The Holistic Approach to Vulvar and Bladder Care: Creating a Symbiotic Environment for Your Vagina


By Isa Herrera, MSPT, CSCS– Do you find you are prone to urinary tract, bladder, or yeast infections? Maybe you have an itchy feeling in the vagina, but all the tests come back negative and you have seen multiple doctors to only be more confused and without answers? Have you ever been diagnosed with vulvodynia, interstitial cystitis, bacterial vaginosis or vulvar vestibulitis? These conditions typically exhibit signs and symptoms of what is referred to as “vaginal dysbiosis”, or a breach in the normal flora of the vagina. This breach reeks havoc on the vulvar area creating debilitating pain sometimes described as itching or burning in the perineum, redness, & irritation, which severely affects quality of life, including sexual function. Vaginal dysbiosis can negatively affect the function and flexibility of the pelvic floor muscles because the pelvic floor muscles are constantly inflamed and guard against this inflammation by going into a “protective state” of hypertonicity or a tightened up state.

It is important to further note that when there is a vaginal dysbiosis the pelvic floor muscles can become tighter, less flexible and develop trigger points and spasms in them. Once there is an imbalance it is important not only to take proper holistic measures and but also to normalize the function and flexibility of the pelvic floor muscles by doing intra-vaginal massage, trigger points and myofascial techniques. To learn more about these amazing intra-vaginal techniques see the recently released expanded second edition of Ending Female Pain, A Woman’s Manual. Because we as pelvic floor physical therapists understand the delicate balance of the muscles and the vaginal environment we invited Carla Savetsky to speak to our patients as part of our 5 part free pelvic floor lecture series. In this blog we will share this information to expose you to alternative methods of vaginal vulvar care that made not be readily available to you.

Carla Savetsky, RPA, MS is an expert and pioneer in holistic bladder and vulvar care, advocating for natural remedies for women’s health conditions affecting the vulva, vagina, and bladder. In our lecture series she discussed a variety of ways to create the optimal environment for your vagina to prevent and combat these debilitating female conditions. In our center we recommend natural methods of healing because we find that the same old way of doing things does not work with every woman and today there is a trend to doing things more holistically and natural.

Many of the women we treat at Renew Physical Therapy have pelvic pain related to the pelvic floor muscles, or muscles that lie at the base of pelvis surrounding the vagina, urethra, and anus. As physical therapists, we are the experts in treating conditions affecting the musculoskeletal and neuromuscular system in the body and use a variety of techniques to combat pain, tension, and fascial restrictions and adhesions. We find that many of these conditions can also benefit from a balance vaginal environment.

We find that the best way to re-establish symbiosis in the vagina, vulvar area, and bladder is through natural herbs, oils, and supplements that help to get the pelvic floor muscles back into proper shape and many of the women become less symptomatic after doing a combination of pelvic floor physical therapy and natural remedies. One of the things that we agree with Carla about is her concept of the “ultra sensitive female”. These are women who may be more susceptible to yeast or urinary tract infections, have sensitive skin, multiple allergies, may suffer from digestive issues, and may also suffer from sexual pain related to pelvic floor muscle disruption. Women typically exhibit signs and symptoms of a cluster of these conditions, hence the term “ultra sensitive female”. Why are these women sensitive? The answers are not clear but we find in our practice that these women usually have sensitivities and it makes sense that these women need extensive and well-rounded physical therapy care in conjunction with natural healing.

Herbal Remedies for Vaginal Flora Health:
Check out these herbal supplements to start to restore homeostasis in the body both systemically and vaginally. As always, you must check with your MD or caregiver before attempting to use these remedies to make sure it is a good fit for your particular case.

1. For chronic UTI’s, a tea made with corn silk can help soothe the urinary tract. Yep, that’s right, if you’re preparing for a summer filled with corn on the cob and have the job of shucking the corn, save that corn silk and soothe your bladder! To complement this treatment try eliminating trigger points or urge point above the pubic bone. Many times we find that a trigger for urge and bladder pain is found in this area. See Ending Female Pain, Chapter 19 “The Real Deal: How to Heal your Bladder” for more information.

Calendula has great anti-fungal and anti-bacterial properties and can also be used as a tea

Calendula has great anti-fungal and anti-bacterial properties and can also be used as a tea


2. Calendula is a natural anti-inflammatory, anti-fungal, and anti-bacterial herb that can be used to soothe irritated skin when applied topically. Calendula flowers can also be used in a tea to help treat bladder infections. We use calendula flowers in our vaginal steams to promote vaginal health and pelvic floor muscle flexibility and suppleness.


Lady’s Mantle is a natural astringent which when used in combination with pelvic floor therapy can help women who are experiencing prolapse.

3. Lady’s Mantle is a natural astringent, which means that the herb helps draw together or constrict body tissues. Many women with pelvic organ prolapse can benefit from drinking a tea steeped with Lady’s Mantle because of its ability to help draw together the vaginal tissue and lift the pelvic organs upwards. This herb can also be used to help treat painful cramps and heavy bleeding associated with the menstrual cycle. To have even more success make sure you are on the correct pelvic floor training program. This tea alone will not help to lift the organs you must work also strengthen the pelvic floor muscles, the core muscles and create stability in the hip and pelvic area.

Renew PT Lifestyle Modification Tips for a Healthier and More Balance Vaginal-Vulvar-Pelvic Floor Connection

Carla Savetsky, here with Isa Herrera, recently presented at the Renew PT lecture series on natural remedies for vulvar health

Carla Savetsky, here with Isa Herrera, recently presented at the Renew PT lecture series on natural remedies for vulvar health


Beyond herbal supplements, there are some simple modifications you can make in your daily life to cut back on possible triggers to your symptoms and help you stay happy and health. Here are five more tips to help you create a symbiotic environment for your vagina and bladder:

1. If you think you have a UTI or yeast infection, ask your health care provider for a culture and get the results before trying any over the counter or prescribed medications. Proper treatment starts with proper diagnosis- antibiotics are powerful drugs that can disrupt the vaginal flora and can sometimes trigger the start of vaginal dysbiosis. We see many women who are not tested properly and given antibiotics. This is a big NO NO for pelvic floor muscles and vaginal health because it can create more of an imbalance for the vulvar-vaginal area.

2. Have you been taking a low level estrogen birth control pill for an extended time period? Birth control is known to cause not only increased vaginal infections, but also decreased libido due to its affect on hormone levels! Also don’t forget to speak to your healthcare provider about your options and the role birth control may play in your vulvar/vaginal health. It is important to note that some birth controls have been linked to inflammation of the vulva, which contributes to pelvic floor muscle spasms, trigger point and sexual pain. If you want a natural alternative talk to treat your pelvic pain us about our Low Level Laser Light program. We are the pioneers in light therapy and over the last 10 years we have perfected our light therapy for pelvic pain.

3. Use 100% cotton and organic pads, tampons, and other feminine hygiene products, and change them frequently! Your vagina is happiest in a dry environment. Also consider the effect your laundry detergent may have on your skin- buy products free of dyes, phosphates, petrochemicals and scents. Using non-organic products can adversely affect your pelvic floor muscle function by sending messages of irritation, which can cause muscles to go into spasms. Stay as organic as possible and at night sleep with no underwear so that this area can breathe and heal.

4. For those of you with gastrointestinal issues and food sensitivities, consider an anti-inflammatory diet that limits gluten, sugar, wheat, and processed foods. These foods can be triggers for systemic yeast and create inflammation in the body. See our recent blog on Natural Diet and Supplements for some tips to get started on an anti-inflammatory diet. Consider going diary free also. We find that women who switch to a wheat-free gluten free diet improve their pelvic floor muscle function and have less itching and burning.

5. Use organic, extra virgin coconut oil on the perineum and vulvar area to combat dryness, irritation, redness, and even yeast. Coconut oil can also be used a sexual lubricant. Check out Renew PT’s trade secret “Down There Oil” Vaginal Serum– a combination of coconut and rose oil, which nourishes the vagina and is wonderful for women with vaginal dysbiosis and even postpartum women with healing perineal tears.

If you are interested in learning more about Carla Savetsky and her wonderful holistic remedies for women’s health issues, visit her website at

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