Blog

July 17, 2020

Painful Sex Is NOT In Your Head: Holistic Solutions From a Pelvic Pain Doc

Podcast: Play in new window | Download

Sexual pain is not in your head. Dr. Sonia Bahlani, founder of PelvicPainDoc.com and author of The Holistic Guide to Navigating Pelvic Pain joins us to answer so many questions including:

• How do I deal with painful orgasms? It feels like the head of my penis is being pushed through broken glass.
• How do my bowel movements and constipation affect sexual functioning & orgasm?
• How can an anti-inflammatory diet improve sex?
• How can yoga improve sexual functioning and pelvic floor tone?
• Why does sex hurt?
• Why don’t I feel anything during sex?
• Are there injections, creams or medicines that can help with pelvic pain?

Dr. Sonia also discusses why preventative medicine is essential to sexual health, various diagnoses related to sexual pain and how holistic approaches can revolutionize your (sex) life.

Also be sure to listen to our episode on pelvic floor health, postpartum sex, perineal massage and de-stressing your vagina.

Follow Dr. Sonia Bahlani on Instagram and Facebook.

This episode is brought to you by Womanizer. Use code DRJESS for a small discount at checkout!

If you’ve got questions or topic suggestions for the podcast, submit them here. As well, you can now record your messages for us! Please record your message/question in a quiet room and use your phone’s headphones with a built-in mic if possible.

And be sure to subscribe on Apple Podcasts, Spotify, Podbean, Google Podcasts, Amazon Music & Stitcher!

Rough Transcript:

This is a computer-generated rough transcript, so please excuse any typos. This podcast is an informational conversation and is not a substitute for medical, health or other professional advice, diagnosis or treatment. Always seek the services of an appropriate professional should you have individual questions or concerns.

Painful Sex Is NOT In Your Head: Holistic Solutions From a Pelvic Pain Doc

00:00:05 – 00:05:05

You’re listening to the sacs with Dr Jess, podcast, sacks and relationship advice. You can use tonight. Welcome to the sex with Dr Just podcast I’m your co host Brandon wear here with my lovely other half Dr Jess. How’s it going? I’m hanging in there. How about you? Much the same. Yes, the same, still a lot of weirdness going on with the changes to the schedule acclimatising to the norm completely zoom meeting. Are you. It’s a thing. It, I’m totally exhausted I. started doing what you’ve suggested. which is turn off the video? If you can. Yeah there’s this pressure to have video on actually I was on a conference call the other day, and while other people were talking I turned off my video and I got called out for it, they said. Are you still there? Yeah, I’m still here. I just felt like having my video off I. Don’t always want people looking at me and you know what I’m distracted by myself. In Real, no, of course you’d like. You’re looking at yourself, so you looking at yourself as other people are looking at you. And Yeah. You need a break from it for sure and we’ve talked about this and there’s research on how exhausting video calls can be. How much more exhausting they can be than in person meetings so? One thing I’m noticing that folks are consistently requesting zoom calls when in fact, these could easily be phone or emails. Yeah the the the effectiveness of a very concise email I said that last week to a gentleman, he requested amino acid. Can we just have a phone call? And it was fine and it works out. They don’t see your face. I mean be honest. You just don’t do your hair. Completely one hundred percent Brennan’s hair was out of control for a while there three and a half months with a haircut news, looking pretty pretty wild treat. My neighbors kept calling you different names like I don’t know if they were actors or Singers or something, but we’re so much younger that I had no clue who they were talking about. Did you know the names they were calling? You know I thought I kind of looked like sideshow. Bob For a little while with the hair in all different. I know now I’m excited because I’m going to be a hawking wares on television in a couple of weeks, or actually in the upcoming week on TSE’s so I think a lot of people think TSE is the shopping channel, but the brand is actually today’s shopping. Choice probably will get into the fact that they probably just didn’t want to pay for the name when they bought the station, but there is there’s. There’s a show and I’m really excited to to be representing. We’ve been womanizer on the show. So I thought I was going. Be a thought I would shout out womanizer, because many people aren’t familiar with the brand and womanizer is not a vibrator. It’s this pleasure air toy, and it’s on sale right now, so the to go version in Canada’s on sell for fifty nine dollars, which is a bit of a steel. It’s normally a one hundred and fifty nine so I’m guessing I can’t see the American site because I’d have to turn on my VPN and I wouldn’t do that, so it’s probably like fifty bucks, but you can’t hold me to that okay. I am not an official spokesperson naming prices, but this is what I see on my website right now. So suggest people check it out the womanizer toy has a small opening that fits kind of around the head of the clitoris, and then it releases these waves of air, these gentle, very very gentle, designed for kind of really sensitive nerve endings of the head of the Clinton and so I gave onto a friend wanted to come on the podcast ’cause. She’s complaining that she’s done in ten seconds. She’s like well I? Just come in ten seconds. So why would i? Why would her words the other night over wine? Where why would I jerk off when I can just do this in ten seconds? She actually said to me. She was like I feel like I. Didn’t earn it. was like well. That’s amazing. She took me ten seconds. I. Feel like I need to do more work to get what I got, so she’s pretty pretty excited about it I’m excited about it. You can check it out on on TSE, but also womanizer dot, com and I suggest please use code Dr J. Dr J. S to save a couple extra dollars, and now it’s time to get to the topic at hand. Joining us today to talk about pelvic pain is Dr Sonya Baloney founder of pelvic pain and author. Of A new book the holistic guide to navigating pelvic pain, thank you so much for being here. Thank you so much for having me. How did you find your way into working around the topic of pelvic pain in pain during sex? It’s so interesting, but you know when I did my residency, no one was talking about this stuff. And yet I would have women come into the office and say I have all of these issues and here practitioners say you know what just have a wine before sex. Just seemed so archaic and just so inefficient for patients, and we weren’t really diagnosing and treating them, so that’s really want I decided to Kinda dedicate my career to it, and it’s been an amazing road and now i.

00:05:05 – 00:10:04

see men too, so it’s super interesting. So a glass of wine, do you? Recommend this. Is it because they don’t know? Is it because doctors don’t necessarily have training in this or because quality of life, approaches may not include sexual fulfilment it such a great question so I think it’s twofold number one I. Think it’s because most practitioners don’t have training in this. Because when you see training programs in medicine, they’re just so diverse and they’re focused on delivering babies. They’re performing surgeries that these. These nuances of care that are so important to quality of life issues or just never really addressed so I think that’s number one and then number two I think it’s because there’s such a stigma attached to having discussions like that’s although we should be, and so when that Stiglitz, their people are not addressing it because they’re not necessarily even bringing it up to their doctor’s. Although we should be always talking about this. I wonder. Do you ever hear people saying two men who are dealing with these sorts of issues Hey, just have a glass of wine near. The pain in your in your penis will go away or can’t see me right now, but I’m coughing my hands exactly that no, we don’t. And so when men have issues with erectile dysfunction paint at the tip of the Pena’s. You know difficulties having an erection. These issues are always addressed almost immediately in the office. So there is such a discrepancy between that and it’s a huge issue. Interestingly actually have a question from from a listener, a listener with a penis. And maybe you can help with this, so he says that he’s a fifty two year old. Who has pelvic pain and general issues for many years? He you know he’s thought it’s all in his head, and his problem is with orgasm. It is either very painful or non-existent, and he says in penetrative sex I last about thirty seconds before a Jackie leading, and it feels like the head of my penis is being. Pushed through broken glass and I have a tearing sensation between my legs. The thirty second thing is new which you know from my perspective, make sense if something feels like pushing through broken glass I imagine there’s anxiety, and then he says when I masturbate. There is no sensation whatsoever I can feel the pulsing ejaculate, but that’s it no tingling pleasure I just suddenly Jackie late. This is key so so one thing. I WANNA point out here. Is that oftentimes impelled pain when it exists both in men and women, the causes are really similar so in in someone like this, you have to understand that a lot of issues are kind of twofold. And I and we use the term in medicine called neuro muscular, because it involves the nerves and involved the muscle. And what it involves the nerves in the muscles an often times. Those pelvic floor muscles, what happens is that you declare blood flow to this area, so people can feel pain at the tip of the penis. People can feel difficulty, orgasm or pain with orgasm that shattered glass ceiling that he’s describing is actually very common in something men that’s known as CPS chronic pelvic pain syndrome. It used to be called chronic prostitites, but that term doesn’t really mean anything. Anything so you know the longest short of it is that yes, this is absolutely something that we see men with it. There’s so much we can do to address it. and I do think that especially in my own practice. I see that people can get better with the right therapies, so he’s definitely not alone in this and it’s. It’s something that can be treated though. And so the treatment I know you can’t tell us exactly what it looks like. But what might it entail if he were to come to your office? So so number one as you said it’s. It’s always individualized. You know we have to take a look at that person examined that person, but oftentimes they said when things are neuro muscular. You have to really calm down the inflammation in the muscles, and that can be done all sorts of ways one with medications, sometimes with different suppositories something. That’s super helpful which. Which I’ve listened to podcasts before actually pelvic floor. PT which men can have as well and and actually public physical therapy is super helpful for pain with erections and workout zones so i. mean you don’t realize these things? But they’re all interconnected and so key and then you know in terms of as I, discussed medications and public for PT. We also have procedures that can be done to fix this. So for lots of people who have this. Sometimes we do things called trigger, point, injections or public, floor Bota. I know I’m kind of throwing out a lot of terms that you can stop me, but the point is that there’s a ton that can be done when you an individualized treatment. You know what this is all new to me and this person is saying that they’ve they’ve actually been told. It’s all in their head and they’ve seen urologists. Is there just a lack of of I? Guess Dissemination of information that these treatments are available and I also question what is a suppository is it? Is it in? Where does it go because I only? Only.

00:10:04 – 00:15:07

Think of one positively. Yeah! Depository for men actually goes in the rectum. Four women can go either in Vagina or the rectum so so there’s different spots that we can put it in either the rectum, the Vagina and you know forget, so thank you for asking that question because I wanNA. Make sure that we’re all on the same page about these things. Now the in your head thing I just want to address because it’s actually one of my biggest pet peeves, and I hear this all the time in your head. It’s in your head and I think that there’s a multitude of reasons that practitioner say this number one. Please know that it’s not in your head. Is there a mind body connection a hundred percent? We all know that and the problem is that issues down there can cause anxiety or can worth an anxiety, and so when you have that association there, you have to think about what’s happening and I want to go through this and feel free to stop me, but remember how I said that it’s a neuro muscular issue. That the muscle spasm and it decreases blood flow, and that affects erections or Jackie relation now if you’re stressed out, what is your kind of reflects reaction? Have you ever seen people? They clench their jaw. Well, you can clench your pelvic floor muscles as well. So why does anxiety or stress worse than physiological symptoms, actually physiologic response in your body? That’s causing this to happen so the in your head thing. I think number one is is not an appropriate answer and number two. There’s a reason for that connection. That makes sense in it I mean it certainly feels dismissive, because in your head can make it sound like. Oh, just just relax just relax, and of course. If you tell me to relax the last thing I’m GonNa. Do is relax right exactly and and I think it’s also a lack of knowledge I. Think when we don’t know what to do. Sometimes the the easiest answer is to kind of say it’s. Your stress but I don’t think that’s the most effective answer for most patients. I could see just as face when she asked about the suppository for people with pianist. Because you’re looking at me and thinking, is he thinking? He has to put something into the peanuts. and. Very glad to hear that if there was an issue that needed a suppository, it would be in the. In the in the rectum. Yeah, even if you don’t like things in your, but you definitely want it in your budget Eureka option between the two. I’ll take the back door. Now going to say a great point to we can see how it’s all connected in that area because. I didn’t even think about that so I. Think it’s such a great point to see how all the muscles actually do kind of connect in the rectum, and that’s why putting and the positivity, and the rectum can actually help the symptoms, but great point. I wonder right now in the midst of this. pandemic that we’re seeing. Are you getting more people calling you? Or contacting you through your clinic, because of the added stress like is there has there been an increase in in calls with people, a hundred percent, and like I said I absolutely I was actually having this conversation with a colleague the other day I think with the backdrop of everything that’s going on number one. People are not also addressing their symptoms as rapidly as they normally would, so it’s kind of building up and building up and building up, and then the added stress anxiety of kind of Coz it, and the climate is just making things worse so for sure. You know I’m I’m glad we’re talking about pelvic pain for the penis because I think oftentimes when we we think about painful sex, it’s just for the vagina and so normalizing this conversation because this this question I received from a listener. Obviously many other people are going through this. We really appreciate you addressing it and letting them know that there are multiple approaches from floor therapy to injections to suppositories now if if we were to move to the vaginas we know that painful sex is far more common than perhaps is talked about, so we have you know a number of conditions that can lead to painful sex and I’m wondering if you can walk us through some of those. For sure yeah, and I love this question because most people just don’t even understand that there are multiple reasons that can cause painful sex, so it’s not like having a common cold than you give someone a pill, and then they’re automatically better and more most cases. There’s actually a multitude of causes that are occurring at the same time, and that’s what makes it so hard to treat because you’re trying to figure out what the actual pain generator is. That’s causing this person painful facts so. I’M GONNA. Kinda go through an algorithm in my brain, although this might be a little confusing, so first things first when someone comes into my office and says I’m painful sex, my first question to them is it is, is it with initial penetration or penetration, or both because that kind of helps a schematic in my brain, so if it’s with mostly with initial penetration, you’re kind of looking at the vulva as a cause for painful sex.

00:15:07 – 00:20:01

So is there some sort of infection? Is there some sort of what we call evolve our Dermot Toasty, or like? You can have exum on your hand. You can have extra money on your. Worries, there’s some sort of pain in the Volvo that we can’t see so something that in the medical world we call Vulva Denia. Denia which is often caused for painful sack. Now, we’ll take that to the other side. Let’s say she says you know what initial penetration is okay, but deep penetration and different position. Because remember you don’t want to just say you can only have sex in this position, and that’s it so you know if I if I change positions. That really hurts now. We’re thinking more pelvic floor. Okay, because when those muscles are spasm being around penetrative intercourse, it often cause pain with deep penetration, so there’s a vulva denia. Denia Pelvic Florida’s function. Now the other thing we have down. There is the bladder and so what people don’t realize. Is that oftentimes penetrative sex even in the vagina hitting up against the bladder? So if you have something known as interstitial cystitis, painful bladder syndrome, you can have pain with penetrative intercourse as well so there’s a multitude of reasons and those are just three scraping the like the surface of view, some patients can also have pain with clitoral stimulate stimulation so couture denia days can have pain with orgasm. Have Difficulty Orgasm ING, so we have to layer therapy based on all of this stuff. So if we go back to the Vulva and you said you can axa around the Volvo. Like potential treatments for that. To it so and I see that kind of just to it understandable to everyone so when I save all of our dermatitis. He’s weakened. Things have things like Lichen Sclerosis or like in planet, or and that’s commonly what you would find there, so it really needs to be by up seed, and then treatment would depend on what the actual pathology came back out, but oftentimes using low steroids in the vaginas helpful, but not for long periods of time, because that can actually out the tissue and cause more issues. And in terms of a another thing we talk about often in sex therapy is Gina Smith so I’m wondering if you can tell us a bit about Belgians Genus so veteran of Mrs so interesting, because it’s a little controversial in the pelvic pain role in the sense that a lot of people will say what is managing this dismissed meet. Do you know what I mean and so? It’s theoretically Maginness, it’s. It’s involuntary contractions of the Pelvic Floor musculature again neuro muscular in your a muscular in nature that prevents penetration now. If you ask a specialist there, tell you well. There’s different causes for actual batching this mess Baginda. We have to break this down, so is it because there’s a lot of nerves in the vulva in addition to the public floor to do, we have a combination of what we would call. Neuro proliferative Vestibule Denia Anti Tone Pelvic Florida’s function because you can treat vaginal adjustment. Do you know what I mean I mean? It’s not something because. Back in the day people think they just had to suffer with this and the don’t so I, think really breaking it down to these causes and addressing each and every one is what makes people be able to have the life that they want to. And, so when we talk about Virginia Smith’s for some people GIS like your hitting a brick wall. When you yeah we, we’ve had pelvic therapists speak about it. In fact, we had a woman come on on the on the paragraph on the podcast Meredith and talk about her experience, overcoming and working through Baginda Smith’s now. What about clitoral pain? Because I’m less familiar with this? What? What does that look like I? Mean I guess it’s pain when you touch the Taurus, but why does that occur in? What can we do about it? So it could be again. Do a couple of reasons one. Sometimes it can be due to what we call atrophy or thinning out of the clitoris, causing something that called Click twirl fibrosis where you can can’t really pull the hood of the clitoris up and so is that Kinda that sticking together can cause pain. That’s one aetiology of it secondly there. The clitoris has a ton of nerve. We know this right, and so sometimes the nerves fire more frequently than they wouldn’t someone else, and so when they fire more frequently, you can have pain with clitoral stimulation. You have pain with orgasm, so it’s an another important part to Really look at when you’re looking at someone. You know when we when we talk about the couturiers we often read in. You know mainstream magazines that the head of the Clitoris has eight thousand nerve endings. And then somebody emailed me asking me for the source. Actually one of the sex toy companies is this true? Do you know that I mean? Maybe you don’t count nerve endings? Maybe that’s not your focus. I.

00:20:02 – 00:25:06

Don’t count them, but the truth is yes. I mean there are a ton of nerve endings on the clitoris, even understanding that innovation of the dorsal nerve of the clitoris which is something that wasn’t discussed in science even ten years ago so I think we’re learning things every single day and kind of what you’re putting across, which is important, is that it’s not necessarily important about the number of nervous, but understanding that it’s probably one of the most innovative places in our body. So what do you do if you have trouble retracting the the hood or the foreskin of the Taurus and that’s causing pain. ’cause that sounds familiar to me. You know for the Penis Yeah. You absolutely have to see a physician who is specialized in this because and I just WanNa. Say That because you don’t want to be tugging at that area on your own especially because. Because that can often cause bleeding. It can cause more pain in in like we said it’s highly intervened. However, one thing that we can do which is important as you kind of want to have that tissue become more supple and one therapy. That’s often helpful is even using like a low dose estrogen testosterone in that area, just adding some hormones to that area to help. Increase blood flow and decrease that that tethering of the skin. Does that tend to be topical yet? Okay interesting. Now I have to ask about the other end of the spectrum. So for some people it’s hyper sensitive an and that can lead to pain, but what about people who don’t feel anything at all. You must hear from me. Patients who say I don’t really feel anything and sometimes I interpret that and you have to ask more questions you know. Is it that you don’t feel pleasure is that you don’t feel what you think you’re supposed to feel? But some people say they feel really nothing at all. And I think this is one of the hardest things to treat. Because just like you just said in this situation, there are actually a multitude of level that are related to this, so part of it is absolutely physiologic. Why are they not feeling anything? And where does that begin? So remember when we’re thinking about these issues. We’re thinking very local leap, but they don’t necessarily always have to be local. There’s a lot of new data looking at spinal pathology, actually related to things like this. So where does this begin this? This kind of schematic of not being able to feel anything and then there is. Libido and arousal and sexual health involves also involved. You know psychological component to it, so there’s always that inner like that interrelation that we have to evaluate so it’s a tougher question to answer only because that is really so dependent on exam and you know you, you speak about a holistic approach, so you have a background in the pelvic floor as well as in medicine I. can you break down overall? What does a holistic guide to navigating pelvic pain? Look like and of course people can go to your website pelvic pain. Doc Dot, com. And you have you have your book? But what does it mean to be realistic? What are you looking at? What are the layers? So you know I think it’s really important to look at every human as an entire human, and not just you know a problem based approach and I think that’s one part of medicine that has to change almost immediately because medicine, we look at different systems right? You see eye doctor for your colon UC H. Y. N.. N. If you have over Vagina. You see a urologist if you have a penis, but why? Why are people tossed around from doctor to doctor? Because we’re not taking a step back and looking at all the organs kind of and how they work as one, and that’s really the key for why even think this is so important, because when you look at it all at one you see how interconnected so appealing. The onion really involved looking at. At how the vagina plays a role in the pelvic floor, or how the penis and the prostate plays a role in the pelvic floor. How all of are related to the bowel? Because you can’t forget that the bow increasing constipation increase in Gi, disorders actually has a connection to the pelvic floor and the pelvis as well so So for me, it’s really number one taking a step back and and figuring out, so we have a lot to deal. Deal, with today, and I often say this to patients in my office. We have a lot to talk about today. But what is your biggest concern right now? And and that’s a hard thing. thing to tease out because addressing the biggest concern helps us take that first layer out to figure out what the next layer would even be because sometimes when you treat one thing you unmasking other set of symptoms, which is important to evaluate as well. Now you bring up the the bowel and the pelvic floor, and I think most of us don’t think about the bowels affecting our Sexual Response Orgasm Jackie Latian pleasure and you brought up constipation so constipation can that either affect your sexual response sexual functioning, or can it even be a symptom related to sexual functioning love to talk about that? Because I’ve never never come across that but I’m sure people have anecdotally been kind of tracking this on their own, but maybe are too shy to bring it up.

00:25:07 – 00:30:04

The. Yes, yes, yes, one hundred percent so actual. Data on this and it’s known as the bowel bladder connection, so we know scientifically that the nerves that synapse on these neurons synapse on both the bladder, and the bow and the pelvic floor so. That’s one part of it the second part of it. That’s super cool, so remember how we talked about the stress and clenching your John Country near Pelvic floor and how that’s related. Let’s take that into the bowel now. If someone comes in with constipation, one of my first questions is do you ever noticed that your symptoms of frequency urgency pain with a Jackie relation or pain? Pain with deep penetration increases when you’re constipated and almost always the answer is yes, why because those muscles are spasm and contracting more when you’re constipated? Because what do you do when you’re constipated? How do you get out? You push your strain to get it out more, and so what you do is actually cycle into the hyper tonic pelvic floor, and that’s really how it’s related. And so when you say a holistic guide, you know this includes your Diet I. Presume a hundred percent. Yes, absolutely and eight includes your diet for a few reasons. Obviously constipation as important, but we have to remember that a multitude of these issues are due to chronic inflammation, so info and eating a lot of inflammatory ingredients, which we don’t realize that we do can absolutely affect your ability to have. Enjoyable facts, painless, sex, good sacks, and and we don’t think about it that way, but it’s true. Anders data on it. So is there a I? Mean I know that there’s not a punishable. Is there something people could be changing in their diets or adding to their diets that might overall improve our sexual functioning, as it relates to to our bowel and bladder. Please tell me that it’s coffee and wine. Okay! We’re good. That is actually hilarious because I would say the biggest culprits. Are both coffee and I’m because what does that do? What Makes You pee more at increases your frequency, but tha that to that point. You know if someone said to my Peterson Pa- someone told me to give up coffee wine. It’d be like no way because it’s again. This is a quality of life issue. Right so we’re trying to balance things out I would say that there’s no hard and fast rules in Diet usually. Things that are helpful are anti inflammatory diet to decreasing inflammation near Diet you know sometimes limiting the amount of dairy that we have is super helpful and then, and then of course making sure that if there is what we call in the pelvic pain, world, dietary trigger that it’s eliminated, so there are certain foods. Coffee. Acidic foods that can actually trigger the bladder and trigger the pelvic floor, and so for some patients they can become more symptomatic with certain foods for others. It might not affect them, but individually looking at that is important. Are there foods that are generally anti inflammatory. You know this is interesting because a lot of people ask me this And I’m Indian background so a lot of this I. Obey the medicine is actually based on an anti inflammatory like. History, do you know what I mean and so you know in this day and age everyone? Talks about Turmeric for example right tumors is one of these like spices that has anti inflammatory effects to it which it does, but one thing that I wanna point out is that it’s really important that you want to activate the Kirkman so just putting to break in your food is not GonNa do anything we’re taking a tumor. Supplement is not going to do anything you need. Either something fatty to activate the Kirkman or you need something spicy, so that’s interesting because an Indian food, you always mixed tumor with black pepper, and it’s because the black pepper actually. Active the Kirkman so that it worked with an anti inflammatory effect to it, so yes, there are anti anti inflammatory things that we can add to our diet, but it’s important that we add them correctly. Because otherwise they just don’t have the potential to work the way they would normally have to work I’ve got to ask a boat curcumin is that the ingredient that needs to be activated for the tumor to be effective. Yeah so so so into merick cooking, and is the what we call the bioflavonoids, so it’s actually the ingredient that works to stimulate anti-inflammatory properties to et. Thank you for that just making sure. I understand everything so I don’t go sprinkle tumor into everything and hope. To Merkin in my morning strawberry smoothies. Will Be. Is your is your work informed by iron medic medicine.

00:30:05 – 00:35:00

You know my holistic approach to medicine is my grandfather was an Arabic doctor and my parents. You know kind of had it in my life all the time. And then when I started studying integrative medicine I really think one of the most important parts of all of our health is prevention, and so you know one of the problems in life now is that we’re always treating treating treating, and that often involves as we talked about medications procedures. Which obviously I love to do me. That’s my training, but at the same time if we support preventative. Preventative medicine in terms of good diet, good healthy lifestyle, and understanding how things are all connected I think that the longevity of treatment just last longer so for sure, it’s something that’s impacted the way that I treat patients but I think it’s just so key to people. Get better and better. You know if you fix something that’s great, but if you fix something in, it comes right back then. Did you really fix it, so I think this is all an important part of adding this into our thought process. We’re thinking about health in general. This makes sense so for folks who may be experiencing pelvic pain If you’re in Manhattan, obviously, they can see you. Do you see people digitally? I, do I I think people until all the time in fact right now, because of vid it’s it’s been a real nice thing because those laws preventing us from you know interstate, and even internationally are no longer really applicable and and our medical licenses have been allowed to kind of To see patients all over, and that’s been really great, and and I always have had patients kind of fly in from different places just because there’s. Not a lot of people who do this stuff, but now it’s so much easier. Because telehealth is something I will never get rid of I think it’s amazing and I think there’s so much you can do with it even over a computer like the conversation that we’re having right now. You know I mean so important. Brandon I fully agree we’re. We’re getting onboard with telehealth here in Canada. We have an APP called. Get Maple, and you can see a doctor at any time of the day and it just it makes so much sense to us. So folks can see you online pelvic pain doc dot com before I let you go. Is there anything people can do on their own to address? You know symptoms of pelvic pain. Yeah, for sure. Number one acknowledging it during it I, think is key because when you acknowledge it and you say I have so. Many people who come into my office for that has had pain for years, and they say you know I just thought it was something that I had and I kinda ignored it because that’s just what I thought was normal so number one having conversations. Conversations understanding that there that there are things that we can do is keep. Lots of people bring up lubricant I love lubricants. Lubricants are great, but it just like science lubricants are can be individualized to people and they should be so you know you don’t need to just by any lubricant from your drugstore there actually lubricants that have probiotics in them that have And you WANNA. Stay away from paradise and sulfates, but we have lubricants that can be really helpful to patients who are having maybe like a little bit of pain, but they’re not really sure if it’s even pain or discomfort. That’s kind of like a good place to start, but again that’s not usually the end. All be all for it, but that’s something that you can do at home A lot of times with pelvic floor musculature discussed a lot about thousand and contracting. So you actually want to be lengthening the muscles to help relax them, and that’s what we talked about pelvic floor PT, but even at home yoga is super helpful especially if patients are having with called pain with deep penetration, all yoga’s not made equal. So you know I don’t mean, do like Hot Yoga Tonga, Yoga anything that you’re contracting your. Your public floor, but anything that you’re relaxing. Your pelvic floor can be helpful as well so you know. Heating pads are also helpful. Warm Bath because they help you. Relax your pelvic floor muscles decreasing constipation I mean there’s a ton of things that we couldn’t go through you know, but those are just some of the first one that I would say even to get started on as you’re kind of navigating this process. This, all makes so much sense to me I really appreciate your holistic approach and I think holistic is a word that Kinda gets tossed around. But hearing you speak from the perspective of Paul, vic floor, therapy from the perspective of of Western medicine from the perspective of vedic medicine, talking about Yoga and the integration of these ancient eastern practices that have been keeping billions of people healthy. For for so many generations I really really appreciate your perspective. Highly encourage people to go check out pelvic pain, doc dot com as well as your holistic guide to navigating pelvic pain available on your website. Thank you so much I.

00:35:00 – 00:38:33

Really really appreciate your time, yes, you. Guys We have so many questions and we’d love to have you back again. Oh, I’d love to do this I. Love How you’re making these conversations normal and you’re making and they should be, and just like having this conversation is so key to me, so I appreciate you guys. Thank you Dr Sun Yat Baloney. Thank you? I really appreciate this discussion, and I especially appreciate medical practitioners who are actually holistic. Who Don’t just slap the label on, but we hear her talking about Yoga Iraq practices integrative medicine, other types of medicine pelvic floor therapy, and I feel like if I had an issue, certainly I’d I’d WanNa go to her. Wonderful bedside manner from this conversation that we had today for a topic that would make me. A little self conscious I think I already feel like I could have a very effective conversation with her. where I think she could find any problems that I have and help me fix them, so I like that already, and the good news is. The suppository doesn’t go on your penis. Clarify! Did I look squeamish. I asked the question I do know where suppository goes, but thank you for clarifying I. Mean I know what a suppository is, but well here I can have an I can have it in my rectum or I can have vaginal suppository so when she was talking about the Penis House like maybe they just slide it in the head there. No, like I said on that podcast conversation in the back door. If I had to take one totally fine with me it, it’s a reverse kidneys. Hey, actually I shouldn’t make fun because there are people who enjoy and it’s part of their king sounding, so we want to be clear that you know as much as it sounds very painful to you and I. Don’t have a penis, but if I did it sounds everything sounds painful to Aquinas for me to reach their own peanut seem so sensitive. You know what it has feelings to. Any. I WANNA. Be Clear not making fun whatever you’re into. We really do want to support you. If you have questions, please reach out to us. We want to have the mansard on the podcast. They know we’ve got a little bit of a backlog do check out Dr Sonya. Belongings work at pelvic pain. DOC DOT COM. It’s so difficult for me to say doc dot in a row, and the Nice thing right now is the ability to see her. Virtually must really increase the ability for people to get these problems fixed. If they want to write telemedicine here, we go love it and it folks checkout, womanizer, dot, com, use code Dr Jess. They’ve got some incredible toys on. On Sale, make sure your checkout intimately you on tse today, shopping choice. So that’s you know if you’re not as familiar with it, it’s like the you know the show being network here in Canada and they’ve got a show all about adult, and actually it’s going to be on TV as well in candidates going to be on city TV actually I should add that, but it’s called intimately you, can you? Would you be willing to hire remains to be Your van wait? There’s a shake could I showcase them. My hands probably need a manicure. You can avoid. Yes, yes yet, but you’ll make all. Your massive hands will make the sex toys look so small when in fact they’re not. That’s okay. Your your hands are very frightening. In a good way. I like it too all right folks wherever you’re at. Have a great one. Thank you so much to Dr Baloney. Thank you to you for listening and we’ll be back next weekend every week with a whole new episode. You’re listening to the sex with Dr Jazz podcast. Improve your sex life. Improve Your Life.