Join Susan Sly for a powerful episode of the Menopause Health Podcast featuring Sheree DiBiase, Founder and President of Lake City Physical Therapy, PA, a premier provider of personalized physical therapy services in the Northwest. With over 40 years of leadership in women’s health, oncology, sports, and orthopedics, Sheree reflects on her personal menopause journey and shares invaluable insights into the lymphatic system, pelvic health, and hormone therapy. 

Drawing on her expertise as a certified Pelvic Rehabilitation Practitioner (PRPC) and International Lymphedema Management specialist (ICLM), she highlights key symptoms like heaviness, bloating, and pelvic pain. Learn practical strategies for self-advocacy, performing monthly pelvic checks, and understanding how pelvic floor health can impact hormone replacement therapy.  Don’t miss this eye-opening discussion, filled with actionable advice to empower your wellness journey through menopause and beyond.

About Sheree: Sheree Dibiase is the Founder and President of Lake City Physical Therapy, PA, with eight locations across the Northwest. With over 40 years of expertise in women’s health, oncology, sports, and orthopedics, she is a certified Pelvic Rehabilitation Practitioner (PRPC) and International Lymphedema Management Specialist (ICLM). Sheree is also the host of the FemTech Health Podcast, where she explores innovations in women’s health. She is passionate about empowering patients, mentoring future physical therapists, and promoting lifelong wellness.

Connect with Sheree:

Website: https://lakecitypt.com/

LinkedIn: https://www.linkedin.com/in/sheree-dibiase-pt-prpc-iclm-dn-pelvic-womens-health-752ba351/

Instagram: https://www.instagram.com/dibiasesheree/

About Susan :  Susan Sly is the host of The Menopause Health Podcast and the Founder and CEO of The Pause Technologies, an AI-enabled platform helping women navigate menopause with precision recommendations and gamification. A seasoned entrepreneur and MIT Sloan graduate, Susan is a second-time AI startup founder. Before The Pause Technologies, she co-led a computer vision company that achieved the largest retail deployment at scale for both interior and exterior analytics. Globally recognized for her work in AI, Susan continues to pioneer the intersection of technology and women’s health, empowering women with the tools to thrive.

Connect With Susan Sly:

LinkedIn: @susansly

LinkedIn: The Pause Technologies Inc.

Website: https://thepause.ai/

Subscribe to our free newsletter here: https://thepause.ai/newsletter/

Susan Sly 0:00

Hello and welcome to this episode of The Menopause Health Podcast. And I just want to, before we get into the show, thank you. It means so much to all of us that you're taking the time to listen and educate yourself. This podcast is a labor of love, and on behalf of myself and the production team, we are so grateful to have you here.

In this episode, we're going to be talking about pelvic health, and I learned so much in this episode, including facts about how our pelvic health is directly related to the efficacy of hormone replacement therapy. We're going to talk about lymphedema. We are going to talk about cancer. We are going to talk about how to do self-screening. And I can promise you, after being in the space for quite a period of time, I learned a tremendous amount from our guest today.

Before I introduce her and get into the show, I just want to say that this episode is brought to you by ThePause.AI.

And our mission at The Pause is to make perimenopausal care and menopausal care accessible at your fingertips on your mobile device. So check it out at www.ThePause.AI.

So, my guest today is the founder and president of Lake City Physical Therapy. She has eight locations, and she has over 40 years of experience in the profession of physical therapy. She has a very strong background in oncology, sports, and orthopedics. She is a certified pelvic rehabilitation practitioner, and she's also certified with the International Lymphedema Management certification. She has her own podcast called The FemTech Health Podcast, which is tremendous—you definitely want to check it out.

In this episode, we're going to talk about what it's like to sort of, I guess, have this intuition that something isn't right and what to do about it. We're going to talk about physical symptoms, and we're also going to talk about the challenges that women face because they're ignoring this, knowing that something is going on but not doing anything about it. I promise you, this episode is going to be illuminating for you.

So, let's go ahead, and I want to introduce you to our founder and health practitioner, Sheree Dibiase.

Voiceover 2:36

The opinions expressed by the guests on this podcast are their own and do not necessarily reflect the views of the show or its hosts. This podcast is for informational purposes only and should not be considered as medical advice. Always consult with a qualified healthcare professional regarding your specific health needs.

Welcome to The Menopause Health Podcast, your go-to resource for practical advice, brought to you by credentialed health professionals and industry experts. Here is your host, Susan Sly.

Susan Sly 3:17

Well, Sheree, we were talking, and I was like, Oh my gosh, we have a show we need to do. We have so many things we're gonna be discussing today. And for everyone listening to The Menopause Health Podcast and really loving it, as we get into today's topic, it's something we haven't discussed before. And we are gonna be talking about pelvic health, which is, guess what, something we all share. But before we get into that, Sheree, I want to jump in and ask you, as an entrepreneur, a specialist, and a mom, tell us about your own menopause journey.

Sheree Dibiase 3:58

Well, you know, it started typically, as it often does, at around 48 years old, and I had a thyroid issue. So, we'll just jump right in, and I'll explain—I had a tumor on my thyroid. The tumor they actually saw ended up being benign, but then they actually saw thyroid cancer on half of that, and they removed it. And then it started almost a snowball journey.

In our household, we called it a perfect storm. It ended up happening during that time frame, so I didn't enter menopause—or should I say, perimenopause—very easily. It was like a surgical intervention, and then a bomb blew up, and basically, it was like, Oh my goodness, so many health crises all at the same time.

And for somebody who had already been a therapist, a physical therapist, a business owner since I was 22 years old, and to suddenly be 48 years old and be the one who's actually out in the world searching for medical interventions when I'm a medical specialist and really not getting the answers in any consistent way—that helped me navigate that time frame.

So, about a year and a half, I was super sick. I had all kinds of health issues that happened, but you can imagine I didn't get put on thyroid medication after I had half my thyroid removed for a year and a half. So, I mean, my body just slowly, you know, went down that slippery slope, and it really took a big hit for not only our family system, my kids, my husband, all of us. It really challenged us and our business as well.

My husband and I are both self-employed—we've been self-employed all our married life. So, it was a rough entry, and now I think back about it, knowing what I know now about all the menopause things and entering into menopause, I'm like, Wow. I wish I would have known those things. I wish there would have been people, you know, surrounding me who could have helped me maybe even understand them better.

Luckily, my sister-in-law is a medical assistant, and she helped me a lot. But I think there are so many things we know now so much better than we did those years ago. And I think this is my passion—to help women not be alone, to have access to good medical interventions. There’s a huge knowledge gap right now, and we need to do better so that women, as they start entering this perimenopause phase, are not alone.

They don’t go to a zillion providers. You know, most of the people who walk into my office have been to five or six providers and still no answers. And, you know, it needs to go from a generalized knowledge base to individualized care.

Sheree Dibiase 8:16

I know this will sound crazy, but I had my surgery in February, and slowly, over that year's time frame, I just felt run down and fatigued. I went to the physicians, and I had a couple of different people I saw, and I kept saying, you know, I’m really run down. I’m super fatigued. And they’re like, Oh, well, you work too much. You know, duh, which, uh, you know, you’re a mom, you’re a business owner, you’re always working.

But by October of that year, I broke out with a rash—a weird rash—all over my body. And I was like, What? I think my body, by then, was like, Okay, I’ve had enough. You know, my thyroid obviously didn’t have what it needed on board. And then, of course, it affects your adrenal glands, and it affects your reproductive hormones. My reproductive hormones were all over the map. I’d always been a steady person, you know, with my menses every 28 days, like a religion. And so, all these just weird things happened.

I would go back to myself back then and tell that person, Hey, your intuition was right all year long. And I did fight and advocate for myself. But what happens when you look healthy? People assume you are healthy. And when you work, especially people who work in the medical community in particular, you know, a lot of people just take for granted that you know all these things. The problem is, when it comes to your own personal health, you’re so used to taking care of everybody else.

I mean, come on—women take care of 80 to 90% of all their health care for their whole family system, their parents, their kids, their everybody, right? And we get overloaded. We’re not used to advocating for ourselves, but sometimes I think we get in that position. We walk into that office, and we forget, just like your friend did, to advocate for ourselves. So, if something doesn’t feel right, use your intuition. If that provider and you don’t connect, move to a different provider.

I moved through a lot of different providers to get the help that I finally needed to get my thyroid back where it was supposed to be. But it took me so long, and there were so many other health crises in the middle of that, that it was not a good place to be.

And I think, if we can tell a woman anything, it’s this: if something doesn’t feel right, you find someone to help you with it. And if someone tries to tell you, Oh, it’s all in your head—and you know, it’s not in my head. I’m bloated. I’ve never been bloated before. I mean, one of my women that I just had with vulvar cancer, I asked her, I said, Did you know something was wrong? She said, I went in with what looked like a little disc. It was tiny, small. And she said, I knew something wasn’t right, and I had to push to get somebody to do something, to biopsy it.

I think that’s where we’re at now—we have to sort of help each other. Like, if you’re not getting the answers in the community that you’re in medically, know that somebody out there is going to answer it. And no, don’t just hand me an antidepressant or anti-anxiety medication and tell me, Oh, you just need a little of this. My women throughout perimenopause to post-menopause constantly—that’s the first order of business. And I say, hold on, let’s slow down.

Well, and to your point, trusting your gut—as women, we do not often prioritize ourselves—and this "it's all in your head" narrative. To the listeners of this show, if you haven't heard the story, in 2016 I had been in Africa, and I came back, and I was really sick. I had one doctor say, "It’s all in your head," and he gave me a personal development book. I’m like, do you realize I’ve shared the stage with Tony Robbins, Mel Robbins, Pitbull, Gary V—like all these different people? I’ve run workshops where I’ve helped women transform. I’m an author of personal development books. I don’t need that.

Another doctor told me it was PMS. What it was, Sheree, was an amoeba, and it was shutting down my organs. I almost—I almost died. Women get gaslit all the time.

And just to level set, in the United States alone, there is one certified provider for every 30,000 women in menopause. You have to be your own advocate, which means, and this is going to be the whole piece around this show, very tough love. Girls, I want you to hear it—from Sheree and from me. Yes, you have five million things you’re doing, and you could be in business. You’re an SVP of a company, or you’re a director-level leader, and you’ve got kids, or grandkids, and you have a partner, and you have a pet, maybe five pets—I don’t know what you’ve got—and you’re like, "I don’t have time." Yes, you do, because you’re the pilot, the flight attendant, and the co-pilot of that airplane you call your life, and if you don’t prioritize it, it is all going to come crashing down.

Sheree, do you want to say anything?

Uh, yes, I do. Because I think when we have that intuition, that gut feeling, right? Like, when I talk to the women that I know, I’m like, no, no, absolutely not. Oh, you got brushed off by somebody? It’s easy for you to sort of step back and think, "Oh, it really wasn’t something." And I’m like, no.

I have young women now who we are helping get diagnosed with endometriosis. Let me explain—so much of the stuff they’ve dealt with for years. I have women now in their 50s and 60s realizing, "Oh my goodness, I’ve had endometriosis the majority of my life."

We have to teach each other, right? How to actually say the things that we need to say and not be embarrassed. Not be embarrassed, not be ashamed to say, "Hey, I don’t know what’s going on, but I don’t feel good." You know what happens now? You teach one young woman in my office, and she tells seven or ten other young women, "Hey, you need to talk to this provider. They’re going to listen to you."

I think that’s the key—if we can teach young women to actually say what they need and stand up for themselves. You know, you can do it kindly, you can do it nicely, but know your body.

That’s what we do every day in our work in the pelvic health world—we are teaching young women. I don’t care how young they are when they come in. I mean, I have young women who come in, they get their first period, and there are issues that start up, or things are going on, and we’re working with them, right?

We’re trying to help them have a quality of life, whether they’re in their reproductive years, prenatal, postpartum, or whether they’re now in perimenopause or menopause. And you know, you and I know we spend 40% of our lifetime in perimenopause and menopause—let’s make it great.

Yeah, well, and for some women, even to that point, every time I hear the 40%, I just make a face. So if you’re just listening and you’re not seeing us on YouTube or wherever you’re watching us, I made the face. And for some women, it’s even longer because of surgical menopause.

One of Brooke Chambers, who we’ve had on the show, she had a hysterectomy, I believe, at age 32. She may live to be, you know, in her 90s, and she will have spent over 60%.

And so, Sheree, this other thing is the conversation between mothers and daughters, or godmothers and grandmothers, or between women who are navigating menopause and perimenopause, and that next generation—to teach them how to be advocates. Because learning how to be an advocate, if you have a healthy relationship with an older woman who is a mentor, it starts at home.

Which leads me to—we were talking before we started the show about you being a pioneer in the space, especially as a woman. So, can you share with everyone? Tell us about your practice, your business, and what it was like to be one of the first women in your space.

So, thanks, Susan, for asking that. I really appreciate it. In our space, it was pretty male-dominated if you owned your own private practice. I bought my first private practice from an older gentleman who was retiring, and literally, I had to talk to him for nine months. He wanted to sell, but he didn’t want to sell to a woman.

What year was this?

Okay, let’s see. It would have been 1987.

S

Wow. So, it’s not, you know, like every—this is recent, you know? I know most people who listen to this show wouldn’t consider ’87 like the dark ages. So, yeah.

It feels like the dark ages now. But literally, I found out he wanted to sell, and I went to him over the course of eight or nine months to convince him that he should sell to me. I was a professor at Loma Linda University at the time, in the School of Physical Therapy. I taught there for seven years.

He knew that, and he knew I knew all these people there, and he knew I was well-respected there. And he still was afraid to sell to me, and it was just such a crazy story. Then years later, he came back to me. He actually visited me, and with his wife, he came to my office. It was probably 10 or 12 years later, after I bought it.

He sat in my waiting room and waited for me to be done with my patients for the day because he wanted to tell me, "I am so proud of you, and I’m so lucky that I sold my practice to you."

At the time I bought it, I ended up getting a male partner, but it’s kind of crazy. By then, I was on my own—self-employed and no partners—but it was just me. I was 25 years old, and I wanted to buy this man’s practice. I had no mentors who were women.

My mentor, thank goodness, was a man I had met in PT school. He’s amazing. He’s still my mentor to this day, and he laughs when I tell him all about my women’s health work because he’s like, "Sheree, you didn’t learn any of that from me, and I didn’t mentor you in any way, shape, or form in that." And I said, "Yeah, but you at least started me on my journey of believing in who I was and what I could do."

I think my goal now is—I have a lot of young women who work in my organization, work on my team, and I am all for mentoring them. We have a huge health initiative in our organization this year. It’s literally to help raise up the next generation of women.

Maybe, if a mom didn’t know how to talk to her daughter, guess what? They have us to talk to. We’re going to have, on our WebEx—it’s part of our internal communication—a moms mentoring group.

Do you know—and you probably know this—but wherever I go, people are like, "Hey, after we have dinner, can I talk to you for a second?" Or I’m at a function with women, and someone says, "I need to ask you this for a second." Pretty soon, the whole table is talking about pelvic health, sexual health, bowel issues, bladder issues, etc. Why?

Because my mom was a nurse, but she didn’t know how to talk to me about sexual health and all these things. That wasn’t the time frame for it.

We’re trying to change this so that we don’t have any knowledge gaps, information gaps, or implementation gaps. Because if we don’t do this, we’re not serving the next generations well.

So, yes, I love that I can now mentor others. I’m thankful for my male mentors, but there weren’t any women mentors back then. I think we, as women—no matter what profession or field we’re in—need to step up to the plate.

We don’t think we have anything to offer others, but yes, we do. We need to tell them, "Hey, I walked through all these things. I’ve been self-employed for 38 years. I’ve learned a wealth of knowledge and experience."

And why are we doing it? Because we care about the next generations coming, and we don’t want them to have to stumble around and make the same mistakes we did, right?

Absolutely, and I love that concept of the initiative—just really, you know, the peer-to-peer mentoring. No matter what we’re going through, someone has gone first, right? And that’s the case in your space. You’re one of the first women to go first, just like in my space in artificial intelligence. I was one of the first women—maybe the only woman in the United States—to deploy computer vision at scale as a co-founder of my previous company. Right?

Someone has always gone first in some way, shape, or form. I want to ask you—have you seen a greater prevalence of certain issues in pelvic and sexual health more recently than you were seeing back in the ’80s? Are there some trends that are rising that our listeners should be aware of, especially as we’re lovingly kicking their booties to go get their checkups and everything?

Susan, I think the biggest thing—when I first started in this space, I was really into sports medicine. I had an orthopedic sports medicine clinic, and we were really pushing. We loved our women athletes. We took care of men as well.

But then I had my own baby, my son Cody, and I definitely changed. My vision started to shift because I realized, you know, women being pregnant—it’s an athletic event, literally, for nine months. And then we’re just kicking them back out on the field and saying, "Hey, good luck. Have a great time out there. I don’t know who’s going to take care of you, but see you around."

Then you get into all kinds of health issues. Mine, in particular, was—again, I don’t know what it is—entering the reproductive years, just like I entered into menopause. It was a full-on, "Whoa."

I had a huge baby—too big for me—and I really worked during labor and delivery to try to use my voice to say, "I need a C-section because I’m not doing well."

And I need to pause for a second because you can’t just say something like that and not tell us how big he was. And as a sidebar, Cody, Sheree’s son, has been a guest on my other show, Raw and Real Entrepreneurship. We will put the link in the show notes. It was such an amazing interview. Love that kid. Congrats, mom. But how big was he? I need to know.

So, at that point in time, I was tiny, tiny, and he was nine pounds, three and a half ounces, 21 and three-quarters inches long, had the cord around his neck twice, and just wouldn’t advance. And innately, I knew something was wrong. I literally said to the physician, "Hey, I need to have a C-section." And he said, "Oh, I think you’re doing okay." Then he said, "I’m going to dinner. I’ll be back in two hours."

Literally, thank God my mom was a nurse. She was retired from nursing at that time. But my girlfriend, a high-risk labor and delivery physician in Washington, DC, was visiting me during this time. She was in the room, and for two hours, she took care of me, turning me into every position. Every time the baby would try to advance, his heart rate would go down.

So, when that kid was born vaginally—which was a terrible, terrible deal—the crash cart came in. All the pediatricians came in. He wasn’t breathing; he was blue. They couldn’t get him out. First, his head came out, but they couldn’t get the rest of him out.

I share these things in a little more detail than I normally would, but I think, Susan, I’m saying this because I innately knew there was a problem. I live in the musculoskeletal world every day, and no one was listening to me. I thought, wow, this is crazy. I was like, no, I’m pretty sure something’s up. This kid’s way too big.

Sure enough, four months later, I had to have a pelvic floor reconstruction. Then my whole world in the medical arena as a physical therapist changed, and I pivoted into prenatal and postpartum care.

Thirty years ago, I started part of this work, as you know. I began working in the breast cancer and oncological world. I started looking at women and saying, why are we not serving women well?

One of my top neurosurgeons at the hospital reached out to me about a patient. They didn’t know what to do with her. She had lymphedema. They said, "Please, Sheree, help us."

At that point, I didn’t know the work yet. The moment I saw her, I thought, there’s no way any woman should have to suffer like this. She had gone so far that her arm was weeping fluid because she’d been so mismanaged.

At that point, I said, absolutely not. I started training myself and my staff in lymphedema and oncological work. And you know what happens when you do that? You fly right into the pelvic health world. Suddenly, I thought, oh my gosh, here we go.

If you’d asked me when I graduated if I’d ever be doing this, I’d have said, "What are you talking about?" No one knew this work. No one trained in it. Because I had no one to teach me, I started learning, doing all the work, and became very adept at putting puzzle pieces together for people.

But I was always like, no woman is going to suffer on my watch or my organization’s watch anymore.

That’s the beauty of the work The Pause is doing. I’m telling you, in the perimenopause, menopause, and post-menopause space, it’s the same passion: no woman’s going to be left alone.

We’re not leaving anybody without medical interventions or a way to find the care they need. We’re not doing this anymore. Women deserve better, and they deserve more.

We’re destroying families and family systems when we don’t look at people and say, "Hey, this woman doesn’t feel good sexually. She loves her husband, but she can’t participate because she doesn’t feel good. Why is that?"

Let us help her. That way, we keep families together, and we keep systems healthier if we can interact in that way and protect them.

Absolutely. And to your point—that we, as women, don’t have the time to go seek out multiple answers—that’s where The Pause comes in. It’s the precursor to seeing someone like Sheree, someone who is knowledgeable and certified, and getting support. Then having the AI point you in that direction is the big piece, right? Women don’t have the time, and we need to get them care right away.

I want to talk about lymphedema for a moment. I remember back in the ’90s, I was a personal trainer and nutritionist in Toronto, and many of my clients were either PhDs, physicians, or women who were post-breast cancer surgery. I had one client, God bless her, and her arm was so big—it was bigger than a linebacker’s thigh. There weren’t many people trained in this, and it came up for me again.

I would learn from her PT, so at the end of her sessions, I’d do a treatment on her because she was suffering so much. When I decided to have my breast explant surgery, one of the first things I did was research post-op care. I went to a lymphatic healing center where all of the therapists were certified in lymphatic drainage, and I recovered so much faster.

I see a lot of women with swollen legs, and their lymphatic system isn’t working. The lymphatic system in the pelvic area is the reason we get leg swelling. That’s an indicator. This is not like, "Oh, just go on some weight-loss drug because your legs are swollen but not anywhere else." That’s an indicator that you need to get help.

Okay, Sheree, I want you to rapid-fire. What tips should women know right now? What should they be doing about their pelvic health and reproductive health? And what are some signs that should make them stop what they’re doing and call their provider?

Well, I think one of the first things is if you feel heaviness and pressure in your abdominal-pelvic region. Heaviness and pressure are signals that the lymphatic system is not working well at all. For example, if your inner thighs feel really full.

My patients tell me all the time, "Oh, I’m just fat down there." I’m like, no, you’re not fat down there. Your abdominal-pelvic region, with its lymph system, is not efficiently draining. Why?

When you see things like that, you ask, "Who helps drain fluid?" The heart and the kidneys fight over fluid all day long, every day. So, if we see an area or region like that, we go up the chain to see who isn’t efficiently helping with fluid drainage. Any surgical procedures, whether it’s a laparoscopy or minimally invasive, pierce the system where the drainage system works for lymphedema.

Heaviness and pressure are the first signs the lymph system is overloaded. If someone tells me, "I feel heaviness and pressure in my arm," or "One of my breasts feels thicker or heavier," I’m automatically asking, "Okay, what’s going on? What’s blocking the drainage of the lymphatic system?" There’s a blockage somewhere.

Now I encourage women to check their breasts for nodules and perform monthly pelvic checks. Get a mirror, look at your pelvic floor. Does one side of your labia look swollen while the other side looks fine? The drainage system for each side of the pelvic floor drains to one side of the body versus the other.

I once asked a room of 16 to 20 people, "How many of you have ever looked at your pelvic floor?" One gal raised her hand—she was the youngest in the room. I said, "You’ve got to be kidding me."

We need to know what our pelvic floor looks like. If something goes wrong, we need to know what to do. Just as we care for our face with creams and lotions, we should be paying attention to this region of our body.

If something looks discolored—redness, rawness—or tissue looks different, especially in perimenopausal women, these are indicators. Even OB-GYNs may not have the same depth of knowledge as pelvic floor PTs and occupational therapists, who specialize in this every day.

We’re looking at tissue to see if the skin looks right, whether it’s pitted or pulling. Just as you would check your breasts, you should check your abdominal tissue and pelvic floor.

If you’ve never had a leaky bladder and suddenly do, or you’ve never had constipation but now you do, those are cues. If you’ve never had pain during intercourse and now you do, that’s a red flag.

You don’t get to wait seven or eight years before telling your provider. Years ago, data showed that women would have a leaky bladder and wait seven to eight years before speaking up.

It’s, yeah, and everyone listening to this—mothers, you need to talk to your daughters. I think about the age range you and I are in. No one was telling us to look “down there” with a mirror. That was not happening. It wasn’t until shows like Sex and the City with the iconic Samantha character, where I remember one of the episodes, she’s like, “I have a gray hair down there.” And the girls are like, “You look at yourself down there?” She’s like, “Don’t you? Don’t you know?”

Even the breast self-exam piece—I don’t know the statistics—but don’t just wait for a mammogram. You know your body. Like you said, Sheree, it’s intuition. Something’s not right. If you’re feeling it, you’re not a hypochondriac. Don’t be gaslit. Look for the changes. Talk about it.

We tell our little kids—I remember when the kids were little, and I’m sure you said this to Cody—“If you see something, say something.” Right? What about ourselves? If you see something, say something. I love it. Final words for everyone listening?

I think trusting your intuition is such a huge component for us. You have to understand that in the medical arena, we don’t have enough research about this timeframe, so it’s super frustrating, even for us as medical providers.

We have all this generalized medical information, but we’re not always taught how to individualize it. So I don’t want you to give up on taking care of yourself just because a provider didn’t hear you. There’s going to be a provider who hears you and says, "Ah, I know what to do."

I want to share a story. I’m taking care of a woman right now—she’s an occupational therapist. Love her. She said to me one day, "Sheree, I don’t know if I should go up on my estrogen or go down on it." She’s very intuitive. She’s running around, and you’re in my neighborhood, right? But she’s saying, “Hey, we’ve tried all these things. Sometimes I just want to give up and forget about it.”

I said, absolutely not. That’s not what we’re going to do. We’re going to work through all the puzzle pieces with your provider, your other medical provider, who’s managing your hormone replacement therapy, and we’ll help you know what your pelvic floor should be doing during that time. Pelvic floor health is a telltale sign of whether hormone replacement therapy is working well, whether it’s topical estrogen—one of the first lines of defense—along with pelvic floor PT.

If a transdermal isn’t working and you need an oral or a mix, don’t give up on it. I want women not to give up on their body and health, just like we don’t give up on the people we love or our monetary way to make a living, right? We never give up on this.

Never give up on your health. Don’t even make it an option in your head. You say, no, my health, the people I love, and my monetary way to make a living—those are my top three things. If I don’t feel good, I’m not going to be able to love the people I need to or work in the field I’ve been gifted with.

We’re not going to put up with this anymore. We have to band together as women and say, no, we’re going to do this better.

When I met you, Susan, at FemTech in Arizona, it was so powerful. It made me think, okay, research, research, research. We need to collect data. I love The Pause because I think that’s the direction we need to go. We need to use AI to synthesize data and figure out what we’re doing well and where we need to improve.

Do different population bases need different things? Just because one population did well postpartum or in another phase doesn’t mean another will. We need research to know. Right now, we just throw everything at everybody, and people give up.

I’ve learned so much in the last 12 to 15 years since I started my perimenopause journey. We can do better, but we have to do it collaboratively, bringing together everyone’s expertise.

When women feel good—bar the door. Their gifts come alive. I see it in my community all the time. We’re all gifted in different ways, and we’ve got to blow this up. We’re not going to make progress unless we take care of women physically.

Absolutely. Sheree, you’ve said so much—from heaviness and pressure in the abdomen as indicators, to checking your breasts, to monthly pelvic checks, and how pelvic floor health is an indicator of HRT effectiveness. I’d never heard that before.

The bottom line is that we, as women, need to take care of ourselves as well as we take care of everyone else.

Sheree, thank you so much for being on the show. You’re amazing. You’re such a force in the world.

Thank you, Susan, so much for having me. It’s been a pleasure. FemTech in Arizona was amazing. I think if we all work together, collaborate, and focus on research, we can keep moving forward. It’s wonderful. Thank you for The Pause. It’s been a great adventure to see all the incredible work you’re doing.

Well, thank you, Sheree, for that. And for everyone listening, if the show has been helpful to you, share it with a girlfriend—share it with three girlfriends. Give us a five-star review. We read all of those reviews, and definitely tag Sheree and me on social. All of her links are in our show notes. And by all means, go back and listen to past episodes, because the most important person you need to educate on all of these things is yourself.

So, once again, Sheree, thank you so much for being here.

Thank you so much.

All right, everyone, with that, this is another episode of The Menopause Health Podcast, and I will see you in a future episode.

This Menopause Health Podcast is brought to you by The Pause Technologies. To find out more, visit ThePause.ai and follow us on your favorite social media channels. Don’t forget to hit the subscribe button, share the show, and connect with us. We will see you in the next episode.

This transcript has been generated using AI technology. There may be minor errors or discrepancies in the text.

The opinions expressed by the guests on this podcast are their own and do not necessarily reflect the views of the show or its hosts. This podcast is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific health needs.