Pelvic Floor, Real Talk: Leaks, Lifts & Life in Midlife with Pelvic Health PT Sandra Ghaly

Written By Michelle Bazinet

Sandra Ghaly, PELVIC FLOOR & PAEDIATRIC PHYSIOTHERAPIST Founder of Makewell Women’s Health

Urinary leaks, pelvic pain, prolapse, dryness—so many women deal with these silently, assuming they’re “just part of motherhood” or “just menopause.” In this powerful, unfiltered conversation, pelvic health physiotherapist Sandra Ghaly, owner of Makewell Health (Oakville, ON), joins Michelle to explain what the pelvic floor actually is, why it matters in perimenopause and menopause, and how evidence-based care (including pelvic floor physio and, for some, vaginal estrogen) can change your day-to-day life—on runs, in workouts, and in the bedroom. Expect zero shame, loads of clarity, and practical next steps.

What we cover

  • What the pelvic floor is (muscles supporting bladder, rectum, uterus) and why it’s central to core and back function

  • Why “common” is not the same as “normal” (stress incontinence, urgency/overactive bladder, painful intercourse, prolapse)

  • How perimenopause/menopause changes tissue (estrogen, lubrication, elasticity) and what that means for symptoms

  • Inside a pelvic floor physio visit: the conversation, consent, assessment (including optional internal), and a whole-person plan

  • Beyond Kegels: hips, core, breath, strength training, and lifestyle—why the floor doesn’t work in a vacuum

  • Vaginal estrogen: who it can help, why some can’t/choose not to use it, and non-hormonal options (e.g., vaginal moisturizers with hyaluronic acid)

  • Time/money worries: realistic expectations, devices vs. visits, and building a plan that fits real life

Timestamps

  • 00:00 – Why this convo matters (and why we don’t talk about it enough)

  • 02:00 – Sandra’s story: from patient to pelvic health specialist

  • 05:00 – Pelvic floor 101: location, role, and how it ties to low-back/core

  • 09:45 – “Common” symptoms in peri/menopause: leaks, urgency, pain, dryness

  • 13:20 – What an appointment looks like (consent, comfort, options)

  • 15:00 – Prolapse signs you shouldn’t ignore

  • 17:30 – Michelle’s candid stories (and why sharing them helps us all)

  • 19:30 – Vaginal estrogen & why tissues feel “plumper”/more comfortable

  • 22:30 – If estrogen isn’t an option: evidence-based non-hormonal supports

  • 25:30 – Kegels aren’t the whole plan: hips, deep core, breath, strength

  • 28:30 – Cost/time concerns, devices, and making progress at home

FREE DOWNLOAD: 5 Ways to Support Your Vulvovaginal Health During Menopause

DOWNLOAD

Get in touch with Sandra: www.makewellhealth.ca. IG: @makewell.health

Michelle Bazinet
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