Why Is Pelvic-Floor Health So Important? What Makes Minor Urine Leakage Worsen? What Are Urinary Urgency Triggers? How Can You Avoid Them? Does Peeing When You Sneeze Lead to Bigger Issues? With Guest & Pelvic-Floor Specialist Dr. Wendy Chorny

Dr. Wendy Chorny is back after  What Happens to Our Vaginas As They Age & What Does Estrogen Have To Do With It? 

• What do Pavlov’s dogs and your coffee-break and post-commute habits have in common?
• How can understanding pelvic-floor dysfunction help you slow things down?
• Do you know the difference between urinary urgency and stress urinary incontinence? And why does it matter? 
• How can you identify early signs it may worsen sooner than it has to? 
• And when is it time to seek professional help?

Dr. Wendy is a doctor of physical therapy specializing in the treatment of pelvic pain, pelvic floor dysfunction, perimenopause, and more.  She is an educator and author, affiliated with the University of Dayton Doctor of Physical Therapy Program & currently doing research on Diastasis Recti in Women. 

https://www.wendychorny.com/

Disclaimer: Though she is a doctor she is not YOUR doctor. As always, please consult a local professional for your particular medical and legal needs and circumstances

- Huberman Lab Podcast with guest Dr. Sara Gottfried
- NYT Mag HRT Story
- Stress Urinary Incontinence
- Detrusor & trigone bladder muscles
- Interstitial cystitis

MAV Tip: You're not alone. There is help available. And hiding or feeling shame (or taking "logical" steps to reduce the frequency of your urinary urges) will only make it worse. Seek support, even if it's just plugging into an anonymous community to learn (like the MAV Sisterhood) or following VETTED pelvic-floor experts on social to get a feel for the things nobody very taught us!

Take care of yourself. And take care of your vagina!

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Transcript

Martha: 0:01

Hey there here's what's coming up in this episode.

Dr. Wendy Chorny: 0:04

And I have some patients that come to me that only drink four cups of liquid a day. I don't know how they blink, but I will tell you, I could see it in their skin. Their skin is like parched. that's a whole nother problem because it lends itself to bladder infections.

Martha: 0:20

Welcome to the My Aloof Vagina Podcast, where we explore the distress and surprise of our midlife transitions. We take menopause seriously, but we don't take ourselves seriously. We believe that learning what to expect in perimenopause can be entertaining. It's inevitable, so we may as well equip ourselves and have a good time. I'm your host, Martha and the delightful Dr. Wendy Chorny is back. She's a pelvic floor specialist with a sense of humor, and she is full of information and eager to share it. She was most recently in the episode, what happens to our vaginas as they age, and what does estrogen have to do with it? And this is actually, the rest of that interview. I wanted to get it to you as soon as possible. What do Pavlov's dog and your coffee break habits have in common? Why might you wanna change your after work routine? To avoid setting yourself up for premature aging issues? How might understanding the progression of pelvic floor conditions help you slow things down or stop them in their tracks? Do you know the difference between urinary urgency and stress urinary incontinence? I didn't. But why does understanding the distinction make a difference to your now and to your future? How can you identify early signs you may be dealing with? It worsening sooner than it has to. have you ever thought about the slippery slope of it all? about the cascade of conditions we can experience at the intersection of perimenopause and a weak pelvic floor? I hadn't, but I'm really glad that I'm aware now. So once we're aware, what well-intentioned effort may worsen things. And when is it time to seek help from a professional? We've got a very full episode for you, and you'll get the answers and a lot of laughs so stick around. By the way as always anything we talk about during the show is referenced in the show notes for each episode links, more details photos, those kinds of things. You can find them any time right there in your podcast app or at myaloofvagina.com I'm so excited to bring back Dr. Wendy Chorny. There was such a big positive response to our first episode about estrogen and the aging Vagina. but before that, this episode's a little bit different, because I'm gonna tell you what's going on. I am not home. I am up with my family and I'm actually recording tucked away in a corner of the house. you'll probably hear some traffic noise and you may even hear some doors opening and closing, during this intro. An older family member of mine fell, was injured and ended up having surgery, I had this episode ready to go, thank God, but it felt weird not to share what's on my mind. So I got the call. And within 20 minutes I was in my car on the way to the airport. I didn't pack any makeup. I didn't pack a hairbrush. No phone charger. I brought one outfit that I'm wearing right now, and also some workout gear and pajamas. I will run out of Estradiol tomorrow, but I think this afternoon that I may have. found a place that has it about 30 minutes away. Um, I did bring my Dyson, so I remembered my Dyson air rep. That's pretty much it. It was a scramble and I was worried and I was really trying to catch the next flight to be here. And the reason I'm telling you about that is because has me really focused on longevity and thinking about it, I'm very focused on maintaining my strength and maintaining my flexibility and, um, my balance and all of these things, partly because I've been watching this situation knowing it was inevitable and then not wanting that for my future. I haven't really talked about it on the show, but I think I'm going to be talking about it more because I realize that it is just as it's important to me, it's probably important to you. And if it's not on your radar screen, it needs to be, if you're of the age that you're listening to this show, then you're of the age where, You can do things now to make sure your sixties your fifties, maybe if you're younger, your fifties, sixties, seventies can look better. And there's no better time than now to start thinking that way. not to be focused on diets as much. I'm not talking about diets and weight loss on this show. There's a different standard. For being healthy, a different standard for looking good and feeling good at this age. and it involves nutrition, and it involves movement and practices. So I'm gonna be looking for someone who is entertaining and funny and will fit the vibe of the show to talk about longevity and maybe provide some hacks and some tips because it is so important. So if you know anyone, if you know an expert who's really good, And entertaining. I'd love to hear it. so now for the actual show, brought Dr. Wendy back. Couldn't wait. Dr. Wendy Chorney is a doctor of physical therapy, plus she has a lot of related certifications that elevate her understanding of women's bodies. And I've listed those in the show note. She specializes in the treatment of pelvic pain, pelvic floor dysfunction, which is what we're gonna be talking about today, postpartum, perimenopause related disorders, and so much more. She is a practicing clinician, educator and author, and is affiliated with the University of Dayton. Doctor of Physical Therapy Program and currently doing research on diastasis recti in women, And a disclaimer, though she is a doctor, she is not your doctor. As always, please consult a local professional for your particular medical needs and circumstances. And in another departure from the norm, um, I actually left in our initial banter because it shows the beginning of this partnership that we have and you get to witness us falling in podcast live. because I left that in, you'll also hear us talk about how other podcasts don't get down to business get right into the meat, which today of course, cracks me up because here I am telling you what's going on in my life, telling you what else is happening, and then also leaving all this stuff in the episode. So I'm amused, but I promise we do get right into it after that initial. Kind of getting to know you And yes, in the show notes, I actually do link to the episode of the Huberman podcast that we're referencing in case you too want to listen to a very, very long episode, chock full of information that just didn't get to the point. a good, it's a good show and it's a good episode. I also link to an important but very long New York Times magazine article about how they did us dirty with the menopause recommendations. of course there are links for finding Dr. Wendy, because if you didn't already seek her out after the last episode, I imagine you're gonna want to after this one. So we talk about how each episode that has incontinence in the title, It gets fewer, listens, significantly fewer listens, we think it's the term, the term incontinence, when I see that, I think, well, that's not for me because I don't suffer from incontinence of any kind yet, but 50% of women will suffer from incontinence. Once we hit 65, 70 5% of us will experience urine leakage. it's a real thing. the roots of avoiding the issues or delaying the issues are in our habits right now. So much like the longevity conversation, this is a conversation about. What should you be for? What can you do now to avoid it? And what are the things that we don't even realize we're doing that are gonna lead to leakage issues, along with other pelvic floor health details that we go over? Listen, I was taking notes because even though I don't have any incontinence issues, and I'm not dealing with that at the moment, I do have the bad habits that she points out, which means I am setting myself up for issues later with my pelvic floor health in general and all the other things, all the other places where that comes into play and where it's important and in. The urinary, the urinary area, the U say that five times fast, the urinary area. but yeah, the word and confidence that brings to mind depends and old ladies. but pelvic floor health is important for more reasons than that. may also notice I'm pretty quiet in this episode. I guess I'm making up for it now with this long intro. I am quiet because I was transfixed. It's gold what she shares, and you know, knock on wood, there's lots of wood in this room. I am not dealing with it now and hopefully learning these things will help me delay I was just listening. In fact, I might have to make a compilation video of my face to put on Instagram because it's hilarious. I mean, I am so into every word she's saying. The reactions are funny. so Dr. Wendy will be back. There's no question about it. So if you have questions for her, please send them to me. I would love to get your questions answered on a future episode, uh, or if you have recommendations for some entertaining longevity experts for tips and tricks for staying vibrant and healthy and strong as we face this decade where we're known to lose muscle mass and balance, and. Begin to really age. You can send me that information or ask me those questions at My Aloof Vagina dot com or on Instagram where you'll see my silly face, and then I'll bring 'em right back to get those questions answered. any further ado, let's get into the love fest. That's where we'll start. So you can witness us becoming middle-aged, nerdy besties in real time.

Martha, My Aloof Vagina: 9:51

our first call was a friend call

Dr. Wendy Chorny: 9:53

Well, really it was us solidifying our relationship, uh, that we are now official virtual podcast pen pal. It is the modern day version of when you have a pen pal across the sea and you'd write those letters in class. This is the modern day version, we connected and realized we are like-minded, fact seeking fun.

Martha, My Aloof Vagina: 10:12

yes, and natural researchers.

Dr. Wendy Chorny: 10:15

to know. I have to be all in.

Martha, My Aloof Vagina: 10:17

I know, me too. because ultimately you'll just. My, Aloof Vagina. Is Dr. Wendy Horny?

Dr. Wendy Chorny: 10:22

well, you know, Dr. Wendy is the physical therapist for the Vagina, so that's okay. I can, I can be that, that's a term of endearment. It's not bad. it's fine. I just really care that we're getting information to people that need it and. after our friend talk, I then went and started listening to the podcast because I thought, well, you better know what is going on and like, I told you I love the length of the podcast because it's so accessible to women. It is so real. You can absolutely do the length of the podcast dropping a child. Coming back or if you're taking a bath or if you're getting ready or if you're cleaning. And I really loved it. We had talked about this other podcast that we were both interested in. Girl, it took me three days to finish that podcast.

Martha, My Aloof Vagina: 11:08

I'm still not done with it. I keep planning, but then I'll have like a 20 minute walk and I think, oh, I could get 20 more minutes of that one done. Or I could listen to an entire other one that helps me with my business

Dr. Wendy Chorny: 11:20

They don't get down to it. They don't get down. Get down to the business like, I don't have time don't stream me along. Give me the facts, make me laugh. Make me remember. Let's do it.

Martha, My Aloof Vagina: 11:32

that whole New York Times thing came out about hormones I read it. It's very long. It's useful, it's maddening. I saw people shortening it for social, and I thought that's brilliant most people are not gonna read all of that. Even as, they summarized it, they're not gonna read it. It's the same thing as that podcast. I need to listen to it for me, cuz I want to know but I want to know so that later we can be like Waka, Waka Waka and drop

Dr. Wendy Chorny: 11:56

But you know what though? Other people. They don't want to. Honestly, you know what I've learned? There are a couple types of people and we are in a specific smaller group where we want to know it all. Most people just tell me what I need to do. And I'll do it. not, everyone needs to know everything some people don't care to know everything. And when I had realized that, I said, oh, well I need to modify what I'm saying to reach that person's. I'm gonna say love language, learning style. Because if the goal is to educate and help people, if it's too long, I'm gonna miss somebody. So small digestible bits is the way.

Martha, My Aloof Vagina: 12:29

Totally. that can start what we're gonna talk about for the podcast. The bits. The bits. one of the things that struck me about you immediately, now, first of all, I could have you come on and talk about anything related to anything and it would be interesting and I right. And I do know that if you and I had a conversation and we, something came up, I'm trying to think the composition of the bricks of the pyramids,

Dr. Wendy Chorny: 12:52

Oh yes,

Martha, My Aloof Vagina: 12:53

you and I could have a conversation about the composition of the bricks of the pyramids and by the next time, talked, you and I both would have some information that we dug up Plus we'd have some other details to contribute to

Dr. Wendy Chorny: 13:04

be obsessed. I would be obsessed. Now, my friend Kelly Slaughter Beck, she tells me, Wendy, you do realize other people are absolutely not like this. And I said, no, I don't know that, but thanks for letting me know Kel. Thanks. And she's like, well, it's your h d. I'm like, well, then it is my superpower because I am a walking little dictionary of stupid.

Martha, My Aloof Vagina: 13:24

I don't think it's a D. H D. I think it's a different kind of brain. And I also listen, I was always a font of useless information. As a kid, I consumed books like crazy, and you always want me on your Trivial Pursuit team

Dr. Wendy Chorny: 13:36

Yes.

Martha, My Aloof Vagina: 13:37

cranium team.

Dr. Wendy Chorny: 13:38

The pink pie. I could always get the

Martha, My Aloof Vagina: 13:41

Yes,

Dr. Wendy Chorny: 13:41

pink pie.

Martha, My Aloof Vagina: 13:42

I could always get green. I always got the green ones so we

Dr. Wendy Chorny: 13:45

Nice job. I think we are a good team

Martha, My Aloof Vagina: 13:48

yes.

Dr. Wendy Chorny: 13:48

Will show the humans that are

Martha, My Aloof Vagina: 13:50

wearing a green jacket and you're wearing a pink thing. We didn't even know our trivial

Dr. Wendy Chorny: 13:56

I couldn't, I could not have planned this if I

Martha, My Aloof Vagina: 14:00

No. So I'm excited because you know a lot about women's health. You know a lot about biology in general, but it's true and. I could bring you on, we could talk about all those things. And the reason I wanted to talk to you, well, first of all, I fell in love with you. I got exposed to you and I, but it's true. And I started watching you and yeah, we're social media friends

Dr. Wendy Chorny: 14:20

pen pals. Now we are like modern day

Martha, My Aloof Vagina: 14:22

we're modern day pen pals. it was the way that you were talking about things. and it felt comfortable to me to learn from you and hear from you because you were

Dr. Wendy Chorny: 14:30

so wonderful.

Martha, My Aloof Vagina: 14:31

Girlfriend style

Dr. Wendy Chorny: 14:33

Yes. A thousand percent.

Martha, My Aloof Vagina: 14:34

yeah. So, I wanna go back to why I'm so excited about you. I want to talk about incontinence, like a broad term. And what I realized as we were talking about it, as I was creating titles for episodes, incontinence is a scary word and it's not an enticing word. on my stats I can see. The episodes that talk about incontinence in the title they get fewer listens,

Dr. Wendy Chorny: 14:56

Yes. It's a scary word. It's true. And some people are afraid to talk about their problems and they don't wanna address those problems. But if you keep it vague to pelvic floor, it seems a little less scary. Now, incontinence, if somebody does actually have incontinence, they want to learn about. I don't know what it is about certain generations. So for instance, with stress urinary incontinence, which is the leaking of urine with a cough or sneeze, and your pelvic floor and your urethra are not able to stay sealed and keep the urine with him. So cough makes a drop of liquid. it happens all the time, but as you get older that incontinence gets worse and worse. Well, in my patients, in older generations, and I will say in the. Sixties, seventies and 80 year old women, they will have reports to me that they have had leaking for two decades. And, uh, they're finally coming in

Martha, My Aloof Vagina: 15:58

Yeah.

Dr. Wendy Chorny: 15:59

so which decade put you over the edge? Meanwhile, women in their thirties, forties, and fifties You may notice some tiny leakage. You're like, well, I can manage this, you know? But then when it starts to leak through your clothes, you're like, that's it. I'm out. I need to find out how to fix this. But statistically speaking with women, if they knew that one in three women will have an episode of leaking that goes through their. They might feel better. when I learned that I felt better and thought, you know what? I did not realize that leaking to that extent could happen so often, but it does.

Martha, My Aloof Vagina: 16:40

Yeah.

Dr. Wendy Chorny: 16:40

talks about the peeing of the pants because nobody wants to pee your pants.

Martha, My Aloof Vagina: 16:44

So we talk about stressing continents a little bit sometimes. Cause you know, even in my podcast description, it used to say, it might still say it, I don't remember. Um, pee your pants when you laugh, you're in the right place. Right. And that's stressing continents. I didn't know that till just now. But that is on that kind of situation, which is different than leaking.

Dr. Wendy Chorny: 17:02

Well, so technically in the incontinence umbrella there is urinary incontinence, and then there's the thing that people are truly scared of which is fecal incontinence. People are scared of that, man. You think urinary incontinence is scary. Fecal incontinence is the scariest, but, but by the time you get fecal incontinence, It means your pelvic floor is so weak now, it's affecting your poo hole. It's not just the urethra sector. The bulk of the pelvic floor muscles are towards that back part by your tailbone, by your toxic bone, back by that rectum. But in incontinence, urinary incontinence, which is a much, more common, thing that we're talking about, stress is when you cough, sneeze, or bear down, urinary urgency can also cause. Incontinence. And that urgency happens with time because kind of like Pablo's dogs, you have accidentally conditioned your bladder to go all the time, and now you're leaking on the way to the bathroom. You know what I mean? It's, it's an interesting thing, urinary urgency. that kind of incontinence is quite fascinating. It's real, it is not in your head.

Martha, My Aloof Vagina: 18:04

Well, in the sense,

Dr. Wendy Chorny: 18:06

There There that. Yeah, like I mean, you were trying to do right by yourself, by when you saw the bathroom, you went just in case,

Martha, My Aloof Vagina: 18:15

Yes,

Dr. Wendy Chorny: 18:16

but you did it so much that then when you are on your way to the bathroom, You now can't even make it because the urgency takes over. you could be leaking, peeing down your leg in route to the bathroom, not even know it, and then you're appalled at yourself. Appalled. there is this horrible epiphany when this happens people think they're just horrid, but really no, no. it's just the physiology of all the things.

Martha, My Aloof Vagina: 18:41

I know we'll talk about things as we go, but I do wanna talk about this idea of conditioning ourselves because I do it too. And we did it with our kids. okay, before we go.

Dr. Wendy Chorny: 18:53

Mm-hmm.

Martha, My Aloof Vagina: 18:53

I now do that to myself

Dr. Wendy Chorny: 18:55

There are a few times we do well that's a, well to some extent. There are some times that we do need to pee just in case. For instance, every woman knows that if you have had sexual intercourse, you need to get your bottom up and go pee after you have sex. That is not a just in case, that is just being wise with bacteria and your little urethra. if you are about to go to a workout, You should go to the bathroom because you're about to be jumping, prior to, an examination with your ob, G Y N. Yeah, go to the bathroom. So there are some things, but when it becomes pathological is when you pass every bathroom and you're going just in case. And if you're about to go to work and you're going to the bathroom, that's okay. There are certain times.

Martha, My Aloof Vagina: 19:40

so we, train ourselves, we inadvertently train ourselves. And when it becomes a problem is when you get to the point where every time you see a bathroom, you need to go. You train yourself

Dr. Wendy Chorny: 19:49

yes. So your bladder does have its own little memory and it has, you know, a muscle called the detrusor and that my muscle will trigone. And, your bladder can absolutely be trained. what happens is in normal physiology of your bladder filling up, the contents, the urine rises, and eventually at about like halfway to 75%, your bladder gives a little ding, ding to your brain. I might need to be going to the bathroom, but you have enough capacity to wait and you're fine with that. So you do. But some people, if they are constantly emptying it and they start to get that rushed feeling, the bell is going off much sooner. Or if somebody has an irritated bladder, that alarm is going off constantly. There are some people that have something called interstitial cystitis, which is an irritated bladder. That kind of feels like a bladder infection. But it's not the same. A bladder infection is bacterial cystitis. So cystitis would be that irritation of the bladder. interstitial cystitis is a non bacterial. Cystitis. these people have urgency. But I'm talking about like in normal people, if you are a woman who has had children and maybe your perimenopausal, your pelvic floor is weaker, your tissues aren't as plump and you aren't keeping that seal and you're leaking and you start going just in case, cuz you're trying to be helpful, you are not. Yourself. You are now conditioning your patterns to have a shorter and shorter interval in between your voids, and that's the real problem. And then people can develop something called triggers where you hear, like your keys jingling as you are about to put the keys in the door and it gives you urinary urgency. And then you're leaking trying to get to the.

Martha, My Aloof Vagina: 21:41

Oh

Dr. Wendy Chorny: 21:42

it's a whole, it is that, that, nobody talks about that. So there are so many moving pieces, but I try to keep it simple and have people remember, we're just gonna start with the pelvic floor. We're gonna see what the pelvic floor looks like and just go from there.

Martha, My Aloof Vagina: 21:58

let's revisit that just for listeners because this is helpful and, we'll get into, and by the way, I'll bring you back a thousand times cuz I have a million questions already.

Dr. Wendy Chorny: 22:06

Oh, that's fine.

Martha, My Aloof Vagina: 22:06

I wanna talk more about this idea of the ways in which we create triggers for ourselves because. I'll ask you instead of proposing are there different habit changes that we might make so that we don't do that we don't turn the keys or entering the house or whatever the things into triggers. What are some things we could do so that that doesn't happen?

Dr. Wendy Chorny: 22:26

Well, I think avoiding schedule like you emptying your bladder, a normal avoiding schedule. Okay? A normal avoiding schedule is you would be emptying your bladder every three to four hours, two and a half. Sometimes it depends on your volume of fluids you've consumed, If you have leaking and you having hotness and you're worried about it and you're trying to leak less and you start going to the bathroom more. so say you went to the bathroom before you got in your car to drive to work, totally normal. Maybe you're drinking your coffee in the car, maybe your commute's like 30 minutes. Sometimes people, by the time they get to work after they've drank that coffee, They might have to go again. that is fairly normal. Uh, in the morning, sometimes people have voids emptying their bladder a little bit sooner, but if you are in an office and every time you're walking past that bathroom, you're going just in case That is where it's a problem.

Martha, My Aloof Vagina: 23:23

Okay. Okay.

Dr. Wendy Chorny: 23:24

it's that you have a little bit of a fear side to it where you're afraid of leaking. And so because you're afraid of leaking, you're not letting your bladder get too full, and so your bladder starts to shrink a bit, and so then the signals to the brain start to change, a whole urinary urgency that can develop. So stress urinary incontinence is generally the very beginning, always. And that's because your pelvic floor is weak. Maybe your vaginal tissues don't have the same amount of bulk. We know that your urethra probably doesn't have the same amount of bulk as your estrogen declines at 35. it starts there, but then it can progress to urgency. And then the urgency in the incontinence is where you're leaking, walking to the bathroom and it takes it to a whole nother level that is very worrisome to.

Martha, My Aloof Vagina: 24:14

Okay, so that's interesting. So what I'm hearing you say is that stress incontinence happens because of age and a number of factors, but as we become more anxious about it, we can actually shift our habits and our efforts to avoid it and

Dr. Wendy Chorny: 24:29

Mm-hmm.

Martha, My Aloof Vagina: 24:30

of the other.

Dr. Wendy Chorny: 24:31

Absolutely. So if you don't. Uh, help from somebody that is knowledgeable. You are more often than not harming yourself, this is why healthcare for women really matters. Because another thing people do when they are leaking is they stop consuming as many fluids. So they're like, well, you know what? I am going to work in this kindergarten class all day today. I don't have time to go to the bathroom every two hours. I don't wanna leak when I'm squatting to help Jimmy out, so I'm just not gonna drink. And I have some patients that come to me that only drink four cups of liquid a day. I don't know how they blink, but I will tell you, I could see it in their skin. Their skin is like parched. So that's, a whole nother problem because it lends itself to bladder infections.

Martha, My Aloof Vagina: 25:18

Yes. I have a lot of older women in my life. I had them through like a dating relationship and things like that, and every time something happened, whatever small thing, and they had to go to the er. Sometimes they had to go to the ER for an injury or whatever. Every single time there for, you know, the splinter or whatever, it would be discovered that they had a U T I.

Dr. Wendy Chorny: 25:39

Mm-hmm.

Martha, My Aloof Vagina: 25:40

I know that we're more prone to it cuz our tissues change and cuz the hormone changes. But I think it's also that habit of not drinking water because you don't wanna have to pee because all these women, I also watch them not drink water.

Dr. Wendy Chorny: 25:51

Well, so that's what I'm talking about, that women's health is this really interesting thing where we really do need to see someone. I mean, we take better care of our cars, we take better care of our hair than our body. But based on what you just said, let me tell you some nerdy facts

Martha, My Aloof Vagina: 26:06

Please.

Dr. Wendy Chorny: 26:07

So we know that the Vagina and the urethra. Need estrogen. you've ever heard me talk about estrogen, I always like to say estrogen is a water loving molecule and it keeps things plump. So at 35, your hormones are decreasing, as you go through perimenopause, you hit your one day of menopause, and then your postmenopausal, your hormones are continuing to decrease. And as they. decrease The water-loving molecules go away. So those plump tissues that you needed to keep plump to keep the seal no longer are keeping that seal. Estrogen regulates vaginal physiology. it's like filler, you know So then you have a thinner mucosa. And that thinner mucosa means there's like a little cracks like the Sahara desert in your Vagina. And then pathogens and bacteria and yeast can get embedded in your skin. And then it's a whole thing. It's awful. So then because you have this estrogen issue, it's less elastic, there's less collagen, and this is my fact of yesterday, and I'm sorry, this does not involve, urine, but it does involve sex. as we age and we lose the estrogen, the vaginal blood flow decreases. So then of course it's gonna decrease our lubrication for arousal. I don't know why I never linked those two together in my brain.

Martha, My Aloof Vagina: 27:24

Right.

Dr. Wendy Chorny: 27:25

I mean, I was like, what? Yes, of course, You have less estrogen maybe you had a baby, so then you had trauma to your pelvic floor, so your muscles are weak, your estrogen is dropping, so you have less plump tissues, and now because you're trying to not leak, you stop drinking water, but your tissues are thinner, you're giving yourself infections. you're gonna have to get on an antibiotic, which is gonna destroy your gut microbiome, which is already a shit show because your perimenopausal menopausal, oh my gosh. It's a cycle. Hey there, this feels like a good time to remind you about the vFit gold. And that you can get 10% off with my code, MAV10 Or by using the link in the show notes. During my panicked research, when I first became concerned about my vagina. All signs pointed to the vFit And here's the deal. Red light. Gentle heat. And Sonic technology. encourage blood flow, which aids, natural hydration. And helps you improve moisture sensation, pleasure, and intimacy all from the privacy of your home. As you may recall, or you may have heard. I use mine scrolling Instagram. And nobody's the wiser. It also specifically helps promote a stronger pelvic floor and a bunch of other things that you can confirm on their website or with your own research. Just go to joylux.com and use code MAV10 as in My Aloof Vagina 10. Or use the link in the show notes and the discount will be automatically applied. You your vaginal health. And comfort and pleasure. Can thank me later.

Martha: 29:04

Thank you for listening. Until next time. Take care of yourself and take care of your vagina. If you love this irreverent podcast, please recommend it to a friend. You think will enjoy it so that we know to keep delivering this very specific style of midlife information and stories for you.