hot flash inc: the vagina coach wants you to know that peeing when you laugh is not 'part of being a woman'
kim vopni, host of the new podcast between two lips, wants people with a vagina to know that your pelvic floor deserves special attention.
5 minute read
there is so much suffering associated with the pelvic floor and it doesn't have to be that way, says kim vopni. getty
vancouver-based kim vopni is a busy woman and she’s got one thing on her mind: your pelvic floor, which is actually the title of her 2021 book. also widely known as the vagina coach, vopni is all about helping women in perimenopause and menopause — and all the other stages of life too — change their lives by taking charge of their pelvic health. the founder of pelvienne wellness and the buff muff app is about to launch a new podcast and the name is everything it should be: between two lips.
what’s the number one thing you want women to know about their pelvic floor?
it deserves care and attention. we never really learn about the pelvic floor and it’s not until something is going wrong that we understand how interconnected it is to everything in our life. it manages our continence, it supports our internal organs, it supports our spine and pelvis, it plays a role in our sexual response, which are all super important, so why are we never told about this and how to keep everything working optimally? the number one thing i tell women is to add a pelvic floor physical therapist to your health-care team and see them once a year even if you have no symptoms. we have been conditioned to go to the dentist once or twice a year even if we don’t have a toothache. we should be doing the same thing with our pelvic health. there is so much suffering associated with the pelvic floor and it doesn’t have to be that way.
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what about all the products out there to help with urinary incontinence?
media is selling us pads and there are many different incontinence underwear companies now too. while these products can be helpful, i want women to know they are band-aids and should be viewed as temporary support while they seek treatment to actually fix the problem. there may be some people who do not want to do the work or make the changes who continue to wear pads or incontinence underwear and that is an informed choice. my issue is that they are presented to us to help manage a problem that is ‘normal.’
what are the different types of incontinence?
stress urinary incontinence (sui) is the most common and is the one that the pad companies like to say is ‘just part of being a woman.’ i disagree 1,000 per cent! it is not just part of being a woman or normal part of aging or something to just accept because you have had kids. sui occurs when little bits of urine leak out with some form of exertion, like a cough or jump or even standing up from a chair. the pelvic floor muscles play a role in closing off the sphincters when we don’t want pee to come out and then also relaxing when we do want pee to come out. the muscles need to react at the right time with the right amount of force so we need exercises that help retrain the timing, while also building strength and endurance.
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urge urinary incontinence (uui) is when there is a trigger that makes the bladder signal that you strongly and urgently to get to a bathroom. it can happen with very little urine in the bladder and can result in a few leaks or a complete release of the bladder. uui responds well to bladder training, dietary changes and also behaviour modification. many people who have incontinence and are afraid of leaking or are afraid of not being near a bathroom will often pee ‘just in case.’ this seems logical but can then train the bladder to signal more often. now they are also dealing with urinary frequency and have not addressed the root cause of why they were leaking or dealing with urgency. pelvic floor exercise, removing bladder irritants and using a bladder diary to undo the unhelpful behaviours is simple and effective, yet most simply are not told.
what do you think we get wrong about this part of our bodies?
i think we have just never been given the tools or told the importance of this group of muscles called the pelvic floor. pelvic health screening should be treated like vital signs when we see our care providers. we should be asked questions like: do you experience any strong and overwhelming urges to pee?; do you leak when you laugh, cough or sneeze? how many times a day do you pee? do you have a bowel movement every day? do you strain? do you have any pain with sex? do you have any burning or itching? these questions don’t take much time and can help screen for issues before they become bigger problems. women wait on average six to seven years before seeking help for a pelvic floor problem — sometimes because they are too embarrassed to ask, but sometimes it is because they don’t want to embarrass their care provider. when they do finally seek help they are either told to ‘go home and do your kegels,’ given a medication, or referred to a surgeon.
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do you see changes in women in other areas of their lives when they resolve these issues?
absolutely. the pelvic floor is involved in so many aspects of our daily life and when it is working optimally, we don’t even think about it. but when things are going awry, it becomes the only thing we think about. it is a constant worry, a distraction, a bother and it takes away focus that could be given to our work, our family, our friends, our fitness. when people address their pelvic floor challenges, they get their life back. when they improve their pelvic health they can ditch the incontinence pads that will cost them between $25,000 to $70,000 over a lifetime, they can exercise with more freedom, eliminate back pain, experience more pleasure, poop better, say yes to social outings — i could go on. improving your pelvic health is life-changing.
ann marie mcqueen is a journalist with 25 years of experience covering health, wellness, science and more, and when she realized she was in perimenopause five years ago, she decided to make this transition her beat. she has since become a global expert on the subject through her platform hotflash inc, where she helps people navigate the gap between medical and holistic treatments with evidence and experience-based research. she will be writing regularly on all things related to menopause and mid-life.
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