good evening tonight show we have two special guests specializing in women's health sta audience a little bit about what you do and do what you ladies and gentlemen do yeah i mean so spears and i do similar and yet different things we work with women usually post reproductive so they are done having a b b s and we kind of work together on different forms of wellness for women as they get older so my practice is you know we do midlife medicine because the women as they're starting to go through their menopausal transition and the health concerns that women have and spirit very frequently not being able to avoid that electrician issues or lapse sisters who wrecked their sales dropped and women who have problems with chronic pain or problems with blood in the urine or recurrent other infections and since these are much more common in older women we have a lot of overlap because martius practice is for women after that than having to drink i have seen twenty year olds having my kind of problem but they're much more common women they don't think to tell their doctor about it they think it's normal to have happen and so for me i ask all women after they've had children the number one miss factor is having had children  laundry basket or you're climbing the stairs or you can't jump rope at the gym or you can't make it to the bathroom in time so i may ask them to examine you and i will tell you about dr moran but i would say you could also try these things and you can try was the most famous going to college because everybody knows his name from the exercises but it was fifty years ago and still fifty years later no woman really knows how to do it unless you have the rational trainer and was going to be your personal trainer or do you just out of the blue into two different kinds with a lot of different names that they're relatively benign don't mean aside the fact you can try them along with physical therapy and if they fail or they give you too much hide the fact then that either overweight or smokers are they more at risk for the so they are but the truth is that eighty six percent of women by time they're eighty five are going to experience this problem about men warning because it was a lot of erosion and other kinds of i were just talking about how we get where we are we've briefly touched on stretch and start i combine both urge and stress incontinence twenty years of doing this and i still manage things and so so tell us a little bit but if you're in our office really what i say to my patients is after menopause you can only have at least forty percent of your life after menopause don't throw that part of your life away right so we talk about many time patients perfect and so as we get older we're noticing this more and more because women are living longer actually would you say is this a lion's share of your business let's go to women that have prolapse these things that fall out of you know so you know what sometimes they know to go to us but sometimes they come to me and they said dr just have this deep pain in my focus or they might say sometimes i feel like something's coming out or they might say i have this kind of chronic low back pain from standing on day and my my doctor sent me to physical therapy for my bad my back is fine what's exactly google are a network health network works a lot better than the other networks they're working on and then you can find some you can certainly find these two x the professionals i were very fortunate to have met our area we no longer have to drive all the way to the city as i try to explain to our listeners and most of them bump into me somewhere along the way it's always the physician that you have treating it's not the bricks and mortar it's not particularly what hospital it is it's more get to get somebody that's boarded and understands it's not somebody that's trying it out for fun for us we practice what i think we call wellness medicine and we want to keep patients out of the hospital sometimes they go to the hospital they need to start writing sometimes they go to hospital they have a problem but we would like to do as much management and office where it's comfortable and so they have to be able to find you but they also have to tell your friends about these two professions because i think it's really import you know we now have someone in the area that does this because up until when you came we really you know now we're really focused on that and actually correct i mean you know our patients are getting older and older just that hundred two year old gentleman the other day they came to the look anywhere from a rink up to wake you up to a pacifier but i don't feel it's when it's and that's the job and they're very happy that's part and again the women when they have these problems is that almost always they present if they're yourself double triple forth depends how many babies how many forceps the risk of having a lapse and if you have never to believe it has to be very rare for you to develop for a lap you have to be a super women are at risk and then what are your sizes are you you need to do both weight bearing exercise is an cardiovascular exercise for your bone how do you have good balance do you have good posture of our younger viewers this am i i'm at work i'm giving a talk to dr how in front of television and i get this more into my chest and it goes to my head and i start sweating and i can't do my job or she might say i'm ok at during the day but at night i can't sleep i wake up with the same palpitations in my heart races what can you do for me one of the things because there are many things that we can offer her as a form of therapy but you're right it's gotten a bad rap and there for us hormone therapy in the right patient and done well have some breasts but is the best thing to improve a woman's life was really suffering from hot flushes ok and i see your list about what else could you do you don't have to have hormone therapy that we talk about exercise and don't eat spicy foods i don't drink too much coffee and keep your room cold i always tell my patients remember how you have extra blankets in your husband used to be going to bed in his kitchen and underwear now he goes to bed with extra blankets and sweatpants and you leave the windows open because that will help them sleep better talk about talk about everything to them yeah are there any over the counter medicine you know for the i mean so over the counter medicines for men  allegheny health network and to be more than help you please tell your friends about this show as i didn't tell you runs quite frequently in the local area and you can certainly get us you can google if you go to youtube google ask the doctor  holiday season be safe out there and we'll see you next month i believe him wires com