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Betsy Greenleaf, DO, FACOOG (Distinguished)
Betsy Greenleaf, DO, FACOOG (Distinguished). Premier women’s health expert, entrepreneur, inventor, and business leader, who specializes in female pelvic medicine and reconstructive surgery for over 20 years, Dr. Greenleaf, is a trailblazer as the first female in the United States to become board certified in Urogynecology. She possesses a professional... Read More
Tabatha Barber, DO, FACOOG, NCMP, IFMCP
Dr. Tabatha Barber has devoted her life to giving women a voice and a choice when it comes to their health and well-being. As a young girl, she struggled with self-esteem and identity issues, dealt with peer-pressure, and survived the ridicule and stigma of becoming a teenage mother. As she... Read More
- Understand the intimate interplay between prolapse, sexual function, and self-perception
- Address common misconceptions surrounding prolapse and its implications on sexuality
- Familiarize yourself with preventative measures and treatments to ensure a vibrant sexual life despite prolapse challenges
- This video is part of the Solving Sexual Dysfunction Summit
Related Topics
Exercise, Fitness, Health Coaching, Mental Health, Nutrition, Pelvic Health, Wellness, Womens HealthBetsy Greenleaf, DO, FACOOG (Distinguished)
Welcome back, everybody, for another great session of the Solving Sexual Dysfunction Summit. We have Dr. Tabatha Barber here with us today. I am so excited to talk with Dr. Tabatha. Thank you, Dr. Tabatha, for being with us.
Tabatha Barber, DO, FACOOG, NCMP, IFMCP
I am so excited for this conversation. It is much needed. Thank you for all you are doing, Dr. Betsy.
Betsy Greenleaf, DO, FACOOG (Distinguished)
Before we get into it, I love everybody telling their back story because I just find it so fascinating. How did you end up in the field that you are in?
Tabatha Barber, DO, FACOOG, NCMP, IFMCP
My goodness. Yes. I have a pain-to-purpose story, so I am essentially a high school dropout. I got pregnant in 11th grade. I dropped out after that to take care of my baby. But I had a very traumatic delivery, and a lot of things were done to me. Nothing was explained. There was no informed consent. I had been miserable, crying, and begging for a C-section after 3 hours of pushing. When the doctor came in, I thought I was finally going to have relief. I was like, Thank you, Lord. He came in and put me up in stirrups. I experienced the most excruciating pain of my entire life.
That day changed me because, unfortunately, he used forceps to deliver my daughter because she was sunny side up, so she was facing the ceiling instead of the floor. She has been a stargazer ever since, but he tore me to the fourth degree throughout my rectum. It turns out he was a family practice doctor, and he did not do a very good job putting me back together. I have had lifelong issues and embarrassing things that I have struggled with that most people would not even admit to, such as the fact that I have to push on my vagina to have a bowel movement and that I have had painful intercourse and issues with my whole life because of that, starting at 17 years old. It was very traumatic.
I had to come to a Jesus moment, and God made it clear that I needed to figure my life out for myself and my daughter and prevent those things from happening to other women that I had suffered through. It has been a long and painful journey, and I’m finally out of it. I have just come to understand that we need to share our stories and our uncomfortable, embarrassing moments so that we can help other women not go through what we went through.
Betsy Greenleaf, DO, FACOOG (Distinguished)
That is such a beautiful story. First of all, I just think it is amazing because, unfortunately, so many people in the United States would take something like that and just get stuck in that victim mentality, poor me. You took it and said, I am going to become a doctor.
That is just amazing. Then that ties into what we are talking about today, which is prolapse. Not everybody knows what that is, but they say 50%. I think that is conservative, but 50% of all women are going to have a prolapse at some point in their lives. I think that number is a lot higher. But can you explain what a prolapse is?
Tabatha Barber, DO, FACOOG, NCMP, IFMCP
Yes, I think that this needs to be talked about more. I am excited to have this conversation because women do not understand what is going on down there. We do not look a lot of times, and we do not feel. I remember getting a call in the office one day in the triage, and the nurse said a patient was freaking out because she felt a mass in her vagina. She was feeling her cervix. It is just that we do not know. We do not teach people this. We do not talk about this in sex education. The cervix does feel a little donut up inside your vagina. It should be up there, a few inches—6 to 8 inches. You should have room for penetration and intercourse.
But a lot of times, our organs start to come down. We lose the supportive structures inside our pelvis that suspend the uterus, the tubes, and the ovaries up and out. Then, when we think about the vagina, we have a front, a back, and a top and sides. In front of the vagina is where our bladder lives. The back is where the rectum lives. The top is where the uterus and cervix live. On the sides, there is more connective tissue. We have lots of little, strong muscles. You know this, you are a gynecologist. Connective tissue, ligaments, and all kinds of things work together to keep everything in place.
But unfortunately, gravity takes its toll. Carrying children takes its toll, as does carrying extra weight and things that increase our pelvic pressure and our cell ring. The new thing is lifting heavy. You are not strong and sexy after 40 unless you lift heavy weights. Unfortunately, there are a lot of women who are now experiencing prolapse because of this trend of lifting heavy weights. Every time you hold your breath and push. You are pushing those organs down. I have had women call me freaking out. Something is coming out of my vagina. I felt a bulge in the shower. What the heck is going on?
It is because there is too much pressure on those ligaments. As we age, we lose some of our connective, supportive tissue. Our collagen starts to break down. We see this on our skin. Our skin gets thinner and creepier. All of a sudden we look, Why am I so old? You are pushing your face up. The same thing happens in the vagina. Things are falling. That is a prolapse. Prolapse can be defined in many different ways, as such.
Betsy Greenleaf, DO, FACOOG (Distinguished)
I am sitting here laughing only because my colleagues all made fun of me. After all, I know too much as a Uro-Gynecologist. I thought I was being smart. When it came time for me to have my kids, I scheduled my elective C-section. No, I did not do it myself, but I had made arrangements with one of my colleagues, and people were there. I did not know you could do that. Well, I would not; I still ended up with a prolapse and still had to get it fixed and everything. My colleagues love to point out that you do not have to have a baby vaginally, just the way to pregnancy. I have had women over the years who’ve never had children or never been pregnant and have developed these things.
Tabatha Barber, DO, FACOOG, NCMP, IFMCP
Absolutely. I think part of it is weight-lifting more than anything and the terrible diet. We are all eating the standard American diet, and we are just not getting the protein necessary for our ligaments and muscles to repair and regenerate. That is a big deal. I did the same thing. I scheduled my second C-section when I was a senior resident, and I thought I was going to save myself because I already had a rectocele which we can talk about. But it did not help it. It just caused my son to have issues because he was born without the vaginal microbiome, saving him. He had chronic allergies, gut issues, and all these other things. I just traded one problem for another, unfortunately, and I am so glad that that trend is over. It was a big, popular trend in the early 2000s. I think it started in Brazil, but thank goodness that was over.
Betsy Greenleaf, DO, FACOOG (Distinguished)
That is a good point, because if I had known about the microbiome back then, I would not have done it. It is one thing if you have to have it for emergency reasons, but to do it electively does not save a darn thing.
Tabatha Barber, DO, FACOOG, NCMP, IFMCP
It does not. Yes, I think if you are feeling a bulge, it is important to get it figured out. What I came to understand is that not all gynecologists are trained the same. A lot of gynecologists were trained in the era when laparoscopy was just getting popular. Vaginal surgery and vaginal examination and pestering, and things fell by the wayside. Luckily, I learned a lot about vaginal surgery. It was important to me to understand prolapse. I got good at evaluating with the exam of like, is it your bladder coming down? Is it the entire uterus? Is it the rectum? What is happening?
I got to the point where I was doing robotic sacrocolpopexy multiple times a week because so many women were struggling with this and no one had ever talked to them. When I asked them, it was, Yes, I quickly created a practice where I was doing pessary every week, prolapse surgery, and all of these things. But it is because we are not having that conversation.
I just do not want women to end up like the one lady I saw in residency. It was an emergency room in the ICU because they thought she had cancer, and literally, it was her uterus between her legs. She said, No, honey, I just push it back up. I know what to do. That was the saddest moment ever, realizing women just struggle in silence. We do not even ask for help. Something that drastic. But there is help, I promise. You might have to go through a few gynecologists to find the one to help you, but there is help for this.
Betsy Greenleaf, DO, FACOOG (Distinguished)
That is why I was going to ask you: What should somebody do if all of a sudden they feel something bulging or something heavy? Because I know too often people’s minds go, it is a tumor. I have cancer. They panic. Then or they go the opposite way and they are, I am just going to ignore it and I will go away. They go into denial. I do not want to know what it is, but I do not want to know.
Tabatha Barber, DO, FACOOG, NCMP, IFMCP
Those are very common scenarios. The best thing to do is to see if your OBGYN knows about prolapse and can do an exam to evaluate you. You have to understand that those who prolapse can be dynamic. Sometimes, if you are doing physical activities or you have a chronic cough because you are sick or something, something can push down in bolt out, but it can go back up. When you are lying on an exam table, nothing might be very obvious to them. Just be aware of that. But I would say that it is good to be examined by the same person every year because then they can see any changes that might be happening.
A lot of women are never told that they have a prolapse, but all of a sudden they cannot empty their bladder because now the urine has to go uphill over the bump or they are leaking and they cannot hold it leaking with a cap, coughing, and sneezing. Sometimes they do have constipation and bowel problems; their stool is not evacuating properly; or a change in their stool or sex is painful. If you have had a great sexual life and things have been fine, and now you are feeling something’s in the way, he is pushing on something. Something hurts. That is a signal that, yes, you might be experiencing some prolapse.
Betsy Greenleaf, DO, FACOOG (Distinguished)
I know what a lot of patients end up going through when they find out they have a prolapse, they get nervous about letting their partner know, or they are afraid to have sex because they are afraid to ruin it or make it worse.
Tabatha Barber, DO, FACOOG, NCMP, IFMCP
Right, and that is just not the case. It might be uncomfortable, but you are not going to hurt yourself damage-wise, you might be uncomfortable, and sometimes you have to push it back up a little bit and try to get into that relaxed state so those organs can go back to where they are. Some women need to have a bowel movement before intercourse because they are afraid they are going to have an accident. They are going to feel like they are having a bowel movement. If you have that issue, you might have a rectocele, meaning your rectums are pouting into the vagina in the back, and it can look a little bulgy.
If you push on it, it might feel the urgency to have a bowel movement; that’s what it feels. If intercourse feels good, I am going to have a ball movement. Yes, you might have a rectocele, or I am going to pee myself. You might have a Cystocele, which is the bladder coming down. So I think these are important things for patients to realize because they might just be using the words. I am uncomfortable with sex, and the doctor is not getting it. Like, What?
Betsy Greenleaf, DO, FACOOG (Distinguished)
Yes, I understand what you are saying. Not everybody knows how to look for these things because I know I am. My regular OBGYN and it depends on where you get trained. My regular OBGYN trained before I did your rocking.
Tabatha Barber, DO, FACOOG, NCMP, IFMCP
That is true.
Betsy Greenleaf, DO, FACOOG (Distinguished)
The vagina was just the pathway to looking at the cervix.
Tabatha Barber, DO, FACOOG, NCMP, IFMCP
Exactly.
Betsy Greenleaf, DO, FACOOG (Distinguished)
Everybody looked at the vagina. Everybody just put them in speculum, got your pap smear to the cervix, got the pap smear, and then got out. It was not until I went to Uro-Gyn and did different training, but it sounds like you had great training. But I went in, and I was like, Wait a minute, there is a whole world in here. A lot is going on. There are other things that you should be looking at and feeling.
Tabatha Barber, DO, FACOOG, NCMP, IFMCP
That is an important point because the speculum pushes the cystocele and rectocele away, so you do not see it with a speculum. You have to remove the speculum. You have to take the speculum apart. You have to put it in different ways. You have to use your fingers to feel those tissues between the rectum, the vagina, the bladder, and such. It is a different exam. It is not a pap smear. It is not a speculum in, speculum out. Especially if women notice that their gynecologists have trouble getting their speculum in; that is uncomfortable or you have to move weirdly, or they cannot find the cervix. A lot of times, that is a prolapse issue.
Betsy Greenleaf, DO, FACOOG (Distinguished)
I am thinking, too, that when it comes to these exams, you were saying, too, that when people lay down, it goes back up. Sometimes, which is sometimes good when it comes to patients, because that may be one of the signs that they are having problems because they are, my discomfort is not as bad in the morning, but as the day goes on and I am on my feet, If you see your gynecologist at 9:00 in the morning, your exam might be different than if you see them at 4:00 in the afternoon.
Tabatha Barber, DO, FACOOG, NCMP, IFMCP
Yes, that is a telltale sign. A gynecologist who is asking you these activity-type questions knows about prolapse. They are going to ask you if it is different with activities. They are going to ask you to cough, push, or bear down during the exam to see if they can elicit that movement of your organs and that relaxation. Those are all important points. I inherited a very mature practice. The gentleman that I replaced was retiring at 74.
I had a lot of older women. He had delivered all their babies and taken them through menopause. I got all kinds of prolapse patients, and I became great at pessaries. I would be remiss if I did not mention pessaries because they are such an awesome tool to avoid surgery. I believe they sometimes reverse or stop prolapse from worsening because you no longer have that stretch and that pulls on the connective tissue in the muscles. Essentially, this is a silicone device or some other material that comes in different shapes, and we fit it as a gynecologist. We figure out which size sits in your vagina properly and pushes up your bladder or your uterus—sometimes the rectum, but not as well.
We find out what one fits you, and then you wear it. For sexually active women, you can remove this for intercourse, clean it off, and pop it back in. That could be a way to prevent yourself from having surgery or from the prolapse getting worse. You can keep exercising and enjoying life and all these great things. For older women, if you are not sexually active, you can leave it in and have the gynecologist take it out and clean it.
I just love that option, and I wish that more gynecologists were trained in that option still, because once you jump to surgery, we know that the relapse rate is, what, 30 plus percent within a couple of years? You are usually signing up for recurring surgeries every 3 to 5 years because we are relying on your tissue, which is already weak, and we are trying to use it to strengthen that area. It can only take so much. I just would encourage women, if you are struggling with this, to find someone who does pessaries who understands prolapse, because you should not have to give up sex and exercise and all that good stuff just because you are having this issue.
Betsy Greenleaf, DO, FACOOG (Distinguished)
I think it is fascinating with the idea of pessaries, and they have been around since the dawn of time. In ancient Egypt,
Tabatha Barber, DO, FACOOG, NCMP, IFMCP
They used the potato.
Betsy Greenleaf, DO, FACOOG (Distinguished)
Pomegranates, and stones, which I do not advise. There is that story about somebody using a potato, and it grew into their uterus.
Tabatha Barber, DO, FACOOG, NCMP, IFMCP
We do not recommend that.
Betsy Greenleaf, DO, FACOOG (Distinguished)
Do not do that. I have a friend who just started a new company that I am trying to find out more about. It sounds fascinating. They are using some technology to individually fit pessaries for people. Then they are 3D printed.
Tabatha Barber, DO, FACOOG, NCMP, IFMCP
That would be so awesome.
Betsy Greenleaf, DO, FACOOG (Distinguished)
Yes. It is just coming around. It is interesting to see where they are going to go with that because I am. Yes, even though the pessaries field, the actual devices have not been updated, and I do not know for how long.
Tabatha Barber, DO, FACOOG, NCMP, IFMCP
Yes, they have been pretty much the same forever. The material is better, so it is not breaking down and causing infections and things like that. But the shapes and sizes have not changed a lot.
Betsy Greenleaf, DO, FACOOG (Distinguished)
I know sometimes people get worried when they have one of these things because it starts drooping and drooping and they are afraid that they are going to be walking down the street and their vagina is going to fall out on the floor.
Tabatha Barber, DO, FACOOG, NCMP, IFMCP
Yes, it is not going to detach. It is still going to be attached to you. As I said, you can push it back up into your body. Sometimes you have to do some deep breathing to relax. That is a very extreme case, I would say. I only saw that a handful of times in my practice, but you can feel that cervix at the opening in the vagina for a lot of women, or the bladder or the rectum poking out of that. So you want to learn how to do pelvic floor exercises properly. Bad kegels make it worse.
I know where I live. We have great pelvic physical therapists, and they are becoming more common across the country, so you can find yourself a pelvic floor physical therapist. They can work wonders on strengthening your pelvic floor and those connective tissues so that if you do have a prolapse starting, you can often stop it or reverse it.
Betsy Greenleaf, DO, FACOOG (Distinguished)
That is so frustrating about the American medical system: when women are giving birth, that is a big trauma to the body.
Tabatha Barber, DO, FACOOG, NCMP, IFMCP
Absolutely.
Betsy Greenleaf, DO, FACOOG (Distinguished)
Then you are just sent home to, Okay, have a nice life with your kid. Where in Europe. In France, in particular, every woman who gives birth automatically goes through physical therapy. I am. Why are we doing that here? If I had surgery on my knee, I would be going to have physical therapy. Why not? If something’s happening to the vagina?
Tabatha Barber, DO, FACOOG, NCMP, IFMCP
We are still second-class citizens, unfortunately. I think that would have changed a lot for me in my life. It would have changed my relationship with my husband. It would have changed a lot of things. It is sad. You have to advocate for yourself. I have to ask you if you cannot put up with these problems. You just know that there are solutions and that there is help out there. But you have to advocate for yourself.
Betsy Greenleaf, DO, FACOOG (Distinguished)
What other things do you find that people tend to get worried about with prolapse? Just going through my catalog, I think one of the things that people think about is if I do not fix it, is it going to get worse? Or, what is going to happen if I leave it alone?
Tabatha Barber, DO, FACOOG, NCMP, IFMCP
I would say that, from my experience, it usually gets worse. Because you need to be proactive. You need to change your diet and start eating more protein-rich foods, getting those amino acids in to help heal your muscles and your collagen, adding extra collagen supplementation, and maybe changing how you are working out. Or do you have a chronic cough from reflux or a lung issue that you need to take care of? So all of those things—do you have extra weight you need to release? That is a whole other topic.
The doctor says to just lose weight. Okay. Well, if we could have done that, we would have already. Thanks for the great advice. You are a genius. However, indeed, carrying extra weight is related to pelvic prolapse. If you can do some functional medicine work and get to the root cause of why you cannot release that extra weight that you could potentially be carrying, that can help a ton, especially with bladder stuff. For some people, they get afraid. They get afraid that it is going to cause cancer or something like that. It is not going to; it is just annoying; it is uncomfortable. As you said, it has been a problem for women since the beginning of time.
Betsy Greenleaf, DO, FACOOG (Distinguished)
I always say that unfortunately, nature does not care that our vaginas stay where they are supposed to be. The key is to get the baby out. We have breakaway zones, unfortunately, and then, certain things that we do during childbirth can sometimes aggravate that, or sometimes it is just the luck of the draw.
Tabatha Barber, DO, FACOOG, NCMP, IFMCP
Somehow, you just made me think of something I do want to say: having a hysterectomy,
Betsy Greenleaf, DO, FACOOG (Distinguished)
Yes.
Tabatha Barber, DO, FACOOG, NCMP, IFMCP
Does not preclude you from getting a prolapse. By removing those organs, you can hopefully avoid removing the bladder and the rectum, but removing the uterus does not prevent prolapse. Often, we see vaginal vault prolapse. We close the shot at the top of the vagina where the cervix was after removing the uterus and cervix. We call that the vaginal cuff. Your vagina turns into a sac. It is just a little tunnel with a closed-up top. But that top can fall, and that can come out of the vagina, and you can have vaginal vault prolapse.
That is pretty darn common with hysterectomy because a lot of gynecologists are not trained in how to protect those ligaments and not destroy them during the hysterectomy or to support them and tack them up afterward. I would say I probably saw the most prolapse post-hysterectomy from other gynecologists doing hysterectomy. Then they would come to me with the prolapse. Just keep that in mind, and I think we trained at the same time when mesh was all the rage,
Betsy Greenleaf, DO, FACOOG (Distinguished)
Yes. I came out when we were putting in mesh left and right and I go, Why were we doing that?
Tabatha Barber, DO, FACOOG, NCMP, IFMCP
We were doing that on 35 and 40-year-olds with grade one and two prolapses that should not have had mesh, but it was all the rage and everybody’s favorite as the greatest. As you will never have to have surgery again. Mesh is the fix.
Betsy Greenleaf, DO, FACOOG (Distinguished)
As this is going to fix everything.
Tabatha Barber, DO, FACOOG, NCMP, IFMCP
Everything. Because there were little anchors on these pieces of mesh that would anchor into your pelvic bones. So, yes, that is a great idea that it is going to be a hammock. It is going to hold everything up. It is never going to fail. We did not account for all the erosion and things that would grow and put holes in our bladder, in our vaginal walls, and in our rectum. If people were not trained properly, the anchors would be in the wrong places and cause artery injuries and nerve injuries with chronic pain.
Unfortunately, women are guinea pigs in the medical system. Let us just be honest, and I still apologize to this day that I was part of that. But once you do better, you do better. We did not know we were residents. This is how we were trained. Then all the backlash came after that. This is not to say that mesh is not useful and necessary sometimes, but it is usually after you have failed a traditional surgery and you have tried other means. I would use mesh as a last resort, and I would make sure that your vagina is very healthy. You have a good vaginal microbiome, and you have good estrogen replacement to keep that vaginal tissue healthy so that the mesh does not have erosion and does not show through because then you are going to have major chronic pain with intercourse and all sorts of issues. Yes, that was quite the thing.
Betsy Greenleaf, DO, FACOOG (Distinguished)
I agree because I trained during that period too, and I go, it is what we know now. But I think near the end of my surgical career before I retired, I was the surgeon who did not do surgery because I started getting to the point: why are we doing surgery when there are all these risks? What is the worst thing that can happen? I always tell people, and this is what I would tell my patients: the time to have surgery is when it bothers you enough, whether that is physically or mentally, that you are willing to take on the risks of surgery and that you have not tried everything else first.
Surgery should not be the first thing; it should be the last thing. Not that I want to bash traditional medicine, but I am so many people have heard me tell this story. Before I retired, I was working at a hospital where we had a guy who was dressed straight out of fellowship, and our salaries were based on how many points we got in every procedure, which had a point value. I came into work one day, and this newly graduated fellowship-trained surgeon was in our office, and he had seen his patients. I see him with the book. I asked him, What are you doing? It is the book with all the hours relative, the code, and the relative value units, and he was deciding on what surgery to do on somebody based on how many points he was going to get. That is something, but not that. This is a small, as much as we bash sometimes on traditional medicine, that is a small portion of the medical field. But I always tell people that if you go to a surgeon, they are going to tell you to do surgery.
Tabatha Barber, DO, FACOOG, NCMP, IFMCP
Absolutely. You are speaking the truth and now is the truth. As much as I am an advocate for women and I went into this field to help women, I loved being a surgeon, and I got caught up in it just as much as a lot of other people. Thankfully, I never completely lost my mind. But you are right that a lot of times those financial incentives drive surgeons’ decisions, and gynecologists are surgeons.
We are not hormone experts. I had to go to extra schooling through functional medicine for them. All these things to learn how to handle hormones and take care of women’s functional health. I was a surgeon. I did hysterectomy and prolapse, repairs, colposcopy, and stuff, C-sections, and delivered babies. I used my hands, and so we were just looking at the wrong people, and we were expecting the wrong options from them, essentially. Just know that.
Betsy Greenleaf, DO, FACOOG (Distinguished)
Yes, I just say, The biggest question to ask is: do I need this? What would happen if I did not do it? If it is as long as you ask then you have to ask yourself, how much does this bother you? It could be that it is mentally bothering you. It could bother you to the point where I am freaked out that my vagina is hanging out. Yes. I have had ladies that have come in whose vagina is inside out—you said, a sack. They have been sent by their gynecologists. I checked, as long as there were not any other medical problems. We go. Is it bothering you? No, I just push them up when it bothers me. Then. Let us come back in six months, and I will just keep an eye on it. As long as nothing else is happening and it is not affecting your kidneys or your bladder, you can leave it alone.
Tabatha Barber, DO, FACOOG, NCMP, IFMCP
Absolutely. That is where the pelvic PT, the pessary, and all the other options come in so handy. Surgery is incredible. I have saved lives, I have saved babies, things like that. I saved people from bleeding to death. It is required sometimes and I get it. But surgeons do like to do surgery, so just know that you might not need it as a major thing.
Betsy Greenleaf, DO, FACOOG (Distinguished)
Is there anything else that I did not ask you about prolapse that you think is important for us to know?
Tabatha Barber, DO, FACOOG, NCMP, IFMCP
I think just be wary of the signs and symptoms; it might be more bladder-related or more bowel movement-related, especially if things have changed for you. If you are going along and you have had normal bowel movements a healthy bladder and a healthy sexual life, then it is, and now I am constipated. Or my stools look like pencils. They are thin and long, or yes, I am not enjoying intercourse. It feels uncomfortable. I can only do certain positions, that type of thing. Then it sounds like something’s changed, and you need to get it checked out for sure.
Betsy Greenleaf, DO, FACOOG (Distinguished)
Well, that is it. This has been amazing. Thank you so much, Dr. Tabatha, for talking with us. Where can people find out more information about you?
Tabatha Barber, DO, FACOOG, NCMP, IFMCP
It is so easy, drtabatha.com, drtabatha.com
Betsy Greenleaf, DO, FACOOG (Distinguished)
Everybody, go make sure you check out Dr. Tabatha on this site and stick around because we have more great sessions coming up.
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An amazing presentation! I am a 30-year bladder prolapse from a very traumatic delivery in 1993. I have avoided for years the reactive comment to get a hysterectomy or reconstructive surgery; to this day still. I am now 62 and a breast cancer survivor (early stage) but that Tamoxifen is affecting gut which then affects prolapse. Very glad I finally got to sit down and listen to Dr. Barber; how refreshing!!!!!! I may reconsider a pessary discussion with the urogynecologist nurse practitioner. Finally got estradiol from an oncologist/sexual health practitioner who also gets the effects of Tamoxifen. I have been my own health advocate for years so this talk is my favorite one yet. I am a whole person not a body part but the medical world is so specialized and not sure that will ever changed. I love my Pelvic PT. Sadly from 1993-1996 was sent home with no help, like Dr. Betsy said. Thank you for this. It has showed me that I have done the right thing.