Things Women Don’t Want to Talk About with Dr. Sarah Boyles

Dr. Sarah: [00:00:00] People are just afraid to bring it up and that just makes it all so much harder for everybody. And I, you know, it’s really isolating because lots of women think that they’re the only person that that have this. And so then, you know, we’re not sharing the little things that can really help 

Hope: Do you want to wake up feeling like you’re stepping into who you’re meant to be into the best possible version of you?

What if I told you that the key to your best life health and happiness are all around you? You just have to find what works for you I’m Hope Pedraza and I believe that there isn’t just one way to live a healthy and meaningful life, and that all you need is a little inspiration to make changes that last from the inside out.

Each week I’ll be sharing tangible tips and inspirational interviews to help you on your journey. These are the steps to take to improve your life and live with purpose. This is hopeful and wholesome. Hey y’all, thanks for listening today. Today I have on the show, Dr. [00:01:00] Sarah Boyles. Dr. Boyles is a urogynecologist who specializes in female pelvic floor health.

She teaches women about how their bladder works, where it can go wrong, and how to make it better. And this is exactly what we’re talking about on the show today. This is all for the ladies listening. So, Dr. Boyles really empowers women to manage their leakage and win back their confidence and that’s what we’re going to talk about today.

All the misconceptions around pelvic floor health, who it affects, which, spoiler alert, it can affect anyone. It’s not just for those who have had kids or for women who are advanced in age. So we’re going to talk about all the misconceptions, what you can do about all the things that we really don’t want to talk about, like leaking when you hop around or when you’re working So I hope you’ll get something out of this episode and you can even reach out to Dr. Boyles after this episode. And I’m really excited to teach you a little bit of something today about your body and empower you to take control if you’re dealing with any of these things that we’re talking about today. So [00:02:00] y’all enjoy. Okay, y’all let’s get going. I’m so excited to bring on Dr. Sarah Boyles today She is gonna teach us all a little something about pelvic floor health And I’m really excited to have her teach all of us a little something.

So thanks so much for joining me. Dr. Boyles 

Dr. Sarah: Thanks for having me. I’m so happy to be here. 

Hope: Yeah, me too. So let’s start with the basics So, can you tell us just in layman’s terms? For everyone out there, what is our pelvic floor? 

Dr. Sarah: So that is a great question. I’m so glad you asked that. So your pelvic floor is a group of muscles.

Those muscles go from your hip, one hip to the other hip, and then from your pubic bone to your tailbone. And those muscles are shaped like a bowl, and they hold up your pelvic floor organs. So in women, they hold up the bladder, they hold up the uterus and the vagina, they hold up the rectum. And these muscles are kind of interesting in that, you know, for women, there are three holes in these [00:03:00] muscles.

One for the bladder, right? You kind of pee through these hole, through the hole there. There’s a hole for the vagina, and then there’s a hole for the rectum. 

Hope: And you, I know you work primarily with women, but this isn’t just a women’s thing. Men have a pelvic floor too, right? 

Dr. Sarah: They do have a pelvic floor.

It’s a little bit different, right? Because I know everyone knows that they have two holes, not three holes, right? Cause there’s no vagina there. You hear about the female pelvic floor a lot more just because our pelvic floor gets more of a workout. And a lot of that has to do with pregnancy and delivery.

Pregnancy affects the pelvic floor. It’s not just vaginal deliveries. But in a vaginal delivery, that pelvic floor, those muscles stretch 200 percent more than they do when you’re not delivering. So it’s pretty amazing that they can stretch so much and then come back to normal, right? I mean, the female [00:04:00] body is amazing.

Hope: Yeah, that’s, I agree. That is crazy. 

Dr. Sarah: Things you might not want to think about too much, right? But I mean, that’s pretty amazing that it can stretch that much and most of the time come back to, you know, something comparable to what it was before. Maybe not the exact same, but comparable. 

Hope: Yeah. Yeah. Right. And I guess that kind of leads us into, you know, what we want to talk about today.

And I know, you know, I know the answer to this, and I’m sure many of the women listening to this know the answer to this, but what is the biggest issue that you see regarding the pelvic floor and pelvic floor health that ladies come to see you about? 

Dr. Sarah: I think the biggest issue is probably bladder leaking.

So a lot of, you know, that pelvic floor mechanism is pretty delicate, and the way we’re designed It’s pretty easy for things to change over time, change with deliveries. And for women to have leaking there are two big [00:05:00] forms of leaking in women So stress incontinence, which is leaking with exercise And coughing anytime you have a pressure in your belly that kind of pushes out the urine and then also overactive bladder so overactive bladder Is when your bladder muscle spasms a little bit and you feel like you have to go to the bathroom all the time You have to go pretty urgently.

Sometimes you can’t quite get there And then some people get Both, where you can have stress incontinence and overactive bladder, and we call that mixed urinary incontinence. I see women for a lot of other things too, sometimes birth injuries, sometimes prolapse, which is a hernia of the vagina. You know, in some ways I feel like the female pelvis is kind of a, a black box and we don’t understand it very well.

And so sometimes people. just come in to see if they’re normal. Right. And kind of how they compare to other people and how their function compares to other people. You know, it’s one part of the [00:06:00] body that most of the time you just don’t know how you stack up compared to other people. 

Hope: It’s true. It’s true.

Dr. Sarah: Right. And it’s also a part of the body that we don’t talk about a lot. And so You know, sometimes people just have a lot of, a lot of questions. I saw a woman yesterday in the office who, you know, was young, she was about 38. And she came in because she was leaking during tennis. And she was so funny because she came in and she said, you know, before I came, I was talking with a couple of my girlfriends and they all leak too.

And she had never spoken to her friends about it. And I hear that every day in the office. And I, I think that’s just such a big problem here, right? Because even with our closest friends, we’re not, we’re not talking about these things. 

Hope: Right. And it’s, why do you think it’s so taboo? Like, I mean, we’re all women, so we all have the same parts, so why do you think it’s so taboo to talk about it?

And do something about it? 

Dr. Sarah: I think, because we’re all a little bit embarrassed, right? And we all I think we’re all just [00:07:00] trying to be a little bit perfect. And I think when you know, you’re leaking or You know, maybe you have pain with something, you know, you’re, people are just afraid to bring it up and that, that just makes it all so much harder for everybody.

And I, you know, it’s really isolating because lots of women think that they’re the only person that, that had this. And so then, you know, we’re not sharing the little things that can really help. And it, you know, sometimes it’s just simple little things like. You know, there are incontinence pads and there are menstrual pads, and the incontinence pads hold a lot more.

And they’re designed to hold, you know, a clear liquid, not something thicker like blood. And so they work a lot better. And so for some people, they just need to use an incontinence pad instead of a menstrual pad and that’ll, you know, help them do whatever they want. And you know, little things like that, we just don’t [00:08:00] talk about.

Right. Or incontinence underwear. You know, there’s this whole industry now with. That works for menstruation and underwear that works for incontinence. And those are great, great items because they make people feel more normal because you’re wearing underwear, not a pad. And some people just hate wearing pads.

So, yeah, I think it’s, you know, it’s, it’s It’s a great question. I don’t know why we don’t talk about this because we talk about everything else, and why is it okay to talk about sex but not leaking? I don’t have a great answer for that. Or constipation, right? I feel like every other ad on TV is about constipation.

But yeah, that’s a great question, and I think that that’s something that really needs to change where we just need to talk about it. 

Hope: Well, and I think, too, like you said, I think it’s a lot more common than most people think, than most women think, and think people are just, like you said, they’re free to talk about it, but then they also don’t know what to do about it.

[00:09:00] Like, what can they do? Right. They think that, oh, this is what it is. And that kind of leads me to my next question, because I know, I hear lots of things. So we have, one of the classes we have in the studio is trampoline classes, and there’s a lot of women who shy away from it because of all the bouncing, right?

And they’re like, well, I don’t want to pee my pants the whole class. And so, you know, we hear this, I’ve had four kids, blah, blah, blah. Like, there’s no way I can fix what’s happening down there. So can you debunk this or is this true? 

Dr. Sarah: So you are more likely to leak if you’re doing something that is kind of high intensity and high pressure like that.

So trampolining is really difficult. And I’ll tell you that, you know, probably about 10 percent of women leak their entire lives with trampolining, right? 

Hope: Even without kids? 

Dr. Sarah: Girls do, even without kids, yeah. Just because it’s, I mean, it’s such a big impact. So, I, I think when it comes to something like trampolining, that’s a hard one.

But [00:10:00] there are things that you can do, right? So, you might need a pad. There are also devices that are called pessaries. So, a pessary is an insert that goes in the vagina and it puts a little bit of pressure on the urethra. So, the urethra is a tube that goes from the bladder to the outside and minimizes the urethra.

Leaking. And so that’s something that you could use before your exercise or activity. You don’t have to wear it all the time. You put it in, you take it out. And that can really help minimize the leaking. So if you, you know, go to runner’s blogs or you know, read things that women who run a lot posts, sometimes you’ll read things like, oh, if I have my period and I’m wearing a tampon, I leak less.

And a tampon in that situation really functions like a pessary, and that’s what it’s doing. It’s just putting a little bit of pressure there. So it used to be that pessaries were only available through a physician and you needed a prescription, but there’s actually a couple that are [00:11:00] available over the counter now.

And, you know, that can totally eliminate leaking with exercise. 

Hope: That’s crazy. So, I, I have never heard of that. That’s 

Dr. Sarah: Oh, yeah. So, I personally think we should rename them and rebrand them and call them something like, you know, Leak Less or Jump Higher or, you know, Run Dry. So that, you know, we’re kind of I mean, you’re marketing it to the right people because, you know, sometimes when we use pastries for other things, too, and the women that have seen them, sometimes they associate it with their grandma or, you know, someone who’s older that has leaking, but they can be a huge help for younger women who leak during exercise.

Right. And the nice thing about it is that, you know, there’s no downtime. It’s not a procedure. It’s not a surgery and it, you know, it can make a huge difference. 

Hope: Yeah. 

Dr. Sarah: So, yeah. 

Hope: That’s super cool. So aside from these, like there’s tools that you can use like the pessary, is there [00:12:00] anything else that women can do to help with leakage that they can do, you know, kind of on their own?

Dr. Sarah: So, you know, one of the big things is strengthening your pelvic floor. Right? So when your pelvic floor is stronger, you are less likely to leak. And I think, you know, we kind of all know this, you hear people talking about Kegels. You can do those exercises on your own. You can do them with a physical therapist.

There are lots of different devices on the market, vaginal weights, different pelvic floor trainers. That can help you do the exercises better and give you some feedback. You know, it’s really for some women, it’s hard to tell how they’re doing those exercises. And so it’s nice to have a little bit of feedback to say, Oh yeah, you’re, you’re getting stronger.

You’re doing this right. And, and some of the trainers. You know, they’re kind of funny. They actually look [00:13:00] like games and they kind of look like Angry Birds. So they, you know, give you different exercises to do, different intensities, hold it for different lengths of time. And nobody really knows that you’re, you know, what you’re, what you’re doing and it can make it a little bit more fun.

The problem with those devices is you have to take the time to put something in the vagina, right? Because that measures the strength. And some people are okay with that. Some people aren’t okay with that. Sometimes that gets old over time, but sometimes those devices are really helpful though. And then, you know, physical therapy is like hiring your own pelvic floor coach, which, you know, a lot of us need, right?

Cause they keep you honest. They tell you what you’re doing right and wrong. And for some women, it’s hard to learn to do those exercises. And sometimes after a delivery, those muscles don’t work well. Right. So some people feel like they, they’re not doing the exercises correctly, [00:14:00] and they’re not because those muscles just don’t work for them.

And they may or may not know that, right? It’s not like looking at your bicep, right, where you can see how well it’s working. 

Hope: Right. That’s true. 

Dr. Sarah: So yeah. The other thing that women can do is weight loss. You know, extra weight puts stress on all parts of your body, right? It puts weight on your knees, on your hips, and it also can increase the risk of leaking.

So even a small weight loss, even 5 percent of your weight. So if you’re 140 pounds, that’s seven pounds. can dramatically improve leaking. So that’s, you know, that’s a good thing to think about. Sometimes I feel a little mean recommending that, right? Because I’m saying, Oh, I know you leak with exercise, but exercise more and, you know, just work on that a little bit harder and it’ll get better.

I mean, sometimes that’s really hard, but that’s where, you know, [00:15:00] pessaries and the right pads can really come in handy. 

Hope: Yeah, so is there ever a case where you know that you’ve seen like we’re going back to my example for us You know, I’ve had four kids and everything’s messed up down there Is there ever like you get to the point where you’re like past the point of no return like it’s like everything’s messed up You can’t fix things.

Is there always something that can be done to help with either pelvic floor with a leakage? 

Dr. Sarah: So, I would tell you that I’m, I’m kind of an optimist, right? And so I would say, yeah, there’s always something that can be done. I, you know what I frequently tell my patients, I can’t always make it perfect, but I can almost always make it a lot better.

Hope: Yeah. 

Dr. Sarah: Well, that’s right. And sometimes it takes a lot of different things. I mean, there are a lot of little things that you can do on your own, but sometimes you need a little bit of expert guidance, but I think it’s [00:16:00] totally reasonable to try some things on your own. Try a pessary, try a little bit of weight loss, you know, really work on your pelvic floor strength and then, you know, come on in and say, Hey, this isn’t working the way I wanted to.

You know, it’s time, can you help me with this? 

Hope: Right, right, right, right. Finding somebody who knows what they’re doing to help. 

Dr. Sarah: Yeah. Yep, absolutely. 

Hope: Yeah, for sure. And I think it’s also important to note, and you mentioned it before, is a lot of people think, or I think, I think a lot of women, just in my experience hearing, you know, ladies talk about things, they think that, you know, this leakage only affects older women, or only women who’ve had kids, but like you mentioned before, women without kids can have the same issues, right? 

Dr. Sarah: It’s so common. Yeah. So 10 percent of women leak their entire lives, right? Even if they haven’t had kids, even teenagers, 20 percent of women over 20 will leak about a third of pregnant women will leak. And it’s [00:17:00] not, you know, it really depends on the person. Sometimes it’s bothersome leakage.

Sometimes it’s not so bothersome. It can be rare, but the, the numbers are pretty staggering just in terms of how common it is. 

Hope: Yeah. 

Dr. Sarah: Right? 

Hope: For sure. 

Dr. Sarah: So it’s not just older women. And I, I think that’s really a problem because when you look at education about incontinence, all the pictures have older women and you know, for the young women who leak, that just makes them feel horribly, you know, ads for pads and medications are all focused on older women.

And it is, it is a very, very common problem. And it’s very common for athletes. Right. And so, you know, younger athletic women have a lot of leaking. I was recently reading a study and I think it was something like 15%, 15 or 20 percent of women actually give up their sport because of leaking. 

Hope: Oh, wow. No way.

Dr. Sarah: [00:18:00] Right. Which is horrible. Yeah. Right. But if you think of, you know, all those gymnasts who are tumbling and cheerleaders who are tumbling, I mean, everyone who’s more likely to leak, whereas, you know, kind of the smallest shorts we can find or smallest bottoms we can find, I mean, who thought that up? That’s a, it’s just mean.

Hope: It’s very true. That’s very true. And then there’s kind of another side to this, right? And you did mention this a second ago too, but there’s like. And, of course, I, and now, you know, we’re talking about the ads on TV, and I’m sure that has a lot to do with it, but there’s, there’s kind of a psychological element to this, too, right?

So there’s, like, you know, people are embarrassed or whatever. Is this something that you address as well, like, with your clients that come to see you, your patients? 

Dr. Sarah: Yeah, it’s a huge part of leaking. So you know, a lot of times by the time people have come to see me, they’re starting to give things [00:19:00] up, right?

And they’re the things that they really enjoy doing, right? So I’ll have patients come in and say, you know, I’m, I’m not playing pick up basketball with my kids anymore because I, you know, I have to go up and change and I have to, you know, kind of gear up for that. And so it’s hard for me to do that. Not going to see, you know, concerts with my friends are because I, I just, you know, I have to go to the bathroom frequently and that that becomes a problem for me.

Or, you know, even giving up intimacy because they’re worried about leaking. Sometimes you can leak during intercourse or maybe they’ve leaked earlier in the day and they just don’t feel great about it. And all of those little things really decrease people’s quality of life over time. And it, you know, it can lead to a lot of shame and embarrassment.

And even depression because of it. And I think that’s just a really important, just an important point of recognize. And I think, you know, when it [00:20:00] comes to medicine, bladder leaking is not the most important thing, right? Cancer, heart disease, all of those things definitely outrank it. This is something that really affects quality of life and really affects how women feel about themselves.

And it’s an important thing to address. 

Hope: Yeah, yeah, for sure. So when someone comes in to, you know, to see you or telemedicine or whatever, and they want help, what is kind of your plan of action? What would be the first thing that you would do to help kind of, you 

Dr. Sarah: So, you know, the, the first part, I mean, just like most interviews with physicians, the first part is always history, right?

So talking to the patient, figuring out what’s bothering them now, what they want, figuring out what they’ve done in the past and the other things, how they’re feeling about, you know, sometimes people are just coming in for information. Sometimes [00:21:00] they want kind of self treatment or really constructive.

Sometimes they want surgery. So you know, really figuring those things out. We spend a lot of time going over habits. So sometimes I’ll have women write down what they’re drinking and eating in 24 hours, how often they’re going to the bathroom, how often they’re leaking, and really addressing those habits and what they’re doing becomes really important.

Just like so many things you don’t realize. All the little do in the day and how they’re impacting you until you write them down, right? So just reviewing all of those things. You know, I’m always screening people. Most of the time incontinence is, you know, very benign condition, but sometimes there can be some other warning signs.

You know, if you’re having numbness and tingling, if it comes on quickly, if you have blood in your urine, you know, there are always other things that we’re just kind of [00:22:00] ruling out. And that doesn’t happen very often, but you know, something to always think about. I always double check and make sure my patients are emptying okay.

Sometimes, you know, the problem can be that you’re not emptying very well and you may or may not realize that. I always assess muscle function. Can you squeeze those muscles? Strong are your muscles? Are you calm in doing that? And that’s usually kind of the starting place. 

Hope: So when you’re looking at, you know, history and you know, their everyday activities kind of thing, are there any lifestyle changes that people can make to help with this?

Dr. Sarah: Oh, I think, you know, we kind of live in a society of over drinkers. And I don’t mean alcohol. I just mean fluid in general, right? Everybody walks around with a big water bottle. And that’s where, you know, sometimes having someone do a 24 hour diary and writing down what they’re drinking. I mean, sometimes I have people write it down and they don’t even have to [00:23:00] come back and talk to me about it.

But they realize. Once they’ve written it down, how much they’re really overdrinking. So I think sometimes it’s drinking too much. And then sometimes, you know, you’re doing things you don’t necessarily realize what you’re doing. So carbonated water is very popular right now. Carbonated water is not great for the bladder and it can cause a lot of irritability and frequency and leaking because of that.

Hope: Really? Now, I did not know that. 

Dr. Sarah: Oh, yeah. And I think, you know, so many people drink a lot of carbonated water.

Hope: What’s that? Well, I have people walk into the studio with their little, you know, bottles of water carbonated. 

Dr. Sarah: Yeah. 

And so, you know, if you’re drinking a lot of carbonation, I would say, you know, just cut it out for a couple of days, see what happens, and you might be amazed at the difference that that makes.

And it doesn’t mean that you. You know, I think one of the things that’s important, I don’t like to make people cut things out, but I think it’s really [00:24:00] important to know how things impact your system. 

Hope: Sure, sure. Right? 

Dr. Sarah: So if the carbonation is doing it, then, you know, maybe you only drink it when you’re staying at home and if you’re going out, you know, don’t drink it.

So carbonated water is a big thing. Artificial sweeteners can have a negative impact on the bladder and some people are really sensitive to foods. So sometimes spicy foods can do it, sometimes tomato based foods can do it, sometimes citrus can do it. You know, caffeine is a big one, but I think most people know about caffeine.

Right. So just, you know, paying attention to those little things. And once again, that’s where that diary really comes into play. If you’re drinking, you know, six cans of diet Pepsi in a day, that’s usually a good place to start. 

Hope: Yeah. Yeah. Yeah. Among other things I could do, but yeah. 

Dr. Sarah: Among other things. Right. 

Hope: Yeah. So let’s talk about, let’s switch gears a little bit and let’s talk about how you got into this realm of women’s health. So [00:25:00] you are a physician by trade. So can you kind of give us kind of how you got onto this path? 

Dr. Sarah: Sure. Let me think. My residency was in obstetrics and gynecology and then I did a fellowship in urogynecology I would tell you that when I first started medical school, I really thought I was going to be a pediatrician And then I kind of quickly realized That I don’t really like dealing with parents and I, I say that as a parent, I really love the kids, but that’s only half of this job.

Hope: Yes, this is true. 

Dr. Sarah: So I moved away from the idea of pediatrics. I pretty quickly realized that I really, you know, my preferred patients are women. I just like dealing with women better. I like men, but professionally I prefer to avoid them. And I really like things that I can fix. Yeah. Right? So I, you know, love what I do because I deal with women and I can help most [00:26:00] people and, you know, really improve people’s quality of life.

When I was a medical student, I went to the University of Pittsburgh and there’s a really great urogynecology department there. And I worked with them, you know, in the third year of medical school. And I knew at that point that this is kind of what I wanted to do. 

Yeah. Yeah. That’s awesome. So a little bit 

of exposure, a little bit of luck, you know, what you pick in medicine is a little bit of a personality test.

And this just, you know, this just suits me. 

Hope: Yeah. That’s awesome. 

Dr. Sarah: But my patients do frequently ask me that and say, you know, why would you, you know, they hate their leaking so much that it’s hard for them to see it from my perspective. Right. Right. And they say, why would you ever do this? 

Hope: Right. 

Dr. Sarah: Well, because I enjoy it.

Hope: Yeah. Yeah. Well, and you’re, I mean, you’re the one that’s helping them, you know, what? Yeah 

Dr. Sarah: It is personally very satisfying for me. 

Hope: I’m sure yeah, I could see that totally [00:27:00] I mean, it’s that’s a really it’s a pretty pretty cool life purpose there 

Dr. Sarah: Yeah, 

Hope: so I I do like to give kind of some tangible things people can take away so You talked already about some lifestyle changes we can make.

So, is there anything else that we could do? You talked about Kegels, but is there anything else we can do or things that we can do to fix, I use that in air quotes, fix or prevent bladder leakage, that things we can do at home, like on our own, women who are kind of dealing with this at home that are listening.

Dr. Sarah: You know, like so many things, it comes down to weight control. It comes down to being careful about your habits in terms of, you know, what you’re drinking and what you’re eating. It comes down to core strength. Right? So, you know, most of the data in this area really points women to physical therapy and working with a [00:28:00] physical therapist and really focusing on the pelvic floor.

But just doing core strengthening, just doing Pilates, that helps a lot as well. And women prefer that, right? They prefer classes and the social aspects. So I think, you know, maintaining a really strong core is important. And then I think one of the important things is talking to each other about it, right?

So that we can all kind of help each other and recognize that, you know, this is just part of life and this is part of who we are. And there’s no shame in it. It’s so common. 

Hope: Yeah, yeah, for sure. So I, I like to end with the same question for everyone, but before I ask that, let everyone know where they can find you.

And you do telemedicine, right? As well? 

Dr. Sarah: So I see patients in Portland and Oregon. And in Washington, I do have a website where I provide information on [00:29:00] incontinence to help educate women, especially for women who aren’t quite ready to see a physician yet. And that website is www. womensbladderdoctor.

com. 

Hope: Okay, cool. I’ll put a link to that in the show notes. Alright, so I will end with this question I like to ask everyone as the theme of the show here. So what do you think is the most important thing people can do to live with purpose? 

Dr. Sarah: So I have, you know, kind of a skewed view on the world, I think. So I’m going to answer that from the urogynecologist perspective.

I like it. So, you know, live with bladder purpose, I guess, and I would say, you know, just take a minute, think honestly to yourself about your bladder and if it’s limiting you in any way, right? If it’s causing you to not do the things [00:30:00] that you want to do, you know, are you avoiding intimacy? Are you not exercising?

Avoiding social occasions? And if that is the case, then I would say commit to doing something, right? Commit to a home routine, commit to, you know, trying physical therapy or maybe even being evaluated. But just think about how that might be affecting you. 

Hope: Right. Because it’s there’s now after listening to you and all of these things that you’re doing, There are obviously plenty of ways that you can help with that.

Dr. Sarah: Yeah. And I think the important thing is that, you know, this is a quality of life issue and you can do what you want. You know, if you go see a physician, it doesn’t mean that you’re committing to surgery, right? Sometimes people just come in and they want resources and what can I do or community. So, and all of that can definitely be provided.

Hope: Awesome. I love that. So there’s no point in living in silence and [00:31:00] depriving yourself of what you love to do. 

Dr. Sarah: Exactly. 

Hope: I love it. Awesome. Well, thanks so much, Dr. Boyles. This was very informative. So, I know this conversation is going to I feel like enlighten people and make them feel Like they’re not alone in this because there is a lot of them out there that are dealing with this and have no idea So yeah, thank you.

Dr. Sarah: And you know, I I think that’s great, right? That is all that I hope for 

Hope: totally Well, thank you so much for chatting with me Appreciate it. 

Dr. Sarah: Thank you. This is great. 

Hope: Thanks for listening to Hopeful and Wholesome, y’all. If you found value in this week’s episode, please subscribe on iTunes, wherever you get your podcasts, and leave a review to let me know what you thought.

I love to know what you find useful in these episodes so I know how I can provide the most value I can to my listeners. And if you have topics that you want to know more about, I’d love to hear those as well. So shoot me a message on Instagram, Facebook, or LinkedIn. It’s at thehopepadraza or visit my website, hopefulandwholesome.[00:32:00] 

com. Thanks, y’all.