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Lots of women have bladder leaking and no one wants to talk about it. And then when you bring it up to your doctor, you're stuck waiting months to see a specialist. I'm Sarah Boyles, an experienced board-certified Urogynecologist and each week I'll combine medicine, science and my expertise to help you understand your bladder and your body and what you can do to get started!
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No one ever wants surgery, but if you need it, you absolutely want the best possible outcome. In this episode of While You Wait… I share practical, science-backed steps you can take before and after surgery to support your recovery. From pre-op education and nutrition to exercise, stress management, and even when to sip clear liquids, I cover the details most patients don’t hear until the very last minute. I also opened up about my own breast cancer diagnosis and what preparing for surgery ha...
If you’ve ever wondered why hemorrhoids, constipation, or “smearing” show up with pelvic floor symptoms, or what actually happens in a colorectal exam, this episode makes it clear, calm, and doable. In this episode, I discuss the interconnected nature of urogynecology and colorectal health with Dr. Bethany Malone, a board-certified colon and rectal surgeon. The discussion covers how hormonal changes and colorectal issues like constipation, hemorrhoids, and IBS can impact urogynecologic and pe...
Overactive bladder (urgency urinary incontinence) can feel overwhelming, emotionally and physically. Many women silently cycle through denial, frustration, and finally, acceptance. But living with constant urgency or leaking before reaching the bathroom doesn’t have to be your “new normal.” In this episode, I break down first-line treatments for urgency incontinence, the practical, foundational steps every woman should try before turning to medications or procedures. You’ll learn: How to keep...
Pelvic floor physical therapy can feel intimidating, especially when you don’t know what to expect. In this episode, I sit down with MJ Strauhal, one of Portland’s most experienced pelvic floor PTs, to walk through what really happens at that first appointment. You’ll hear: - Why pelvic floor PT isn’t like any other therapy you’ve had - What the intake process looks like (yes, we ask about pooping, peeing, AND sex!) - Why comfort, privacy, and patient choice are centra...
In this episode, we dive into the challenges and strategies of discussing intimate and potentially embarrassing health issues like bladder leaking with healthcare providers. I revisit an insightful conversation with Dr. Kara Wada, a board-certified allergist and immunologist, who emphasizes the importance of patient empowerment and effective communication in the healthcare system. Dr. Wada, a certified life coach and autoimmune patient, shares valuable tips on how to take ownership of your he...
Pessaries have come a long way from their ancient origins. Today, they're sleek, medical-grade silicone devices that can help with prolapse and stress incontinence, no surgery required. In this episode, I break down the different types of pessaries, how they work, and why they're not just for "frail grandmothers" anymore. We'll cover: • How pessaries support prolapse & stress incontinence • Over-the-counter options like Poise Impressa, Uresta, Revive • Custom-fitted pessaries & innova...
Hormones play a bigger role in bladder health than most women realize. In this week's episode of "while you wait…" podcast, I break down how estrogen shifts during perimenopause, menopause, postpartum, and even certain birth control methods can affect urgency, leaking, and pelvic floor function. I also explain why vaginal estrogen may be part of the solution, common risk factors for incontinence, and how lifestyle factors like weight, sleep, and stress can make symptoms better or worse. Timel...
Planning a vacation but nervous about traveling with bladder issues? You're not alone, and you're not out of options. In this episode, I share practical, proactive strategies for women managing bladder symptoms during travel. Whether it's stress incontinence, urge incontinence, or a mix of both, you'll learn about everything from bladder irritants and urge suppression techniques to pessary options and helpful apps. Plus, I share bonus tips like trying AZO Go-Less and tracking your food and fl...
I sat down with Jim Surek, CEO of Valencia Technologies, to explore eCoin, an innovative tibial nerve stimulator designed to treat overactive bladder (OAB) with fewer visits, fewer side effects, and more freedom. Unlike traditional sacral nerve stimulation or ongoing Botox treatments, eCoin is a nickel-sized device implanted near the ankle that delivers consistent, effective relief. It's minimally invasive, easy to implant in an outpatient or office setting, and requires little follow-u...
In this powerful episode, I interview Dr. Laua Williams, a practicing OB/GYN with extensive training in functional, restorative, and integrative medicine. We dive deep into how our medical system often misses the mark when it comes to hormone testing, fatigue, and perimenopausal symptoms. Dr. Williams explains how lifestyle, cortisol levels, iron levels, sleep quality, and stress responses are often overlooked and why progesterone, not estrogen, is often the missing piece. If you've ever been...
What happens when your bladder pain starts in childhood, but doctors don't believe you until adulthood? In this episode, I talk with Callie Krajcir, IC dietitian, coach, and founder of "Road to Remission," about her journey from suffering in silence to becoming symptom-free. We unpack the layers of interstitial cystitis (IC), pelvic floor dysfunction, and the nervous system's role in chronic pain. Callie opens up about college struggles, pelvic PT challenges, pelvic wand use, and how she help...
In this episode, I'll break down the real reasons behind getting up at night to pee, a condition called nocturia. From overactive bladder to fluid intake and systemic conditions like sleep apnea or diabetes, and why looking at the whole picture is essential. I'll also discuss effective treatments from bladder training to Botox and why a 3-day voiding diary is a crucial first step in figuring it all out. Timeline: 00:30 Introduction to Nighttime Urination Issues 01:06 Understanding Noctu...
If you've ever been prescribed medication for overactive bladder, you might wonder what it's actually doing and what the risks are. In this episode, I break down the two main types of medications used to treat OAB: anticholinergics and beta-3 agonists. We'll talk about how they work, the side effects (including memory concerns), and how to weigh the benefits and risks. I also explore alternative options like Botox and nerve stimulation, and why shared decision-making with your provider matter...
In this episode, I'm talking about something I see all the time in my practice but that too many women still suffer through in silence: Genitourinary Syndrome of Menopause (GSM). This condition shows up in women as estrogen levels decline, most commonly during and after menopause. If you've been dealing with vaginal dryness, itching, pain with intercourse, or repeated urinary tract infections, you're not alone, and it may be GSM. I walk you through the updated guidelines from the Americ...
In this episode, I sat down with Dr. Suzette Sutherland, a seasoned urologist who recently transitioned from the University of Washington to a large urology group in Arizona. Dr. Sutherland shares her expertise on treating overactive bladder (OAB) and the latest innovation in neuromodulation therapies, specifically focusing on the efficacy and safety of tibial nerve stimulation. We discuss the evolution of treatment guidelines, the pros and cons of various therapies, including medications, Bo...
If you've tried lifestyle changes and medications for overactive bladder, but you're still dealing with urgency, frequency, or leaks, you're not out of options. In this episode, I break down tibial nerve stimulation, a lesser-known but powerful treatment for overactive bladder that's often overlooked in early care plans. I discuss what neuromodulation means in pelvic health, and how it works, why the tibial nerve (yes, the one near your ankle!) plays a key role in calming bladder activity, th...
In this episode, I’m answering some of the most common (and commonly avoided) questions about women’s pelvic health, questions that too often go unasked but deeply affect the quality of life. We dive into the difference between a rectocele and rectal prolapse, what causes urinary leakage during sex (and what you can do about it), and how to know when it’s time to seek care for incontinence. I also share why early education and intervention matter so much, and why these conversations belong in...
This week's podcast is about prolapse—what it is, how it affects daily life, and what you can do about it. A few weeks ago, I joined Janice Mitchell from MyPFM and had the chance to answer some incredible questions from her coaching group. The conversation was honest, insightful, and filled with the kinds of questions I hear every day in my practice. We talked about whether prolapse can improve after childbirth, how to manage symptoms without surgery, and what to know if you're considering on...
This episode was inspired by a recent coaching group I joined with Janice Mitchell, a pelvic floor physical therapist with incredible insight and compassion. The women in that group had thoughtful, important questions about recurrent urinary tract infections, which I often hear in my practice. So today, we're diving into that discussion and sharing it with you. If you've ever dealt with bladder infections that come and go (and come back again), this episode will help you better understand wha...
1In this episode, I interview Janice Mitchell, a pelvic floor physical therapist and founder of the Pelvic Bra. This external support device helps with pelvic floor issues like prolapse. We discuss Janice’s personal experiences and the development of the pelvic bra, likening it to an industrial-strength thong that provides perineal compression. Janice explains how the device works and its benefits, and shares feedback from users who have found significant relief from symptoms such as stress ur...
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