The Therapy for Black Girls Podcast is a weekly conversation with Dr. Joy Harden Bradford, a licensed Psychologist in Atlanta, Georgia, about all things mental health, personal development, and all the small decisions we can make to become the best possible versions of ourselves.
This week I’m joined by The Vagina Rehab Doctor, Dr. Janelle Howell, DPT, WCS. She’s a Pelvic Physical Therapist and Board Certified Women's Health Specialist, who treats painful sex, urinary frequency, urinary incontinence, pelvic pain, and bowel dysfunction. She creates content on social media advocating for open, honest, and inspirational awareness regarding vaginal health, pelvic floor health, and reproductive health. Our special conversation for Sex Positive September explores myths about sex and the vagina, tips to optimize your pelvic and vaginal health and wellness, and more.
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Welcome to the therapy for black girls podcast, a weekly conversation about mental health, personal development and all the small decisions we can make to become the best possible versions of ourselves. I'm your host, Dr Joy hard and Bradford, a licensed psychologist in Atlanta, Georgia. For more information or to find a therapist in your area, visit our website at therapy for black girls dot com. While I hope you love listening to and learning from the PODCAST, it is not meant to be a substitute for a relationship with a licensed mental health professional. Hey, y'all, thanks so much for joining me for session two seventies of the therapy for black girls podcast. We'll get right into our conversation after a word from our sponsors. This week I'm joined by the Vagina Rehab Doctor, Dr Janelle Howell. She's a pelvic physical therapist and board certified women's health specialists who treats painful sex, urinary frequency, urinary incontinence, pelvic pain and Bild dysfunction. She creates content on social media advocating for open, honest and inspirational awareness regarding vaginal health, pelvic floor health and reproductive health. Our special conversation for sex positive September explores myths about sex and the vagina, tips to optimize your pelvic and vaginal health and wellness and more. If something resonates with you while enjoying our conversation, please share with us on social media using the HASHTAG TBG in session and visit the website sex positive September dot com to join us for the other events and conversations we're having all this month. Here's our conversation. Thank you so much for joining me today, Dr Hell, I'm so excited to be here and just grateful for the opportunity. Yes, it's very excited to dig in with you. So tell me what inspired you to start creating content as the Vagina Rehab doctor. Okay, so, believe it or not, when the pandemic started, before that I was actually teaching a lot about traveling, because I was into traveling physical therapy, and what I would do is I would work these three month contracts, mainly in California, and then when it was over, I could go anywhere in the world, and so I really love going to these different countries and I wanted to show other people that looked like me that they could also travel, but when corona hit, no one was trying to leave, everyone was in their house, and so I said, okay, I might as well start sharing more about what I do in my career, and that's when I started talking about Pelic health and vaginal health, and it's just kind of sword. It wasn't really on purpose the growth as second place, but I'm really thankful in the way that it has kind of blossomed. Yeah, I mean it's very necessary so for us to talk about it and I think a lot of people are interested in learning more. So I'm really glad that you fell into that and has started to share more. So can you give us like a one, oh one, like in basic terms, what is vaginal and Pelvic Health? So vaginal and peblic health is focused mainly on your public floor muscle group, which is like this basket of muscles that sit at the base of your pelvis. So we know about the vagina because we know if someone is having sex, then that's the organist use for that. We know that babies come out of the vagina and then we have these pelvic health assessments. Are these paths where we go to see a Ghana colleges and then go through the vagina, but we don't typically hear about the pelvic floor, which is in a dynamic group that really helps us with so much like sports sex. These are the muscles that contract when we have an orgasm. These are the muscles that have to lengthen out when we're giving birth. These are the muscles that need to support us for bladder control and even our gut health, because if those muscles become uncoordinated, are two tents that can cause things like constipation. So it shows up so much in our life and especially for our mental health as well, because if we're dealing with some mental health dissurbances, public for dysfunction is actually really common, you're gonna be at a higher risk for some public flor issues. So can you say more about this group of muscles and like why it is important for us to make sure that we're strengthening it and what happens if we are not? So these muscles are again at the base of the pelvins right and so it's like a diamond. You have your anus down in the back and then to the sides of the vaginal opening you have these sit bones right on top. You have that pubic bone and then the vagina is smacked up in the middle. These muscles are important because if they start to become two tents, two weak or just weak period or uncoordinated, meaning your muscles are contracting when you want them to open. Let's say you're trying to pee or you're trying to Poop, you need your muscles to open and really relax. But if those muscles are too tense, then you're gonna likely have some issues with that, maybe feeling like you have to pee all the time because those muscles are pressing on your bladder, or maybe feeling like you didn't really empty your bowels all the way because your muscles are not opening and relaxing. So I can talk about these muscles all day joy, but that's a really great introduction. They support your organs. They are really important for a bowl, bladder and sexual health. Got It okay, and so if we are not exercising these muscles and strengthening them, then we see these complications that you mentioned, or we could well. So actually that is a myth that most of us think that we have to strengthen the muscles, but what I'm seeing in practice is eighty percent of women and people that come through the doors. They actually don't have a lot of weakness, they have too much tension. So I'm sure you know that anxiety is a real, huge problem right now and the body responds to anxiety by tensing the peblic floor muscles. So the muscles are too tense. We also sit for a really long time. That puts our PELIC floor in a shortened position. So many issues go back to how relaxed you are, how at peace do you feel? Are you in traumatic and stressful environments? All of that can drive too much tension in the pelate floor. And you know, for years we thought a type Vagina was the right vagina, but I'm here to tell you that a type of vagina is not a right vagina. Most of what I see people peeing on themselves, not being able to control their bladder pan as often as every fifteen minutes, sexist, hurting, can't poop, tense, peblic floor too tight and sometimes it can be weak as well. But it really goes back to our lifestyle. What's going on in our life? What are the situations surrounding different things that we do, like maybe sports or how we move, or even how we breathe. There's so many things, but the good thing is that we're learning more about the public floor and so there's hope. I mean all of these conditions are treatable. It's not like you have to be in that position forever. So I know a lot of what you do is helping people to then learn exercises to release the tension in that Pelvic area. So can you say a little bit about what those exercises are and like how you teach your clients to do those? Yeah, so a big part of what we do is actually looking at before we even get into exercise, how is someone breathing? Because if we're breathing the correct way, actually our pelic floor relaxes just like this and then it goes right back up. But if we are breathing like from our chest, our shoulders are rising, our chest is moving out, but our bell is not relaxed, then we're gonna be fourth. It ain't pelic floor muscle relaxation and contraction, and that's why I'm really also adamant about being real about waste trainers and things that suck you in, because if your diaphragm is not moving enough, your pelic floor also is not. So no one wants to have coochy chaos. If you want your vagina to be supporting you, you need not to be putting all that pressure down on it. That can contribute to things like prolapse, and that's when the bladder can start to droop through the vagina, the rectum can start to come down even the uterus. So it's really important that we support the environment of the PELIC floor as well. Basic exercises, though, are similar to other exercises, like in Yoga or pilates. Bridges are common things that we do. Stretches are common things that we do, very similar to other forms of fitness and exercise. God it or Kegel exercise is something that also relaxes the pelvic area. No, so that would tense it up. If someone had a weakness or, let's say laxity, the term that we use is looseness in a community, but medically that term is laxity, and if that's there in addition to weakness, then many times we do use Keegeles. But the problem is a lot of people assume that their problem floor is weak when they're having any issue at all. They're paying their pants or maybe they're playing sports and they don't feel like they have support, or maybe they just had a baby and they don't feel like they have the same level of strength and support, and everyone just assumes they need to do Keegeles. But that's like giving yourself a prescription medicine without seeing a doctor. You don't know what's going on. And so again, most women and most people are too tents. So if you just start squeezing and gripping and squeezing, you're just losing more mobility. And, believe me, you want mobility in your color score. You wanted to move well, just like any other muscle group. M So, doctor, how how would we know we need to come see you? Like, I don't know that I've ever heard any physician that I've worked with talk about like, Oh, I'm gonna Send Youtube this pelvic we have doctor or a pelvic therapist. What kinds of concerns might we be having that would make us think, oh, we probably need to see someone like Dr Howell? Okay, so I'll go over the four basic major ones and then also kind of extra. Number One, if you've recently had a baby or just have had a baby, ever, you definitely should go see a public physical therapist because for nine months your pelic floor was under more strange, more stress holding up the weight of the Placenta, the baby. You know, everything that we have or we are pregnant. It's your peblic floor that was holding all of that up. So there can be weakness, there can be strength. There can also be scar tissue, because a lot of women tear or maybe we have four steps delivery. There's a lot of trauma that goes into delivering a child, and so that is a number one sign. Just go get a console. It doesn't mean that anything is wrong, but you should definitely go get seen, just like we go see our Ghana colleges once a year. The next thing I would say was any sort of p problems, whether you feel like you always gotta go pee or whether you feel like P is out when you laugh, sknees, jump, run or maybe you don't feel like you're emptying your bladder all the way. I have a lot of people that say they just paid five minutes ago. Why do I feel like I gotta go again? I feel like I didn't get it all out. So bladder pain, frequent urinary track infections. Sometimes people have a symptom of like burning or urgency, and they think they have a U T I, but it's really their public store muscles that are compressing on the your wreath for other bladder and that can make it feel like you have a U T I. So anything bladder, that's a sign. You should go. Anything poop right. constipated, can't hold your poop in, or maybe you're straining. Your poop looks like those little pebbles and those little rocks. That's embarrassing poop. If your poop is embarrassing you and you're eating all the fiber, you're doing all the right things. That is another sign. And then sexual function. Sex should never be painful, and it's so many people that just grit through painful sex or it's uncomfortable. I mean even things like inability to achieve orgasm could be a sign of Pelic sloor dysfunction. Um. So sexual bladder about and recently having a baby, but also just getting older. I think we deserve to know as much as we can about our bodies so we don't necessarily have to wait until we have a huge problem to go check up on our public floor. M So, doctor, how I want to go back to something that you just mentioned around painful sex, because that is something we've talked about here on the podcast and I wonder if you can say more about what causes the painful sex as it relates to like maybe clients that you've seen. Yeah, so around the opening of the vaginis called the Introitus, and that's this tissue right here, and this opening is so responsive and sensitive to hormones. So let's say you're getting older, maybe you're forty, five, fifty year approaching menopause. Sometimes the lower amounts of estrogen and testosterone can make that tissue more, let's say, raw or ordable, or it's just not stretchy enough, so when you try to insert something into the vaginal canal, it's not flexible enough to really allow pain free penetration. The other thing would just be, even if it's not related to hormones, your muscles again are just two tents because they've been guarding so long, they've been trying to protect you. Maybe you've gone through a lot of trauma, maybe you have anxiety, then your muscles typically are gonna be tensing up whenever you feel stressed. Anxiety, high amounts of nervous energy, all of that. So if that's happening on a regular basis, if those muscles are too tense, then it's not gonna be opening enough to allow pleasurable penetration. And the same thing for the deeper part of the pelvic floor. When you achieve deeper penetration, are thrusting if there's tension or trigger points. The same way we have trigger points like in our neck, our back or hamstrings, you can have the same thing in your pelvic floor and imagine a penis or a toy hitting a painful muscle. That's not gonna be comfortable at all and that's gonna Block arousal lubrication, orgasm and so forth. So how would you work with the client who came to you with that kind of a concern? If the patient is open to an internal mild fashion release? And what that means is with one finger, of course, a glove and lubricant, we're assessing the inside of the public floor. So we want to know where are you holding your attention, what likeliest contributing to it. So if you have like postural deficits, are again, if you're breathing abnormally or maybe you suck your toming in and you don't really realize that we do have to address the weaknesses and the abnormal body movements surrounding the public floor, but we also can't ignore what's going on inside of the vagina and inside of the public floor. So then we want to try and release that and stretch that with one finger. We'll have you do breathing, we might have to do some hip rangeing motion while we're trying to relax those muscles and then sometimes even the same day, I can feel more movement in their public floor. So surprisingly, if muscles are really tense, so tense that they're not moving, well then your contraction is actually gonna be weak because the muscle can't move. As soon as we release a lot of that tension, you now have stronger contractions and a better vaginal grip because your muscles can now move again. So that's a big part of what we do, in addition to the exercises, behavioral changes, posture, trying to help them with stress management, all of those things. So when you say behavioral changes, what do you mean? Different things like how they're sitting, that's behavior, how they're standing. How do they stand? A lot of people have done different types of sports, our activities like ballet, where they learn to just hold everything in, suck it in, such your tummy in, or maybe they have body image issues and they don't feel comfortable relaxing their abdominal wall. Other things like what they're drinking or what they're eating. A lot of people that have bladder pain are drinking too much coffee. Coffee is a bladder irritant and so you drink that all the time, that can lead to blider pain and different things. So those are all behaviors. Even setting up better sleep hygen like. If you're not getting enough rest, your muscles are gonna be more irritable, you're gonna be at a higher risk for vaginal Ph and balances. So I try to address as much as I can and then, of course, refer out when I'm not qualified to help. But behaviors definitely will impact the pelvic floor more. From my conversation with Dr How after the break. Yeah, I'm glad you mentioned the idea of a referral because as you were talking I was thinking there are likely cases you've seen where someone has maybe a history of pelvic trauma right and that of course we'll cause some of the attention and so I wonder what it looks like for you to work with somebody who maybe has a history of Mamma and are you ever working in connection with a bustal health professional to kind of tag team and help this person to to release some of the attention? Absolutely. I remember having one patient who came to see me. She struggled with a lot of anxiety and her main issue what she came to me was she was peeing like seven, eight times a night, so she wasn't sleeping through the night, she wasn't feeling rested because she was always up paying and her pelt floor was full. It was an angry vagina. I mean that thing was guarded tense tight. Barely could get my finger to do the examination. But we got her so much better. She was down to urinating maybe once her twice a night and I discharged her. Now, when I discharged her, pealic floor wasn't perfect. So that's not even really my goal is to get someone perfect, but to get them functional, like can you sleep to the night, can you have sex without paying? Can you still do the things that you want to do? And she did Flye. She came back a few months later, maybe like five or six months later and I'm like, you know what's going on, and her pelic store was exactly the same at which I discharged her. So again her pelic Flore was still not perfect, but it was no different than when I discharged her last and I said, how are you doing with your anxiety? How are you doing with your mental health? And she said I'm struggling. I feel anxious all the time, I feel depressed. The pandemic is making things worse, and so I referred to her to go see a psychiatrist. She was able to get on some medication and then almost immediately her urination went right back down to once or two times a night. So it's definitely a joint approach. I'm not gonna treat in isolation, you know. I'm not gonna treat on the island. Sometimes the patient doesn't have access to all different forms of health care providers, but it's definitely great to at least tell your patients, hey, this could help you if you're able to go see a mental health care provider, because it doesn't matter how many stretches we do, I can dig out all those vagina trigger points. If you don't address that mental health then it's gonna keep driving the peblic for tension or the Pelic for dysfunction. So I love you. I love all people that do what you do. We need more of you and I'm happy that it's the awareness is so much better than it was even just five years ago. The stigma is starting slowly. I mean the stigma was still there, but I'm grateful for the awareness and the education that we're getting around and now. So are there as a part of like your discharge? Besides, like the behavioral changes that you're talking about, are there like everyday exercises that you are instructing clients to do, like stretches or other things that you think would be helpful for our community to know about as well? A lot of stretches are gonna be specific to what they're going through. So, for example, I have a patient that has evolvadinny, which is just fancy term for the outside of the vagina hurts. Maybe the inner lips are the clitter risks, if may feel like burning or stinging pain. I was focusing a lot on her pelic floor, doing a lot of Pel for exercises, and she got minimally better. She didn't get completely better until I start looking at her neck and shoulder. So if we just give the same exercise to everyone, you're probably not gonna achieve that optimal level of fitness. However, I do have a vagina CEO release a guy that shows you my top six team peblic floor exercises for common public floor dysfunction, painful sex, frequent urination, tense public floor MESSAL's anxiety. And that's where I just use, okay, one of our most common exercises that I tend to give to people. They look like things like happy baby, child's posts, hip flex or stretches, stretches that we see commonly. But I give you queueing on how to breathe, how to relax your pelic flooring and vagina, how to make sure you're doing it correctly, and also just understanding. What does this have to do with your lifestyle as well? So I also give you cues on what's gonna attend to right back up, which is kind of what we talked about, posture and other things. So that e good is a great resource. Already, people have been loving it. I had a patient or a client who hadn't been able to have painfully sex with her husband for over six months. She didn't exercise it for one day and she was better. So sometimes it doesn't require six months of public fat. Sometimes you just need to move your body M so, based on your experience and talking with clients and even the work that you've been doing online, what do you feel like are some of the most common myths that you hear about sex and the vagina? That sex is supposed to hurt the first time. It's never supposed to hurt. Even if it's commonly happening, that doesn't mean that it's supposed to hurt. There can be anxiety your first time. There may not be enough for plag your first time. You may not know what you're doing the first time. So That's a myth. Another myth the penis has to be big in order for you to enjoy sex. I mean, to me that's a myth because the vagina and averages like two and a half inches long. Our Vagina is not this eternal canal that just keeps going and going. So That's a big myth that I see. Communication, you know, actually having a connection with your partner, being patient and understanding. I think that has more of an impact than just size. Alone. Obviously we're gonna have preferences, and nothing's wrong with having a preference, but I think that's a myth. Another myth, again is that we should be doing keegels and that we need to have a really tight vagina. I spend so much time untightening vaginas. I'm telling you, that's about any nine percent of my work, and it doesn't matter if someone's young or old. That's the common trend that we don't know how to let go because we've been told how to squeeze for years. We know how to squeeze, but how do you know if you're letting go and releasing your coloring floor? That is a huge men last thing I would say is that you need to be using like sentence soaps and special brands of Feminine Hygiene just to maintain a basic level of vagional health, and that's false. You actually don't need any special soap or cleanser. You just need to not do anything to you don't put things inside of your vagina. You don't need an earth ball in there, you don't need a detox ball, you don't need to put anything in there. Surprisingly, the vagina secrease things like lactic acid and hydrogen peroxide. So the less you do actually the better. In terms of sentence products and products with a million ingredients you can't even pronounce. I think that's a big means that you have to do all of this stuff just to maintain this basic level of vasional health. You know. That's how you're getting at something else that I wanted to kind of hear your thoughts about, and I'm sure you see a lot of it. What kinds of like sexual and vaginal kind of health disinformation and misinformation do you see that you want people to be very careful about? One of the things I see is that they only eggs, just putting you only eggs in the vagina to tighten it and again, and if any percent of us are already two tents, then putting something in your vagina and just holding a stone in your vagina does not simulate what your pelic floor likes to do on a regular basis. The way our pelate floor works is that it contracts what it needs to and then it let's go. It doesn't just squeeze and hold a contraction. That's like squeezing your arm and just holding it up all day. Your arm is gonna Start to hurt, it's gonna become too tent, you're gonna lose function and fitness in your arm. So the same thing happens with the pelic floor. The other problem I have with these Yoni eggs is that they're porous. I mean there's these tiny little holes in them. That means the bacteria can get trapped inside of that. Now you're putting that in your vagina, potentially disrupting this really sensitive balance of good bacteria. The good bacteria is what creates your vational Ph not so soap is actually decreasing the amounts of healthy bacteria that's down there. So that is a harm and I see it, unfortunately, a lot in our community because we do have distrust with medical providers. Doctors don't believe that we're I'm paying, not all doctors, of course, but we have been under heard, we've been overlooked, so we turn to natural remedies, which I am for. I Love My tea, I love my assential oils, I'm here for natural medicine, but when it comes to the vagina, we do have to be careful and make sure that we're not just doing something because you know, our cousin is doing it or someone on Tiktok is doing it and actually understanding what is the vagina looking for? And many times it's not looking for a star war or it's not looking for an herb ball. It's looking for us to be healthy and to have the sexual boundaries and to take care of our mental health and to use unsented products and really just trust that everybody knows what it's doing. For having an issue, it just means it needs more support, maybe more testing to see what's contributing to our problems. Why is this happening, as opposed to assuming that we need to help our vagina cleanse itself or detox itself? M More from my conversation with Dr How after the break. So is it important, Dr how, for us to be peeing after sex? Okay, oh, that's a really good one. How you're getting into it. I don't think it's a bad practice. So nothing bad is gonna happen if you empty your bladder, because you could likely be emptying out any extra bacteria that has entered into the urethra, the sweat, the semen, your vaginal fluids. You're lubricant. I mean there's a lot of different fluids in bacteria that can enter into the urethra. So paying is not a bad thing and I think it's helpful. Whether it's scientifically proven or not. I'm not sure that it is. So are there any kind of like pre or posts intercourse kinds of routines or things you think that would be helpful for us to know about? It maybe be practicing? Yeah, before sex definitely gets sexually tested. Make sure that your partner doesn't have sexually transmitted infections or, if they do, that you know about it and that you know how you're gonna move forward safely, because we don't want to make any assumptions. The other thing would be is that if you know that you have recurrent vaginal infections, like, let's say, recurrent yeast infection, is really common. is nothing to be ashamed about. It happens all times, like the common cold for the vagina. Our bacterial vaginosis, which can create like a gray discharge or a fishy smell, also really common, especially among black women and women of color. If that's happening, what I want to say is that you should look into getting a vaginal Ph test kit. It's really cheap, no more than twenty dollars. You can check your own vaginal Ph at home and if it's over four point five, then you definitely don't want to be having a hot girl summer, no condom. You know, doing this right today, doing this tomorrow. Use Protection and if you know your sensitive, you might want to look into those non latex condoms. But you definitely don't want to be having unprotected sex because semen has a very different ph level than vaginal fluid, and so if you're already sensitive, if you already have this history of infections, then check your vaginal Ph before doing sexual activity, especially if you're thinking about doing out protection. But of course I encourage using protection as often as possible. After sex you want a dry as that's that's what you want. So we hear about the wall right so, which means a wet or a lubricated vagina after sex. You don't want all that fluid sitting around. So after you're done with intercourse, you want to dry off, whether that's checking your shower, whether that's getting a warm towel and wiping off that fluid front to back. That's gonna be helpful with preventing infections as well, because bacteria and viruses thrive on moisture. They really can't survive without a source of water. So if you get rid of that, then you're gonna be decreasing your chances of getting an infection, which is a source of anxiety, frustration low confidence for a lot of us that are struggling with their vational health. That is another great tip that I would recommend before sex, if you have pain, definitely do some public floor exercises, some stretching, some breathing and know I'm making sure that you're relaxed and you're not tense. Stretching those hips is a really great sexual routine to help you with your sexual wellness. And what about birth control, DTR? How does that impact our sex life at all? Absolutely. I just was talking to a Guyment coologist yesterday who specializes in sexual medicine and she was telling me that when we're on birth control, specifically for a longer periods of time, that lowers the level of Androgens in the body, which are like male horm but really it shouldn't be called male hormones because they're in the body of females and thems and we need them for our sex drive, we need them for our minstrel health. We need them for lubrication, and so if you're on birth control for a long period of time, it takes you down lower when it comes to your hormones. So you can experience dryness, you can experience pain with sex. Your clitterest and the vagina can atrophy a bit because when you're taking birth control, it's almost like you go into this temporary menopause. Right, you're not able to get pregnant right, you're not ovulating right. So it's similar to menopause, and one thing that that happens in menopause is that the vagina can send out and that makes it more likely that sex is going to be painful because there's less cushion right, the tissue is not as juicy, for lack of a better medical term, and so that is something that we don't talk about enough. Our VOLVA health, our clitteral health. You know that stuff is really important is the clitterest. there. clteral atrophy is the thing, and it happens to people not just that are older, it happens to younger people too. So yes, birth control can impact our vaginal health. It also can change the Ph balance, so it can predispose you to more yeast infections. So if you're noticing those changes and you weren't having them before birth control, then you can consider talking to your doctor about other options. But if you're on birth control and you're not noticing any issues with sexual function, cltural health, public for health, then by no means don't worry and go out fearing, but it definitely impacts our health because it impacts our Mormons. Got It. So what questions would you suggest we be talking with our physicians or health care practitioners in our yearly kind of vaginal wellness checkups? What kinds of question should we be asking? I think we should be asking why are we in pain? Okay, so a lot of us have five woids, a lot of us have painful periods, a lot of us have painful sex and if the doctument is not able to answer why you're in pain, it's okay. Doctors don't know everything, but can they do more testing? Can they do maybe an endometrio biopsy? Can they do a public ultra sound? Can they refer you to a public physical therapist if you have sexual pay, if you have painful periods and you're taking birth control? Okay, that's impacting your symptoms and that's helping you to tolerate your periods better. But your period should not feel like you're having a baby. It should not be like you're taking off from work, you're curled up in a ball, you're vomiting. Can we do more testing? Can we test my hormones? Can you refer me to a Dietitian? There's so many things that we can ask. No, I would say don't settle for that easy answer of Oh, let's just watch it or let's just see if things don't get worse. No, you don't want to wait until things get worse. You want to achieve wellness now if you can. So those are a few questions that I would recommend. And definitely looking into your nutrients. So vitamin D deficiency is so kind and it's related to period paint, it's related to our associated with fibroids, it's associated with sexual dysfunction. Vitamin B as in boy, that's really important. Your iron levels. A lot of US grew up anemic. We don't like taking our iron bills. We're like, I am not swallowing that thing. Since take your iron please. It's gonna help you so much, even with your fertility and all of that. So get those hormones and get those nutrients tested. I have to advocate for my own self and say I want you to check my vitamin B, I want you to check my vitamin B as. And boy, sometimes you gotta ask, and nothing's wrong with that. They should be open and we wanted to join that. MM HMMM. So you've already talked a little bit about foods that you know are related to our vaginal in sexual health. What kinds of foods do we need to eat more of our consumeless of related to wellness, related to have Regina in sexual health? Okay, so I'll start with what we should likely try and at least manage our limits, and I'm gonna Start with sugary stuff, because sugar can change our hormonal balance. It can lead to increase estrogen levels. If we're having too much sugar in the Diet, that can increase our insulin, which can then increase our estrogen. And if we have something called polycystic Ovarian Syndrome, which is pcos number one cause of infertility, that is like at the core of really getting on top of your condition, managing your blood sugar and managing your insulin resistance. So decreasing the amounts of sugar nutrient. And you know nutritionists, they recommend no more than twenty six grams of sugar per day. Y'All, one Latte as starbucks can have as much as sixty grams of sugar in it. That listen, starbucks doesn't care about your womb, doesn't care about your vagina, doesn't care about your Ministrul tycle so look at how much sugar you're having. You don't have to get rid of it completely. Sometimes it's just okay, I don't need this solda today, or maybe I don't need five cocks. Maybe I'm just gonna have one. So sometimes the just so smaller changes. And then next thing I would say is inflammatory foods. These are gonna be your processed foods. These are gonna be processed meats like sausage, bacon, Burgers, things that are heavily fried. That's gonna lead to more inflammation in the body around the ovaries near the uterus. All of that and if we want to start nourishing a healthier vagina, especially when it comes to our vaginal Ph we don't want to have an inflammatory environment. That's also something that can lead to vaginal dryness. So your body sets up these mechanisms that tries to protect you. It's like, okay, if there's already a lot of inflammation in the body, we don't want a penuts coming in here, we don't want a sex toy coming in here, so let's make it as dry as possible. And so that's your body actually trying to protect you. You might notice that if you change up your diet a bit, making sure you're still getting enough food, enough calories, but you're changing the type of foods, you ain't noticed more vaginal lubrication, other things that I talked about in my vagina food egot is getting enough fats. So our hormones are made from fat. So if you're not getting enough foods, let's say olive oil or Avocados, are nuts. Um, yogurt is a great source unsweet and Greek yogurt great source of fat. That helps us to make estrogen and make the hormones that support our sex drives, support our menstrual cycle, support our fertility. So I would start there by saying, okay, what am I eating that's inflaming my body? Can I decrease that. And what can I eat? More of that? Comes from the earth? Does it come from a tree? Does it come from the ground? EAT IT, eat more of it, and you don't have to be vegetarian or Vegan. I'm not vegetarian or Vegan, but just saying, okay, today I'm gonna try and get plant based protein for one meal out of the day. Instead of getting my chicken or my beef, I'm gonna get black beings, or maybe I'm gonna get toad food, or maybe I'm gonna get it even a protein shape that may have plant based protein. So there are several things that we can do to just improve our vaginal health when it comes to food. There was a really huge study that came out recently and they looked at thousands of women that were trying to get pregnant, but they weren't ovulating. So if you're not ovulating, you're not dropping that egg, you're not gonna get pregnant. What they found is that when women substituted animal protein for plant based protein, they had a fifty percent higher chance of populating. So again, it doesn't mean that you have to go vegan and starting brass, but can you substitute every now and then the meat for plant based protein, and I talked about that as well in my vagina food egot different forms of protein that are not meat, because I think we grow up thinking protein is only meat, but meat does not equal protein and protein does not equal meat. Protein is found in a lot of plant foods. Now, is there anything we can eat that will increase our iron intakes so we do not have to swallow the big iron heels? You are really, really funny. This is a great question. I'm gonna tell you about three foods that I think it would be great, but before that I just want to say liquid iron is a great way to get your iron in a way that doesn't make you nauseous, doesn't make you constipated. Chase it down with some apple juice or some water or whatever. That's a great way to get your ironing because most of the time foods are just not gonna have enough iron and one serving when you're low on iron. But Spinach is packed and iron. It's a great source of iron. Black strap molasses, that's a good source of iron. Again, not the tastiest thing, but you guys, iron is a mineral. It's not gonna be very tasty. Tasty. Yeah, imagine eating metal. I mean, if you eat metal, it's not gonna taste just start chopping on metal, it's not gonna taste very good. Beats are great source of iron, but also nitric oxide, and we need that to expand the blood vest, which is needed for sexual function, arousal lubrication. This overall general help, even for exercise and high blood pressure. So beat, beat, juice, spinach, get your grain smoothies in and yeah, just take your eyes and stuff with me, no way around it. So this has been so much fun. Dr How so much great information. Tell us where we can stay connected with you. What is your website, as well as any social media handles you'd like to share? Yeah, so my website is Vagina Rehab doctor. Everything lower case Vagina Rehab doctor. There you can contact me if you want one on one consults, and I also keep you updating on upcoming bad stretch labs, bad strength labs and my master classes on my website. Then mainly and primarily, I'm on instagram. That's my main way of just stay in contact with the world and entertaining my own self with reels and different things. So I'm Vagina Rehab doctor on Instagram and on Tiktok. If you send me a message on Instagram, I may not see it in time, but you can send me an email if you have any questions. Vagina Rehab doctor at Gmail Dot Com, and those are the main ways that you can find me. So what do you have coming up that we should know about? I know you do lots of fun classes and things. What do you have coming up for us? Yeah, so my next virtual masterclasses on October second and it's a vaginal fitness masterclass, and so in this class it's gonna be virtually recorded. If you can't make it, it's recorded and sent to everyone. The name of this masterclass is things your Mama couldn't say about your PA China, and a lot of what you couldn't say was that, you know, thinking about sex is healthy and it's normal. So in this class I'm gonna be teaching you how to support your sex drive, in your libido, with foods, with understanding it better how it works, and also exercises. Were also gonna be talking about how to do a self internal HELV explore exam, so how to check the inside of a vagina for strength, weakness, tension, pain, core nation and then we're gonna end the class with colors for fitness exercises to better support you with sports and sexual activity. So that's on October two and you can find more information about that also on my website. Perfectly. We will be sure to include all of that in the show notes. Thank you so much. Like to how I appreciate it. I'm so glad Dr how was able to share her expertise with us today. To learn more about her and her work and the classes she has coming up, visit the show notes at therapy for black girls dot com, slash session to seventy six, and don't forget to text two of your girls and tell them to check out the episode right now. If you're looking for a therapist in your area, check out our therapist directory at therapy for black girls dot com, slash directory. And if you want to continue digging into this topic or just be in community with other sisters, come on over and join us in the sister circle. It's our cozy corner of the Internet designed just for Black Women. You can join us at community dot therapy for black girls dot com. This episode was produced by Frieda Lucas and Alice Ellis, and editing was done by Dennis and Bradford. Thank you all so much for joining me again this week. I look forward to continue in this conversation with you all real soon. Take good care.