The Thing I Finally Put Down Or: Perimenopause Is Not My Friend, Episode 4

Click here for Episodes one, two, and three. Or just read on.

When I got pregnant ten years ago, I gained 55 pounds (25 kgs). I didn’t do pelvic floor therapy before pregnancy, during pregnancy, or after. I didn’t even really know it was a thing I was supposed to be thinking about.

Then, slowly, as my daughter grew, so did my inability to control my bladder.

Stress incontinence is the unglamorous term for peeing when you sneeze or cough or jump or skip or… It’s not constant, but it’s often enough to be annoying. If I’m walking down the street and I feel a sneeze coming, I instinctively cross my legs like a cartoon character. Sometimes I make it in time. Sometimes I don’t.

It’s embarrassing. It’s inconvenient. And according to everything I’ve read and heard, it’s also not something I just have to live with.

It’s fixable.

So I tried.

A few years ago, I decided to pursue pelvic floor therapy here in Jordan. At the time, there was only one practitioner in the whole country that I knew about. I saw her for a couple of months. I went regularly. I did the exercises. I showed up.

Nothing changed.

Even though my insurance covered it, it was still costing me time, emotional energy, and mental space. It started to be one of those things living rent free in my penthouse.

So, I stopped.

A year or so later, I ended up seeing another physical therapist for something unrelated and learned she also did pelvic floor work. I tried again. Same story. No noticeable improvement. Same creeping sense of failure.

I knew it wasn’t her. She’s magical with the injuries I seem to collect, and I still see her to this day.

Some people say, “Just do your Kegels.”
And to them I say, “YOU just do YOUR Kegels.”

The experts know that for most of us, it takes more than that. And I was doing more than “more than that” and still peeing when I sneezed. I felt like I was bad at pelvic floor therapy. Like I was failing at something my body was just supposed to get.

Then I talked to my cousin, Sam, who is a pelvic floor specialist in the U.S. (click the link, she’s the tiny-but-terrifyingly-capable one in the middle). We decided to try virtual therapy. She was upfront that she hadn’t done it before and that in person work usually includes internal exams and treatment, which obviously wasn’t possible over video.

So we adapted, working together for months on video calls.

This was the first time I noticed any real difference. Subtle, but real. Thanks to Sam’s thorough explanations and skillful guidance, I understood for the first time what my pelvic floor looked like, what was expected of it, and why it was likely not playing ball.

Still, nothing life changing happened. I was still dealing with stress incontinence. I was still expected to do daily pelvic floor work on top of other physical therapy, exercise, 10K steps a day, work, parenting, and just being a human.

And slowly, the present emotional cost started to outweigh the potential future physical benefit.

So I tried the tools Sam recommended.

Two different insertable devices. Things that promise support and relief.

No support. No relief.

Pelvic floor therapy became another perimenopausal reminder that my body was failing. Another daily reminder of something that needed fixing. Another demand on my already limited energy and my already whacked out body.

The time I was spending on pelvic floor therapy was time I wasn’t spending on other physical therapy that mattered more to my daily comfort. Or on fitness that made me feel strong. Or on hanging out with my daughter. Or learning a language. Or writing. Or resting.

So, I stopped.

Pelvic floor therapy isn’t the ROI I’m looking for at this point in my life.

Sam and I had what I call a great breakup call. She didn’t fire me as a patient. She didn’t shame me. She told me she’s always there. She gave me resources, and we made a plan for me to see her in person when I’m back in the U.S. this summer.

She gave me a few maintenance exercises to keep things from getting worse until I can see her. I’ll keep doing those. (Don’t tell her I haven’t done them in the last month though.) I’m jealous of Sam’s patients that get to experience the full in-person package, but I’ll take what I can get.

And still, I pee when I sneeze.
I pee when I cough.
I pee when I run.

Yes, it’s irritating.
Yes, I want to fix it.

But also. There are about one hundred things higher on the list that feel more urgent.

My nervous system.
My kid.
My business.
My sense that my body is speaking a language I don’t fully understand anymore.

So, for now, I’ve set it down.

And the relief I feel isn’t physical. It’s mental.

I stopped carrying the story that I should be fixing this right now. I stopped giving precious penthouse space to something that, at least in this season, costs me more than it gives back.

I’ll pick it up again later. Maybe with better tools, better timing, more capacity. But not now.

What in your life do you need to put down?

Maybe it’s your pelvic floor. Maybe it’s a project, a goal, a self improvement effort, or a should you’ve been dragging around that feels like too much. Maybe it’s something totally different.

What if you set it down?
Maybe not forever.
Maybe just for this moment.

P.S. If you’re not in the Philadelphia area and Sam’s brilliance is also inaccessible to you, you can follow Pelvio PT on Instagram for tips that make your pelvic floor far less of a mystery.