Pill Alternatives with Dr. Jolene Brighten, & Pelvic Floor Health, Breathwork, & Mobility with Vanessa Gengler

#384: Pill Alternatives with Dr. Jolene Brighten, & Pelvic Floor Health, Breathwork, & Mobility with Vanessa Gengler

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Pill Alternatives with Dr. Jolene Brighten, & Pelvic Floor Health, Breathwork, & Mobility with Vanessa GenglerTopics

  1. News and updates from Diane & Liz [2:00]
  2. Part three with Dr. Jolene Brighten: pill alternatives [3:43]
  3. Introducing our guest, Vanessa Gengler [21:45]
  4. Precipitating facts for weak core and pelvic floor [29:33]
  5. Practicing the breath [35:24]
  6. Typical assessment and suggestions  [40:25]
  7. Vanessa's collaboration with Baby Making and Beyond [43:51]
  8. Long-term benefits [53:05]


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Pill Alternatives with Dr. Jolene Brighten, & Pelvic Floor Health, Breathwork, & Mobility with Vanessa Gengler Pill Alternatives with Dr. Jolene Brighten, & Pelvic Floor Health, Breathwork, & Mobility with Vanessa Gengler Pill Alternatives with Dr. Jolene Brighten, & Pelvic Floor Health, Breathwork, & Mobility with Vanessa Gengler Pill Alternatives with Dr. Jolene Brighten, & Pelvic Floor Health, Breathwork, & Mobility with Vanessa Gengler

You’re listening to the Balanced Bites podcast episode 384.

Liz Wolfe: Welcome to the Balanced Bites podcast. I’m Liz; a nutritional therapy practitioner, and author of the Wall Street Journal bestseller Eat the Yolks; The Purely Primal Skincare Guide; and the online program Baby Making and Beyond. I live on a lake in the mystical land of the Midwest, outside of Kansas City.

My usual partner in podcast, Diane; is a certified nutrition consultant, and the New York Times bestselling author of Practical Paleo and the 21-Day Sugar Detox. Her newest book, Keto Quick Start, released on January 1, 2019. She lives in San Francisco with her husband and fur kids.

We’re the co-creators of the Balanced Bites Master Class, and we’ve been bringing you this award-winning podcast for more than 7 years. We’re here to share our take on modern healthy living, answer your questions, and chat with leading health and wellness experts. Enjoy this week’s episode, and submit your questions at http://balancedbites.com or watch the Balanced Bites podcast Instagram account for our weekly calls for questions. You can ask us anything in the comments.

Remember our disclaimer: The materials and content within this podcast are intended as general information only, and are not to be considered a substitute for professional medical advice, diagnosis, or treatment. Before we get started, let’s hear from one of our sponsors.

Liz Wolfe: Today’s podcast is sponsored by Perfect Keto. Dr. Anthony Gustin and his teams have created a line of supplements that are super clean and effective, no matter what your dietary needs. Diane has been blending their MCT oil powder into her matcha latte lately. Not only are MCTs; medium chain triglycerides; a premium source of your body’s preferred type of energy, they help to fuel your brain and body, but there’s also no added taste. It makes your coffee or matcha wonderfully creamy. Check them out at PerfectKeto.com and use the code BALANCED for 20% off at Perfect Keto; and their sister site, Equip Foods.

2.00

Liz Wolfe: OK, friends. Just a couple of quick updates. I’ll give you the update on Diane’s book tour. You can go see her, along with some special guests, like myself, at a few different book signings that are coming up. You can go to www.balancedbites.com/tour for all the details and to RSVP. The next stops are; let’s see. We’ve got Houston; California; Los Angeles; Seattle, Washington; Portland, Oregon; Washington DC; Charlotte, North Carolina; Las Vegas, Nevada; Denver, Colorado; Kansas City with me in February; and Phoenix, Arizona.

Ok, so we have Dr. Jolene Brighten back again today for the third installment of our five-part series with her. Make sure you go back and listen to our other episodes, as well, to check out what Dr. Jolene has to say. First, a quick word from one of our sponsors.

Liz Wolfe: Today’s podcast is sponsored by Vital Choice wild seafood and organics. America’s leading purveyor of premium, sustainable seafood and grass-fed meats, and a certified B corporation. Now is the time to stock up on deliciously healthy foods you’ll be proud to serve all through the winter. Vital Choice offers a wide selection of wild seafood, grass-fed meats and poultry, and zesty organic soups. The perfect paleo-friendly fare for any of your feasting. And, they make hosting easy with luscious Nova Lox, Alaskan Crab, frozen at sea spot prawns, and much more. Be sure to save 15% on one regular order with the promo code BBPODCAST or get $15 off your first Vital Box with the promocode BBVITALBOX.

3.43

Diane Sanfilippo: Ok, we’re back with our third installment of our five-part series with Dr. Jolene Brighten. So make sure you go back and listen to the previous two episodes, as well. You’ll absolutely love the tidbits that we’re sharing all along. And of course, the previous episodes were Dr. Jolene was our guest for the entire time.

Ok, do you want to address alternatives that you recommend to the pill?

Dr. Jolene Brighten: Yeah. I think as we come into this conversation, it’s important to recognize that every form of contraceptive has its own side effects. So fertility awareness method, as much as I love it; the side effect of doing it incorrectly is getting pregnant. {laughs} So you have to understand where you're at in life, and what risk you're ok taking.

So, fertility awareness method can work beautifully. And these days there are femtech devices that can help support you so you don’t have to have to do the paper charting, or be second guessing yourself. Although I do think every woman should read Taking Charge of Your Fertility. I think it’s a super valuable resource for women.

But what’s really cool is that we saw in 2018, the FDA approved natural cycles as the first contraceptive device. This is history making. Natural cycle actually were already approved in Europe for this. To now see that the FDA is approving it; and that’s because they have research to back it up, being over 99% effective when used correctly. So you have to understand, you’re going to have to use a barrier method or abstain from sex; intercourse itself. That’s not to say that you can’t still, you know, have your romantic time.

But it’s really important that if you are having intercourse during that window when you're fertile, you are running the risk of becoming pregnant. You have to be aware of that before you start fertility awareness method.

Now, with the pill, just to contrast that, with typical use. We’re always told the pill is 99% effective. With typical use, it’s only about 91% effective. So what that means is if you don’t take it at the same time every day, if you are a 20-something in college and maybe you're binge drinking and you missed your pill, or you take it with alcohol. That can impact absorption. If you have a motility issue. If you have some kind of gut condition where you can’t absorb; these are factors that we have to weigh in. So with that, understand that the pill is, with typical use, about 91% effective.

Other non-hormonal options that we have; there’s only one IUD that is non-hormonal. It’s the copper IUD. I’ve seen it work beautifully with women. I have patients who absolutely love their copper IUD. And yet I have other women who got the copper IUD; now their periods are more heavy, we’re seeing inflammatory changes, we’re seeing changes with their thyroid. This is something that, before you start a contraceptive or you have any medical device inserted into you, track your data. Get your baseline labs, track your symptoms, and if anything is not feeling right, go to your doctor and have that discussion.

Now if you are a woman who has heavy, painful periods, a copper IUD is not for you. It will make that so much worse. And I say that with first hand experience. I was so stubborn; for two years I tried to fight keeping that IUD, until I ended up anemic. I was a vegetarian, heavy periods, and then my ferritin was 3. So you guys; you should know, your ferritin should be above 50; 90 is good. And I was at 3. And I remember, I was walking up the stairs, and I couldn’t understand. I’m like; what’s going on? Why am I so tired? I can’t even go up the stairs. I was teaching group fitness. I was like; I can’t even pick up a weight; what’s happening? I was anemic. And that’s something that can happen with the copper IUD.

And then of course we always have barrier methods. So I think it’s really, really important for women to understand that the pill does not prevent STIs. Some women might be listening to this, and be like; why do you even feel like you have to say that? Because women aren’t getting the full story. And I definitely had women who were like; I’m protected because I’m on the pill. Because it wasn’t discussed with them. And this is just; we’ve got to have these real talks in life about what’s going on and what we’re at risk for.

So barrier methods, like the condom; there’s a female condom, male condom, and there’s so many versions of condoms these days. {laughing} The days of just the latex; those are done! But a barrier method can prevent pregnancy and protect you against STIs. Just like everything else, it has to be used correctly. And thank goodness we have YouTube. You can get on YouTube and see exactly how to use a condom correctly. Back in my day {laughing} there was no YouTube. There was the epic fail that was sex-ed class. I’m like; you do what with a banana, now? {laughing}

So those are some of the alternatives that women can consider. And I think it’s really important to have that dialogue with your doctor in the context of your life. And what is going on with you personally; your family history. So as we talked about in other segments, there’s the risk of developing Crohn's disease. If you have a family history of Crohn's disease, then the pill is not going to be the best option for you. If you have a history of fibroids or endometriosis, a copper IUD is not going to be best for you. So these conversations need to be happening with the individual in mind, rather than just a one-size fits all. I almost crack up when I say that because it’s so much of how women’s medicine is done. Same, same. Treat it all the same.

It’s something that’s interesting with your book and writing about keto; this is absolutely something we’ve seen. Where all the research is done on men, and then they’re like; eh. You know what; it applies to women. {laughs} It’s like; no, hold up. We are a little bit different there. And we need to start having these dialogues and these conversations. And of course, we know way too much now to be practicing one size fits all medicine.

We have to understand that person’s; their life. What is happening for them? If they cannot get pregnant; they just cannot, then maybe the pill is going to be the best option for them. If that’s what they feel like is going to help them prevent pregnancy.

So, again I just want to reiterate. This has got to come from a place of looking at your life. And what is good for one gal ain’t necessarily going to be good for you. So you have to really examine what is the best decision for you. We have a whole series called Beyond the Pill stories, and I’ve interviewed so many women who have said; I just wanted to get on the pill because my friends were doing it, and I thought; I didn’t want to be the only one who wasn’t on it. And I’m like; that is so being a teenager, right there. I’m not judging anyone because I definitely did that kind of stuff. And it’s something where we really have to recognize; does that work for you?

And as you talked about before with environmental toxins; and that’s the other thing we have to recognize. They’ll say things about the pill, it mildly increases the risk of breast cancer. But where does she live? Is she living somewhere where she is bombarded with environmental toxins? What is her family history with that? Does she have genetic variations that make it really hard for her to detoxify estrogen, or put it in the right pathway so that it isn’t potent and carcinogenic? These are the kinds of things we have to be asking.

Or, how about what’s her diet like? Because you can say; it’s a small increase in risk. But for all you know she never eats a vegetable! So that risk is going to be different in her life. And ladies; eat your vegetables. {laughs} Vegetables always win in the research. Move your body; eat your vegetables. Winning.

Diane Sanfilippo: So, today I want to hear more about how the pill can affect your mood, anxiety, depression. Because we know this is such a huge topic when it comes to talking about things that are beyond the pill. So what can you tell us about that?

Dr. Jolene Brighten: Yeah, this is probably one of the most commonly dismissed symptoms in women’s medicine. Woman starts hormonal birth control, she starts the pill. Now she’s noticing that she’s anxious, or maybe she’s feeling depressed. She lacking motivation. She’s lost her spark in life. And doctors are super quick to dismiss this. And be like; well, you're stressed. You need a depression or anxiety medication. And nobody is really questioning the impact of birth control.

Because the story goes, in medicine, that this hormonal birth control does not influence a woman’s mood. And to me, it always confuses me. Because on one hand, if you are having PMS, or PMDD. You're having mood symptoms because of your hormones, your doctor may actually recommend the pill for that. And just say; take the pill, that can help with your mood. So if we can recognize our natural hormones can have an impact, then we can certainly recognize that synthetic hormones can have an impact.

I get really; I mean, there was a study that came out of over a million women. And the researchers concluded; yeah, there is a correlation here. Are we saying causation at this point? We’re not saying causation, we’re saying correlation. We’re saying association. And we’re saying we need to ask more questions. But how quick everybody was to jump on and say; well, it was an epidemiological study. Those are not great. And oh, here are all the other reasons we’re going to poke holes in this. This is not real, this is not true.

And to that I say; then you tell the woman who is experiencing that. The woman who is living in her own body, who is telling you that it’s true. You tell her, to her face, that what she’s experiencing is not true. It’s not real. I mean, is there anything more disempowering than dismissing a woman’s symptoms? Or telling her that they’re all in her head? Seriously, I have no patience for this anymore. I’ve been watching it for too many decades now go down.

So what we do know about hormonal birth control; and if you just understand a little bit about nutrition, biochemistry, and how all this business works in your brain. You can certainly understand that B6 is depleted. Magnesium is depleted, by hormonal birth control. And those two nutrients alone are needed. So if you are one of the people who subscribes to the serotonin theory of depression, that’s one theory of depression. Then you can understand that you're not going to make serotonin. That’s not going to happen if you do not have those nutrients.

Now, on the flip side, we also know that low testosterone and low thyroid hormone, like in hypothyroidism, those can also cause mood symptoms. So hormonal birth control, when you're on the pill, it’s reducing ovarian production of testosterone by maybe 50% or more. And then we also have the issue that it affects your liver at the genetic level, so you have higher levels of sex hormone binding globulin. You can’t even use your testosterone that you are making. And low testosterone in women will cause them to fall out of love with their life. They lose their kick-ass edge. They’re not motivated anymore, and they’re tired all the time. And it can look a lot like hypothyroidism, which has the similar effects. So that’s one piece.

By the way; the pill is depleting things that your thyroid needs to be able to function. I know we’re going to talk a lot more about that, so stay tuned ladies.

Now, if you are someone who subscribes to this cytokine theory of depression, or the inflammatory theory of depression, then you can also understand that hormonal birth control is inflammatory. In fact, they have done studies where they measure a woman’s C-reactive protein. That’s a marker of inflammation. And it’s elevated while she’s on hormonal birth control.

There’s also a study that has come out showing that the kynurenic pathway is disrupted. So the way you process tryptophan. So you all know about tryptophan in turkey, we’ve all heard about that. I’m not going to give it away; I share with you in my book all about that. But with the tryptophan, it needs to get converted into kynurenic acid. Instead, when we are inflamed, we have these nutrient depletions, we start making neurotoxins. So now we’re making neurotoxins in our brain.

If you just understand those basic physiological components, then it’s not off the table. It’s not out of the question to be questioning hormonal birth control and its connection to mood symptoms. And what really troubles me, too, is that this has been one of the number one thing women have complained about since the introduction of hormonal birth control. So it’s not like just yesterday, women started saying, “hmm, I think maybe now this study has come out now I’m having that experience.” That’s not the way it happened. Women were having this experience, so they started doing studies. They started researching it. And that is really what we need to be doing in science and medicine. We need to stay curious. We need to stay humble. And if our patient is telling us something, we need to investigate to understand why.

And what was really startling with the large study that came out, it was over a million women. 13 years they followed them. And they found women that were prescribed; so the combination birth control pills. That’s synthetic estrogen and progestin; not progesterone. It doesn’t act the same way. If you know that right there, you have a leg up on most of medicine. {laughs}

But women who were prescribed the combination pill were 23% more likely to be prescribed antidepressants. And that made some people’s jaws drop. And then they went even further to let us know that teenage girls were 80% more likely to develop depression. And they were at a much higher risk of suicide. And the progestin only pill wasn’t much better. It was a two-fold increase in teen risk for depression. And we don’t usually use the progestin only pill unless there’s a risk of stroke, or clots, and in postpartum. It’s not that effective. It’s been estimated 60% of women will still ovulate with it, and can be at risk of getting pregnant. So we don’t use it that often. But it wasn’t performing much better in comparison to the combination pill.

Then they started looking at things, like the patch, and the IUD, and the NuvaRing. And understanding that all of these hormones; they’re correlated with changes in our mood symptoms. What really troubles me about people putting on their blinders, and doctors not wanting to have this conversation is that if we know teenage girls are at a much higher risk of suicide; and I’m not about to argue that teenage girls do not get access to hormonal birth control. But we have to have this conversation. Because how many gals will go into the clinic, they get passed that brown paper bag of birth control pills. Ladies, you know I’ve been there. And nobody is talking to them about this. And maybe their parents don’t even know. But their mom starts to notice that her mood is going downhill. This is some scary business.

And maybe she doesn’t have that kind of relationship where she can tell her parents. But if she doesn’t know that this is a risk; a risk of suicide. What is that? We have to be having this conversation. As uncomfortable as they may seem, as much as it may seem at times where people are like; that’s anti-women. You're just peddling fear keeping women from their rights. No. You know what is scary, is not knowing.

I feel like I’m going to pull out some G.I. Joe, and be like; knowing is half the battle here, you guys! Because if you know the risk, and you know what to look out for, then you know when it’s time to go to your doctor. You know when it’s time to break up with hormonal birth control. You know what you need to do to care for yourself.

There was a time when I was put on the pill. I wish I would document all of this, but I was like 19, what did I know? I remember being on this pill. I was crying. I would get in the shower, and I would just sit there and cry. That was a week of my life, until I went back to my doctor. And he was like; no, it’s probably not birth control but let’s switch you anyway. And when I switched, everything shifted, and everything changed. And at that time, I was like; huh, maybe it had something to do with that. Oh, no, but then like a good girl I listened to my doctor, and I doubted myself.

That’s one thing, if I could go back and tell my 20-something -year-old self; my teenage self. Always advocate for yourself, always believe in yourself. And if your doctor is not believing your story, time to get a doctor who will listen.

Diane Sanfilippo: Whoo! Amen. I need to; I’ve got the praise hands emoji. We talked about this on a previous clip, so I just want to wrap it up with this thought. This is really all about awareness and empowering women to know that some of these things can happen alongside taking the pill. Some of them can be results of having taken it for a very long time. And we know this firsthand as practitioners, whether it’s in naturopathic medicine or just in nutrition and what we’ve had questions about on this podcast over, almost a decade. It’s 7-plus years now. It seems like we sometimes feel ill in different ways, and we can’t uncover why or where it came from. Or we’re struggling to do that. If we find out that; you know what? This thing I took for 10 years depleted me for 10 years of these nutrients, it doesn’t mean it’s a one problem, one solution answer. But it’s so much more information than we had before. And I absolutely love that.

I’m just so excited for this book to come out to just open women’s eyes. Especially even; I almost feel especially for women who do decide I want to still take the pill. What do I need to know to set myself up the best way possible, even knowing that things won’t be perfect, or may not be, because to me, that informed decision is so much more powerful than an uninformed, go along with whatever you're told? I think at the end of the day, having the information is always better. So I think this is exactly what women need.

21.45

Liz Wolfe: I’m really excited about today’s guest. Today on the podcast, I’m having a conversation with Vanessa Gengler. Vanessa is our Baby Making and Beyond movement specialist. We’re so intent on working with Vanessa for Baby Making and Beyond, because of her background as a restorative exercise specialist, and as a hypopressives level 1 instructor. Hypopressives is a breathing and exercise technique that, among other things, targets the pelvic floor. Which can be instrumental in postpartum recovery. She’s also a restore your core teacher in training. You’ve probably heard of restore your core before. It is an amazing program.

She produced our Baby Making and Beyond video content while significantly pregnant, which made it so much more helpful and pertinent to our audience. And we are incredibly grateful for that. Vanessa, thank you so much for coming on the Balanced Bites podcast with me today.

Vanessa Gengler: Thanks! I’m so happy to be here.

Liz Wolfe: So I gave your professional introduction, but I would love to give our folks a little bit of an idea of how you came to doing this work, to being a movement specialist and working with women on their core and pelvic floor health. Is there a personal journey that we could hear about?

Vanessa Gengler: Yeah, there absolutely is. So it’s definitely not a coincidence that I started my journey to becoming a movement teacher who works primarily with pelvic floor and core health, after my first daughter was born. My first child was born. And that was 7 years ago. Because, like a lot of people who work in wellness, I would say, I had my own challenges after she was born. We had kind of a rough birth, for both of us I’d say. And then pretty soon afterwards, I’d realize that things were just not functioning the way they should. And after a lot of trying to figure out what was going on, why was my body not feeling right. I realized after going to the doctor and doing a ton of online research that I had a prolapse, and diastasis recti. Which is overly separated abdominal muscles.

And that really sent me down a hole. I had so many feelings about that. It’s something I feel now people are starting to talk about it more. But in general, it’s something that remains very private and people don’t; the bad part about that is there is not a ton of information or support for women necessarily beyond hearing “this is normal”, this is something most women have happen. Later on, maybe you can have surgery. You're just sort of; I think there’s a feeling that it’s something you should accept or sort of power through in some way. And I just was not satisfied with those as my options at all.

And that really led me to seeking a lot more information. And it began as just trying to heal my own body. And then the further along I got, I quickly could tell that what I really wanted to be able to do was to be able to help other women with the same issues that I had. Especially as I started to see more and more progress happening in my body.

So that really; it definitely comes from my own personal experience, what I do. And what I like about that is it really has ended up taking something that, 7 years ago was super hard, and turning it into something very positive and affirming, giving me an opportunity to really have helped and be helping a lot of other people. And that’s something; it makes me happy to take something that was difficult and turn it into something good.

Liz Wolfe: I love that. And I want to; let’s mention a few things that maybe happen to women postpartum that we kind of pretend are normal but are not normal. So my thought would be peeing when you sneeze or when you're working out of something like that. What would be something else that women are told is normal?

Vanessa Gengler: Yeah, so stress incontinence, peeing when you're sneezing, jumping, lifting, coughing, these kinds of things. It’s like; common and normal are two different things. So if you're like; wait, this happens to me, don’t freak out. There are so many things; any of the things we’re going to list here, there are many ways to help with. So that would be one.

And I feel like more women know about that. But the one thing that I wasn’t prepared for was symptoms of prolapse. Which would be a real heaviness in your pelvic floor. Like you sort of feel like a weighty feeling. Maybe you feel like you have a tampon in that’s falling out. It’s like, you can tell it’s not the right feeling that you want to be having. That’s very common after childbirth to have symptoms of that.

Liz Wolfe: And even if you’ve had a C-section too, right? I mean, just the stresses and strains of pregnancy can cause some pelvic floor dysfunction.

Vanessa Gengler: Yeah. I have clients who haven’t had babies ever, and you can still have pelvic floor or core issues. Men can have core and pelvic floor issues, as well. So it’s not necessarily related to pregnancy, or vaginal birth, either. But those, I would say, that is sort of a higher; you’re at more susceptibility to having those symptoms.

But the prolapse one; I think because women are; talking about that kind of thing isn’t encouraged that much. And providers aren’t necessarily right there with really good info for you. So a lot of women will go for a while without seeking help.

Liz Wolfe: And we almost talk about some of it like it’s funny.

Vanessa Gengler: Yeah.

Liz Wolfe: Like the peeing when you’re working out thing. I’ve seen it mentioned lately, and I’m glad that people are talking about it, because at the very least it’s kind of like; oh, hey, that happens to me too. I didn’t know that happened to everybody. But, we also say it as if it’s kind of funny and inevitable.

Vanessa Gengler: Yeah. I think there’s sort of a certain dark humor that makes sense to have when people are going through difficult times. And that is; I totally get that. And I think that’s a coping strategy that is good; or it works for some people. But on the other hand, the normalizing lifting a super heavy weight and peeing on the floor is really not helping anybody. Because there are great strategies that you can use to prevent that from happening. So to kind of just make it like; this is funny, or this is just something that happens, or this is showing how tough you are. I feel like we could do better.

29.33

Liz Wolfe: Ok, so what are a few of the precipitating factors for women struggling with the function of their core and their pelvic floor?

Vanessa Gengler: You mean things that kind of make you; what can lead to those kinds of issues?

Liz Wolfe: Yeah. We’ve talked about childbirth. But is there an underlying; I don’t know what to call it. Movement deficiency, or something like that, that can make you more susceptible to that. Like footwear, or how you breathe, and things like that.

Vanessa Gengler: Yeah. Well I think I’d start by saying first; this is kind of scary stuff. Especially if you're out there and you're like; pregnant, or want to be pregnant, or already have some of these things going on and you're feeling challenged. My cat is freaking out {laughs} hopefully she’s not going to start dancing on the microphone.

So if you're feeling challenged, just know that not everybody; there is no kind of A+B=C, or you know, there’s no kind of equation that results in an absolute outcome of having a pelvic floor issue. I really see that there are a lot of factors that are involved. Your patterns in how you move, how you breathe, footwear. We can talk about that. But also just that people can; you can be doing all kinds of things with your body and have no issues. And then someone else can have tons of issues. Just to keep that in mind. Because I feel like it’s easy to carry a lot of fear around this area. And I certainly; when I work with my clients, I really try and help and encourage them to let go of some of those fears. Because if you do have any of these symptoms, or you're afraid of them, for me, part of healing is being able to kind of let go of being attached to those symptoms. If that makes any sense.

Liz Wolfe: It does. And I can also vouch for how powerful fear can be in almost; I don’t want to say creating symptoms that aren’t there. But for a long time, I was so convinced that there was something wrong with me that I almost created a problem when I didn’t actually have one. And for me, it was a challenge and a process to learn to let go of problems that didn’t exist. Including pelvic floor stuff. I still have some stuff to work on. But went so far as to go and do a full workup with a pelvic floor physical therapist. And she did tell me; you're fine. Everything is functioning ok. So at the very least, that helped me stop moving through the world as if; oh god, I’m on the precipice of something bad happening. Something is wrong with me, and we’re going to find out about it, and it’s going to be catastrophic. We don’t want to cause problems where there are none, and we also don’t want to cause fear that will exacerbate problems that can be corrected with some simple tips.

Vanessa Gengler: Yeah, totally. Sometimes that anticipation or that anxiety that something may be wrong is worse than actually dealing with the things that might be challenging you. {laughs}

Liz Wolfe: Agreed.

Vanessa Gengler: The biggest things that I like to work with people on, whether they are manifesting pelvic floor or core issues, or they’re wanting to become more functional in general to better support their body are breathing, is a huge one. What your breathing habits are make a big difference in how well your core and your pelvic floor can function. And how well you're basically managing pressure in your core, pelvic floor, and diaphragm. And that’s something; you kind of have to go back a couple of steps to what seems like basic stuff. But I think a lot of you don’t realize we’ve picked up habits over time that maybe creating excess pressure. So pressure that’s pushing down, bearing down on your pelvic floor, or pushing out on your core muscles. And those things can be a big factor in core and pelvic floor health.

You also want to be able to engage your core properly, when you're not just exercising, but you're just moving through your daily life. We want our core to be able to turn on reflexively, which means that it’s just able to activate in the moment, when it’s needed, when you're doing the thing. This is really different from me bracing my stomach, or sucking in my belly, or holding my stomach tight. For example, you may have heard; I’m picking up this heavy box. I’ve got to brace my core. This is actually working with your breath to retrain your core to turn on to be able to support you. Especially those deep core muscles, the transversus abdominus.

A lot of us have lost our connection to those deep core muscles. And it can make a huge difference in how effective your training is. If you're an athlete, or you're doing yoga, or just in daily life. Because the reality is, you make workout however much a day or a week. But the rest of your day is what you're doing most of the time. So you want these parts of your body to be there to support you.

35.24

Liz Wolfe: Ok, can we talk more about breath?

Vanessa Gengler: Yeah.

Liz Wolfe: Do you work with people on their breath?

Vanessa Gengler: I work with people on their breath, yes.

Liz Wolfe: Let’s talk about that. I’m kind of into the breath thing right now. Because I’m shocked at how difficult it is for me to bring my breath all the way down, for lack of a better term. My breath really hangs out, I feel like, in my shoulders. {laughs}

Vanessa Gengler: Yeah. I think a lot of us who are parents, moms, caregivers. Also all the work we do, but the carrying. You carry a lot of tension in your shoulders. I know I had a really funky pattern going on right now because of carrying my son. And I notice my left arm comes across, even though I try to switch it up, just like I tell everybody to bury their carry all the time. But I think that can add to it.

So breath, you're working on kind of really tuning into your breath during your workouts, or what are you doing right now with that?

Liz Wolfe: Let’s think about tuning into your breath when you have a moment to really fully think about it. Maybe when you're lying in bed before you're falling asleep. When we can really give some thought to it.

Vanessa Gengler: Yeah, so there’s two different things. So you're lying in bed. I would have you; or even, Liz as you're sitting there, if you put your hands on the sides of your ribcage. Put one hand on the side of your ribs, and the other hand on your stomach. And just take some regular breaths. So you don’t have to be doing these deep, inhale exhale. Just breathe normally. And just notice where you feel movement.

And if you're listening and you can lie down, that’s even better. So your hand on your ribs you might notice is moving a little, moving a lot. Not moving at all.

Liz Wolfe: I would say it’s moving a lot. {laughs}

Vanessa Gengler: Moving a lot. And then your hand on your belly, notice is it moving? Is your belly kind of going in and out, or is it staying pretty much still?

Liz Wolfe: It feels like it’s staying pretty much still.

Vanessa Gengler: That’s awesome. So what you want, ideally to work towards, which Liz it sounds like you're doing awesome right now. Is to notice if your breathing into your stomach. If you put both hands on your stomach and just breathe normally, if you're someone who noticed some movement in your stomach, or you just want to spend more time with this. Notice if your hands are moving up and down a lot. I see so many women who are belly breathing. And this is a pattern; it happens to so many of us. And what essentially is going on is your breath is bypassing your ribcage, which really should expand when you breathe. And then going straight down to your stomach.

Liz Wolfe: OK. Because we hear about belly breathing, so I always think I’m supposed to be really expanding my belly.

Vanessa Gengler: Right. It gets confusing. Because people have; for one thing, people look at infants who belly breathe, and say belly breathing is good and relaxing, so let’s teach people how to relax and breathe fully by breathing into their stomachs. But babies are not; they’re in a very different developmental and physiological stage than we are. They don’t stand upright yet. It’s not really a fair comparison to compare an adult with a baby, in terms of breathing.

I think often in the fitness world, we’ll kind of latch onto one idea and then think; this is good. And take it 20 notches too far, that it’s now like; everybody has got to belly breathe, it’s the only way! When really it’s more complicated than that.

So what can happen with belly breathing is you’re creating a lot of downward and outward pressure. So downward on the pelvic floor, and outward on your core muscles. So if you try to spend some time lying in bed, noticing if you can breathe into your ribs and feel your ribs expand. Do this really gently, because you don’t want to be forcing yourself, here. You just sort of want to be more aware of where your breath travels.

To a lot of people, this is like; really? You want me to do this? Because breathing is something that we don’t really; we take for granted. But it does make a huge difference.

40.25

Liz Wolfe: OK. So breathing is one piece of the puzzle. So when you're working with someone; and in just a few moments we’ll talk a little bit about what you're bringing to Baby Making and Beyond. But I’d love to hear a little bit about a typical client that comes to you with some basic pelvic floor and core concerns. I know you probably have an assessment that you do. And I’m not asking you to give away all of your professional secrets. But what are kind of the first few things you like to assess with people?

Vanessa Gengler: One of the first things I like to do is look at how well their core is firing. It’s also related to breath, but it’s to check and see if they can feel when they do a long exhale. So if they take an inhale, and then do a long exhale, often it helps to hiss out your air really slowly. If they can feel their core start to turn on during that long exhale. That’s a way; I would do that seated and just see if the person feels their core start to kick on. A lot of times women, especially if you're postpartum within a year or two. Depending on what you have going on, that might be harder for you to feel that.

Another thing that’s really important with core and pelvic floor health is how mobile your spine is. We need to be able to move our spine in a lot of ways. And a lot of times we’re often very stuck and not very mobile. Or rotating, twisting is very difficult. And that can show me that someone maybe carries a lot of tension in their core.

And these are all things, along with the breathing that we were talking about, that can be little indicators of what directions we might want to go, in looking at what someone’s patterns are.

You also want to check how functional someone’s butt is. Whether they’re able…

Liz Wolfe: Do you have a functional butt?

Vanessa Gengler: If you have a functional butt.

Liz Wolfe: That should be a hashtag of some kind.

Vanessa Gengler: Functional butt actually would be a great hashtag. I don’t know if that exists. We should totally use that.

Liz Wolfe: Yes.

Vanessa Gengler: It’s really not helpful to think of core and pelvic floor or your core and your pelvic floor as separate from the rest of your body. They’re very much in relationship to each other, and to the rest of you. But making sure that you're using your butt. Your glute muscles are part of that whole support system for your pelvic floor. So you want to be able to be using those. Not just when you're doing squats, which actually I love working on squats with people. It’s one of my favorite things. But also in how you're using your body in your daily life. So how you're standing and moving around. And whether you're setting yourself up, so your structures are really supporting you. So that would be kind of the alignment piece.

43.51

Liz Wolfe: Ok. I think that brings us to a good spot to talk a little bit about what you're bringing to Baby Making and Beyond. And I connected with you through my friend, Kristine Rudolph. Who also is a movement coach. And she was like; you have got to talk to Vanessa. She brings all of these things together so well. She’s absolutely wonderful. And of course, she’s a mom who has been through all of it. And that in a nutshell was why I was so excited to talk to you about Baby Making and Beyond and to have you on board.

I feel like one of the things that we have very consciously chosen to do with our core four, in Baby Making and Beyond. And folks; if you haven’t listened to any of the most recent year of Balanced Bites podcast, maybe you don’t know what Baby Making and Beyond is. But I’m going to kind of assume that folks know it’s my and Meg the Midwife’s and Vanessa’s and our research team’s collaborative effort to bring a well-rounded program about fertility, pregnancy, and postpartum wellbeing to the holistic health community, and hopefully beyond that. But we have a core four that’s based around nutrition, movement and exercise, sleep, and stress reduction. Those are our core. And then we have a ton of content outside of that on fertility, pregnancy, and postpartum health.

But what we really consciously chose to do wit the core four element on movement and exercise was to focus very whole-heartedly not on; oh, can I squat and deadlift while pregnant. But rather, we chose to focus on how to really bring women’s bodies into alignment to have the most comfortable pregnancy experience. Also to enhance fertility and to help you carry baby without pain. All of these different things that come down to adjustments in alignment and how you move through the world more so than just giving people permission to go to the gym. Which I think a lot of people are looking for, and that’s actually relatively simple.

So I feel like we’re doing something that is not talked about all that much. And I’m very proud of us for doing so. So I would love to talk a little bit about what you’ve brought to Baby Making and Beyond, and why you feel it’s important.

Vanessa Gengler: Yeah, absolutely. I feel like one of the exciting things about being a part of this project has been to get to kind of almost go back in time; well, I’ve had two children now. And I was pregnant with my second while we were filming the videos I made for Baby Making and Beyond.

Liz Wolfe: Which, can I just say how great that was to have legitimately pregnant Vanessa doing all of these videos. Because it was so real life. It was so perfect. And just another reason why the collaboration was just meant to be. That was wonderful, if I could just slip that in there.

Vanessa Gengler: Yeah, I was very pregnant. {laughs} But to get a chance to put together not only what I want for my clients, and for the people who have Baby Making and Beyond, but what I would have wanted those 7 years ago, or more now, when I was pregnant with my first child, and to really have the information there to take it in and really kind of break things down. Make it accessible. Have it be doable and fun and informative for you. So you can have more choice.

Because I think a lot of times, you are pregnant and you just kind of are going through it. And that can be awesome. But it’s really wonderful to have more support. And to know how to support your body better. Because I know I felt like my first pregnancy, I had some information about nutrition, which was actually super different from what I know now. But the movement part was just not really part of the education that I got going to my midwife or my childbirth education. And afterwards I was like; maybe if I had known some of these things, some things may have turned out better.

And I think, I feel a real duty and passion for helping women take better care of themselves. Because it really does make a difference, you know.

Liz Wolfe: Yeah, and I think the way you have put together the programming for Baby Making and Beyond, and what you do. You’re putting stuff out; you can visit Vanessa’s Instagram. We’ll put all of the links in the show notes and we’ll let you know where to find Vanessa, obviously, again at the end of the show. But via your Instagram and via your programming for Baby Making and Beyond, and what you're doing at Move Well Mama. You're making it very accessible and much less intimidating. I think a lot of women come to this, and think; if I don’t know everything I can’t do anything. It’s that paralysis by analysis. And for some women, that’s the end of it. I can’t do anything. This is too complicated. This is too much.

But you bring a lot of really simple ideas to help people get started, and then move forward more confidently. And it’s kind of hard, I think, on a podcast to explain this verbally, at least for me, which is part of the reason we did so many videos for our collaboration. Or you did so many videos for our collaboration. Because it really does help to see it. And it helps to simplify it to see you actually doing it.

Vanessa Gengler: Yeah. So in the program, I don’t know how much, there are some videos that are me talking about concepts, and showing leading you through the alignment part and movement habit part of the program, or the modules. And then I think there are at least 5 videos that are movement videos that are like movement classes. Like if pregnant me was leading you through a movement class. Which feels really good when you're pregnant and you need to motivate, and you kind of want someone to be there with you. But you might not want to leave your house to go to a class.

Liz Wolfe: And not everybody has movement classes close to them, either. That’s another one. {laughs}

Vanessa Gengler: I don’t. I have to teach them. Yeah, so it’s all in there. So it’s not just me giving an info dump. Because that’s totally what I wanted to avoid with this. Because I feel the same as what you have just said; you want to be able to take in information in a way that makes it doable for you. And that’s always what I want to provide for people.

Liz Wolfe: We really wanted to help build a foundation for people. Sometimes, and at least this is what I’ve found. Sometimes all that stuff; like what can I do in the gym? Can I go take an hour and a half hot yoga class postpartum. All of those things. Am I moving well enough to do that? Those are; that’s the dessert bar. And I feel like what we wanted to do was really look at those foundational things. How are you moving. Are you in alignment? These really important things that build the foundation of your house that you can build on top of. Or maybe this is like the main course, where people tend to skip over. So I think we’ve really brought something to folks that is not being talked about enough. And in general.

So hopefully we’re providing information that folks can not only use just in their homes very easily without having to have a whole lot of equipment, or a whole lot of work, or join a gym, or whatever it is. Yet it will also make all of that other stuff that people want to take on that maybe is more highly resourced in the real world. There are more people talking about how to help a pregnant woman do a deadlift. Or how to help you deadlift postpartum. Whatever it is. But you're going to be able to bring this to those activities and do them better.

Vanessa Gengler: Absolutely. Yeah. And it does all help a lot with just sort of general aches and pains during pregnancy discomfort stuff. Which is really essential. Because 9 months is a long time. And you want to be caring for your body so that you can get to doing the things you really want to be doing. And recover well after baby is born, too.

53.05

Liz Wolfe: Ok. So let’s just give a couple of ideas of how women benefit from this type of stuff long-term. The type of things you're teaching. So, like you just said. Recovering better postpartum. What else is there maybe that you noticed in your life after you started implementing these principles that you teach?

Vanessa Gengler: Well I have to say I’m kind of stuck on the recovering postpartum one, because I do have two different birth experiences. My second birth experience, my recovery was just light years’ difference. Going into it knowing I had a history of diastasis and prolapse, even though I was doing all these things, I did have kind of some; I worked a lot on my anxiety, we’ll say, around how it would all play out. And my recovery was so different the second time.

I feel really strongly that having the tools to be able to support your body better and your core and pelvic floor, it’s so important for women to have that. So that is a number one thing for me that I would say.

Liz Wolfe: And that’s pretty priceless, once you're really looking at it. {laughs}

Vanessa Gengler: Yeah. I mean, you're like; do you want to be able to pick up your baby and not feel like your pelvic floor is falling out? My first experience was so much more difficult than my second. And of course, not everybody has my experience. But to feel the difference, and have known that I had a history of prolapse, but not have the same kind of symptoms that I did after my first birth, was sort of mind blowing to me.

Liz Wolfe: So for me personally, postpartum, it was kind of; I don’t want to say rude awakening. But maybe something akin to that. Where I was still worried about the same stuff that I had been worried about before I got pregnant. I still, at times, looked in the mirror and was like; I want to be more fit. Or I want to be able to do a pullup, or whatever it is. But then very slowly, postpartum, I started to realize that there were these basic deficits in how I was functioning. I started to notice things, like when I squat down with my kid to play in the grass, it doesn’t feel right. The pressures don’t feel right. Or I was uncomfortable carrying her in certain ways.

When I finally got back into the gym, my shoulders, and neck, and upper back were firing completely dysfunctionally.

Vanessa Gengler: Right, and this is 2.5 years later, right?

Liz Wolfe: Yes!

Vanessa Gengler: So people should note, you have to be gentle with yourself. Because it does take a long time. You're taking care of small humans, which that is part of why it takes a long time.

Liz Wolfe: A long time. But it was cool, and I did this all kind of through the process of working with your content, with Baby Making and Beyond, and just kind of realizing that I needed to shift my focus towards these smaller things that were actually going to give me a much better quality of life long-term. And I could worry about building up strength to do a pullup. I could worry about that stuff later. I kind of started to become less performance oriented, and much more function oriented. And I am so glad for that. Because I feel like my body works so much better now. I feel like I can make small corrections that maybe would have completely escaped me one, two, three, or four years ago. So I'm really, really happy about that. And I think that’s just one small reason why this stuff is so important.

Vanessa Gengler: Yeah. Having that body awareness is so huge. And it sets you up for just being a better athlete and just functioning better as you're doing your regular daily things.

Liz Wolfe: Could not agree more. Ok, well I think that’s all we wanted to say for today. Can you let folks know where to find you?

Vanessa Gengler: Sure. So I’m on Instagram at Vanessa.Gengler. And I’m on Facebook under my name, also. And my website is my name. And I do have some slots available for Skype if anyone is interested in working with me that way. They can contact me through my website, and find my information there.

Liz Wolfe: Fantastic. Well thank you so much for being on the podcast with me today. Hopefully folks will see much more of you by joining us with Baby Making and Beyond. We’ll be opening that up hopefully mid or later February for enrollment. We’ve closed to work with the betas over the last few months, and we’ll be reopening that hopefully permanently at some point in February. So folks can look for you there as well.

Vanessa Gengler: Great. Thanks so much Liz, this was really great.

Liz Wolfe: Thank you, Vanessa. Let’s hear from our final sponsor.

Liz Wolfe: The Balanced Bites podcast is sponsored in part by the Nutritional Therapy Association. The NTA trains and certifies nutritional therapy practitioners and consultants (including me; I’m an NTP), emphasizing bio-individuality and the range of dietary strategies that support wellness. The NTA emphasizes local, whole, properly prepared nutrient dense foods as the key to restoring balance and enhancing the body’s ability to heal.

The NTA’s nutritional therapy practitioner program and fully online nutritional therapy consultant program empower graduates with the education and skills needed to launch a successful, fulfilling career in holistic nutrition. Registration is now open for February class, and you can learn more and save your seat by going to http://www.NutritionalTherapy.com. Don’t forget to check out the NTA’s annual conference, Roots, happening March 1 through 3 in Portland, Oregon. It’s one of the most empowering and educational holistic nutritional events of the year, and all are welcome.

Liz Wolfe: That’s it for this week. You can find me, Liz, at http://realfoodliz.com/, Diane at http://dianesanfilippo.com and Vanessa at VanessaGengler.com. Be sure to join our email lists for free goodies and updates that you don’t find anywhere else. While you’re on the internet, please leave us an iTunes review. We’d greatly appreciate it. See you next week.

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