Women's Health and Wellbeing Discussion

Speaker 1 0:00

Women's health is not just bikini medicine . Women are more likely to die of heart disease than men . We're more likely to have dementia , more likely , unfortunately , to be exposed to sexual violence . East Indian affects every cell in our body and so actually we are so more likely to suffer from lots of different conditions . And it's much wider than just talking about our uterus or our boobs . It's everything that we are .

Speaker 2 0:29

Shift work can be brutal but it doesn't have to be . Welcome to a healthy shift . My name is Roger Sutherland , certified nutritionist , veteran law enforcement officer and 24-7 shift worker for almost four decades . Through this podcast , I aim to educate shift workers , using evidence-based methods , to not only survive the rigors of shift work but thrive . My goal is to help women who are not only in their work but thrive . My goal is to empower shift workers to improve their health and wellbeing so they have more energy to do the things they love . Enjoy today's show and welcome to another episode of a Healthy Shift podcast , your podcast , our podcast , the podcast where we discuss evidence-based strategies to help you in your shift working life .

Speaker 2 1:24

I have one of my best friends way , way , way across the other side of the globe , chloe Stevens , who is a women's health physiotherapist and nutritionist . Why would I have Chloe on the show ? Well , chloe is actually studying her MSc in women's health at UCL and she has 14 years experience working in a women's health setting . I have discussed that . We will be diving on into women's health today and I've got to be brutally honest with you . Today we are going to be discussing everything women's bits . Today , lady , strap yourself in , because there's quite a lot that we're going to discuss here along the lines of a pelvic floor dysfunction . We'll be discussing prolapses , incontinence , a non-relaxing pelvic floor which can cause painful sex , and we'll talk about nutrition and women's health . We even dive into pubic hair yay or nay and we'll also talk about smelly vaginas . Is this something that we should be worried about ? All right , so , without much further ado , let's get on with today's show . There's plenty for us to discuss . Chloe Stevens , how are you , chloe ?

Speaker 1 2:40

I am great . Thank you , I'm very happy to be here .

Speaker 2 2:43

Happy International Women's Day . We're actually recording this podcast , which is very , very appropriate today . You and I just seem to do this . Well , international Women's Day today . Now , I'm going to say this we're going to dive into vaginas and women's health today . So brace yourself , everybody , because if you don't already follow Chloe , you're going to need to , because it is literally exactly as it is that she calls it . So , before we start , tell me , chloe , what does International Women's Day actually mean to Chloe Stevens ?

Speaker 1 3:13

I think it has its roots in women's rights . I feel that it has been commercialized a little and kind of a bit of a big company is using it to buy women a free lunch . I think that we need to get back to the idea of equality in so many levels that is lacking in women's health . So that is in healthcare , that is in gender pay gaps , that is in gender pain gaps , that is in hospital settings for women , healthcare for women . There's a long way to go , but don't get me wrong . We are going such a long way further and people like yourself advocating for women on so many different levels and talking about complex issues is so exciting .

Speaker 2 4:00

It's incredibly exciting . I can tell you that every single one of my clients are female . I don't have any male clients at all . I know I say this at the start of majority of my podcasts that I do , but I absolutely love my ladies and being able to help them and educate them in this space , and it's from people like yourself that really , really guide me in what is the latest up-to-date evidence that we understand around women's health , because it is a very , very confusing world , and we're going to talk about some really top topics today , which are questions that I know a lot of women have got that are just far too scared to ask , cannot wait . So , chloe , tell our listeners a bit about yourself .

Speaker 1 4:47

So I'm Chloe and I'm based in the UK . I'm based in a small city just outside London called Canterbury . It has some very beautiful gardens . I have been a pelvic health physio 10 years now . I do do some musculoskeletal work as well , and you and I met by doing our nutrition course together , which was four years ago now .

Speaker 2 5:09

Oh no , it's crazy , isn't it Nearly five 2019 .

Speaker 1 5:12

Amazing . I love lifting weights , I love running , I like traveling and I definitely like eating . I would say the neatest fact about me is I've had heart surgery twice and I think that was really a big game changer for me , changed my whole career and made me focus a lot on my health and fitness , and that's how I kind of came into physiotherapy and healthcare .

Speaker 2 5:37

Exactly the same as me as well . You know I was suffering from socroillitis , you know ankylosing spondylosis myself , and I was really suffering and I was told , oh , you've got to take this and you've got to take that . And I thought , oh , there's got to be a better way . So then I got into resistance training myself and then I started looking at foods that I could have that were more anti-inflammatory and cutting out the inflammatory foods out of my diet . And so I started the journey as well , exactly the same as you . Now . We did Mac Nutrition Uni together . Obviously , it's an online course , so we didn't do it together together , but we were in part of the same alumni . And here we are today with you out there absolutely smashing it , and I in your specialist area and we've spoken about this a lot in the background and , of course , I then branched straight off into the shift work area , because it's just such an uneducated area as well , like women's health is .

Speaker 2 6:29

Over the last four years since graduation , I've watched you go from your heart surgeries into literally running a marathon , and I can remember tracking you through that marathon that day I literally , I literally was tracking you as to how you were going and continually checking on where you were , and no one maybe your boyfriend did but no one smiled as much as I did when you crossed that line , because I know how hard you worked for that and how much it meant for you . It was just an amazing achievement .

Speaker 1 7:00

Yeah , that was really special . And that marathon was so special because I raised so much money for British Heart Foundation , so it really meant so much to me . I am doing another one this year .

Speaker 2 7:15

I am you are a sucker , aren't you Like ? I guess it's like childbirth , isn't it ? Women say , oh my God , that was the most painful experience I've ever been through . Next minute , child two , then there's child three , and then there's well , for someone that we know is a mutual friend as well , there's child four on the way as well . It can't be that bad , but a marathon . I would have thought it was a bucket list item that you would tick off and then never go back and do .

Speaker 1 7:36

but look at you go I entered Berlin Marathon on a whim and I thought I won't get in and then I did . But I'm excited to do it because I'm going to raise money for a British charity that works with women who have had birth trauma . So like third degree tears , fourth degree tears after giving birth . So I really feel like I'm motivated to raise money for that charity .

Speaker 2 8:00

Congratulations , well done , and we'll go in and put links and things like that into the show notes around all of your charity to do the fundraising for this . Now , how long have you been working in the area of women's health , chloe ?

Speaker 1 8:11

So I started working in women's health 14 years ago . I was actually doing a language degree and I quit and I went and worked in my local hospital as a maternity care assistant which is like an assistant to a midwife Because I thought maybe I'll go down the route of maternity my mom's a midwife but I decided that actually I wanted to go into physio . So I trained as a physio whilst I was working as a maternity care assistant and then after that , when I got into physio and graduated , I realized that I could do women's health physio , which kind of brought physiotherapy and women's health together , and back then it was so much more niche than it is now . I feel like it's gained a lot more popularity recently and people are more aware of it . But I was very lucky with my placements and I was put straight into women's health and it's kind of just gone from there . So 14 years now 14 years is incredible .

Speaker 2 9:06

So you've studied nutrition and we did the evidence base . We did make nutrition together and we learned all about that . But you've taken another step again . You are an absolute sucker for punishment . Not only will you traumatise your body in a marathon , but you want to traumatise your brain as well . Tell us what you're studying now , how far you've come and how are you actually finding it .

Speaker 1 9:28

I am doing my master's degree at UCL , university College London , in women's health . So there's quite a few different routes that you can take as a post grad , but I decided to do the one at UCL because it's quite a zoomed out view of women's health . So we look at women's reproduction , we look at researching women , but we also look at the political side of things and the controversies and the concepts around women's health . I didn't want to just go into physiotherapy on its own . I wanted that broader view so I could encompass my nutrition stuff and look at all the political problems that surround women's health as well .

Speaker 2 11:02

So it's all going to be the absolute latest and greatest evidence . I'm sure you must come out of your lectures and you're sitting on the tube on the way home thinking to yourself oh my God , like I've got posts and posts and posts and there's so much information that I can get out there . And we know that this is all current and that's what I lap up as a male in this space , because I've got female clients and I just love it because it gives me the opportunity to help them . When you see a person with a doctorate , we don't realise just how much work's gone into it . What do you think about working in the MSc personally ?

Speaker 1 11:37

I'm not going to lie to you . Trying to do an MSc , working full time in the NHS and running my small business on the side is a lot . And I think me and you have even spoken where you've given me little pep talks along the way because I've been like Roger , I can't do this .

Speaker 2 11:54

Yes , but what do I always tell you in the background ? You will absolutely find a way , and then , when you look back in 10 years , you will be ever so grateful that you actually pushed on , because you can't fail at it . You will just keep going and keep going until you finish , and then you will be an authority in this space , which is just so needed . We understand why you've gone down in that path . So , ultimately , where do you want this to actually take you ?

Speaker 1 12:23

I have to be honest , I don't have a plan

Women's Health and Hormonal Changes

Speaker 1 12:25

. I just know that I'm so passionate about what I do and I go through and I think , oh , maybe I can do this thing next , like my MSc . Or then I'm like I've noticed that PTs don't have much of an education in women's health , so maybe I'll do this thing , isn't it ? There's no like bigger plan . I just love what I do and every opportunity that comes my way . I'm like , oh , I think maybe I could do that . So I can't say that ultimately I want a multi-million dollar business . I just want to enjoy every day of my career and , as things come along and opportunities come along , if I think that's for me , then I'm going to take them .

Speaker 2 13:06

Absolutely fantastic and , like me , I started with one journey doing the nutrition . You and I , as I said , we're so parallel that what you're doing now is just seeing what's there , because we don't know what's out there , do we ? And things come along and you think , oh no , I need to help with that . You know , oh no , I need to do this and this is going to be fantastic . So let's get into it , because we've covered all the background now . You've qualified yourself as without data subject matter expert on this . At the moment , I know you always feel like you've got imposter syndrome because you're just never going to know enough . And we're all the same . We all feel exactly like that . Let's talk about women's health . Let's really get into what you've learned about , what you know , what you understand . So I've got certain questions that I would like to ask you around that , and then we'll cover off on what you feel we need to know as well , which would be fantastic . When we refer to women's health , what does it actually mean ?

Speaker 1 13:58

So , even I had this perception until I started to really deep dive into this . I used to think , oh , women's health , we're talking about the uterus , the ovaries , the fallopian tubes , the boobs . But actually , if we step away from that and think about the fact that actually women's health is not just bikini medicine , it's way wider than that . Women are more likely to die of heart disease than men . That's the biggest killer . We're more likely to have dementia . We are more likely , unfortunately , to be exposed to sexual violence . We are more likely to die in well , obviously , in pregnancy and childbirth , and so actually it's so much wider than just PCOS or endometriosis , because estrogen affects every cell in our body , and so actually we are so more likely to suffer from lots of different conditions , and it's much wider than just talking about our uterus or our boobs . It's everything that we are .

Speaker 2 14:58

You're saying that I never , ever , considered the sexual violence side of women's health . Now , don't get me wrong here , and this is not my ignorance in relation to it . Because of my vocation , I'm very aware of sexual violence . But for you to be a women's health expert and to be bringing advice to women around how they need to be aware to protect themselves from sexual violence is women's health . It's super important , isn't it ?

Speaker 1 15:26

It really , really is . And when I think about my clinical practice as a women's health physiotherapist , a lot of women who have sexual dysfunction have experienced sexual violence and that's the reason why they have sexual dysfunction and how they end up with me as a women's health physio because they are having problems with penetrative sex .

Speaker 2 15:45

And we're going to get into this one later on . They're very famous words , but women are not small , men are they ? And other than the obvious in reproductive organs , how are females different biologically to a male ? Because , you know , we all look at it and go , oh , they're just small men . They're different , everything's exactly the same . They've got a heart and they breathe , and so on and so forth . But women are not small , men are they ?

Speaker 1 16:08

No , most definitely not , and if we even just think about the fluctuations in our hormones , the interplay we have between our hormones , our estrogen , progesterone , luteinizing hormone , lalalala , could go on all of them , they are always fluctuating throughout the 28 day cycle , also throughout the day for us , and also then what we also have to think about is , like I said before , the estrogen and the progesterone affecting every cell in our body . I think one of the best things that you can do if you want to know how widely these can affect you is look at a body chart of a woman and look at what happens in menopause when those hormones start to decrease , especially estrogen , hair changes , skin changes , mouth dryness , vaginal changes , dryness , leaking . I could literally sit here and list the list for about 20 minutes . You know the list I'm talking about . It is mind boggling how much can change when our hormones change .

Speaker 2 17:09

Absolutely , and this is what a lot of women you know we really do need to be aware of that . It's perfectly normal as well . It's unfortunately , it's the card that you've been dealt , but it shows you the importance of pre-perimenopause , of maintaining good health all around to keep those hormones balanced . So , while you're keeping those balanced , everything is running really , really well , because once those hormones start to go out of balance , that's when we literally start hitting the skids , don't we ? And then emotionally , physically , we start to really really suffer . So I think that's the point that you're making , isn't it ? The estrogen and progesterone is just so important in our , you know , from the time that we're eight , nine years of age right up until we become perimenopause , or . It's so important to keep that all beautifully balanced and we'll get into how you can later on , but it's important because when it starts to change , that's when it all really starts to change , doesn't it ?

Speaker 1 18:07

Most definitely , and I think what we have become more aware of recently is the complex interplay between these hormones and I think it wasn't really spoken about . I don't even think in the last 10 years . I really feel like the education around the menstrual cycle has changed . In the last five years We've started talking about perimenopause , menopause , so much more , and I think we are far more aware of how our lifestyle affects these hormones and can have a big impact on our overall health .

Speaker 2 18:38

Let's be honest . We talk about menopause and we've always known and I know in particular myself as a male , I know menopause , but it was only recently that I started to learn perimenopause and what perimenopause is as well , because that's a whole period prior to the menopause as well , especially poor women . You really do suffer with this , but that is just the gradual decline of those hormones , that estrogen in particular , but estrogen and progesterone , they go out of balance . We go through that perimenopause . Could you just roughly give us some indications , if you could , for females that are unaware of what perimenopause literally means ? What are we actually identifying ? What are we actually going like if I don't know if I'm perimenopause or what should I be looking for ?

Speaker 1 19:23

So our ovaries just don't suddenly stop working one day . They have a slow decline and there's a slow decline in the production of estrogen , which predominantly comes from the ovaries . So we get this fluctuating estrogen for quite a while , and this normally starts between the age of 45 to 55 . It's quite a range , and we often see 51 banded around as the average number , but we need to have more nuance than that because it's different for different women . So it's quite a wide age range and we see this fluctuating estrogen which has impacts for so many different things that are going on for a woman .

Speaker 1 20:05

Now what I think a lot of people get confused with is that a menopause is just one day in a woman's life and that is when she has not had a period consecutively for 12 months . So we may have perimenopausal symptoms for some women for up to 12 years , even more , and in this time women can see things like brain flog , mood changes , problems with their incontinence , problems with their sex drive , sleep problems , insomnia , different changes in how they want to eat , different drivers in foods that they're craving . There's so many things that start to change at this time . But the perimenopause is this kind of fluctuating time . For some women .

Speaker 1 20:53

This can be a breeze For some women . It can be so challenging . For some women , going through menopause can be one of the most liberating experiences that go through . They no longer have to worry about their periods , and I think it's really important that we don't just always have this really negative rhetoric around perimenopause and menopause . You're really going to suffer . It's going to be dreadful , because some women feel really liberated by it not having to have a period anymore , maybe being able to have less responsibilities with family life and really just put themselves first again . So it's not always this miserable time for every women , but some women do really suffer and there are lots of things out there that can help them .

Speaker 2 21:35

A lot of women say oh , I'm going through menopause . You're actually not going through menopause , are you ? You're going through perimenopause because when you get to menopause , that's the liberation of the perimenopause , that is you're done , it's all over . So if you are still getting your hup flashes , you're still getting your dryness , everything else , everything that's going on , this poor sleep , that is actually perimenopause . So you're not going through menopause , you're going through perimenopause . Then you hit menopause , which is you're done .

Speaker 1 22:04

Some women can have postmenopause , so post that , 12 consecutive months of no period they can have symptoms after . But for most women that isn't the case .

Speaker 2 22:14

Incredible . Now we hear about a circadian rhythm all the time and I , obviously , as a shift working coach , talk about this circadian rhythm all the time because it is our 24 hour body clock that runs , regardless of what we're doing , it is still running 24 hours a day . But females also have a rhythm as well that us males do not have , and it is known as the infradian rhythm . Would you like to just explain to our lady listeners , and to our men that are listening as well , what is the infradian rhythm ?

Speaker 1 22:45

So the infradian rhythm is a 28 day clock that starts with your first menstruation so the first menstruation is at puberty and it ends with your last menstruation before menopause , which we were just talking about . And this is this 28 day cycle . Now , what we have to be mindful of is , yes , it involves your menstrual cycle and not everyone's menstrual cycle is 28 days , but the 28 day cycle , if we talk about that as an average , is a period for most women . So through this time , you have different stages and , to keep it as basic as we can , we have our follicular phase , which is where we start on the first day of our period , and through this time , we will have our period and our estrogen will start rising , driving us towards ovulation .

Speaker 1 23:36

We have other hormones that are coming in at this time as well , like luteinizing hormone , and at 14 days for most women , we will ovulate and this is where we have an egg that is released into the fallopian tube . And after this time , our estrogen starts to decline and our progesterone starts to kick in and we go through the period to nourish and early pregnancy and then we go through our luteal phase , which is two weeks . Some women might have PMS sort of symptoms where estrogen is high and then we go into our period again . So that's a very basic rundown of what happens in that 28 day cycle for a woman .

Speaker 2 24:17

Really , really good summary , as I would expect from you , of course , but what is the normal length ? I know we say 28 days , but it can be 26 . Can you just tell us what would be a normal length of it ?

Speaker 1 24:27

Well , yeah , we say 28 days , but actually not many women are 28 days . Most women have differences from cycle to cycle , let alone woman to woman . It's such a variety , but we're really looking at anything normally from about 25 to 35 days .

Speaker 2 24:46

It's quite a big range then , isn't it so , ladies , if you 26 days in one month and then you're 34 days , that's still perfectly normal , is that right ?

Speaker 1 24:55

You probably wouldn't see such huge changes from cycle to cycle , but we would still say that was a normal range and you probably want to take an average for about three , four months at least to see where you're falling . But you can get differences from month to month . Even for me , for example , I would probably range for about two to three days outside of 28 days , and I'm not on any hormonal contraception .

Speaker 2 25:21

There you go , so that's a perfectly natural cycle that you have there as well . One thing that I would like to touch on here for a lot of ladies which I know you see this all the time and so do I is when women say oh , I've got a regular cycle because I'm on the contraceptive pill . You actually don't have a cycle , do you ?

Speaker 1 25:37

No , so it's a synthetic hormone to create this and it's a breakthrough bleed , so it's not a normal period .

Speaker 2 25:45

That's right . So it's not a normal period . So if you are oral contraceptive , you can't say that you're regular because it's a fake cycle . Now , on that as well , I think it's important for people to understand that with that , the longer you postpone , because , as you know , a lot of women will skip placebo pills during the cycle , but eventually you will get that withdrawal bleed , won't you ? And it will be when you least expect it . So what would be a safe period of time ? Or , as a guess I know I'm putting you on the spot here , not scripted what would be a safe period of time for someone ? What would you recommend to a woman that continually skips those sugar pills in the packet to avoid the withdrawal bleed ?

Speaker 1 26:22

So I would caveat it with saying that I am not a doctor and I can't prescribe , so I can't give specific medication advice . But I think from the literature that I have read they don't say to do that anymore than three months in a row .

Speaker 2 26:36

Okay , fantastic , very good answer . I love that I'm not a female and I'm never , ever , ever going to understand this and what it's like , but I would imagine it would be such a relief

Female Health Issues

Speaker 2 26:44

to lose your cycle and think , oh my God , I'd be that person that would probably be championing it the bit to get to menopause . But I'm a male and I don't understand it . I mean , some people wear their cycle as a badge of honour and I think that's a real credit to them , and I think we are actually going down this line with the younger girls now as well , talking about wearing it as a badge of honour instead of it being something that you've got to be ashamed of , and there's some excellent books around this .

Speaker 2 27:09

It's Coming of a Woman . A Female Losing Her Cycle is a real warning symptom , isn't it ? What are the health impacts for a female losing her menstrual cycle ? I've done a podcast on this with Rachel Lee , which was around hypothalamic amenorrhea , and it was really quite interesting . But if you'd like to just summarise it from your perspective , what are the health impacts of someone losing their cycle ?

Speaker 1 27:30

So I think the symptoms of hypothalamic amenorrhea the main one is obviously losing your cycle , but there can be other symptoms that go alongside that . So it can change your libido , it can change your mood massively , increase your anxiety , really disrupt your sleep . It can lower your blood pressure , lower your heart rate , which can lead to fainting , and really lower your motivation to be involved in exercise or anything like that Can increase your injury risk as well . So from a musculoskeletal perspective , these symptoms can increase . Now what we can't say is that it will have a long term impact on your fertility . We know if you manage to get your cycle back , it doesn't impact your fertility . However , in the short term , you're not ovulating , your body isn't healthy enough to sustain the pregnancy , so you will not be fertile . So if you don't have a cycle and you are wanting to conceive , you want to look after your fertility , you need to get your cycle back .

Speaker 1 28:34

We can't look at the literature and say you will always have a fertility problem if you lose your cycle and you regain it . But what we do know , which we must remember for women when we're thinking broader than bikini medicine , is it can have a massive impact on your bone health . So osteoporosis is much higher in women who have hyperlamentary arenaria and this means like thinning of our bones . It's kind of like if we look at like cheese it's got the holes in , it's much softer and you're on far more risk of a fracture . And I don't want to be pessimistic but women who have osteoporosis are far more likely to fall at an older age and fracture , go into hospital with a fracture , then catch a hospital acquired infection and die . So , realistically , if we're thinking about our long term health , thinking , oh great , I've lost my cycle , that's a relief . This is really going to be more convenient for me . Sorry , you have to think forward . Your bone health is going to be fundamentally affected by this .

Speaker 2 29:38

And we don't want that . It's not a badge of honor to lose it . It's a massive problem and there's a number of reasons that you can lose it Stress , undernourishing yourself , over exercising . It's very common for female bodybuilders to lose their cycle in the last 12 weeks of their preparation because of what they're actually doing there . It's important , vital , that you get it back or maintain it as much as you can possibly maintain it Right .

Speaker 1 30:05

Most definitely , and that comes from stepping back from exercise , which can be really challenging for some people . I think obviously increasing your calories can be a really big thing , lowering your stress . So , thinking about the stresses in your life outside of exercise and food , but also thinking about the psychological factors , is there an underlying disorderly pattern which we know , with hypothalamic anirin can easily go into an eating disorder . So even getting psychological help can be really important .

Speaker 2 30:40

It's one of the things that women are actually blessed with , isn't it ? Is that early warning sign that men don't actually have , because men can literally become undernourished and I guess not being able to maintain an erection or gain an erection would be a really good warning sign in relation to that . But for females , the second you lose your cycle is a warning sign that your body's in trouble , because it's your body saying we are not in a position here to nurture a baby , so therefore we're going to turn off the baby making side of things . It's like your mobile phone shutting apps , isn't it ?

Speaker 1 31:11

And I think the other thing to add is that it can get a lot lighter as well , so it might not completely stop , but if you see massive changes in your flow and it's very light , that can be an even earlier warning sign .

Speaker 2 31:25

Wonderful . That's a great indicator . So take note , ladies , it's very , very important . I hope you're enjoying the show . If you are , please don't forget to rate and review once you've finished . This helps the show's reach enormously . And have you got my free ebook the Best Way to Eat on Night Shift ? Well , this is a comprehensive guide to the overnight fast , why we should fast and how to best go about it . I've even included a few recipes to help you . I've put a link to the ebook in the show notes .

Speaker 2 32:00

And are you really struggling with shift work and feel like you're just crawling from one shift to the next ? Well , I've got you . If you would like to work with me , I can coach you to thrive , not just survive , while undertaking the rigors of 24 seven shift work . I also conduct in-house live health and wellbeing seminars , where I will come to your workplace and deliver evidence based information to help your wellbeing team to reduce unplanned leave and increase productivity in your workplace . I've put the links in the show notes to everything mentioned . You can find me at ahealthyshiftcom or on Instagram at a underscore healthy , underscore shift . Now let's get back to the show Now . As a women's health physio , what do you see are the biggest issues that you come across because you actually practice one to one . Yeah , what do you see is the biggest issues that you come across as a women's health physio in 2024 ?

Speaker 1 33:02

I think the biggest thing is a prolapse . If you look at the statistics for prolapse it's mind boggling . So actually 50% of women will have a prolapse . 50% a prolapse , so a pelvic organ prolapse is where the walls of the vagina are not strong enough anymore and different pelvic organs collapse into the vagina . So that could be an anterior vagina wall prolapse where the bladder slips into the vagina . That can be a cervical or uterine prolapse where that comes down into the vagina . Or we can see a bowel posterior vaginal wall prolapse where the bowel or falls into the vagina . There's also a fork which could have bolted prolapse . So women often think I've had a hysterectomy . That won't happen to me . The space where the uterus used to be can descend as well .

Speaker 2 33:59

My goodness me , no problems for your ladies . Can you tell me what sort of things would cause prolapses , because our body is an amazing machine

Pelvic Floor Health and Nutrition

Speaker 2 34:09

and it holds everything into place . What sort of things are there that would cause this to actually occur , or what do you see are the main causes of this occurring ?

Speaker 1 34:19

The two main causes are age and childbirth . And so when we are aging we talked about estrogen a lot that estrogen has a massive plumping effect for the vagina walls and as we get older and that estrogen depletes , we can see atrophy in the vagina and that's where all of these organs can descend into the vagina . Childbirth obviously the pressure of giving birth can weaken the walls and reduce the tension or the strength of the pelvic floor , and that can lead to prolapses as well . Other things that can contribute are chronic constipation . This is a big issue . I say this is the third most common issue that we see . Chronic constipation is such a problematic thing for a woman and a man Not that I know so much about that , but straining to open your bowels is very problematic .

Speaker 2 35:12

I think , as a nutritionist , and you would be exactly the same we could easily identify where this comes from , couldn't we ? Because it's all the highly processed foods and the lack of fiber that people are actually putting into their diet today , and that's why we end up straining , because we're just not putting enough water through our system and we are not getting enough fiber in our system and we think we're going all right until all of a sudden we're not going all right . Yeah .

Speaker 1 35:35

Yeah , 100% . You're so right . I have this conversation every day . How much fiber do you eat ? What is fiber ? Most people don't even know , and then if I sit down and look at their diet , I'd say some people are getting five 10 grams of fiber a day . Oh , no . And we have to be really careful . Yeah , how quickly we up that fiber . But , like you said , yeah .

Speaker 2 35:57

I know it's horrendous , and this is another reason why I actually get my shift working , ladies , because we talked about the difference , before you know , between women and men . But I'll talk about what I've learned about the Femal anatomy as well , which is really impacted by our circadian cycle , and that's why I get my clients as well to put a teaspoon of metamucil every morning , or one or two . Putting psyllium husk through your system , because it forms a nice gel , runs through the system , keeps the system moving for you , and at least it's a way of getting somewhere between five and 10 grams of fiber without eating anything else as well . Fiber is essential . I provide my clients with a fiber resource to make sure that they get enough fiber in . And it's ladies , it's really , really important . I don't think you realize just how more important it is for you over males , and what would be the recommended grammage of fiber for females today ? Chloe ?

Speaker 1 36:55

I try to get people up to about 30 grams , but that is very challenging . If we're getting over 20 , I'm starting to feel happier , but if we can get to 30 , amazing .

Speaker 2 37:06

I always aim 25 to 30 grams for fiber . I think it's super important and if you actually look at where you can get fiber from and you eat that , it's not that hard . Fruits and vegetables do contribute an awful lot to so much , particularly fiber as well , and that fiber is so important for us in relation to feeding our gut microbiota and producing that butyrate acid , the short chain fatty acids , and things like that too , which are so important . Now , pelvic floor dysfunction causes a number of problems as well , and it causes , like incontinence in women as well . Now , you're on a real rant at the moment in relation to leakage on your social media around this , and I'm really appreciating this type . I'm sure a lot of women will not resistance train because of this problem . In continents , one in three women with a prolapse , or one in three women suffer from incontinence .

Speaker 1 37:56

One in three women suffer from incontinence . 50% of women have a prolapse .

Speaker 2 38:00

So 50% of women have a prolapse . One in two women will have a prolapse . I know I'm bouncing around a bit here because it's a topic that you're so passionate about and I know that and I want to learn more , and I know our listeners need to as well . If 50% of women have a prolapse in today's society , it's not just because we've started to identify it . It will definitely be environmental . Is that because of lack of exercise , activity , learning how to look after it , etc .

Speaker 1 38:28

I think the statistic is so high because a lot of women will have a very low grade prolapse and they won't know they have one , so you can have no symptoms . The most common symptom is postpartum and when we're getting older that we feel this kind of bulge or heaviness in our vagina . But yeah , I would say , if we assess everyone , we probably some sort of bulging , especially postpartum and when we're perimenopausal . Menopausal women , coming back to incontinence , that is , one in three women will have some sort of incontinence . So that will be stress incontinence , which is leaking , with an change in abdominal pressure . Coughing , sneezing , laughing , jumping , squatting , running , having sex All of these things change your abdominal pressure and that can lead to leaking . Then we have urge incontinence , which is a sudden urge to go to the toilet that you cannot control . You've got to get there right now and that's a little different , but we should be able to delay it .

Speaker 2 39:30

It's been labelled safety woes around this house and I've listened to what you say about this and I know it's easy to say but not as easy to do . But safety woes , why are they bad ?

Speaker 1 39:40

So if you think about the fact that if I tell my bladder that I'm going to go to the toilet when I don't really need to go , my bladder will not be at its full capacity . A bladder should be able to stretch to about 600 mils . If I have 100 mils in there and I say I'm going to go to the toilet just in case , then I will void or go to the wee . When I have 100 mils in there , it tells my bladder that when I have 100 mils in there we go to the toilet . So over time my bladder gets stiff . It doesn't stretch to that full capacity and the signals that I need to we start much earlier . So then we go into the territory of overactive bladder and we're going to this toilet far more frequently than we should be .

Speaker 2 40:24

Absolutely love this , Because our body , once again and I'll go back to it is an amazing machine because it is responding to what we're educating it , isn't it ?

Speaker 1 40:33

Yes , exactly Our brain has such an impact on our bladder and our pelvic floor .

Speaker 2 40:39

Yeah , I've got no doubt about it , because if you keep on going to do the safety weas or the adjusting caseways , you are literally , as you've just explained , you're conditioning yourself . This is where we go to the toilet at this stage . So your body thinks so . Therefore , you think no . No , I'm different , this is what I have to do , but you've actually trained yourself into there . I'm not going to keep on going on about that because I'll get in trouble . Is it 49% of females suffer from sexual dysfunction , or is it 49% of females with a prolapse ?

Speaker 1 41:08

49% of women have some sort of sexual dysfunction .

Speaker 2 41:11

So we have one on two with a prolapse . We have one in two with a sexual dysfunction . It's incredible , it really is , and this is why don't get me wrong but when you say sexual dysfunction , we're talking about .

Speaker 1 41:22

So we're talking about a wide spectrum of things . So this can be painful sex that you can tolerate sex , but it's painful . This can be something called vulva dinia , so this is pain around the vulva area that can be very sensitive . This can be pain within the vagina , vestibular dinia , which is just at the entrance to the vagina , and then we can be into more of the penetrative problems , like we used to call it vaginismus and most people call it vaginismus . So this is where we have like spasm or involuntary contractions of the pelvic floor and the vagina which literally will not allow any penetration . And when I say penetration , I'm not just talking penis , I'm talking finger , I'm talking tampon . These women cannot put anything in their vagina and you can only imagine how troubling that can be for them . And then women who cannot achieve orgasm as well .

Speaker 2 42:18

Another just raft of issues there around that , which is why we need to look after the health of everything that we have . They're the sort of things that we need to be looking after our health in that area there . So what are the considerations for females in the area of actual nutrition ?

Speaker 1 42:33

With regards to sexual function , pelvic floor . I think the main things that I talk about a lot when it comes to nutrition is , first of all , what you are drinking . If we think about in terms of our bladder habits , things that can be irritating are caffeine , alcohol , citrus things , sweeteners all of these things can really irritate our bladder . So what I always say to my own patients is make sure you are hydrated . Concentrated urine , because you are dehydrated , irritate your bladder and that will make you leak Obviously . Then we have our diuretics . So we have our caffeine and our alcohol , which is going to make us pee more , which irritates our bladder . So if we think about that in terms of our drinks , managing those and reducing caffeine and alcohol can be a very low hanging fruit when it comes to managing pelvic floor dysfunction .

Speaker 1 43:28

If we're thinking about our nutrition in terms of our sexual health , our fertility , female health , endometriosis , pcos , all of these conditions , I think one of the easiest ways to start is a Mediterranean Leaning Diet . You said a lot about anti-inflammatory before . This is vitally important for women and this can be that Mediterranean Leaning Diet , rich in fruit and vegetables , legumes , pulses , grains . We want to have fish in there oily fish , our olive oils , our nuts . We want to have a bit of white meat in there . Maybe , if you want just a pescateria , some red meat every now and then and limited amount of processed foods . This can really help with inflammation . It can really help with sexual function . We know that actually women who have this follow this diet , are more likely to be fertile and also have better sexual health .

Speaker 2 44:25

The Mediterranean style of living full stop is very , very conducive to full health all around . It just makes sense that it's going to be so supportive of women's health in so many ways . I think , for people to understand from the nutrition perspective as well , if we have a Mediterranean style of eating with our nuts , seeds , legumes , pulses , fruits , vegetables and our olive oil , it helps to balance all of those hormones . It balances our system out . It's anti-inflammatory by its very nature , the more that we go . Oh , I couldn't help myself . I had chocolate , and don't get me wrong .

Speaker 2 45:03

Here we see people not demonizing chocolate , not demonizing processed foods , and that that's true . We shouldn't demonize it because that's all we want . We do need to cast the vote in the direction of Mediterranean style of eating whenever we do eat , because that is going to be what's optimal for our health If you're suffering from problems with reproduction , if you're suffering from problems with your own women's health , with whatever mental health , diet , exercise and making sure that you're on a Mediterranean style or pattern of eating . And you can Google it and see what it involves . It's very , very simple and it's all been easily mastered by the Mediterranean and they are the picture of health when they do all this sort of stuff .

Speaker 2 45:49

I'm there , going to dive into vaginas here , I'm going to throw that in there and you don't even react to that , chloe , but I know people are going what . I've listened to a podcast recently on this and I think it's really , really important that it's something that we discuss and bring a lot of awareness to , because it is so topical and it's something that's not discussed amongst women . It's certainly not discussed and a lot of women individually battle in their own minds with this . But here's the question Women of today have become increasingly paranoid of having a quote unquote smelly vagina , right ? Can you just discuss this for us ?

Speaker 1 46:28

So the reason that this has become such an issue is because it is exploitative , it is commercialization of women's health and it is preying on the insecurities of women and seeing women as just there , as a vessel for their sexuality , and that they are unclean . When we do this , when we say you need to smell a certain way , you need to be a certain way there , it is

Feminine Hygiene and Pubic Hair

Speaker 1 46:54

really just to benefit men most of the time . Now , not all men and I'm not saying that it's all men are like this , but it really has its roots in exploiting women and making profit off of women's insecurities . So if we think about one of the first things that a female child might be teasing oh you smell . It's that playground tort . It's that accusation that we fear most and it's the hardest to protest right , and so it really is a challenging issue . We really have to come away from this stigma , because a vagina is a body part . It will smell and taste like a body part . It shouldn't taste like a pineapple and smell like roses .

Speaker 2 47:38

You've got me there .

Speaker 1 47:39

yeah , okay , so sandfresh , buying scented cleansers . This is so bad for your vagina . The only thing that you should wash your vulva with and let's get our anatomy clear first our vulva should be washed with water , nothing else . Our vagina does not need water in it . So spraying water , douching yourself up your vagina , is very bad for it . You're just washing your vulva , the outer surface , with water . Don't put anything up your vagina . It disrupts the very specific pH and the micro-blamin of your vagina . So we are just looking to wash the vulva with water . Nothing goes up the vagina , especially nothing scented .

Speaker 2 48:22

The more you're using these products , the more you're actually upsetting that own ecosystem . It's a self-cleanser . It runs its own bacteria . It's healthy bacteria , and the more that you insert all of these feminine products which these companies and I'll get on my soapbox here as well these companies are exploiting your insecurity and they're actually selling you these products , thinking that you need them for your man . But if you run a good , healthy , mediterranean style of eating practice , look after yourself . You don't need any of this , because your vagina has its own microbiota . It's got its own self-cleansing system . Everything is really really fine . When should a female be concerned about the odor from her vagina ? Because it's not all roses and unicorns . When should you be concerned ?

Speaker 1 49:11

If the smell is very potent and changes radically , then you need to get that checked . If your discharge changes , you need to get that all . So looking at your discharge is important . It's not gross . It's there for a reason . It can be a good indicator of something changing . So if your discharge changes or the smell has radically changed and is much more potent , then I would definitely get yourself to your GP to have a swab taken .

Speaker 2 49:40

An odor is an indicator of an upset bacteria or a bacteria there that should not be there because , let's face it , it's the bacteria that's giving off the odor . It's not that you've got a smelly vagina . It's the bacteria that needs to be dealt with that's causing that problem . So I think we've covered that . It's got its own pH level . Everything monitors . It runs itself . It's a very , very well run machine and it will look after itself if you look after it from the inside as well as looking after it from the outside as well . But you don't need to be shoving anything in there to try and make it better , because you are actually making it a lot worse . The next question Claude pubic hair .

Speaker 1 50:21

Oh , I see a lot of vaginas every day and I would say 80% are hairless 80% .

Speaker 2 50:28

So is there a function of pubic hair , and should it really be there ?

Speaker 1 50:32

Yes , there's a function to pubic hair . That's why it's there , because it is protective , just as around our nose , around our eyes , our eyelashes , our ears . That hair is there for a reason , and that's to stop germs going in , but it's also to keep the vulva moisturised , to keep warmth in there and keep it moisturised . It's very delicate skin and it can also help with the friction in sex as well , so it has a role in reducing infection .

Speaker 1 51:02

Now I think we have to be mindful here , because there will be some people of the camp of you shouldn't

Pubic Hair, Feminism, and Biologically-Driven Choices

Speaker 1 51:08

do this to your pubic hair , you shouldn't shave it off , you should have it this way and as a feminist , I believe that women can have their pubic hair however they want . You can have a bush , you can have a Hollywood . That's absolutely fine , and it would be anti-feminist of me to dictate how you should have your pubic hair . However , biologically , we cannot deny that it's there for a reason and I do think that the kind of a narrative or the idea that we should have hairless , barbie-like vaginas is heavily rooted in the unethical porn industry . This can be quite destructive for women's sexual health and lifting . So , yes , it has a function . I know there are trends when it comes to pubic hair and however you decide to have your pubic hair is your decision . However , I would consider that I believe the Hollywood bald people even having plastic surgery for their vagina to look a certain way is rooted in unethical porn industry , which is very problematic for women .

Speaker 2 52:18

Beautifully put . I really do like that , because you said this is the function of it , but it's your choice and I think that is the most important thing as well . I know men find it sexy , but there's also men out there that find having a bush sexy as well , so that was really really well put . Thank you for that . So understanding that there is a function . But it's like people who smoke cigarettes and drink alcohol , isn't it Like ?

Speaker 2 52:42

You know what's bad , you know it's bad for you , but you still choose to do it . That's okay , and I'm not saying that having a hairless vulva is bad for you . It's just that it's there for a reason . On the back of that , because you've told me that you look a lot of vaginas every single day sorry , vulvas . I'm standing corrected you look at a lot of vulvas every day . Every single one is different , isn't it ? And I think it's important for women to not be paranoid about whether I'm right , whether I'm not right , whatever , because if you looked at 20 women during the day , you'd probably struggle to find 20 vulvas . That would be the same right .

Speaker 1 53:15

You're so right and you know what I always say to women . You know , like women always say my eyebrows are sisters , not twins . Your labia are sisters , not twins .

Speaker 2 53:26

Really Okay . Well , there you go . So it's not , we're not talking . Isometrical vulvas .

Speaker 1 53:31

Yeah , exactly , they're all so different and they look so different . One thing I would say on the back of this is every time I assess a woman's pelvic floor , I look at her vulva . They always apologise and I think me and you have had this conversation before . Every woman will say oh , I'm so sorry , I haven't shaved , I'm sorry I haven't painted my toenails . I haven't done this . And women are always apologising for taking up space . If you ever see me in clinic as a woman , I do not judge your pubic hair . I don't care . I am not there to look at your pubic hair . I'm there to help you with your women's health issue . As healthcare practitioners , I don't remember what your pubic hair looks like when you leave the room .

Speaker 2 54:17

That's exactly right , because you've seen it all . I just don't understand this from people as well , and I think you and I have had this conversation a lot , but the other conversation that we have as well , which I think is really really quite funny You've also commented on this on your own Insta stories . People , you've got to go and follow Chloe , because it is literally warts and all . When you say to a woman here's the gown , you can go and get changed in there , when they're going to be laying in front of you with their legs spread for you to inspect it and I think , like , what do you want to do ? I get changed privately so you can come back here and spread your legs for me . Anyway , I know .

Speaker 1 54:53

I always think it is funny . I always leave this little bit of towel and I'm like , cover yourself up with this bit of towel . And then I always say I'm just trying to give you some of your dignity before I just go and have a look in there and put my hand in .

Speaker 2 55:10

I think it's fantastic . I always laugh at it because , ladies , this is the sort of thing that Chloe talks about on her stories as well . To totally normalize what is actually going on here . So your vulva is normal . You don't have to go off and get changed because you're going to be lying there with it all revealed anyway and it's not like . Your vulva is the first vulva that Chloe's ever seen in her life . She probably saw eight before yours and she's going to see eight after yours in that particular day . So the next question that I have here as well is should a woman sleep with underwear on or not ? I want this from the perspective of biologically , not so much personal choice , because some people do feel secure by wearing underwear . It just gives them that sense of they're not so vulnerable . I don't know why , but it gives them that sense of I don't feel so vulnerable without my underwear on . Biologically , should they or not ?

Speaker 1 56:03

I would say biologically get your knickers off .

Speaker 2 56:05

Why is that ?

Speaker 1 56:06

Because it allows your vulva to breathe . We wear underwear all day , we wear tight clothing Some wears gym leggings nowadays , or you're wearing jeans and this tightness and heat can increase the risk of having things like thrush . So I think it becomes a really great thing to just let your vulva breathe at night , and this can be really helpful to reduce the risk of thrush .

Speaker 2 56:33

That's really , really good . It just gives that bacteria a chance to just breathe . But once again , we come at it from the perspective of biologically what's right wrong . It's a very , very big book . Women's Health like it's a monster book . There's a lot that goes into it . We sort of touched on hormonal imbalances and their importance , but I do feel incredibly sorry . I've had a client with PMDD and I'm now coaching another one with PMDD . It's like reading a nightmare , reading PMDD . Pmdd is shocking For those that don't know what PMD is . It's like having PMS 365 days of the year . It's just absolutely horrendous . When I'm having success with it , chloe , you'll be pleased to know , with just simple strategies because there's no solution , there is actually ways that you can help in . Increasing protein . Increasing hydration and adding fruits has been a game changer for some of the clients that I'm actually helping with , that they don't feel so tense .

Speaker 1 57:28

Good .

Speaker 2 57:28

Is there anything that we haven't covered that you would like to touch on ? We're recording this on International Women's Day . It won't be released , obviously , on International Women's Day . I'm not holding it off for 12 months . I can tell you right now . But is there anything that we haven't touched on that you think is important that we should touch on ?

Speaker 1 57:43

I think one of the biggest things for me that I would say is that I don't know what is happening in Australia

Women's Health and Abortion Stigma

Speaker 1 57:50

, but women in the UK are being prosecuted for having abortions at an alarmingly increasing rate . My personal view is that abortion is a part of healthcare and women should have autonomy over their bodies . There are a lot of situations around abortion that we do not know at face value that may be going on for that woman . I think that is a big problem to do with women's health , that we should not make it taboo and we should have open conversations about it . I appreciate a lot of people have wildly different views on this subject and it's very stigmatised , but talking about it , whatever your view is , is important in my opinion .

Speaker 2 58:32

For the record and this will come as no surprise to you , but I totally agree with you on that . It's one thing to turn around and just say , oh , you're taking a life , but by golly . How unfair is that when you don't know the circumstances in the background that's going on in that woman's life all the way through her circumstances and things like that . So to cast judgment is so absolutely unfair . You publish some stats around abortion on your Instagram . Am I putting you on the spot here ? I don't know , but in the UK obviously , because you're very UK orientated . I was absolutely gobsmacked . I could not believe it . Are you prepared to share them ?

Speaker 1 59:10

Yeah , if I can remember them off the top of my head , the biggest one for me was that by age 45 in the UK one third of women will have an abortion .

Speaker 2 59:20

That's crazy . That's one in three . Let that sink . In Popo yeah .

Speaker 1 59:25

I think about that , as the women around you , I personally . If I think about that , I try and think do I know one in three women that's had an abortion ? I sat there and I thought I don't know if I do . But then I thought do I not know ? Because it's so stigmatised ?

Speaker 2 59:42

Yep so demonised .

Speaker 1 59:43

And that made me sad yeah .

Speaker 2 59:46

I totally agree with you . When you're going to have a pint at a pub and you've got 12 friends with you , four of those have had abortions , according to stats . But you wouldn't know that . They're not going to come out and talk about it because of how stigmatised it is and how demonised it is . And if that's the case in the UK , why would it be any different anywhere else in the world ? Well , realistically , what's to say ? It's not like that in Australia . You can't say , oh yeah , but the weather's miserable in the UK I'm going to come back to the weather , because I always do with you but the weather's so miserable in the UK so they've got nothing better to do than have sex . But hey , what about in Australia , where the sun's shining and everyone's up and about and full of life and feeling virile and away they go with having sex . So you know , the figures could be higher . I think that's something that's really , really interesting , that I was just absolutely shocked by that , and I've mentioned here as well about the mothers in Gaza .

Speaker 1 1:00:35

I saw a statistic today that was like 37 mothers a day are dying in Gaza and again , whatever your political views are like , that is tragic . There's going to be so many babies or children left without mothers , and I think it's so great to celebrate International Women's Day , but recognising that so many women in the world do not have basic human rights at the moment , which is so sad- Wow , what a potty .

Speaker 2 1:01:05

That's fantastic . I'm so happy that you've come on and once again , I know you're sitting here really holding yourself back , because we could just literally prattle on for so long , and I hope that this is enlightening people around certain topics . If anybody's got anything that they would like to raise , I can get Chloe on for a quick chat with and we can just have quick chats or particular topics that I'd love to cover with you . Going forward , chloe , have you got anything exciting coming up that you would like to share with our listeners ?

Speaker 1 1:01:35

So I actually launched today a consultancy service . So if you are a coach or a PT or a fitness professional and you kind of felt like your qualification really didn't cover the fundamentals of women's health , I'm launching a consultancy service where I can help to support you with your education in women's health , help you to really hone down on issues with your clients who've got women's health related problems and consult with you and them so that they can get through those hurdles and you can really invest time into coaching them and doing what you do best as a fitness professional .

Speaker 2 1:02:12

Is it a weekly meeting ? Is it just a webinar type set up , or how are you actually structuring it at the moment ?

Speaker 1 1:02:18

So it's a three month program . You will receive two webinars for your own education as a coach every month and you will also get plug-in videos so you don't have to record the content , so you can put more energy into a lead generation business development . These plug-in videos will be used to put on your members' area which educate your women clients about their own women's health . You don't have to do that . And then the final thing will be the consultation calls . So these are calls twice to a month you get and we will sit there , either me and the coach , to discuss your problematic clients , or we can bring your client in to the situation and really dig deep into those women's health issues . And then we'll have a Q&A with all of your clients where we can really dig down into other , maybe less personal women's health questions that they have .

Speaker 2 1:03:08

What a phenomenal service that would be to a coach . I know just the little bit of education that I have with how I've educated myself to help my late female clients as well . But to be able to have plug-in videos and to be able to just say , hey , I would steer you in the direction of having a look at this , or I'd steer you in the direction of having a look at that , or this is a problem , but I'm a male , I don't understand this . But I'm going to bring my friend Chloe in , who's my mentor , and she will help us to talk through this issue and find a way . That's just an unbelievable service . Chloe , and I do honestly and sincerely wish you all the very best .

Speaker 2 1:03:43

And if there are any coaches out there that are listening that really do feel like they get full short understanding women's health , and the reason why I say that is because majority of clients are females and majority I know resistance training coaches , pt's they're all females . So the more you understand it , I can guarantee to you , the more clients that you will get . Because if you have clients females , they all talk . And if you say and help a client through particular women's health issues and I'm not saying you're a doctor and trying to cure it , but having an understanding and empathy around that makes a huge difference to a female , and then a female will refer you on as someone who's a really good authority and someone really worth working with in that area . Where can people find out about that , chloe ?

Speaker 1 1:04:31

So you can go on my Instagram , which is Chloe Stevens , physio Stevens , with a V , or you can go onto my website , which is wwwchloestevenswomen'shealthcouk .

Speaker 2 1:04:43

Both of those will actually be in the show notes for people I would highly recommend . As I said , if you're a PT or a coach in the online space and you want to learn more about women's health , then Chloe is definitely , definitely going to be your lady . You've listened to it today . She's all over all of this sort of stuff . So that brings me to my final and closing question . Today and everybody knows what's coming If I bought you a holiday house anywhere in the world that you've got to live in , all right , and you've got to live in there for six months of the year , where would you like me to buy and build it for you ? I'm prepared to build it anywhere in the world for you . If you want to take your boy , you can take your boy . If you want to just go and chill for six months yourself , I'm going to Melbourne .

Speaker 2 1:05:22

You're coming to Melbourne .

Speaker 1 1:05:23

Just so I can be a bit closer to you .

Speaker 2 1:05:27

That's so cool . I'd love it . I'd look forward to that too . And , by the way and I know he'll listen to this podcast because he's such a big supporter review as well I still have to meet these boy viewers as well , because I've got to run the ruler over him there . I know it doesn't matter what I say , but it's going to matter what I say Trust me , you love him .

Speaker 2 1:05:47

I know I will . I can see because he puts a smile on your face and that's all that's important to me , chloe . So I love that and I've got no doubt that he cops the absolute best of you and he cops the absolute worst of you while you're trying to run businesses working women's health , in doing your physio business , trying to just make such a difference in the women's health area , doing your MSc . Chloe , thank you for all of your work and everything that you do , and thank you for your time on this podcast . I'm so appreciative of it and so are our listeners , I'm sure .

Speaker 1 1:06:16

Thank you so much for having me . I really appreciate it . I've had a great time .

Speaker 2 1:06:19

And thank you so much to Chloe for giving us her time . I told you I did say and I did warn you that it was going to be a war to know and we were going to dive deep into vaginas . Anyway , it's an important topic , this one . All of my clients are now females and I think majority of the listeners to this podcast will be females as well , and females definitely do struggle more with shift work . So that's why it was such an important topic to discuss . Now , don't forget , I want you to head on over and give Chloe a follow and if you are actually a PT or a coach , an online coach and you are listening to this podcast , it is super important go over and check out Chloe's website , because Chloe is running that course and I think you'll find that it will be a really , really good , very beneficial consultancy service for PT's that really are very unsure on how to manage their clients with women's health issues .

Speaker 2 1:07:22

Once again , thank you so much for listening to the show . I do sincerely appreciate it . I try and bring you guests , which are the guests that will really tie in to what you need to know on this show in your shift working life . So don't forget , give us a rating or a review . It does help the show enormously . I know by the time you get to an hour and 15 minutes , you've literally had enough , but if you could just take one moment just to give it five stars or give it a rating or review on Apple podcasts , it really , really does help the show enormously and I will catch you on the next one . Thank you for listening . If you enjoyed this episode , be sure to subscribe so you get notified whenever a new episode is released . It would also be ever so helpful if you could leave a rating and review on the app you're currently listening on . If you want to know more about me or work with me , you can go to ahealthyshiftcom . I'll catch you on the next one .