Kim Vopni (00:01.378)
Hi Marina, thank you. This is a long time coming, this conversation, and I'm glad that we're finally able to connect and chat about your amazing book. When I first saw the title, of course, it was one that we had to talk about, the vagina business. I would love to, I guess, start out with, know, who are you and what brought you down the path of writing a book called The Vagina Business.
Marina Gerner (00:11.483)
Hehe.
You
Marina Gerner (00:26.234)
Yes, I'm so, so, so excited to talk to you. And likewise, I knew that we would have to talk about this book. And yeah, I really look forward to it. So thank you so much for having me. I'm several things. I'm a journalist. I've been a journalist for a long time. I'm also an adjunct professor at the NYU Stern School of Business and
Kim Vopni (00:35.458)
you
Marina Gerner (00:55.44)
I've covered a whole range of topics as a journalist. I've covered health, technology and culture, oftentimes with a focus on women. So I've always been interested in the stories of women and underrepresented voices. And so when I came to the topic of women's health and innovation on women's health, I realized my kind of strange combination of interests comes together quite nicely because
If you only look at it from the business side of things, you would think, wow, this is, it's a $1 trillion market opportunity. know, everybody should be investing and should be seeing this. Why isn't it happening? And if you only looked at it from the cultural side of things, you wouldn't understand the financial underpinning of it. So I was really excited to bring business and culture together and to bring, you know, commerce and society together in this. And it all began with an insight.
I had, well, it all began with a bra actually, about five or six years ago, I had an insight, which is probably something you already know about, but a lot of people are not aware that if I ask you to imagine a person who's having a heart attack, most of us tend to picture the same kind of person. It tends to be an old white man. And then if I ask you to picture the symptoms, we tend to imagine pressure on the chest and then pain radiating down the left-hand side.
And so I learned that those symptoms are typical for men, but they're not typical for women. And I thought that was mind blowing because that's the mental image that we have. And that's what most people think of. For women, our symptoms are considered atypical and they tend to include things like jaw pain and long-term debilitating fatigue. And when we experience pressure on the chest, we're more likely to call it
discomfort rather than pain. So the way that it's experienced and the way that we communicated is different. So my mind was blown by that realization. And then as a journalist, I was really excited to come across a company that's creating a smart bra that can help women who are at risk monitor their heart health. And I thought this is so cool because not only did I just learn about a new problem, but there are also people who are working on something that could be part of the solution.
Marina Gerner (03:14.044)
And the company is called Bloomer Tech. The CEO is called Alicia Chung Rodriguez. I met her at a conference and I ran down to meet her after her talk and she gave me her business card and I said, I'm going to write about you. know, more people need to know about this. And then I pitched the story and there was no interest from my editors. There was this impression that the topic was a bit niche. And unfortunately that's something you often hear when
you try to do something on women's health, it's still perceived as being a bit niche. And then the pandemic happened. And I think a few things shifted during the pandemic. I think the power relationship between patients and the doctor's office shifted a bit because we trusted people to test themselves at home and so on. Plus, if you think back to the start of COVID, men had worse symptoms than women. So...
If you wanted to be cynical, you could say we started to pay attention to sex differences and health because men were more affected by it. And that was the time when I finally managed to write the story about the smart brand. was published in The Guardian and it did really well. And through that, I was invited to various events and I was drawn into this world of innovation that focuses on women's health. And I've heard you say before that when you started out, you focused on postpartum and birth initially.
And that was something else that was definitely on my mind because at the time I was in my early 30s and I knew I wanted to have children soon. And so I was looking into the space and I knew that nine in 10 first time mothers experience a birth injury. And I thought that was again, one of those mind blowing statistics. It's something that's unfortunately so normalized. And, know, we just say, welcome to being a woman instead of coming up with.
better solutions. And so I was looking for people who are part of the solution, for people who are not accepting that attitude, but are trying to create something else. And I found a company in California called Materna Medical that's creating a dilator that can help us hopefully prevent birth injuries. It dilates the vaginal canal in the first stage of labor so that by the time the baby comes through, the idea is that you've pre-stretched those muscles.
Kim Vopni (05:09.975)
Mm-hmm.
Marina Gerner (05:38.076)
and then you're less likely to experience tearing, you're less likely to experience pelvic organ prolapse and urinary incontinence further down the line. But they're testing all of these things in clinical trials right now. So, you know, it's going to be evidence-based and hopefully this device will make it to the market. And there are a few other devices like that that are being developed right now. And I thought that was really exciting. And when I looked into the space of birth, I realized the last big innovation.
in the standard of care of birth was the epidural, which was popularized in the 1950s. And I just thought, you know, there's no other area of society and technology where we bring something out from the 1950s and we say, hey, look, this is the best thing we got. Look at this cutting edge floppy disk. But in birth, that's exactly what we do. And I thought that was shocking. I spoke to people who have a vagina centric innovation and I learned that
Kim Vopni (06:21.026)
Yeah.
Marina Gerner (06:36.397)
One of the main obstacles they face is that they struggle to raise money because investors are predominantly male. And unfortunately, there's still a lot of stigma around vaginas. And so they don't want to put their money into something that would require them to talk about vaginas in a business setting. So I have this quote from an investor who says, I don't want to talk about vaginas in my Monday morning partner meeting. And I wrote this story for Wired magazine and it was called, We Need to Talk.
about investors' problem with vaginas. And that story did really well. It went viral. And it led me to write the book.
Kim Vopni (07:13.709)
Wow, that is such a cool story. I love it. Yeah, you know, there's so many little nuggets that you had in there and just on the last comment you've made, I, when I first started, yes, it was very much prenatal postpartum. Well, originally it was pregnancy. I really wanted women to, to have the knowledge of pelvic health before they gave birth. And so there was my program prepared to push, but you, you mentioned a product or company called maternal.
Marina Gerner (07:37.445)
Yes.
Kim Vopni (07:42.942)
The product that got me into the world of pelvic health is called the EpiNo. And it's been in Germany for many, years. I feel like, that is, yeah, okay. So that was my catalyst into this world of pelvic health. And of course, I learned a lot more afterwards. But so it was originally pregnancy-focused.
Marina Gerner (07:47.567)
yes, yeah. Decades, yes. I know the epino, yeah.
Kim Vopni (08:07.005)
I created this program because I wanted to incorporate fitness and training. And then of course, I also had this product that I was a Canadian distributor for. So it was the intention of getting more people aware of the epino as well to help reduce the likelihood of tearing and yada yada. Then it was like, okay, well now postpartum recoveries are overlooked. So then I partnered with two other women. We, created our own postpartum recovery rap, taking inspiration from other cultures around the world. But the point that I want to make is all that was 20.
I started 21 years ago, right after the birth of my first son and Belly's Inc was kind of 2011 when that was starting. And initially there was no social media and part way through we had, we had Twitter came along and we could use hashtags, know, hashtag pelvic floor, but, but we definitely didn't say the word vagina. I remember hiring a PR firm to help me get the, you know, to, have more awareness of what I was doing. And they said, you can't say vagina.
Marina Gerner (08:46.97)
Mmm.
Marina Gerner (08:51.65)
Right.
Kim Vopni (09:05.773)
little ears might be listening. It's not appropriate for our audience. And I just was like, was, was, it was blood boiling. It made me so angry. that, but social media also, when we started to leverage it really, you know, I, Twitter was initial, then Facebook came along and then Facebook started to have a business component. Then Instagram came along and for so long, anything you could not say vagina, you had to code name everything. My posts were taken down.
Marina Gerner (09:09.891)
Marina Gerner (09:15.801)
Yes.
Marina Gerner (09:33.914)
Yeah.
Kim Vopni (09:35.5)
all the time. meanwhile, we could see all these posts about, you know, when women could have strings over her nipples, and that was fine, but a breastfeeding image was not. And you know, it was just so much. It was so frustrating, so frustrating. so the point you're making about so many people just don't even though you say the size of this industry, the health care decisions are predominantly made by women, yet nobody is investing in these.
Marina Gerner (09:42.308)
Hmm. Yeah. The double standard of it. Yes. Yeah. Yeah.
Marina Gerner (10:00.051)
Mmm. Yes.
Kim Vopni (10:04.343)
companies or ideas or everybody's still uncomfortable with this word vagina. It's crazy.
Marina Gerner (10:08.762)
Exactly. Yeah. So 80 % of healthcare decisions are estimated to be made by us, but only 4 % of R &D funding focuses on us, as you're saying. And that's actually one of the questions I was going to ask you is, you know, what is it like to have the word vagina in your Instagram handle? Because you're out there, you're the vagina coach, you're the queen of the pelvic floor. And I'm completely not surprised.
to hear that you've encountered censorship. And it's been a journey for me as well, having the word on the cover of my book. And it was so important for me to have it on the cover because of that insight that investors don't want to use the word. And because of that, we're not getting the innovation that we clearly need and want and deserve, including things that are relevant for nine in 10 first time mothers.
Kim Vopni (10:43.895)
Mm-hmm.
Kim Vopni (11:04.257)
Mm-hmm. Mm-hmm.
Marina Gerner (11:05.37)
So I knew from the start that I wanted the word to be on the cover and I wanted to pair it with business because, you know, I write about finance, I teach at a business school and so I wanted for this book to be in the business section and to be read by investors and so on, among other people, of course. And from the start, I had this idea for the title. And then when my agent and I, when we went to speak to different publishers,
Pretty much all of them said, this is a great book, brilliant book, but you'll have to change the title. And I've heard various explanations. One of them was, you know, a publisher usually has a sales team and oftentimes the people on that sales team might be guys who are then not comfortable pitching the book to Barnes and Noble or to Amazon. And if they don't do a good job of pitching the book, that creates a problem. So that was one of the...
Kim Vopni (11:41.805)
crazy.
Marina Gerner (12:04.109)
one of the obstacles. And I kept explaining to them, but look, the whole point is that I want to destigmatize the conversation and I want to have the word on the cover. And the book was sold to the largest women owned publishing house in the US. So I thought, okay, now the issue is solved. But then unfortunately, after a while, as I was getting close to the deadline, my editor got back to me.
Kim Vopni (12:09.547)
Yeah. Yeah.
Marina Gerner (12:29.89)
And she said, you know, we've had some feedback from independent bookstores and they're saying, some of them are saying they're not going to promote your book. They're not going to display the book. They're not going to mention it in their newsletters because the title is too much for them. And why don't you come up with a euphemism of some kind? So I was asked to come up with 16 alternative titles for the book, which I did. I called two of my best friends and I said, my God, help me. And we came up with
Kim Vopni (12:38.469)
my gosh.
Kim Vopni (12:50.473)
my god.
Kim Vopni (12:56.865)
Let's have a pussy party where we're gonna come up with names.
Marina Gerner (13:00.698)
Yes, so we did. one idea was something like, when women are well, you know, it would have been a very different vibe, a very different title. And frankly, I didn't like any of the other titles because I knew this was the true name of the book. And then they ran a whole market research project online. And guess which title won? The vagina business. And I think that's because women are...
Kim Vopni (13:22.903)
Nice, nice.
Marina Gerner (13:27.492)
tired of euphemisms and it really resonates with my target readers. And so at that point, I had the research to argue and to say, look, this is clearly what we need to go for. I thought the issue was solved, but it continues to crop up. It continues to be an issue. when I was looking for a venue for my book launch, there was a venue that turned me down purely based on the title of the book.
There was another author who refused to write me a blurb, again, based on the title of the book. Yeah, these things keep happening. There was somebody who tried to write an Amazon review and then her review got flagged as violating community guidelines because it included the word vagina in it.
Kim Vopni (14:14.143)
Even though that's crazy. It's just crazy. The book on Amazon has the word.
Marina Gerner (14:16.761)
Yeah.
Yeah, it's just, yeah, because it is on Amazon. So then why would it be an issue in the review? But it just, it just keeps happening. And, you know, I do a lot of speaking engagements and corporate speaking engagements. And I'm sure that for some companies, the title of my book is unfortunately too much. Even though I think that the content and that my message would really resonate with many people.
Kim Vopni (14:23.543)
Right, right.
Kim Vopni (14:49.067)
Yeah, well, yeah, yeah, but you know what, it happened, you made it happen, you did the research and you it's like, you know, you're kind of like, okay, I'm going to go through these motions, but this is the title and this is what it has to be. And, and I'm incredibly, I'm just thrilled that you did that, because we need more of that, we need more people saying this word, because that is a huge reason why there is so much silent suffering associated with women's health.
Marina Gerner (14:49.283)
So it continues to be a challenge.
Kim Vopni (15:17.261)
particular pelvic and vulva vaginal health is because we can't say the word. We aren't allowed to say the word. We don't like saying the word we whisper the word. And so when I originally I my my brand when I was working with prenatal postpartum was fitness doula because I was again trying to trying to leverage fitness as part of the pelvic floor muscles and training for birth and and recovering and you know, so that's that's what it was for long time. And then as I started to expand into
Marina Gerner (15:33.005)
Mmm.
Kim Vopni (15:47.066)
Menopause space, Dulo didn't resonate quite as much and I knew it needed a bit of a brand change. I joked one time doing a talk. It was a business conference and I joked like, okay, now you have a vagina coach for your business. And it was like, oh, there you go. That's the brand. I've got to step into this really uncomfortable word. so it was, was, yeah, it was kind of like, ooh, should I do this? And it was one of those turning points where it made a significant impact in the business.
Marina Gerner (15:49.933)
Mm. Mm.
Marina Gerner (16:00.341)
He
Marina Gerner (16:04.888)
Yes.
Marina Gerner (16:09.122)
Yeah.
Kim Vopni (16:15.117)
even facing those challenges, I would still do it over again in a heartbeat.
Marina Gerner (16:19.991)
Yeah, exactly. There's definitely the point where you have to make that decision and, okay, am I going to be that person? When people see me at the supermarket, they're like, isn't she the one who talks about vaginas all the time? And you're like, yeah, you know what? I am going to be that person. And please, welcome. You know, talk to me. Yeah, and it makes so much sense that you started with this doula angle. Because, so I'm thinking back to my...
Kim Vopni (16:29.655)
Yeah, yeah.
Kim Vopni (16:34.443)
Yep, yeah. Yeah. Yeah.
Marina Gerner (16:48.429)
birth preparation courses here in the UK. Everyone does a course, a prenatal course. And I remember it was led by a midwife. And at one point she asked everyone in the room if people had ever heard of the pelvic floor before and what it was and nobody knew about it. It was quite, it was so eye-opening to me because
It was a really engaged, really educated group of people and they knew about all the different types of strollers and all the different gadgets and things. then, you know, how do you not know about your own body? Yeah. And such a powerful part of it too. I feel like I'm always aware of my pelvic floor. Is that weird?
Kim Vopni (17:22.381)
Your own machine, your own, yeah, yeah.
Kim Vopni (17:28.407)
Yeah, I know.
Me too, but I know, you know, I always think is it just me? Yeah, yeah, it's, it's, I've been doing, I've been talking about super 21 years and I still am surprised daily that there are people that haven't heard the term pelvic floor, they haven't heard of women's health or pelvic health physios, they, they might have heard kegel, some people still aren't even familiar with the term kegel exercises. So yeah, it's
But I do see that there also has been a huge shift and change over this last 20 years. And I would say a lot of it has even been within the last seven-ish years on social media. Social media has played, as much as it's been a challenge, it has for sure played a role in helping move the conversation forward.
Marina Gerner (18:18.071)
Yeah, I think so too. I've also seen some changes over the last five or six years in that when I started this research, nobody really spoke about perimenopause, whereas now I feel it's a term that's everywhere. And the same goes for endometriosis. That was not really something people were aware of five or seven years ago, whereas nowadays more people would recognize the term.
Kim Vopni (18:38.605)
It's talked about a lot. What was so another term that some people will be very familiar with others may never have heard is femtech. So this bra falls under this category of femtech. So can you explain what is femtech? And then I'm curious to know what were like your top three or five companies or products that you found in your research that
Marina Gerner (18:49.529)
Mmm. Mmm.
Marina Gerner (18:55.341)
Yes.
Kim Vopni (19:06.027)
that really were kind of hitting the mark in this femtech world.
Marina Gerner (19:09.433)
Yeah. So the first thing to say about FemTech is that people often mishear it as FinTech, financial technology, but it's FemTech, female technology. And that's technology that's focused on the female body and women's health. It was a term that was coined in 2016 by Ida Tin, the founder of the period app Clue. And she wanted to bring together all these different companies under one umbrella, partly also to give investors a more comfortable term that they could use.
Kim Vopni (19:14.925)
Mm.
Marina Gerner (19:39.829)
So that they could say, know, I have two femtech companies in my portfolio, rather than saying I've got this company that helps women not pee their pants. So that was her, her idea. And some people prefer the term women's health innovation. I think femtech has been a really useful term because it's brought people together. People use it to create communities and conferences.
and so on. And it is estimated to be a $1 trillion market opportunity. The way I define it is that it's usually consumer focused and oftentimes digitally enabled. But then some things that are in this category are not necessarily tech or not strictly speaking tech like contraceptives or period underwear. You know, it is quite a broad category.
Kim Vopni (20:35.393)
Right. Yeah. So you talked about the bra. What would be like your top three to five products that you when researching the companies for your book, what were your favorites?
Marina Gerner (20:50.41)
Yeah, people often ask me that. It's really hard to say because I've covered so many different areas and I've interviewed over 100 people. You know, I've got hundreds of innovations in the book. And so I wouldn't want to rank them. I wouldn't really want to say one is more important than the other. You know, one woman's endometriosis is not more important than somebody else's menopause symptoms, I would say. But and also not everything is for every woman. And, know, we all we're all different. We all are at different stages and
Kim Vopni (21:15.789)
for sure.
Marina Gerner (21:19.734)
and so on. But the reason I usually talk about the birth, die later and the smart bra is because I want for people to remember that women's health is not just about reproductive health. So it's also about our heart health and about our bone health and so on. So I've made sure to include innovation in those spaces too. There's a belt called the osteoboost. Have you heard of it? Yeah, for menopausal women to strengthen their...
Kim Vopni (21:43.714)
No.
Marina Gerner (21:48.451)
bone mass density, works through vibration and you can wear it in conjunction with doing exercise or medication. So that's something in the menopause space that I thought was interesting. And then there's another company I've covered called Medora that is creating an external device that uses ultrasound to help with vaginal dryness. And I've oftentimes looked at devices that are preventative.
or minimally invasive because I think that's the future that we all should be moving towards.
Kim Vopni (22:18.541)
Mm-hmm.
Kim Vopni (22:25.773)
Yeah, I totally agree. What on the so I appreciate the not wanting to necessarily lump what were your favorites, but it you've talked about the dilators, you've talked about the vaginal dryness, what others specific to vulva vaginal health maybe were there that you covered or were those the two main ones?
Marina Gerner (22:50.872)
There are many others and they're both a vaginal. But I'm thinking there's the O-nut, for example, which is, have you come across them? It's range of silicon rings and that can help with painful sex. So I have a whole chapter and that was a really conscious decision that focuses on sex tech. You know, to make sure that sex is included under the wider umbrella of femtech.
Kim Vopni (22:57.645)
Mm-hmm. Mm-hmm.
Kim Vopni (23:11.959)
Perfect.
Marina Gerner (23:20.054)
because sexual function and sexual wellbeing is part of our overall health. And even the World Health Organization and there lots of studies that are now acknowledging that if you include sexual pleasure as part of an intervention, it tends to be more effective when it comes to public health issues, for example. I feel I've gone a bit off course, but...
Kim Vopni (23:42.167)
Mm-hmm.
Kim Vopni (23:47.083)
No, no, no, that's fine, that's good. That's good, what?
Marina Gerner (23:49.507)
but it's all still in the vagina area. And there's one company I've included that's actually a sex toy called The Lioness. they, so what they do is they can track your orgasm data. So they measure pelvic floor contractions and they have, I can show you a picture if I find it quickly.
Kim Vopni (23:52.652)
Yeah.
Kim Vopni (24:16.013)
For those that are listening to this, you head over to the YouTube channel, you'll be able to see the video version of the conversation.
Marina Gerner (24:23.916)
Yes, I don't know if you can see this, but they have found three main orgasm patterns. so there's the ocean wave, the volcano and the avalanche. And the one that's the most common one is the ocean wave. Whereas the one we tend to see in movies is, you know, the avalanche or the volcano. But they have found that three quarters of orgasms actually fall into the ocean wave pattern, which is a more rhythmic pattern.
Kim Vopni (24:30.903)
wow.
Kim Vopni (24:45.345)
Yeah.
Marina Gerner (24:53.4)
pattern. And what Anna Lee, the CEO has explained to me is that, you know, your orgasm data can also give you insights into your overall health because it's correlated to things like your cardiovascular health and potentially to things like sleep apnea. But they're all just beginning to research these things right now. There's obviously much more that's focused on
Kim Vopni (25:15.649)
Yeah.
Marina Gerner (25:19.7)
male sexual function and how that correlates with cardiovascular health and so on.
Kim Vopni (25:24.077)
Yeah, very, very cool. get asked about, there's a lot of devices, a lot of products for pelvic health, a lot of technology. And I get asked multiple times a day about different products. I always like to say that my bias is to take your money first to invest in seeing an in-person pelvic floor or PT to get an understanding really of what is the nature of your pelvic floor. And a lot of people just
Marina Gerner (25:34.679)
Mmm.
Marina Gerner (25:52.982)
Mm-hmm. Yes.
Kim Vopni (25:53.514)
as you said, as we were saying, they don't even know the term pelvic floor. They don't know they call the vulva, the vagina, like we just think of the whole area as the vagina. So we really are, we were poorly educated as it comes to our anatomy and function and the importance of specific muscle groups and that we even have muscle groups. So I always say, invest your money there first. And then all of these opportunities that we have with technology, with, with femtech, with devices.
Marina Gerner (26:16.715)
Yep.
Kim Vopni (26:22.335)
are all there as options that could potentially serve you if when the pelvic PTSD, it determines that that would be, they could help you determine which ones would be more beneficial or not and would be a waste of money. But I think there's a, there's a, there's an excitement with devices. There's an excitement with product. People like buying a product that people like to think that something can be done for them instead of them having to do something themselves. Right. But I do think that
Marina Gerner (26:34.805)
Yeah.
Marina Gerner (26:39.287)
Mmm.
Marina Gerner (26:46.999)
Yes. Yeah.
Kim Vopni (26:50.941)
At the end of the day, we are the ones if we are able bodied and enabled to, we should be doing the majority of the work and then we can supplement. kind of look at them like supplements, like we take for supplementing our diet kind of thing. but I'm also intrigued by some of them that some products, not necessarily specific to pelvic health, that as you were saying, they were tracking orgasm data. They, the bra that senses your heart health, like the tracking, the, the health awareness that we can gain from some of these is.
Marina Gerner (26:59.735)
Mm.
Yeah.
Kim Vopni (27:19.817)
is kind of cool too. yeah, I think it's.
Marina Gerner (27:21.047)
Yeah, I'm so glad you made the previous point though, because that's actually something I say in the book too, is that you first ideally would need to see a pelvic floor physiotherapist to find out what exactly is going on with your pelvic floor. Because I do mention pelvic floor trainers, but they may not be right for you. And Kegels as well just seem like such a tool a lot of the time. Plus most people do them wrong, as far as I know. So...
It really depends and there's a lot of individual variation. I guess the counter argument would be to say many people don't have access to a pelvic floor physiotherapist. So in that case, you know, what can you achieve by looking at YouTube videos and so on?
Kim Vopni (28:09.261)
Yeah, and there are some some biofeedback devices similar to the the epineau I would say at the time was very innovative and now is not so it doesn't really have technology per se and there are other things like The peri fit or the LV that do have technology associated with it that can help somebody understand if they are Like the LV does can differentiate between a bearing down versus an actual pelvic floor contraction a proper one which
Marina Gerner (28:20.16)
Yes.
Marina Gerner (28:24.649)
Yeah.
Kim Vopni (28:38.237)
the people that don't have access then at least there is something there that's going to be the next best thing. I'm excited to see more innovation. I love that all of this is happening and yeah.
Marina Gerner (28:44.587)
Yeah.
Yeah. And there's actually a device, I was speaking at a big tech conference in Paris a few weeks ago, and I met with the CEO of a company that's creating a device similar to the Epino, but it will be digitally connected. And you will know exactly by how much the balloon has extended and, you know, they're testing it right now. So they'll have all these parameters and then they'll be able to look at the birth outcomes as well. So tearing and so on.
Kim Vopni (29:00.641)
Mmm, cool.
Kim Vopni (29:14.571)
Yeah, yeah, I'm actually surprised it's taken this long for somebody to to innovate beyond the epi. No, I sort of feel like I thought that would be copied and improved upon a long time ago. But yeah, interesting.
Marina Gerner (29:22.519)
Mm.
Yeah, right?
Yeah, yeah, there is another similar device as well to the Epino that came out recently, but I agree. I think there should have been hundreds of innovations focused on birth injuries. It's such a weird gap. the whole normalization of female pain is just so weird to me that we, when it comes to so many things, we tell women, you've got extreme period pain. Well, that's normal.
Kim Vopni (29:37.506)
Yeah.
Yeah, yeah, yeah.
Marina Gerner (29:57.474)
painful IUD insertion, know, that's normal, or, you know, just suck it up. It's just all birth. A friend of mine was told, well, there's no birth without pain, you know, and she said, well, can't you at least try? Yeah, or another friend of mine who had a C-section, she was given paracetamol and she was told, well, only if you really can't...
Kim Vopni (30:02.966)
Have a glass of wine. Yeah.
Kim Vopni (30:12.768)
Yeah, yep.
Marina Gerner (30:25.483)
take it anymore, then we can give you something else. And why do we have to wait to get to that point? Like, why don't we just take female pain seriously? Why don't we prevent it?
Kim Vopni (30:36.202)
Yeah, and that same thing happens, even if it's not necessarily pain, but the discomfort or the acceptance of symptoms, particularly incontinence and prolapse. Well, just, you know, let's just put off what we can do. And often it's surgery. Let's put off surgery until it gets so bad, and then we can intervene and I think, well, maybe they don't even need surgery. Has there been enough
Marina Gerner (30:42.647)
Mmm.
Kim Vopni (31:00.96)
thorough investigation to see is surgery even like have we addressed all the root causes and what could we do even if surgery is going to be needed? What could we be doing in the meantime to better prepare that person so they have a more successful outcome? And why do we have to also though prolong that and say if somebody is really suffering and they have tried all the things, why do we have to wait and and why can't we accept that this is a this is an injury we would we wouldn't tell somebody with an ACL tear.
Marina Gerner (31:05.143)
Mmm.
Marina Gerner (31:13.771)
Yes.
Marina Gerner (31:20.663)
Mmm.
Marina Gerner (31:28.863)
Yeah, yeah.
Kim Vopni (31:31.104)
wait until it, like you really can't walk on it anymore and then we'll repair it. It makes no sense.
Marina Gerner (31:33.567)
Right. Yeah. Yeah. Yeah. And the fact that it's estimated to affect what 50 % of women, to some, it's just one of these mind blowing statistics again. And it was actually a years ago, it was my mother-in-law who first sent me your profile and it was in the context of pelvic organ prolapse. And then I feel like I've learned so much from you, know, looking into your work and I really appreciate that you have this whole body approach.
that you look at how everything is interconnected. And I remember you talking about things like breathing and how your organs are actually always moving when you're breathing and how much you can do with things like posture and even shoes, I think. Yeah. But still, what are the ideal shoes? Is it about avoiding high heels?
Kim Vopni (32:20.075)
Mm-hmm, mm-hmm. Yep, yep, low tech, but.
Yeah.
Kim Vopni (32:31.413)
Yeah, yeah. There's been research about the height of the heel and the ability, like the support of the bladder neck and the ability of the pelvic floor to respond. There's also been looking opposite to that with barefoot shoes and the ability, the better response of the pelvic floor. The basic principles are when we have an elevated heel, and that could be even like a quarter of an inch or half an inch in a
quote unquote neutral running shoe that that small seemingly insignificant change still creates compensations up the chain. So over time the adaptations in the calf in the foot musculature in our hamstrings in the position of our pelvis all can we can come back down to that small little change in the height of our heel and so transitioning to
Marina Gerner (33:25.503)
Wow.
Kim Vopni (33:30.207)
Either a zero drop is a term that's used where there's no elevation of the heel. There's also some negative heel where the heel is actually a little bit lower, which people can transition to as well. So that's one piece of it. The other piece would be having a room for your feet to actually move rather than when you think about putting on a pair of socks, we put our feet into these tubes that then squeezes our toes together.
Marina Gerner (33:33.812)
Hmm.
Marina Gerner (33:38.452)
Mmm. Mmm.
Marina Gerner (33:53.738)
Mmm.
Marina Gerner (33:59.507)
Yes.
Kim Vopni (34:00.299)
And then we put them inside a shoe that will also contribute to more restriction within the toe, the ability of the toes to splay or spread. And so that will also over time, it's, it's narrowing our base of support. And I always think, especially now because I'm post menopause and the fall risk and watching my parents age and we, want to, we want as much of a strong base of support as we possibly can. And a lot of the quote unquote geriatric or
Marina Gerner (34:07.774)
Yes.
Marina Gerner (34:17.369)
Mmm. Mmm.
Marina Gerner (34:25.014)
Mm.
Kim Vopni (34:28.511)
Older people shoes are very narrow. They often have a have a heel there. I just think that that is the worst possible shoe they could be in. So something with a wide toe box zero drop and also that is that ideally less cushion so that we can feel the ground because all of that provides sensory input that creates movement adjustment all these things that are important for the body to to know and function well and when we have
Marina Gerner (34:31.913)
Okay.
Huh.
Marina Gerner (34:38.922)
Yes.
Marina Gerner (34:45.0)
Yes.
Hmm.
Marina Gerner (34:56.566)
Mmm.
Kim Vopni (34:57.581)
huge amounts of cushioning and really restricted toe boxes and this elevated heel, all the compensations go up and we have more ankle, we aren't able to dorsiflex and plantar flex our ankles so much. have tighter calves, hamstrings, we have more of a posterior tilt in the pelvis and less efficiency with supporting the bladder neck. So yeah, so foot was the big thing.
Marina Gerner (35:21.6)
You should be designing shoes, I think. That's your... Okay.
Kim Vopni (35:24.277)
there are millions of people doing a very great job. I'm not going to design shoes. But it is a big part of the teaching that I have in my cert and also my regular consumer program because people just, we just think like, neutral shoes or I need more support in my shoes. And actually, really we want to transition to not needing, we should build our own support, similar to what we're doing with our pelvic floor.
Marina Gerner (35:32.372)
Yeah. Yeah.
Marina Gerner (35:40.244)
Yeah.
Marina Gerner (35:45.527)
Mm. Mm. Mm. Yeah. That makes a lot of sense,
Kim Vopni (35:50.529)
Yeah. Yeah. So, you know, all these, all these things we just never know. And, and,
Marina Gerner (35:57.204)
Yeah, what else do you wish everybody knew about the pelvic?
Kim Vopni (36:03.405)
I wish I knew I wish people knew that constipation is a problem for the pelvic floor and also can be a tight pelvic floor can be the reason for your constipation. So constipation we think of as I need to eat more fiber. But it's not always that it's, can be that but if we're straining to poop, it's really damaging to the pelvic floor. It also will make us feel like we need to pee more often.
Marina Gerner (36:19.647)
Yes.
Kim Vopni (36:30.125)
So the people that are saying like, always feel urgency, I always feel like I have to pee. I am always asking how much water do you drink and how often are you pooping? And also do you poop well? Because people could poop three times a day, but if you're pooping rabbit pellets, that's, you're constipated and that's gonna create more issue. So that would be something I would want. What's been, like since you've released the book, no, no, no, that's a...
Marina Gerner (36:39.958)
Mmm.
Marina Gerner (36:45.036)
Mm. Mm-hmm.
Yeah.
Marina Gerner (36:54.228)
Yeah, sorry, I'm such a journalist, I've just started asking you questions.
Kim Vopni (36:58.865)
That's funny. Since you released the book with the title you wanted, I know you've said some people weren't going to host a book launch or weren't going to write in their newsletter, but what has been the opposite, like the positive response that you have had, whether it's from businesses or investors or like what's happened since you've launched the book?
Marina Gerner (37:02.186)
Yes. Yes.
Marina Gerner (37:09.407)
Yes.
Marina Gerner (37:15.638)
yes. Yes. Yes. it's been incredible. I get so many lovely, lovely messages from readers and I think that's just the best. I mean, I thought I would hear from people, but I hadn't quite imagined what that would be like. it's, yeah, just really heartfelt messages of people saying things like, you know, you've...
Kim Vopni (37:28.013)
Mm-hmm.
Marina Gerner (37:43.434)
changed the way I speak to my daughter, to my young daughter, or I finally had that conversation with my mother where we finally didn't use any euphemisms. I often hear from women that they read the book in public on purpose, so they'll read it on the train. And one woman messaged me saying, I'm reading it on my commute and I can confirm that not everybody's comfortable seeing it on a Monday morning.
Kim Vopni (37:45.875)
I love it.
Kim Vopni (37:58.965)
Yeah, I love it.
Marina Gerner (38:13.437)
And then another woman who was a physician, she took it onto the plane and then started out conversations with the women who were sitting around her about menopause. And so it's fascinating to see that people use it to start conversations and to see people's reactions. And that's really fun. And that's what I was hoping would happen with the book. Because also while I was writing the book, a lot of people said to me, well,
Kim Vopni (38:33.389)
Mm-hmm.
Kim Vopni (38:37.623)
Yeah.
Marina Gerner (38:43.283)
With that title, can you really imagine somebody reading it on the London Underground? That was a question I would often get. And now I know that people are reading it on the London Underground.
Kim Vopni (38:51.585)
And now it's happening.
Well, that was another double standard that I've seen as well is on Subways, the underground. We'll see ads for Viagra all over the place.
Marina Gerner (39:00.499)
Yes.
Marina Gerner (39:03.931)
Exactly, everywhere. Even at my local shop, a drug store, there's a huge banner, know, two for three, only 10.99 Viagra. And it's right there. And there's no equivalent. There's, you know, nothing like that. And it's just so, I think we're so used to it. And the same goes for social media ads, of course, where erectile dysfunction is just...
proudly bounce through the algorithms while everything else, anything whether it's focused on lactation or UTIs or you know, everything else gets censored. Even if it doesn't have the word vagina in it, if it's just something in the women's health space, it's likely to encounter censorship online.
Kim Vopni (39:32.205)
Mm-hmm. Mm-hmm.
Kim Vopni (39:41.483)
Yeah, yeah.
Kim Vopni (39:47.65)
Yeah, and then I made a post about kind of calling that out saying, okay, we're, we they're handing out Viagra like candy, the ads are all over the place. Any man who's having erectile dysfunction challenges can can get their Viagra. But now they want to, you know, if they're pursuing sexual activity with a female, a lot of the men who are having erectile dysfunction typically are within the same age category as the women who are now dealing with pelvic floor dysfunction and vaginal dryness.
Marina Gerner (39:57.973)
Mm.
Marina Gerner (40:17.173)
Mmm.
Kim Vopni (40:17.321)
And do you, like, women have never heard of vaginal dryness. They are denied vaginal dryness, have a glass of wine, use lube. These are all the messages that they're given. when we think about how many, I don't know any statistics about this, but I would be very curious for it to be looked at how many relationships and how many divorces break down because of pelvic floor dysfunction. Whereas the man is being well-served with his Viagra.
Marina Gerner (40:28.106)
Yeah.
Marina Gerner (40:44.116)
Mmm.
Kim Vopni (40:47.275)
and the woman cannot get vaginal estrogen. Nobody's offered it to her, nobody's told her about it. If she asks for it, she's denied. And that should be really, in my opinion, something that is also here, two for one, get one and buy two, get the third for free. Why is it gate-kept for us? It's crazy.
Marina Gerner (40:51.625)
Mmm. Mmm. Mmm.
Marina Gerner (41:02.781)
Yeah. Yeah.
Yeah, exactly. yeah, unfortunately there still is this stigma and the shame. And I think with period products, it's changing slowly where, you know, was feminine hygiene, term that I hate. And now slowly that term at least is changing, but you still don't see massive ads at the shop saying two for one. So I think it will still take a bit of time for us to get there.
Kim Vopni (41:23.245)
Mm-hmm. Mm-hmm.
Kim Vopni (41:38.476)
Yeah, yeah. And I agree with you on the feminine hygiene piece. And also the transition that I've started to see where, you know, it was always blue, the color blue, whenever they were showing liquid and absorbability of this thing. And there is more now with appropriate coloring and stuff. And yeah, yeah. Yeah. About time. About time. Yeah. Well, and I mean, your book, think, has come at a... I think it came at the right time.
Marina Gerner (41:47.358)
Yes.
Yeah.
Red blood. Exactly. Yes. Yeah. About time.
Kim Vopni (42:05.163)
I think it should have come, like ideally it would have been great if it was out earlier, but I don't think it would have been as received as well. I think the world is very open right now. The conversations around menopause has done a huge service for pelvic health conversations and vulvavaginal health. Like it has in turn increased awareness and conversation around vaginas. It really has. And I think this is perfectly positioned to be accepted and.
Marina Gerner (42:07.698)
Mm. Mm. Mm.
Kim Vopni (42:32.479)
and I'm glad you wrote your book. I'm so grateful for your work. Thank you.
Marina Gerner (42:35.86)
Thank you so much. I'm blushing. Thank you. That's very kind of you. Yeah, go on.
Kim Vopni (42:38.509)
Where can people sorry, I was just going to say like, where can people what's your website? Where can people learn more about you and and follow along your your journalistic, like everything that you're doing in the world of journalism, but also be able to purchase your book.
Marina Gerner (42:54.247)
Yeah
Yeah, absolutely. So my book is on Amazon. You know, just search for The Vagina Business by Marina Garner. You can also find it at your local bookstore, although I can't promise that they're displaying it. You might have to ask them about it. You know, you might have to go inside and say, hey, where's the vagina business? And that might help. And you can find me on Instagram as marinagana. You can also find me on
LinkedIn, if you like, and I have a website which is marina.com and a sub stack newsletter, which I write very sporadically. So there's no risk of being spammed with my newsletter. My sister-in-law calls it my quarterly newsletter. know, yeah.
Kim Vopni (43:37.581)
Awesome.
Kim Vopni (43:42.933)
little bit of something. Yeah, no, I'm so grateful for your work. I love the book. I love everything that you stand for. And I just think it's elevating this movement that we're in right now. So it's very well positioned.
Marina Gerner (44:00.542)
Thank you so much. That's exactly what I was hoping to achieve, was to shine a massive spotlight on this movement and to attract more investment, more research, more entrepreneurship, more people into this space and to create more awareness and educate more people. So thank you very much.
Kim Vopni (44:14.637)
Yeah, yeah, you're welcome. One last thing, did you, I don't know where in the UK you are, but are you familiar with the vagina village in London? Or sorry, the Vagina Museum, sorry, yes, yes. Okay, okay, yeah, that's, okay, good. I was gonna say you probably would have. I was able to go, I remember, I think I just randomly found them on Instagram and I said, okay, I have to do something with them one day and I was able to go visit and then,
Marina Gerner (44:23.188)
I know the Vagina Museum. Yes, yes, yes, I do know the Vagina Museum. Yes. I've collaborated with them on a few things. Yes.
Kim Vopni (44:44.683)
The company, the publisher of my third book, Your Pelvet Floor, is in the UK and they held an event at the Vagina Museum a few years ago that I was able to go to and they had a bunch of their female authors highlighted, which was really cool. So I figured you probably had aligned with them. So that's good. Yeah. Awesome. Thanks so much, Marina.
Marina Gerner (44:53.864)
Mm-hmm.
amazing.
Marina Gerner (45:02.484)
Great. Yeah. Thank you.
