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Dr. Lisa King is a pharmacist with 33 years of experience and a brand new mission in life. After she and her sister authored, Tiny Little Changes, she realized that she had the great fortune – ability - to encourage and show women how to create change in their grown up lives.
But she realized that she could take the power of her voice and put it to an even greater purpose. You see, Lisa had a bit of secret. Despite being a practicing pharmacist, she experienced what she now knows was interstitial cystitis for years before finding the right medical doctors, wellness practitioners and whole body approaches to repair herself FULLY. It was hard at first for her to go out publicly with this new mission as well the subject is shall we say, awkward, but now that she has, she’s fully game and is super passionate about it. And is wholeheartedly a Caire kind of woman. We applaud and celebrate women who use their voice and brains to help their fellow women, menopausal or not, in their ever evolving paths into health and wellness.
Lisa, who now goes by the moniker, The Fulfilled Pharmacist, is also a Certified Holistic Herbalist, Life Coach and Amazon best-selling author. Her mission is to share a gentle approach to optimizing wellness with a particular emphasis on reducing bladder pain and urgency.
IC, interstitial cystitis is closely related to a rarely discussed and very misunderstood menopausal manifestation – overactive bladder. For those new to our Caire blog, manifestation is our own vocab for symptom because at Caire we recognize that menopause is not a disease but rather a natural part of life’s journey:
I had an opportunity to chat with Dr. Lisa about overactive bladder and was surprised to discover that I’ve probably been overactive or been borderline most of my adult life. My sisters too! So let’s dive in with the biggest question - - how do you know if you’re in Camp Overactive?
** If you pee more than 8x a day or more than 2x at night,
you’re probably in Camp Overactive, too. **
What is Overactive Bladder exactly?
Overactive bladder, sometimes simply referred to as OAB is not a disease but it is a condition where you have sudden urges to urinate and often can’t control these urges or sensations. The other signal is if you have an unexpected pee right after you’ve actually already pee’d. OAB is different than urinary incontinence which is when you have an unexpected leak.
Having said that, overactive bladder can be divvied into 2 separate types, overactive dry versus wet. Dry means that you’re experiencing urges without actually peeing vs wet which is when you’re experiencing incontinence aka peeing aka leaking at the same time. Regardless, if you find yourself changing your plans because you’re worried about having to go to the bathroom unexpectedly, it’s probably time to find a good doc.
Lisa notes there are many causes of overactive bladder, ranging from hormonal – hello menopause – to MS (multiple sclerosis), Parkinson’s disease or other neurological situations such as back surgery or a herniated disk.
In terms of perimenopause and menopause, it’s all about our friend, Ms. Estrogen. Before perimenopause – which, let’s recall, typically begins in our forties, we’re making a steady supply of estrogen, which helps to keep up the flexibility and strength of our pelvic and bladder tissues. As estrogen levels contract during perimenopause and especially post menopause, this tissue strength can weaken. And the surrounding muscles too. These days a doctor can prescribe a vaginal-only estrogen therapy which can help. And there are a host of other minimally invasive treatments as well including if you can believe it, BotoxÒ. A urologist can inject Botox into the bladder to treat overactive bladder or incontinence. Apparently, it helps muscles relax which gives women (and men!) more time to get to the bathroom when the urge to urinate take over.
For some women, hormone change can show up as increased UTIs – those dreaded urinary tract infections. Lisa King told me that symptoms can look and feel similar, and experienced doctors may find it difficult to distinguish between the two. All this to say, don’t just take antibiotic after antibiotic without some deep learning. Millions of women experience pelvic floor disorders which encompass all of these conditions and experiences. But keep in mind that while these issues might become more common as we age, it is not a normal part of aging. In other words, get educated, get treatment, change your lifestyle and feel better.
What is the PELVIC FLOOR anyway?
Let’s back up a moment and discuss something that most of us non doctors don’t know! The pelvic floor refers to a complex structure that includes muscles, ligaments, nerves and connective tissues that together support our vagina, uterus, bladder and rectum. In a nutshell, your pelvic floor keeps everything else in place. Pretty crucial, girls! Problems with the pelvic floor include urinary incontinence which includes the overactive bladder we talked about earlier aka ‘urgency incontinence’ or something strangely called ‘stress incontinence’. Which is when you have a leak or unexpected pee while laughing, sneezing, coughing or exercising.
Incontinence issues, overactive bladder, IC or pelvic prolapse are common issues. Estimates of incontinence frequency alone in the overall female population range wildly. Between 12 and 47% of middle aged women and 17 and 55% of older women experience urinary incontinence according to Menopause Review article published in 2014. Sorry, but the Study itself doesn’t clearly define the difference between middle and older. But suffice to say it’s not uncommon, and no one should be embarrassed about it. The fact that 3-17% have daily incontinence is something that should just figured out. Because at the end of the day, in 99% of women this is something that can be vastly improved.
Men are in the 1 in 4 range and their issues not surprisingly are largely related to the prostate. What you feel can range from discomfort - a loaded word as every person experiences and even describes discomfort differently – to significant pain. Many times, problems with our pelvic floor, in both pre and post menopause leads to sex problems, including low libido, difficulty in orgasming, decreased arousal and pain during intercourse. Lisa strongly suggests that even if you don't think your problem is that big a deal – perhaps it’s something you’ve experienced for years and are sort of accustomed to, treatments can be highly effective and can really change your total quality of life.
Lisa King herself suffered for years from interstitial cystitis, which is defined as a chronic bladder condition that creates pain and discomfort in the bladder or pelvic region. This is why she wants to “give women hope that they’re not alone.” Here is an excerpt from our conversation about her recommendations and learnings:
CAIRE: How do women figure out their bladder problems?
Dr. Lisa: People will typically wait up to 5 years before even ever mentioning it to their doctor. There’s so much stigma and embarrassment that comes with bladder issues. On my instagram (@thefulfilledpharmacist), there are beautiful women who follow me, and eventually many will private message me with questions.
CAIRE: What are your top lifestyle recommendations?
Dr. Lisa: For diet, you should avoid spicy, acidic foods, sugary foods & drinks. Take a look at and www.bladderpain.com as there’s a free e-book there. Spicy food is a bladder triggering food. And I suggest supplementing with pumpkin seed extract which was used for thousands of years but has only fairly recently become rediscovered for its benefits to modern women with overactive bladder situations. I also highly recommend Raspberry Leaf extract which is a ‘toning herb’. You can use it even before getting pregnant because pregnancy impacts pelvic strength for many women. It offers toning and tightening benefits and really helps.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4032845/
CAIRE: Is this an ‘old’ learning as well?
Dr Lisa: I believe so. I believe that women - people - are really looking to get at the root causes of overactive bladder as opposed to simply taking medication.
CAIRE: How can we strengthen menopause impacted or otherwise weakened bladder?
Dr. Lisa: Pelvic-focused workouts including kegels are important. But keep in mind an experienced physical therapist can show you many exercises, not just kegels. Also breathing exercises. Studies show that people with pelvic floor issues are often lacking Vitamin D. So make sure you’re adding that into your diet in addition to Collagen I and III to strengthen to pelvic floor. https://pubmed.ncbi.nlm.nih.gov/30710765/
CAIRE: If a woman wants to seek a doctor, who should she ideally go to?
Dr Lisa: A urologist or urogynecologist. Find someone who is going to listen to you and is going to be supportive. If someone doesn’t believe you’re in pain, find someone else! Find a rapport with them. It can take7 years and 7 doctors before you will have the right diagnosis and successful treatment for painful bladder syndrome whether it be lesions, tight pelvic floor, interstitial cystitis or something else.
CAIRE. How does a woman find a good doctor?
Dr. Lisa: Interstitial Cystitis Association or ask your friends.
CAIRE: Tell me about you. How did you find out?
Dr. Lisa: I always had bladder issues. I always had to go to the bathroom on trips. And it became more prevalent when I went to college. Then, I finally saw a doctor – who did a hydrodistension which is a painful test of the bladder, but I got a good diagnosis. From there I started an IC diet (Lisa was diagnosed at 29 and is 55 now). There weren’t a lot of options then. Now, you can try herbal supplements, pelvic floor physical therapy and Chinese medicine. Then, it was just diet and medicine.
CAIRE: How many years was it between diagnosis & starting to feel good again?
Dr. Lisa: I was able to move forward after some time and have now been off medication for 17 years! Stress reduction and really taking care of myself is the icing on the cake. I feel a lot of mine was stress induced. In general, I believe that 75% to 90% of doctors’ visits are due to stress whether migraines or anything.
CAIRE: Are bladder conditions hereditary?
Dr. Lisa: I don’t have statistics but there doesn’t seem to be a thread.
CAIRE: When did you know that you were in peri-menopause?
Dr. Lisa: I had a hysterectomy 8 years ago, so it was then.
CAIRE: Your menopause was sudden because of the hysterectomy - did you have a lot of symptoms all at once too?
Dr. King: We hear about how common sleepless nights are with hot flashes, and there was a little bit of this for me but not a big deal. But what was impactful was weight gain (8 lbs) and a ‘flat’ mood. A few years ago I found myself staring out of the window, and I felt empty inside. No mood inside. I knew I wasn’t depressed, I knew it was hormonal and that I had to do something.
CAIRE: So do you mind our asking what you did about this “flat mood”?
Dr. King: My sister is a brain cancer survivor, but I am still able to successfully use HT (hormone therapy) a low dose estrogen and testosterone cream.
CAIRE: That’s very helpful to know. Thank you so much for sharing your story and your purpose in life with us. And thank you also for choosing Caire Beauty as part of your skincare health regimen! It’s always good to be reminded that taking collagen internally and including finding skincare, like Caire, that can encourage collagen synthesis is so important. It’s fascinating to learn that just like skin, the pelvic floor’s ECM (extracellular matrix) has so many collagen fibrils and the loss in fibril regeneration over time, with hormone change, menopause and such a wide range of conditions of pelvic and bladder and urinary conditions is so critical.
Watch this video to learn more:
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