Menstrual Pain: the missing part of phase based training? Episode 124 with Michelle Lyons

Hello & Welcome! October is Menopause Awareness month and the theme for this year's International Menopause Awareness Day (Oct18th!) is chronic pain at midlife - and I have some thoughts... In today's episode, I'm exploring the intersection of menopause, disrupted sleep, pain, mental health, and bladder function. These issues often overlap in a multi-directional relationship, where poor sleep can increase pain sensitivity and vice versa, and then we add some inflammation, insulin resistance, constipation, bladder frequency, urgency and nocturia... As always, I'm emphasising the importance of clinicians acting as detectives to identify what is actually waking a woman up, rather than assuming a single cause. In this episode I describe the THRIVE model I'm developing (more soon!) covering tissue health, hormones, rest and recovery, integrated nutrition and gut health, values and goals, and exercise, as a framework for a whole-woman approach. Its worth noting that while hormone therapy is the gold standard for vasomotor symptoms, lifestyle strategies like morning sunlight, consistent wake times, strength training, and mindful nutrition can also support recovery. If you're a frequent flier here, you'll know I believe that the goal of treatment should be improving overall quality of life and capacity, not just reducing individual symptoms, and empowering women through evidence based education and interventions; in other words teaching women how to be experts in their own bodies and health experiences. in this episode, I'm exploring the intersection of hormones, sleep, pain, mental health and bladder function; nighttime awakening factors, urinary symptom management, the mental health implications, sleep improvement strategies and more! Discussion like this, where we explore the overlapping circles of different biopsychosocial systems going through menopausal changes and challenges, are drawn from the research I've been exploring and translating into clinical practice for my online course, Flourish! The Menopausal Toolbox, which gives women's health professionals the language and structure to navigate peri to post menopause WITH the women we work with. All of the details for all of my online courses can be found at CelebrateMuliebrity.com Prefer live online (with access to the recordings & bonus material afterwards)? Join me Oct18th and Nov1 as I teach a Menopause Integrated Approach for Pelvic Health Solutions. Questions about the courses? Send me a DM on instagram, where you can find me as @michellelyons_muliebrity Until next time, Onwards & Upwards! Mx #celebratemuliebrity

Hello & Welcome to today's episode - all about supporting the young female athlete! After a brief break while I was away at Pelvicon..getting ready to fly out to ICS in Maastricht but in the middle, I went to a Meath Local Sports Partnership conference - all about women in sport and leadership...lots of good stuff BUT worrying stats about the drop-off girls and women from sports and physical activity as they navigate adolescence and early adulthood So - I was inspired to record my thoughts on how we can support body literacy, including pelvic health, in the young female athlete I wanted to explore in this episode, the topics that are fundamental in their importance in supporting young female athletes, particularly those aged 11 to 13, to help them remain active and healthy through adolescence. Remember, that girls are not small versions of adult women or men and require a development-focused approach rather than just a performance-focused one. Key areas of discussion included: Menstrual health, where I advocate for age-appropriate tracking and body curiosity rather than rigid cycle-based training. I highlight the critical role of adequate nutrition, warning against calorie counting and the demonization of carbs, and linked low energy availability to REDs and increased injury risk. I also covered the importance of iron and bone health, the benefits of supervised strength training for physical literacy, and the need to manage training load and protect sleep. Unsurprisingly (!) a significant portion of this episode focuses on pelvic health, including normalising conversations about bladder leakage, bowel health, and the use of the PFD Sentinel screening tool, created by Dr Silvia Giagio. I reference the NICE guidelines to support early pelvic health education and discuss the impact of breast development on sports participation. Finally, I always want to stress the need for body literacy over body surveillance, and encouraging an environment where young athletes feel safe to discuss health concerns with coaches and parents, and you as the clinical at the intersection of pelvic health & sports medicine and much more... If you'd like to take a deeper dive, my online course, The Menstrual Detective, comes with free access to 'Pelvic Health for the Younger Female Athlete', focusing on the pelvic health needs of the adolescent athlete. All of the info on all of my online courses can be found at CelebrateMuliebrity.com - but if you have a course related question, send me an email or DM on instagram - @michellelyons_muliebrity Until next time, Onwards & Upwards! Mx #celebratemuliebrity

Today is World GO Day!World Gynae Oncology Day, in my world, focuses on the importance of pelvic rehabilitation for women after gynecologic cancer treatment. In today’s episode, I’m discussing how pelvic rehabilitation extends beyond simple pelvic floor exercises to address comprehensive physical and psychological needs, including pelvic pain, bladder and bowel dysfunction, sexual health issues, and movement difficulties.

Hello & Welcome to today’s episode! This is one for the pelvic health in sports medicine fans! I’m interviewing Helen McKeever about pubic and inguinal pain in female athletes, based on Helen's chapter in Grainne Donnelly's book "Sports Medicine: The Pelvic Floor." In this conversation, myself and Helen discuss the importance of considering multiple factors beyond just pelvic floor issues when treating groin pain, including musculoskeletal drivers, hypermobility, and REDs - encompassing reproductive, endocrine, digestive, and sleep factors. We explored how pelvic floor physiotherapists should expand their assessment beyond mechanical issues to include questions about bladder and bowel function, menstrual cycles, and psychosocial factors. Helen shared clinical insights about the anterior pubic ligament complex and the role of deep hip rotators in managing chronic groin pain. The conversation highlights the need for collaborative approaches between pelvic health and sports medicine specialists, with Helen currently working at Aspetar in Doha where she sees female athletes presenting with complex pelvic and groin pain issues, as part of a multidisciplinary team approach. We also talked about pelvic girdle pain in pregnancy, differential diagnosis and clinical reasoning for hip, pubic & groin pain, hypermobility and we discussed how pelvic floor physiotherapists should broaden their differential diagnosis beyond just pelvic floor issues, considering factors like motor control around the hip, deep rotators, and anterior-posterior tilt capabilities. Helen shared a case study of a tennis player where addressing both pelvic floor and musculoskeletal components was crucial for successful rehabilitation. This was a rich conversation that I think really highlights the importance of pelvic health in sports medicine. If you'd like to learn more, the textbook 'Sports Medicine & the Pelvic Floor' edited by Grainne Donnelly and of course, my online course 'The Menstrual Detective', includes access to 'Pelvic Health for the Young Female Athlete' as well. You can find Helen and her research on ResearchGate and LinkedIn and you can follow my continuing adventures in women's health on instagram @michellelyons_muliebrity and all of my online courses can be found at CelebrateMuliebrity.com Until next time, Onwards & Upwards! Mx #celebratemuliebrity

Hello and welcome to today’s episode – a bit off the normal schedule as I was teaching my Endometriosis Pain Management course over the weekend and then I was asked to come on the Claire Byrne show on Newstalk Radio to discuss the recent decision by the Spanish FA to support egg freezing for their female footballers. Understandably, it was a brief overview on the radio but of course…I have thoughts that need a bit longer to explore so I thought – why not do a podcast episode! In today’s episode, I’m exploring: Why, at last, we are acknowledging that female athletes have reproductive lives! How this should prompt a broader conversation about supporting female athletes throughout their reproductive lives rather than just focusing on fertility preservation. I believe that female-specific health is fundamental to performance and outline the need for individualized, informed decision-making regarding pregnancy and postpartum participation in sport; good resources for this include FIFA's "Stay in Play" and "Stepping into Play" decision aids. I want to stress that supporting women requires addressing pelvic health, but also broader physical and psychological factors, and creating systems that allow athletes to make reproductive choices without compromising their sporting careers; advocating for an approach that recognizes women's physiological stages as integral rather than disruptive to athletic performance. But it’s about physiology across the female lifespan, not just in elite sports. I believe that female athletes (actually all women!) should receive education about menstrual cycles, nutrition, fertility, and postpartum recovery, rather than being forced to choose between a sporting career and motherhood. I believe that supporting women's reproductive choices should be part of a broader conversation about creating an inclusive sporting environment that accommodates all women's life stages and decisions, from menstruation to menopause. I really want to rephrase the question about women in sports from "can women have it all" to "what can we change about our systems so women don't have to choose." I believe there’s the need to create sporting environments that support women's health and bodies rather than requiring women to adapt to sports, a system that’s designed to support the needs of male athletes. And of course…if you’d like to learn more about supporting female athletes, from recreational to high performance, at every age and stage…check out my online courses The Menstrual Detective, Pelvic Health for the Younger Female Athlete, Perinatal Pelvic Rehab (Preconception to Postpartum) and Flourish! The Menopausal Toolbox – all available at CelebrateMuliebrity.com Until next time, Onwards & Upwards! Mx #celebratemuliebrity