Here are some good links that can provide more specific information about Orthopedic and Pelvic Floor disorders:


A Headache in the Pelvis

By Rodney Anderson, MD and David Wise, PhD

The V Book
By Elizabeth Stewart, MD and Paula Spencer

Explain Pain
By David Butler PT and Lorimer Moseley

Explain Pain Supercharged
By David Butler & Lorimer Moseley

Heal Pelvic Pain
By Amy Stein, MPT

Ending Female Pain
By Isa Herrera, PT

Ending Male Pelvic Pain
By Isa Herrera

Pelvic Power
By Eric Franklin

The Truth about Hormone Replacement Therapy
By The National Women’s Health Network

Wild Feminine:
Finding Power, Spirit, & Joy in the Root of the Female Body

By Tami Lynn Kent

The Bathroom Key
By Kathryn Kassai and Kim Perelli

Mind Over Bladder: I never met a bathroom I didn’t like
By Jill Maura Rabin

Pelvic Liberation
by Leslie Howard

The Graded Motor Imagery Handbook
By David Butler, Lorimer Moseley et al.

Painful Yarns
By Lorimer Moseley

Why Pelvic Pain Hurts
By Adriaan Lowe, Sandy Hilton & Carolyn Vandyken

Why Do I Hurt?
By Adriaan Lowe

"We Have Been Misled About Menopause" NYT article
By Susan Dominus This Feb. 2023 article elucidates and clarifies the confusion around hormonal treatments for menopause. I HIGHLY encourage all perimenopausal and menopausal people with vaginas to read this. 


Physiological Quieting

Janet A. Hulme, MA, PT

Health Journeys
Audio CD’s for various illnesses and pain, here are a few for women’s health

Pelvic Health and Awareness for Women and Men
By Deborah Bowes

Wonderful videos with a Yoga emphasis made by my friend and colleague, Dustienne Miller PT, MS, WCS, CYT for 1) Relieving Pelvic Pain and 2) Optimizing Bladder Control

Healing Pelvic and Abdominal Pain DVD


These are products I recommend, but it’s best to speak with me or your medical provider about their potential benefits prior to ordering. (Click on bolded line for link to product.)


Three great cushions for perineal pain, pudendal neuralgia, and vestibulitis

DILATORS: Vaginal and Rectal

A dynamite line of dilators!

These are great too!

These are dilators for use after gender affirmation surgery.

These are also very nice dilators for older, younger, or for use after gender affirmation surgery.

An affordable dilator set with an option for vibration.

An expanding dilator that increases size incrementally with a push of a button!

Rectal dilator set.

Another rectal dilation option.

WANDS: Vaginal and Rectal

Several Self-Care Wands for internal pelvic muscle trigger point release and massage

More options for Wands.

*Always speak with your doctor or provider before using any of these products.

The best electric heating pad

My patients ALWAYS ask, “What kind of heating pad is this?” It’s this one.

BLADDER SUPPORT  (talk to your provider first!)

Supplement for PBS/IC.

A supplement taken to neutralize acid in bladder-taken before eating.


There are SO many products out there now for people who menstruate: Tampons that self clean (!), washable cotton pads, Diva Cups, period panties and more! Look for gadgets that can track your flow, electrical stim units that can decrease period pain, and apps that track your cycle.  

Check out these products to help with menstrual issues of all sorts!

A quality TNS unit that your PT can program for you to help with pain (menstrual or otherwise.)

These are products to help support the perineum if suffering from varicosities or pelvic organ prolapse:

This one is used in non-pregnant situations
These two are used during pregnancy:


Pelvic Floor specialists recommend using water-based vaginal lubes FREE of parabans, glycerin, and other harmful chemicals. Many health food stores (eg, Whole Foods) and local food coops, stock lubes made from all-natural ingredients. Avoid lubes that heat up or cool or tingle. Avoid lubes that have flavoring or fragrance. Avoid lubes that have allergens.  (Read more about this here.)



Normal vaginal pH runs between 3.8 to 4.5 (acidic) and can flux during perimenopause.

Normal vaginal pH AFTER menopause is > 4.5 (still acidic.)

Rectal pH is 7.0 (neutral.)

Vaginal lubricants typically are not symbiotic for anal usage.


Osmolality: a measure of dissolved particles per unit of water in a solution; we want a balanced osmolality in a lube to help skin cells maintain equilibrium with the lube. This means we want a lubricant with low (but not too low) osmolality.

Normal vaginal hypo-osmolality is 260-290 mOsm/kg

WHO recommends a range of 38-1200 mOsm/kg 

Eg: YesYesYes WB lubricant, Good Clean Love organic WB lube, Sliquid, Blossom Organics.

Read more about this here.

Read more about chemicals in lubricants here.

Read more about harmful chemicals in everyday products (geared to those with vaginas especially) here.


  1. Always do a spot check on the inside of your wrist or elbow prior to using a new lube, especially if you are sensitive. Then do a spot check in the vestibule. If after 24 hours all is OK, then try it with your dilator, sex toy, or partner.
  2. If using latex condoms check packaging to ensure compatibility of lube with latex.
  3. If using silicone products (dilator or toy) don’t use silicone lubricant unless the package specifically says it’s OK to do so.
  4. Women with severe vestibular pain/irritation should speak with their doctor or PT or NP about products and always do a test patch first. We generally advise avoiding glycerin and petroleum-based products. Stick with water-based.
  5. Women prone to yeast infections should avoid lubes with glycerin.
  6. Women trying to conceive should speak with their doctor about lubrication. There are products to avoid (for eg, avoid lube with spermicide. Some studies have shown that water and saliva can potentially make it hard for sperm to swim…) Do find lubes with the right pH and free of harmful chemicals.
  7. Menopausal, perimenopausal women want to take extra care to ensure their vaginal/vestibular tissue can handle penetration and if there is pain to see a practitioner to assess the cause. 
  8. Trans people may need special products. SLiquid is a company that has a line of products for trans men. 


  • Raw Organic Coconut Oil:
    Many women (and men) enjoy using Coconut Oil; it is solid, but liquefies as it warms up in your hands. It’s food grade and gentle and rinses out easily. Some people find it doesn’t have the staying power of say, silicone. Look for "unrefined" not refined coconut oil to avoid added processing. NOTE: Coconut Oil is ALKALINE! So while it might seem like a nice thing to use as a lube, it is may cause imbalance in the vaginal pH, which is ACIDIC.
  • Water-based lubricants: These are typically safest since they clean out well and are gentle if they don't contain harmful chemicals.  Examples: YesYesYes WB (water based) lubricant, Good Clean Love organic WB lubricant, Blossom Organics, Aloe Cadabra, and SLiquid WB products are some WB lubricants with appropriate pH and osmolality for the vagina. SLiquid has a plethora of products, including some for gay men, and for the trans community. There are others, just check the packaging or website of your favorite brand and contact the company if necessary! 
  • Silicone-based lubricants:
    Many people describe the long-lasting effect offered by silicone lubes. This is because silicone is NOT water-based, so it isn’t absorbed by the body’s tissue. These lubes have good staying power, but you must not use them with silicone dilators or silicone toys as the 2 silicones can break down and the toy can become sticky. They are good for anal sex and male masturbation. Silicone should not be considered “certified latex-safe,” so be sure to check the labeling if using latex condoms.
  • Petroleum (oil)-based lubricants:
    Generally not good with latex condoms.
  • KY and Astroglide:
    These are 2 lubes that have been around forever, and many people use them. Both brands have different products with different sets of ingredients. Please read ingredient labels carefully and make an informed decision about what is right for you.

Local Links


Leslie Howard Yoga

1030 E 19th St

Douglas, AZ 85607


Natural Resources

1051 Valencia St.

San Francisco, CA 94110


The Center for Sexual Health & Rehabilitation

1420 Jones Street

Suite 7

San Francisco, CA 94109

For questions or more information

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