When It Sucks To Be A Woman: The Treatment Of Pelvic Problems, Incontinence, And Other Taboo Topics

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Join Dr. Betsy Greenleaf, a board certified gynecologist and urologist, inventor, entrepreneur, and business leader as she discusses all things female on the pelvic floor. Join us in learning how peptides could have the potential to help with common gynecological problems, including vaginal infections, vaginal prolapse, incontinence, interstitial cystitis, recurrent urinary tract infections, and more!

How Do Peptides Help Pelvic Health?

Some of the other conditions are recurrent urinary tract infections, incontinence, prolapse where things are drooping and dropping, especially as people get older.

The two kinds of incontinence are stress incontinence and urge incontinence. Stress incontinence happens when you cough, laugh, sneeze, jump up and down, you leak. A lot of that type of incontinence is usually due to ligament damage that may have initially happened during childbirth, though you don’t have to have given birth to develop that. It could be any kind of ligament damage to the pelvis from pressure, if you cough too hard, or you lift something too heavy. Then there’s urge incontinence when people have to run to get to the bathroom. It’s like one minute they’re fine, next minute they’re like, “Make way!” Rush to the bathroom. That’s usually due to either irritation in the bladder wall itself, or muscle spasms, or even nerve irritation. 

Discovering peptides is like opening a Pandora’s box. For stress incontinence, the treatment was surgical where you go in and implant a sling. There has been studies on rats and actually cut their urethra and administered BPC-157, which is a peptide.

They found that whether they gave it orally or if they injected it, that those rats, their urethras returned back to normal. So they got rid of their stress incontinence. One of the nice things about BPC-157 is that you can take it orally. It doesn’t have to be injected like some of the other ones. And there are really nice improvements in urethral sphincter function. So the urethra is the tube that the pee goes through. 

The BPC-157 will tighten the upper gastric esophageal sphincter and tighten that and loosen the lower, so you don’t get that reflux. It seems to do the same thing in the bladder where it’s going to tighten the lower, so that brings it back to normal. The BPC-157 is a kind of homeostatic peptide. We find if people have—they’re hypercoagulable, it brings it down, if they [inaudible] it brings it up, their blood pressure is too high, it brings it down, if it’s too low, it brings it up. So it’s very interesting how it brings everything back to normal. 

TB4, which you can do orally, the TB4 fragment basically even kills Lyme cysts better than Tinidazole. So, it has a lot of great properties. They act synergistically.

Mycoplasm and ureaplasms, which are a type of bacteria, are very common as causes of urethritis in women. Urethritis in women is often overlooked, but that can cause spasms, or hesitancy, or swelling.

With some of the anti-microbial activities of these peptides is that these things can prevent mycoplasm infections or Lyme disease. We’ve seen a lot of effects with Lyme on the functioning of the pelvic floor and pelvic inflammatory diseases.

The Whole Gut Brain Access

Because these people typically have not only pelvic pain, but they usually have some kind of gastrointestinal, like irritable bowel or some kind of chronic intestinal complaints. They almost always have anxiety or depression, which we used to, in the traditional medicine sense, used to just kind of blow off and be like, “All right, well, they’re stressed because they’re chronically in pain.” Then I started finding that a lot of them had these lower immune systems, like the IGA deficiencies and I started going, “Okay, what does depression, anxiety, immune dysfunctions, these GI symptoms, these pelvic symptoms all have in common?” And, “Well, the gut!” 

We know that 90% of our serotonin, which is one of our feel good hormones, is made in your gut. So there’s definitely a connection between the gut and the brain.

Pelvic Pain

It’s interesting ’cause that’s, once again, that’s a subject when you try to look up traditional medicine, there’s not a lot of studies on it. So really, once again, the pelvis for males and women is made of muscle and those are skeletal muscle and they spasm. The reason they’re spasming is because they’re trying to protect you. They’re splinting against something. So there’s something else that’s causing an irritation. So it’s always like, we gotta find the irritation. Because treating the muscles—you can get muscle relaxers, you can give pain medicines, but you’re just gonna treat the symptoms where we really need to look into why that’s happening. Some of the interesting things found over the years is the connection with orthopedic injuries, because a lot of orthopedic injuries will actually refer to pain in the pelvis and not to where—especially hip injuries and low back. The funny thing about that is you try to get the orthopedist to see a patient who’s having vaginal pain. I’m like, “It’s their hip! It’s their hip. I know I’ve done their little tests into this, it’s their hip!” And they’ll be like, “No, no!” They hear vaginal pain and they put their hands over their ears and are like, “Not my problem, not my problem.” I can’t tell you the number of people where we found that they’ve had labral tears of the ligaments, the cartilage in their hips, but it referred to the pelvis. I mean, other things like infections cause that irritable bowel. So, these are all other things too that, especially the BPC-157, is great for. It helps with muscle, helps with collagen, and we know it helps with bone repair. It helps with muscles, it’s antimicrobial . 

So a lot of people have muscle spasms in the pelvic floor. You can actually get nerve injuries, like the pudendal nerve often gets injured especially—we’ve seen a higher rate of pudendal nerve injuries, not only during coronavirus and COVID, because everyone was home, they started going on their bicycles a lot more, but also around the holiday time, because everyone’s getting—for Christmas or Hanukkah, they’re getting Pelotons. Not to bad mouth Peloton but it’s just the seat that you’re sitting on for the bike, there’s a lot of compression on the nerves that are in the sitz bone area. 

If you don’t take care of it early, you can end up with permanent crush injuries that are harder. Now with the peptides, there are better results with that.

Interstitial cystitis, we know that the inflammatory chronic infections in the pelvis can cause that. Pelvic pain sometimes is related to bowel issues, if you have chronic bowel issues like inflammatory bowel issues. A lot of the BPC-157 was originally studied for inflammatory bowel because it is a bowel related peptide. 

Peptides and Urogynecology

These peptides are the reason urogynecology exists, for the most part, is for people who have babies. Nature doesn’t care if you damage your pelvic floor, your ligaments. Nature wants to get that baby out. So as long as people keep having babies, there will be vaginas that need to be fixed because things will be dropping and dropping as time goes on. But I’ve been thinking about it, I was like, “You know what? We need—” Because there really hasn’t been anything for prevention of pelvic floor disease. It’s more of a treatment. And I’m like, “You know what? Maybe we need to start looking at using some of these peptides in our women who have just given birth.” I know that there’s a question about use in breastfeeding women, but I think it’s more just to cover their butts about the usage of some of these peptides. If you gave, especially the BPC-157, to people who have delivered then maybe they would—their ligaments would heal the way they’re supposed to and they won’t have those long term effects down the road.


Kent Holtorf, M.D.

Here we go. Hi this Dr. Kent Holtorf with another episode of the peptide summit. Today we’ll be interviewing Dr. Betsy Greenleaf with the title of When It Sucks to be a Woman: Treatment of Pelvic Problems, Incontinence, and Other Issues we Don’t Like to Talk About. I think that that’s very true and it’s such a huge problem. Women just don’t talk about it. I know a lot of women have the issues—I find out later, but when they come in, they don’t tell me. So, I think she’s doing some great, cutting edge work. She’s a premier, a women’s health expert, entrepreneur, inventor, and business leader. She specializes in pelvic medicine and reconstructive surgery for over 20 years. She’s a trailblazer, she’s the first female in the United States to become board certified in urogynecology. I’m interested to see how that really connects and makes a difference.

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