Ep 9: Female Pelvic Rage

This was a first time diagnosis for Marisa and Molly, which required a deep dive into the literature for this week’s SPECIAL CASE EPISODE! Learn about the pelvic floor referral diagnosis of “Pelvic Congestion Syndrome” and how we all are probably missing this potential differential diagnosis with our patients.Ratings:Molly: 4.5 starsMarisa: 4.5 starsReference: Alsannan et al. Diagnosis and Management of Pelvic Congestion Syndrome: Comprehensive Review. OGynecol Obstet Invest 2024;89:437–444 DOI: 10.1159/000539931

Marisa and Molly rant about bed rest during pregnancy and debunk the old school thinking (with medical approval). This week’s episode talk about why pregnant people need to be active and define what is appropriate levels of activity for the pregnant person. It is time to GET YO ASSS UP!Ratings:- Molly: 4.5 stars- Marisa: 4.5 starsReference: Sciscione A et al. Activity Restriction in Pregnancy and the Risk of Early Delivery The AWARE Study. OBSTETRICS & GYNECOLOGY. 2026. 147 (4): 451-459.

HOT OFF THE PRESS. This brand new article (as of May 2026) looks deeper into people with chronic pelvic pain and neurodivergency. Follow along as Marisa and Molly gives real life examples and patient cases as they review the “neurospicy” pelvic floor.RATINGS:Molly: 4.5 starsMarisa: 4.5 starsReferences:Bond J, et al. A scoping review of alterations in sensory and motor function, and body perception in women with chronic pelvic pain. Journal of Pain. 2026. https://doi.org/10.1016/j.jpain.2026.106343Lobo, F et al. Pain and Attention-Deficit/Hyperactivity Disorder: A Closer Look at the Relationship. European Psychiatry. 2025. EPV1340. doi: 10.1192/j.eurpsy.2025.1894

Women deserve to feel great in their bodies, especially after having kids. On this week’s episode, learn the science behind the “Mommy Makeover” that is marketed directly to postpartum women in order to “bounce back.” Remember, you do you boo but review the science before any surgical procedure.Ratings:- Marisa: 2.5 stars- Molly: 1.5 starsReferences:- Carniol ET and Carniol PJ. Clinical Case 1: The “Mommy Makeover” Package. American Medical Association Journal of Ethics. 2010. 12(5): 363-366.- Toto V et al. Combined Surgery (Mommy-Makeover) Compared to Single Procedure (Abdominoplasty) in After-Pregnancy Women: A Prospective Study on Risks and Benefits. Aesth Plast Surg. 2023. 47:2533–2542 https://doi.org/10.1007/s00266-023-03579-6

This week on Clinically Hot or Not: Pelva HydroSlix. This is a new product (company is less than 1 year old) with great potential! Marisa and Molly dig into the theoretical research on why the Pelva HydroSilk is a great option for your complex chronic pain patients.FINAL VERDICT: Clinically Warm! We love the product and think it has so much potential but the evidence is still in the theoretical stages and they are currently securing grant funding to provide a scientifically sound clinical trial (YAY FOR SCIENCE!) Plus, the company is a GEM to reach out and ask questions and provide their own research to support their product.Pelva Webinar: https://drive.google.com/file/d/1N8fXxVAjP_3An5Te3qBjHilN29HRxsh7/view?usp=drivesdkReferences - Lee Y. Patients’ perception and adherence to vaginal dilator therapy: a systematic review and synthesis employing symbolic interactionism. Patient Preference and Adherence 2018:12 551–560. - Ayehunie et al. Hyperosmolal vaginal lubricants markedly reduce epithelial barrier properties in a three-dimensional vaginal epithelium model. Toxicology Reports 5 (2018) 134–140. https://doi.org/10.1016/j.toxrep.2017.12.011 - Smith et al. A longitudinal case-control analysis of pain symptoms, fear of childbirth, and psychological well-being during pregnancy and postpartum among individuals with vulvodynia. Midwifery 114 (2022) 103467. https://doi.org/10.1016/j/midw.2022.103467. - Parenti et al. Botulinum toxin injection in vulva and vagina. Evidence from a literature systematic review. European Journal of Obstetrics & Gynecology and Reproductive Biology 291 (2023) 178–189. https://doi.org/10.1016/j.ejogrb.2023.20.028

Marisa and Molly dive in deep about the problem child of the pelvic floor. AKA the Obturator Internus. This week’s article shows that you must look at the entire lumbopelvic region to address the pelvic floor. Don’t forget your hip exercises my friends!Ratings: It finally happened…. FIVE STARS! PERFECT ARTICLE! Reference: Lori J. Tuttle, Taylor Autry, Caitlin Kemp, Monique Lassaga-Bishop, Michaela Mettenleiter, Haley Shetter & Janelle Zukowski (2020) Hip exercises improve intravaginal squeeze pressure in older women, Physiotherapy Theory and Practice, 36:12, 1340-1347, DOI: 10.1080/09593985.2019.1571142

Learn about a new type of exercise with hypopressives. Molly calls them the MLM of pelvic exercises and Marisa is literally along for the ride. We will let you make up your mind about this very specific exercise modality.Ratings:- Molly: 2.5 stars- Marisa: 2.5 starsReference: Katz, CMS and Barbosa CP. Effects of hypopressive exercises on pelvic floor and abdominal muscles in adult women: A systematic review of randomized clinical trials. Journal of Bodywork & Movement Therapies. 2024. 37: 38-45.

Ever wonder how to train athletes while they are pregnant and postpartum? Molly and Marisa break down the phases of perinatal and postpartum with the most thorough article on the topic. This was the #1 article Marisa references in her presentation and teaching (this year).Ratings: - Marisa: 4.5 stars- Molly: 4.5 starsReference: Koschel T. Perinatal Periodization: Trimester Phased Training for Beginner to Elite Athletes. Strength and Conditioning Journal. 2025. 47 (6).

Learn about the hottest new trend in pelvic floor: Red light therapy for the vaginal canal! Molly and Marisa tear apart the bias that is red light therapy and the skeptical science behind it.Rating: COLD AS ICEReference:- Alayat et al. The Effectiveness of Photobiomodulation Therapy on Perineal Pain and Wound Healing After Episiotomy—A Systematic Review and Meta-Analysis. J. Clin. Med. 2025. 15 (964). https://doi.org/10.3390/jcm15030964- Santos, F.P.; Carvalhos, C.A.; Figueiredo-Dias, M. New Insights into Photobiomodulation of the Vaginal Microbiome—A Critical Review. Int. J. Mol. Sci. 2023. 24, 13507. https://doi.org/10.3390/ ijms241713507- Lanzafame et al. The Rationale for Photobiomodulation Therapy of Vaginal Tissue for Treatment of Genitourinary Syndrome of Menopause: An Analysis of Its Mechanism of Action, and Current Clinical Outcomes. Photobiomodulation, Photomedicine, and Laser Surgery. 2019. 37(7): 395–407.- Butrick C and Lamvu G. Transvaginal Photobiomodulation Improves Pain in Women with Pelvic Muscle Tenderness and Interstitial Cystitis/Bladder Pain Syndrome: A Preliminary Observational Study. Ambulatory, Office-based, and Geriatric Urology. 2022. https://doi.org/10.1016/j.urology.2022.08.036 0090-4295

Calling all Bendy People! Ever wonder why bendy people are more likely to have pelvic floor issues? Let’s review the evidence on Joint Hypermobility Syndrome (aka Ehlers Danlos Syndrome) from a urologist point of view for this hot off the press article.Ratings:- Marisa: 4.66 stars (OK ROUND DOWN TO 4.5)- Molly: 3.33 stars (OK ROUND UP TO 3.5)References:- Abaza et al. Joint hypermobility syndrome for the urogynaecologist – A narrative review. European Journal of Obstetrics and Gynecology 2026. 318 (114943)