Ladies: Dr. Tanya Goodrich’s tips for improving your pelvic floor and bone health are life-changing. Say good-bye to peeing multiple times a night, leaking, incontinence, and pain during intercourse, and hello to feeling vibrant and enjoying sex again! You’ll also get the lowdown on how to prevent and reverse osteoporosis.   

Sharing the latest science about menopause and the truth about hormone-replacement therapy, Dr. Tanya busts the myth about Kegels, and explains why doing them could be making your symptoms worse.   

We dive into how she and her colleagues at Evernow are offering advanced healthcare for women over 40, the benefits of pelvic physical therapy, the importance of early DEXA scans, and the key things that should be part of your daily routine.   

With her “No Vagina Left Behind” mandate, Dr. Tanya will have you laughing and feeling empowered as you learn what’s going on in your body and how to take charge of it. To drastically improve your quality of life, do not miss this episode. 

TESS’S TAKEAWAYS: 

• Pelvic health is critical to overall wellbeing and quality of life.  
• You can prevent and reverse bladder and bowel dysfunction. 
• Kegels are not the answer to every vagina problem.   
• Retrain your system to get rid of leaking and incontinence. 
• Avoid pain during intercourse and enjoy sex at any age.  
• Osteoporosis is not inevitable. It is 100% preventable. 
• A DEXA scan in your early 40’s is a proactive strategy for bone health. 
• Hormone therapy has advanced and can be completely safe. 

MEET DR. TANYA GOODRICH 

With a background in dance and a doctorate in physical therapy, Dr. Tanya Goodrich is passionate about educating women on the importance of pelvic health.  

The founder of Healthy Pelvis Physical Therapy, Dr. Tanya specializes in addressing a wide range of pelvic health issues, including those related to pregnancy, postpartum care, menopause, pelvic pain, bladder and bowel dysfunction, and sexual health.  

Through her holistic approach and dedication to education and innovation, Dr. Tanya is helping to advance the standard of women’s healthcare. She serves as Clinical Physical Therapy Advisor to Evernow Inc, an innovative tech company dedicated to redefining menopause care. Dr. Tanya also supports pregnant and postpartum women through her work with the non-profit Blossom Birth and Family.  

Maria Shriver's Sunday Paper featured Tanya as an "Architect of Change" for women's health.  

CONNECT WITH DR. TANYA 

Website: https://healthypelvis.com/ 

Maria Shriver’s Sunday Paper Article: https://www.mariashriversundaypaper.com/pelvic-floor-health/ 

Instagram: @thehealthypelvis 

LinkedIn: https://www.linkedin.com/in/tanya-goodrich-pt-dpt-b6125330/ 

 Dr. Tanya’s Menopause Resources: 

https://docs.google.com/document/d/1tQU3jT7zUxnf736BgOf4pt2LQJof4ikBc46bGxAt080/edit 

Meet Tess Masters:  

Tess Masters is an actor, presenter, health coach, cook, and author of The Blender Girl, The Blender Girl Smoothies, and The Perfect Blend, published by Penguin Random House. She is also the creator of The Decadent Detox® and Skinny60® health programs.     

Health tips and recipes by Tess have been featured in the LA Times, Washington Post, InStyle, Prevention, Shape, Glamour, Real Simple, Yoga Journal, Yahoo Health, Hallmark Channel, The Today Show, and many others.   

Tess’s magnetic personality, infectious enthusiasm, and down-to-earth approach have made her a go-to personality for people of all dietary stripes who share her conviction that healthy living can be easy and fun. Get delicious recipes at TheBlenderGirl.com.  

Connect With Tess: 

Website: https://tessmasters.com/  

Podcast Website: https://ithastobeme.com/   

Facebook: https://www.facebook.com/theblendergirl/  

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

Twitter: https://twitter.com/theblendergirl  

YouTube: https://www.youtube.com/user/theblendergirl  

LinkedIn: https://www.linkedin.com/in/tessmasters/  

Get Healthy With Tess 

Skinny60®: https://www.skinny60.com/  

Join the 60-Day Reset: https://www.skinny60.com/60-day-reset/ 

The Decadent Detox®: https://www.thedecadentdetox.com/  

Join the 14-Day Cleanse: https://www.thedecadentdetox.com/14-day-guided-cleanses/ 

The Blender Girl: https://www.theblendergirl.com/  

Thanks for listening!  

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So earlier this year, my friend Steph introduced me to Dr Tanya Goodrich, and it was life changing. So if you are a woman of any age, you have to hear what she has to say about pelvic health. So Dr Tanya is the founder of healthy pelvis physical therapy in San Francisco, and she specializes in treating all kinds of pelvic health issues like those related to pregnancy, postpartum, menopause, pelvic pain, bladder and bowel dysfunction, and sexual health problems like pain during intercourse, which is a problem for so many women. And Tanya's really passionate about promoting awareness about pelvic health issues. She makes it so fun and interesting, sharing the latest research and strategies and encouraging women to be open about what's going on with their bodies, getting rid of the shame in order to find solutions to improve their quality of life. And outside of her own practice, she is really driving advancements in medical treatment, particularly for women over 40, through her role as the clinical physical therapy advisor to ever now, a company that's really revolutionizing the standard of care for women going through menopause. And Dr Tanya also supports younger women through her work at Blossom birth and family, an amazing nonprofit helping pregnant and postpartum women have a joyful experience. You may have seen her listed as an architect for change for women's health, and Maria Shriver Sunday paper and so many other places. She is just incredible. I am so excited for you to hear how Dr Tanya is helping women get rid of leaking and incontinence so you can stop peeing multiple times throughout the night, enjoy having sex again and reverse osteoporosis. Oh, we are going to get into all of it. So let's get the skinny from Dr Tanya Goodrich, oh, Tanya, I am so excited to have this conversation about pelvic health. So I want to start with the it has to be me moment. How did you go from being a dancer to doing physical therapy to deciding that women's pelvic health was the thing that you had to help women with? Oh,

Dr, Tanya Goodrich: I love this question, because it's so pristine in my mind, yeah. So you can almost think like, how are they connected? And now that I'm doing them together, they're super connected. And it took me a while to get there, but basically I got my bachelor's in dance. It was a wonderful experience. And then I knew for my career I was going to do something. How am I going to connect the dots? And so I went into physical therapy school, and I thought for sure I was going to work with dancers after, and I was going to work backstage, and I still do, but while I was there, and this is the fun part, during my, one of my, one of my rotations in school, my clinical instructor said, Hey, you should follow our women's health specialist around for the day. And I was doing that, and I was like, Wait, what are you talking about? Sex, bladder, bowels. I was like, what and my eyes, like, I wish you could see me now, like my eyes and my ears. I was like, What is going on? Because we got, like, so little of this in school. And then I did research, and I was like, hold the phone. This is so important. How is this not being like, like, scream from the rooftops? And then I went back to all my friends in physical therapy school, and I said, Isn't this so fascinating, isn't this incredible? And they were like, oh, whoa. We want nothing to do with all that crazy talk. And it was really that kind of like light bulb eye opening moment that I was like, Oh, I like talking about this. This is so important, and our country is so far behind, and I'm gonna do this, I'm just gonna completely kind of switch gears and just go into this head on. And so that's what happened. And so the rest is history, and it's been 15 years,

I know, and you are really helping to revolutionize the way that women think about this. So whether we're all starting from the same knowledge base, can you let's start by explaining what the pelvic floor is and why we need to care about it.

Dr, Tanya Goodrich: Yeah, the pelvic floor, we don't really talk about it much in school, right? A lot of people kind of have heard that word before, but they're like, what exactly is it? And so I'll break it down right now. So the pelvic floor is a group of muscles, and if you like, touch your own pubic bone and kind of your tailbone, they're the muscles that connect from the front to the back, and they're like a hammock, basically, that connect those bones together, and they're the base of your pelvis, and they are three layers deep of muscle, but they play a huge important role in not only keeping, like your organs upright, but they're completely responsible for intercourse, and then, of course, like having a baby, so they're just incredibly important. And sometimes we've. Read about them, and we also didn't learn about them. So that's the pelvic floor.

It's, it's, it's just so important so that you you alluded to this, that there's so many misconceptions about it. So what are some of the big ones that you see these, oh yeah, women have and where it gets us into trouble? Yeah?

Dr, Tanya Goodrich: Yeah. So many misconceptions. I would say the largest misconception, and one that I still hear toted by many people, is that Kegels are the answer to all vagina

grade. I gotta do you gotta do your exercises. Gotta tighten those muscles. Yeah, right.

Dr, Tanya Goodrich: I hear it. That's it, and it's just some throwaway term given to women, as if it's the answer to all vagina problems. And it makes it actually, It enrages me, because it's so far from the truth. And in fact, I, first of all, I live in Silicon Valley, right? So there's a lot of like type a people, and what people don't realize is that the pelvic floor can be too tight, right? So if you're telling someone just to squeeze without really kind of a more holistic understanding or evaluation, just to do Kegels, I mean, that is a disservice to those women. So it's not okay. It's not only just a throwaway term, but it can be dangerous.

So let's talk about when Kegels are appropriate, and when, yeah,

Dr, Tanya Goodrich: yeah. So I'm just going to start so first of all, why? Why are they called kegels? Right? They kind of it's so interesting. It was named after an old an old doctor, an old dude named Doctor Arnold Cagle. And so that's where the term comes from. So just as a heads up, I actually in our clinic, especially, we don't call them Kegels anymore. We call them blueberries.

Tell me why a blueberry?

Dr, Tanya Goodrich: Yeah, so first of all, my approach is very different. I think that we're talking about vaginas, and we're talking about sex, so please feel like you can laugh and smile. Oh yeah, and it doesn't have to be dour, and there's so much exciting learning to be done. So why blueberries? So the idea is that a kegel, right, or blueberry? Now, it's super helpful when you have an image, and I'll refer back to this a lot, so it's super helpful. The idea is that the pelvic floor, right, just like your bicep should be able to contract and relax, yeah, so when you have that idea, that's what a kegel is, right? It's, it's the pelvic floor being able to isolate and squeeze and then release. Now, the idea is, is, once you have an image, because you can't see that area, it's so much more helpful to connect to those group of muscles. So the idea is, can you squeeze? Can you lift up a blueberry with your pelvic floor, and then can you release it? Now, what some people are doing all the time is squeezing a blueberry. I call them secret secret butt clenchers or secret vaginas squeezers. And it's helpful, because a lot of people resonate with that. And if that sounds like you like, oh my god, I think I've been squeezing blueberries since I've been 10 years old. You're not alone. You do that. I know, right? The blueberry concept, but it helps so much. And then, you know, later, when we talk about, like, leaking with which is so common, again, right? It helps to go over that blueberry and what's happening with the pelvic floor, and how do we coordinate it? So I feel like I went on some long tangent, but basically, that's, that's, that's the idea,

Oh, great. So when should we not be squeezing the blueberry?

Dr, Tanya Goodrich: Yeah, such a good, such a valid question, right? So, just like our regular body, when you are at neutral, when you're resting, your pelvic floor should be resting, right now, when you need to lift something or cough, laugh and sneeze, then you want a contraction, right then you want to relax, because you don't want anything to come out or come down. So the system works together. A really great way to think about it is your pelvic floor is the floor of your core, they are the same. When you're doing core work, you're also doing pelvic floor work. So when the core contracts, your pelvic floor should contract also. Then you don't want to be stuck like in a like a sit up all day, right? That would not be helpful, right? So if you do it horror, it's not great imagine and and then super fun. I hope we get to it. Your pelvic floor and your jaw and your mouth are connected. Oh, we're so

getting to these. Oh, my goodness, no,

Dr, Tanya Goodrich: I know. I Yeah, yeah. So then, basically, that's the idea. Is that, yes, it should contract basically when you have to engage your core, right, when you need to live in and then it relaxes. So when you're at rest, you're okay. Now I'd like to talk about the analogy of stress, right? Because now stress, people can hold stress in many positions, right? Your TMJ, your core. A lot of people are kind of core squeezers and pelvic floor, it's a very easy place to hold tension. And a lot

of people hold tension in their butt, 100%

Dr, Tanya Goodrich: secret puck centers, 100% Yeah. I mean, I hope I can say this online, but, like, a tight ass, like, it is literally from being a tight ass. It's like you're uptight. Like, that's what it's from holding the blueberry, when you can start to make this, and then you want to release the blueberry, and then you're at ease. Yeah. So it just, it's super helpful when we start to have imagery. So that is my whole approach. That is the idea connecting with that area, not making it scary, not mysterious, completely breaking it down. So it makes total sense. And

let's talk more about this connection with the jaw and some of these other parts of our body that we're dealing with a whole system, and all of the systems and the parts are all connected. And when you're working with a practitioner like you who's interested in the whole system and how it's all connected, then we can find solutions for how we deal with the whole thing so, so in terms of jaw, I know personally that I hold tension in my jaw and I wear a mouth guard because I Yeah, you know, and it causes headaches and all kinds of stuff, so I have to wear that mouth guard every night. So how is the jaw? And some of these other parts of these type places connected to the pelvic region.

Dr, Tanya Goodrich: Yeah, I have a giant smile on my face because connecting these dots is one of my favorite things. It is so mind blowing what I'm about to describe so they are literally connected, not like woo. They're connected spiritually. They are fascially connected. So if you can imagine, like, if you open your mouth, that's the beginning of the elementary canal and your vagina is the end, they are the same tube. Okay, so now the same fascia that goes deep, that connects from your tongue back of the tongue and mouth goes all the way down to the pelvic floor. So the way we're formed as an embryo is it's that layer, it's the second layer, and so your mouth and your vagina are right next to each other, and then the tube opens from there. So it's literally the same cells. It's the same fascial, the deep fascial plane. So in a really amazing

word, to the term vagina power, doesn't it like that is literally your voice and your vagina?

Dr, Tanya Goodrich: Yes, yes. And they're connected on multiple ways and with breath, which we'll get into in a second. But when you can relax your jaw. You can also connect that to your pelvic floor. And conversely, when I'm helping somebody repair their pelvic floor, if it's leaking with coughing, laughing and sneezing, you can connect them together. So when you want to have a baby, it's actually primal, like you want to like, you release your jaw and have almost like a, like a deep, guttural, primal you are opening that deep pathway. And then when you cough, laugh and sneeze, you want to actually connect them. So I even call them the hahahas. And if you're like, in the car listening, you can practice this, but literally you like, right now, we can do it like, you go, ha, ha, ha. And imagine that you're just, you just have a vagina and a throat, and you can Ha, ha ha, you can connect your tube. And that is so profound. And it is, I mean, I get to do this on a regular basis, and so I just see it work every day, and it's just like, light bulbs where you're like, Oh, they're connected. I'm gonna connect them, and then you have, you know, it's just a huge deal. It is so

empowering to know that if you are leaking a little bit when you cough, laugh and sneeze, you let a little bit of urine out, that it's not a fate to complete, that it's not inevitable that you will be wearing a little panty liner, or it depends, as you age that there are things that you can do to strengthen your pelvic floor.

Dr, Tanya Goodrich: Amen. In fact, if, if you took anything away from this talk today, it is that nobody should be in diapers later on, and it is very important to me that we don't just sweep that under the rug and kind of ignore it. If you a lot of people, I ask, Are you leaking? And they say, No, and then I'm like, with coughing, laughing and sneezing, and they're like, Oh yeah, yeah, I am with that. It's just been so normalized in society that that's okay, that we don't even think that it's a problem, and so that we have to start to address it early, rather than later. Uh, because honestly, I the statistics on how many women buy depends, and the billion dollar industry that depends and adult diapers are it's just it's really not okay. And I do think it is rooted in shame and stigma and also normalized. And so I am here to just completely flip that and rip it away and say, no, no, no, we there's so much holistic approach that we can do early on where we're connecting your brain to that area and just rehabbing it like you would your back or your shoulder or your knee. Um, it's

prehabbing it.

Dr, Tanya Goodrich: Oh yes. Oh no, that's my love language, yes.

So we're talking about getting in early, getting in early, and connecting our brain to our pelvic region so that we don't have these problems later on. Talk me through some of the proactive things that we can do in our 20s, 30s, 40s, 50s, 60s, so that we don't have these issues later on. Yeah,

Dr, Tanya Goodrich: so in a perfect world, I wish everybody would just be able to get evaluated by a pelvic physical therapist, right, or physiotherapist, depending on where you are, and the reason is, is because we, I was talking about earlier, you can't see that area. So a lot of people think that they're doing Kegels or blueberries and they're not doing them correctly. They're doing them the opposite, opposite or paradoxical breathing, we call it. So if I had my magic wand, I would say, Everybody go get checked right now, I realize that that's not possible for everybody. And then the second most important group that would be like, if you're having any pain or dysfunction in that area, please know that there's things that you can do early on and you don't just have to suffer, right? That's pain with intercourse, that's hemorrhoids, that's all the leaking that we're talking about, constipation issues. I mean, anything down there that's TMI, can be fixed. And then my next thing would just be to start to learn about this area, connecting it to your breath and a few things, and even just Googling it, so you can be like, oh, yeah, that I do. I think everything's working. Well, I'm not having any pain and dysfunction. I'm good or Hey, I am I squeezing correctly? I don't know. I don't feel scared or nervous that you don't have to come in with a major problem, you will it is so nice to get ahead of it, if you go in early. Now,

you talked about googling it, but there's so much missing that's true. Enrages you. Yeah, that's true. You have the most amazing Google sheet that we got in the show notes, where I went over that document that you sent me, and I was just geeking out on the websites, the podcast, the books, the everything from lube to exercises to all kinds of stuff that can help. So I mean that resource is just invaluable. Thank you so much for putting that together. So listener, Dr Tanya, her Google Sheet is incredible. And if you go to healthy pelvis.com, is that not the best URL ever. So many incredible resources. So we I don't just Googling it. Yeah, now that I've seen your list and some stuff that's out there, if you Google, what about kegels? And then you actually a whole bunch of stuff rises to the top of Google that is actually the antithesis of what you're talking about. Yeah?

Dr, Tanya Goodrich: So even better, yeah, feel free to email me and go to our website, because I really have curated a list of great books and websites. And the cool thing about it is it's a living document, right? Because it's on Google, so I can, I'm constantly updating it. So if you have the link, then you'll I'm constantly, kind of filling it with new stuff. So that's the best news. And that link

is in the show notes and on our website, and it has to be me.com on Dr Tanya's guest page, which is amazing. So we can come to you and do telehealth, right if we don't live in the San Francisco Bay area. You great thing about technology now, so talk me through how we can have a session with you without you physically being able to to look at us?

Dr, Tanya Goodrich: Yeah, that's a great question. So in a perfect world, you would get seen one on one. Now, again, there's so much that we can do virtually, because so much of it is an education and a learning about what's going on with you. And our approach is very holistic, or whole person. The idea is not to just put a band aid over it. It's to really get a sense of what's going on. So we do a lot of that through asking questions. We find out what the heck's going on. What are these person's symptoms? And then we start to break down very concrete things tailored to you that are going to be the most helpful. And then we'll have a follow up session. So in the beginning of the session, it'll. Look like a very normal appointment where we're asking you questions. We're hearing about what's going on with you. We're hearing your biggest symptoms. Then we're going to do our best we can, to take a look at you and maybe ask you to jump and cough and laugh and sneeze, all the things that we can see. And then we'll go over how to make it better. Oh yeah, big time sneezing in

front of you. Yeah. Okay, okay. Oh yeah. I

Dr, Tanya Goodrich: do it all the time. Yeah. I just place the camera in certain ways. I'm like, can you cough? Can you laugh? Can you jump? And then we just evaluate what the heck's going on, and then we make it better, yeah. Oh, this is so great.

Okay, I want to ask you about something that you talked about a minute ago. I want to dive in deeper about constipation and bowel irregularity and the connection between that and the pelvic region, because over 75% of women experience constipation. I mean, it's an epidemic, yeah, and certainly on our skinny 60 community, so many women come in and they're not moving their bowels every day. So can you explain to us in the most amazing way, like you did with the with the mouth, the jaw and the pelvic region, how the bowels, how that region is connected to the pelvic leg, how, if you are constipated, not moving your bowels, or you've got diarrhea and all these other issues, how then that's going to have a flow on effect to the health of your pelvis.

Dr, Tanya Goodrich: Yeah, this is, again, one of my favorite topics. I'm such a nerd. I love putting it all together. Put

your nerd hat on, dirty with you, right? So, yes,

Dr, Tanya Goodrich: constipation is a huge deal again, kind of goes under the kind of shame, stigma, like you're not going to bring it up, maybe to your friends, but we're going to talk about it here and now. So you're we talked about the pelvic floor, right? How it's the base of your pelvis, right? It's the bottom. Now, if you can imagine, if you put your hands like on your hip bones, and you walk in, right, those are your organs, right? Now you're literally your uterus and your rectum sit right on top of those pelvic floor muscles that we just talked about. Now, if you can imagine it's like your plumbing system down there. If you are constipated, you are now adding a lot of weight and pressure to those precious little pelvic floor muscles that we just talked about, right? It's a pressure system. Now you can imagine that it's just harder for that system to work if it's got poop stuck in it. It just like, right? So then, then it's more likely to have what's called that prolapse, which is just kind of a heaviness or sinking into the vagina or rectum, and then you're adding more weight, which adds more weight to your bladder and your urethra, so you're more likely to also leak. So again, it's just hard for those muscles to be healthy and happy when they're heavy. In the simplest terms,

that is such a great way of describing it. Thank you so much. So what about the opposite with diarrhea and stuff like that? And often, you know, there's a misconception that diarrhea is the opposite of constipation. Sometimes it's just full of stool, and it's gotta come out some way, right? So diarrhea can be a symptom of constipation. So, so how does that work? If you're experiencing persistent diarrhea, how does that Yeah,

Dr, Tanya Goodrich: I mean that just doesn't it's just, again, it's the system isn't working well, and it just doesn't feel good down there. So I would say that it would create irritation, right? And the micro tears, and then the micro tears are not comfortable, so then you have it just doesn't feel good, so there's probably tightening up. So whenever there's pain, your brain goes, oh, let's like, let's grab and squeeze to protect that area. But then again, we're stuck in that blueberry squeezing right because we don't want to be squeezing all the time. And then does sex feel good when that happens? No. So the idea is basically, how are we the body is a self writing machine. The problem is especially in the pelvic floor. When it goes off course and you don't talk to the right people, it can become like a negative feedback loop. And we're just trying to get that back towards healing and feeling good. So we're trying to get constipation better. It's one of the first things that we'll be working on, right? You want that area to be able to relax and and pee? Well, um, yes. People don't also really, yeah. I mean, the whole peeing is a whole nother thing. Oh, oh, can

we talk about this? Yeah. I mean, I want to talk about sex. I want to talk about all of it. Okay, let's talk about the PE. I mean, what do you

Dr, Tanya Goodrich: think big? Yeah, peeing. I love talking about peeing because it's actually one of the easier things to treat because there's so many misconceptions about it. So what does that mean? Yeah. So basically, I see a lot of people that come in with what I have my hands in quotes, like small bladder. They have. They feel like they have to go all the time. They have the verge a lot. They're going. They're the people I always tell everyone. There's one person in a friend group that always knows what the bathroom is, has to go pee all the time. It's stopping on the right. Literally, every friend group now. So they see, right? It's so true. This is universal. Now, what has happened to this person is they don't actually have a small bladder. They have trained their bladder to be small. And this resonates with almost everybody in our PT language, we call it jicking, just in case, peeing. Now, what does that mean? Yeah, so no jicking. Now, a lot of us, especially as moms, we might have gotten in this habit even since we were kids. Oh, we're gonna go somewhere. Go pee, go pee. Now that's not great for the brain, because the bladder, normal peeing is every two to four hours, not every 45 minutes. Now what happens is, when you start to go all the time, and you always go with that first instinct to pee, well, now the brain, the bladder, goes, Oh, she loves to pee at 30% we're gonna always go at 30% and then the person needing to go all the time, we need to go all the dang time, when really you just need to bladder retrain. So that's one of the things I do every day, is help women learn. And then too, to be honest, it's really, it doesn't it's really both. Everybody could benefit from this is learning to start to count the length of your pee. You should be peeing for at least 12 seconds long. I can pee for like, 29 seconds. That's not to brag. That's just to like, know how long the pee can go for? Tanya, yeah. Okay, yeah. So this is great. You can start to now. Now, if it was a six second pee, you can go like, Oh, that was a false alarm, even though it was screaming at me, I need to teach it to go longer. So now you're gonna get the urge to go, and you're gonna say, Uh oh, bladder, we're this. It ends today. So you say, I'm gonna not go. I'm gonna distract myself and move on. And it'll go away. And then you'll go, you'll get the urge again, and then you'll calmly walk to the bathroom, and then count the length of your pee. And it is a game changer, because it is horrible to be ruled by your bladder. Yes, you you want to be in charge of your bladder. You don't want your bladder to be in charge of you. Yeah. So this, this is a lot of just easy education that we can learn and

training. We can train our bodies. I love this. How does that affect older women who are getting up multiple times throughout the night when you Oh, yeah, I don't like this. I imagine it's pretty life changing. And I know that is affected by other things too, hydration, status, etc, but and absorption. How? What have you seen with that?

Dr, Tanya Goodrich: Oh yeah, this is it is a true game changer for old for older women. And this is the deal. If you are over the age of 35 you get one pee a night, not That's it. Night. Time is for sleeping. It is not for peeing. Is what I tell people, we do not there's not in charge of us. We tell it, stop it on

a jiggy bladder. It is a naughty little child. You only get what I mean, healthy pelvis, healthy life. I mean happy pelvis. Yeah, right, yes. Wow. Okay, okay, so this, this is, this, is this just gives, gives people hope.

Dr, Tanya Goodrich: So it's not only hope, because it I get, I mean, I know that right now, listeners just have to believe me, and it almost sounds too good to be true. But it really is. It really, I mean, I get to do this like every day. It's the best, you know, for 15 years. And these simple changes are enormous. They make an enormous difference in the quality of your life. Now, when we start talking about perimenopause and menopause, and we do talk about the decreased estrogen, we should also really talk about the importance of vaginal estrogen and how vital it is for the vulva, right? So just some terminology, right? The vulva, we always say vagina. It's kind of like everyone's go to word, but really they're different. The vagina is just the inside, right? What you can poke and put your finger in, that's the inside, yeah? And then everything else that you look at, that's the vulva. So in general, we should be calling it the vulva. Now it the vulva and the vagina and the urethra where we pee, there are a ton of estrogen receptors, yes, and when we go through perimenopause and menopause, our estrogen plummets, and that has a huge effect on our vulva and that whole area, because there's so many estrogen receptors down there now that creates not a healthy, happy vagina. And I follow Dr Rachel Rubin and many other urologists and sexual medicine doctors who now believe that vaginal estrogen cream is so important for women, it should be given to every woman over the age of. 35 that's how safe it is. Wow. Now I think that this is, I mean, it's a revolution, and it's going to be here, and I know in like 10 years, we're going to re listen to this and go like, Oh my god. How was that not a thing? How did not everybody have this? But it really is almost like vitamin C for your face, right? When you get older, your skin just gets your skin gets dry on your face. And so you want a cream same thing for down there. It really is lacking in that estrogen and vitality. And one, one of my favorite terms, is that you're when your vagina and vulva is young, it's like a ruffle skirt, and as you get older, it turns into a pencil skirt. Lose a lot of those ruffles. And so we want to keep it nice and healthy and an oasis and not the Sahara Desert. So it helps to re rehydrate. So that is

one of the things you know, as we have a decline in estrogen, progesterone, testosterone, DHEA, DHEA, all of these. Yes, everything gets dry right to your mouth, to your vagina, to your vulva. Now we're learning to talk about, yeah, so let's talk about sexual health. I mean, people don't want to talk about their pee and their poop. Nobody wants to talk about pain during intercourse and an MO libido and, you know, not enjoying sex and all these things. I mean, my goodness, let's talk about this stuff. It's one of the great pleasures of life, right? So, can you connect the dots again of how the pelvic region and and the health of the whole system affects our sexual health and our enjoyment of sex, and how we can help ourselves in that way too.

Dr, Tanya Goodrich: Yeah, so again, those same muscles that we just talked about are also the sex muscles, right? So pain with intercourse, again, is one of the most common things that we treat on a regular basis. It is we should be able. We should be talking about it more, because it's a staggering statistic, like 75% of women through their lifetime is going to have pain with intercourse. So we just need to address it. There's two different types of pain with intercourse, right? There's the more superficial, feels like burning type of pain, and then there's the deeper pain, deep inside, they can be together, they can be different. But essentially, when you're having the more superficial type of pain, it's typically a skin problem. The skin is dry. It's getting micro tears, and that doesn't feel feel good, also potentially hormonal issue. Now, when you need to have when you want to have sex, what should be happening is your pelvic floor softens and lubricates and relaxes. It's ready for an enjoyable activity. Now, when sex becomes painful, do you think your body is gearing up for that?

No, it's tightening even more, like I'm closed

Dr, Tanya Goodrich: for business, correct? So now we have a mind body connection. And so I get a little bit upset when it's just like, oh, relax, have a glass of wine. Or it's all in your head. I mean, which is still, I mean, women have been taught, I'm

sorry. I cannot believe the doctors say that to women, just have a glass of wine to relax. I see it all the time, getting enraged. Yeah,

Dr, Tanya Goodrich: It enrages me. It just in general, I feel like women's health, we have been neglected. We have done dirty, as the young kids say these days, I do think that we need to understand what's going on so that we can have language to empower ourselves, to ask for more and to ask for better, and to know that things can get better. And yes, a lot of times pain with intercourse is because of tightening muscles, but it's doing it's doing what it thinks it should do, which is tightening against something that doesn't feel good. So just understanding that is really helpful in kind of breaking that down. So where, like pelvic physiotherapy comes in, is we help to kind of retrain it and to relax it and have it be ready for it, so that intercourse is, is it's understood to the body what's happening so it's not scared and gripping against pain, because now it's just not a good recipe for success in that area. So I mean,

just like some men have to prepare for sex, and I know that that can feel like people are taking the spontaneity, spontaneity out of it, women can also prepare. So I like sheet how you've got the specific vibrators and the things that you're doing in order to get ready for a pleasurable experience. Tell us a little bit about that. Yeah,

Dr, Tanya Goodrich: so basically, intercourse is exercise, and before, especially as we get older, you have to warm up so you don't have a glowing cold hell. So much to think of it like

that. So it's your own foreplay 100%

Dr, Tanya Goodrich: it can be by yourself, it can be with a partner. It's whatever you want. But the key is, is to understand, like some of the the new formula to help it feel better. So now we're talking lubrication, right? So there's amazing types of lubes out there. Now, yeah, I have some great recommendations. And

I saw that in your sheet. That was amazing. You, you know, you had different lubes catering to all sensibilities. If you want a natural one, yes, yes, yes,

Dr, Tanya Goodrich: yes. And so there's, you know, oil based ones and silicon. I mean, it's this. It's a new market out there. It's fantastic. And then there's some vibrators and some dilators that are designed to help warm it up with you, so that your body is prepared for that activity. Now I'm also going to, I it's on the list, and I continue to add to it. If you're older, if you're feeling like that area is super dry. You can also put, like a suppository in early that's full of, like, oils. There's few different types out there, bonafide and reverie, and even some new ones on the market, and that, like, an hour before, completely hydrates the tissue. So now, now it's just a game changer again, in terms of that experience for you, it's wonderful. It's it's truly, truly wonderful. So again, this just helps right, identifying what's going on, not being scared, being prepared, and then having a much better experience and getting

the right information from a practitioner who's an expert like you. So again, you can see dr Tanya and her team at healthy pelvis.com Yeah, you are so involved in really opening the conversation and the possibilities for women's health through your work with pelvic health. Can you tell us about more about what you're doing with some of these organizations and apps. I mean, it's just so exciting what you're doing. So, um, there's so many resources now, and I know that you've got a coupon code too, so tell everybody about that. It's amazing. Yeah. So

Dr, Tanya Goodrich: in addition to, um, owning healthy pelvis, and there are four of us now, and we're a growing team, and we're all awesome. I mean, if usually physiotherapists are just the most loving, caring kind of people that are trying to make people better. And then I also want to say that we are a small field. So if, if you had a session and it didn't go great, I don't want you to feel like that's it, and the field is not good for you. Just try somebody else, right? It's kind of like a dentist. You have to go. You gotta find the right fit. So please don't feel like it's it's done for so please keep looking. And then, yeah, so I am a part of also. So again, Silicon Valley, it's so great. It has basically filled the gap in some of this care or lack of care, I should say that we were getting for menopause and menopause, and there's these tech based companies that have started, and I am a on the medical board or a clinical advisor to ever now, which is based tech company. That is, it's incredible resource where you're having gynecologists and nurse practitioners, all of whom are menopause educated, and so you're going to get sent to somebody that's right away you have a virtual appointment. They are now accepting insurance. This is like as of last week, life changing, life changing. They also give you free vaginal estrogen. I mean, monthly, because, again, it's just, it's that safe. Everybody can be on vaginal estrogen. And I have basically created a bunch of videos, and I do like, I host, I give all of their physical therapy, education stuff. And so it's wonderful to be a part of that organization. And again, that's ever now. And I am also part of a menopause brain trust committee, where we are just a bunch of incredible practitioners in their different zones of genius. And we have come together to give panels and talks, both, you know, on Zoom webinars, but also in person, we're doing a lot more in person, like panels, where people can just ask us question and we come together. So that's been incredible resource. And I also am part of a nonprofit organization in the bay area called the loss of families. This is, again, just an incredible resource for for parents and birthing people that need more. And so I do a prenatal and postpartum pelvic floor workshop. Um, every, every Wednesday. And so, again, wonderful. So I kind of really have these different avenues that I'm connected with. Oh,

it's incredible. And you are still helping perform as back. Stage in the Bay Area, in San Jose area, and still exercising your your muscles as a you know, a performer, you know, like helping performers be their best. It's so incredible. These resources just absolutely life changing. And again, you can learn more about Dr tanya@healthypelvis.com and definitely click on that Google sheet in our show notes, because I am telling you, these resources are incredible. I want to shift gears just a little bit, because some of the information that you share about bone health and osteoporosis is also an absolute game changer. There is this misconception that once you get diagnosed with osteoporny and osteoporosis, that's it done, and I want you to tell our listener, but that is true, and we are so behind in our knowledge about the

Dr, Tanya Goodrich: Yes, yes. So let's,

let's hope Yes.

Dr, Tanya Goodrich: More about that? Yeah, um, bone health? Yes, I am almost like gonna pause for dramatic effect, because a big deal, but people do. Women don't know this, that it is, it is 100% preventable. I'm talking nobody should be getting osteoporosis. And I think that the knowledge out there is still, oh, my grandmother had it, or I'm gonna get it. It's just inevitable. And I It drives me crazy. It is there, right? I so there is a group in the UK called sticks and stones, and their mission is to eradicate osteoporosis by 2040 something, like it's like it should like polio, like it should be gone. That's what I want listeners to walk away with, like, oh my god, osteoporosis should be gone. And so how do I not get it? How do I spread the word and let people know so it is a silent disease. You don't often know you have it until you break a bone later and again. For women, it is one out of two women will end up with an osteoporotic fracture. Not okay, not okay. And, and I, I think women and general knowledge out there knows that if you break a hip, it is a very dangerous, you know, sequela or sequence that often happens to death. And it is a big, big, big deal. And I want women to know what the heck to do. So this, this is where it comes in. It really is like a puzzle piece. So yes, nutrition matters, but bone is living tissue. It is living tissue. It changes. It moves up until the age of 35 what happens is there's two different types of bone cells. One lays down bone and one takes it away. And until the age of 35 you're laying a lot more bone down. Now what happens in menopause and perimenopause? You have the big change in in hormones. You have a plunge of estrogen, right? And if you could see me, my hand is doing like a cliff, like it's falling off a cliff, but in men,

women,

Dr, Tanya Goodrich: yeah, and that has a huge effect on muscles and bone, because there's so many estrogen receptors in your muscles and your bone. So the problem is, is that women lose up to five to 10% of their bone mass within the first five to 10 years of menopause, which is problematic, as you can imagine. So then what do we do? So you want to stay healthy and strong, that means lifting weights and keeping the muscles strong, and that also means impact, and I'm like thumping my hand against the ground, because it's not jumping on a trampoline, which is good for your muscles too, but you actually need to be getting the earth connection. So walking and one of my new favorite tools for women, which is such an easy add on, is a weighted vest. So again, I think I'm hoping that you're going to start to see more women just throw a ring on a weighted vest when they go for a walk, yeah, but research shows that if you're 10, if you know, so I'm like 120 pounds, so I try to wear a 12 pound vest. Now, when I take a 30 minute walk, and I'm adding all that weight to my body, and it's helping my bones and my muscles get stronger.

So talk me through the of how you would calculate the kind of weights, 10%

Dr, Tanya Goodrich: 10% so if you are 100 pounds, you would want to wear a 10 pound vest, right? So it's, that's what I recommend, yeah, and they're really easy. Here. You can order them on Amazon, or they're not hard to get, and they're inexpensive and they're such. Easy add on, just like you're going for a loss, grab and then when

you take it off, you feel like you're floating on a cloud. It's like you could carry more weight. No problem at all. I used to wear ankle weights when I was awake, yes, when I was in my early 20s. Amazing. My husband gave me that idea. He said, you're gonna get a better workout. You get you're on your feet for eight hours. He goes wear ankle weights. I should have worn a weighted vest, but anyway, I wore ankle weights. And then when I would walk home after my shift, oh, my goodness,

Dr, Tanya Goodrich: I felt light as could be. I thought, This is awesome, but

yeah, that's Yeah. Okay. What else can we be doing? Yeah,

Dr, Tanya Goodrich: so jumping, right? And for me, it's full circle, right? Because if you're leaking urine. Do you want to be jumping? No, so it all fits together. So you again, that holistic approach, like your bladder also affects your bones, like, Who knew, right? So, yes, you should be. You should be jumping a little bit, some jumping jacks, working on balance,

rebounding, yeah, 100%

Dr, Tanya Goodrich: Yeah. Stepping, you know, even just a curb. You know, jumping on and off a curb is one of my favorite things to do. Yes, easy, easy things that don't require money or a lot of time. I I want you exercising. I want you just lifting some weights. It's so, so, so important. I know I do feel like the trend people are starting to pick up on that that, you know, as women, we were told, like, be skinny. A long time ago, like, be be little, and now we're like, no, we want to live these long, healthy lives. And so we should be lifting weights, we should be jumping, we should be getting impact, and we should be eating well. And yes, like alcohol and cigarettes will also affect bone health, so we want to be reducing all of that, and we want to be eating our calcium. So that's a nice, healthy diet. A lot of people still think that only dairy has calcium. Yes, we not. True

is, since kidney 60,

Dr, Tanya Goodrich: oh, you know, right, like, I mean, dark leafy greens, hello, you're getting great, yeah, I mean, it's just incredible. So again, it's that it's a puzzle, and we're adding all that puzzle to make a healthy, healthy bone. So that's good diet, that's exercising. Yeah.

We're also brainwashed into thinking that the only thing that we need is calcium. We need, oh, yes, phosphorus, all these other things that make up that mesh structure and keep it strong. It's not just about calcium. We actually see a lot of women over supplementing with them. Calcium is not balanced with magnesium, it starts depositing in places it doesn't belong, right? So, yes, that education nailed it. You nailed it. Oh, that, that's the piece that enrages me, is that if you're taking a multivitamin and a calcium supplement, and you've got a calcium rich diet, you could be taking in too much calcium if you're not balancing it, right? So I mean, oh gosh, I could geek out on with you about this all day long. What do we do if you already got the Osteoporosis diagnosis, we've already been told, Oh, doom and gloom. We've got the whole you're gonna you're done for now. What? What do you say to those women?

Dr, Tanya Goodrich: I would say that you can reverse a lot of it based

on we just do. Can we pause for dramatic?

Dr, Tanya Goodrich: I know that. Pause, yeah, it's right. This

is pain, changing information, yes, teaching women. So please subscribe into this, because this,

Dr, Tanya Goodrich: let's dive huge, huge. So this is, this is a big deal. Yeah. So again, remember, bone is living tissue. It's not a death sentence, even when you have what's called, so there's osteoporosis, and then if you back up a little bit, you have osteopenia, which is, you're not quite in the level of osteoporosis, but your bone mass is not what it should be. So there's a few

osteopenia. I don't know why. With my osteopenia, I don't know why I always say that, but now that you're saying to me, I'm like, Oh God, I always do that. Yes, no.

Dr, Tanya Goodrich: I mean, I think it's potato potatoes. It depends where you are, right? Just

to clarify, if you're going, Oh, are those two different things? No, I'm just keep going. Sorry. Dr, Tanya,

Dr, Tanya Goodrich: no, no, I love it. Um, so this is important. Very important information is that i If you don't know what a DEXA scan is, this is what we're going to talk about right now. Because I feel like women know about getting mammograms for their breasts, right as preventative care. They know about pap smears, which is preventative care for their the lining of their uterus. And they don't necessarily know what a DEXA scan is, which is the equivalent for your bones? Yes, and this is where it gets really juicy. And I want people to know is that it is not we are we are doing women dirty again. This is going to be like the tagline of of of this podcast, right? Because, especially in the US, it. It's not insurance does not pay for it until you're 65 but that's way late. We were thinking about bone health way earlier, like in your 40s. In your 40s, we want 35 Yes, ma'am, because that's when that estrogen pound the bonus, yes, we want to start working.

That could be a hashtag. Girl. You're not laying down the bone as much anymore.

Dr, Tanya Goodrich: Exactly, exactly. So the key is, the good news is that DEXA scans are very inexpensive, and they're like $99 and they literally help tell you what's going What the heck your bone, what's, what is your mass level, so you can get a marker and then be able to track that, because that's what I wish. I wish every woman in her early 40s got a DEXA scan, so now that we can have we can measure it from here on out. And then we do all these things we eat well, we're doing the jumping, we're doing the weighted vest, we're using our bones. And now, guess what? We're not going to be getting osteopenia or osteoporosis. And if you have osteopenia, you're still going to be doing a lot of these things. You're going to be talking with a provider about somebody who's menopause educated to see if you should be on hormone therapy, and going over your numbers to see what medication you should be on. And a lot of times it's just as easy as hormone replacement therapy and everything we just talked about. So I feel like, in a nutshell, again, everyone's different. And I this is not necessarily medical medical advice. I would love for you to see somebody individually. But are these the recipes in general? Are these what we should be striving for as society, to be eradicating osteoporosis? Yes, yes, and yes,

I want to ask you about HRT All right, because there are some pros and there are some cons, and it's whether or not it's appropriate for you, and you make those determinations in consultation with an educated practitioner who takes the time to know your story. So talk me through some of that. What are your opinions about that? What do you see in terms of the context of this conversation?

Dr, Tanya Goodrich: Yes, so just to clarify, so I'm a Doctor of Physical Therapy. So I in our practice physical therapists, at least in this country, we do not prescribe hormones for people. However, I work in this field all the time. I have done a ton of research, and all I want you to know is that you should be seeing a provider who is menopause knowledgeable or certified, and if you're getting pushback, making sure you're knowing why you're getting pushback, it's not just reflexive, because the science has changed. And there was that study done in the early 2000s from the WHO that basically came out and halted the study, and that's where women have learned and have been terrified of hormones causing breast cancer and heart disease. But guess what? That was a poorly done study, and the science has changed, and how we administer hormones has changed. And so in science, it takes about 18 years for the standard of care to change, and we are riding that wave right now, so it is not the standard of care yet for all women. And the key to know is that all you need to do is go to someone who is up to date on their on menopause. That's That's my big so that's the epiphany.

Tell everybody again where they can go to get a practitioner who is up to date with the latest research.

Dr, Tanya Goodrich: Yeah. So on the the show notes, on the podcast notes, is a link to my living Google Doc. I have an entire six to seven links of where you can find these practitioners, and it that's all you need to know. Find someone. And again, if you don't like the person, if you did not have a good experience, you can find somebody else. That's the best news. Is, again, I feel like a lot of times, honestly, in my practice, I see a lot of people, and I ask, you know who they're seeing or who their doctor is. And I see a lot of like, oh, I don't like don't like my practitioner, though. And I'm like, let's change that. Like, I want you to have a good relationship with your medical provider. And so please, if that sounds like you, you need to do a little digging. You need to be asking your friends, who are you seeing? Who do you like? Because nobody should not be happy with their medical provider.

Oh, amen to that. Can I pause for dramatic effect on that? So I saw in your Google sheet that you had a coupon for a discount for the first month, right? Can you tell everybody what that is? Because I really want everything go

Dr, Tanya Goodrich: and use this so that. Yes, it's healthy pelvis in ever now, but honestly, I think it's even as of, as of this week, they're starting to accept insurance. So I would say it's a game changer. I mean, I think that, yeah, I mean game I mean, like, you should just go right now, ever now.com because now it's going to be available to so many more women. And they do video, virtual visits, and it's, it's, it's huge. It's a huge deal. It's not in every state, and it's going to grow, but it's huge. It's a big deal.

It's a huge deal. And just going to people that are up with the latest science and are really also communicating in a multidisciplinary way with other complimentary practitioners, you know, so you've got a general practitioner who's educated in menopause, you've got a physical therapist like you who's educated in menopause, you've got a specialist who's educated in menopause, or whatever you might need for your particular situation where you've you've assembled this multi disciplinary team, a dietitian who specialized in menopause. I mean, all this sort of stuff, where you can put these different elements together.

Dr, Tanya Goodrich: Yeah, it's, it is? It's creating a team, right? It's creating a team approach that you feel supported and like you have a roadmap that's, that's what's key,

right? Oh yeah, the road map. All right. I have to ask you, what happens when you start to clean up all of this stuff like you must see transformations with women every hour of the day when you're in your practice, when women empower themselves in this way with the this knowledge and these tools and these practices to turn things around, I just want to give everybody You've given them the resources. Thank you so much, but the hope to just get started with somebody like you and how it can literally change your life in a very dramatic way.

Dr, Tanya Goodrich: Yeah, I get the privilege of seeing it every day, but I see pain and suffering go away. I just think that, I think a lot of people in general feel like, when they start rehab, that they can't see the progress, but I want everyone to know that it's sort of, it's baby steps. And I really like the idea of a ladder, because the whole point of a ladder is that you have these little steps, and then all of a sudden you look back and you see how far you've come. So if it's never too late. If you're somebody that's been struggling for many years, please know that you can always, always get started and you will see improvements. And then also know that little little bits will start to get better, and then you get to just start to improve the quality of your life. And again, no vagina left behind, like and everybody feeling good

behind and happy

vulva, happy life. Yes,

yes. Oh, I love what you are doing. So much. So healthy pelvis.com. I mean, seriously, oh, gosh, thank you for how you're showing up in the world. It's just so needed and so wonderful. I always close every interview with the same question, and within the context of the conversation we've been having, I might phrase it a little bit differently. Normally, I ask for somebody you know, to be going after there, it has to be me moments, you know, within the context of this conversation, it has to be me to make my my vulva happy and my body happy, right for a woman out there right now who has a lot of these issues, or even one of these issues that you've been talking about and just feels like they don't have what it takes to change their life Turn this around, what would you say to them?

Dr, Tanya Goodrich: I would say, and again, the dramatic pause is real. I would say, believe in yourself. Believe it will get better, because I have the heart and the knowledge and the hindsight to know that it will, it will. And it's little by little, and all of a sudden you're going to realize that you are suffering for too long, and that life life is better. So I am an optimist by nature, and so I am infused with hope and and warmth, but I see it all the time. It changes lives. So get started. Don't, don't wait

and go to healthy pelvis.com and you know, Dr Tanya and her team will, will fix you up. It's so incredible. And please, please, please click on the link in the show notes and go over to her Google Sheet, because it is. Incredible. Oh. Dr, Tanya, you know, we've been talking about all these things, like the estrogen creams and the things that we can put on, I tell you what we might, you know, if we could bottle a bit of your optimism and energy and knowledge and creativity in explaining these things, destigmatizing and de shaming, these things about being a woman that are so miraculous and beautiful, yes, oh, I wish that we could truly but so I hope listener, you got just a taste of the electricity that Tanya brings to this and the beauty of you. And I think the overarching message is you have the power to dramatically change your health journey and your quality of life, and healthypulbas.com is just an amazing resource. So thank you so much for spending this time with me.

Dr, Tanya Goodrich: Thank you so much for having me.

Isn't she fun? Oh, we're all gonna be thinking about blueberries now. I mean, she busted a bunch of myths about menopause, and hopefully gave you some hope about what being an older woman can look like, that you have the power to feel amazing in your body. One of the big takeaways is the importance of having a holistic evaluation and understanding of your body that Kegels aren't the only answer. Your pelvic floor can actually be too tight. That connection between the jaw and your pelvic floor and the connection between your bowel health and your pelvic health are so important that if the system isn't working well in one area, it's going to have an effect on all these other areas. They're all connected. And the importance of early intervention that you don't have to leak or have pain during intercourse or suffer with hemorrhoids. You could do prehab and get in early and connect your brain to your pelvic region. Get evaluated by a pelvic physiotherapist, and you can connect with Dr Tanya and her team at healthy pelvis.com they do telehealth. When she said, your body is a self writing machine that really spoke to me that, yeah, you get to change the inputs in order to change the outputs, that you can train your body out of the negative feedback loop of pain and into a place of healing that you can retrain your bladder. I mean, I'm going to be counting the length of my pee now to make sure it's at least 12 seconds that you don't have to pee multiple times throughout the night, you can retrain your bladder and change that story and that information about sexual health was just incredible, right? All those estrogen receptors and the power of a vaginal estrogen cream, and it should be part of every woman's daily routine, like a face cream and that stuff about pain during intercourse, I hope that gives you hope if you are experiencing that, that when she said, intercourse is like exercise and you gotta warm up, oh yes, that really spoke to me that there are vibrators and dilators and lubes and suppositories and all kinds of things that you can do to have a pleasurable experience. I think the big takeaway, though, is the importance of seeing menopause trained practitioners, if you are in that phase of life, and assembling a team of people that are up with the latest science and research. So join ever now such an incredible resource, and those practitioners are going to know about this bone health stuff that Dr Tanya was talking about, that Osteoporosis is 100% preventable. It is not inevitable. Go and check out sticks and stones. What an amazing organization you know you can be doing all of this preventative stuff like lifting weights and bouncing, wearing a weighted a weighted vest and walking, getting your DEXA scan early in your early 40s, that you can actually reverse some of the damage that has been done. I mean, that was eye opening, right? So definitely check out Dr Tanya's Google Doc, such an extraordinary resource. The link is in the show notes, and you can learn all about Dr Tanya and connect with her and her team at healthy pelvis.com Do coverage, effort, second.