The Hole Shebang

f you've had a cesarean birth, whether it was recent or decades ago, this episode will change how you think about your scar and your recovery. Registered massage therapist Nicole Nifo joins Kristen Parise to break down what actually happens to your body during a C section, why your scar affects far more than what you see on the surface and how specialized scar therapy can restore function at any stage of life. Nicole also shares her own experience with three cesarean births including an emergency cesarean where her uterus tore from the incision into her cervix. What You'll Learn in This Episode This conversation covers the anatomy of a cesarean, what is actually cut during the procedure and how scar tissue forms through approximately seven tissue layers. Nicole explains how scar restrictions can contribute to back pain, pelvic floor tension, incontinence and core dysfunction. She walks through her approach to C section rehabilitation including manual scar release, the Dolphin Neurostim microcurrent technology and functional movement retraining. The episode also digs into the emotional side of cesarean recovery, why so many people struggle to touch their scars and what that tells us about unprocessed birth trauma. Key Topics Covered What happens to your body during a cesarean section, the seven layers from skin to uterus, and how the procedure has evolved to include gentle cesarean techniques that support immediate bonding and breastfeeding. The gap in postpartum care after surgical birth and why being discharged with only a "what not to do" list fails cesarean parents. How the Dolphin Neurostim uses microcurrent point stimulation to soften scar tissue, reduce adhesions and improve mobility in both new and decades old scars. The connection between C section scar tissue and pelvic floor dysfunction, including why many cesarean parents experience tight pelvic floors, pain with intercourse and stress incontinence. Early postpartum movement including shallow squats, marching, chest opening stretches, hip flexor stretches and desensitization techniques for the scar. The emotional component of scar healing, nervous system upregulation after birth and the practice of placing hands over the incision while affirming safety and healing. About Nicole Nifo Nicole Nifo is a Registered Massage Therapist with over 20 years of experience specializing in C section rehabilitation and scar therapy. After experiencing an emergency cesarean with her first baby, followed by two planned cesareans, Nicole made it her mission to give postpartum parents the recovery support the medical system doesn't provide after six weeks. She combines manual scar release techniques with the Dolphin Neurostim, a clinically proven microcurrent tool used in over 60,000 hospitals worldwide. Nicole is the creator of the C Section Recovery Method, a 12 week online program, and has just joined the Blueberry Therapy team in Hamilton, Ontario. Theme Song: "Larger Than Life" by Backstreet Boys Resources Mentioned The Dolphin Neurostim microcurrent device for scar release therapy Nicole's C Section Recovery Method 12 week online program Nicole's Early Recovery Guide (zero to six weeks post cesarean), available through her Instagram Connect with Nicole Nifo Website: Fully Alive Wellness Instagram: @csectionrecoverycoach Book with Nicole at Blueberry Therapy in Hamilton, Ontario Related Episodes You Might Love Episode 78: The Bounce Back Lie and What Postpartum Recovery Actually Looks Like with Michelle Gauvreau Episode 66: The New Postpartum Exercise Guidelines That Ditch the Six Week Rule with Dr. Margie Davenport Episode 11: Postpartum Pelvic Floor Health with The Vagina Whisperer Dr. Sara Reardon Episode 9: Understanding Severe Maternal Morbidity with Dr. Giulia Muraca Visit blueberrytherapy.ca and subscribe to The Hole Shebang Podcast. Connect with The Hole Shebang on Instagram @blueberrytherapypelvichealth

In this episode of The Hole Shebang, Kristen sits down with Chloe Lewis, a women's health physiotherapist with 12 years of clinical experience working within the UK's National Health Service. Chloe holds an MSc in Women's Health and is currently completing a PhD investigating resistance training during the menopause transition. Alongside her clinical and academic work, she teaches, speaks, and creates educational content aimed at improving standards in women's health and translating research into practice. She has also set up group based resistance training classes for menopausal women at the doctor's surgery where she works. What You'll Learn: This conversation covers the real reasons menopausal women aren't lifting weights and what actually helps them start. Chloe breaks down the barriers, including time scarcity, the fragility myth, non inclusive gym environments, and the cultural belief that strength training is only for younger, more athletic bodies. She also shares the facilitators that work, like group based exercise, lower cost options, and motivators rooted in long term independence rather than aesthetics. Chloe explains the just released ACSM (American College of Sports Medicine) resistance training guidelines, updated for the first time in 17 years, and why they represent a shift toward accessibility. She provides a concrete four exercise starter program: overhead press, vertical row, a push movement like bench press, and a lower body movement like a squat or deadlift, done for two to three sets at a challenging weight, at least twice a week. The conversation then tackles one of the most persistent myths in pelvic health: that lifting worsens prolapse or incontinence. Chloe breaks down the intra abdominal pressure research and explains why training at the edge of symptoms, rather than avoiding exercise entirely, is how we build tolerance and capacity. Chloe also shares her PhD direction. Her goal is a four arm intervention study comparing resistance training alone, resistance training plus pelvic floor exercises, pelvic floor exercises alone, and a control group over 16 to 20 weeks to determine whether progressive strength training improves pelvic floor function. Theme Song: "Can't Hold Us Down" by Christina Aguilera Key Topics Covered: Barriers and facilitators to resistance training in menopause, the updated 2026 ACSM resistance training guidelines, a beginner friendly four exercise program, intra abdominal pressure and the prolapse lifting myth, musculoskeletal syndrome of menopause, why menopause specific exercise programs can be predatory marketing, pain education and DOMS (delayed onset muscle soreness) for new exercisers, progressive overload and building confidence through group training Resources and References Mentioned: ACSM Position Stand: Resistance Training Prescription for Muscle Function, Hypertrophy, and Physical Performance in Healthy Adults (2026) Stuart Phillips, PhD, McMaster University (referenced re: resistance training in menopause) Anthony Lo (referenced re: breath strategies and movement modification for pelvic symptoms) Connect with Chloe Lewis: Instagram: @chloelewisphysio LinkedIn: Chloe Lewis Connect with The Hole Shebang: Visit blueberrytherapy.ca Subscribe to The Hole Shebang Podcast Instagram: @blueberrytherapypelvichealth

Michelle Gauvreau is a certified nutrition coach, fitness instructor, published writer, product developer, public speaker, and trusted television nutrition correspondent with nearly two decades of experience in the health and fitness industry. She began her career as Assistant Editor at RK Publishing for MuscleMag and Oxygen Magazine, later serving as Advertising Director and health writer with Inside Fitness and IFM Media. She has competed at the provincial and national level in bikini fitness representing Ontario and Canada, and is the founder of The Michelle Method, a philosophy built on sustainable nutrition, self-love, and helping women build a lifestyle they can maintain for life. She is a mom of three and a dedicated fur mama. In this episode, Michelle and Kristen dig into the real story of postpartum recovery. Michelle had her first son at 30 and her second at 41, following a complicated delivery that required both a C-section and a surgical repair at 36 weeks. Her recovery the second time was dramatically faster, and she attributes it entirely to what she did differently. What listeners will learn: Why consistent movement and clean nutrition during pregnancy is the most powerful investment in postpartum recovery How to build back postpartum in phases from zero to two weeks through to four to five months, including when to add impact and how to listen for warning signs What postpartum nutrition should focus on, including protein, fiber, hydration, collagen, and the breastfeeding-specific adjustments that are often overlooked How postpartum and perimenopausal symptoms can overlap for women having babies in their late 30s and 40s The truth about C-section overhang and why pelvic floor physio plus nutrition addresses it far more effectively than surgery Resources and References Mentioned: Dr. Margie Davenport's postpartum return to exercise guidelines: Canadian Physical Activity Guidelines for Postpartum Inner Wealth amino acid supplements (mentioned by Michelle for perimenopause symptom support): search Inner Wealth on Instagram Theme Song: I'm Every Woman by Chaka Khan Connect with Michelle Gauvreau: The Michelle Method website @themichellemethod on Instagram Connect with Kristen and Blueberry Therapy: Blueberry Therapy website The Hole Shebang Podcast @blueberrytherapypelvichealth on Instagram

Dr. Dolores Fernandez never planned to specialize in menopause. She opened her naturopathic practice with dreams of treating fertility patients, but menopause kept walking through her door. Today, she's a NAMS Certified Menopause Practitioner, founder of IRIS vulva care products, and a passionate advocate for destigmatizing conversations about vaginal health. What You'll Learn In this episode, we explore Genitourinary Syndrome of Menopause, or GSM, which is a collection of symptoms affecting 85% of postmenopausal women. These symptoms include vaginal dryness, pain with penetration, recurrent UTIs, and structural changes to the vulva. Dolores explains the science behind why these changes happen, how to assess symptoms clinically, and what treatment options actually work. We discuss the critical difference between vaginal moisturizers and lubricants, why vaginal pH and osmolarity matter for product safety and efficacy, and how to meet patients where they're at when it comes to treatment comfort levels. This conversation also explores why GSM remains so undertreated despite its prevalence, the shame and stigma that prevents people from seeking help, and why Dolores created IRIS when she couldn't find products that met her clinical standards. Guest Bio Dr. Dolores Fernandez, ND, MSCP, is a naturopathic doctor in Ontario, Canada, with a clinical focus in menopause. She is a North American Menopause Society (NAMS) Certified Menopause Practitioner and a member of the International Society for the Study of Women's Sexual Health. Beyond her clinical work, Dr. Dolores is the founder of IRIS, offering clean, science backed vulva care products aimed at ending the stigma around women's health. She's also a wife, mom, reader, and fitness enthusiast who believes in creating safe spaces for conversations about intimate health. Theme Song: The Climb by Miley Cyrus Key Topics Covered What GSM (Genitourinary Syndrome of Menopause) is and why 85% of postmenopausal women experience it The progressive nature of vaginal changes and why symptoms can appear years after menopause begins Clinical assessment approaches including physical exams and symptom based evaluations The difference between vaginal moisturizers (daily use with hyaluronic acid) and lubricants (for penetration) Why vaginal pH and osmolarity matter for product safety and effectiveness Treatment options from over the counter moisturizers to prescription vaginal estrogen and DHEA The shame and stigma that prevents people from discussing vaginal health with healthcare providers Why patients often feel vaginal symptoms are their private responsibility while hot flashes feel acceptable to discuss The importance of anatomical education and helping patients understand their own bodies How IRIS was created to fill a gap in the market for evidence based vulva care products Lichen sclerosis and why it's important to treat vulvar conditions Bacterial vaginosis and recurrent infections Genitourinary syndrome of lactation in postpartum people Resources & References Mentioned North American Menopause Society (NAMS) at https://www.menopause.org International Society for the Study of Women's Sexual Health at https://www.isswsh.org IRIS Vulva Moisturizer and Personal Lubricant (products formulated with hyaluronic acid, optimal pH, and ideal osmolarity) IRIS IRIS was recently included in a journal article as a safe for vaginal use lubricant based on clinical criteria Connect with Dr. Dolores Fernandez Website: https://www.lovemyiris.com Instagram: https://www.instagram.com/drdoloresnd IRIS Instagram: https://www.instagram.com/lovemy.iris LinkedIn: https://www.linkedin.com/in/doloresfernandeznd Dr. Dolores will be speaking at The Pleasure Principle Conference on May 8th as IRIS is the platinum sponsor. Visit https://www.blueberrytherapy.ca to learn more about pelvic health services in Hamilton, Ontario. Subscribe to The Hole Shebang Podcast on your favourite platform. Connect with The Hole Shebang on Instagram at https://www.instagram.com/blueberrytherapypelvichealth

If you're experiencing brain fog, unexplained weight gain, crushing fatigue, or night sweats during perimenopause, this episode will help you understand what's actually happening in your body—and what you can do about it. Daphne Kostova is a certified holistic nutritionist, registered natural nutrition clinical practitioner, and hormone balancing coach who specializes in helping women over 40 restore their energy, balance their hormones, and achieve sustainable weight management. After experiencing severe perimenopausal symptoms in her early thirties following years of restrictive dieting and over-exercising, Daphne went back to school to understand what her body truly needed—and now she helps other women do the same. In this episode, you'll learn: Why your metabolism hasn't actually broken, and what's really changed in your body between your twenties and your forties The four pillars of hormone balance: gut health, liver function, adrenal health, and thyroid support—and why all four matter Common nutrition mistakes women make during perimenopause, including why intermittent fasting often backfires How chronic stress you don't even recognize anymore is affecting your cortisol, insulin, thyroid, and ability to lose weight Why foundational hormone support through nutrition is essential even if you're taking bioidentical hormones The role of sleep, meal timing, and movement in supporting balanced blood sugar and energy throughout the day What "living in the gap" means and why waiting for the "right time" to prioritize yourself keeps you stuck Theme Song: "Unwritten" by Natasha Bedingfield Daphne chose this song as a reminder that we're all constantly evolving and that perfectionism often keeps us frozen. Life is always unwritten, and that's okay. Resources Mentioned: Free Masterclass: Hormone Balance Over 40 - Daphne explains the four pillars in depth and how to support them through personalized nutrition and lifestyle changes. Connect with Daphne Kostova: Website: DK Wellness Instagram: @daphnekostova Facebook: DKwellness Free Masterclass: Hormone Balance Over 40 Free Discovery Call: Book Your Call More from The Hole Shebang: Visit blueberrytherapy.ca for pelvic health resources and to learn more about our Hamilton-based clinic. Subscribe to The Hole Shebang Podcast wherever you listen to podcasts. Connect with us on Instagram @blueberrytherapypelvichealth

Cardiovascular disease is the number one cause of death in women, yet most women don't realize that menopause itself is now recognized as a cardiovascular risk factor. In this episode, Dr. Daiana Castleman returns to The Hole Shebang to break down what's really happening to women's hearts during midlife—and the sex-specific risk factors that standard screening tools completely miss. What You'll Learn: Dr. Daiana Castleman explains why the menopause transition is such a critical window for cardiovascular health. During perimenopause and menopause, women commonly experience increased cholesterol levels, changes in blood pressure, insulin resistance, and worsening cardiometabolic health—changes driven by hormonal shifts that don't happen in men's bodies the same way. We discuss traditional cardiovascular risk factors that affect both men and women (smoking, high blood pressure, high cholesterol, physical inactivity, poor diet, obesity, diabetes, and psychosocial stress). These traditional factors account for 80-90% of cardiovascular disease risk. But here's what's crucial: three of these factors—smoking, diabetes, and psychosocial stress—have significantly heightened impact in women. Women who smoke are twice as likely to experience a heart attack compared to men who smoke. Then we dive into sex-specific risk factors that most doctors never ask about: Pregnancy complications carry significant cardiovascular risk: preeclampsia increases heart failure risk 4-fold and cardiovascular disease risk 2-fold; gestational diabetes increases cardiovascular event risk by 1.5-2x; preterm birth before 37 weeks carries 1.4-2.5-fold higher risk; stillbirth increases risk 1.5-2.2-fold; and placental abruption carries 1.8-fold higher cardiovascular disease risk. Lipoprotein(a) is a genetic marker that affects about 1 in 5 people (20% of the population) and is 6x more atherogenic than LDL cholesterol. It's more than 90% genetically determined and can increase during menopause while remaining stable in men. Everyone over 40 should have it tested at least once, yet most women have never heard of it. We also discuss premature or early menopause, PCOS, and autoimmune conditions like lupus and rheumatoid arthritis as additional sex-specific risk factors. Daiana explains why the Framingham Risk Assessment—while valuable—has serious limitations for midlife women. It only calculates 10-year risk and doesn't account for any sex-specific factors, meaning many women receive "low risk" scores that don't reflect their actual cardiovascular risk profile. The empowering news? 80-90% of cardiovascular disease is preventable when you know your risk factors and advocate for yourself. Theme Song: Put a Little Love in Your Heart by Annie Lennox and Al Green The Decads Ahead Summit (Apr 25, 2026): Information about The Decades Ahead Summit (Oakville) covering heart health, osteoporosis, hormone therapy, sleep, and nutrition for long-term health. Register Here: Decades Ahead Summit Registration Link Connect with Dr. Daiana Castleman: Website: Dr. Daiana Castleman Instagram: @dr.dianacastleman More from The Hole Shebang: Visit blueberrytherapy.ca Subscribe to The Hole Shebang Podcast Connect with The Hole Shebang on Instagram @blueberrytherapypelvichealth

What does proactive relationship care actually look like? In this conversation, Dr. Jessica O'Reilly breaks down the simple daily practices that prevent relationship breakdown and explains how cancer survivors can rebuild intimacy when bodies and identities have fundamentally changed. What You'll Learn: Why relationship quality (not just having a partner) is what impacts cardiovascular health, mental health, and longevity The 1-5-30 formula for maintaining relationships proactively: one minute daily, five-minute weekly check-ins, and thirty-minute monthly dates How to start intimacy conversations after cancer diagnosis without jumping straight to "what will sex look like?" Why practicing clinical and pleasure language out loud matters for healthcare providers Communication strategies for couples when one partner is navigating chronic illness or cancer treatment About Dr. Jessica O'Reilly: Jess O'Reilly (@SexWithDrJess) is a sex and relationship expert with a background in education and behavioural and organizational psychology. Her research and passion involves teacher training in sexual health and she works primarily with business leaders to improve relationships from the boardroom to the bedroom. Jess is also a television personality, author, podcast host (@SexWithDrJess Podcast) and award-winning international speaker who has facilitated hundreds of corporate workshops and retreats in 45+ countries from Lebanon to Switzerland. Theme Song: "All Over the World" by Proteje and Lila Iké Key Topics Covered: Dr. Jess's journey from high school teacher to relationship expert The gap in sexual health education for teachers (only 15.5% of Canadian teacher education programs had mandatory sex ed training) How Western culture centers intimate partnerships and why that makes relationship quality even more critical The protective health mechanisms of quality relationships Why couples wait too long before seeking support Using popular culture (Netflix, TikTok, streaming content) to start difficult conversations The sexual values interview as a foundation for rebuilding intimacy Teaching children anatomical language for safety and empowerment Resources & References Mentioned: Book referenced by Kristen: Women's Anatomy of Arousal by Sheri Winston Weekly relationship check-in questions (available through Dr. Jess's resources Connect with Dr. Jessica O'Reilly: Website: Happier Couples Instagram: @sexwithdrjess Podcast: Sex with Dr. Jess Podcast Keynote Speaker Announcement: Dr. Jessica O'Reilly is the keynote speaker at The Pleasure Principle Conference on May 8, 2026 in Hamilton, Ontario. Her session, "Pleasure as Practice: Eroticism, Desire, and Connection After Cancer," will provide healthcare professionals with practical strategies for supporting cancer survivors' sexual health. Learn more at blueberrytherapy.ca. Visit blueberrytherapy.ca | Subscribe to The Hole Shebang Podcast | Connect with The Hole Shebang on Instagram @blueberrytherapypelvichealth

Episode Overview Natalia, founder of Dott, joins the podcast to discuss why clitoral vibration should be considered healthcare for menopause—not just pleasure. As an industrial designer who experienced Premature Ovarian Insufficiency in her thirties, Natalia breaks down the physiology of estrogen loss, decreased blood flow to pelvic tissues, and how vibration therapy supports tissue health, natural lubrication, and nervous system regulation during hormonal transitions. What You'll Learn Why blood flow to your vulva and vagina decreases during perimenopause and menopause—and what that means for tissue health How vibration therapy prevents the thinning, dryness, and sensitivity loss that many people accept as "normal aging" The three-phase ritual (regulate, release, restore) and why nervous system regulation comes before addressing the vulva The difference between using vibration therapy preventatively versus therapeutically once symptoms have started Why standards matter in the intimate wellness industry—and what Health Canada licensing actually means Guest Bio Natalia is an industrial designer and founder of Dott, a Health Canada licensed intimate wellness company focused on perimenopause and menopause care. After watching her mother suffer through menopause in silence and experiencing Premature Ovarian Insufficiency herself in her thirties (which led to bone density loss before diagnosis), she founded Dott to treat vibration therapy as real healthcare for women's bodies. She designs tools and education that support hormone balance, pelvic floor health, nervous system regulation, and sexual comfort during hormonal change. Natalia collaborates with menopause clinics and pelvic floor therapists to integrate evidence-based vibration therapy into treatment protocols. Theme Song: The Chain by Fleetwood Mac Key Topics Covered The physiology of estrogen depletion and decreased pelvic blood flow How vibration therapy increases circulation to vulvar and vaginal tissues Nervous system regulation as the foundation of the three-phase protocol Why preventative care matters before symptoms become severe The lack of standards in the intimate wellness industry Partnering with healthcare providers to integrate vibration therapy into pelvic health treatment Connect with Natalia Website: Dott Wellness Instagram: @dott.wellness LinkedIn: Natalia B. Visit blueberrytherapy.ca and subscribe to The Hole Shebang Podcast. Connect with The Hole Shebang on Instagram @blueberrytherapypelvichealth

Dr. Jordin Wiggins is a naturopathic doctor, author of The Pink Canary, host of The Pleasure Principles podcast, and an intimacy coach for high-achieving women. Her journey into women's sexual health started in grade 10 with debilitating pelvic pain that felt like "somebody was shoving a knife in between my vagina and my rectum." Doctors dismissed her pain as psychological, offering antidepressants because they couldn't see the problem on imaging. It wasn't until naturopathic medical school that she learned about pelvic floor physiotherapy—the answer she'd been searching for. That experience of being dismissed by healthcare, combined with horrible reactions to birth control, shaped her mission: understanding why 50% of women globally suffer from sexual dysfunction and why so many successful women have everything they thought they wanted but feel completely unfulfilled. In this conversation, Jordin introduces super traits—personality strengths like empathy, loyalty, tolerance, and hard work that make you extraordinary in your career and relationships. But when there are no boundaries around these traits, women build their entire relationship around their partner's moods and comfort, carrying all the emotional labor while their own needs shrink smaller and smaller. What happens in the bedroom becomes a mirror of what happens outside the bedroom. What You'll Learn: How being gaslit about pelvic pain shaped Jordin's approach to women's health, why she ran a successful 7-figure women's health clinic that almost swallowed her whole, what super traits are and why conventional advice doesn't work for women who have them, the four hidden patterns that destroy intimacy in relationships, why "just communicate better" doesn't address power dynamics, the difference between desire that's gone versus desire buried under resentment, how to start examining your relationship without making things worse, why accountability requires checking for safety first, what it means to come home to your head, heart, and body, and why sex being "for him" while connection is "for us" keeps women stuck. Resources Mentioned: Super Traits Research: Sandra Brown's original research on super traits as personality strengths Free Resource: Super Traits Quiz — Take the quiz to discover your super traits. Jordin notes the quiz sends your top trait, but she can send all results profiles if you DM her on Instagram, as most women have three or four super traits. Theme Song: River by Bishop Briggs Connect with Dr. Jordin Wiggins: Website: Dr. Jordin Wiggins Instagram: @drjordinwiggins Podcast: The Pleasure Principles Book: The Pink Canary by Dr. Jordin Wiggins Visit blueberrytherapy.ca and subscribe to The Hole Shebang Podcast. Connect with The Hole Shebang on Instagram @blueberrytherapypelvichealth

When cancer treatment forces you into menopause overnight, the experience is drastically different from natural menopause. Your hormones don't gradually decline—they stop. And the symptoms? They hit hard and fast. In this episode, I sit down with Dr. Ashley Chauvin, a Naturopathic Doctor and Menopause Society Certified Practitioner who has built her practice around cancer survivorship and menopause support. Ashley shares her journey from radiation therapy intern to naturopathic doctor specializing in integrative cancer care, and why she's passionate about helping patients feel like themselves again after treatment. What You'll Learn: The physiological differences between medical menopause and natural menopause—and why symptoms are more intense when treatment shuts down your hormones overnight What to ask your healthcare providers before cancer treatment begins, and why establishing your baseline matters Ashley's non-restrictive approach to nutrition for cancer survivors (spoiler: it's not about eliminating gluten, dairy, and coffee) Why muscle mass is critical for cancer survivorship, longevity, and bone health The truth about hormone therapy for cancer survivors—including when vaginal estrogen might be an option How to collaborate with your oncology team without feeling like you're asking for permission to feel better What gives Ashley hope in this work, and why her patients inspire her to try adult gymnastics at 40 This conversation challenges the narrative that cancer survivors just have to suffer through menopause symptoms. You don't. There are options, and quality of life matters. Theme Songs: Can't Stop by Red Hot Chili Peppers (family friendly) Till I Collapse by Eminem (non-family friendly version) Connect with Dr. Ashley Chauvin: Website: Clarity Health Burlington Instagram: @ashleychauvin_nd Practice: Clarity Health, Burlington, Ontario (Virtual and in-person appointments available across Ontario) Visit blueberrytherapy.ca and subscribe to The Hole Shebang Podcast. Connect with The Hole Shebang on Instagram @blueberrytherapypelvichealth

Why Muscle Is Your Longevity Organ with Barbara Birke When your body stops responding to the same old strategies, it's not because you're broken—it's because your hormones are changing, and your body needs something different now. Barbara Birke is a German sports scientist and nutritionist who specializes in supporting women through perimenopause, menopause, and beyond. She studied sports science with a focus on psychology and motivation, managed an orthopedic rehab center, and has spent years teaching women how to build strength, optimize nutrition, and thrive through hormonal transitions. But her most powerful lesson came from her own body in her 40s, when she realized that muscle wasn't just professional advice—it was personal survival. In this episode, you'll learn: Why muscle loss accelerates when estrogen declines (and why muscle quality degrades if you don't actively work against it) How strength training acts as metabolic medicine—pulling sugar from your bloodstream, releasing protective myokines, and improving blood work markers The connection between strength training and bone health, brain health, and mood Why managing stress becomes harder in perimenopause and how to set better boundaries What "strength training" actually means for women who've never lifted weights before How building outer strength creates inner strength and empowerment Theme Song: "Unstoppable" by Sia Connect with Barbara: Website: Optimum-U.com Instagram: @strongwithbarbara Programs: Power & Balance (strength training), Clean Up (nutrition), Thrive Formula (12-week holistic program) If you're feeling dismissed by conventional medical advice or struggling with a body that suddenly won't cooperate, this conversation will give you the framework to understand what's actually happening—and what you can do about it. Subscribe to The Hole Shebang Podcast wherever you listen, and visit blueberrytherapy.ca for more resources on pelvic health and wellness. Connect with The Hole Shebang on Instagram @blueberrytherapypelvichealth

In this powerful episode, Kristen sits down with Michiko Tsukada Caringal, a pelvic health physiotherapist in British Columbia who brings both clinical expertise and deeply personal experience to her work. Michiko spent three years recovering from vulvodynia before becoming a physiotherapist, and that journey shapes everything about how she treats patients today. What You'll Learn: Michiko opens up about her non-linear recovery from pelvic pain, including the moments she gave up hope and how she eventually found her way to being symptom-free for over 10 years. She shares the golden nuggets from her journey—particularly the critical role of hope, finding your own advocate, and believing recovery is possible even when the path isn't clear. You'll hear about Michiko's unique approach to gender-inclusive pelvic care, her work as a subject matter expert with TransCare BC, and how she navigates the tension between maintaining professional boundaries while creating genuine human connection with patients. She explains her "detective cap" approach to understanding each person's unique story and why relationships are the foundation of all healing. The conversation also covers practical topics like post-prostatectomy incontinence recovery, functional pelvic floor training that makes sense in real life (not just on a treatment table), and why the best healthcare professionals can be both your cheerleader and your source of evidence-based facts. About Michiko Tsukada Caringal: Michiko is a pelvic health physiotherapist with a master's in bioethics who treats people of all ages and genders at two clinics in BC: Inner Circle Physio in Burnaby and Kaia Health Care Center. She specializes in gender-inclusive care, works as a subject matter expert for TransCare BC, and is passionate about empowering anyone with a pelvic floor to understand and heal their bodies. Theme Song: I'm a Believer by The Monkees Connect with Michiko: Website: Happy Down There Email: Available on her website Clinics: Inner Circle Physio (Burnaby) and Kaia Health Care Center (BC) Visit blueberrytherapy.ca to learn more about pelvic health services in Hamilton, Ontario. Subscribe to The Hole Shebang Podcast and connect with us on Instagram @blueberrytherapypelvichealth

Dee Hartmann is a pelvic health physical therapist who spent nearly three decades specializing in chronic vulvar pain. After treating thousands of women in her Chicago practice, she discovered that conventional approaches were missing critical connections - between old injuries and current pain, between visceral tension and pelvic floor dysfunction, and between pain elimination and pleasure cultivation. In this conversation, Dee shares her journey from treating incontinence to becoming a leading voice in vulvar pain treatment. She explains why pelvic floor dysfunction is a symptom rather than a cause, how seemingly unrelated issues throughout the body contribute to vulvar pain, and why her approach now centers on pleasure as a pathway to healing. What you'll learn: How Dee's own experience having five children in six years led her to specialize in pelvic health Why treating just the vulva or just the pelvic floor isn't enough The five exercises that can decrease vulvar pain before penetration of any kind How pleasure and arousal fit into physical therapy treatment What to look for (and avoid) when seeking pelvic health care Why a multidisciplinary approach matters for chronic pain Dee retired from clinical practice in 2017 and co-authored "The Pleasure Prescription" with Elizabeth Wood. She now travels internationally teaching her approach and speaking about the intersection of physical therapy, sexual health, and pleasure. Theme Song: Don't Stop by Fleetwood Mac Connect with Dee Hartmann: Dee Hartmann Physical Therapy Website: Dee Hartmann Physical Therapy Book: The Pleasure Prescription on Amazon:  Find Dee on Facebook and LinkedIn Connect with Blueberry Therapy: Website: Blueberry Therapy Instagram: @Blueberrytherapypelvichealth Subscribe to The Hole Shebang Podcast on your favorite podcast platform

Episode Overview Breathwork facilitator Jenn Mansell joins The Hole Shebang to talk about how intentional breathing can shift everything from chronic illness to pelvic floor dysfunction to trauma patterns. If you've ever felt trapped in your body or caught in stress loops that keep you stuck, this conversation offers both the science and the hope you need. What You'll Learn In this episode, we explore how breathwork actually works in your body and why it's become such a foundational practice across healthcare disciplines. Jenn breaks down the physiology of breathing, from oxygen as your brain's primary fuel to how breath shifts your nervous system state and creates space for tension release. We discuss practical applications for pain management, pelvic health, and accessing emotions that live in your body beyond cognitive memory. You'll hear Jenn's powerful story of growing up chronically ill with severe eczema, allergies, and asthma, and how she moved from fear and disconnection to becoming a facilitator who's breathed with thousands of people. We talk about the moment she realized her body wasn't the enemy, how breathwork bridges the gap between feeling trapped and feeling wild, and why this simple practice keeps showing up in conversations with neuroscientists, physiotherapists, and trauma specialists. About Jenn Mansell Jenn Mansell is a breathwork facilitator and mentor who has been guiding people through intentional breathing practices for eight years. Her work combines breathwork with somatic therapy, internal family systems, and nervous system healing. She also DJs conscious dance spaces and has recently expanded her practice to include low dose cannabis and ketamine work for trauma and attachment healing. Based in Toronto, Jenn runs regular events and works with clients privately to help them reconnect with their body's innate intelligence. Theme Song: "Keep Going" by HRRTZ SHELLS Key Topics Covered The physiology of breathwork and nervous system regulation How stress is held as tension in the body Breathwork for chronic illness, pain management, and pelvic floor dysfunction Shifting from the default mode network (survival brain) to the limbic system Trauma release and accessing nonverbal body memory The role of oxygen in brain function and energy Somatic therapy and body intelligence Connect with Jenn Mansell: Website: jenmansell.com Instagram: @jenmansell Find Jenn's guided breathwork sessions on Insight Timer Ready to explore more? Visit blueberrytherapy.ca and subscribe to The Hole Shebang Podcast wherever you listen. Connect with The Hole Shebang on Instagram @blueberrytherapypelvichealth

Episode Overview Dr. Margie Davenport is rewriting the rules on exercise during pregnancy and postpartum—and the outdated advice about waiting six weeks or avoiding heavy lifting is officially being replaced with actual evidence. As an exercise physiologist at the University of Alberta and the lead researcher behind the 2025 Canadian Postpartum Exercise and Sleep Guidelines, Margie shares the groundbreaking research that's changing how we support people through this massive life transition. What You'll Learn Why the six-week postpartum checkpoint has been completely removed from the new guidelines and what replaced it (hint: it's way more individualized and actually useful) How the Get Active Questionnaire for Postpartum helps you determine when YOU'RE ready to start moving—not when some arbitrary timeline says you should be The shocking research showing that people who lifted heavy (>80% of their 1RM) throughout pregnancy had a 51% reduction in adverse pregnancy outcomes Why the "don't lift more than 20 pounds" advice during pregnancy is based on occupational lifting literature and doesn't apply to intentional strength training How to gradually and safely progress toward 120 minutes of moderate to vigorous physical activity per week postpartum using symptom-based cues Why starting exercise during pregnancy is beneficial even if you've never been active before Resources Mentioned Get Active Questionnaire for Postpartum - Use this self-screening tool to determine when you're ready to start your postpartum exercise journey About Dr. Margie Davenport Dr. Margie Davenport is an exercise physiologist and researcher at the University of Alberta, where she founded the Program for Pregnancy and Postpartum Health in 2013. A former national team athlete, Margie has dedicated her career to pushing the boundaries of what we know about exercise during pregnancy and postpartum. She led the development of the 2019 Canadian Pregnancy Exercise Guidelines and the groundbreaking 2025 Canadian Postpartum Exercise and Sleep Guidelines. Theme Song: Survivor by Destiny's Child and My Way by Frank Sinatra Connect with Dr. Margie Davenport: Website: Exercise in Pregnancy Instagram: @DrMargieDavenport Visit blueberrytherapy.ca and subscribe to The Hole Shebang Podcast wherever you listen. Connect with The Hole Shebang on Instagram @blueberrytherapypelvichealth.

Episode Overview Dr. Daiana Castleman, naturopathic doctor and menopause specialist, joins Kristen to talk about Genitourinary Syndrome of Menopause (GSM)—a condition that affects up to 85% of women by 20 years post-menopause but remains dramatically underdiagnosed. This conversation goes beyond vaginal dryness to explore the full impact of estrogen decline on sexual, urinary, and overall health. What You'll Learn In this episode, we discuss the real symptoms of GSM including painful intercourse, recurrent UTIs, urinary urgency and frequency, and vaginal irritation. Daiana explains how estrogen loss changes the vaginal and urinary microbiome, increasing susceptibility to infection and why vaginal estrogen is a game-changer for prevention and treatment. We also dive into sleep disruption during perimenopause and menopause—why waking up multiple times to urinate isn't normal aging, how sleep apnea presents differently in women (often without snoring), and what proper assessment looks like before reaching for supplements. Finally, Daiana shares the incredible stat that over 90% of cardiovascular disease is preventable, making perimenopause and menopause the ideal time to focus on longevity, heart health, bone density, and cognitive function. About Dr. Daiana Castleman Dr. Daiana Castleman is a naturopathic doctor specializing in menopause, hormone therapy, and women's sexual health. She was inspired to pursue naturopathic medicine after her own transformative experience with an ND, and found her passion for menopause care through conversations with her own mother about perimenopause. Daiana was a keynote speaker at The Pleasure Principle Conference 2025 and is deeply committed to helping women get the evidence-based support they deserve during this life transition. Theme Song: "Rise Up" by Andra Day Connect with Dr. Daiana Castleman: Website: Dr. Daiana Castleman Instagram: @dr.daiana.castleman Newsletter: Subscribe through her website for expert menopause education Additional Resources: Menopause Foundation Canada - Evidence-based menopause information and resources Visit blueberrytherapy.ca to learn more about pelvic health physiotherapy and multidisciplinary care in Hamilton, Ontario. Subscribe to The Hole Shebang Podcast for more honest conversations about women's health topics others whisper about. Connect with The Hole Shebang on Instagram: @blueberrytherapypelvichealth

Episode Overview: When was the last time you actually looked at your vulva? If you're like most people, the answer is "never" or "I don't even know what I'm looking for." In this eye-opening conversation, nurse practitioner Kathryn Flanigan, Nurse Practitioner,  breaks down everything we should have learned about vulvar health—but didn't. What You'll Learn: The crucial difference between vulva and vagina (and why it matters for your health) How to talk to kids about their anatomy using correct terms without awkwardness Common vulvar conditions like lichen sclerosus and when to seek treatment Why the vagina is self-cleaning and what products to avoid How hormonal changes affect vulvar health across the lifespan—from postpartum to menopause Proper vulvar care practices (spoiler: ditch the scented soaps) How to recognize what's normal aging versus what needs medical attention About Our Guest: Kathryn Flanigan is a nurse practitioner with over 25 years of experience in primary care. She's been recognized as Preceptor of the Year three times and specializes in vulvar health and pelvic conditions. After recognizing that her elderly patients lacked the vocabulary to describe vulvar changes, Kathryn dedicated herself to educating both patients and healthcare providers about this under-addressed area of health. She's passionate about giving women across the lifespan the language and knowledge to advocate for themselves. Key Topics Covered: Vulvar anatomy 101 • Stigma and health literacy • Teaching children body autonomy • Vulvar skin conditions • Hormonal changes and vulvar health • Proper vulvar care practices • Patient advocacy • Canadian health resources Resources Mentioned: GynQI.com - Canadian gynecologist-developed resource for vulvar care, lichen sclerosus, menopause, and more FemmeSense Balm  The Body Book by Kathy Stinson Connect with The Hole Shebang: Instagram: @blueberrytherapypelvichealth Visit: blueberrytherapy.ca Subscribe to The Hole Shebang Podcast wherever you listen to podcasts

What if sex was supposed to feel good—but your body won't let you get there? In this episode, Kristen sits down with Dr. Janelle Frederick, a pelvic floor physical therapist known as the Vagina Rehab Doctor, to talk about vaginismus, sexual pain, and how virtual pelvic health treatment is changing lives. Dr. Frederick shares her journey from working in orthopedics to specializing in sexual dysfunction—and why she left her dream job at a top hospital to build a remote coaching practice focused on patient empowerment. If you've ever wondered how pelvic PT could possibly work over Zoom, this conversation will blow your mind. What you'll learn in this episode: What vaginismus actually is (hint: it's a pelvic floor muscle disorder, not a psychological problem) Why early signs like difficulty with tampons or pap smears matter—and shouldn't be ignored How religious upbringing, cultural messaging, and even childhood constipation can contribute to vaginismus Why "just relax" is terrible advice when your pelvic floor is in overdrive The three first steps to take if you think you're dealing with sexual pain or vaginismus How Dr. Frederick's virtual model gives patients more agency and often leads to faster healing What "Vaj Stretch Labs" are (and why moving your body matters for pelvic floor release) This episode is for anyone who's been told their pain is "in their head," who's tried treatment that didn't work, or who's just starting to realize that painful sex isn't something you have to live with. About Dr. Janelle Frederick: Dr. Janelle Frederick is a Doctor of Physical Therapy who specializes in treating vaginismus and sexual pain. After completing her pelvic health residency at Loyola in Chicago, she built a thriving remote coaching practice that's helped over 300 people experience pain-free, pleasurable intimacy. Her approach focuses on patient empowerment, self-assessment, and addressing both the physical and mental aspects of healing. Connect with Dr. Janelle Frederick: Instagram: @vaginarehabdoc Visit Blueberry Therapy: blueberrytherapy.ca Subscribe to The Hole Shebang Podcast Follow us on Instagram: @blueberrytherapypelvichealth

Episode Overview What if the future of pelvic health looks more like Invisalign than one-size-fits-most devices? In this episode, Kristen sits down with Derek Sham, biomedical engineer and founder of Cosm Medical, to explore how precision medicine is finally coming to women's pelvic health. Inspired by his grandmother's struggle with pelvic organ prolapse, Derek is revolutionizing vaginal pessary technology with custom devices designed using AI, digital scanning, and data from thousands of women. What You'll Learn How custom pessaries work and why 1-2 millimeters actually matters for patient outcomes and comfort The shocking innovation gap between men's and women's pelvic health (hint: the prostate market is 10X larger) Why the same surgery gets reimbursed 30% less when performed on women versus men The future of postpartum recovery: "gynothotics" that could prevent prolapse through tissue remodeling How AI is transforming pessary fitting from an art based on experience to data-driven precision medicine What digital scanning technology could mean for moving beyond finger measurements in urogynecology About Derek Sham Derek Sham is a biomedical engineer and founder of Cosm Medical. He previously built the world's most utilized urodynamics system and brings over a decade of experience in medical device development to women's health. Driven by his grandmother's experience with pelvic organ prolapse, Derek is on a mission to bring precision, innovation, and digital technology to a field that has been underserved for decades. Key Topics Covered Custom pessary design and fitting • Postpartum tissue remodeling • Women's health innovation gaps • Healthcare reimbursement disparities • AI-assisted clinical decision making • Digital gynecology platforms • Access and affordability in pelvic health • The entrepreneurship journey in medical devices Connect with Derek Sham and Cosm Medical Website: COSM.care Instagram: @cosm.medical LinkedIn: Derek Sham Resources Visit blueberrytherapy.ca to learn more about pelvic health physiotherapy in Hamilton, Ontario Subscribe to The Hole Shebang Podcast for honest conversations about women's health topics Connect with The Hole Shebang on Instagram @blueberrytherapypelvichealth

Episode Overview What's the connection between how you eat and how you experience intimacy? In this episode, Kristen sits down with Emily Arthur, a registered dietitian specializing in women's health, to explore the surprising intersections between nutrition, body image, sexual health, and endometriosis. What You'll Learn How disordered eating patterns affect intimacy and sexual expression—not just with partners, but with yourself Why people with endometriosis are five times more likely to struggle with disordered eating, and how pain becomes tangled with attempts at control What interdisciplinary endometriosis care actually looks like, and why it's so effective (yet so rare in Canada) The spectrum of eating behaviors—from intuitive eating to eating disorders, and all the messy stuff in between How cultural expectations around gender literally shape what we put on our plates and how we relate to our bodies Practical approaches to addressing nutrition in pelvic health without falling into restrictive diet culture About Emily Arthur, RD Emily Arthur is a registered dietitian who specializes in nutrition for women's health "from first period to last period and everything in between." She completed a graduate certificate in sexual health education and has specialized training in endometriosis and pelvic health. Emily is part of the Endometriosis 360 interdisciplinary team, which provides comprehensive group programming combining nutrition, physiotherapy, and psychology for people with endometriosis. She also provides one-on-one nutrition counseling through Brandt Nutrition and is actively involved in endometriosis research. Key Topics Covered Disordered eating and its impact on intimacy | Endometriosis and nutrition | Body image and sexual health | Gender expectations and food | Intuitive eating | Interdisciplinary pelvic health care | The Endometriosis 360 program Connect with Emily Instagram: @emilytheperiodrd Website: emilytheperiodrd.ca Resources Visit blueberrytherapy.ca to learn more about pelvic health physiotherapy and comprehensive care. Subscribe to The Hole Shebang Podcast wherever you listen to podcasts. Connect with The Hole Shebang on Instagram @blueberrytherapypelvichealth