In Your Pants with Dr. Susie G Dr. Susie G

Today, we delve into a topic that may have raised a few eyebrows 🤨: the prescription of vibrators for pelvic floor and sexual health for men and women. Yes, you read that correctly! In this podcast episode, I had the privilege of hosting Dr. Alexandra Dubinskaya, MD, who shared her  research findings on this intriguing (and taboo) subject.
**Meet Dr. Alexandra Dubinskaya, MD**
Dr. Alexandra Dubinskaya is a board-certified gynecologist specializing in female pelvic medicine, reconstructive surgery, menopause, and women's sexual health. She is not only a dedicated clinician but also a passionate advocate for her patients. As the Chair of the Communication Committee for the International Society of Sexual Medicine, she has actively contributed to advancing medical care for women through research.
We cover topics such as:
- 00:00 Introduction
- 02:40 Dr. Dubinskaya’s motivation to research vibrators for pelvic floor health
- 04:11 A tool that women (and men) use to support their pelvic floor muscles
- 05:10 How vibrators work on the body
- 05:45 Vibrator use benefits on sexual function, incontinence, and pelvic floor muscles
- 07:10 External or internal vibrator stimulation; is one better than the other?
- 09:30 Benefits using vibrators for men’s pelvic floor and sexual health
- 11:15 Women who use vibrators partner’s improve their sexual function
- 12:23 Aging, sex, pelvic floor health
- 15:14 Considerations for vibrator use in older population
- 16:00 Will long term vibrator use make it harder to orgasm?
- 18:55 Can manual stimulation offer similar effects to a vibrator?
- 19:45 How do we define and measure orgasm?
- 22:47 Orgasms change with age
- 24:03 Barriers for vibrator use
- 27:29 Adverse reactions with vibrator use
- 29:50 How clinicians can talk about sexual health with their patients

RESOURCES:
Free sex and pelvic pain resources https://drsusieg.com/resources
Online Pelvic Pain Relief Program for Men https://drsusieg.com/pelvic-pain-in-men-online-program

CONNECT WITH DR. ALEXANDRA DUBINSKAYA, MD:
Website: http://drurogyn.com/
Instagram: @a.dubinsky
Twitter: @dubinsky_a
Facebook: https://www.facebook.com/alexandra.dubinskaya.7

CONNECT WITH ME (DR. SUSIE) AND TEAM:
Website: https://drsusieg.com/
Instagram: https://www.instagram.com/dr.susieg/
___________________________________________________________________________
Disclaimer:
This information is not intended to substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a healthcare professional with any questions you may have regarding treatment, medications/supplements, or any medical diagnoses. This information is intended for educational purposes only and is in no way to substitute the advice of a licensed healthcare professional.
#pelvicfloor #sextoys #pelvicfloorexercises #vibrators #pelvicfloorhealth 

Sex after prostate cancer treatment can be a goal for some men and not a priority for others, but recovery is all connected. Taking time to address sexual health concerns will simultaneously improve urinary incontinence. It’s time to revitalize your pleasure.
In this special 4-part series featuring Dr. William Mills, PT, DPT and Dr. Susie Gronski, PT, DPT we delve into insights and solutions centered on the treatment and rehabilitation of men's pelvic and sexual health following prostate cancer.
Dr. William Mills, PT, DPT is a physical therapist who specializes in male pelvic rehabilitation, particularly post-prostatectomy and chronic pelvic pain. With a forte in manual therapy and corrective exercises, he enhances outcomes, enabling men to regain urinary control, bowel function, erectile function, and overcome pain. Together with his colleagues at Alinea Performance, he is committed to assisting men of all ages in enhancing their quality of life.
00:00 Introduction
03:30 How erections are good for your health
05:22 Using a penis pump after prostate cancer treatment
07:50 Focusing on pleasure over performance
09:31 Becoming comfortable with new sexual experiences
13:00 It’s all connected!
16:20 Shock wave therapy and vibration stimulation
18:20 Holistic approach to recovery
**Reframing Sex Post-Prostatectomy**
I’m not going to sugar coat it: things are different than they were, but your capacity for pleasure is limitless! Connect with your pleasure rather than the performance. While using something new to help you get erect may seem unfamiliar, getting comfortable with it is only a temporary hurdle. Once you’re comfortable, you’re free to keep swinging.
**Strategies For Getting Hard**
At this phase, you want to focus on blood flow. Tools like the penis pump, medications like Cialis or Viagra, and techniques like physical touch can help you get and maintain an erection. But remember: it’s not just starting in body, you also need to get your brain involved and retrain your neural pathways with mental arousal.
**Your Concerns Are Interconnected**
Recovery is a package deal. There’s research that supports using a penis pump can improve urinary incontinence. Focusing on all things that have changed will bring your recovery faster and farther.
**How Pelvic Floor Physical Therapy Can Help**
Pelvic floor physical therapists think outside the box, considering your personal experiences, physical health, a hands-on exam, and what matters to you most. We look to see what treatments are on the table for you and which to try first. Everyone is unique and some particular modalities or treatments may be more or less beneficial for some.
RESOURCES:
Free sex and pelvic pain resources https://drsusieg.com/resources
Online Pelvic Pain Relief Program for Men https://drsusieg.com/pelvic-pain-in-men-online-program
CONNECT WITH DR. WILLIAM MILLS:
Website: www.alineaperformance.com
Instagram and Facebook: docmills.dpt
Twitch: docmillsdpt
CONNECT WITH ME (DR. SUSIE) AND TEAM:
Website: https://drsusieg.com/
Instagram: https://www.instagram.com/dr.susieg/
___________________________________________________________________________
Disclaimer:
This information is not intended to substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a healthcare professional with any questions you may have regarding treatment, medications/supplements, or any medical diagnoses. This information is intended for educational purposes only and is in no way to substitute the advice of a licensed healthcare professional.
#prostatehealth #prostatecancer #prostatectomy

Many men experience urinary incontinence after prostate cancer. It’s common to delay treatment, thinking that it’ll go away on its own, but there are many strategies you can start using right away to stop peeing and start living again.
In this special 4-part series featuring Dr. William Mills, PT, DPT and Dr. Susie Gronski, PT, DPT we delve into insights and solutions centered on the treatment and rehabilitation of men's pelvic and sexual health following prostate cancer.
Dr. William Mills, PT, DPT is a physical therapist who specializes in male pelvic rehabilitation, particularly post-prostatectomy and chronic pelvic pain. With a forte in manual therapy and corrective exercises, he enhances outcomes, enabling men to regain urinary control, bowel function, erectile function, and overcome pain. Together with his colleagues at Alinea Performance, he is committed to assisting men of all ages in enhancing their quality of life.
Our episode covers topics including:
00:00 Introduction
01:00 Bladder retraining for post prostatectomy
01:26 Pelvic floor contractions in treating urinary incontinence
02:23 Cueing pelvic floor contractions with Star Wars
03:42 Applying pelvic floor contractions to improve daily activities
**Intake and Output**
Start by taking note of how much water you currently drink a day: the goal you should aim for is ~half your body weight in ounces of water. Also note how often you go to the bathroom: the goal you should aim for is creating a bladder schedule where you pee every 2-3 hours. If you’re nowhere close to that 2-3 hours, don’t panic and don’t force yourself to hold it. A pelvic floor physical therapist can plan out a treatment path to get you where you’re at to where you want to be.
**Pelvic Floor Contractions**
Pelvic floor contractions are a coordinated effort with key three areas: simultaneously pulling in and lifting back of the pelvic floor, lifting the testicles upwards, and lifting the rectum towards your belly button. If you’re struggling with these movements, you’re not alone. Many men feel more confident with contraction exercises after working with a physical therapist.
RESOURCES:
Free sex and pelvic pain resources https://drsusieg.com/resources
Online Pelvic Pain Relief Program for Men https://drsusieg.com/pelvic-pain-in-men-online-program
CONNECT WITH DR. WILLIAM MILLS:
Website: www.alineaperformance.com
Instagram and Facebook: docmills.dpt
Twitch: docmillsdpt
CONNECT WITH ME (DR. SUSIE) AND TEAM:
Website: https://drsusieg.com/
Instagram: https://www.instagram.com/dr.susieg/
___________________________________________________________________________
Disclaimer:
This information is not intended to substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a healthcare professional with any questions you may have regarding treatment, medications/supplements, or any medical diagnoses. This information is intended for educational purposes only and is in no way to substitute the advice of a licensed healthcare professional.
#prostatehealth #prostatecancer #prostatectomy

After prostate cancer, men often grapple with urinary incontinence, sexual dysfunction, and other pelvic floor challenges. The significance of pelvic floor rehabilitation is that it can mitigate symptoms after prostate cancer and help you quickly get back to enjoying the activities you love. Whether it's regaining intimacy or achieving better bladder control, getting an early start can set you years ahead on your recovery path. 
While it's expected to face new and persistent symptoms, it’s empowering to know that with tailored rehabilitation methods, these challenges can be temporary.
In this special 4-part series featuring Dr. William Mills, PT, DPT and Dr. Susie Gronski, PT, DPT we delve into insights and solutions centered on the treatment and rehabilitation of men's pelvic and sexual health following prostate cancer.
Dr. William Mills, PT, DPT is a physical therapist who specializes in male pelvic rehabilitation, particularly post-prostatectomy and chronic pelvic pain. With a forte in manual therapy and corrective exercises, he enhances outcomes, enabling men to regain urinary control, bowel function, erectile function, and overcome pain. Together with his colleagues at Alinea Performance, he is committed to assisting men of all ages in enhancing their quality of life.
Our episode covers topics including:
00:00 Introduction
00:35 Deciding on radiation or prostatectomy for prostate cancer
02:01 Urinary incontinence post-prostatectomy
04:26 Sexual function challenges post-prostatectomy
06:04 Viagra and Cialis post-prostatectomy
07:03 Treatment approaches for post-prostatectomy
11:44 Should I go to the doctor for post-prostatectomy symptoms?
**Delaying Treatment:**
You’re not alone. Many men experience sexual difficulties and urinary incontinence post prostatectomy. When concerns are not addressed early on, they may become more difficult to treat as time goes on, leading to unnecessary long-term suffering and reduced quality of life. There’s help and there’s hope. 
**Prostate Cancer Rehabilitation Options:**
A comprehensive understanding of post-treatment rehabilitation for prostate cancer is key. While the key decision may feel like deciding between radiation and prostatectomy, there are many decisions for after-cancer care.
**Intimacy After Prostate Treatment:**
Some men experience reduced sensation in their penis and erectile dysfunction, feeling less connected to physical stimuli and their sexual selves. Nerve injury and diminished blood circulation, which can be a result of prostate cancer treatment like prostatectomy, can lead to reduced penis sensation and erectile dysfunction. Penile vibratory therapy, a penis pump, and medications are just a few treatment options that can help in improving blood circulation and erectile function. An individualized approach is best. 
**Urinary Incontinence After Prostate Treatment:**
By addressing bladder habits, such as hydration and reducing potential bladder irritants, and with functional pelvic floor exercises, recovery can be expedited and post-treatment symptoms like incontinence can be mitigated. Proactively seeking knowledge and tailored rehabilitation strategies enables you to regain urinary control, greatly enhancing your quality of life outside the bathroom.
RESOURCES:
Free sex and pelvic pain resources https://drsusieg.com/resources
Online Pelvic Pain Relief Program for Men https://drsusieg.com/pelvic-pain-in-men-online-program
CONNECT WITH DR. WILLIAM MILLS:
Website: www.alineaperformance.com
Instagram and Facebook: docmills.dpt
Twitch: docmillsdpt
CONNECT WITH ME (DR. SUSIE) AND TEAM:
Website: https://drsusieg.com/
Instagram: https://www.instagram.com/dr.susieg/
___________________________________________________________________________
Disclaimer:
This information is not intended to substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a healthcare professional with any questions you

Prostate cancer patients face a multitude of challenges post-treatment. From incontinence to erectile dysfunction, the journey to recovery can be daunting, and finding the right prostate cancer pelvic floor therapist for you becomes paramount.
In a special 4-part series featuring Dr. William Mills PT, DPT and Dr. Susie Gronski, PT, DPT we delve into insights and solutions centered on the treatment and rehabilitation of men's pelvic and sexual health following prostate cancer.
Dr. William Mills, PT, DPT is a physical therapist who specializes in male pelvic rehabilitation, particularly post-prostatectomy and chronic pelvic pain. With a forte in manual therapy and corrective exercises, he enhances outcomes, enabling men to regain urinary control, bowel function, erectile function, and overcome pain. Together with his colleagues at Alinea Performance, he is committed to assisting men of all ages in enhancing their quality of life.
Our episode covers topics including:
00:00 Introduction
00:35 Prostate cancer journey
01:04 How to find a male pelvic health physical therapist
02:04 Post prostate cancer treatment in Baton-Rouge Louisiana
03:34 Pioneers in the male pelvic health space
04:00 Treatment plans post-prostatectomy
04:58 Early warning signs and rehabilitation for prostate cancer
05:56 The Prosfit app for post-prostate cancer treatment
07:52 How prostate cancer symptoms affect daily life
**Need for More Expert Male Pelvic Health Therapists:**
Everyone has a pelvic floor, including you, and it plays a pivotal role in concerns such as erectile dysfunction and urinary incontinence. Unfortunately, due to societal stigmas and narrowly focused marketing, there's a disconnect in the availability of pelvic health therapists specializing in men's care. Addressing this educational and accessibility gap is crucial for providing comprehensive healthcare to those who need it most.
**Leading Voices in Care for Male Pelvic Health:**
Dr. Susie G and Dr. Jo Milios are at the forefront of efforts to educate both patients like you and physicians about male pelvic health while improving access to necessary care. Dr. Susie is the founder of a pelvic and sexual health clinic exclusively for men, serving patients in-person in Asheville, North Carolina and globally online. Her clinic brings together the expertise of pelvic floor physical therapy, pelvic floor occupational therapy, nutrition, sex therapy and mental health. Meanwhile, Dr. Milios's research promotes sexual recovery and continence control through tailored pelvic rehabilitation using pelvic specific exercises for men and therapeutic ultrasound for Peyronie’s Disease that can be adopted to improve therapeutic outcomes post prostatectomy.
**Confronting Chronic Challenges in Post-Prostate Cancer Care:**
Issues accompanying prostate cancer, such as erectile dysfunction and urinary incontinence, can severely hinder your quality of life. These conditions extend beyond physical repercussions, also taxing mental and emotional health. It's essential to understand that for many who have accepted these issues as the new norm, there are avenues to alleviate or even completely overcome these concerns.
RESOURCES:
Free sex and pelvic pain resources https://drsusieg.com/resources
Online Pelvic Pain Relief Program for Men https://drsusieg.com/pelvic-pain-in-men-online-program
CONNECT WITH DR. WILLIAM MILLS:
Website: www.alineaperformance.com
Instagram and Facebook: docmills.dpt
Twitch: docmillsdpt
CONNECT WITH ME (DR. SUSIE) AND TEAM:
Website: https://drsusieg.com/
Instagram: https://www.instagram.com/dr.susieg/
___________________________________________________________________________
Disclaimer:
This information is not intended to substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a healthcare professional with any questions you may have regarding treatment, medications/supplements, or any medical diagnoses. This informati

It’s human nature to get excited by the latest and greatest treatments, from outer space to muscle tone pelvic pain, we’re captivated by scientific advancements. But this enthusiasm has a dark side, causing many clinics and patients to exchange simple and effective strategies for flashy new treatments that come with a hashtag.
Dr. Rachel Worman is a licensed physical therapist (PT) who has experience in acute care physical therapy and extensive dual training, clinical and teaching experience in musculoskeletal and pelvic health physical therapy. After 13 years of clinical practice, Dr. Rachel earned her PhD with a focus on pelvic health outcome measures and male pelvic health.
We cover topics such as:
1:15 What to call it? Hypertonic pelvic floor, overactive pelvic floor, tight or non-relaxing pelvic floor muscles?
8:55 How and who treats pelvic floor dysfunction
10:30 Educating patients with pelvic pain and choice of language
16:37 Uncertainty and the biopsychosocial model
17:40 Pain and hypertonicity
20:00 ICS and reasoning scale
36:00 EMG biofeedback for pelvic floor physical therapists
45:00 Internal and manual therapy for male pelvic pain
51:30 Psychosexual measures and sleep, hormonal, or musculoskeletal factors
55:00 Bridging research with clinicians on social media
Pelvic floor physical therapists and patients have to be mindful of the influence that media (including social media and speakers at conferences) has on trending treatment ideas and how common it is for a 10-second video on social media to hijack a patient’s treatment plan, simply because it wasn’t a good fit.
There’s no one-size-fits-all treatment strategy for pelvic pain, which is why there many treatment strategies. Through critical evaluation, clinicians must determine the most appropriate and effective treatment strategy, or combination of strategies, for that single patient. Dr. Rachel shares how important it is for clinicians to be flexible, individualized, and science-based, and to avoid getting caught up in clinical habits of using one hallmark treatment for all patients.
In such a difficult field, where all the measures we have for tone are problematic, these  generalizations and trending treatment ideas, while good for marketing, ultimately delays effective treatment and harms patients. It’s necessary to prioritize the knowledge of evidence-based practices and personalized care to ensure optimal outcomes for patients.
RESOURCES:
Free sex and pelvic pain resources https://drsusieg.com/resources-for-pelvic-pain-in-men
Online Pelvic Pain Relief Program for Men https://drsusieg.com/pelvic-pain-in-men-online-program
Research paper on resting pelvic floor muscle activity https://academic.oup.com/ptj/article-abstract/102/7/pzac059/6585840?redirectedFrom=fulltext&login=false#no-access-message
CONNECT WITH RACHEL WORMAN:
Website: https://www.researchgate.net/profile/Rachel_Worman
Instagram: @pelvic.fiiit.facts
Twitter: @rachel_worman
CONNECT WITH ME (DR. SUSIE):
Website: https://drsusieg.com/
Instagram: https://www.instagram.com/dr.susieg/
___________________________________________________________________________
Disclaimer:
This information is not intended to substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a healthcare professional with any questions you may have regarding treatment, medications/supplements, or any medical diagnoses. This information is intended for educational purposes only and is in no way to substitute the advice of a licensed healthcare professional.
#tightmuscles #pelvicpain #pelvicfloorphysicalthearpy