Does Your Pelvic Floor Need an Exercise Program?

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[00:00:37] Hello and welcome to Beyond The Paper Gown.

[00:00:53] I'm your host, Dr. Mitzi Krockover.

[00:00:56] Our focus here, of course, is women's health.

[00:00:59] And sometimes the conversation takes us to places many don't want to talk about, even

[00:01:03] when our lives are greatly affected.

[00:01:05] Well today we're unpacking a topic that's surprisingly common yet often whispered about,

[00:01:11] and that's pelvic floor issues and incontinence.

[00:01:15] Believe it or not, it's something that impacts over a quarter of women in the United

[00:01:19] States at some point.

[00:01:21] Whether it's due to having children, changes as we age, or even participating in high

[00:01:26] impact sports, pelvic floor disorders can result in incontinence, sexual dysfunction, and more.

[00:01:33] Good news is that we have as our guest today a philosopher turned inventor and entrepreneur

[00:01:39] who because of a personal experience felt compelled to do something for women struggling

[00:01:44] with pelvic floor challenges.

[00:01:46] Dr. Stephanie Scholl is here to talk to us about her journey, her insights, and

[00:01:52] her product.

[00:01:54] I'm just a reminder that this podcast is for informational and educational purposes only

[00:01:59] and should not be taken as personal medical advice.

[00:02:03] We encourage you to discuss your specific issues with your healthcare provider.

[00:02:15] Today we have a very special guest that is going to talk about something that many

[00:02:20] of us don't like to talk about.

[00:02:22] And that is incontinence and pelvic floor issues.

[00:02:27] And with us is Dr. Stephanie Scholl.

[00:02:29] Stephanie, hi, welcome.

[00:02:31] Hey, Mitzi, thank you for the invitation.

[00:02:33] I always wanted to be on your show.

[00:02:36] Oh, well it's great to have you.

[00:02:38] And just so that our audience knows who you are and what you do, give us a little

[00:02:44] bit of an introduction.

[00:02:45] Sure.

[00:02:46] Yeah.

[00:02:47] So Dr. Stephanie Scholl, but I'm of the philosophy professor variety of doctor, not

[00:02:52] medical doctor.

[00:02:54] So let me say that straight out.

[00:02:56] I won't, maybe I should skip the speech about how philosophy is the queen of the

[00:03:00] sciences and we started it all.

[00:03:02] But you know, humble brag there about us.

[00:03:06] I have a art history teacher who basically schooled us in exactly that, that

[00:03:12] PhDs are the real doctors, doctors means to teach.

[00:03:17] I was a professor for a few decades.

[00:03:19] And then I also did university administration where I found out I'm kind

[00:03:24] of good with the business side of things.

[00:03:27] But you know, my insatiable curiosity led me to be the director of the

[00:03:32] Frank Lloyd Wright School of Architecture, where I was around a bunch of

[00:03:36] architects and makers and doers.

[00:03:38] And so one day when I found out that, you know, my mother had been crippled by

[00:03:47] these pelvic surgeries, crippled with she's going to be in pain for the

[00:03:52] rest of her life from surgeries that did not go well trying to address

[00:03:57] pelvic floor problems.

[00:03:59] You know, I got to researching and I decided to roll up my

[00:04:02] sleeves and see if I could do something about it.

[00:04:05] You know, it's a but it quickly became bigger than just my mother.

[00:04:11] I immediately realized the scope of the problem was so vast that I felt like

[00:04:17] I needed to stop doing armchair feminism and academia and start doing,

[00:04:21] you know, applied feminism as I like to call it, getting out there in

[00:04:25] the world and seeing if I could, you know, help people's lives.

[00:04:29] And so I thought to give it a try after being around all these

[00:04:32] people making things and I invented a device and I pursued manufacturing it

[00:04:40] and then retailing it and trying to get it out there in the world.

[00:04:43] Terrific.

[00:04:44] And we're going to talk much more about that.

[00:04:47] I don't think I asked you what's your PhD in?

[00:04:50] Philosophy proper.

[00:04:51] Philosophy proper.

[00:04:52] What's improper philosophy?

[00:04:55] No, no, I mean, philosophy is great.

[00:04:58] And I was just not that long ago at a dinner with the president of ASU.

[00:05:03] You probably have met him.

[00:05:05] Dr. Gro, yes.

[00:05:06] Yeah, a marvelous and interesting person.

[00:05:08] And someone asked in the room, hey, what's the best degree to get

[00:05:12] to be an entrepreneur?

[00:05:14] And his answer was philosophy.

[00:05:18] I mean, right?

[00:05:19] Incredible.

[00:05:20] There you go.

[00:05:20] I think second and third was tied with like engineering and economics

[00:05:23] on his list.

[00:05:25] But I just was, you know, captured with that answer.

[00:05:28] And so I just basically am always curious and want to be learning.

[00:05:32] And so jumping into medical devices was like an endless learning,

[00:05:41] endless possibilities to not know something and then learn about it

[00:05:45] and then try to master it, which is, I think, just a wild ride that I love.

[00:05:50] Let's tell the audience about what your device is and what it does.

[00:05:55] Well, thank you. Yes.

[00:05:57] So, you know, pelvic floor problems was what got me started.

[00:06:00] And I was surprised in my mid forties to find out that there's such a thing

[00:06:04] about pelvic floor and that there are problems with it.

[00:06:08] I mean, that's how I started out really at zero.

[00:06:11] But the shock of it as a woman finding out that the majority of women

[00:06:15] around me, unbeknownst to me, were secretly struggling with problems.

[00:06:21] Of incontinence, of organ prolapse, of sexual dysfunction,

[00:06:25] that we're holding them back from living life as I wanted to.

[00:06:29] Like blew me away.

[00:06:31] And then I think maybe it's probably as a philosopher, the fact that taboo,

[00:06:36] meaning our belief system and our prejudices that aren't grounded on reason

[00:06:40] or logic kept us from solving the problems and talking about the problems

[00:06:45] like animated me even more to do something about it.

[00:06:48] So I think it's precisely that was taboo that I got so ticked off

[00:06:52] that I said, uh-uh.

[00:06:54] No, no, no.

[00:06:55] For our listeners, describe what the pelvic floor is because you said you didn't

[00:06:59] know what, you know, these kinds of conditions were.

[00:07:02] I don't think many folks even know what a pelvic floor is.

[00:07:07] Yes. So when we think of like the genital region,

[00:07:11] we think it's hair and skin down there in a pedestrian way.

[00:07:14] Just you know, person on the street.

[00:07:16] That's what we're concerned about.

[00:07:17] Or that's what we think of it as, but it's actually this intricate

[00:07:21] architecture of muscle and those muscles have many important jobs.

[00:07:27] Again, I did not know how it all was tied together.

[00:07:30] And so sure, a lot of us walk around with atrophied muscles.

[00:07:34] By that we mean weak muscles.

[00:07:35] And okay, so we can't lift as much in the gym or we can't do certain jump

[00:07:39] very high or whatever the thing may be.

[00:07:41] But when pelvic floor muscles are weak or atrophied,

[00:07:45] a lot of important tasks kind of go offline.

[00:07:49] And so how one would know if one's muscles are weak or atrophied is

[00:07:55] they would start to sense or see some bladder leakage when they laugh, cough, jump,

[00:08:01] walking downstairs, exercising, all of those kind of high impact moments

[00:08:06] throughout our lives.

[00:08:08] And then they would eventually, you know,

[00:08:13] no one wants to talk about this other thing.

[00:08:15] I find people are okay talking about bladder leakage,

[00:08:18] but people are hesitant to talk about gas leakage and fecal leakage,

[00:08:22] which aren't far behind.

[00:08:24] Pardon the pun.

[00:08:26] They are there ready to happen next since it's the same network of muscles.

[00:08:33] And so fecal leakage and gas leakage also possible with those

[00:08:37] same types of events.

[00:08:39] And then there's the dropping of the uterus, the rectum and the bladder,

[00:08:44] which I find nobody talks about.

[00:08:45] I mean, you'll hear someone after the fact say, oh, I got a bladder lift

[00:08:49] or I had a hysterectomy because my uterus was dropping.

[00:08:52] But no one I have heard that but didn't add up what that meant,

[00:08:56] what was going on? Why is it dropping?

[00:08:58] What makes it drop?

[00:09:00] And, you know, if in a large part of the muscles are toned

[00:09:04] and holding it up in many cases, they won't drop or they can be corrected

[00:09:07] while it's while dropping if it's not too late.

[00:09:11] And then the sexual dysfunction is so fascinating.

[00:09:15] So there are many ways pelvic muscles relate to sexual function.

[00:09:21] Many, many ways.

[00:09:23] People I'll put on the list laxity.

[00:09:27] Now I have trouble putting that on the list.

[00:09:29] That's why you heard me hesitate.

[00:09:31] I don't think laxity is actually a problem.

[00:09:33] A woman could have loose or a vagina or lax muscles.

[00:09:36] Not a problem for her.

[00:09:38] But the reason why I put on the list is if she's not confident

[00:09:43] or insecure about it or it keeps her from saying yes to events

[00:09:47] that she wants to say yes to, then I consider it a sexual dysfunction.

[00:09:52] And and that's just and she may have a partner who's not very kind

[00:09:57] and that may be a source of trouble for her.

[00:09:59] So I put it on the list, but laxity is when the muscles are so loose

[00:10:04] or lax that creates that phenomenon.

[00:10:07] But there's also a vaginal dryness.

[00:10:11] Yeah, vaginal dryness could have other causes, medicine, dehydration,

[00:10:15] other things, hormones.

[00:10:18] But it could be if the muscles aren't toned enough to be that

[00:10:24] sump pump and if the blood flow isn't there to get that moisture to the surface.

[00:10:29] Sidebar.

[00:10:31] I was dry throughout my 40s.

[00:10:33] Thought it was just a thing that I was going to live with for the rest of my life.

[00:10:36] Thought I was addressing it with artificial lubricants,

[00:10:40] which by the way, I never found a good one for me.

[00:10:42] They always irritated me or disturbed me in some way.

[00:10:46] But in the process of inventing my device, my lubrication came back.

[00:10:51] Mitzi, hmm, that's fascinating.

[00:10:53] I don't have any artificial lubricants anymore.

[00:10:56] I don't need them.

[00:10:58] And I had like 15 because I was looking for one that didn't bother me.

[00:11:02] So my cupboard was full, but now I don't need any.

[00:11:04] So dryness, which is not often thought of as being related to pelvic muscle tone.

[00:11:09] I wanted to put that out there to raise awareness because your crowd can go

[00:11:13] into the detail and into the nuance.

[00:11:15] And then most probably obviously or maybe not obvious, nothing's obvious in this

[00:11:21] and orgasmia, the difficulty reaching climax.

[00:11:25] And so orgasm seems like this magical event, this mysterious happening.

[00:11:34] But but underneath it all, it's a muscle contraction.

[00:11:37] Right. It's powered by muscle.

[00:11:40] And so if our muscles are toned and responsive,

[00:11:43] they can achieve climax more easily, which means, you know, more positions.

[00:11:47] And then the quality of the climax is more interesting.

[00:11:52] So even if we don't think we have pelvic floor problems,

[00:11:54] we may be slightly held back in ways that we're not yet connecting the dots on.

[00:11:58] And the origin may be pelvic muscle weakness.

[00:12:03] You know, I've not heard that expansive of a discussion about pelvic floor weakness.

[00:12:09] So thank you for that.

[00:12:10] And I think that that's going to open up a lot of eyes.

[00:12:14] So you talked about what happens when you tone the muscles.

[00:12:18] Is there something that one can do to prevent it?

[00:12:21] Yes. So prevention would be to keep the muscles toned.

[00:12:27] Like any so you ask yourself, how do you keep muscles toned?

[00:12:30] Well, you know, hormones do a certain amount of work to make it easier to keep them toned.

[00:12:35] Whatever exercise you're doing is more effective when hormones are feeding

[00:12:38] the muscle and making that more productive.

[00:12:41] So when we reach menopause, yes, it is harder to keep that muscle tone,

[00:12:45] much like we're all kind of aware that we will be aware eventually

[00:12:50] that when you hit menopause, you have to spend a little bit more time in the gym

[00:12:54] to get the same results that you did before more easily.

[00:12:57] That's true with, you know, the atrophy of the pelvic floor.

[00:13:00] And so I think it's best just to think of it once you learn its muscle,

[00:13:04] just think of it intuitively like you think of any muscle group.

[00:13:07] So how do you keep it toned?

[00:13:08] Well, there's a range of movements and exercise.

[00:13:11] You know, Pilates is known as being one of the best

[00:13:14] for keeping the pelvic muscle toned.

[00:13:17] Yoga is also known

[00:13:20] as orgasm itself is an exercise.

[00:13:23] So if you want to use a vibrator toward that end or however you want to reach that,

[00:13:28] that alone can also keep those muscles in good tone.

[00:13:35] And so, you know, my device was intended to help people make it more effective

[00:13:40] and easier and less time on task to exercise those muscles.

[00:13:45] I would argue that using something like Kegelbell

[00:13:48] would even enhance your time trying to exercise through orgasm

[00:13:54] because it will improve that experience as well.

[00:13:58] And also prepares you for those types of exercises.

[00:14:02] Wanted to ask about causes of issues like prolapse and incontinence.

[00:14:10] Thank you, right? What causes it?

[00:14:13] So there's a range of causes.

[00:14:15] You know, that's the complexity of this.

[00:14:17] And that's why I'm so glad we have this long format to discuss it

[00:14:20] because it doesn't fit a three second commercial sound bite.

[00:14:23] What can cause it is girls and women at any age

[00:14:26] if they practice basketball, volleyball, gymnastics, marathon running,

[00:14:31] heavy weightlifting competitions, all of that puts a lot of pressure

[00:14:35] on the pelvic floor.

[00:14:37] And if the muscles don't have the endurance or these counter strength

[00:14:40] to counter that, they will encounter leakage.

[00:14:44] You know, when I was just in Japan talking with a soccer player

[00:14:47] who is now going to take Kegelbell

[00:14:50] to her the soccer team, the professional soccer team to discuss it

[00:14:53] because it's a problem for them, even though they're in the peak health,

[00:14:57] obviously, as professional football players.

[00:15:00] So I'm thinking as a mom of two girls.

[00:15:03] And again, well, one of them was very active in basketball.

[00:15:09] Should we be thinking about discussing this with our female athlete?

[00:15:15] Children.

[00:15:15] Yes, please.

[00:15:16] And what should they be doing?

[00:15:19] Yes, I think that is so thank you for bringing that up.

[00:15:22] Please have discussions with your young children, their girls

[00:15:28] in their practicing sports about leakage and why and how it happens

[00:15:33] because they are so proud of their bodies

[00:15:37] and they are, you know, it's one of their strengths.

[00:15:39] And then it's all the more humiliating that they're they have these accidents.

[00:15:45] And then they start to hold back in their sport, trying to avoid

[00:15:49] those explosive movements that created, which keeps them from competing

[00:15:53] at the highest level.

[00:15:54] And then the third worry is they drop out entirely

[00:15:56] because they're so embarrassed and don't want to manage it anymore.

[00:15:59] And they stop the sport entirely.

[00:16:01] And when there is information and studies out there,

[00:16:03] people want to Google women dropping out of sports because of incontinence.

[00:16:09] But yes, and, you know, but how to encourage them to solve it?

[00:16:13] We can't describe to them how to do Kegel exercise.

[00:16:16] Like we're going to need to create muscle endurance

[00:16:19] to counteract the forces that you're countering as a high performance athlete.

[00:16:24] So we can just encourage them and then also let them know,

[00:16:27] hey, it's just because you're so awesome and you're doing these massive

[00:16:30] jumps and these massive things that you're getting some leakage.

[00:16:33] And but yeah, I would encourage them to understand it.

[00:16:36] And then if they can strengthen the muscles so that their bodies can

[00:16:39] endure the high impact nature.

[00:16:41] So you mentioned the term Kegel or Kegel exercise.

[00:16:46] I'm sure many of our audience know what that is.

[00:16:50] But for those who may not, could you explain that?

[00:16:52] Because that's certainly a big part of the name of your device, the Kegel belt.

[00:16:59] Yes. So.

[00:17:02] Kegel exercise is a first line treatment, according to medical

[00:17:07] professional associations in America for treating incontinence and sexual dysfunction.

[00:17:14] And it is easy to describe.

[00:17:17] It's wonderful.

[00:17:18] It's in a couple of sentences, which I can do.

[00:17:20] It is to contract the muscles of the pelvic floor, you know,

[00:17:26] inward and upward a few times, three times a day.

[00:17:30] So to do it like for a few minutes, three times a day, every day for the rest of your life.

[00:17:35] So the idea is to integrate exercising the pelvic floor three times a day.

[00:17:39] Every day for life is to say it's a part of the body.

[00:17:41] It's a muscle group and it needs to be activated to stay healthy.

[00:17:46] And so it's easy to describe doctors prescribe it.

[00:17:49] However, the medical studies, diverse medical studies show that

[00:17:53] about 25 percent of women get it right, which is great news.

[00:17:57] One out of four of us get it right and get the benefits.

[00:18:00] They get the protection and they get the treatment and they get all the, you know,

[00:18:04] all the prevention and all the good stuff.

[00:18:07] However, that means 75 percent of us aren't getting it right

[00:18:11] because either we're not doing it at all or what actually happens quite a bit

[00:18:14] is we think we're doing it right.

[00:18:18] But what why why would it be so easy to describe contract those muscles up

[00:18:22] and in, you know, relax them, alternating, you know, for a few minutes,

[00:18:27] three times a day, you know, activate them.

[00:18:29] Why is that so hard?

[00:18:30] Well, the muscles are atrophied and it's really hard to target

[00:18:34] an atrophied muscle group.

[00:18:36] So women activate their thighs or their buttocks or their stomachs

[00:18:39] that they think they're doing cables, but they're not.

[00:18:43] And so they get frustrated and they go to the doctor and they say,

[00:18:46] I'm doing it. The doctor says, well, but just not there's no improvement

[00:18:49] in tone and everyone's kind of wondering what's going on.

[00:18:53] Let me add a layer from like a philosophy professor.

[00:18:56] I also studied philosophy of psychology when I was at it

[00:19:01] that taboo and how we were taught as children cut us off

[00:19:05] from our mind-body connection a long time ago.

[00:19:10] And so what it looks like is this, and maybe this also has something

[00:19:13] to say about how we raise our children and how the audience may think

[00:19:16] about the conversations they have with their children

[00:19:19] when we kind of energetically say to our children, don't look, don't touch.

[00:19:25] You know, we're in public or something or whatever the case may be.

[00:19:28] We have anxiety around them looking or touching the genital region.

[00:19:33] Good little girls, which most of us are, take that message very seriously.

[00:19:38] And we are like, oh, what, you know, what bad things are there?

[00:19:42] And we cut off unconsciously and otherwise.

[00:19:45] And so it's there's a disconnect in my body.

[00:19:49] And when doctors tell patients to Kegel, well, Kegel, what?

[00:19:54] It's the connection is gone.

[00:19:57] And that's partially, you know, a big part of why I invented Kegel Bell.

[00:20:01] It's a biofeedback device that helps people reconnect and sense those muscles.

[00:20:06] And it takes the guesswork out of it because it makes it a reflex.

[00:20:10] So talk to us about.

[00:20:13] You've got 25 percent of women doing it right, the Kegel exercises.

[00:20:17] But then those 75 percent.

[00:20:19] And again, I think it's really interesting.

[00:20:21] It's almost worse if you don't know what you don't know, right?

[00:20:25] So they think that they're doing it right and don't know.

[00:20:28] So what is the Kegel Bell and how does it work and how does it answer this problem?

[00:20:36] Yes. So the Kegel Bell has two parts to it.

[00:20:40] First of all, it's a mechanical device.

[00:20:42] It doesn't involve batteries, electronics or apps.

[00:20:45] And I made it intentionally that way to keep it simple,

[00:20:49] to reduce friction and using it.

[00:20:51] And so that could be easily sold around the world and help women everywhere.

[00:20:55] So basically.

[00:20:57] There is an internal portion, which is inserted into the vagina like a tampon would be.

[00:21:02] And the woman is standing while using this.

[00:21:05] And she uses it for five minutes about three times a week when she's building muscle.

[00:21:10] And then when she's happy with her muscle tone,

[00:21:13] she can reduce that to once a week just to maintain muscle tone.

[00:21:17] So what we've done is we've reduced the time Kegeling.

[00:21:19] So she doesn't need to do any other Kegel exercise if she does not want to.

[00:21:24] And we've increased increasing effectiveness

[00:21:28] by putting the weight outside the body,

[00:21:31] which is the second part of the invention.

[00:21:35] It's externally weighted and it's externally weighted on a dynamic elastic cord.

[00:21:41] Which those of us, those people listening,

[00:21:44] maybe they have a hard time in visualizing it.

[00:21:46] There's a small egg shaped tampon size bulb.

[00:21:50] There is an elastic cord and from it is hanging a weight.

[00:21:54] And that weight is wanting to pull it out of the body when you're standing.

[00:22:00] So imagine you have the insert in, maybe you've really lubed it up

[00:22:04] to make it slippery and it's kind of want to slip right out.

[00:22:07] And the weight is dragging it out, you know, gravity is doing its work.

[00:22:12] And here's where you don't have to think about it.

[00:22:15] If you just say, body hold this in, that's all you have to do is think body hold it in.

[00:22:20] And because your legs are apart and you're not cheating by squeezing your thighs together,

[00:22:23] your legs are apart.

[00:22:24] The right muscles will squeeze up and in to hold it in.

[00:22:29] And that is what makes it so effective

[00:22:32] is you're triggering the right muscles, otherwise it will fall out.

[00:22:36] So you have that immediate biofeedback.

[00:22:38] And then here's the genius part of this little device, which is that dynamic weight.

[00:22:45] So movement is then and any bouncing if you do with your knees

[00:22:50] is communicated to this and it moves around.

[00:22:52] So it gets the fast twitch muscles as well as the slow twitch muscles,

[00:22:57] which an internally weight held weight will not do.

[00:23:01] Wow.

[00:23:02] And it's the heaviest vaginal weight and it's the most customizable.

[00:23:06] So here's, you know, the thing is we put in two insert sizes, a larger one,

[00:23:12] postpartum perhaps, maybe just people started different places

[00:23:16] with different levels of laxity.

[00:23:18] Some women met, see, you're going to find this interesting.

[00:23:21] They, the larger insert will still immediately fall out while standing.

[00:23:28] Immediately they can't hold it for a second.

[00:23:31] And so there we have instructions that they would lay down,

[00:23:35] insert it and gently tug on the cord,

[00:23:40] resisting it coming out.

[00:23:42] And in about two weeks, two weeks is a kind of a

[00:23:46] fortnight is a kind of an interesting time period in medicine.

[00:23:50] Maybe you would agree that the body can do lots of things in a two week time frame.

[00:23:54] And it seems like two weeks is where you say,

[00:23:56] test to see if you could stand up and you'll be able to hold it in.

[00:24:00] Also, when I tell them, by the way, when if they're laying down is to do like a finger test,

[00:24:06] which is because we've lost that mind-body connection.

[00:24:09] Right.

[00:24:10] So I'm like, OK, insert a finger and tell yourself to squeeze.

[00:24:15] Now, keep that finger inserted now cough.

[00:24:19] They may notice that they have a stronger response

[00:24:22] autonomically without, you know, unconsciously with the cough than they would

[00:24:25] consciously with a command.

[00:24:28] And then also, you know, put a finger in there while you're laying down and feel your

[00:24:33] your muscles squeezing.

[00:24:34] We're trying to retrain the body, mind connection

[00:24:38] and through that biofeedback.

[00:24:40] So that's basically how it works.

[00:24:42] And we give them Mitzi in the kit, the original kit

[00:24:47] about there's eight combinations per insert.

[00:24:52] So what that is is they get like 30 gram increments from 30 grams up to

[00:24:56] like 240 or so grams.

[00:24:59] And that gives them, you know, when you get when it gets to be easy, Mitzi,

[00:25:02] they just go up a level and wait.

[00:25:05] If I was someone who looked at this for the first time and I see this

[00:25:09] weight and I think about, you know, is it painful?

[00:25:15] Could I hurt something?

[00:25:17] Could I tear something?

[00:25:18] I'm sure you've gotten some of those questions.

[00:25:20] So I want to have you have an opportunity to answer them.

[00:25:24] Yes. Yes.

[00:25:26] Contrary to be painful, it's pleasurable.

[00:25:30] So there's that.

[00:25:32] In fact, I mean, I don't know how cheeky to be or how much to reveal in my own

[00:25:36] marketing and maybe I'm doing it all wrong, but it's pleasurable.

[00:25:41] To me, you know, it leads into a self-pleasure session

[00:25:45] because it's the same muscle group.

[00:25:47] It kind of, I mean, if you don't want it to just want to be very business

[00:25:51] like and get this done in the shower and be done with it.

[00:25:53] Sure. But it is pleasurable.

[00:25:56] And in our counter indications, you know, it says if you ever feel pain,

[00:25:59] stop using and see a doctor.

[00:26:02] And also if you have preexisting pelvic pain, do not use it.

[00:26:06] Now.

[00:26:09] If they're preexisting pelvic pain is because they have hypertonic muscles.

[00:26:12] I mean, it's not going to hurt them.

[00:26:13] They're not damaged by anything.

[00:26:15] It's just not going to necessarily help them.

[00:26:18] But so to answer the question, is it painful?

[00:26:21] No. If it is painful, if inserting this inch long device

[00:26:25] and holding it in as pain folders, an underlying issue.

[00:26:29] And who is this intended for?

[00:26:31] Is it specifically for incontinence or are there other reasons

[00:26:37] why women might use the product?

[00:26:41] OK, so that whole constellation of issues of the varieties

[00:26:46] of incontinence, the varieties of organ prolapse,

[00:26:48] the varieties of sexual dysfunction.

[00:26:52] They can all have the same cause, laxity.

[00:26:55] And therefore Kegelbell, as you could tell, it's a weight system.

[00:26:58] Laxity will not be the problem if you use Kegelbell properly.

[00:27:03] And therefore those problems should go away.

[00:27:06] Assuming their cause was atrophy, right?

[00:27:10] And orgasmia, if the cause is atrophy, it should go away.

[00:27:15] If there are other issues like psychological issues or things like that,

[00:27:20] then it won't necessarily address that, right?

[00:27:23] But it will if it's atrophy, for sure.

[00:27:28] And there's also a whole

[00:27:33] I forgot to say at the time because the list is so long.

[00:27:36] But I want to say it here because when I was in Japan,

[00:27:39] Mitzi, this was the one symptom that I got the most traction with

[00:27:43] when talking with the audience.

[00:27:45] I didn't even mention it here and that is constipation.

[00:27:50] For some reason, that was socially acceptable.

[00:27:53] It's a huge issue and it was socially acceptable in Japan to discuss,

[00:27:57] whereas sexual dysfunction I could not.

[00:27:59] Interesting.

[00:28:01] But yeah, constipation can have other causes.

[00:28:04] If it's because they're dehydrated because of medication you're taking

[00:28:09] or because you don't have enough fiber, those need to be addressed.

[00:28:13] But assuming that's all OK and it's really your muscle atrophy isn't pushing it out.

[00:28:20] So pelvic muscles have to hold back.

[00:28:23] But they also have to push out.

[00:28:25] And so constipation is interesting.

[00:28:28] Are you FDA approved or cleared?

[00:28:31] Registered, registered.

[00:28:34] So you can only I know that you have to be very specific about the claims that you make.

[00:28:39] And so at this point in time, what are those claims right now?

[00:28:43] Yes, I can say that it's a Kegel adjunct device.

[00:28:48] So everything that Kegel exercises known to help with.

[00:28:51] This is an adjunct device.

[00:28:53] And I can say it treats female sexual dysfunction, FSD.

[00:28:58] OK.

[00:28:59] And those those encompassed

[00:29:01] satellite of things, you know, constellation of things.

[00:29:04] And so then it's diverse range of things.

[00:29:09] OK, so that includes incontinence then?

[00:29:13] Incontinence, so Kegel exercises considered a first line treatment for bladder

[00:29:17] leakage and incontinence.

[00:29:19] So is there any condition that women should not seek out Kegel exercises or the Kegel

[00:29:27] doll?

[00:29:29] We have on our list, if they've had surgery recently that they need to heal,

[00:29:36] they've given birth, they need to heal.

[00:29:39] Right.

[00:29:39] They need to count themselves out if they have active pain because there's an

[00:29:42] underlying issue and that needs to be resolved.

[00:29:45] And I tell a customer, if you don't see changes in two weeks,

[00:29:49] we give your money back and we encourage you to see a pelvic floor physical therapist.

[00:29:55] Let's get back to that conversation about causes.

[00:29:57] So yeah, you know, that the one about the female athletes was really

[00:30:03] fascinating and something I did not know.

[00:30:06] Other causes of.

[00:30:09] Pervic floor disorders.

[00:30:11] Yeah, I want to kind of go in the age range.

[00:30:14] So starting with youngest, so we've talked with athletes,

[00:30:16] obesity can also create that problem at a young age as well.

[00:30:21] So you have a lot of weight on the pelvic floor and that downward pressure,

[00:30:28] you know, keeps that system from working properly and they could start to have

[00:30:32] those symptoms.

[00:30:35] So the bladder leakage is probably the most noticeable symptom a young woman

[00:30:40] would have due to obesity.

[00:30:42] And then chronic cough.

[00:30:44] So if you have asthma, if one has a chronic cough, that explosive action

[00:30:50] repeatedly can lead to that kind of problem.

[00:30:56] And then childbirth.

[00:30:57] Well, the weight of carrying the baby, even if you have a C-section,

[00:31:01] can create the problem.

[00:31:03] It's kind of like temporary obesity, if you will.

[00:31:06] And then delivery, of course, as we know,

[00:31:09] and the recovery process of just the body going through that, carrying the weight,

[00:31:15] the delivery.

[00:31:17] And so that can create some issues that are lead to laxity and weakness.

[00:31:26] What we're really talking about is exercising a set of muscles that, again,

[00:31:32] as we talked about earlier, many of us

[00:31:35] didn't know we had and don't know we have until it becomes a problem.

[00:31:40] And by that time, it certainly can be treated, but it's much more difficult.

[00:31:47] Yeah. And it's heartbreaking, Mitzi,

[00:31:50] when people reach out to me about pelvic organ prolapse and it's too late

[00:31:54] and they write to me and say, can I use your device?

[00:31:57] Well, it helped me to avoid surgery.

[00:32:00] It's like, ah, it's too late.

[00:32:02] But it's so hard, Mitzi, to tell people about the preventative story,

[00:32:07] to avoid pelvic organ prolapse through exercise because it happens a cult.

[00:32:12] Unbeknownst to us, the organ is slipping for a long time

[00:32:16] and we're not aware of it until it's too late.

[00:32:19] You know, it reminds me of osteoporosis, too.

[00:32:23] And again, having two 20-something daughters and realizing that this is

[00:32:30] the time for them to be building bone.

[00:32:32] This is the time for them to be strengthening their pelvic floor.

[00:32:35] You know, and again, the 20-plus year old may hear that, but obviously,

[00:32:41] it's a lot easier to think about than it is to actually go and do,

[00:32:45] especially if you don't see it in your very near future or it's not

[00:32:48] bothering you at all.

[00:32:49] But it seems like this is an opportunity to get those messages out.

[00:32:54] I'm curious that

[00:32:57] we obviously don't have the discussion with our children.

[00:33:00] By the way, I'm childless, so I'm just speaking in the abstract here

[00:33:05] because we don't know ourselves.

[00:33:07] But let's say someone's listened to this podcast and now they have the knowledge.

[00:33:11] You know, why would we hesitate to speak with our children about it?

[00:33:14] Well, the conversation we've been having or society has been having

[00:33:20] is one that I think implicitly, if I can get nuanced here,

[00:33:24] implies that that part of the body almost is for other people.

[00:33:30] It's for your partner, it's for your doctor.

[00:33:32] That's why they're not looking at it.

[00:33:34] Who looks at it? The doctor looks at it.

[00:33:35] Who's when we don't talk about it because it's for when you're intimate

[00:33:40] later, which involves another person usually.

[00:33:43] And I think the conversation would be healthier going forward once we're all

[00:33:48] educated and no more is that it's your body.

[00:33:51] Here's what you need to do.

[00:33:52] You brush your teeth, you shower.

[00:33:55] OK, you need to take care of that part of the body.

[00:33:58] It's yours and now they own it.

[00:34:00] It's part of their sense of self-awareness.

[00:34:04] And I mean, they don't have the mind-body disconnect.

[00:34:07] My forward looking thought is I'm curious if we can reach a time where we

[00:34:11] educate our children to just think of the pelvic floor as part of their body,

[00:34:18] part of their self-care routine, part of their health.

[00:34:23] And it isn't implicitly something that is for others or that only the doctor can

[00:34:30] know about, which is to remove their ownership and their sense of self.

[00:34:35] Couldn't agree more.

[00:34:37] Have you experienced with respect to marketing your product any obstacles

[00:34:44] with respect to not being able to advertise on certain media or any other kind of censorship?

[00:34:51] Yes, the censorship has been intense across all social media.

[00:34:57] It's been an obstacle.

[00:34:59] It's kept me from reaching people and helping educate people.

[00:35:04] It's really a problem.

[00:35:07] Do you feel like this censorship has impacted on your ability to sell your product?

[00:35:12] Yes, the censorship unequivocally has impacted my ability to sell product.

[00:35:17] So therefore it's also overall, I know,

[00:35:20] impacting our ability to communicate with people and educate them about their health.

[00:35:26] What is women's health?

[00:35:27] It's however we're different from men.

[00:35:29] How are we different from men with the sex characteristics, genital health?

[00:35:36] And our inability to discuss that means that we can't discuss women's health.

[00:35:43] Well, first of all, what do they cite when they say that you're violating the policies?

[00:35:49] They say it's adult content by adult.

[00:35:52] That's a euphemism for they think lascivious sexual content.

[00:35:56] They say I'm talking about, you know, nudity or sexuality.

[00:36:02] If I try to show a model of something.

[00:36:07] Yeah, the language itself, if I try to say treats female sexual dysfunction,

[00:36:12] I get pinged on the word sexual.

[00:36:15] If I try to say anything about the vagina, which is the medical term,

[00:36:18] I get pinged on using the word vagina.

[00:36:21] And, you know, what's so interesting is I remember early days like Facebook,

[00:36:27] I would put out these ads or even posts, ads, say some ads.

[00:36:33] I would get these click through rates that were in saying bonkers.

[00:36:37] I have screenshots of it.

[00:36:39] No other, you know, when you're talking with marketing people,

[00:36:42] no one saw those numbers and then it would be shut off for violation.

[00:36:46] So what was happening is people were hungry for this information.

[00:36:50] They were clicking on it like crazy.

[00:36:52] But the censor said no.

[00:36:55] You've been very generous with your time.

[00:36:58] What did I not ask you that you wanted to make sure that you shared with our audience?

[00:37:03] Well, I'm trying to get this to go global, Mitzi.

[00:37:07] When I invented this, I had in mind women everywhere.

[00:37:12] And I really had this visual in my head and I can't shake.

[00:37:18] Arranged marriage is still one of the most dominant forms of marriage in the world.

[00:37:22] And I imagine a woman who doesn't have maybe necessarily an understanding husband.

[00:37:29] And these symptoms can lead to abuse, neglect, abandonment.

[00:37:36] Where she doesn't have the ability to sustain her herself.

[00:37:41] You see what I'm saying?

[00:37:42] The picture I'm trying to paint and I wanted to get out to her and help her.

[00:37:48] And so that's been a big part of what I'm up to.

[00:37:51] And I made a device that actually Mitzi I just launched on Walmart.com today.

[00:37:57] Great, OK.

[00:37:59] As we're taping this is today.

[00:38:01] And it's a more accessible price.

[00:38:07] And this is the one that I'm trying to get out into Africa and Asia and Latin America.

[00:38:12] But hey, we have a lot of poverty in America.

[00:38:16] A lot of people that can't afford, you know, Kago Bell, the original kit.

[00:38:20] And so I have a device that replaces the external weight with a bottle cap adapter.

[00:38:28] Say more about that.

[00:38:30] So the so the external weight was that game changing feature that made it very

[00:38:35] effective and very different and but it's expensive to make the way.

[00:38:40] It's very expensive to ship the way.

[00:38:42] Shipping costs are going through the roof.

[00:38:44] So I can replace the heavy external weight with a little bottle cap adapter.

[00:38:50] And that allows her to screw it on to any standard water bottle anywhere in the world.

[00:38:56] It's a pretty universal bottle cap adapter.

[00:38:59] And then she provides the weight, but it also allows her to customize it like

[00:39:03] infinitely a drop or a leader.

[00:39:07] And you know, you asked me earlier, were there any problems or worries?

[00:39:11] You know, if it's too heavy for her, it just falls out.

[00:39:16] So she doesn't have to like wonder about what she can lift.

[00:39:21] She can just whatever she can lift, she can lift and she adds weight as she gets

[00:39:25] stronger, it's very organic like that.

[00:39:28] And so this bottle cap adapter allows women to be at whatever level they are of strength,

[00:39:33] grow however far they want to grow and strengthen their muscle.

[00:39:36] And they can do so with lower costs, you know, and it's just also a nice travel

[00:39:42] version for women with any income level because you just have to travel with it.

[00:39:46] With the bottle cap adapter.

[00:39:48] So I'm really excited to get that out there.

[00:39:50] It's brand new.

[00:39:51] It's on Walmart.com right now.

[00:39:53] And it's also something that I'm trying to get into lower income

[00:39:57] environments around the world.

[00:39:59] So let's see what happens with that.

[00:40:01] Absolutely.

[00:40:02] Well, we will have all those links in our podcast notes.

[00:40:06] Dr. Stephanie Scholl, this has been an enlightening conversation.

[00:40:10] So thank you for your work and your creativity and for your time today.

[00:40:17] And thank you for giving us a chance to have these long form conversations with

[00:40:22] people around the world.

[00:40:28] And that's a wrap on today's eye opening discussion.

[00:40:32] A big thank you to Dr. Stephanie Scholl for joining us and sharing her incredible

[00:40:37] journey and insights into solving one of the health issues many of us might face.

[00:40:42] Yet seldom talk about openly.

[00:40:45] If you are having any of the symptoms we discussed today, don't hesitate to reach

[00:40:49] out to a health care provider.

[00:40:51] There's help, there's hope.

[00:40:52] And most importantly, there's no reason to suffer in silence.

[00:40:57] And I encourage you to take this conversation back home.

[00:41:00] Talking with our daughters early on about all aspects of health,

[00:41:04] including pelvic health can pave the way for healthy habits and even prevention

[00:41:09] of issues that they could face later on in life.

[00:41:13] I invite you to visit our website at beyondthepapergown.com for more information

[00:41:19] and to sign up for our newsletter.

[00:41:21] You can follow us on social media and leave a comment.

[00:41:24] We love hearing from you.

[00:41:25] And please rate us wherever you listen to our podcast.

[00:41:29] Thanks for being with us today and take good care.

[00:41:44] This episode was produced by Patrick Shambayati and me and our associate

[00:41:48] producer is Kyla McMillian.

[00:41:53] If you enjoy podcasts like this, you should check out our other shows on Health

[00:41:57] Podcast Network.

[00:41:58] For example, Nurse Wellness Podcast, hosted by Wendy Garvin Mayo, focuses on the power

[00:42:05] of stress management and how it's foundational to being your best,

[00:42:09] doing your best and giving your best.

[00:42:11] There's a wonderful episode that you should check out called Letting Go,

[00:42:15] where Wendy Garvin Mayo shares six strategies to release control

[00:42:19] and manage stress effectively.

[00:42:21] Check out Nurse Wellness Podcast on your favorite podcast platform or visit

[00:42:26] healthpodcastnetwork.com.