Brooke’s journey with endometriosis plus how women’s physiotherapy works with naturopathy
Guts and Girl Bits Episode #51
In this episode I interview Women’s Health Physiotherapist Brooke Blair (previously Hile) about her health journey. We discuss how naturopathy and women’s health physiotherapy can work alongside each other. We chat about period pain, bladder health, prolapses, rectoceles, constipation and of course, poo.
This episode was recorded in early 2020 when the COVID-19 outbreak had just begun in Australia.
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Transcript
Alison Mitchell 0:00
Hi everyone, you’re listening to Guts and Girl Bits, I’m Alison Mitchell a practicing naturopath, and I hope to share with you all sorts of information about women’s health and digestive health to educate and empower you to make informed choices about your own health. Please remember that all information is general and does not replace consulting with a health care practitioner. Hi everyone welcome to Guts and Girl Bits. Today, I’m joined again with the lovely physiotherapist, Brooke, no longer Brooke Hile… We have a newly married woman- Brooke Blair! Welcome.
Brooke Blair 0:40 Thank you.
Alison Mitchell 0:42 It’s so exciting. You had a little surprise wedding didn’t you?.
Brooke Blair 0:47 It was a bit stressful, having everything happening with Coronavirus around the time of it but it worked out perfectly and it was beautiful, and everyone was surprised, which we didn’t think they would be.
Alison Mitchell 1:00 I was certainly surprised when I found out
Brooke Blair 1:05 Noone was expecting it, which was good.
Alison Mitchell 1:07 Yeah. And so for everyone listening, we’re kind of in that stage at the moment of that level one lockdown but Brooke was able to sneak her wedding her surprise wedding in just before all of these massive isolation started so it was literally like two days before.
Brooke Blair 1:25 Two days before they stopped all weddings unless it was just the five people there so we’ve managed to have 60 I think 55 to 60 of our closest family and friends and it was perfect. It was very good timing. Couldn’t we couldn’t. If we hadn’t had it a day later, it wouldn’t have happened.
Alison Mitchell 1:45 so exciting and today we’re going to be talking about your personal history and how you’ve gotten into your realm of work and how you and I have come to work together as well so yourself as a women’s health physio and myself as a naturopath and talking about some of the areas that these two types of modalities really mesh nicely together. So, if you haven’t had a listen before, Brooke and I have done some really interesting podcasts on how your body changes during pregnancy, and about hypertonicity, which is like when your pelvic floor is really overactive and causes vulval and vaginal pain, and also we talked about mastitis and how physiotherapy can be helpful for that. So have a listen to some of those if you want to as well. And yeah, let’s get started let’s talk about your history.
Brooke Blair 2:45 Yeah, it’s a very long one. So I’ve got lots of notes here about where everything started, but I feel like. So I did get into women’s health physio therapy in my third year of uni and everyone says to me they say why, why women’s health like that’s such a bizarre area of physio to get into. And if you have asked me in my second year of uni, I was definitely going to be a sports physio had never considered the realm of women’s health, that was just something really bizarre and weird to me and pregnant women were terrifying because what if you lay them the wrong way or something like that so that was not in my realm, at all. But then in our third year of uni we started covering women’s health, and we were lucky enough to be taught by the wonderful Taryn Hallam who is amazing in the women’s health physio world and all women’s health world in general. And so that’s what really started my love of women’s health. And then I think it kind of made sense when I then started to look back at my history as to why it sparked my interest. So when I was younger I think I started getting my period when I might have been 13 or 14. And they were horrendously painful, and I would have one or two days of school each time I got my period, or I would just have to sit at the back of the classroom, sometimes I take a heat pack with me, definitely always armed with my Panadol my Nurofen Naprogesic when that was around as well, and I was trying everything and still was in a lot of pain, and even though my mom had gone through the same thing she would just say to me, it’s all right darling like it’ll be okay this is just your period and you’ll get better. And it obviously didn’t. So eventually we ended up going to see a gynecologist, and my options she basically said yeah sounds probably like you’ve got endo. Options are, we do a laparoscopy, which is the operation that you know about where they open you up and they check and see if you’ve got endo there and at that stage I think they were still burning it out rather than removing it. So it was that as an option, or the pill. So, as a 14 year old who was not sexually active, had never heard of any of these things before. My mum was a bit like I don’t really want her on the pill and I don’t really want her having an operation. So eventually we did come to the conclusion to go on the pill that seemed kind of like the lesser of two evils. At that point in time. And it didn’t really do anything other than giving me the ability to be able to stop my periods, a little bit so I’d still get my breakthrough bleeds when I got a period, it still sucked, and I hated it. So I think it would have been so I went on it when I was 14, and then stayed on it until uni, and in that time I was still having lots of issues, not only with my period but with my bowels. So, it would have been in year 10. So 2010 I might have been 15 Maybe 16 And I’ll never forget it. I was constipated for four weeks over Christmas, we were away on holidays and it was the most horrible most uncomfortable four weeks of my life and my mum just kept saying well you know have some bread maybe that’ll be good for you but I felt like I was up to my eyeballs in things inside of me. So I was in lots of pain before and after that I was bloated I was uncomfortable. So there was a lot going on in that side of things as well, so things just weren’t great with my bowels, things weren’t great with my hormones my periods. So eventually we got home from holidays and we went you know what this is just ridiculous I tried gluten free diet I tried dairy free diet. I was still getting abdominal pain, period pain, the whole shebang still constipated and then I’d get diarrhea for a little bit. So that was really fun. So we thought, let’s maybe start to yeah so fun, so we thought let’s start to look into it a little bit more. And the first avenue that we went down was we went back to the naturopath. I mean, the gyneocologist sorry, you came in a bit later. We went back to the gynecologist who said right, let’s do the laparoscopy then and let’s just see. So, I had my laparoscopy just before I started at uni, where they did find they confirm that I had Endo, but also she said I had a very distended bowel at the same time. So she said that might be something worth looking into as well. So she’d removed my Endo, or however much she could remove of it. Put me straight back on the pill so nothing there really changed. And then from there, my periods, pretty much stayed exactly the same, we I skipped them so that I was only having three maybe four periods a year. And my gut and my bowels still were horrendous, so I then went to a gastroenterologist and did a colonoscopy endoscopy, which he came back and said well you’re not intolerant to anything but you’ve got irritable bowel syndrome. And at that point in time I went, Oh cool, like I’ve got a diagnosis it all, it all makes sense. Knowing what I know now I’m like, okay, that just tells me that I’ve got the symptoms, I’ve got it gives me nothing else but all right. Um, so from there I trialed a FODMAP diet, which really stressed me out because I felt like there was not a lot I was able to eat, and if I do eat something that I wasn’t meant to, I got stressed about it, which made me realize a lot of my gut problems were made worse by stress. So it made a lot of sense that in year 10 I was constipated for four weeks because that was around the time I had school certificate. Then, around HSC, I would get bowel issues because it was that time and everything was stressful. I’m starting uni, it was really bad because I was really stressed at uni. So then the FODMAP diet added that extra layer of stress of I know I shouldn’t be eating this but I have nothing else that I feel like I can eat right now, I’m stressed about it and it’s not going to do me any good. So then it kind of all just culminated and became this really vicious cycle that was quite horrible. And so I never really got to the bottom of that except for going, Okay, I know that stress really affects me so I’m going to try and avoid stress, which is not always easy to do, as I’m sure you’re aware, but I managed to sort of go okay if there’s a scenario that I’m putting in, I can try and not stress about it, and then hopefully my gut will be okay, but my gut also gave me a really good indication of when I was stressed so I knew that I needed to do a bit more self care and take care of myself a little bit more. Then to add on top of that I started getting thrush really chronically, which fantastic. So I probably would have been all through uni, I would have thrush, at least once every two to three months, sometimes I would trade it but it wouldn’t really be 100% So I just keep having these thrush flare ups wondering why my vagina just felt so horrible all the time. Around that time I’d also become sexually active so sex was quite painful and uncomfortable. Of course, having thrush and being irritated in the vagina didn’t help anything. So there was those things that were starting to happen at the same time as well, which then come the time that we were in our third year covering Women’s Health physio, and we started to talk about how all of these conditions can really be affecting one another, and that conditions of the uterus, of the vagina can affect the bowel and conditions of the bowel can affect the bladder. Thankfully I never had any bladder conditions. But just knowing that there was that really big Interplay it made me go well hang on I know I’ve got endo technically they didn’t find anything on my colonoscopy, so maybe I don’t actually have a true bowel issue, but maybe there’s something that’s happening that’s got to do with my endo that’s causing things to be a little bit flared up and so then I started really loving women’s health and that’s how I got into it and just the idea of pain with sex which I’d experienced and pregnancy, which I haven’t experienced yet will one day soon, maybe. But yeah, all of those different conditions but I think a lot of women get told, Oh, it’s just a period you’ll be fine or, you know, it’s fine. You’ll be okay just take some Panadol and everything will be okay, or yeah pain with sex is normal, get over it. A lot of those really resonated with me because I’ve been through a lot of them and I didn’t really feel like I had any answers as to why those things were affecting me. So that’s why I so much love women’s health and love being able to work with you because we can kind of cover things from both sides, both the anatomical side and the muscular side, as well as what’s happening at an internal cellular level and hormonal level, and being able to actually start to get to the bottom of things, which is really nice.
Alison Mitchell 12:42 Oh my gosh, it’s, it’s such a connected thing everything’s all so connected, and all of those things working together. Oh my gosh what a journey.
Brooke Blair 12:57 Yeah, so it took some time it’s still ongoing as you know we’re currently working on lots of things at the moment. But I think that having been through all of that has made me very much, empathetic towards the women that come in who are having these conditions who they might have seen a practitioner who said, Oh yeah, that’s just normal, that’s just what happens in women. And they’ve been constantly told it’s normal, it’s okay, everything’s fine. It’s all in your head. And then when they can come in and sit down and I can go. I’ve been there and I know that there’s things we can do to treat it and no it’s not all in your head. It’s really quite a lovely process and quite a nice journey to be able to go through with women.
Alison Mitchell 13:39 I think a lot of the time when people feel heard, they feel acknowledged that they’re not crazy about it, that this is such a big relief for them in many ways. Oh, I’m not making this up so I know a lot of my patients say that and I know that some of yours do too. And like you were saying like sometimes other practitioners might say yeah that’s just part of having periods but sometimes it can be because things evolve and we know that certain things aren’t normal anymore, but our parents practitioners might have told them that their stuff was normal. Until then, our parents have told us here, that’s just normal, that’s what I had. That’s what my sister had that’s what your sisters had all of that sort of thing and so you just come to expect it and so it’s just breaking that cycle and, you know, takes one person to say, Hang on, we can actually do something about that. And that’s what I love about what we do as well as we’re with we’re popping that bubble we’re saying: You don’t have to have people sex and didn’t have painful periods, and you shouldn’t even notice your digestive system, they should just be like, La-La-La Everything feels wonderful. Yeah, absolutely. But it is a journey isn’t it.
Brooke Blair 14:54 absolutely is. I’m trying to think how many it’s probably been 11 or 12 years but I’ve been working through all of this stuff and we’re still going. And that’s being educated and knowing that there’s things that we can do to help. That’s, you know, other women don’t have that education and they haven’t been told that there’s things they can do so it’s gonna take a lot longer for those women.
Alison Mitchell 15:21 I definitely see that with naturopathy because it’s not as conventionally well known, it’s not as accepted, and what sort of avenues you can work on with with diet is not that well known, so I might have like someone that’s never really even realized they can work on them for something until you know they listen to a podcast or they read an article and they’re like, I wish I had known that earlier.
Brooke Blair 15:48 Absolutely. So I hope that this podcast goes out and people listen and go, oh hang on a second, I can go and get help, amazing.
Alison Mitchell 15:57 Yes. And, you know, I know that some of the things that you and I are working on together, it’s, it can be a little bit off putting when you hear that like it’s actually a bit of hard work that you have to do for a little while.
Brooke Blair 16:13 It is.
Alison Mitchell 16:13 *Nodding vigorously. But it’s worth it because it doesn’t last forever. And so, like, a month of hard work. Compared to years of pain and discomfort is so much better.
Brooke Blair 16:28 Yeah, it’s worth it, that’s for sure.
Alison Mitchell 16:32 So, I guess we could talk about how you and I came to me. Well I guess I should we say that because we might have actually spoken about this in some previous podcast but I’ll say it again anyway. I was pregnant with Lara with my second baby, and I had had a caesarean section with my first baby, and it was a bit of one of those situations where you’re not completely sure what happens, like I was very much adamant that I was going to have a natural birth but then all of a sudden, something like, like there was a non reassuring heartbeat, and my obstetrician had said to me previously I’m not sure about the shape of your pelvis, and I was very unsure what she meant by that. So she was basing that on like some internal examinations and I was like, like what does that even mean and so I was adamant. I was going to have a really great natural birth for my second baby. And so, I’m just, I’m very grateful that Ash is healthy and I recovered fine but I also had some really bad abdominal separation following him, and I had heard some great things about about you, about Brooke, about helping with abdominal separation or, because I had only heard that you know you just shouldn’t do sit ups. Okay. Bring it on, never get up out of bed. And so this was two and a half years that was two and a half years was no it was probably two years that I had had this abdominal separation for and it was. I mean, it was fairly severe, wasn’t it like five fingers. At that point is that moderate or severe or moderate,
Brooke Blair 18:32 moderate, I’m trying to think back to the integrity of your abdominal wall as well.
Alison Mitchell 18:37 thats a long way back for you to remember. anyway I thought I put on a bit of weight but now I just had like my abdominal muscles were just so weak, and then I had all this back pain because of that. So all of these sorts of things that started to fall into place like my back pain. The abdominal separation and then I also just wanted to make sure that everything was in tip top shape ready to have a natural birth. And I think it was like, probably our third appointment, where it was a natural person you’re like, oh, I should thinking about doing a community for women’s health, with one of the Chelsea from Mummy Movement. And I was like, Y’all be involved in that I love spreading awareness and then it just blossomed from there.
Brooke Blair 19:31 And I think I said let me tell you all about my horrible periods.
Alison Mitchell 19:34 I think there might have been a couple of people that, because you were like what did what do you treat with naturopathy and I was like, I do lots of children’s health. Lots of women’s health, and you were like “hmm.. hmmm… I might send some of my bed wetting children to you and period pain people and then yeah it just grew didn’t it.
Brooke Blair 20:02 It did, and now we have this very good communication and lots of clients that we share together which is amazing,
Alison Mitchell 20:07 and it just it just gets that next level of results really doesn’t it.
Brooke Blair 20:13 Absolutely, absolutely.
Alison Mitchell 20:15 And I think for me, I’ve always, I’ve always had that awareness, pure hypertonicity so pelvic floor problems can worsen Endo, because it creates this local inflammation that worsens pain, but I also didn’t have anyone that I could refer to, because you women’s physio is a few and far between.
Brooke Blair 20:38 Yeah, it’s a growing field which is amazing. There’s actually a lot more of us than what most people know about and it’s funny going to courses and you meet and you go oh hang on, you work in the mountains, I’m like not that far away from you. And then there’s about six people who work in the mountains and you oh wow okay there’s a lot of you in the mountains im just down here. There’s actually a lot of women’s health physios, it’s just that, a lot of us work in musculoskeletal physio practices so it’s not necessarily a world that people know so much about. Whereas if you are either a sole practitioner like I currently am, who has a business name that sounds like women’s health, or who specifically says Women’s Health physio as the main point of call. That tends to be how people are finding us a little bit easier, but there is actually a lot more now, which is amazing.
Alison Mitchell 21:32 That’s so good.
Brooke Blair 21:33 Yeah, yeah.
Alison Mitchell 21:36 first before you I only knew of one, and then you showed me a few more and then all of a sudden you do start to see it when, when you’re looking around for referrals for people. Oh, it’s a lot more.
Brooke Blair 21:49 Yeah, which is nice because there’s so many women who have so many concerns and just like a naturopath I’m sure everyone does things slightly differently in women’s health physio, everyone does things slightly differently. So, what works for one person might not work for the other and a different type of treatment might be what that person needs that maybe this other person couldn’t give you. So it’s always nice that there’s lots of people out there lots of different opinions and ways of doing things and ways of looking at the body that helps women to be able to get their best results which is nice.
Alison Mitchell 22:24 Yeah, that’s lovely. So I guess we could, you know, move on from that to talk a bit more about how much Naturopathy and physio work well together. So I think the probably the one of the things we could start with our favorite thing to refer for which is period pain.
Brooke Blair 22:41 Yes, personal experience of course we’re going to refer for that.
Alison Mitchell 22:48 So you and I both have a strong history of period pain. And so mine has settled down a lot with a little bit of time and using herbal medicine and possibly even having kids as well that might have something to do with it too but we’ve both got that passion for it and also that level of empathy for our patients that have it too. But there’s a really strong correlation between like having the stuff going on internally, like you said before at a cellular level hormonalIy as well as having the physical, the muscular component to. So, working on one side of those without addressing the other is going to be not as complete as could be. And this is actually applies to everything else that we’ll be talking about. So, you can’t do as good a job without doing both sides of it.
Brooke Blair 23:43 Exactly, you just get that extra bit better so that you get that extra little bit so you can get to 100% Rather than just sitting in being happy at 90%. If you know both working together, then you can get such better results and it’s amazing to see.
Alison Mitchell 23:58 Exactly. So, in terms of how I as a naturopath go about addressing period pain. I’m looking at, like there’s a few different aspects of what causes period pain and so when I’m working, I’m looking at people from a more energetic constitutional level as well when it comes to pescribing herbs which I mean might sound a little bit strange, but I do find that it gets the best results so you’re looking at like a person is hotter or colder. And so if you’ve got a lot of cold. For instance, like, there would be stagnation and dark red blood and clots, and they feel better for applying heat and so we use herbs that are going to be warming and stimulating. And then if they’re very hot person to then there’s usually that bright red blood, and they feel better for having a cold bath or a cold shower or buying an ice pack, and like there’s various other things that you look at in like the tongue, their skin and their hair, or like, assessing where they are at a constitutional level, but using herbs that are specific to that, as well as thinking about what are their hormones doing and what is their immune system doing because with things like endo with endometriosis, it’s very immune driven condition, so you need to think about what’s causing your immune system to go shonky in the first place, like is it a bit of a bug that’s hiding around, or is it something that you’re eating that your body is reacting to, and then it’s also things like is there a nutritional deficiency, that’s causing your body to be more immune driven, or is it an deficiency that’s causing you to become tighter and more crampy. So those are some of the areas that I look at with period pain.
Brooke Blair 25:48 Okay, I sort of way that as women tell physios we, that’s why I love working with you because you can work with things that are causing some of the pain. And then I can treat some of the byproducts of that pain, so a lot of women, particularly with endo sometimes with polycystic ovaries or just women who do have incredibly painful periods. I’m more so looking at the musculoskeletal system and the neural system to work out what’s happening more so at a pelvic floor level, but more recently we’ve sort of been looking all the way up basically to your neck and all the way down to your toes to work out if there’s something that may have set off some of the pain. So, for girls who have endo/ polycystic ovaries, some of them will be coming in not just because they get pain with their periods, but because they’re now starting to experience sexual pain, or they’re getting difficulty using tampons or different things like that that they starting to notice that isn’t normal. They shouldn’t be having where previously they were able to use tampons just fine. Or they’ve had sex pain free, but something has triggered this pain to start up. And so we’re starting to look at why is that happening, is it because they’ve had these pain because of that inflammation that you were talking about, for such a long time that the body has just started to go into a protective cramping type state trying to protect all of the organs and protect everything vaginally and saying no I don’t want anything inserted here because it could cause me pain. In some women, I see they could have had an injury so they may have had completely fine periods, they may have always had endo but not had any symptoms of Endo, but their periods were fine, and then all of a sudden they’ve had an incident where they’ve fallen and they’ve hit their tailbone, or their hip or they’ve whacked their knee, and all of a sudden they’ve started to get painful periods crampy sensations the pain with sex. Sometimes even leakage, and those sorts of things are very different for them and so yes we know there’s probably going to be findings in a pelvic floor level but also elsewhere throughout their body we might need to see what’s happened at their knee, we might need to see why their tailbone is sore and work out that perspective rather than just going straight to treat vaginally.
Alison Mitchell 28:08 Exactly because the body is a unit. And one thing is going to be like causing another area to shift and your body will always try and compensate, and just keep compensating compensating until it’s current anymore and then it’s like, ouch!
Brooke Blair 28:23 what’s happening here. Yeah, so it’s nice to be able to see and unravel all of those sides of things I had a lady in the other day, and I think she was in her 50s and she was having period troubles, and no one had ever brought up the idea that potentially there could be something hormonally or systemically like Endo, or something like that, but she has had painful periods and vaginal pain for the last 40 odd years. And so I sat down and I took her history with her for an hour, and we took it all the way back to as a child, she’d had eczema vaginally, and she had, I think she had constipation and gut issues as a child, and then all of a sudden she got her periods and they were really painful and then she woke up one day with vulvodynia and that’s never gone away. And even just sitting with her and going back through her whole history and her going wow no one’s ever sat with me and gone all the way back to my childhood to work out that actually, these things have been happening since I was very young, before I got my periods. So she’s another person, I’m going to get to come and see you to work out what’s happening at a gut level because she was close. Yep. Yep, exactly. Yeah, it’s lovely to be able to work on those sides of things and work out where the pain is coming from rather than going yeah cool you’ve got Period Pain what next. Yeah.
Alison Mitchell 29:49 Oh my goodness, I can’t believe that it was going on for that long, but this is this is often what happens in this realm of vaginal pain period pain but also digestive pain is because you don’t, you don’t get people asking you about these things and, often, if it’s something vulnerable, you to be too nervous to bring it up. So like what situation and will you be and so going to the doctor directly about that where that will get asked. Apart from an appointment, like a women’s physio or a naturopathic appointment or potentially even the gyno but often they’re very focused on a specific issue in conventional appointments, and so it doesn’t get brought up unless you specifically do so it is important to talk about these things. And I know that I mean, I probably ask the weirdest questions when I do my naturopathic screening I’m like, do you like talk about poo a lot people say I’ve never had a conversation about my poo as in depth.
Brooke Blair 30:49 Likewise, love a poo chat.
Alison Mitchell 30:53 And, Yeah. And do you give any vulval pain, any vaginal pain if you get pain during intercourse like all of those sorts of things that people like, what, why are you asking me that
Brooke Blair 31:04 some women say, yeah, no one’s asked me that before and, but actually yes I do have these issues and it’s until you raise that conversation, they’re not going to be forthright with it and say, Actually my vagina hurts all the time. That’s just not something that a lot of people feel comfortable saying yes, and there is such a stigma around it. We just love popping. So, I think that’s just such an important area that people need to know that you don’t have to put up with
Alison Mitchell 31:36 sex should not hurt
Brooke Blair 31:38 No exactly and if somebody tells you it’s all in your head it’s not and you need to see somebody else.
Alison Mitchell 31:44 Yeah, exactly what some other areas that we love to trade together so I love working with urinary conditions. So, chronic UTI’s, and a bladder pain as well so when people are constantly getting symptoms that are not not related to an actual infection which is one of those things. It’s just like so much mind boggling for so many people but they just came back negative and why am I still getting the pain, what’s actually causing that.
Brooke Blair 32:21 Yeah so that’s definitely something that we work together on which is lovely. I see that quite a lot, a lot of women come in and they say, because if oftentimes if they’re getting symptoms like that like UTI is a lot of them are leaking as well. So they might come into the session because their GP referred them for incontinence, but then when you sit down and chat to them will actually I’ve got pain when I pass urine and I go to the toilet and I empty my bladder but even though I know I’m empty it still feels like I need to go or I never get the sensation that I’m completely empty, or things like that pain with bladder feeling all of those symptoms that you shouldn’t be aware of that. A lot of women do actually notice can be coming from something anatomically, so I treat a lot of women who they sometimes have overactive pelvic floors like we just spoke about. And it’s because of that over activity that all the nerves in that area are quite overstimulated causing bladder pain sensations. Also not allowing the bladder to fill completely or empty completely. So I go through about 20 Questions about when you sit on the toilet does your flow start straight away does it stop start does it go off in a funny direction do you feel empty, all of those sorts of questions because if that’s what your body has always been doing, you don’t know if that’s wrong or right, you don’t know if there’s an issue there.
Alison Mitchell 33:44 You’d just think it’s a funny Quirk.
Brooke Blair 33:46 Yeah, exactly, exactly. And so I’ve had women who say Oh yeah no every time I sit down I have to wait 10 seconds before my urine starts to come out and I have to really think about it, that’s not what should be happening. And so, if then they have issues with what’s happening around their urethra where the urine comes out and around their pelvic floor they might not be able to completely bladder empty, which will put them at risk of having UTI over and over again because they’re not allowing that urine to exit their body. But also, if they are constantly having an irritated bladder, whether that’s from infection or not, and they’re leaking, then they’re definitely going to be getting more at risk of having irritation infection, things like that so it’s definitely something to try and work out, why is that happening.
Alison Mitchell 34:34 And the way that I would be working with these people is using mostly herbs that work on improving the mucous membrane health of the vagina and the urethra and all of that so nutrients that work on that sorry and then herbes that work on reducing spasm of the fine, finer muscles in there and then soothing bladder herbs so we’ve got one of my favorite of all time is Crataeva because it’s just this nice most beautiful bladder tonic, but it’s so soothing. And so that’s like my staple with chronic bladder conditions of all forms, really loving Kava relaxing the muscles down there too. And that’s also really useful in treating UTI as too. And then probably leads us on to the next topic which is prolapse.
Brooke Blair 35:23 Yes, I love prolapse, I don’t love it when it happens to women, but I love trading. So I think there’s a big misconception about prolapse, in that it only happens to older women. And it means that everything is falling out of you and it’s the worst thing in the world and all you can do for a surgery. So when I have women coming in who’ve been told that they have a prolapse or who think that they have a prolapse, it’s all doom and gloom and it’s the worst thing that could possibly happen to them, and prolapse isn’t something like that, most women. I think the stat is that 75% of women will experience some level of prolapse across their lifetime. And what we’re coming to realize is that prolapse, to some extent might actually just be normal because we are upright mammals, and our pelvis and our pelvic organs are at the very base of us, and they don’t have bony support underneath them, they only have muscular support. So over time there is going to be some degree of movement that happens purely because of gravity and because of how we move around. All other animals are basically on all fours, so they’ve got the whole abdominal wall but all of their organs or the pelvis that their organs are supported by, But we don’t have that support structure. So, most women that I assess there will be some degree of prolapse that I go okay, I’m not really going to call this prolapse because it’s just the natural movement that’s happening in your body, and everyone will have some normal amount of movement, some women move not at all and some women are quite mobile in their tissues, and they are going to be the women that are more at risk of prolapse, whether it means that things have dropped internally one centimeter three centimeter five centimeters. It’s one of those things that it’s quite scary for women, to hear the term prolapse and to get the symptoms of prolapse, which are things like heaviness or vaginal discomfort or feeling like you’ve got a dislodged tampon internally but you don’t have a tampon in. I also have lots of women who start to experience sexual pain if they have a uterine prolapses. So that’s one of the really lovely things to be able to treat, is being able to work on either pelvic floor strengthening or using pessaries which are pelvic floor support devices to help support the organs, and to get rid of those symptoms and change how women are functioning so that they can feel symptom free and comfortable.
Alison Mitchell 37:49 Definitely I feel like there’s, there’s various levels of it and sometimes people are not sure whether what they’re feeling is normal or not. It’s good to also just get it assessed to like to give you that peace of mind for someone like yourself to say, actually, where you’re at right now is fairly normal for your stage of life or for everything else that’s going on. Yeah. And then, how can we work on it naturopathically Well I actually really liked working alongside acupuncture too but I look at this from structural integrity of this muscle cells themselves. So things like nutrients that help with connective tissue strength collagen strength, and then using herbes they’re have lifting actions, and reducing inflammation and then also some hormonal support too so, working on a that oestrogen level in a very gentle way. And then using herbs that help with improving digestive function because we want to be reducing any sort of pressure from their digestive system that might also be affecting it too. Which I guess is another segue into digestive digestive stuff so one of the main things that I would probably be sending people to you for in regards to digestive stuff is constipation so when I feel like there is just a poor nerve signal going on or people are deciding, they’re just not getting that urge to go to the toilet because they’ve been constipated for such a long time. So do you want to talk a bit about that.
Brooke Blair 39:27 Yeah, I love treating poo conditions, could talk about poo all day long. So when women come into me for any sort of bowel conditions more often than not it is constipation related, but oftentimes I also do treat fecal incontinence which no one really loves to talk about but it’s actually really, really common and can be caused by constipation. So, in terms of treating something like fecal incontinence, which I’ll talk about first and then talk about constipation because that’s quite commonly related. So people experiencing fecal incontinence, I think the studies, wanting for one in four men and one in five women will experience fecal incontinence in their lifetime. Oftentimes, it can be post childbirth. After third or fourth degree tears, or after nerve injuries. It can come on with things like back conditions and back pain as well. And so a lot of it comes from the muscles at the back passage not functioning optimally, meaning that people aren’t able to hold on to this tool for as long as possible and can become fecal incontinence. A lot of the time, the women that I say for this, it’s because their bowel motion isn’t where it should be. So whether it’s too soft, so it’s like your type five six or seven on a Bristol stool chart, it’s just far too soft and the body’s not made to hold on to a bowel motion like that. So working with you and giving women techniques of how to bulk up their bowel motion can be quite helpful. Then from the constipation side of things. If they come in with fecal incontinence, we need to make sure there’s no constipation there, otherwise we need to treat that first and not worried about the fecal incontinence, because what people don’t realize is, in your rectum, if you’ve got a really big firm hard bowel motion sitting there, your body’s not going to be able to push that out without extra assistance. And so what the body does is it sends this mucus layer to try and help to lubricate the rectal walls to help pass about motion. And if your body doesn’t feel like it can pass it, you just won’t feel that there’s all this mucus there and it will leak out of the rectum, like it’s a fecal incontinence, where it’s really just your body tried to help you to pass this bowel motion. So we need to try and work out. Is it true fecal incontinence or is it that there’s an underlying constipation there. Then in terms of constipation a couple of the things that I see quite commonly is women feeling like I know that I have the sensation that I need to go to the bathroom, but I just don’t feel like I can empty myself, or I feel like something gets stuck. And so from that regard, if we talk about what their bowel motion type is like, sometimes it’s a perfect bowel motion and we’re going okay we don’t need to change your bowel motion type at all, we need to change either the sensation of you going to the toilet, or what’s happening. Anatomically, so really frequently I see rectal prolapses so we call them Rectoceles, not where the bowel is dropping out at the back passage but where the bowel creates a pocket more towards the vagina, and it allows bowel motion to get caught in there, so that women pass a bowel motion but then they just feel like something’s getting stuck, and they can’t quite get it out, and they’re always gassy and uncomfortable, and they might need to go to the bathroom six or seven times in a day but they still just never feel empty. So that’s something that I really love treating because doing a good poo is actually life changing. And if you sit down on the toilet, you do a great poo and you feel empty it’s a wonderful sensation. So that can definitely be something that I work with, but then also making sure that women know what the sensation of bowel emptying should feel like. And when they should emptying, empty their bowels. So working a little bit more with their nervous system to change that up. But yeah, sometimes it’s anatomical work sometimes women don’t actually relax their pelvic floor to empty their bowels they tighten it, instead, which makes it far more difficult to empty their bowels and it’s not that there’s an issue with the bowel motion, it’s just that they’re not relaxing and we can change that also.
Alison Mitchell And I think that with the rectocele, the way that I treat that is very similar to the prolapse stuff, but also yeah like getting all, there’s so many things that can be going wrong with digestive health, and natural remedies, it’s one of my main things that I treat your digestive health, for women’s health and digestive health, so it’s very very satisfying things to treat.
Brooke Blair 44:20 Yeah absolutely people, I have women who all of a sudden they can relax their, their pelvic floor muscles and all of a sudden they do this amazing pool and I say when that happens, I want you to message me because it’s going to be the best day of your life, and they go oh my gosh I didn’t realize that I could do like that and feel this good and it’s, it’s wonderful when you get a lot of neurotransmitter release when you’re actually doing a nice big poo.
Alison Mitchell 44:40 So if you haven’t been able to do for a long time, then you’re not going to get those neurotransmitters, but then it works the other way is if you’ve got constant, diarrhea, you kind of be running low on those. So having that perfect balance makes you happy lately.
Brooke Blair 45:05 Good poos are good.
Alison Mitchell 45:10 Did you want to talk about anything else.
Brooke Blair No, I think we’ve covered off a lot of it.
Alison Mitchell 1:54 My kids are going insane so I should probably wrap up now. like there’s, so many ways that we can work well together. I just so happy to be able to share this information to people and whether they do decide to see both of us or even do some of it, I just want people to know what is available to them. So I’m just so grateful that you and other women’s physios are around and thank you so much for sharing all of your amazing information today already
Brooke Blair 45:54 thank you and thank you for helping me to work on my body. At some point we’ll have to talk about everything that’s amazing that’s happening in my body at the moment which will be wonderful. Alison Mitchell So we’ve got a little bit of a teaser there and then we can follow that up later once we’ve we’ve got you towards the end of your health journey too. perfect. Alright, well thank you everyone so much for listening. Bye! Brooke Blair Bye
Alison Mitchell 46:40 Thank you so much for listening. I hope you’ve enjoyed today’s episode. Please join me over at the Guts and Girl Bit’s Instagram page and share any other words of wisdom that you would like to contribute as well. Guts and Girl bits now has a collection of eight courses that you can view online. The primary course available at the moment is Natural menopause support, which provides information on supporting yourself through the latest symptoms of menopause and easing through this transitional life. You can find the collection of E courses at gutsandgirlbits.teachable.com And they will also find a course of understanding underactive thyroid and coming up soon will be a courses called cyclical woman. Navigating the teenage years, children’s health, nourishing the mother, and more. If you’ve enjoyed today, please leave a review and share this episode to help spread the word. Thank you.
