Physical Health

When I talk to other women about their experiences going off birth control, I often hear different stories. Some women complain about irregular periods, painful cramps, or mood swings, and others say the transition was relatively easy. Studies have shown that 80 percent of women regain hormonal balance no less than three months after stopping the pill, but for some, it can take even longer. Our bodies are all unique, and birth control affects us differently. After experiencing my own side effects and speaking with other women about theirs, I realized that a lot of women are looking to stop hormonal birth control (for a variety of reasons) and want to make the transition off it easier. So I looked to the experts to share their best tips.
I spoke with Dr. Trevor Cates, a naturopathic practitioner, as well as Jade Mesquita, a holistic nutrition practitioner and clinical herbalist. Before we get to the tips, both experts agreed that the first step should be remembering why you went on birth control in the first place. “When someone goes on birth control, it’s usually either for birth control or they’re trying to manage some symptoms,” shared Dr. Cates. If you originally started birth control for symptom management, there’s a good chance that “whatever was being suppressed hormonally is going to come back,” so work with your doctor to identify and heal the root cause of the symptoms. But no matter your reason for going on and going off birth control, read on for some expert tips to make the process easier.

1. Eat nutritionally-dense meals
The body is an interconnected organism, so it’s no surprise that what we eat can affect our hormones and help to balance them. Mesquita shared that the number one focus should be balancing blood sugar by making sure every meal or snack has a source of protein, fat, and nutrient-dense carbohydrates. “Instead of just eating a banana, pair it with greek yogurt for protein and almond butter for some healthy fats,” she suggested. She also explained the importance of never skipping meals (especially breakfast) and eating when you’re hungry. 
Dr. Cates explained that B vitamins, such as B-12 and B-6, and certain minerals like magnesium, selenium, and zinc, are common vitamins and minerals that can get depleted by taking the Pill, so you may be low or deficient in them if you’ve been on hormonal birth control for a while. These deficiencies can cause symptoms to become worse, so Dr. Cates recommended boosting your intake of foods like dark leafy greens, healthy fats, and protein, and talking to your doctor about testing and/or supplementing these nutrients. 

2. Boost your gut health
The gut is the control center for the rest of the body. It affects so many areas, from detoxification to brain health, so it’s no wonder that ensuring good gut health during this transition is important for your hormonal health. “You want to start boosting your gut health by eating lots of fiber-rich foods, like chia seeds and cruciferous vegetables, or taking a probiotic,” Dr. Cates suggested. Jade agreed, recommending you get enough fiber to ensure you’re having at least one bowel movement a day so your body is able to properly detoxify. You should always listen to your gut (pun intended), and if you are having any gut issues such as bloating and constipation, talk to your doctor about ways to increase your gut health. 

3. Reduce stress levels
Stress can have a huge impact on the body, especially our hormones, which is why it’s helpful to prioritize practices that can manage stress levels. “If we’re really stressed out and we’re not getting a good night’s sleep, it can impact adrenal function, cortisol, and nervous system balance,” Dr. Cates said. She suggested getting at least 6-8 hours of sleep a night and going to bed at the same time every night so your body is able to get an optimal amount of high-quality shut-eye. Aside from sleep, practicing other methods of stress management, such as meditation, breathing exercises, journaling, or physical activity, is also a good idea.

4. Opt for low-impact workouts
While it’s fun to switch up the type of workouts you do every now and then, many experts recommend sticking with low-impact workouts during this period as your body is adjusting to a new hormonal balance. “High-intensity workouts can raise cortisol in the body, so during this period, reducing cortisol as much as possible can help to make the transition off birth control easier,” Jade explained. Luckily, there are so many low-impact workouts to choose from such as pilates, yoga, and—my personal favorite—walking. We want to make this process as easy for the body as possible, and if a low-impact workout helps, then a hot girl walk it is. 

5. Have a reproductive health plan
If you’ve decided to go off birth control, it’s a good idea to have a plan in place. If an unplanned pregnancy is a concern for you, Dr. Cates emphasized the importance of having an alternative form of birth control to put into practice immediately after (yes, you can get pregnant even soon after getting off the Pill). “Whether it be a non-hormonal IUD or fertility awareness methods, tracking your ovulation is a really powerful thing, and it’s something we don’t have access to when on birth control pills,” she shared. 
While this transition can sometimes feel scary, it can also be an empowering time to better understand your body. And building a plan around your body’s natural cycle can make the process even smoother. If you’re going off birth control for the purpose of family planning, work with your doctor to balance hormones to improve fertility as much as possible. No matter your current goals, having a reproductive health plan is always important, and transitioning off hormonal birth control provides a good opportunity to rethink what’s best for your body, goals, and lifestyle.

I Asked an OBGYN All the Questions You Feel Too Embarrassed to Ask More

Women often have a lot going on BTS that we don’t think about unless something feels off. Many of us come up with excuses to put off going to see the doctor, whether it’s because we’re uncomfortable laying everything out there (literally) or afraid of the answers we might get. Long story short, going to the gyno isn’t exactly a walk in the park (anyone else shudder at just the thought of the scary-looking—not to mention, cold—speculum?). But we’re here to normalize regularly seeing your OBGYN if you have a vagina, as well as creating dialogue around all the topics related to female wellness.
Enter: Dr. Alyssa Dweck, a practicing gynecologist in Westchester County, NY and advisor to Tru Niagen. From vaginal odor to birth control and everything in between, I probed (pun intended) Dr. Dweck on the most important questions to ask your OBGYN, and we left nothing off the table. Read on for her answers to questions you may be embarrassed to ask your own doctor.

Meet the expert
Dr. Alyssa Dweck
Gynecologist
Dr. Dweck provides care to women of all ages and has delivered thousands of babies. Voted “Top Doctor” in New York Magazine and Westchester Magazine, she has a special interest and expertise in female sexual health and medical sex therapy. Dr. Dweck is co-author of three books, including the newest release “The Complete A to Z for Your V (Quarto Press 2017),” and has appeared on The Today Show and Good Day LA. 

1. What is my vagina supposed to look like? 
While every vagina is unique (just like the person who it is a part of), Dr. Dweck explained what you can generally expect: “A healthy vagina, the internal canal, is typically a shade of pink, lush, sometimes glistening with normal clear fluid and with many folds called ‘rugae.’ The vaginal opening might have darker pigment and variable skin folds depending on history of childbirth, previous surgery, and/or sexual activity, for example.” Take a cue from Charlotte in Sex and the City and grab your trusty handheld mirror to get up close and personal with your vulva. 

2. Is it normal to have vaginal discharge and odor? What causes them?
Before you go down the Google rabbit hole, slow your roll. Dr. Dweck assured us vaginal discharge and odor are typically not causes for concern: “Most vaginas have a natural physiologic discharge made up of mucus from the cervix, vaginal fluid and cells, and cells/fluid from the uterus.” However, there are instances in which vaginal discharge and odor can raise red flags. “Infection with viruses, bacteria, and other microbes, including STIs (sexual transmitted infections), hormone changes, and/or external irritants, can disrupt the normal vaginal pH and microbiome and cause infection. In these cases, an atypical vaginal discharge or foul odor can occur.” The main takeaway? If you’re not sure and can’t decipher what’s what, it’s best to consult your doctor.

3. Why do I have urinary or fecal incontinence, and what can I do to resolve it?
If you experience loss of bladder or bowel control (AKA leaking urine or poop), you’re not alone (it’s more common than you may think). “Both can occur due to weak or relaxed pelvic floor muscles,” said Dr. Dweck. “Genetics, prior childbirth (especially for big babies or instrumented deliveries), and obesity may play a role.” So how do you address urinary incontinence? Dr. Dweck encouraged taking into account treating any underlying UTI (urinary tract infection), minimizing or eliminating caffeine (which can create urgency and frequency), practicing Kegel floor exercises, engaging with a pelvic floor physical therapist, and consulting with a urologist/urogynecologist for more intensive testing. “Similarly, for fecal incontinence, one may consider increasing fiber intake to bulk up stool, Kegel exercises, pelvic floor physical therapy, or seeing a colorectal or gastrointestinal specialist.”

4. How many yeast infections or UTIs are too many? When should I see a doctor?
One yeast infection or UTI is enough to send anyone into a frenzy. So how do you know when an OTC remedy will do the trick or it’s time to pay your doc a visit? “Recurrent UTI typically refers to greater than or equal to two infections in six months or three infections in a year,” Dr. Dweck clarified. “Recurrent yeast infection implies more than four infections per year. Both scenarios are best addressed by a HCP [health care provider]. Severity of infection is also a reason to check in with a HCP.”

5. Why is it painful to have sex?
PSA: Sex should only be pleasurable. So if you’re experiencing any discomfort between the sheets, seek help from your gyno or a pelvic floor therapist. As for what’s the culprit behind painful sex? “Painful sex could occur for a variety of reasons, including vaginal dryness, infection, hormonal changes, and mechanical or anatomic issues, such as fibroids, cysts, endometriosis, scar tissue, vaginal muscle tightness, and/or traumatic sex,” Dr. Dweck elaborated. 
 
6. Can I have sex while I’m on my period? And is it possible to get pregnant during my period?
While you may not feel the sexiest during that time of the month (there are ways to flip the script, BTW), if the mood strikes, Dr. Dweck gave the green light: “One can engage sexually while menstruating if comfortable and, in fact, period sex may relieve cramps or enhance pleasure for some. Precaution should be taken since blood-borne infection, including HIV, can be transmitted. It is possible, although unlikely, to get pregnant from sex while bleeding since some have irregular menses and unpredictable ovulation.”
 
7. How do I determine what type of birth control is best for me?
It goes without saying that birth control is a personal choice. It can be overwhelming and confusing to choose a birth control method that checks all the boxes for your needs and lifestyle. When deciding the best method for you, talk it out with your physician “[Determining the right birth control] is a shared decision made between patient and HCP based on menstrual habits, desired permanence of contraception or future fertility, medical history, and medications, lifestyle, and insurance coverage,” stated Dr. Dweck. “Keep in mind, condoms prevent against STIs while most other forms of contraception do not.”

8. If my state outlaws abortion, what are my options for unintended pregnancy?
In light of the reversal of Roe v. Wade, it’s no surprise there’s a lot of confusion and fear around reproductive health and abortion (it’s OK to feel all the feels, BTW). Whether or not you’re pregnant, arming yourself with information and resources from a trusted source (read: your OBGYN) is never a bad idea. But if you find yourself at a loss as to what safe recourse you have in the case of an unplanned pregnancy, Dr. Dweck pointed us in the right direction: “There are several online sites that will provide services, though travel may be required. Hey Jane is one example of a virtual clinic.” 

9. Why can’t I have an orgasm?
According to the Cleveland Clinic, only 10 percent of women easily climax. So if you’re part of the other 90 percent, Dr. Dweck shed some light: “This can be complex, but some reasons include not enough direct clitoral stimulation, pain during sex, medications (most notably antidepressants), medical conditions, prior surgery, or psychological factors.” Whatever the root cause may be, you can rest assured your OBGYN can help you find the solution that works best for you. Because we all deserve orgasms. 

10. How do I talk to my partner about STIs/STDs?
Sure, we can list a hundred things we’d rather do than get tested for STIs/STDs—let alone talk about them—but think of it as a form of self-care. And as awkward as it may be, Dr. Dweck emphasized that having a direct conversation about STIs/STDs with your partner is necessary. After all, you can’t go wrong creating a safe space for open and honest dialogue surrounding sexual health. It may just bring you and your SO closer and make the sex even better (talk about a win-win). 

11. I feel lumps in my breast. How do I know if it’s something more?
If you’ve ever done a breast self-exam, pat yourself on the back. Familiarizing yourself with “your girls”—from their appearance to how they feel—is a healthy habit to add to your wellness regimen. While breast lumps are common and most often non-cancerous, it’s nonetheless unnerving to find one (or more). So knowing what to look out for can help calm a bout of the jitters: “Lumps that are approximately 1 centimeter or larger are palpable,” Dr. Dweck pointed out. “A clinical breast exam with a HCP and imaging, including mammogram, sonogram, or MRI, are potential next steps.” During your next check-up, don’t hesitate to get some pointers on at-home protocols to maintain from your doctor. 

Please consult a doctor before beginning any treatments. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical or mental health condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this article.

I Tried Pelvic Floor Therapy, and You Should Too More

It’s no secret that stress can take a toll on your body, so it’s unsurprising that it can mess with your vaginal health too. Now, I know what you’re thinking: Another thing I have to worry about?! Trust me, I get it—sometimes you get so caught up in trying to ward off  stress that you end up stressing yourself out even more because you’re stressed about not being stressed. It’s a vicious cycle and one that’s easy to fall into. That said, taking the time to learn about how stress truly affects your body can help you manage stress and its effects, or might even know what signs and symptoms to look out for that your body might be trying to tell you.
A brief disclosure: If you’re experiencing any of the symptoms mentioned below, scheduling an appointment with your OB-GYN is never a bad idea. If stress is the root cause (or you feel a lot of stress, even if it’s pre-symptoms), make sure you’re also carving out time for yourself to practice self-care and using healthy outlets, such as meditating, journaling, or exercising as ways to manage stress. At the end of the day, finding what works for you and nourishing your mind, body, and soul is going to keep both you and your vagina happy and healthy. Keep scrolling to learn five major ways stress can mess with your reproductive health and how to deal accordingly, along with tips and tricks to de-stress so you can better take care of your mind and body.

1. Changes in discharge and increased risk of infection
Stress can suppress the immune system and may seriously disrupt the pH levels in the vulva. When this happens, you may notice discharge that smells funky, is thicker than usual, or darker in color. This occurs because your body’s defense mechanisms are lowered and your vagina has more difficulty weeding out bad bacteria, making it more susceptible to infection. Although discharge is totally normal and changes throughout your cycle, think of it as a window into your body’s overall health: If there’s an abrupt, drastic change in it, it’s usually a telltale sign that something more is going on.
It may be an isolated incident or an infection, like bacterial vaginosis or a yeast infection. Talking to your doctor about any changes in discharge or concerns about possible infection is always a good idea as they may be able to provide you with a prescription or over-the-counter remedy. You could also talk to your doctor about trying over-the-counter supplements and vitamins like probiotics or vitamins D and C. Some types of probiotics may help the vagina maintain a healthy pH level, while vitamin D and C can help strengthen your immune system.

2. Vaginal dryness
Stress can reduce the amount of blood flow to the vagina, which in turn can reduce moisture and cause dryness. “With stress on your mind, hormone levels will begin to shift—as cortisol rises, testosterone (essential for your libido) will dip,” Dr. Alyssa Liguori, an OB/GYN based in Georgia, wrote for Northside Hospital. “Your body won’t be sending enough blood down there to increase moisture, so vaginal dryness and/or discomfort is more likely.” This dryness can also cause painful sex and an inability to orgasm—two things you definitely do not need in your life.

3. Low libido
When you have a huge work deadline looming, student loans to pay off, and a packed social calendar, sex is probably going to be the last thing on your mind. It’s normal, but it turns out there’s a medical reason for it. Because your testosterone levels dip as cortisol levels rise, you not only experience vaginal dryness, but may experience low sex drive as well, since testosterone is essential for libido. However, getting it on can actually destress you: orgasming regularly can improve your mood, release stress hormones, and keep your vagina from getting depressed (who else remembers the Sex and the City episode where Charlotte announces at lunch her vagina has depression?). Even if you’re not totally in the mood, it may be worth reaching for your vibrator to try to destress. However, if you’re experiencing zero interest or changes in sex drive, always talk to your doctor (remember that libido is an important vital sign!)

4. Changes in menstrual cycle
If you have a menstrual cycle, its completely run on hormones (the different changes in your cycle are due to estrogen and progesterone levels). If your stress hormones are out of whack, your menstrual cycle can become irregular, those notorious PMS symptoms can intensify, or you may skip a period altogether. This can also cause fertility issues since irregular periods can distress ovulation schedules and make getting pregnant more difficult. If you’re experiencing painful or irregular periods and have felt extra stressed, your cortisol levels could be to blame. As always, if you experience any changes in your menstrual cycle, always talk with your doctor to get to the root cause.

5. Tight pelvic floor
The pelvic floor is especially important for women with uteruses since it’s responsible for bowel and bladder movements, and provides support to the reproductive system. A strong pelvic floor makes sex more enjoyable and orgasms stronger. When we’re stressed, however, we can physically seize up (think: clenched jaw or fists) and that tension can reach our pelvic floor.
A few early signs of a tight pelvic floor are constipation, pain during sex, and lower back pain. Hip, back, abdominal, or leg pain, a feeling of heaviness as though the pelvic floor is dragging, strain with bowel movements or emptying your bladder, or inability to completely empty the bowels or bladder, and a strong urgency to run to the restroom are also signs of pelvic floor dysfunction. If you’re experiencing any of these symptoms, consider seeing a pelvic floor physical therapist.

This Holistic Expert is Helping Women Have Better Periods
Here’s How More

Growing up, my period was never allowed to be the topic of any conversation. Around my brothers, my mother and I would shoot code words at each other, referring to pads as “things” and periods as “your stuff.” The shame even seeped into friendships: I remember waiting for one of my close friends to spill about puberty before I did (even though we all wanted to scream about our awkward, changing bodies) and boys joining in on the gossip of who got their period, who was developing, etc. Don’t even get me started on the “If you don’t use [insert any period product here], you’re not clean” conversations that bounced around my middle school and high school hallways. All this reminiscing is to say that talking (proudly) about my period hasn’t felt safe.
The rise of more period products, period education, and period un-shaming in the last few years alone speaks volumes to the world’s changing view on women’s health. Although my friends and I can be much more explicit in the way we talk about our bodies now and my mother can finally say the word “period” in our house without checking around a corner first, there’s still lurking shame and trauma that exists for myself and women who dealt with these feelings. No amount of outside validation can heal that for anyone. I had to dig deep into the trauma, shame, and overall disgust I was taught to feel about my period. It took some time, but there are a few steps that have helped me dismantle my feelings of inadequacy and trade them for love and acceptance instead. Here are five things I did to change my perspective on my period and actually—dare I say—love my menstrual cycle.

1. Binge *good* TV
If you’re anything like me, you enjoy the slow-burn of reality shows. But finding meaningful TV shows or movies that actually help you tackle the reality of what you’re feeling can be a great substitute sometimes. This may be oddly specific, but I am absolutely obsessed with Big Mouth. Although it can be extremely explicit, this show is so authentic when it comes to puberty and women’s health. Although I wish I had a less awkward and more celebratory experience with my period like the characters in the show, finding media representation of others going through the same thing is a reminder that my body is normal and functioning the way it should. 

2. Just talk about it
Of course, this one might seem to be the easiest solution, but it was actually the most difficult for me. Talking to others about your period can be daunting. You might be thinking your body is weird or wrong, but unless there’s the need for medical attention, your body is operating the way it should. Everyone deserves a community, but taking the first step to make period talk not so taboo requires you to put yourself out there. Whether it’s swapping period symptoms, talking about cycle-tracking methods, or asking for advice on period products, work on getting comfortable talking about your period with others (whether they also menstruate or not!). 

3. Recognize the significance of your moon cycle
With the increased popularity of mercury retrograde and the eclipse cycles, it’s time we talk about how our menstrual cycles relate to moon cycles. I recently came across the Moonly app, a resource for understanding the eastern moon calendar, alongside rituals, meditations, and affirmations to connect with yourself during each moon cycle. Moon cycles are different phases the moon takes on as it adjusts from a new moon to a full moon, and there’s a lot of connection between menstrual cycles and moon cycles. In fact, many practices from ancient Greece to indigenous cultures to Ayurvedic traditions have used moon cycles to track female ovulation and fertility. 
Finding out that my body was so connected to the universe changed my relationship with my period. I began a lot of the affirmations and practices recommended by the Moonly app, and I even dove into learning more about mythology (I especially connected with Selene, the Greek and Roman goddess of the moon, and worked on treating myself with the same love and affection she had). Bottom line: Our cycles are amazing, and we are our most in-tune and connected when we’re on our periods. If you don’t connect with the concept of moon cycles, find what will. Whatever type of goddess you prefer, be her. All women (menstruating or not) are truly magical, so don’t forget it.

4. Notice (and stop) your unconscious behaviors
Have you ever hidden a pad or tampon on the way to the bathroom? Maybe you’ve released a sigh of frustration when you get your period at an inconvenient time? Even negating painful cramps or taking prescriptions to stop your period altogether can be unconscious ways of shaming yourself and your body. I used to partake in these harmful behaviors all the time, but it only made me feel worse about myself. If you’ve never heard this before, please know that periods are normal. Too often, we hide ourselves and what we need from the world because we’re scared of being embarrassed. But what’s embarrassing about a period? Half the world has a menstrual cycle and bleeds on a regular basis. 
Next time you notice any of these behaviors, take a moment and ask why you’re doing it. Do you feel uncomfortable talking about your period with a certain group of friends? Give them the chance to be completely there for you if you feel like you’ve been holding back. But if they make you feel wrong or gross, move on. If your partner gaslights your bodily pain, move on. There are millions of people, whether they bleed or not, who are mature enough to not only talk freely about periods but are willing to support you too.

5. Celebrate every single period
My mentor once told me that periods are good luck. I laughed, thinking she was insane, but it made me slowly start to look at my period differently. I noticed my period would show up right before job interviews, anxiety-filled social gatherings, and even before my college graduation. I began to recognize that maybe it really was good luck. The tradition of looking at your period as a good omen rather than a major inconvenience is a great way to remember how perfectly curated your body is to you.
Just like how your body grows hair or needs exercise, your period is an essential part of who you are, so why not celebrate that? Some go-tos that I’ve done are taking myself on a solo date for whatever food I’m craving, buying myself a new candle (for a relaxing bath time), and simply allowing myself to rest. Just because the world expects you to be productive throughout even the most gruesome days of your cycle (toxic productivity culture!) doesn’t mean you have to. Let yourself feel sexy, happy, and free, and welcome in all the possibilities of a great week because of your period, not from the lack of it. 

A Self-Care Guide for Your Period Week More

When it comes to health and fitness, adding new habits to your busy life can be a real challenge. Whether you are trying to balance your summer wedding invitations and vacations or simply want to enjoy the sunshine with friends, summer can be one of the busiest times of the year. For those of us with packed calendars who also want to be our healthiest, it’s much more realistic to commit to leaving certain behaviors behind rather than adopting new ones. The good news is that sometimes, getting in the best shape of your life is less about what you should do and more about what you shouldn’t do.
First, let’s define what being “in shape” means. Regardless of what it used to mean, we’d like to rebrand it to be your healthiest self, which looks and feels different to everyone. Being in the best shape of your life is not a number on a scale or even a six-pack of abs. After all, a certain pants size could never be powerful enough to give you that lit-from-within glow and limitless energy. With that being said, say goodbye to these 10 habits, and you can become your healthiest self (without adding a single task to your to-do list!). 
 
1. Staying up late
I get it: Sometimes, you can’t help but binge the newest Netflix show, but sacrificing sleep to watch “just one more episode” will affect your body long after the credits have rolled. Lack of sleep can cause unnecessary cravings, negatively affect your metabolism, increase stress, and make you feel less motivated to get your body moving the next day. To prioritize sleep, try establishing a bedtime routine, such as having a cup of tea or reading a book, and aim for the same lights-out time each night. 

2. Drinking (too much) alcohol
It may be hard to pass up the third pour of your favorite cocktail (especially when summer party season is upon us), but drinking too much alcohol can negatively affect your health in multiple ways. Alcohol is dehydrating and we’re all familiar with that lack of motivation or a craving for breakfast sandwiches and pastries after a night out. If you’re sober-curious or know you are your best without alcohol in your life, swap your next margarita or glass of rosé with one of these non-alcoholic spirits. If you live for an Aperol spritz come summertime and believe in everything in moderation, you go girl! Just create boundaries around your drinking (like limiting alcohol to the weekends or stopping after two drinks) that help you feel your best (and avoid a hangover the next day). By setting parameters around your drinking, you’ll be saving your body from some serious stress.

3. Relying on processed foods
Whether you call it “snack food” or “junk food,” you probably already know that processed foods should be a treat that’s occasionally enjoyed, and whole foods should make up a majority of your diet. Now, we’re not about restricting, limiting, or avoiding (all food is meant to be enjoyed!), but if every meal is built around something processed, frozen, or with an ingredients list full of words you can’t pronounce, you could probably afford to add a little more veggies, healthy fats, and clean protein to your meals. When you eat more whole foods and less processed foods, you can notice a difference in mood, gut health, digestion, sleep quality, and physical performance (just to name a few!). 

4. Over-Stressing
Although it’s easier said than done, reducing stress has been shown to have many benefits to your overall health. The stress hormone cortisol might cause you to overeat (or crave less nutritious foods), affect sleep quality, and suppress the immune system, all of which negatively impact the health of your body. If getting into the best shape of your life is a priority, managing your stress is paramount. Whether you talk it out with someone you trust, journal, or exercise for stress relief, decreasing stress will improve your life, health, and body.
 
5. Using a fitness tracker
Fitness trackers can provide us with really cool data about how much we move, how well we sleep, and our average heart rate, but it can be easy to get fixated on how many calories it tells us we burn. If you want to get into the best shape of your life, stop relying on fitness trackers for caloric burn and instead, maintain as much consistency in your workouts and diet as possible. Rather than checking how many calories you burned during a workout, focus on how you feel and how strong you are.

6. Staying sedentary all day
If you’re really looking to maximize your time to become more fit, add in movement wherever and whenever you can throughout the day. After all, true health is not about fitting in a 60-minute intense workout—it’s just about living less sedentarily. Take the stairs instead of the elevator, incorporate movement breaks in your work day (going for a walk or doing 10 push-ups before a meeting), and walk or bike instead of hopping in your car. As small as these changes might seem, they really add up.

7. Focusing on the scale
Weight might seem like the most obvious measure of success when it comes to fitness, but the reality is that the scale doesn’t come close to telling the story (and can even be damaging!). While there’s a time and a place to track your weight (i.e. if encouraged by your doctor, etc.), it can be easy to fixate on a number and forget the bigger picture (and worse: spiral into destructive patterns). Instead of using your weight to determine progress (which can fluctuate based on your cycle, water retention, digestion, and training load, FYI), try using how you feel as a measure of success. While weight is an important health factor, it’s not the one and only way to measure progress.

8. Skipping meals or eating a low-carb diet
PSA: Your body needs food (and a lot of it) just to survive. It needs a lot more to move, to think, etc. If you’re not getting enough glycogen (AKA energy from carbohydrates stored as sugar), you may not perform well, which leads to sluggishness and lackluster workouts. Likewise, if you’re not getting enough of a variety of nutrients (like protein, fats, phytonutrients, antioxidants, etc.), your body cannot function its best, much less recover from workouts and work hard again the next day. The best way to make lasting changes is not to eat less but to eat more healthy foods. Listen to your hunger cues and fuel up before and after workouts.

9. Counting calories
Counting calories often leads to an unhealthy relationship with food. Instead of tracking your caloric intake, focus on ensuring that most of your meals are nutritionally dense, contain lots of protein, and make you feel good. You’d be surprised just how many calories you need per day (which is highly specific and difficult to estimate without real metabolic testing or talking with your doctor), but if you really listen to your body, it’ll tell you when it needs sustenance and when it has had enough. Focus the energy it takes to count calories on something more valuable, like cooking your own meals. Oh, and if you want some ice cream, have some ice cream.

10. Comparing yourself to anyone else
Social media can make it easy to play the comparison game, but it’s important to remember that even if we all ate the same things and exercised the exact same way for the same amount of time, we’d all still look very different because no two bodies operate the same way. Having goals is extremely important so we can stay motivated, but make sure your goals are intrinsic (like “to feel confident in a bathing suit” or “to get more energy”) rather than extrinsic (like “to look like [insert celebrity or influencer here]”). The most confident people know that they don’t need to be perfect in order to be worth celebrating, so stop trying to look like everyone else and start celebrating exactly who you are. There is no finish line in the pursuit of health and fitness, so enjoy every step of the journey. 

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If there was an award for “Best Supporting Muscle Group,” it would be the pelvic floor, hands down. While it’s finally starting to get the recognition it deserves, the pelvic floor remains an obscure set of muscles to most people. Until recently, my knowledge of the pelvic floor started and ended with Kegel exercises (thanks, Sex and the City!). Little did I know the importance of maintaining a healthy pelvic floor, nor the starring role it plays in everyday functions or even where/what it is. 
If you’ve experienced the best orgasm of your life or managed to hold your pee in rush-hour traffic, you have your pelvic floor to thank. On the flip side, if your libido is leaving much to be desired or, worse, you feel pain during sex, consider them red flags that your pelvic floor muscles could use some TLC. I decided it was time to give Kegels a rest and look beyond Samantha Jones for sexual health tips. I tapped into the expertise of Dr. Jennifer Carr, an orthopedic and pelvic health physical therapist and clinical director of Origin in Brentwood, California in Los Angeles, and gave pelvic floor therapy a go. Below, find an intensive course on all things pelvic floor. Step aside, Kegels. 

Meet the expert
Dr. Jennifer Carr, PT, DPT, OCS
Orthopedic and Pelvic Health Physical Therapist
Dr. Jennifer Carr is an orthopedic and pelvic health physical therapist and clinical director of Origin in Brentwood, California. In addition to her specialization in treating the pelvic floor for women, she provides clinical instruction to doctoral candidates from the physical therapy program at the University of Southern California and is a mentor for the USC post-doctoral residency program.

In this article

What is the pelvic floor? 
Let’s start with Pelvic Floor Anatomy 101. At the bottom of your pelvis lies a group of muscles—the pelvic floor—that form a bowl-like shape between your sit bones. “The pelvic floor is composed of three layers of muscles that sling from the pubic bone in the front all the way to the tailbone in the back,” Dr. Carr explained. “It’s made of muscle, but it’s unique in that it not only gives us strength and power as it coordinates with our trunk muscles, but it also supports our internal organs and keeps urine and poop in our bodies until we are ready to empty,” Dr. Carr continued. “A healthy pelvic floor can stretch and open to empty the bowel and bladder or have sex and stay closed to keep us dry, clean, and feeling supported.” In other words, the vital muscles give us the ability to control our bladder and bowel movements and enjoy physical intimacy—things we don’t give a second thought to and take for granted, unless something doesn’t feel right.
What better way to understand (and appreciate) the female anatomy than by seeing it IRL? Using a pelvic floor model, Dr. Carr showed me the various pieces of the puzzle, so to speak, including the urethra, clitoris, and vagina. Then, using a mirror I imagine you’d find in Inspector Gadget’s bag, came the eye-opening exploration of my own pelvic floor. Until that day, I had never gotten an up-close-and-personal look down there and my relationship with my vagina and surrounding parts would best be described as acquaintances at best. Let’s just say I was mind-blown and we’ve all become much more familiar with one another. 

How do you determine the health of your pelvic floor?
Think of your core, the act of going to the bathroom, and knocking boots as windows into your pelvic floor. If you have any issues in those areas, chances are, you have a pelvic floor dysfunction. Dr. Carr explained that symptoms like leaking urine, constipation, pain with penetration (including a tampon), or discomfort sitting are signs of pelvic floor dysfunction. 
According to Dr. Carr, to understand what’s going on with your pelvic floor and get to the root cause of your symptoms, you might want to start with an internal pelvic floor examination when seeking pelvic floor therapy—that is, if you’re comfortable with it. “If you opt in for the pelvic floor internal assessment and your therapist determines it’s safe and appropriate to do so, the setup is very similar to when your OB-GYN performs a Pap smear, except we are looking at the muscles, not the organs,” she explained. 
Other common symptoms of pelvic floor dysfunction can include but are not limited to: 
hip, back, abdominal, or leg pain
feeling of heaviness or dragging in the pelvic floor or like something is falling out
strain with a bowel movement or strain and push to empty your bladder
unable to completely empty your bowel or bladder
strong urgency to urinate or feeling like you must use the restroom all the time

What can you expect from pelvic floor therapy?
It should come as no surprise that the first session involves a lot of chatting. Your pelvic floor therapist will ask a series of questions to understand what’s going on with your body and pelvic floor (think: medical and family history, concerns, goals). Then, when proceeding to the more intimate part of the appointment, they’ll know what to look out for. So what does a pelvic floor therapist look for down there? “Part of the examination involves looking at the pelvic floor to see how it responds to cues,” Dr. Carr stated. “It involves examining the skin to see if it’s healthy, looking for any scarring, and then evaluating each layer of the pelvic floor for strength, coordination, length, and response to pressure using a gloved, lubricated finger.”
Once the therapist has performed the examination, they can determine a course of treatment. While there is no one-size-fits-all approach, Dr. Carr said the plan of action should almost always involve education on the function of your pelvic floor for various activities, like what it should do when you cough, sneeze, or lift something heavy. For example, if you have pain or discomfort in your pelvic floor, you may need help lengthening its muscles. Your pelvic floor therapist can walk you through exercises that encourage relaxation of the muscle group, which you can also do at home. 

Why should pelvic floor therapy be a part of our wellness routine?
About 25% of women in the U.S. are affected by a pelvic floor dysfunction (and there’s probably a lot more women who don’t know they have it). Needless to say, it’s about time we get some one-on-one time with the hammock of muscles that we don’t give enough credit to. “Understanding how your pelvic floor functions can be life-changing,” Dr. Carr said. “It can make sex more comfortable and pleasurable if it isn’t, facilitate delivering a baby vaginally more effectively (and optimize your recovery), cultivate feeling more comfortable in your skin, and help you feel stronger and more capable with all types of activity.”
Just like we do push-ups to strengthen our triceps, pec muscles, and shoulders and squats to build our glutes and quads, everyone with a pelvic floor can afford to prioritize and be mindful of the important muscle group. It does a lot of the heavy lifting in our body, after all! When most people think of pelvic floor exercises, it’s all about Kegels. But that buzzworthy movement isn’t for everyone, and when performed incorrectly, it can do more harm than good. By working with a pelvic floor therapist, you’ll get an individualized plan to train your pelvic floor muscles for optimal health, whether you have dysfunction or not. 
Find a therapist who makes you feel comfortable and takes the time to guide you through every step of your session. Dr. Carr advised that your therapist should always explain what they are going to do and why. “Advocate for yourself if you think you need physical therapy for your pelvic floor,” she said. “Whatever pelvic floor symptom you have, I guarantee, there are many others out there who are dealing with the same problem.”

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