Exploring the Pelvic Bra: A Revolutionary Support for Pelvic Floor Health

In this episode, I interview Janice Mitchell, a pelvic floor physical therapist and founder of the Pelvic Bra. This external support device helps with pelvic floor issues like prolapse. We discuss Janice’s personal experiences and the development of the pelvic bra, likening it to an industrial-strength thong that provides perineal compression. Janice explains how the device works and its benefits, and shares feedback from users who have found significant relief from symptoms such as stress urinary incontinence and bladder control issues. Highlighting the option for live Zoom fittings and upcoming restocks due to high demand. Join this insightful conversation to understand more about the innovative solutions for pelvic floor health and how the pelvic bra can help you or someone you know. 

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Timeline

00:30 Introduction and Guest Welcome 

01:40 Understanding the Pelvic Bra 

04:03 Anatomy and Prolapse Explained 

06:15 Benefits and Use Cases of the Pelvic Bra 

07:42 Target Audience and Design Insights 

17:10 Feedback and Real-Life Experiences 

28:21 Sizing, Return Policy, and Availability 

33:28 Conclusion and Future Plans

Transcript

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I am here today with Janice Mitchell, who I've spoken to many times, who's a friend of mine. He is a pelvic floor physical therapist. She's had her own journey with prolapse. She is in charge of my PFM, so my pelvic floor muscles where she educates women on the pelvic floor and helps them, um, with their process.

She's, she's done just so many things and she has a new venture, um, to help women with pelvic floor issues that I wanted to talk to her about today. So, welcome. Thank you so much, Dr. Sarah Boyles. I'm really honored to be here and I'm honored to be your friend and know you really, when you look over the last five years of all the different things that we've done together.

It's exciting, and then you think about the future and the possibilities to reach so many people with these virtual methods. So super exciting. Yeah. It, it's a fun space, right? And it's, it's fun to have friends who have common interests in this very unique niche, I would say. Right. And whose goal is really just to help women figure all of this out.

Tell me about the pelvic bra and, and what that is. So I have a lot of anatomy props that I'm gonna pull out, but in words, the pelvic bra is kind of like a jock strap for women or people with vaginas to help support the pelvic floor and those tissues externally. Okay. So we've talked a lot or I've talked about pessaries.

So pessaries are an internal support, so you put it in the vagina and it helps support the prolapse. That is not what we are talking about here. We're talking about an external support, right? So I'll just show it to you so that you have a visual of it. So here's the front of it and then the back of it, and it has a stretchy waistband.

We'll go over some more about the Yeah, and I would say, you know, it kind of looks like an industrial strength thong is what I would say, right? Yeah. Mm-hmm. And, and, and what we're calling it is a peroneal compression thong, so, exactly. Yeah. Um, and, and I should say I had never heard of an external support for prolapse until we met and, and I had been.

A practicing urogynecologist for I think, what, 15, 16 years at that point in time. So on that, like I really kind of self discovered external, external support as an option. And that's another story. I mean, we're here to tell stories, right? Yeah. So after the birth of my first baby, I had a friend and she was around me and she was an older friend and she was like.

She was from Puerto Rico. Okay? And so she was like, Janice, you need to wear support. You're wearing, the clothes are too loose. You need to wear something underneath. And I said, why? Why do we wear something loose, flowing clothes are comfortable? Like, why am I needing to do that? And she's like, no, you just had a baby.

You need to support that tissue. And I really didn't. Process that. But what she said has come back to me over and over and over again in my mind. And so then when I started to wear like some Nike compression leggings or maybe, uh, a pair of jeans that had more support from below and I would have less symptoms, I started putting suit suit together.

So the mechanics of that, I'm just, for those of you that wanna. Learn a little bit or see what we're talking about with support. So we have the pelvis here, pubic bone in the front, and then the tailbone in the back. And we're gonna open up the pelvis and we have the bladder and the urethral canal. And then the uterus and the vaginal canal, rectum and the anal canal.

And the vaginal canal is what we're talking about with vaginal, pelvic organ prolapse. And so putting something inside, so, so with prolapse, the front wall may descend, the back wall may descend the top, the uterus might come down, or you might have some kind of combination. Could be a little bold, or it can be a bulge that comes to the opening or out of the opening.

And so that's a really nice model, how you can push on it. Thank you. I've never seen anybody do that before that. I mean, I think, you know, picture, um, is worth a thousand words. That's really helpful. Thank you. So internal support, you're putting something inside, right? So that's worth pries or period products or, so there's medical grade pries and temporary pries.

So that supports those walls inside. But then perineal compression is supporting from the outside. So as those tissues may be descending, we are lifting from the outside. And so we have the ability to lift the perineum, but that also that external urethra. One other, I think, helpful, um, analogy here with this model, let me clip this back in place.

Is one of the landmarks that we use in pelvic floor physical therapy are these bones, your sit bones, your ischial tuberosities. And so these structures, we're looking to see where they are when they're lined up with the ischial tuberosities. Are they even, are they higher? Is it lower? And so if this tissue is sitting lower than, this is another visual example of how lifting, lifting that tissue from the outside can be a.

Powerful tool for a lot of people to help reduce symptoms. Um, do you find that the pelvic bra, which I, I mean I love that name. I think it's brilliant because it, I think it just helps, I mean, it, it, um, just represents what it is so well, right. That it's a pelvic support. Um, do you think it helps for one type of prolapse more than others?

Right. So does it help more for a rectocele versus a cystocele? So supporting that back wall instead of the front wall. No, I do not see any differentiation. Okay. With that. Even, even uterine prolapse and severe versus mild. So we have people with all stages, all, all, um, all grades and all types of prolapse that are feeling, um, improvement with this.

I think that the key here, I'm gonna use another, another model is. So here is the anus, and then this would be the vaginal opening. The key kind of self-test that I like people to do is take a hand, put it in your perineum and lift up. Does that feel good? And does that help with reducing symptoms and helping you do your activities without the bulge or without leaking or without pressure?

And if it does, then the pelvic bra. Is potentially a good tool for you to help with reinforcing that pelvic floor foundation in front of you both. Um, who do you think is a good candidate for the pelvic bra? Is it everybody with prolapse? Is it, um, everyone with prolapse and, um, maybe women who just delivered?

Who, who are you targeting this for? I love this question. Okay. So certainly I would love. I would love everyone with prolapse to be able to try multiple options of internal support until they find what works for them and multiple options of external support. So the pelvic bra is one type of external support.

I designed it because there wasn't an external support like this out on the market, but there are other external support options out there. Anyone with prolapse I think would benefit from some type of external support. It is the pelvic bra the best fit for everyone? No. But if you're somebody that likes to wear cute clothes and you don't wanna show panty lines or straps.

You wanna wear your own clothes, then the pelvic bra is a great fit and we'll go over some of the, I think, objections in a little while, um, to kind of help problem solve that. So, uh, number one, everyone with prolapse. Number two, I would love everyone with stress urinary incontinence. So that's where you have leaking with exercise or activity.

We're seeing some fantastic outcomes when people saying, Hey, I was able to jump on the trampoline and I didn't leak. Or, Hey, I was able to run my marathon and I didn't leak, and I used to leak. Like, wow. I mean, that wasn't specifically the population that I designed this for. But it is providing support there for the urethra and helping to counteract that, um, that pressure from, yeah, and helping with the urethral closure pressure, basically.

That's pretty amazing because I would not have predicted that either. I mean, I would've thought, oh, yeah, this'll help with prolapse. I would not have thought that it would help with stress incontinence. So I, I just wanna comment on a couple of things that you said. So I, I totally agree with you. I think everyone with prolapse should try conservative things first, if that fits them, you know, before surgery.

And sometimes we do move quickly to surgery, um, just because there are other, other things. And if you can avoid surgery, you absolutely should. I do like pessaries a lot. We can't always find a pessary to fit someone though, right? Just based on your anatomy. Sometimes it just doesn't work, you know, that we can't get the sizing right.

It's a little bit too uncomfortable, it slips out. There are just all kinds of, of reasons. Um, or, or maybe you just don't like it. And, and so then I think something like the external support, um, is, is just an amazing option. When you talk to women about this. Are you. Um, are, are most people surprised? Have most people heard of this?

Or is this a really novel concept? Absolutely not. It is like what? I mean, you can just see, so if it's a provider, and especially if they're in the pelvic health space. Yeah. If they're gonna sit there and like their wheels are turning, they're asking questions, it's it, I've been to a couple, like, uh, community facing events, people are shocked.

I went to a senior fair in the middle of Texas. Yeah. And so look, we're starting the conversation and that's kind of my mindset going in. We're starting the conversation. A lot of them haven't even heard about their pelvic floor muscles and what they do it. I mean, that is true. Probably not. So it's like, wow.

Um, but yes, I would say everyone is surprised except for a few pelvic floor physical therapists that are already using some type of external support. Yeah. So you, why did you design this? What, what was lacking out there? Can, can we pause that and let me go back? Yeah. Because on that prior, um, a couple questions ago you asked who would I love for this to be for?

Yeah. Who is this for? Because there's a couple other populations that I'd like to go over. Oh, birth injuries. Okay. So we have two main areas where the pelvic floor is affected. So Leva injuries, and I have some models. Um, so pretend like. So here's the pelvis and here's the bowl, right? And these are the pelvic floor muscles and the baby.

Sarah, I know you know all of this. I'm not educating you, I'm talking to your audience. I, I mean, I think everybody needs to hear this multiple times, right? It, it's totally fine. Okay. So we have, as the baby, as with a vaginal delivery, you have two doors that that baby exits through, and those are controlled by your pelvic floor muscles.

So the first door is gonna be these deeper. Muscles right here. These are called the levator anai muscles. And so as that baby is going through, it's, it's, that door needs to open and descend some so that that baby can exit. Sometimes that doesn't always happen. Sometimes there's injuries and so those are called levator anai avulsions or levator anai overstretching.

So, so, and with that, that. This gap here, we can measure this gap and, and if that is widened, a widened lator hiatus, that is one of the number one risk factors for pelvic organ prolapse. So catching the people. That have birth injuries of their levator anai avulsions either after birth or maybe they don't recognize that they had any injuries and they had no issues for many years, and then they hit menopause.

And then all the hormone changes and the anatomy changes that happen with aging, then that hits, so, okay, levator anai avulsions or lator anai injuries. And then the second group, as this baby is exiting, that birth canal is gonna come through a second. Full, which is the urogenital hiatus. Okay, so babies coming through urogenital hiatus, and this is, so this is the anus.

That's the vaginal opening and that's the urethral opening. This is where peroneal tearing can happen. Overstretching. Um, and so if there's somebody that had a severe perineal tear or even a significant grade two tear, so you have grade threes and fours that go all the way into the external anus or the rectum, and then you have grade twos that may, may not go all the way to the external anus.

Um, but you still have some significant muscle function damage there. And so I would love, love, love to see these people too that are at risk of. Injury and, um, needing that extra support there. And honestly, I'm gonna actually say this out loud. I would love every postpartum person that has a vaginal delivery to be able to have this in their first year postpartum.

This does not mean that they're gonna have to use the pelvic bra forever, but those tissues, the pelvic floor goes. Under a huge amount of stretch, up to 3.78 times. Its resting length. So if you think about your bicep, it attaches here to here. If you stretch that almost four times its length, it's gonna rupture, right?

The muscles aren't gonna be attached. So regardless of what kind of, uh, tearing, amount of tearing or maybe you had no tearing, the structure still go through a tremendous amount of stretch. I'd love for you to have the option to use the pelvic bra in that first year postpartum. As your fascia is recovering, your muscles are recovering.

It's resetting. We want that fascia to reset in a supported position and not a LinkedIn position. So I love all that. I, I should also tell you, I always like listening to people describe things or, um, educate on things that I educate on because I always learn something, right? Or, you know, I hear someone use a phrase and I'm like, oh, yeah, that's good.

I, I really like that. And I, I think that explanation is, is brilliant, right? And for most people, prolapse really happens over time and it's multiple injuries. And if you do have a muscle injury, then you know, your tissues just aren't as well supported. And over time you, you'll develop a prolapse. And so doing things that can prevent the progression of prolapse or prevent prolapse from happening is, is amazing.

The only other thing that I would add about the postpartum um, piece is that, you know, sometimes when you're healing, having pressure on the perineum might be uncomfortable, right? And so if that's the case, then I would say, you know, wait for a couple of weeks and then try it again. Because sometimes those tissues are, are pretty delicate.

But you know, it all speaks to, um, you know, how we need to identify these injuries earlier, right? And, and start intervening. And start preventing, and, and it's just a hard time for women to be aware of their pelvic floor, right? When they're up Nursing, feeding. Yeah. Figuring out their lives, right? All the things.

All the things. Yes. All the things that are normal, but much harder than you ever thought. They, they would be. So I, I think you were gonna speak to this, but Yes. Um, what are you hearing about the pelvic bra? What feedback are you getting besides, I don't leak when I run or get on a trampoline, which is amazing.

Right, right. So before people try it, some of the questions would be, or, or some of the objections would be like. Ah, I don't like thongs. So that would be probably the biggest objection that we hear because the pelvic bra is, uh, it has a, it has a supportive thong. This is a medium, and so the, the hammock piece is gonna, it's gonna change based on sizes.

So we go down, we go from uh, XXS, which is very small, up to an xl, and we have some. Testers right now trying out two x, three x and four x. So then those are gonna be larger, right? So, um, so that's one of the objections. One of the things that we find is that people, once they wear it, they're like, wow, that feels really good.

I don't even like thongs and I like this. So don't let the thong piece kind of deter you. This can still be a really nice support. One of the key things is, does that, does lifting that perineum from the outside feel good? So that's, uh, that's some of the feedback. Um, another piece of really interesting feedback that I've had from, um, two people has been, I.

They have prolapse. And so she was telling me this, she said, Janice, I always was jealous of people when I was in a public restroom, so I would hear these really strong urine streams from the stalls around me, and it's like a strong, steady urine stream. And I'm like, man, I'm so jealous because I'd have to twist and turn and mine would stop and start.

And she said. After I wear the pelvic bra or when I'm wearing the pelvic bra, I have a better urine stream. I have a solid urine stream where I don't have to twist and turn. And that's still, I think for me, that's one of the most like, wow, this could be, could in some people actually be helping them to empty their bladder easier.

Um, so that's something interesting. Another piece of feedback would be that. I'm able to run more errands when I'm out and out and I'm drinking coffee because this compression is helping me hold it longer so I can make it to the toilet. And I have more confidence when I, when I'm out in the community because I'm not having to find every toilet.

So those are some kind of from the bladder side that I wasn't expecting. From the pelvic organ prolapse side of things like is helping with perineal, descent is helping lift. I can wear it. Nobody knows that I'm wearing it. It's invisible. So only I know or the people that I tell know that I'm wearing it.

I don't have the vaginal bulge when I'm wearing it. This is magic. I wish you would've created it years ago. Um, so. Those kinds of con, yes, over and over bulging, perineal, descent is helping to lift. Well, and that's exactly why you designed this, right? I mean, that must be, uh, so amazing for you to get that feedback and realize that you, you know, you did what you set out to accomplish.

I know. And you were, I mean, do you remember, so it was probably a year and a half. Like I was in the testing phases, right? Like I'm in developing it and, and you and I have had these conversations Yeah. Over the years. And you have been one of my biggest supporters. I'm like, oh yes, yes. And so I think I even, I just remember that one interview.

I was in Austin and we were, I think it was on Instagram or YouTube. I'm not sure where we were. But you have been so encouraging and it's been a journey, but yes. I personally, on that note, like I had my first baby in 1999. I find, I found out I had prolapse at a pelvic floor PT course with my lab partner checking me in 2000, and so this has been, and it's 2025 right now.

I launched it in May of 2024. So this has been like. Wow. Almost 25 years. Yeah. Imagine I could have had this earlier and all the, all the fun, cute clothes that I could have worn. So that's kind of going back to, yeah, I was gonna circle back to that. Mm-hmm. I mean, I did wear them, but, uh, so, okay, so the external support options that are out there right now, I'm gonna give you, and I, I want to be really, um, graceful here.

So I am happy that. All of these support options exist. Yeah. There's things that I like about them and that there's, there's things that I don't like about them, and so I designed the pelvic bra to be what I wanted, but I'm still happy they exist. So there's some types of garments and, and your goal was to have support, but also something that was, um.

You could wear cute clothes, was easy to get in and out of. I mean, some of them, you know, just require some time to get in and outta Right. Um, and, and something that was flat under your clothes. Yes, yes, yes. And I'll show you, I'm wearing one right now, so in a minute I'll do a little, a little runway walk.

So Nice. But yes, so I wanted it to be discreet, something that I could wear with my own clothes. So there's some that have the perineal support built into shorts or built into leggings. So this would be one type. So the sides here are really stretchy, but then there's this panel, this black panel that runs front to back.

This panel is, is rigid support, like this panel isn't giving and it has support. And so that has been something that I found helpful. You know, that was a lift. But then I wanted to wear my own clothes, right? I wanted to wear my own weddings. I wanted to wear my, you know, my own things. Um, there's other types out there that are able to be worn over your panties, but under your clothes.

But then they would have bigger straps in the butts. I like to wear fitted clothes and I didn't wanna have, I didn't want that strap in my butt. Um, also in terms of being able to take it on or, or rather put it on or take it off when you're out and about. So with the pelvic bra, we have these adjustable hooks.

Are like bra hooks on the waistband of, we have two types. One has a solid waistband, one has those adjustable hooks. So with the adjustable hook one, you can put it in your bag and you can go out and do your day. And then if you're halfway through your day and you're like, Hey, I need some support, you can just go in the bathroom and put it on.

You don't have to take off your pants and your shoes and all that. So it's a nice flexible option. Or let's say you started off the day with support, but then you're gonna be sitting the rest of the day and you don't need the support when you're sitting. Some people, most people don't need it when they're sitting.

There's a few people that do need that extra lift, but, but let's say you're someone that doesn't need it when you're sitting, then you can go into the bathroom and take it off. So that just gives you. The freedom that you want. Uh, the also, I think that's a, a brilliant idea, right? Because, you know, sometimes a support like that, you know, it might get uncomfortable over time and it's amazing that you can just put it on without changing all of your clothes.

And I think that really speaks to the design being by someone who uses it, right? Because I'm sure you are out and about some time wanting it, on, wanting it off and thinking. You know, how do we, how do we do this? And Yeah. You know, if you're thinking about it, someone else is thinking about it too. Also, we didn't have the option to have it be adjustable size.

So with these hooks, yeah. If you, let's say you have bloating, um, and you're bigger towards the end of the day, or for whatever reason you want more pace, then you can adjust it. Out, but if you want it tighter, then you can just tighter. And then we've also made raw hook extenders that would go in between here.

So if you're someone that has a larger abdomen and you want the support that the median hammock gives, but you don't need the, um, well look, I'm gonna get all my sizes mixed up here, but basically if you want a bigger waistband and a smaller hammock, those bra hook extenders let you do that. Um. I, you know, I can see pregnant women wanting to use this too, right?

Because some pregnant women have support issues, prolapse issues, and so having all of those, um, options, I think is, you know, pretty, pretty great for that population too. Okay. I have two questions. So, one, do you wear underwear underneath, or no. So let me.

Most people are wearing it with their underwear underneath, and that is how, that's a beautiful way to wear it. But we've made reusable extra long thong pantyliners. And so this wraps around the thong strap. And it covers all the openings. Okay. You can use the pelvic bra with these liners and they come in different colors and sizes and so forth.

So, uh, what, and it's a hundred percent cotton, so this side is like a flannel, and then this is, um, just a print. But, so you can use it that way. Uh, sometimes when I'm on my period. I'll just use the pelvic bra, I'll put a pad on, and then I'm using the tampon and so I'm using it as panties. Uh, but I have a barrier in between because it's a pretty expensive pair of panties.

The sports is $49, and then the classic, the adjustable one is 79. So you wouldn't, I mean, hey, you wanna get seven and rotate through them every day. Great. But. That's, again, a very expensive pair of panties. And so using these liners or using, uh, yeah, even an extra long thong panty liner, um, works well too because let's say that you're someone that likes thongs.

I'm, I'm gonna go, we're, we're talking about everything. Okay. So let's say that you're someone that likes thongs, so you don't wanna wear like regular bikini underwear under this. And so you wear your thong. But your thong doesn't give full coverage to cover all the areas with the strap. And so then you're like, ah, man, what do I do?

I guess I'm washing this thing every day, right? And so we don't, um, we, we allow space for that. But uh, I think that unless the thong is really full coverage, you might have some touching of the pelvic on some of those openings that you may not want. So using a barrier in between is good. What about sizing?

How do I know what size to get? Well, we have some sizing guidance on our website. Basically what you're measuring. So pretend like this is the waist and then you come down and here is here your iliac crest. So I'm gonna stand up here. I'm in a hotel room and it's really bright in my face, so hopefully you can see me.

So here's my waist, here is my pelvis, right? And so I'm gonna put the, I'm gonna use the tape measure right below my iliac crest here, and I'm gonna pull it snug and I, ideally you are not. Um. You are not wearing clothes because you want to have as little barrier in between your skin and the tape measure as possible because that's how you're gonna be wearing the bra.

You're wearing the bra directly on your skin, or you have some panties underneath, but a very little layer. And so then you'll take that measurement and you'll go to our website, the sizing guide, and you'll see where you fall, whether it be a XXS or all the way up to xl. So right now we have six sizes, and then again, we're doing some testing.

Some people are testing out some models for two x, three x and four Forex. Um, what's your return policy? We allow returns as long as the tag and the hygiene liner are intact, and the bra is in its original condition. So if it looks like the tags are taken off or you've warned it, then we're not going to accept it, but.

Right now we're in April, so we've been out like 11 months and we've not ever, we've never rejected a return yet. Everybody's been really good and people will just switch it back. Um, in the US we include prepaid labels, so you can just pop it in the mail, and that's something else that I as a consumer like, oh.

Um, if I have to return something, it drives me crazy to have to go through all of these hoops and then also to have to find a printer to print this label so I can do it. So we've included the label. We do ask that you complete the little, um, serving about why you're returning it because we want to understand and we want to know, but.

We accept returns. If you're outside of the US you need to pay for return shipping. But we do accept returns outside of the US as well. So let's say I'm listening to this and I think this is the best idea ever and I want one, how do I get it? Go to my pelvic bra shop. And you'll see the options on there.

And it's the e-commerce site. So you can order directly there. And if you had any questions, you can email us or submit, um, a question online there. But our email is hello at my pelvic bra shop. Okay. Um, anything else? Is there anything else you wanna share about it? Um. I am just overwhelmed. Oh, yes. I do wanna say this.

Like we are out inventory of a lot of sizes. Okay. So that's probably like in terms of. Of when you create a product and you're launching a product, you don't really know how popular it's going to be and how many to make and what, what depth that the inventory you need before you launch. And so we had a good depth, but our supplier isn't able to keep up with demand.

So if you go to the website, which is a great problem for us, I was just gonna say that. Uh, so you go to the website and you look for your size, and it's out of stock. There's a little button that you can sign up for restock alerts. And so we're restocking regularly, like she is busy at work and we have a, we have several other.

People that we're working with or, or entities, suppliers, that are creating samples for us to be able to help boost our production. But the samples at this point haven't been, um, what we wanted them to be because we want it to be a consistent Yeah. You know. We want the product. Product, it is our product, so it needs to be what we want it to be.

And so we're working on it. Sign up for restock alerts and sign up for our newsletter. 'cause we'll also send, um, little alerts there in our newsletter about restocks. Yeah, so some growing pains, um, as, as you, you know, dominate the external support market. Um, so be patient. Yes. Yeah. And uh, just again, any questions, we're here for you.

We want to help you find the right fit. Oh, this is something else too. We do offer live Zoom fittings one-on-one. So if you had, uh, questions or you wanted some feedback, schedule a Zoom, setting a zoom session with us and we'll help. We'll help. That's really nice. I, I like that. I'm sure a lot of that, you know, a, a lot of women are, are looking for that.

Yeah. Well, I just wanna thank you for all you do and for your creativity and how you never stop. Right. It's always something new. Something that was so fun. Thank you again for this opportunity and we'll look forward to doing more things in the future. And really I do want to meet you one day in person.

So hopefully it is funny to have, you know, online friendships. I totally agree with you. I'm sure I'll see you in person and be like, oh, you're so tall. Right. Or I never knew. Oh, you know, listen, um, I may be out in the Portland area sometime in the next year, so. Well, you should let me know. Yeah, I would be happy to pick you up from the airport and take you out to dinner.

Thank you. Okay, my friend. Thanks so much again. Thank you.