Nighttime Challenges in Menopause: Expert Insights with Dr. Heidi S3E15

Perimenopause Nocturia & Dissappearing Labia?! Pelvic Floor PT, Vaginal Estrogen, UTIs, and Painful Sex with Dr. Heidi | Period Coaching In this period coaching episode, the hosts talk with pelvic floor physical therapist Dr. Heidi about why many women in perimenopause and menopause start waking up at night to urinate (nocturia), how estrogen reduction, weight gain, fluid retention/edema, medications, and bladder “training” habits can contribute, and why nocturia is a hallmark symptom of overactive bladder. They discuss practical support including bladder diaries, bladder retraining, pelvic floor PT, managing intraabdominal pressure, fall risk when rushing to the bathroom, timing and types of fluids, and common bladder irritants such as caffeine, carbonated/citric drinks, acidic/spicy foods, chocolate, and alcohol (including red wine). Dr. Heidi explains benefits of topical vaginal estrogen for GSM symptoms, UTIs, and postpartum recovery, addresses painful sex with lube, moisturizers, stress/tension work, and position modifications, and clarifies social media claims about labia minora shrinking with age. Dr. Heidi shares her daily non-negotiable: walking outside with her dog, and where to find her at heydrheidi.com.   00:00 Welcome and Introductions 00:24 Why Nighttime Peeing Happens 02:01 Weight Fluid and Comorbidities 03:19 Bladder Habits and Training 07:19 Urgency Leaks and Fall Risk 08:47 Perimenopause Timing and Estrogen 09:35 Vaginal Estrogen and UTI Prevention 12:29 Where to Start Treatment 14:59 Diet Triggers and Caffeine Timing 18:17 Hydration Timing and Electrolytes 22:11 Alcohol Cannabis and Bedtime Tips 26:38 Nighttime Pee Anxiety 27:17 Painful Sex Causes 28:51 Lube and Estrogen Basics 30:11 Pelvic Floor PT Tools 33:01 Moisturizers vs Lube 35:02 Labia Changes Explained 38:02 HRT and GSM Layering 39:10 Daily Nonnegotiable Walk 41:36 Nature Talk Bears Gators 44:48 Find Dr Heidi 45:29 Lightning Round Wrap   Todays episode is sponsored by: Period Coaching School and Katie Bressack Wellness. Email us: [email protected] Our Websites: PeriodCoachingSchool.com KatieBressack.com Instagram and Facebook: @StashaWashburn  @KatieBressack  Freebies: Charting with Stasha https://ThePeriodCoach.com/etrc Eating For Your Hormones Guide https://katiebressack.com/freegift/ Books: The Revolution Will Be Bloody https://ThePeriodCoach.com/Revolution Bloody Brilliant Business https://PeriodCoachingSchool.com/Bloody-Brilliant-Business-book  Eating For Your Hormones Recipe Book https://katiebressack.com/hormone-balancing-recipe-book/ Theme music composed, recorded, performed, engineered, mixed and mastered by Ted Wulfers 663 Sound