Pelvic Floor Myths and Real Sexual Health Fixes with Dr. Rena Malik

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So good, so good, so good.

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It's crazy to me that vaginal estrogen's not just a standard of care now. Like, why is that not a thing?

It's crazy. I feel like it should be in the water. Like, I'm not even joking. It should just be like everyone should have it. It is extremely safe. There's never been a blood clot. There's never been a stroke, never been a heart attack with vaginal estrogen.

Today we're cutting through the noise with Dr. Rena Malik. She is a board-certified urologist and one of the internet's sharpest mythbusters. Her YouTube channel has racked up over 300 million views and 2 million subscribers, and Men's Health named her a top 10 health influencer. And you've seen her everywhere from Scientific American to Huberman Lab to Mel Robbins. We're talking real-world fixes for pelvic floor dysfunction, bladder health, sexual health, and menopause care. Evidence first, zero shame. How often should someone have orgasms to have a great pelvic floor?

I mean, so there's no good data on this, but I would say at the very minimum Hey, I'm JJ Virgin, PhD dropout—

sorry, mom— turned 4-time New York Times bestselling author. As a certified nutrition specialist, Fitness Hall of Famer, and globally recognized leader in health, I'm driven to keep asking the tough questions and use my podcast to simplify the science of health into actionable strategies that help you thrive. Want an ad-free experience? You can now subscribe to my exclusive exclusive VIP podcast at subscribe2jj.com for just $4.99 a month or $49.99 a year. It's like your daily latte, but better for your health. I'd also love to hear your thoughts on the show. And here's the fun part. When you send me your review, I'll reply to you using my on-demand virtual me. That's right. My team and I created a virtual JJ packed with my books, speeches, and wisdom so I can personally connect with you. Here's how you do it. Subscribe and leave an honest review of the podcast. Take a screenshot of your review. Text it to 813-565-2627. That's 813-565-2627. My virtual JJ Virgin will reply directly. And trust me, This will make your day. So subscribe now at SubscribeToJJ.com and text me your review. Let's keep thriving together. Dr. Rena Malik, I've been waiting a long time to interview you. I'm so happy you're here.

I'm so happy to be here. Thank you for having me.

I would love to dive in. So funny fact, I was in a room where a gal was doing a talk about pelvic floor and the room was mainly men. And these men, I kid you not, were unaware they had a pelvic floor. So it was a pretty fun, funny, uh, conversation. But I think in general, people don't really know what their pelvic floor is, what it does. So I'd love to start the conversation with that.

So yeah, you are absolutely right. Most men don't know that they have a pelvic floor or don't think about it. And to be honest, like, why would they, right? No one's ever taught them. And so the pelvic floor is essentially this bowl of muscles that sits in our pelvis that holds up all our organs, but it's also connected to our abdominal muscles, our back muscles. And so it's actually part of the core. And it is so important for a variety of different functions. But for most people, what they notice is when it becomes dysfunctional, they might have issues with urination, with having bowel movements, with sex. So they might have difficulty, pain with sex, they may notice their orgasms are less intense, they may notice they're having less sort of ejaculate volume. And so, you know, ultimately, it is sort of, you know, a really important structure. And it's something that you can have dysfunction in. So it can get weak over time, or it can become sort of dysfunctional, like really tight and not relaxed when it should. And so it can create a lot of different problems. And the problem is that most people don't even really know how to evaluate it, and then how to treat it if something is wrong.

So how common are issues with pelvic floor, with pelvic floor dysfunction, I guess you call it? Is it something that happens with age, childbirth? Like what, what makes this happen? And how common is it both with men and women?

Well, so in general, pelvic floor weakness, you can either get weak or it can get tight, right, and dysfunctional. So when it's weak, that usually happens when— definitely in women after childbirth, which is probably the most common notice of it. People will know, women will say, oh, I leak a little out and I cough or sneeze or jump on the trampoline. But it can also become weak if you have genetic disorders. So like if you have neurologic conditions like Ehlers-Danlos, or you have anything that affects the nerves, multiple sclerosis, that can cause the pelvic floor to be weak. It can be weak because you stand a lot, or you do a lot of heavy lifting, or you do a lot of like CrossFit or high-intensity interval training where you're putting a lot of pressure on the pelvic floor over time.

Those are—

if you have a chronic cough, that's another way that it can become weak because you're constantly straining against your pelvic floor. Anything you do that sort of increases abdominal pressure, that will increase pelvic floor pressure, and over time that can cause weakness. Now, women more often see the issues of weakness, so they'll see the leakage. They'll also potentially see pelvic organ prolapse, so the organs in the pelvis can sort of start dropping down. The vagina can essentially herniate, and it can create sort of a feeling like something's coming down or a bulge. And it can be very, very bothersome for a lot of women, and they sort of like are freaking out, like, what's going on? And this is just sort of a normal variant of pelvic floor weakness, and it's not normal to have it happen, and you can do something about it, which I think is really important. With men, occasionally— and this is not very common— but they get what's called rectal prolapse. So they'll actually be straining and pushing so hard all the time. And it could also happen with constipation. And now they'll actually start seeing some rectum come out of the anus. And then with tightness, when it's overtight, I like to think of it like TMJ dysfunction, right? People get TMJ, they clench their jaw, they grind their teeth at night. They don't really know they're doing it, but they wake up with headaches and that area is tense all the time. And so it creates dysfunction. Very similarly, your pelvic floor can get tight or tense. And when it's tight or tense, it essentially can create all these issues where now your organs are sitting on this structure that's supposed to be relaxed. And so it can make sort of your organs act differently. So it can cause urgency, like you've got to go, got to go to the bathroom. It can cause frequency. It can also sometimes make it difficult to pee if it's too tight because it's not relaxing when you pee or when you poop. So you might have constipation or you might have trouble emptying your bowels. And then also you can imagine that when your muscle's tight all the time, one, it, it can be painful. So it can cause pain in the, in the structures themselves. You can have lower back pain, you could have pain in your pelvis, and you could have pain with orgasm or pain with erection or pain with ejaculation. Anything that's sort of even attached to it that becomes dysfunctional. So sometimes people have hip problems or they'll have back problems, and that can actually sort of destabilize the pelvic floor and then create dysfunction. So it can happen to a lot of people and it can create a wide variety of problems. That, you know, can be addressed and can be treated, but are often sort of overlooked.

Yeah. I mean, as I'm listening to this, first of all, I'm thinking about a lot of these different, different symptoms, which tend to get pushed off as something else, everything from constipation to erectile dysfunction, right?

Mm-hmm.

You talked about it getting loose or weak, and that makes a lot of sense. What would make someone have tight pelvic floor muscles?

So oftentimes it is due to trauma, to people who you think of, like the very anxious person, the person who is a Type A personality, they're sort of clenching down, right? So that can happen if you've had surgery or other issues down there. Sometimes your pelvic floor responds by being too tense. If you've had birth trauma, again, sometimes it responds by being too tense. A lot of things that women do and even like behaviors that men do can lead to some dysfunction. So like if you're always hovering over the toilet, it's like sitting and relaxing, that can create some dysfunction. There's different things that you can do if you're sitting all the time and you're not moving around. You're not standing, you're not walking around. We actually saw a huge surge in pelvic floor dysfunction during COVID because we were sitting all day, and so they weren't getting good blood flow to the tissues, and the tissues then responded by getting tense and dysfunctional.

It feels like to me— and I will tell you, I had another gal, Kim Vopni, was on the podcast, and she was talking about pelvic floor, and I thought, how have I gotten to 62, had 2 babies, a hysterectomy, was an exercise physiologist, you know, all the way up through PhD work and really never dove into any of this. And no one along the way, and this is what was really frustrating, after 2 babies and after a hysterectomy, no one ever suggested going to a pelvic floor therapist, having a pelvic floor exam. It just feels like this is this forgotten area that we don't talk about. What, am I right on this? What's going on?

Totally. I mean, one is like, I think there's not enough training. So like I learned about the pelvic floor because I did a fellowship where I treated, you know, women who had pelvic floor dysfunction, and then started noticing the parallels between men as I started seeing my clinic who also came in with pelvic, you know, with— on their exam, I would notice that their pelvic floors were tight. And then sort of being curious and understanding the basics of the pelvic floor helped me figure that out. But a lot of people are not taught, right? So that's one thing. And two, we don't have an abundance of pelvic floor physical therapists who are like the, the people who really help us fix these issues. And, and they— there's not enough. There's some, and they're being trained, and they're learning about the pelvic floor. But I think even like 20 years ago, it would be very difficult to find someone who truly understood how to relax the pelvic floor. It was always like, do Kegels tighten the pelvic floor, which is actually harmful. So I'll find people who are like having trouble, and they'll start doing Kegels, and they're actually even worsening their condition because you're tightening an already tight muscle instead of relaxing it. And so it's hard sometimes for the average person to tell, is their muscle tight or is it weak? You can only sort of go on symptoms. But that's why you sort of need a professional who can help guide you.

Well, and these, uh, so many of these symptoms, you would never put two and two together. So that's the other challenge. And to be honest, going to a pelvic floor therapist for an exam is not the most fun thing ever, especially, you know, bad enough for a woman. But when I went to one, I went, oh, I should really have my husband in here. How am I going to talk him into this? So can we talk about how you get diagnosed for having some kind of an issue here?

Yeah, so for females, it's a pelvic exam.

So it's not a cervical exam, you know, you don't need like a big speculum looking at your cervix. That's for the purposes of cervical cancer screening, which is very important. But when I do an exam, I don't do that. I am looking first at the pelvic floor muscles. So it'll be looking at observing, making sure they're contracting and relaxing the way they should. So what I would expect is when someone bears down or coughs, that I see actual movement in their pelvic floor that shows relaxation and then tightening and then relaxation. And so that sometimes is dysfunctional. And then there's a physical exam where we'll actually feel the muscles. So is there tension? Is there pain in any of the muscles? That's so basically feeling inside the vagina where the different muscles are. And then there can be like, usually I'll use half a speculum just so I can look at the inside walls and see how they move. So when I have a female bear down or push out, I'm seeing, is there any descent or is there any herniation of the vagina that's noticeable? Or are things not moving at all? And that sort of helps me decide.

And so basically, based on that, you can often feel feel, right?

As a clinician, I can feel that the muscles are tense or tight, and they're not relaxing as they should. And then for a man, there's no vagina, obviously. So you're doing a rectal exam to feel those muscles. And I tell people, like, I think for women, they've been told, at least to some degree, that a pelvic exam shouldn't hurt. But I think for men, like, most guys don't talk about it, but a rectal exam should— it shouldn't hurt. It might be uncomfortable slightly, you feel pressure, but it shouldn't painful. And so if it is, that might be a sign that you have some pelvic floor dysfunction.

The other thing that struck me as I was going through this process is a lot of what I learned in graduate school way back when on proper form and exercise and what you do with your abdominals actually was creating a problem. Yeah. I'm hoping some of that shifted, but I don't think so based on just even some of the, you know, exercise prescription I see out on YouTube is it seems like that we're still being taught things that seem incorrect about neutral spine and, you know, sucking in your deep abs, things that would make this worse, not better. And you talked about Kegels being problematic, 'cause it sounds like for a lot of people, if it's too tight, you're just making it worse. Are we actually creating more of a problem with a lot of these things we're doing? And it could be anything from yoga to Pilates to weight training.

Well, I think that the key is using your muscles in a functional way. So if you're contracting and relaxing your muscle, like you're doing with an ab workout, out, as long as you're relaxing and you're breathing appropriately, meaning you're exhaling on exertion, you shouldn't create harm. But what happens is a lot of people are not doing that, right? They're clenching those muscles and they're not actually relaxing, or they're holding their breath the whole time. And so that's where the problems come in, right? We want to strengthen these muscles and they should be strengthened, obviously, but you want to strengthen them in the right way. It's just like if you're doing a deadlift, you don't want to hold your breath, or you're doing any sort of exercise. You're always told, even from, you know, physical PE when you're a kid, like you don't hold your breath. And there's a reason for that, because that creates dysfunction. When you hold your breath, you're actually letting your pelvic floor relax, and when you need it to actually stabilize and hold things in place, right, and help stabilize you during a movement. And so absolutely you can harm yourself, but I think again, it's like you just need to be doing the movement in a way— such a way that's functional, that feels good, and you're also breathing, right? It shouldn't be like, oh my God, I feel so uncomfortable, my trainer is telling me to do this, right? Like, it should feel like adding tension, but it shouldn't be like painful and like you're holding your breath and you're, you know, doing all these things.

So for someone who wants to, you know, train their pelvic floor, work on their pelvic floor, is the first step really that you should get a diagnosis, an exam, or is this something you could do without doing that?

So you can sort of self-evaluate. So the way to do that would be sort of feeling in your perineum and feeling those muscles, sort of understanding like, okay, take a deep breath, breath, see how those muscles move. And you can feel tension, right? We can feel tension in our own muscles, right? When we do, like, you feel your shoulder feels tense, my muscle feels tense, you can sort of feel tension. So what that can help you assess, like, okay, is it really tight or uncomfortable? Are the muscles feeling tense? For a female, they can actually feel inside the vagina, right? And they can see, like, okay, shouldn't hurt when something enters the vagina, right? That's a really big red flag. Like, why is it hurting? Is it like— very often it's because the pelvic floor is not relaxed thing. And obviously there's other things like you may— if you were to have sex and it hurts, it could be that you're not aroused enough, you're not lubricated enough, and those are separate issues and should be obviously addressed. But sometimes it really is the pelvic floor muscles are not relaxed. So sex has never been pain-free for you, that's a big red flag. And then I think just like knowing like, okay, if you are someone who already struggles with maybe TMJ dysfunction, or you have a lot of anxiety or a lot of stress, I would probably not do Kegels, and I would start working on relaxation exercises. So I would Google pelvic floor down training or pelvic floor relaxation exercises and work on those rather than focusing on tightening and strengthening.

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And for women 50-plus, say, going through menopause, postmenopausal, are there things that shift from hormones shifting, or does that not impact this? Absolutely.

So there's estrogen receptors all entire the vulva, on the pelvic floor muscles, and in the bladder. And so what happens is the lack of estrogen also contributes to sort of ongoing weakness, and it also contributes to some of that overactivity in the bladder. So the urgency frequency that women start to develop after menopause and even recurrent UTIs. So a lot of women will start having recurrent urinary tract infections, and the source is the lack of estrogen because estrogen keeps the vagina in a low acidic pH. And as soon as you lose that estrogen, it starts— you start losing that protection of the acidic environment. And so you get at high risk for recurrent UTIs. So a lot of times supplementing with vaginal estrogen can help with some of the things. They're not going to strengthen your pelvic floor muscles, but it will sort of help with some of that urgency, that frequency. It will absolutely prevent recurrent UTIs, and it will absolutely prevent you from having atrophy or thinning, which can cause dryness or discomfort. And so it can— and it can help restore lubrication during sex. So I think ultimately it's a great way to sort of keep things optimized. But the pelvic floor muscles, yeah, they are— they— you're working against sort of the lack of estrogen. And as of now, there's no good data that like supplementing estrogen either systemically or vaginally is going to help strengthen those. You still have to sort of do the actual physical exercises, but it will prevent sort of the decline.

Yeah, I mean, it's just like your muscles. When your estrogen goes down, you're not recovering as well. It's not as anabolic. So it seems like the same it's crazy to me that vaginal estrogen is not just a standard of care now. Like, women are going on HRT and they're not doing this. Crazy.

It's crazy. Why is that not a thing?

I feel like it should be in the water. Like, I'm not even joking. It should just be like everyone should have it. It is so safe unless you have active breast cancer. That is really the only contraindication. Um, if you don't have active breast cancer, you can take vaginal estrogen. Um, even if you've had breast cancer in the past, even if you have family history, there's— it's it's just very locally absorbed. Like, yes, some of it gets systemically absorbed, but it is such a drop in the bucket, especially if you're completely postmenopausal and you have like no estrogen around. It's not getting very systemically absorbed. So it's extremely safe. There's never been a blood clot. There's never been a stroke, never been a heart attack with vaginal estrogen. And so it's super safe. And I think there's just been this like— and we're actually there, we're trying to, you know, petition the FDA to take off the black box warning because they applied this big black box warning. To estrogen as a whole, and it also got applied to vaginal estrogen. And so, you know, we're trying as clinicians who take care of patients to get rid of that.

I thought that got taken off. It still hasn't gotten taken off?

No, it is still there, and we are working on getting it removed. But very recently, the testosterone black box warning for men was removed. So, of course, of course, that went first. Typical fashion. I mean, I'm glad it did, but in typical fashion, we are lagging behind.

Okay, well, that's frustrating. I mean, this whole thing It seems like, and I know I've heard in different countries that you give birth and then you have a series of pelvic floor therapy sessions. It seems like a pelvic floor exam should be part of your overall exam when you go to the gynecologist. It should be. It absolutely should be.

And you know, in France, for example, all women after giving birth see a pelvic floor physical therapist, but it's a much smaller country. And so it's able to do that. And like, I think we would protect so many people from ongoing issues if they just had the education and the examination, because I think, you know, especially when we were growing up, like there was a lot of like sucking your gut all the time and cross your legs all the time. And all those sort of behaviors were actually very dysfunctional for your pelvic floor.

Well, that's, I mean, that's a lot of what I was learned. I was paying my way through graduate school and teaching aerobics and doing personal training. And a lot of the stuff we were taught to teach back then, I was like, I was in biomechanics. I go, this does not make sense. And I think now a lot of that was doing the exact difference where they'd say, neutral spine and want you to actually kind of get into flexion, I go, that couldn't have possibly been good. You know, and everything was belly button to spine. I'm like, this couldn't possibly be the smart thing to do with all of the things you're doing. So it makes it tough.

Right, it's like you can do it for a second, but not for like the whole class, right? And I think really like the other thing is like, people tend to just push through. Like they'll be like, it hurts, but I'm gonna keep going. And it's like, use your brain, like use your body as a guide. Force yourself if something doesn't feel right. Like, you are a smart person, and you're not less than because you're not doing something that maybe you're in a class or whatever everyone else seems to be doing. If it's hurting you, like, stop for a minute and figure out why. And maybe you're doing something where the form is off or whatever, but, but don't do that. Try something else.

Love it. The only way your body can tell you. So it sounds like one of the big symptoms of pelvic floor dysfunction is our issues with sex. On the men's side, it can be erectile dysfunction, and, and I think probably they're in even worse shape than us in terms of not hearing about this whatsoever. How big of a problem is pelvic floor dysfunction for men with erectile dysfunction? I think it's definitely an issue.

I think it's probably more common in younger guys because as men age, they tend to develop more comorbid conditions, right? They're high cholesterol, high blood pressure, diabetes, and those are then affecting the blood flow to the penis as well. And they can have those issues, but those are also, you know, concomitant issues. But when we see younger guys who are really struggling, often it's because of a pelvic floor issue, because they don't usually have the health conditions and the other risk factors like low testosterone or whatever that might affect their erections. And so we're finding, like, if you really, you know, probe a little deeper, they're walking around with a tight pelvic floor and they didn't know it.

So how does someone know if they, if they have things that they could solve with doing some home exercise or working with the physical therapist versus you need to have surgery?

Well, so that's very individual and difficult to sort of parse out specifically, but I think it depends on the individual condition, right? So for example, for things like incontinence and prolapse, those things can often be treated with lifestyle changes and pelvic floor physical therapy. However, if you fail those things, then we move on to more invasive, maybe medications or procedures. And generally speaking, I think it's always very reasonable to try pelvic floor physical therapy or exercises first and try lifestyle changes before you proceed with any sort of surgical intervention.

So what I would love to have are some practical things, like some pelvic floor happiness every day. So some of the mistakes we're making that could be creating pelvic floor dysfunction, that tightness, or the weakness, and then some of the things that you could do. So first of all, some of the things you might be doing every day, not meaning to, that are creating a problem.

Yeah, so I mentioned this some earlier. So one is like hovering over the toilet. So a lot of people, like for women especially, because they don't want to sit on the toilet, they will hover. You're not allowing your pelvic floor to relax, and so then you're basically peeing against a tight pelvic floor, and you may not empty your bladder completely. You then create dysfunction because your brain starts sort starts like making connections that it's okay to pee like that. And so that's a problem. When you— if you're constipated, a lot of people live with constipation and they just like live with it, like, oh, whatever, it's hard, it sucks. But like, honestly, it is wrecking— it is wrecking your pelvic floor because you are constantly pushing against that pelvic floor and you're doing all these crazy things to try to get stool out. So I love a Squatty Potty, basically like a stool that you can put your feet on. It actually helps you get in the right position to help stool evacuate. And so that's great. And then adding fiber. I really feel like fiber is so important to help you have regular bowel movements. And if you're still struggling, then talk to your doctor about options to help you alleviate constipation, not just for the short term, but like for the long haul. Because I think that's— who lives with that?

Like, who? How? One day of that, I'm angry.

Oh my God. I can't tell you how many patients are like, yeah, I have it. Yeah, I live with it. Yeah, I'm used to it. I've had it for my whole life. I've had it for decades. Like, it is is insane to me that people will just accept it and be like, okay, so that's a big one. Another one is sitting all day. Make sure you're moving your body, like make sure you are walking, get a standing desk if you have to be at a desk all day. Make sure you're just moving, make sure you're breathing. I think diaphragmatic breathing, yoga can be helpful in general for strengthening and just because it really incorporates breathwork. So if you want to do, you know, movement, mindfulness and breathwork, so all those things together are great for your body. And then, you know, in general, just go through normal ranges of function all the time. Like, you should be doing things and straining your body to some degree, like in different movements and different positions. It's good for you to get blood flow down there. And the last thing I would add is, is pay attention to your sexual health. So if you are a man or a woman, having orgasms is great for your pelvic floor because it's allowing it to move, it's allowing it to have contractions, regular contractions. It actually may even contribute great to strengthening your pelvic floor. So I think including that in terms of like, you know, what helps you get orgasms, vibration can help get blood flow to the pelvic floor muscles. There's a whole bunch of things. But like, look, it's good for your health. It's good for your body. It makes you feel good. Like, please do it.

Yeah, darn it. That's a prescription. How often should someone have orgasms to have a great pelvic floor?

I mean, so there's no good data on this. But at the very minimum, I would argue like by yourself or with a partner once, at least once a week is, is good to aim for at the minimum.

Okay, so minimum effective dose, probably more is better. Perfect. Yeah, I know you have some tips on sexual health. Tell us about what you're giving us, and I'm gonna put this at JJVirgin.com/DrRena. Dr. Rena, my tips—

I have my top 10 tips for more pleasure, and I think this is so important, right? Because when you have more pleasurable sex, you want to have that sex, right? And I think a lot of times we treat sex as a chore, like something to do, and we just keep doing it the same way every time. And it becomes stale and routine. And like, yeah, it's comforting, but sometimes you just need a little bit of excitement, a little bit of novelty. And so I'm giving you my top 10 tips for enhancing pleasure in the bedroom with your partner, even by yourself, and really just going back to looking at sex as something fun, playful, and to enhance pleasure in your life.

Well, and you talked about how fixing pelvic floor dysfunction— I'm not going to say strengthening because it might be relaxing it, or it might be strengthening it— can help with better sex. How— if someone's— someone starts to work on the pelvic floor, how quickly can you start to notice differences, say, with things like peeing and constipation and sex?

Depends on your base baseline, right? Like if you're completely normal, you're just working on strengthening for overall health, you might start seeing, just like you would go to the gym, right? You're going to see incremental benefits over time. It may take a month to see the beginnings of it. It might take 3 months before you notice really big improvements. But I think that you should be seeing like slow, gradual improvements and everyone's going to be different. But ultimately what you can, when you have a normal, healthy functioning pelvic floor, that means that you are urinating without without problem, you are having bowel movements without problem, you are not having pain, and you are having strong, intense orgasms. And for men, you are having strong ejaculate volumes that are, you know, propelling at a, you know, not dripping out, they're sort of propelling at a normal force. And so that's sort of what we're looking for when you have a normal, healthy pelvic floor. I love everything you've been doing.

So it's really, I feel like this is the silent epidemic that everyone's ignoring, and this message out here of like making this not taboo and don't ignore your pelvic floor. And if someone's working on their pelvic floor, does this— is this something that you basically kind of got to work on every day? It sounds like it, just with some of the habits and things.

Jane, it doesn't need to be every day. You need to give yourself rest, right? So you want to balance sort of relaxation with strengthening. I think everyone should have some relaxation exercises. So that could be like happy baby pose, child's pose, like a figure four stretch, diaphragmatic breathing. I think those, you know, should be incorporated regularly. And then strengthening, it doesn't have to be every day, but like whatever approachable for you. But like, I'd say 3 times a week at a minimum, like trying to incorporate some sort of pelvic floor exercise.

That is very doable. So are the things that we do every day. And, and what I, I always notice is those things that help with one thing in health tend to help with everything in health. So they do, they do. I'm going to put a link to your YouTube channel, which is just fantastic, all of that at jjvirgin.com/drreena. And again, thank you for everything that you're doing doing, because this is like such important information, and I don't want other people to have to wait till they're 62 to find it.

Well, thank you so much for having me, and I really appreciate you.

What you probably noticed from listening to all this is that your body has been whispering to you for years with painful sex, bladder leaks, maybe some constipation. Remember, that's not weakness, that's feedback. And today you learned the my book, you can shift your pelvic floor health 3 days a week and then just doing some simple things every single day, like moving more often, right? Changing your bathroom habits, getting that Squatty Potty. So you don't need to be perfect here, but you need to start doing something. So today, pick something, pick one thing and do it before you go to bed. Then tomorrow, add the next thing and just stack these great habits up. Maybe even go see a a physical floor therapist, a pelvic floor therapist like I did, made a huge shift. Get that exam and you're going to start to feel like you can own your body again. That's the win and you deserve it. Be sure to join me next time for more tools, tips, and techniques you can use to look and feel your best and be built to last. Do you prefer an ad-free experience? Join my VIP podcast at subscribe2jj.com for just $4.99 a month or $49.99 a year to unlock uninterrupted ad-free access to all the episodes and insights you love. Also, I'd love to connect with you and hear your thoughts on the podcast. Here's how. First, subscribe to the podcast and leave an honest review. Second, Take a screenshot of your review. And third, text it to 813-565-2627. That's 813-565-2627. When you do, I'll reply using my brand new Virtual JJ Virgin. It's my on-demand virtual self built from my books, talks, and years of experience so I can I can interact with you directly. You'll make my day, and I can't wait to hear from you. Thanks for tuning in, and I'll catch you on the next episode. Hey, JJ here, and just a reminder that the Well Beyond 40 Podcast offers health, wellness, fitness, and nutritional information that's designed for educational and entertainment purposes only. You should not rely on this information as a substitute for, nor does it replace professional medical medical advice, diagnosis, or treatment. If you have any concerns or questions about your health, you should always consult with a physician or other healthcare professional. Make sure that you do not disregard, avoid, or delay obtaining medical or health-related advice from your healthcare professional because of something you may have heard on the show or read in our show notes. The use of any information provided on the show is solely at your own risk.