Nurse Maureen‘s Health Show

Does Alcohol Hit Differently in Menopause?

Maureen McGrath
Speaker 1:

Good evening and welcome to another episode of Nurse Maureen's Health Show podcast. I'm Maureen McGrath, a registered nurse, nurse, continence advisor and sexual health educator. I also educate a lot about menopause as well and perimenopause, as I see many women in my clinical practice who are experiencing that life transition. But there's something that is almost a common denominator that can impact perimenopause and menopausal symptoms that you know, sometimes we don't talk about because it's socially acceptable and it's one of those things that we celebrate with and that we don't educate about the negative impacts or the fact that it's a type one carcinogen, and what I'm talking about is alcohol, and so I had a question does alcohol hit differently at perimenopause and menopause? And there was none other to invite to this podcast but Madeline Shaw. She's a writer and a social entrepreneur. She's also the author of the Greater Good, which is available online at Amazon and through her website, madelineshawca. She also entered the world of sobriety four years ago and she joins me on the podcast this evening. Good evening, madeline. How are you?

Speaker 2:

Hey, maureen, I'm great.

Speaker 1:

Oh, good, yeah, so nice to connect again. It's been a little while.

Speaker 2:

I'm a huge fan. I'm excited to chat with you.

Speaker 1:

Oh, you're so sweet. Thank you so much. Well, I'm a huge fan of yours and I'm so delighted that you're talking about this subject, because it's something that we don't really talk about. It's misunderstood, it affects women differently than men. We're talking about alcohol, so I'd like to start with your journey. What role did alcohol play in your life before you chose sobriety, and did you notice any changes in your relationship with alcohol as you approach perimenopause or menopause?

Speaker 2:

Yeah, 100%. So I mean like over 70% of Canadians and Americans, for that matter. You know I consumed alcohol. I started drinking when I was a teenager. I thought it was cool and you know it's just kind of a way to relax and party and celebrate and kind of all.

Speaker 2:

The social trop was in my mid 40s and alcohol sort of changed, like it became.

Speaker 2:

Instead of just being this you know, wahoo, celebratory cheers kind of thing, it also started to become something that was important to me when maybe I wasn't feeling that good, when I maybe I was feeling a bit sad or lonely or disappointed or just kind of bored at the end of the day when I was making dinner and all of that sort of came to a head during menopause, when I started to experience hot flashes and night sweats in particular and sleep disruption.

Speaker 2:

I learned I started, you know, identifying that in my mid 40s that alcohol definitely had a negative impact on my sleep and I did that through experimenting with dry January for probably about five years before I quit alcohol for good, and it really showed me, kind of gave me, a window into like life without alcohol and how do I feel different. And I certainly noticed that there was a direct correlation with the sleep, because you know, if I had a couple of glasses of wine, I'd wake up at two or three in the morning, I wouldn't be able to get back to sleep, I'd be dehydrated, I'd feel kind of yucky, and then I'd finally get back to sleep and then I'd be woken up with hot flashes around 5 am and I was literally at my wits end with that conundrum and I realized that I could do one or the other, but not both.

Speaker 1:

Right, and I think a lot of women realize that. I see a lot of women in my clinical practice who are entering the perimenopausal time of their lives. They're experiencing hot flashes, night sweats, heart palpitations, anxiety, dry skin, hair loss. And when I talk to them about alcohol especially if they want to entertain hormone therapy and are interested in the risk of breast cancer, especially with combined hormone therapy I'll ask them how much they drink and if they notice and I don't even have to ask them half the time. But they pretty much all say if I don't drink alcohol, I sleep better, I don't get the night sweats and my hot flashes are reduced.

Speaker 1:

But some women use alcohol to treat their perimenopausal and menopausal symptoms because they say it helps them to actually get to sleep. It may not help women to stay asleep and then some women also feel that alcohol helps them sleep much better or it helps their anxiety and so they drink for that. So they're kind of drinking not to celebrate, not to cheer somebody on, not because they're getting together with friends. They're actually drinking to treat symptoms of perimenopause and menopause. Were there specific symptoms? You mentioned the hot flashes, but any other symptoms that alcohol seemed to worsen for you?

Speaker 2:

Oh yeah, like just my overall energy. I would say like again all of the insight that like if we, if we are gradually increasing our drinking or we're, you know, just having one a day or whatever like you don't really like there's no kind of benchmark in terms of how you would feel without it, and I would encourage anyone who's feeling kind of sluggish and just thinking that it's aging or perimenopause, that to just give your body a break from alcohol for a month and see how you feel and if that feels good, then try 100 days and see how that feels. And like my experience in doing it was like I. So I graduated from a 30 day like dry January to 100 day challenge in I guess it was 2023. And I couldn't believe how good I felt, like my energy was back. And listen, as a sexual health educator you're you know, I'm going to say it out loud I had orgasms more easily.

Speaker 1:

Without alcohol. Yep, there you go, a plug for my work.

Speaker 2:

I knew I had to mention that to your listeners because and I wouldn't say that, like I'm a pretty private person but I'm like, okay, if having more energy isn't enough for you, if reducing your risk of cancer isn't enough for you, if, you know, reducing your risk of heart disease isn't enough for you, if sleeping better isn't enough for you, how about your sex life? Come on and literally and that was a really, really big realization for me Like I just felt more present and as awkward. And as you know, I know a lot of people use alcohol to kind of relax in, you know, intimate situations and it's associated stereotypically with romance and whatever. But really it's dulling your senses, Like that, that kind of fun feeling of the fuzzy edges and numbing out a bit when you are in an intimate situation with someone, like it might help you kind of enter that, but to actually like orgasm it's not going to help you.

Speaker 2:

And it's the same story, Maureen, as you know, with sleep. It's like alcohol helps you get to sleep but it does not help you stay asleep. And in fact alcohol, you know there's four main levels of sleep and alcohol stops you from getting to those deeper, really, really nourishing levels of sleep the level three and level four, the REM sleep, where our brains are literally cleaning themselves Okay. So yes, there's an initial kind of buzz and that's fun and maybe that feels good, but in the end alcohol adds to anxiety. It reduces our ability to be present, to experience pleasure and to fully be ourselves. I think.

Speaker 1:

And sticking with that sexual health theme, which I absolutely love. You know, so many women present to my clinical practice experiencing some of the typical and atypical, or ones that are lesser known, symptoms of menopause, but from hot flashes to night sweats, to anxiety, to dry skin, to burning tongue, to itching ears, to vaginal dryness and leakage of urine, urgency and low libido. And they don't tie that to alcohol, you know. And alcohol is absorbed differently in women than men. And also when the hormonal fluctuations occur, as they do during perimenopause, when the hormonal fluctuations occur as they do during perimenopause, I would imagine that has an impact on absorption of alcohol. But they come in asking for testosterone these days because there's a lot of influencers on social media who are pushing testosterone for low libido on women, because, even though the evidence is not there and it's not approved for that purpose in North America, you know. But are we looking at the alcohol consumption?

Speaker 1:

um, for women, and you know, a lot of women are not willing to give up their gin, their wine their you know, um aperol spritzers, uh, even though it can be, as you say, related to low libido and the experience, the female sexual response, the experience of desire and orgasm.

Speaker 1:

And you know, going through that whole, you know the lubrication, the arousal, I should say the arousal, the desire, because, especially if in a long-term relationship plateau and orgasm, so that can impact that female sexual response cycle because, as you say, it really can numb us. And a lot of people say that we talked in the past about the gray area of drinking. Can you talk a little bit about that please? Because if somebody's listening to this and thinking I don't have a problem with alcohol, I'm not an alcoholic, alcoholics are. You know they're living on the streets, they're not working, they're not. You know, it's my understanding that 90% of alcoholics are functional alcoholics, so in other words, they're living in the white pillared homes in the suburbs. It's much more common than we realize and you know it really can be toxic, especially to the brain. But tell us a little bit about that gray area of drinking.

Speaker 2:

Yeah for sure. So I mean there's there's two concerns around alcohol. One, as you've we've just been jumping into, is around health risks and cancer risk and heart disease risk and that type of thing. But the other one is around addiction and that's the one that sort of gets the most attention. Like when people are questioning their relationship with alcohol, what they mean is I am not an alcoholic right, so they're not necessarily going. Wow, my risk, for you know seven different types of cancer is kind of elevated even with as little as a drink a day.

Speaker 2:

So my experience with gray area addiction what I mean by that is it doesn't present in this stereotypical, like all the things you just said someone falling down in the street. He's kind of lost everything and they've lost their job, they've lost their family. And that was not my experience of addiction. It was a gradual realizing that I was no longer free, I was no longer in control, but I wasn't really drinking that much. Like it was very alcoholism. I don't accept that it's a disease personally, but a lot of people frame it that way. It's either way that behavior is progressive. So I, you know, I went from drinking occasionally to having a glass of wine every day when I came home from work, to pouring myself another glass with dinner, pouring myself another glass with dinner, to it being this sort of daily, ritualized, sort of essential thing, to finding that it never sort of happened. I never ran out of wine. You know, I always noticed whether people were drinking or not in social situations and just being really sensitive to it, and so I call it gray area because it doesn't, it's not obvious and you know I wasn't drinking a bottle of wine a day. I was probably drinking sort of a half to two-thirds at the height of my drinking. Okay, so to a lot of people that's not going to sound extreme, that's going to sound maybe normal for some people, which is fine, but everybody is different and in my case it was exacerbated by perimenopause.

Speaker 2:

The things I wasn't an alcoholic and like for starters I don't love the word alcoholic, it carries so much judgment but they were like you're fine, you know you don't like whatever, you're not waking up and having beer for breakfast and doing embarrassing things and whatever. But I was like, no like for me. The kind of hallmark of addiction for me is is I thought about it so much, like it was something that had a grip on my mind and that it just occupied what I call mental real estate. Of like this worrying of like, am I an alcoholic or am I not an alcoholic? When, in fact, the question that I should have been asking myself and I encourage people to ask is like is alcohol, do I have a net positive relationship with alcohol in my life? Does it give me more than it takes? Is it, am I free? It's really what it comes down to.

Speaker 2:

When the question is around addiction, when the question is around health, I think people really need to be looking at the new guidelines by the US Surgeon General, by the Canadian Center for Substance Use and Addiction, the World Health Organization, like, really look at, what does the American Cancer Society tell you about breast cancer and alcohol, or the Canadian Cancer Society, for that matter. Like, especially for women, like alcohol causes breast cancer. I'm sorry, it just does. It's an endocrine disruptor, it increases estrogen, it depletes testosterone in most women and you know, I think these are things that and thank you for bringing me on the show and thank you for being so knowledgeable about these things already, because it's like so many people don't know that they just think it's wine. I'm just having my wine with my. It's my me time, it's my girlfriend time and it's like this could really be hurting you, right?

Speaker 1:

So many women who, after they've been diagnosed with breast cancer, will come back to the clinic and they'll say they told me to stop drinking alcohol. I had no idea that alcohol caused breast cancer, and you know. And also their health. You know, when women quit alcohol, they noticeably feel much better. You know, and also their health. You know. When women quit alcohol, they noticeably feel much better. You know, fairly immediately. It might take a couple of weeks, but they all report back that they feel better.

Speaker 1:

Gentlemen, let's talk tech For your tool. The Firm Tech Ring is revolutionizing erections, tracking performance, boosting stamina and supporting your sexual health with real science Ready to level up in the bedroom. Head on over to MyFirmTechcom. Use the code NurseMaureen15 for 15% off of any FirmTech order. Firmtech hard science for harder health, because performance matters. That's Nurse Maureen 15, for 15% off of any FirmTech order. And so I imagine quitting alcohol helped your hormonal symptoms in perimenopause, like the night sweats you described, or I don't know if you were having mood swings, but you did mention fatigue, and these are very common complaints in perimenopause.

Speaker 2:

Yeah, I mean, it just made Maureen, it just made my whole life better and you know, I hit menopause in December of 2020. So I was fully in, like I was in COVID, like life kind of sucked. Covid, like life kind of sucked, and I just got to the point where I just I knew that I needed to take better care of myself. Like I obviously I wish I quit much earlier in my life, but it was like there's no way out but through, like I'm not getting any younger. My, you know, and it was sort of the only thing that I knew to do.

Speaker 2:

That was the best, single, most number one thing I could do to take care of myself, to stop making space for it, to stop making excuses, to stop saying oh, just one, and then one becomes two and la, la, la, like trying to moderate and all that stuff. Like every single part of my life has benefited from getting rid of alcohol. Honestly, every single one. Like all of my menopausal symptoms, my anxiety, my self doubt, my energy, my workouts, my sleep, my sex life, my, you know, just overall well being, that's fantastic, and I'm just curious because I know that oftentimes doctors or healthcare providers don't talk about alcohol and hormonal health.

Speaker 1:

I mean, it's hard enough for sex, hard enough for them to talk about any of those subjects, never mind put them all together. Did you receive support from healthcare providers about the interaction between alcohol and hormonal health or sexual health, or did you figure this all out on your own?

Speaker 2:

You know, it's a conversation that is just happening right now and, unless I've missed it, because really again it's this red herring of it being all about addiction and it's like no, no, no, no, no. This is a public health issue and it starts with very low levels of alcohol consumption. But I even I was on a call with a very famous OBGYN doctor and asked her I didn't read anything about alcohol in her book about menopause. And her answer to my question in an online like huge forum was basically that it was no big deal. And I received a similar answer from my family doctor when I told her I was concerned about it and this is many years ago and you know she said how much are you drinking? And I said a glass or two of wine a day. And she's like you know what? You've got a me it's no big deal. And here's like a world renowned women's health expert telling me it's no big deal. And yet in my heart I knew that something wasn't right and I forget the rest of the question you just asked me.

Speaker 1:

I'm so sorry, no, no, no, just asking about if you provide, if you were provided with support from your doctor, for example you know about alcohol and hormonal health and sexual health. Just figuring it out on your own.

Speaker 2:

Yeah, but interestingly, I attended a screening of the M-Factor a couple of weeks ago and I asked one of the people on the panel, dr Sukhpreet Patel from MenopauseWise and about. I said what do women in perimenopause and menopause need to know about alcohol? And she was all over it and from everything from cancer risk, sleep disruption, energy depletion, mental health, brain health. Like you know, people don't know that alcohol attacks the brain.

Speaker 2:

You know like like that's how it works right. That's why you feel good. It's because your prefrontal cortex is essentially taken offline and anyways. She was very up on all of that and I was really, really excited to hear her response to my question and that's posted on my LinkedIn feed as well. And yeah, so, no, I didn't, but I did so much reading Maureen and so much podcast listening.

Speaker 2:

There are so many incredible women who are talking now openly about sobriety and alcohol and addiction and whatever all these things, because one of the biggest problems is the social taboo around it. It took me years to and this is again relates to the gray area thing Like it was like I to be an alcoholic when I was growing up, like that's a terrible thing to be and and I knew like that that was. There was so much judgment around it and blah, blah, blah. And anytime you try and talk to somebody about drinking, there's the like people kind of freak out and it's not a neutral thing. It's something that's people feel a sense of judgment around it in a way that isn't like other things.

Speaker 1:

And absolutely there's so much stigma and I think you're using more progressive terms like substance use disorder, alcohol use disorder, you know versus that labeling of alcoholic Because, as you say, you know it really is not necessarily about how much you're drinking, but it might be related to binge drinking, or you have to drink every day, or you're treating symptoms that you're experiencing that are you know where you're not feeling good and so you're figuring that alcohol will make you feel better and it might for the first 20 minutes. What? What did you find that? What were some of the biggest challenges you faced in maintaining sobriety while navigating hormonal changes and like things? Like you know, did friends, you know friends, like friends to drink with them? You know there's a lot of pressure. People don't want to drink alone. That's one of the things. Did you experience that or did you have other challenges to maintain sobriety?

Speaker 2:

Yeah, and so many things. Maureen, I guess my first thought to that is that once I like I was struggling so hard that by the time I did quit and I knew it was my last day and I knew it was just time to let go, and I knew how much better I was going to feel, like it wasn't even really a challenge Like the. To me, the challenge was struggling with my relationship with alcohol and the idea of maintaining, like I'd struggled with trying to, you know, be sober or not sober, and la, la, la at that point, for like five years, by the time I quit for good, and so messing with, you know, so-called moderation and um which, by the way, I think is kind of a joke Um, and you know my dry January stuff, and do I go back? And then this hundred day challenge, and then do I go back to drinking, and so was this.

Speaker 2:

I was so exhausted by that that by the time I like I was like I am so done, like I'm not screwing around with this for another minute. I felt fantastic and I just knew that this was the right choice for me and that, no matter what, like it, just the temptation was gone. It was like leaving a bad relationship, honestly, and I felt free and I felt relieved and I knew that all the benefits would be there for me because I had experimented with it so many times. Like it wasn't like, oh, I wonder if I'll sleep better. It's like, oh, I can't wait to sleep well and feel well-rested and energized. So, yeah, I had some weird stuff with people a little bit, but mostly I think I don't know, people just knew that it was what was right for me and I know now that and I started writing about it and I've written.

Speaker 2:

I don't know a good like 10 essays on Medium about my journey with this and so many people have written to me on LinkedIn or people I don't even know and just thanking me for telling my story and that helped.

Speaker 2:

And you know, those little niggly bits, like I get a bit annoyed if I'm around people who are kind of drunk, like I don't enjoy that and my, you know, I feel lonely sometimes when other people are drinking and I'm not, because once people have had a couple of drinks, like I just don't feel like I'm on the same page as they are anymore and that can be hard and that's, I think, what a lot of people fear is like, oh my God, if I go to book club and everybody else is drinking wine, or if I go for this dinner party and everybody else is drinking like whatever everybody else is drinking wine.

Speaker 2:

Or if I go for this dinner party and everybody else is drinking like whatever, you do feel a bit lonely but I don't care. It's like there's nothing that is worth it about drinking for me ever again for the rest of my life to have the feelings that I had about it, to have the fears that I had about it, to have the anxiety that I had. You know all of that stuff, and not to mention the health risks.

Speaker 1:

Oh my God, like I'm the winner here. That's for sure, absolutely. You know, a lot of people are afraid of stopping drinking because they have this. I've heard this from many people. They have this in their mind. I can never have another drink again. Did you experience that phenomenon?

Speaker 2:

Yeah, I mean I was scared right, like it would be like because I loved drinking, like I really did. It was like a friend and then so what do you do without your friend? Like how do you know? But it was a process, I guess I would say, of unlearning and also realizing that it wasn't actually a friend. It was this fake thing. Like how can a level one carcinogen be a friend? You know? Like it's just not, it's not reality, like it's we are being marketed to, like when you go to a you know a liquor store and there's cupcake, wine and all this nonsense, and like it's.

Speaker 2:

It's so sad to me. Now I'm, like you know, sure wine is delicious, makes you feel good for 20 minutes. If you have one glass, okay, great, but it's not worth it. Like in the end, and especially if you do develop a dependent relationship with it, like I did, it's just, it's in no way. It's in no way worth it. Like I know that my cancer risk has gone way down, my heart disease risk is way down. You know there are so many things that are good that risk is way down. You know there are so many things that are good, that feeling like I'm missing it or I'm not missing anything. It's not worth the risk for me.

Speaker 1:

Right, exactly, and you know a lot of people require support programs AA, for example, or other online programs that are available. 12-step programs Did you need that? Do you recommend that? What are your thoughts on those types of programs? Are you able to do this all on your own?

Speaker 2:

Yeah, no, for me it was a combination of just doing a ton of research, which really helped me. It's like once you sort of start to realize the truth about alcohol, it sort of wakes you up and you can't stop. You can't unsee that. Wakes you up and you can't stop. You can't unsee that. But interestingly, maureen, I was introduced to an online group called the Luckiest Club, which was a huge support to me in my first year of sobriety and, in fact, the way my day one happened was attending my first meeting of the group, and you're going to love this story.

Speaker 2:

The person who was the featured speaker was a woman who was celebrating her one-year sobriety anniversary and her name was Hope. Hope, oh, for real. And and she told her story and it wasn't. Her story was not like mine, it was. It was different, but like there she was and, if anything, her, her story was way harder, what she went through, but she was sitting there and she was like a ray of light and I just wanted to be her so badly like and she was so happy and she was so proud and she was so free. She was telling everybody how amazing she was feeling and I was like I am doing this right now.

Speaker 1:

There is no clearer sign.

Speaker 2:

I require no further evidence and it was just amazing. So, yeah, I attended those meetings for a year and, like I said, it was during COVID and so the you know, the availability of everything online just went through the roof and that was great. But the biggest therapy for me has been writing about it and just as a way to share it with lots of people, and so I don't attend meetings anymore. I've never really connected with the 12-step philosophy, but it's amazing. I know lots really connected with the 12-step philosophy, but it's amazing. I know lots of people for whom it's been great, but there are so many Like there's been this incredible, like the resources for people who are sober, curious or want to get sober, whatever's going on. Holy moly, there is so much now online. It's just amazing.

Speaker 2:

And there's so many non-alcoholic beverages and there's all this thing. There's never been a better time to get sober. And yeah, I would just encourage anyone just to just see what happens. You know, quit for 30 days and see what it's like. And you know, see what you notice.

Speaker 1:

Right, exactly, and yes, you're right. There are so many options today online. I think that was one of the benefits of the pandemic, if we can count a few, so you know. Just in wrapping up, madeline, what advice would you give to other women who are in perimenopause or menopause, experiencing symptoms and you know are consuming, you know, alcohol consistently or are considering giving up alcohol? What advice would you give or considering?

Speaker 2:

giving up alcohol. What advice would you give? I like that kind of experimental approach, like to kind of go I am quitting forever. Like that can feel very overwhelming. And you know, one of the good things I think about the 12 steps is they have this mantra of one day at a time and it's like just see how you feel, like just you know, without setting huge, massive goals, like if quitting forever feels liberating for you, and that you don't need to make up your mind every single day not to drink and struggling like am I doing this, am I not doing this? Like just make it achievable and and notice. Like notice, like how do I feel? Do I feel a sense of anxiety? Am I thinking about drinking? Is there a voice inside my head and this one is huge For me I had a voice that I don't know when it started, but it came into my life and it basically started telling me to drink and it said things like you deserve it.

Speaker 2:

You've had a hard day. You're, you know whatever. You work so hard. No, no, no. You do so much. You take care of so many other people. Blah, blah, blah. You deserve a glass of wine. You made such a nice meal tonight you deserve a glass of wine. If there is a voice inside your head that is telling you that you deserve to drink. Pay attention, because it's like this is. It's a well known phenomenon of addictive like it's a common symptom of addiction, and so I would encourage people to watch out for that. I would encourage people to just, yeah, take a break and see how you feel, and see if you feel better and know that it is possible to let it go. You don't need to be scared that. It's a journey for sure. To be scared that it's a journey for sure. But you know, I for one wouldn't change a thing. If anything, I wish I'd quit earlier and I feel fantastic and I just wish everybody good health and freedom.

Speaker 1:

Well, you've quit now, and that's wonderful, and I just wanted to mention for women listening out there if you're considering that you might have an alcohol use disorder, you might ask yourself questions like are you drinking more alcohol over a longer period than you originally had intended? Are you unable to stop once you've started? Are you unsuccessfully trying to cut down or control your alcohol use? Do you have a craving or a strong desire or urge to use alcohol? And does your drinking interfere with responsibilities at home, at work or at school? And sometimes you have to ask yourself those questions because only you know the answer, the true answer, even if somebody else doesn't find out that you maybe, you know, miss something because of your alcohol use, but there's no shame either.

Speaker 1:

And, as you can see, alcohol use, but there's no shame either. And, as you can see, it can be a beautiful thing because it can, as we've heard from Madeline Shaw, it can certainly impact your life in a good way More energy, less night sweats, less hot flashes, fewer palpitations and a better mood. Madeline, you've always been a delight since I've known you.

Speaker 1:

And you're even more delightful now Because I can hear the happiness in your voice and and the relief and you know I love the fact that you're educating and encouraging other women and de stigmatizing this and sharing your stories, because when women share their stories, they empower other women. So namaste to you. Thank you so much. I really appreciate you coming on the podcast.

Speaker 2:

Thanks, friend. This has been a wonderful conversation and thank you so much for the work that you're doing. It's so valuable and I'm honored to be part of it.

Speaker 1:

You're so sweet Madeline.

Speaker 1:

Shaw is a writer and social entrepreneur. She is the author of the Greater Good. It's available online at Amazon and through her website, madelineshawca. I am Maureen McGrath. If you think that somebody would benefit from tuning into this episode, feel free to share, and thank you so much for tuning in. I always appreciate it. I'm Maureen McGrath, registered nurse, nurse, contents advisor, sexual health and menopause educator, and you have been listening to Nurse Maureen's Health Show Podcast.

Speaker 1:

Gentlemen, let's talk tech for your tool. The Firm Tech Ring is revolutionizing erections, tracking performance, boosting stamina and supporting your sexual health with real science. Ready to level up in the bedroom? Head on over to MyFirmTechcom and use the code NURSEMOREEN15 for 15% off of any FirmTech order. Firmtech hard science for harder health, because performance matters. Guys, if urinary leaks or struggles in the bedroom are holding you back, it's time to take control. Leaks or struggles in the bedroom are holding you back. It's time to take control. Btlm cell, better known as the Kegelthrone, is a game changer boosting pelvic floor strength, improving bladder control and even enhancing blood flow for better performance. In just 30 minutes, this non-invasive treatment delivers thousands of muscle contractions, helping you regain the confidence where it matters most. No surgery, no downtime, just results Stronger pelvic floor, better bladder control, improved intimacy. Book your session today. For more information or to find a provider, go to btlastheticscom. That's btlastheticscom.