1b. Then the symptoms I was having all went! Surprising what you can imagine and tricks your body. I had a plan of treatment and was feeling positive and so much better. I now told my 16 year old daughter which was the hardest thing I’ve had to do! She had already lost her nan to cancer. I decided not to tell my son as he wouldn’t understand and as having autism has no empathy. I then started to tell the rest of my family and friends. I wasn’t scared or worried about the Operation just wanted it over. Surgery went ok but from my scan to operation the tumour grew aggressively so was too close to my bum to get clear margins so had to have radiotherapy to make sure. The lymph node biopsy came back clear. I stayed in hospital for 5 days and once home I had to lay in bed mostly for 4 weeks as sitting was too painful especially as all my stitches came out so took longer to heal but it was ok. Once I had healed enough I started 5 weeks of radiotherapy (August 2016) which wasn’t easy. I was tired all the time and had bowel problems and my skin on the inside of my groins started to go red and hot then the skin started to come off and weep. I found walking painful and the journey up to London on the train during the hot weather extremely hard. But I did it! After a few weeks I went back to work and tried to get back to normal but my scan showed a node was still swollen from a previous scan so they decided in December 2016 to remove more nodes to check. They removed 6 lymph nodes from my left groin and 3 came back cancerous. I was devastated again! It had already been 9 months and I was going to have to have more radiation on both left and right nodes plus my abdomen to make sure. I spent New Year’s Eve weekend in hospital because I got cellulitis while on holiday and had 2 more Operations on my groin so spent most of January 2017 in hospital because I had many problems getting the infection under control and had to have the groin drain put back in. I then started my second lot of radiotherapy in March 2017. 33 sessions over 8 weeks. I knew what to expect this time and as it was higher up walking this time was much easier. Still having bowel problems and so tired all the time. By the time I had my next scan it had been 16 months of scans and treatment and finally in July 2017 I was given the all clear! In remission, cancer free. It had spread to my lymph nodes so I beat stage 3 vulval cancer! Yes I was happy and relieved but I had been on autopilot the last 16 months so now it was over? I can get back to normal? No, now I have to deal with the side affects of the surgery’s and the radiation. It put me straight into the menopause, I then had lymphedema confirmed in my legs, pelvis and abdomen. I have nerve damage and pain in my left groin , still have bowel problems and is tired all the time But yes I beat cancer! For now! I still have Lichen Sclerosus which is the skin condition that caused my cancer and was left untreated for many years as seems I’ve had since a child but numerous times was missed and misdiagnosed as cystitis and thrush multiple times over the years. I had swabs and blood tests but Lichen Sclerosus was never mentioned. If a doctor or nurse had recognised the symptoms I would have been diagnosed much earlier and been using the steroid, so I might not have got cancer as there is only a 5% chance of Lichen Sclerosus turning to cancer if the skin is left to thicken, and the cancer would not of had time to spread to stage 3 Cancer. I would not have had to have radiation which caused all my life changing side affects. If I had known about LS and Vulval cancer I would have gone back to the doctors and not given up going. If I hadn’t seen all the adverts for thrush and vagisil for vaginal itching and thinking this must be normal. If the nurses that did my smear tests had been trained in LS and vulval cancer. If midwives had also been trained in LS and Vulval cancer then it would have been diagnosed on one of the multiple times I’ve seen a nurse or midwife. It’s now been 1 year since I was given the all clear but life hasn’t gone back to normal it never will. I have to find my new normal and accept every new sore or red area or pain that it Could be back! I worry that other symptoms are a different cancer. Worry every scan they find something. Feels like a ticking time bomb. Worry that my family will get cancer too. ### The depression and bad days I still go for a bath and have a good cry. The guilt you have for surviving and others don’t. The anger of so little awareness of both conditions. Why the medical profession don’t know or misdiagnose. Just because it is commonly in the older women they dismiss it if you're younger. So now I’m trying to raise awareness as much as I can especially as Vulval cancer doesn’t have any charity’s of there own or a Awareness day/week of its own or official ribbon or any celebrities to help or have tea party’s. More awareness and research is needed in LS, VIN, Vulval and Vaginal cancer. I don’t want anyone to go through what I have and am still going through. Nurses and GP’s need training in All these conditions especially those that do smear tests. Vulva cancer needs it’s own awareness week to make any impact. More Research is needed I like to help who ever I can, whether is tips, support or just someone to talk to who is going through the same as you. We need to use the word Vulva more! --- ## What does 'Success' really mean in pelvic organ prolapse surgery? URL: https://www.womenshealthpathway.com/blogs/what-does-success-really-mean-in-pelvic-organ-prolapse-surgery/ Metadata: - intro: - metaDescription: Understanding pelvic organ prolapse surgery success beyond statistics. Define your goals, recurrence rates, and quality of life expectations. - publishDate: 2025-09-10 - author: Margo Kwiatkowski - authorSlug: margo-kwiatkowski - featuredImage: margo-kwiatkowski-feature.jpg - tags: continence,prolapse - draft: false - hcp: true - headingTitle: What does 'Success' really mean in pelvic organ prolapse surgery? - headingSubtitle: - headingDescription: When discussing surgery for pelvic organ prolapse (POP) with patients, the number one question I hear is: What is the success rate? It's a valid question. If you're considering undergoing major surgery for prolapse, you want to know the chance of improvement or resolution of your symptoms. Here's the tricky part: before we can break down the success rates, we have to define what "success" actually means. ## What Is Considered A Successful Outcome After Prolapse Surgery? Success in older research studies was defined strictly by anatomical improvement. The patient outcomes were deemed successful if the prolapse was completely resolved after the repair. That means the severity of prolapse was graded as stage 0 or 1 on the POP-Q scale. The difficulty with this success indicator is that a large number of women still have a visible prolapse bulge after the surgery. Even more challenging is the fact that the prolapse stage is not correlated with symptom severity. In other words, just because your anatomy looks "better" on paper doesn't always mean you feel better. Other studies define success by symptom relief: no more bulge sensation, fewer bladder and bowel issues, improved comfort with intimacy, or being able to exercise without symptoms. This is a much better indicator of success because it values the person and their perception as to whether the surgery was efficacious. This is why asking about "success rates" is more complicated than it sounds. Success can mean different things to different people, and it's important to know what definition is being used before quoting statistics. ## Setting Your Goals Before Prolapse Surgery One of the most important steps before deciding on surgery is clarifying your personal goals. Ask yourself: - Do I want to reduce the stage of my prolapse? - Do I want to become symptom-free? - Do I want to return to work, exercise, or intimacy without discomfort? Having clarity around your goals matters because it sets realistic expectations. Prolapse surgery might improve anatomy without completely eliminating symptoms—or the reverse. When you know your priorities, it makes surgical decisions easier and conversations with your surgeon more productive. ## Prolapse Surgery Recurrence Rates The second most common question I hear is: Will my prolapse come back after surgery? This is where recurrence rates come in. But keep in mind: - Different procedures have different recurrence rates - Different doctors have varying recurrence/success rates - An individual's medical history greatly influences recurrence including: levator ani avulsions, hypermobility disorders, unresolved chronic constipation, chronic cough, etc. - Surgeons use different definitions of "recurrence." Most surgeons are not following their patients long-term so they cannot confidently claim their procedures have 20 year success rates - Hormone status is an important consideration because someone in menopause who has not used hormone replacements has lower quality vaginal tissues than someone in their late 30s Understanding the nuances helps you approach surgery realistically, knowing it may not be a once-in-a-lifetime fix. ## Prolapse Surgery and Quality of Life Prolapse is about more than the visible bulge. It can impact your bladder and bowel health, your sex life, your ability to lift, run, or even just go about daily tasks comfortably. Arguably the most important questions to ask is: Will surgery improve my quality of life? For many people, the answer is yes. Research on quality of life after prolapse surgery shows improvements in daily function, comfort, and confidence. But what matters most is how you personally define quality of life—it could mean playing with your kids without leaking, exercising without pressure, or simply feeling like yourself again. ## Why Choose Surgery for Pelvic Organ Prolapse? Not everyone jumps straight to surgery. Many people try pelvic floor physical therapy, lifestyle strategies, or pessaries first. Prolapse can often be well managed conservatively with the right exercises, diet changes, and pressure management considerations. A well experienced physical therapist can guide you in these strategies. Even so, some women have tried everything, and are still bothered by their prolapse symptoms. Maybe pessaries don't fit your anatomy, or they just don't feel right for you. Or maybe you're simply tired of dealing with prolapse and want a more definitive option. Choosing surgery isn't a failure—it's just another tool to restore function and improve your quality of life. ## The Bottom Line on POP Surgery There's no universal definition of success in prolapse surgery. The numbers can give you part of the story, but what really matters is: - How YOU define success for yourself - Whether your goals align with the procedure being recommended - What the research says about recurrence rates and quality of life improvements Before making a decision about pelvic organ prolapse surgery, take time to: - Define your goals - Understand the definitions behind the statistics - Ask your surgeon about both short- and long-term outcomes - And always—get multiple opinions You deserve to feel informed and empowered as you make this decision for your body, your health, and your quality of life. --- ## What Is Breathwork & How Does It Support Women? | Amanda Curry PT, DPT URL: https://www.womenshealthpathway.com/blogs/breathwork-your-questions-answered/ Metadata: - intro: - metaDescription: Physical therapist and breathwork practitioner Amanda Curry explains what breathwork is, how it supports the nervous system, and why it's becoming a powerful therapeutic tool for women. - publishDate: 2026-03-08 - author: Amanda Curry - authorSlug: amanda-curry - featuredImage: amanda-curry-feature.jpg - tags: prolapse,sexual-health - draft: false - hcp: true - headingTitle: Breathwork, your questions answered - headingSubtitle: - headingDescription: If you've been hearing more about breathwork lately and find yourself curious but unsure where to start, you're not alone. As both a physical therapist and breathwork practitioner, Amanda Curry sits at a unique crossroads where clinical science meets deeply human experience. As you may have noticed in the news and social media, there’s been a lot of attention around breathwork recently. And with that attention, I have noticed a wave of curiosity, confusion, skepticism, and very real questions especially from women who are wondering what breathwork actually is, how it works, and whether it could truly support them. I love always LOVE answering these questions. Because they usually come from a place of longing. A longing to feel better. To feel safer. To feel more at connected and at home in your own body. I hear the HOPE within the inquiry. As both a physical therapist and breathwork practitioner, I am honoured to stand at an intersection that allows me to see breathwork through two lenses: the clinical and the deeply human. The science of the nervous system, fascia, and physiology paired with the energetic and emotionality presence in each lived experience. This isn't just about supporting the body physically, it's about meeting the body in the stress, stories, trauma, and deep responsibilities we also hold. So let’s start simply. Breathwork is the intentional use of breathing patterns to support people physically, emotionally, and mentally. It's the entry way into learning about and supporting the nervous system. At its core, it’s about creating a NEW relationship with your breath and through that, with your body. But unlike many breathing techniques that focus purely on calming or relaxation, therapeutic breathwork can also gently but powerfully access layers of sensation, emotion, memory, and awareness that often live beneath our conscious control. Your breath is directly connected to your nervous system. Every inhale and exhale sends signals to your brain about whether you are safe, threatened, overwhelmed, or regulated. The breath interacts and can influence EVERY PART of your body. In modern life, many of us live in a state of low-grade chronic stress, otherwise known as chronic sympathetic state. Our bodies have adapted to always being “on,” alert, productive, braced, and responsible. Over time as this becomes our baseline, our body also started to shift and change in result. Chronic pain, shallow breathing, disrupted sleep, and reactive behaviours start to become the norm. Breathwork offers a way back into regulation, capacity, and presence. Not by forcing calm, but by allowing the body to complete stress cycles, process held tension and increase capacity. From a physiological standpoint, breathwork supports oxygen delivery, carbon dioxide regulation, circulation, lymphatic flow, digestion, immune response, and hormonal balance (just to name a few). It directly influences the health and adaptability of the vagus nerve, which plays a central role in emotional regulation, resilience, social connection, and stress recovery. From a lived experience standpoint, breathwork often feels like being met. I know for me, it was as if I was able to finally allow myself to decompress and in turn allow the body to speak what was deeply stuffed down. Many women come to breathwork feeling disconnected from their bodies, emotionally shut down, anxious, overwhelmed, exhausted, or stuck. Some are navigating motherhood, caregiving, grief, burnout, identity shifts, trauma, or long seasons of putting themselves last. Breathwork becomes a place where they can soften the armour, feel safely held, and reconnect to themselves, their emotions, and their power. IMPORTANT REMINDER: Breathwork isn’t about pushing, forcing, or reliving trauma. (If you ever are in a space that promotes this.... RUN.) The way I facilitate breathwork is grounded in safety, consent, and nervous system awareness. Sessions are designed to build capacity, not overwhelm it. To allow release without retraumatization. To support integration, not emotional flooding. One of the most common fears I hear is: “What if I lose control?” In truth, breathwork doesn’t take control away. It gives it back. It helps your body remember its own intelligence. You remain aware, present, and guided throughout the process. What unfolds does so because your nervous system feels safe enough to allow it. Another question I hear often is: “Do I need to have trauma or something ‘wrong’ with me to benefit?” Absolutely not. Breathwork isn’t only for supporting stress and trauma. It’s for expansion, clarity, connection, creativity, rest, and growth. It supports women who feel stuck, numb, disconnected, uncertain, and also those who feel deeply alive but want to go deeper. It meets you where you're at. Whether you’re surviving, stabilizing, or ready to just step into a fuller expression of yourself. As a physical therapist, I deeply respect the body’s wisdom and knowing. As a breathwork practitioner, I trust the body’s timing. Breathwork doesn’t rush. It doesn’t force. It doesn’t bypass. It invites. And perhaps that’s why it’s becoming such a valued therapeutic tool right now. In a world that moves fast, demands productivity, and praises resilience at all costs, breathwork offers something radically different: A return to presence. To listening. To slowing down enough to feel. Not to fix yourself but to remember yourself. Breathwork isn’t a magic pill. It’s a relationship. One that deepens over time. One that teaches you to notice sensation, emotion, thought, and breath as interconnected rather than separate. One that slowly rebuilds trust between your mind and your body. If you’re curious, uncertain, or quietly hopeful, I want you to know this: You don’t need to feel ready, calm, or confident to begin. You simply need breath and have a willingness to meet yourself with honesty and care. That’s where the real work begins. --- ## When Sex Hurts URL: https://www.womenshealthpathway.com/resources/books/when-sex-hurts/ Metadata: - subtitle: - author: Andrew Goldstein, Caroline Pukall PhD, Irwin Goldstein MD, Dr. Jill Krapf - publishDate: 2026-07-24 - tags: sexual-health - category: book - image: /images/reviews/books/when-sex-hurts.jpg - infoLink: - purchaseLink: https://www.amazon.com.au/When-Sex-Hurts-Understanding-Healing-ebook/dp/B09ZDRS1HM - draft: false - spotifyLink: - appleLink: - googleLink: - youtubeLink: Pelvic pain can lead to embarrassment, silence, and misdiagnosis. It can hurt your relationship as well as your sense of self. Tackling the stereotypes, myths, and realities of pelvic pain, this easy‑to‑understand, accessible guide will help readers get the help they need and deserve, offering key information on: * The most urgent questions about the causes of pelvic pain * The more than twenty causes of pelvic pain * How to find the right doctor * The relationship between pelvic sex and genetics * The newest in treatment for pelvic pain and pelvic pain indications * How psychological factors can contribute to and reduce pelvic pain * Featuring groundbreaking research and stories from people who've lived it, When Sex Hurts provides the tools you need to stop hurting and start healing. --- ## When she's not 'just stressed': perimenopausal mental health conditions URL: https://www.womenshealthpathway.com/blogs/perimenopausal-mental-health-conditions/ Description: Perimenopause is one of the most significant transitions a woman will go through during her life. It is often framed as a physical shift, with hot flushes, irregular periods, and disrupted sleep being classic signs. But, for many women, the mental health impact is far more disabling than night sweats or unpredictable periods. Metadata: - intro: Perimenopause is one of the most significant transitions a woman will go through during her life. It is often framed as a physical shift, with hot flushes, irregular periods, and disrupted sleep being classic signs. But, for many women, the mental health impact is far more disabling than night sweats or unpredictable periods. - metaDescription: Perimenopause raises the risk of depression, anxiety, and PTSD — often before hot flushes begin. Learn the signs, risk factors, and treatments that actually work. - publishDate: 2026-04-12 - author: Dr Nadia Boscaglia - authorSlug: nadia-boscaglia - featuredImage: nadia-boscaglia-feature.jpg - tags: menopause - draft: false - hcp: true - headingTitle: When she’s not "just stressed": Perimenopausal mental health conditions - headingSubtitle: - headingDescription: Perimenopause gets talked about in terms of hot flushes and disrupted sleep, but for many women, the mental health toll is far heavier. Perimenopause is one of the most significant transitions a woman will go through during her life. It is often framed as a physical shift, with hot flushes, irregular periods, and disrupted sleep being classic signs. But, for many women, the mental health impact is far more disabling than night sweats or unpredictable periods. In many studies across different cultural groups, it is reported that during the perimenopause: - the risk of new onset depression or relapse of depression increases substantially, - suicide rates peak, - those with severe mental illness such as schizophrenia, are at increased risk of relapse or treatment resistance, and - PTSD symptoms may intensify compared to both pre- and post-menopausal periods. Whilst there are now endless humorous Instagram reels about women having reduced tolerance for unsuspecting spouses during this life phase, the evidence points to something far more serious: perimenopause is a period of genuine vulnerability to significant mental health deterioration. What makes this life phase so high risk for some women? During the perimenopause, which is the 4-10 years preceding the last menstrual period, hormone levels change. Broadly, testosterone declines steadily; progesterone declines but fluctuates until menopause is reached; and oestrogen levels fluctuate markedly before ultimately declining and stabilising after menopause. These hormones are not just reproductive, they are neuroactive. Diagram note: From [“The primary care management of perimenopausal depression,”](https: The brain is highly sensitive to these hormonal shifts, and in turn, the hormones affect the neurotransmitter systems involved in mood regulation, cognition, and stress responsivity. As a result, women may experience changes in memory, emotional regulation, and resilience to stress. Importantly, these effects can emerge years before classic symptoms such as hot flushes, meaning women in their late 30s or early 40s may present primarily with psychological symptoms. Depression in the perimenopause can manifest differently than at other life stages. Cognitive symptoms (e.g., brain fog and memory loss), plummeting self-esteem, and irritability and rage are more prominent. Paranoia (of the non-bizarre type) can also be part of perimenopausal depression, for example, thinking that she’s disliked by everyone in the workplace, or worrying that her spouse or children no longer love her. It is not all women, of course, who will experience mental illness in the perimenopause. Women with a history of mental health difficulties, particularly those linked to hormonal sensitivity (such as severe premenstrual symptoms or postnatal depression), may be at increased risk of relapse. For others, the perimenopause may be the first time she experiences significant psychological distress or mental illness. Additional risk factors for perimenopausal depression include early menopause, neurodivergence, childhood trauma, and experiencing family violence. Crucially, it is not only biological change that drives the experience of perimenopausal depression. The perimenopausal years often coincide with substantial psychosocial load: raising teenagers, empty nesting, or accepting (or rejoicing!) that the child bearing years are drawing to a close; caring for ageing parents who perhaps may have been the cause of the childhood trauma/neglect that led to her PTSD; and managing senior responsibilities at work. Sexual functioning can also be affected. Perimenopausal hormonal changes can result in a loss of libido, recurrent urinary tract infections and/or thrush, and vulva fissures (small splits in the folds of the skin of the vulva) that are so tender that wearing a pair of jeans is unbearable, let alone engaging in sexual activity. The cumulative load of these changes in the perimenopausal woman’s whole being is enormous; no wonder it contributes in such a profound way to her mental health. For women who are wondering whether they may be experiencing perimenopausal depression, completing a screening tool such as the [Menopause Depression Scale (Meno-D)](https: Effective care requires a genuinely multidisciplinary approach: GPs, psychologists and medical specialists where required. Menopause hormone therapies (MHT) can be effective for mood and anxiety and can also help alleviate some of the contributing physical symptoms (e.g., hot flushes and genito-urinary symptoms). Antidepressants may be effective for some women, though the emotional blunting side effects can be problematic. Psychological support is vital; seeing a menopause-informed psychologist can assist with identity transitions, meaning-making, sleep and lifestyle interventions, and the processing of trauma that may have resurfaced. Perimenopausal depression is common and can be debilitating, but it is also highly treatable with care is coordinated, nuanced, and addresses the whole woman. ## References Behrman, S., & Crockett, C. (2024). Severe mental illness and the perimenopause. British Journal of Psychiatry Bulletin, 48(6), 364–370. https: Dorani, F., Bijlenga, D., Beekman, A. T. F., van Someren, E. J. W., & Kooij, J. J. S. (2021). Prevalence of hormone-related mood disorder symptoms in women with ADHD. Journal of Psychiatric Research, 133, 10–15. https: Hendriks, O., McIntyre, J. C., Rose, A. K., Sambrook, L., Reisel, D., Crockett, C., Newson, L., & Saini, P. (2025). Menopause and suicide: A systematic review. Women’s Health, 21, Article 1360517. https: Kulkarni, J. (2018). Perimenopausal depression – an under-recognised entity. Australian Prescriber, 41,183–185. https: Kulkarni, J. (2023). Depression: A major challenge of the menopause transition. Medicine Today, 24(6 Suppl), 8–13. Kulkarni, J., Cashell, C., Harvey, E., Chelvanayagam, S., Gurvich, C., & Mu, E. (2026). The primary care management of perimenopausal depression. Australian Journal of General Practice, 55, 197–202. https: Michopoulos, V., Huibregtse, M. E., Chahine, E. B., Smith, A. K., Fonkoue, I. T., Maples-Keller, J., Murphy, A., Taylor, L., Powers, A., & Stevens, J. S. (2023). Association between perimenopausal age and greater posttraumatic stress disorder and depression symptoms in trauma-exposed women. Menopause, 30(10), 1038–1044. https: Page, C. E., Soreth, B., Metcalf, C. A., et al. (2023). Natural vs. surgical postmenopause and psychological symptoms confound the effect of menopause on executive functioning domains of cognitive experience. Maturitas, 170, 64–73. https: Shea, A. K., Frey, B. N., Gervais, N., Lopez, A., & Minuzzi, L. (2022). Depression in midlife women attending a menopause clinic is associated with a history of childhood maltreatment. Climacteric, 25(2), 203–207. https: Wood, S. (2026, March 21). The impossible task of caring for ageing parents who did not care for you: “There’s a lot of reliving old triggers”. The Guardian. https: Xi, D., Chen, B., Tao, H., Xu, Y., & Chen, G. (2023). The risk of depressive and anxiety symptoms in women with premature ovarian insufficiency: A systematic review and meta-analysis. Archives of Women’s Mental Health, 26(1), 1–10. https: --- ## Why Mum's Don't Jump URL: https://www.womenshealthpathway.com/resources/podcasts/why-mums-dont-jump/ Metadata: - subtitle: - author: Helen Ledwick - publishDate: 2025-09-16 - tags: prolapse - category: podcast - image: /images/reviews/podcasts/why-mums-dont-jump.jpg - infoLink: - purchaseLink: - draft: false - spotifyLink: https://open.spotify.com/show/3PSOIKwyVj0RcwAkQ9Ysxl - appleLink: https://podcasts.apple.com/us/podcast/why-mums-dont-jump/id1507937343 - googleLink: - youtubeLink: https://www.youtube.com/channel/UCfFWOmtJ1uXxZ22zHPZ4olQ One woman’s mission to end the stigma around leaks and lumps after childbirth. Honest chat about incontinence, prolapse and pelvic pain. Not a trampoline in sight. Hosted by Helen Ledwick. --- ## Why pelvic pain isn’t all in your head — and what you can do about it URL: https://www.womenshealthpathway.com/blogs/why-pelvic-pain-isnt-all-your-head/ Metadata: - intro: - metaDescription: Pelvic pain is real, not 'in your head'. Jersey specialist explains causes, treatments, and evidence-based strategies for chronic pelvic pain management. - publishDate: 2025-09-07 - author: Alex Frankham - authorSlug: alex-frankham - featuredImage: alex-frankham-feature.jpg - tags: vaginal-vulva-health,continence - draft: false - hcp: true - headingTitle: Why pelvic pain isn’t all in your head — and what you can do about it - headingSubtitle: - headingDescription: Pelvic pain is real, not 'all in your head.' Learn from a pelvic pain specialist physiotherapist in Jersey about causes, treatments, and evidence-based strategies to manage chronic pelvic pain. If you've ever been told your pelvic pain is "just stress" or something you need to learn to live with, you're not alone. Around the world, women with chronic pelvic pain face long delays in diagnosis, limited treatment options, and the burden of not being believed. But here's the truth: pelvic pain is real, complex, and treatable with the right support. I'm Alex Frankham, a Clinical Specialist Physiotherapist in Persistent Pelvic Pain, Director of [Physio.je](https: This blog is for you: to help you understand why pelvic pain is not "all in your head," why it's often misunderstood, and what steps you can take today. ## Why Pelvic Pain Is Often Misunderstood Despite being common, pelvic pain in women remains a highly under-recognized health challenge worldwide. Research shows pelvic pain is often overlooked even in medical education the FIGO–IPPS consensus statement highlights the global unmet needs of women with chronic pelvic pain, pointing out major gaps in diagnosis, treatment, and support leaving clinicians underprepared to help. The result? Too many women are dismissed, told their symptoms are "in their head," or passed between specialists without answers. ## What Causes Pelvic Pain? Pelvic pain is not caused by one thing — it's usually an interplay of factors, again another reason why people and clinicians cannot give one solution, or that every person has the same problem and same recipe to help them. Pelvic pain could be caused by specific medical conditions such as: - Gynaecological conditions of endometriosis, adenomyosis, or post-surgical adhesions - Bladder and bowel conditions such as interstitial cystitis, irritable bowel syndrome - Pelvic floor dysfunction, where the muscles are not functioning at their best and may be overly reactive - Neuro-immune system sensitivity, this is complicated but essentially pain pathways can become overactive, amplifying discomfort – the body is more sensitive – like a fire alarm going off and calling the fire brigade just because you made toast in the toaster! - Hormonal and inflammatory influences - cyclical pain which may be linked to menstruation or inflammation and can overtime perpetuate more inflammation - Emotional and social context – this is not saying "it's in your head" but there is empirical evidence that stress, trauma, or not being believed can worsen pain perception The important thing is that pelvic pain is real. It is not "all in your head." Instead, it is a whole-body experience where both body and brain play a role. ## What Helps: Evidence-Based Approaches The EAU Guidelines on Chronic Pelvic Pain recommend a multidisciplinary approach — meaning the best results often come from a combination of strategies. ### 1. Medical Specialists To help with specific pharmacology (not all medicines help), ensuring the most appropriate investigations (MRI, USS, blood tests) have been undertaken, and undertaking relevant surgery following detailed investigations. ### 2. Specialist Physiotherapy Pelvic health physiotherapists can help with muscle tension, posture, breathing, and safe, guided movement and pacing, instead of "boom and bust" (doing too much on good days, then crashing), pacing activities builds confidence and resilience. Yoga, Pilates, or tailored exercise can help. ### 3. Pain Education Learning about how the nervous system processes pain can change how you respond to flare-ups, reducing fear and anxiety. ### 4. Multidisciplinary Support This may include gynaecologists, urologists, dietitians, psychologists, pain specialists, psychosexual therapists working together. ### 5. Emotional Support and Self-Compassion Living with pelvic pain is tough. Recognising the emotional toll and seeking support is part of healing. ## Finding Hope with Pelvic Pain Pelvic pain may feel overwhelming, but you are not alone. With the right care, many women find ways to reduce pain, improve quality of life, and feel more at home in their bodies again. At [Physio.je](https: If you're struggling for support or being believed, explore trusted resources like the [EAU Chronic Pelvic Pain Guidelines](https: ## References Coxon, L., Horne, A.W. and Vincent, K., 2022. Identifying gaps in pelvic pain education: A scoping review and structured analysis of obstetrics and gynecology training milestones. American Journal of Obstetrics and Gynecology, 227(3), pp.440–448. EAU, 2025. EAU Guidelines on Chronic Pelvic Pain. European Association of Urology. Available at: https: ESHRE, 2022. ESHRE guideline: endometriosis. European Society of Human Reproduction and Embryology. Available at: https: FIGO & IPPS, 2021. Addressing the global unmet needs of women with chronic pelvic pain. International Journal of Gynecology & Obstetrics, 155(1), pp.1–6. NICE, 2025. Endometriosis: diagnosis and management. National Institute for Health and Care Excellence. Available at: https: --- ## Womankind Collective: Spill The Tea URL: https://www.womenshealthpathway.com/resources/podcasts/spill-the-tea/ Metadata: - subtitle: - author: Jinty Sheerin and Lou Hockings-Thompson - publishDate: 2026-08-17 - tags: general - category: podcast - image: /images/reviews/podcasts/spill-the-tea.jpg - infoLink: https://www.instagram.com/reels/DY8-qKKtrT1/ - purchaseLink: - draft: false - spotifyLink: https://open.spotify.com/show/42KniEtc5WGQhNvREsN1WP - appleLink: https://podcasts.apple.com/gb/podcast/womenkind-collective/id1557937820 - googleLink: - youtubeLink: Women’s health, gender bias, extraordinary stories, and the menopause conversation, served with honesty, humour, and heart by authors and lifelong friends Jinty and Lou. Every Sunday we spill the tea on the stuff society shies away from: hormones, health, relationships, equity, midlife pivoting, and finding your confidence again, plus menopause, because it keeps coming up for good reason. No topic’s off-limits and no conversation is too awkward. With expert guests including Menopause specialists, GPs, Gynaecologists, Nutritionists, Sleep Therapists, Advocates, and Comedians, we mix evidence-based facts with real talk, real laughs, and the occasional faux pas. Beyond the podcast, we’re authors of Tackling Gender Bias in the Healthcare System: What Patients Stories Teach Us About Implementing Systemic Change, and our #WheresMyClinic campaign helped bring the NHS Devon Menopause Service to life. We founded Exmouth’s first Menopause Cafe and hosted BBC Radio Devon’s first-ever menopause cafe. Find us daily on [Instagram as Womankind Collective](https: --- ## You only get ten minutes URL: https://www.womenshealthpathway.com/blogs/you-only-get-ten-minutes/ Metadata: - intro: - metaDescription: Raelene Ristevski's story of menopause misdiagnosis and dismissive healthcare. Why women deserve proper support, not just 'ten minutes' for complex symptoms. - publishDate: 2025-09-05 - author: Raelene Ristevski - authorSlug: raelene - featuredImage: raelene-feature.jpg - tags: menopause - draft: false - hcp: false - headingTitle: You only get ten minutes - headingSubtitle: - headingDescription: I didn’t know I was menopausal. I just knew something was changing, and not in a gentle way. My moods were unpredictable, my nights were spent fighting with the covers, my bones ached, and my brain felt like fog. I found it hard to concentrate. I couldn’t explain it. I just knew I didn’t feel like myself. So, I did what we’re all told to do: I booked an appointment with my family GP. I explained my symptoms, night sweats, poor concentration, aching joints, mood swings and waited for guidance. Instead, my doctor looked directly at me and said, “You only get 10 minutes. Next time, come in with just one symptom.” There was no mention of hormones. No suggestion that this could be menopause. In fact, he didn’t even ask about my cycle. Just handed me a prescription for antidepressants, with no mention of a follow up appointment. I walked out feeling even sadder than when I walked in. I wasn’t offered information. I wasn’t offered support. I wasn’t offered a conversation about what was happening to my body. I was offered medication to “get me through.” I never filled the prescription. Not because I didn’t need help, but because I needed the right help. I needed someone to say, “This is normal. This is hormonal. This is menopause.” Instead, I turned inward. I read what I could. I meditated. I journaled. It wasn’t perfect. It wasn’t enough. But it was all I knew. And it was a lonely time. Why am I sharing this??? Because I know I’m not the only one. Too many women are dismissed, misdiagnosed, or medicated without context. Too many are left to navigate menopause alone, without education, without support, and without language for what they’re experiencing. I created Women’s Health Pathway, to offer what I didn’t receive. A space where women’s Health is understood and supported and spoken about freely. To bring together, evidence based resources, podcasts, blogs, and peer stories that speak with clarity, compassion and without judgement. ---