In this episode, we tackle a topic that deserves a heck of a lot more attention than we’re giving it—our pelvic floor. Kim Vopni, the "Vagina Coach," and founder of the “Buff Muff Method” helps us understand what it means to care for your pelvic health through perimenopause and menopause. Kim shares valuable advice on managing common symptoms like painful sex and annoying leaks.

We dive into the genitourinary syndrome of menopause, hormonal changes, and whether those popular biofeedback devices really work. Plus, we both advocate for the benefits of pelvic floor physiotherapy as part of your health routine.

Kim's compassionate guidance offers a reminder that you don’t have to suffer alone or just “suck it up”.
Tune in for insights and support, and let us know what you think!

To learn more about Kim and her work, check out her website at www.vaginacoach.com and follow her on IG at @vaginacoach.

Links Mentioned:

Episode 88: What Everyone Needs to Know About Pelvic Health in Midlife with Erika Burger

TRANSCRIPT

Introduction to Midlife and Menopause Support

Jenn Salib Huber: 0:00
Hi and welcome to the Midlife Feast, the podcast for women who are hungry for more in this season of life. I'm your host, Dr. Jenn Salib-Huber. I'm an intuitive eating dietitian and naturopathic doctor, and I help women manage menopause without dieting and food rules. Come to my table, listen and learn from me, trusted guest experts in women's health, and interviews with women just like you. 

Each episode brings to the table juicy conversations designed to help you feast on midlife. And if you're looking for more information about menopause, nutrition, and intuitive eating, check out the Midlife Feast Community, my monthly membership that combines my no-nonsense approach that you all love to nutrition with community, so that you can learn from me and others who can relate to the cheers and challenges of midlife.

Jenn Salib Huber: 0:49
Hi everyone, welcome to this week's episode of the Midlife Feast. We are talking all things vaginas today, not just vaginas—vulvas, pelvic floor. I'm talking to Kim Vopni, who is also known as the Vagina Coach, and Kim is a great source of information about how to not only take care of your pelvic floor but also how to manage some of the pelvic floor symptoms that we can encounter as we transition through perimenopause and menopause. You know, we talk a lot about the genitourinary syndrome of menopause. We talk about what's happening to hormones, what's happening to tissues, and we talk about some of the most common symptoms that you've asked me about. 

So we're talking about why it hurts to have sex in menopause, why we leak and dribble, and do those devices that are popping up on our Instagram—those biofeedback devices—do they actually work? And you will hear that both Kim and I are huge fans of pelvic floor physiotherapy. We talk about it a lot and about how helpful it is, reiterating that having a pelvic floor physio as part of your healthcare team is just a good idea. Kim offers an amazing amount of encouragement, advice, and education on how to take care of your pelvic floor in menopause and manage some of the symptoms that come with a changing pelvic floor. Let me know what you think.

The Journey of a Vagina Coach

Jenn Salib Huber: 2:20
Hi Kim, welcome to the Midlife Feast.

Kim Vopni: 2:24
Hello, thank you very much for having me.

Jenn Salib Huber: 2:27
It is fun to speak to a fellow Canadian, even though we're literally on the other side of the world from each other, because you're in BC and I'm from Nova Scotia but living in the Netherlands. But it's always nice to connect to another Canadian, so thanks so much for joining me.

Kim Vopni: 2:40
Yeah, likewise. We were, you know, offline talking that you're in. I knew you were in Canada. I thought you were in Ontario, but my family lived in Nova Scotia for a little while.

Jenn Salib Huber: 2:52
It's a beautiful part of the world. Oh, that's fun. That's a fun little connection, and I have lots of family in BC, mainly like Cranbrook area. So, yeah, actually no, I have an aunt that just moved back to Vancouver too. So there we go. All right, so tell us about you and the work that you do.

Kim Vopni: 3:10
Yeah, this is always a favorite question because people are like, how did you become a vagina coach? You don’t grow up thinking you want to have this title of vagina coach. But really, I could say it started in sixth grade. I saw a childbirth video as part of our sex ed and that was really good birth control. It also planted the seed that I don’t want to have babies ever. So that's where it started.

Kim Vopni: 3:31
I had this kind of fear but also fascination about pregnancy and birth. I asked my mom questions. She was an OR nurse, very open with anatomy conversations, and I watched her suffer. She had chronic back pain, stopped running because of incontinence, had surgery for it, and eventually a hysterectomy for heavy bleeding. I saw this evolution in her that I knew I didn’t want to experience myself. So I thought I just won’t have babies, and that will solve the problem. Then, I met my husband, decided I did want to start a family, and became determined to have a different story than my mom.

Pelvic Floor Health in Perimenopause and Menopause

Jenn Salib Huber: 6:54
Awesome. And oh my gosh, do we need to talk about pelvic health in perimenopause and menopause so much more! There’s all these layers of obstacles that we kind of go through in perimenopause—first is recognizing that we’re in it, and then there’s so much shame around having symptoms and aging. But the shame around pelvic floor symptoms is still very much a thing. Nobody’s cracking jokes about bladder leakage like they are hot flashes, right? So there’s this deep sense of “I’m really broken now.”

Jenn Salib Huber: 7:28
What’s happening to our pelvic floor? Why does it also seem to go into menopause?

Kim Vopni: 8:26
That’s a good term—"the pelvic floor going into menopause." The pelvic floor is a group of muscles with a huge blood supply, nerve supply, ligaments, tendons, just like everything else. From a skeletal muscle perspective, it’s what helps transfer load and provides core stability. It’s a key part of the core, yet we aren’t given education about it. As we age, go through perimenopause and menopause, estrogen, progesterone, and even testosterone drop, which greatly affects the tissues and the function of the pelvic floor.

Kim Vopni: 18:45
...uncomfortable with the idea of somebody doing an internal exam. So in those cases, biofeedback devices can be a good resource. The ones that I like the most are ones that use technology, like Bluetooth, that will sync to your phone, and then you can see a little bit more of what’s happening. So what biofeedback is, in case people aren’t familiar, it’s giving you feedback from your body on what is happening. So typically you insert a device into the vagina, and it will measure things like muscle contraction, pressure, or even the endurance of your pelvic floor. Some of the more expensive devices will also give you information about whether or not your pelvic floor is relaxing when it should be and if it's overactive.

Kim Vopni: 19:25
So these devices can give you really helpful information. And I used the Epi-No, which was the first device I used for childbirth preparation. It’s also biofeedback, but it’s a different type of biofeedback. It’s more for preparing the pelvic floor for birth by helping it stretch and relax. But for pelvic health in menopause and perimenopause, biofeedback devices like Elvie or Perifit can help train the pelvic floor to contract, relax, and hold strength for a period of time, which is really important.

Jenn Salib Huber: 20:00
That’s so helpful to know, because I think a lot of people see the devices but don't really understand how they work. But it sounds like they can be really helpful for people who either can’t access a pelvic floor therapist or who just need a little bit more guidance at home.

Kim Vopni: 20:14
Yes, exactly. And the other thing to keep in mind is that they’re not a quick fix. Like anything else, it takes time. So whether you’re doing Kegels or using biofeedback, consistency is key. You’ve got to give it at least three to six months of consistent work before you’ll really start to notice a difference.

Jenn Salib Huber: 20:31
Yes, that’s a great reminder. I think sometimes we expect quick fixes with things like this, but the pelvic floor is just like any other muscle. It takes time to strengthen and improve function.

Kim Vopni: 20:42
Absolutely. And that’s why I’m such a big fan of pelvic floor physio. They can give you a tailored plan based on your unique needs and symptoms, and help you understand how to incorporate exercises into your daily life. You know, when you’re working with someone who understands the pelvic floor, they can really help you progress over time, whether it’s dealing with incontinence, pelvic organ prolapse, or pain during sex.

Exploring Biofeedback Devices

Kim Vopni: 22:02
Maybe they're not in Europe yet, or I think they are, but they're popping up everywhere in Canada and North America, and the technology is a little bit different. But it's basically marketed as being able to do 11 to 13,000 Kegels for you in a 20-minute session. You just have to sit there fully clothed. It sounds awesome—like you don’t have to do the work, perfect, let this machine do it for me. But it’s a really expensive outsource. It absolutely plays a role for people who have nerve damage, spinal cord injuries, or mobility challenges, or if they've tried everything and need a little more help. Sure, it can come in and play a role. But people with incontinence, who’ve been struggling for years and think Kegels don’t work because they've never been evaluated properly, are spending thousands on these devices or therapies, and they don't actually work—they’re not a miracle cure. You ultimately still need to do the work.

Real-Life Experiences with Pelvic Floor Physiotherapists

Jenn Salib Huber: 23:05
Yeah, I haven’t used the biofeedback device. I’ve had two pelvic floor physiotherapists—one in Canada (we’ll link to Erica’s episode below, she was on last season) and one here in Europe. And yeah, they are all up in your business.

Jenn Salib Huber: 23:21
As I always tell people, I try to warn them, this is an entry exam and there’s going to be some very up-close and personal moments. But they can really feel things that you don’t even know are there. I remember my first session with Erica—she’d say, “Oh, this muscle’s really tight,” and it was like having a charley horse, just from her touching it with her finger. I had no idea I had that kind of tension in my pelvic floor. But getting that feedback—this is what it feels like when it’s tense, and this is what it feels like when it’s relaxed—and she led me through breathing exercises where I could feel the tension reduce. It was amazing. So, if biofeedback can offer that to people who can’t access it, that’s great.

Pelvic Floor Therapy and Painful Sex

Jenn Salib Huber: 24:47
I want to ask a question that came up in my community around painful sex, which is one of the common symptoms that people in menopause experience. There are a lot of great conversations happening around vaginal estrogen therapy and how important that is, as well as lubricants and moisturizers. What can pelvic floor therapy do? As a vagina coach, how do you coach people to have less painful sex?

Kim Vopni: 25:12
Yeah, super common, especially during this transition in life. We need to understand why it’s painful, because there can be different reasons. It could be anticipation, where people think it’s going to be painful and experience pain before anything even touches them. Or it could be pain from touch externally—vestibulodynia, which refers to pain at the opening of the vagina, or vulvodynia, which is pain in and around the vulva. Pain during insertion is often referred to as vaginismus or dyspareunia. But we need to understand what’s causing the pain—is it pain at the point of insertion, deeper inside, or is it due to dry, estrogen-lacking tissues, or maybe even fear causing the muscles not to relax? There are many contributors.

Understanding Causes of Pain and Treatment Options

Kim Vopni: 25:36
There are many reasons for pain—whether it’s due to tight muscles, scar tissue from childbirth or an episiotomy, or fear of pain causing tension. This is why I advocate for seeing a pelvic floor physical therapist at least once a year. Even one session can provide valuable insights. For instance, they might identify tightness in specific muscles or scar tissue that is contributing to the pain. It's not just something that happens immediately after giving birth; scar tissue can develop over time. Finding the root cause is essential. If it’s tight muscles, breathwork and posture release exercises can help, which is a big part of what I share in my work. Tools like pelvic wands can also be useful. These are S-shaped silicone devices that mimic what a pelvic floor therapist would do with their fingers. By pressing around inside, people can find trigger points, tender spots, or scar tissue and help release tension.

Kim Vopni: 28:09
For those dealing with anticipation pain, dilators can be helpful. These are cone-shaped devices of increasing size, used to build confidence that something can be inserted without causing pain. This can be done with a therapist or at home.

Then, there’s tissue support. If low estrogen is a factor, vaginal estrogen, moisturizers, and lubricants should be considered, especially during sexual activity. Vaginal DHEA is another common option. We can address both the muscular and tissue components to allow for more comfort and even pleasure. Better blood flow and circulation, along with tissue rejuvenation, can be beneficial.

Patience with Progress and Multiple Solutions

Jenn Salib Huber: 29:14
So what I'm hearing from you is that it’s not a quick fix. We all want a pill or a cream to solve the issue, but there are many solutions to explore, and it’s important not to give up if one doesn’t work. A lot of people I hear from say, "Oh, I tried XYZ and it didn’t work, so now what?" I love that you explained what happens when one thing doesn’t work and why it’s worth exploring different options.

Kim Vopni: 29:54
Sometimes it feels like I’m giving people a long to-do list when they’re already overwhelmed. But I try to reframe it as an opportunity—an options list. You have all of these choices, and when you're ready, you can pursue one or more of them. Or you might choose not to, but at least you know the options are there.

Is Pelvic Floor Therapy a Lifelong Practice?

Jenn Salib Huber: 30:19
That’s a great way to look at it. Another question that came up was—if someone does the work you suggest and finds relief, is this something they have to continue doing? Can it be "fixed" and done with, or is this an ongoing part of healthcare?

Kim Vopni: 30:52
I like to compare it to dental care. If I go to the dentist and I’ve been brushing and flossing, and they find no cavities, that’s great, but I don’t stop brushing or flossing afterward. Similarly, if they find a cavity and fix it, I still don’t stop. Pelvic floor care is part of our lives. My hope is that, eventually, it becomes ingrained in early education. When we teach young people about sexual health, bodies, and menstrual cycles, we should also talk about the pelvic floor. Both men and women have a pelvic floor, but women face more challenges due to menstruation, pregnancy, childbirth, and menopause. By planting the seed earlier, we can normalize pelvic floor therapy as part of routine healthcare.

Kim Vopni: 32:14
It’s also important to remove the stigma and embarrassment around it. Many messages we hear from the media or passed down through generations make pelvic health seem taboo. I hope that it becomes a normal part of life, and that women understand the importance of their pelvic floor, just like we’ve normalized brushing our teeth.

The Missing Ingredient in Midlife According to Kim

Jenn Salib Huber: 32:47
I figured that would be your answer, but it’s a great one! Before we wrap up, I’d love to ask my favorite question: what do you think is the missing ingredient in midlife?

Kim Vopni: 33:08
Education.

Jenn Salib Huber: 33:23
I love that! I’m here for it. We need to talk about all the things, all the time, in all the ways. Thank you so much for sharing your expertise, Kim. This will be incredibly helpful for many people. We’ll make sure to include all your links in the show notes and on Instagram. What's your Instagram handle?

Kim Vopni: 34:48
Vagina Coach.

Jenn Salib Huber: 34:50
Perfect. You offer lots of great content there.

Kim Vopni: 34:53
Thank you.

Jenn Salib Huber: 34:55
Thanks for tuning in to this week's episode of The Midlife Feast. For more non-diet health, hormone, and general midlife support, click the link in the show notes to learn how you can work with me. If you enjoyed this episode and found it helpful, please consider leaving a review or subscribing, as it helps other women just like you find us and feel supported in midlife.