Episodios

  • 65: Why 85 Percent of Women Develop the Genitourinary Syndrome of Menopause with Dr Daiana Castleman
    Dec 11 2025
    In this episode, I sit down with Dr. Daiana Castleman, naturopath and menopause specialist, to talk about something that affects most of us but rarely gets the attention it deserves: genitourinary syndrome of menopause (GSM). What you'll learn: GSM includes symptoms like vaginal dryness, painful intercourse, recurrent UTIs, urinary urgency, and frequency—all stemming from declining estrogen levels. It's chronic and progressive, meaning it gets worse over time if untreated. And here's the stat that should wake us all up: by 20 years post-menopause, 85% of women will experience GSM, yet it remains underdiagnosed and undertreated. We dig into why vaginal estrogen is such a game-changer—not just for sexual function, but for preventing UTIs by supporting healthy vaginal and urinary microbiota. Daiana explains how estrogen decline alters our protective lactobacilli, making us more susceptible to infection. We also talk about sleep, because when you're waking up four times a night to pee, your sleep quality tanks. Daiana shares why multiple nighttime bathroom trips aren't normal (despite what we've been told) and what to assess before reaching for supplements. Spoiler: sometimes it's sleep apnea, and it doesn't always include snoring. Finally, we touch on cardiovascular health—because over 90% of cardiovascular disease is preventable, and menopause is the perfect time to take action. (We're absolutely doing a part two on this.) About Dr. Daiana Castleman: Daiana is a naturopathic doctor specializing in menopause, hormone therapy, and women's sexual health. She's passionate about empowering patients to understand their bodies and advocate for the care they deserve. Daiana was a keynote speaker at The Pleasure Principle 2025 conference. Theme Song: "Rise Up" by Andra Day Connect with Dr. Daiana Castleman: Website: dianacastleman.comInstagram: @dr.dianacastleman 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. Additional Resources: Menopause Foundation Canada - Evidence-based menopause information and resources
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    41 m
  • 64: Vulvar Health Basics Every Woman Should Know with Kathryn Flanigan
    Nov 27 2025

    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

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    36 m
  • 63: Vaginismus Isn't in Your Head and Here's Why with Dr. Janelle Frederick
    Nov 25 2025

    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

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    39 m
  • 62: Purple Pessaries, AI Fitting, and Building the Invisalign of Pelvic Health with Derek Sham
    Nov 21 2025

    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

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    39 m
  • 61: From Your Plate to Your Pleasure: Food, Body Image, and Intimacy with Emily Arthur, RD
    Nov 12 2025

    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

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    49 m
  • 60: Perimenopause as Your Sexual Debut: Rewriting the Narrative with Taylor McConnachie
    Nov 5 2025

    Episode Overview: What if perimenopause wasn't the end of your sex life—but the beginning of something completely new? In this honest, educational conversation, Kristen sits down with psychotherapist and sex therapist Taylor McConnachie to talk about what's really happening to your body, your desire, and your voice during perimenopause.

    What You'll Learn:

    • Why perimenopause can be a "sexual debut"—a chance to completely transform how you experience pleasure
    • How the non-linear model of sexual response explains why your desire has changed (and why you're not broken)
    • What pleasure mapping is and how to rediscover what feels good in your changing body
    • Why that "bullshit meter" you're suddenly feeling is actually a gift—and how to use it
    • The role of differentiation in maintaining sexual connection while honouring your individual experience
    • Practical tools like lube, sex toys, and new ways of communicating about sex

    About Taylor McConnachie: Taylor McConnachie is a registered psychotherapist, AASECT-certified sex therapist, and certified sexologist. She's the founder of Embodied Sexual Wellness and Psychotherapy, with a physical practice in Simcoe, Ontario, supporting people across the province with sex therapy, pelvic pain support, and sexual wellness education. Taylor's own experience with endometriosis and sexual pain drives her passion for creating safe, shame-free spaces to talk about sex and sexuality.

    Key Topics Covered:

    • Sexual pain and pelvic health during perimenopause
    • Medical gaslighting and being told "you're too young" for perimenopause
    • Body changes, weight gain, and shifting self-image
    • Vaginal dryness and arousal changes
    • Finding your voice and setting boundaries during midlife
    • The connection between caregiving roles and sexual desire

    Connect with Taylor: Instagram: @embodiedsexualwellness Website: embodiedsexualwellness.com

    Resources Mentioned:

    • Climax Conference (Ottawa, November)
    • Non-linear model of sexual response

    Visit blueberrytherapy.ca to learn more about pelvic health support in Hamilton, Ontario.

    Subscribe to The Hole Shebang Podcast on Apple Podcasts, Spotify, or wherever you listen.

    Connect with The Hole Shebang on Instagram: @blueberrytherapypelvichealth

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    43 m
  • 59: Your Vagina Is Shrinking and Nobody Told You: The Hormone Conversation We NEED with Dr. Carrie Jones
    Oct 29 2025

    Episode Overview: What if everything you thought you knew about hormone therapy was based on a misunderstood study from 2002? In this conversation with Dr. Carrie Jones—naturopathic doctor, hormone specialist, and host of the Hello Hormones podcast—we unpack the real data behind hormone replacement therapy, why perimenopause might be starting earlier than you think, and what's actually happening to your body during this transition.

    What You'll Learn:

    • The truth about the 2002 Women's Health Initiative study and why "estrogen causes cancer" isn't the full story
    • How perimenopause can start in your late 30s (and what other conditions to rule out first)
    • The specific hormone labs you should request from your doctor—and why "everything looks normal" isn't good enough
    • What genitourinary syndrome of menopause (GSM) is and why nobody talks about vaginal atrophy until it's too late
    • Why pain during sex is common but absolutely not normal, and what you can do about it
    • How to advocate for yourself when doctors dismiss your symptoms as "just stress" or "too young for hormones"

    About Dr. Carrie Jones: Dr. Carrie Jones is a naturopathic medical doctor with a passion for women's hormones and helping people understand their bodies. She graduated from the National University of Natural Medicine (NUNM) in Portland, Oregon, and has been practicing for over 20 years, specializing in hormone health through all life stages. Dr. Jones is the host of Hello Hormones with Dr. Carrie Jones podcast and has an upcoming book (Fall 2026) that promises to make perimenopause education fun, accessible, and actually useful. Her mission is simple: help women not feel so crazy and understand what's happening in their bodies.

    Key Topics Covered: Hormone replacement therapy, bioidentical hormones, perimenopause symptoms, menopause, estrogen, progesterone, hormone testing, FSH, LH, estradiol, thyroid function, genitourinary syndrome of menopause (GSM), vaginal atrophy, painful sex, Women's Health Initiative study

    Connect with Dr. Carrie Jones: Website: drcarriejones.com Free hormone labs ebook: drcarriejones.com/labs Podcast: Hello Hormones with Dr. Carrie Jones

    Connect with The Hole Shebang: Visit blueberrytherapy.ca for pelvic health resources Subscribe to The Hole Shebang Podcast wherever you listen Follow us on Instagram @blueberrytherapypelvichealth

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    42 m
  • 58: Simple Strength: What Really Works for Women's Fitness with Dr. Lauren Colenso-Semple
    Oct 23 2025

    Fact Check Fridays

    Episode Overview Muscle metabolism researcher Dr. Lauren Colenso-Semple joins Kristen to debunk fitness myths that are keeping women confused and away from strength training. This evidence-based conversation covers everything from cycle syncing to protein needs, with practical advice for building and maintaining muscle through perimenopause and beyond.

    What You'll Learn

    • Why muscle building capacity remains strong at any age and how to harness it effectively
    • The science behind why cycle syncing workout programs may actually hinder your progress
    • Realistic protein recommendations that don't require obsessive tracking
    • How to adapt your training as recovery needs change with age
    • Simple strategies for consistent strength training with compound movements

    About Dr. Lauren Colenso-Semple Dr. Lauren is a muscle metabolism researcher with a psychology background who translates complex science into actionable fitness guidance. After working in business development and personal training, she pursued graduate research focusing on muscle physiology for women. She's passionate about evidence-based approaches that cut through industry confusion and help people exercise effectively throughout their lives.

    Key Topics Covered

    • Anabolic resistance with aging and what it really means for your workouts
    • Why consistency and progression matter more than perfect programming
    • The truth about protein needs for muscle building (it's less than you think)
    • Recovery differences in your 40s, 50s and beyond—and how to adapt
    • Starting resistance training later in life and the powerful functional benefits
    • Simple workout strategies that work: compound movements, shorter sessions, regular frequency

    Connect with Dr. Lauren Instagram: @drlaurencs1

    Resources Mentioned Sign up for Dr. Lauren's evidence-based newsletter for weekly myth-busting fitness insights

    Visit blueberrytherapy.ca for pelvic health physiotherapy in Hamilton Ontario Subscribe to The Hole Shebang Podcast Connect with us on Instagram @blueberrytherapypelvichealth

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    43 m