April 4, 2025
Beyond Kegels: The Key to Bladder Control with Dr. Nigel Brayer
Feeling held back by urinary incontinence? Discover Dr. Brayer's holistic approach to regaining control, linking life's stresses to bladder health, and stepping beyond Kegel exercises. It's a journey to empowerment and healing you won't want to miss.
Are you struggling with urinary incontinence but feel too embarrassed to seek help? Many women suffer in silence, thinking there's no solution beyond medication or surgery. But what if the key to regaining bladder control lies in rebalancing your nervous system?
BY THE TIME YOU FINISH LISTENING, YOU'LL DISCOVER:
- Why 70% of bladder control is unconscious and how to retrain your autonomic nervous system
- The surprising link between life experiences, stress, and incontinence
- Natural, non-invasive ways to strengthen your pelvic floor beyond just Kegel exercises
Dr. Brayer's personal story and innovative approach offer hope for those struggling with this common yet rarely discussed issue.
When you finish listening, I'd love to hear your biggest takeaway from today’s episode. Take a screenshot of you listening on your device, share it to your Instagram stories and tag me, @drtamarlawful!
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00:00 - Breaking the Silence on Incontinence
03:13 - Dr. Breyer's Personal Journey
05:40 - The Neurology of Bladder Control
09:32 - Autonomic Nervous System's Role
15:22 - Treating Incontinence Without Drugs
22:02 - Stress, Relapse and Pattern Change
28:18 - Future of Natural Bladder Health
WEBVTT
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So we have a lady who may not share it with her friend or her spouse or her doctor because of all these things that we hold on when it comes to incontinence.
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So if I could eliminate as many barriers as possible, then I'd be able to help a ton of people.
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If you want to break the mold of traditional pharmacy and healthcare, you are in the right place.
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Welcome to the Pivoting Pharmacy with Nutrigenomics podcast, part of the Pharmacy Podcast Network.
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Here's a little truth bomb.
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We're all unique, down to our DNA, so it's no wonder we react differently to the same medications, foods and environment.
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Here's a million dollar question how can you discover exactly what your body needs, which medication, what foods or supplements and which exercises are right for you?
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How can you manage chronic conditions like diabetes without more medications?
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How can you lose weight and keep it off?
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How do you tap into your genetic blueprint so you can stop surviving and start thriving in health and life?
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That is the question, and this podcast will give you the answer.
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I'm your host, Dr.
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Tamar Lawful doctor of pharmacy.
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Let's pivot into genomics and bring healthcare to higher levels.
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Welcome to Pivoting Pharmacy of Nutrigenomics.
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I'm your host, Dr.
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Tamar Lawful doctor of pharmacy and certified nutritional genomics specialist.
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To Pivoting Pharmacy of Nutrigenomics.
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I'm your host, Dr.
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dr Lawful, lawful Doctor of Pharmacy and Certified Nutritional Genomics Specialist.
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Today we're going to discuss a topic that isn't talked about enough, yet it affects so many, particularly women urinary incontinence.
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You know, for far too long this has been a whisper topic.
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It's shrouded in unnecessary embarrassment, but the silence stops here today.
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Whether you're on a jog, driving to work or just relaxing at home, I want you to know that today we're breaking down barriers and lifting the veil on this all too common issue.
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Join me as we welcome Dr.
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Nigel Brayer, a standout advocate for patient-centered care and a pioneer in treating bladder control issues.
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Dr.
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Brayer, an expert in natural medicine and women's urinary health, has developed the Ironclad Bladder System, a drug-free approach that cleverly blends neurological insights with traditional Chinese medicine to help many women overcome urinary incontinence.
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Drawing on his personal experiences and extensive knowledge of the autonomic nervous system, Dr.
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Brayer offers eye-opening perspectives on natural, non-invasive ways to strengthen the pelvic floor, moving well beyond traditional Kegel exercises.
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By the end of our conversation, you'll discover why 70% of bladder control is unconscious and how you can start retraining your body and mind to tackle the problem at its root.
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And you'll be surprised to learn about the powerful link between your life experiences, stress and incontinence.
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If you find a moment that resonates with you today, I would love for you to share it on social media, and don't forget to tag me at Dr.
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Tamar Lawful.
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I'm excited to see your takeaways and engage with you all, and remember to leave a five-star review wherever you listen to podcasts.
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So, without further ado, let's welcome Dr.
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Brayer Breyer and begin our journey to understanding and taking control of urinary incontinence.
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Naturally, Dr.
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Brayer, thank you for joining us today on Pivoting Pharmacy with Nutrigenomics, you know your story really started with a personal connection.
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Tell us about the personal story that you have, that you went through or experience that led you to where you are today and in that process, tell us a little bit about yourself.
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Sure, well, thank you.
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Most people always ask me.
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They say, doc, why are you considered the bladder doctor and you're a male?
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So for that to connect, I have to kind of share my story.
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And the story is I didn't choose this necessarily.
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It kind of chose me and so I don't want to sound selfish, but there was a selfish motive that kind of motivated me.
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My last child, or my wife's last child he's seven now.
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About six or seven months after my son, jude, was born, she started really reducing her activity.
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We've always been an active family hiking, biking, skiing, all those sort of things and my wife just slowly stopped participating and I didn't really know why.
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I thought, ok, well, you're tired, we have a new baby, you know all the things that go along with getting back to not being pregnant.
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And then it took probably six to nine months and I started kind of probing because I thought it would be temporary.
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And I'm been a doctor now for 28 years in the natural healthcare field, from nutrition to acupuncture to chiropractic, and so I was a little frustrated.
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I'm like, why didn't she share it earlier?
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You know, obviously I'm her husband and she was very, very embarrassed and I thought to myself, well gosh, here I am doing what I do and she's embarrassed to share it.
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So it kind of made me think it's like, wow, what a barrier that we hold around this subject.
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And so I kind of took it upon myself.
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I like solving problems.
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That's kind of inspired to say, well, I have to figure this out, because and here's the selfish motive it's like I want my friend and partner, my wife, to be able to do all these things that we had done before.
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And so so I started looking and I went through the usual course.
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I referred her to a pelvic floor therapist, a physical therapist.
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They did the PT, the physical component, and that helped very modestly, maybe 20, 30%.
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And so again I was thinking more.
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I'm like, well, why isn't this resolving it If it's all physiological.
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From a physical standpoint it should resolve with exercise and you know, trigger point release in the pelvic region and all those different things.
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And so I kept seeking.
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And then she went to some other doctors, of course, and they're like well, we can do some beta blockers and we can do some Botox injections, and all these things just seem so dramatic.
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And again, being in the natural health field, my deep belief is the body's really good at healing itself.
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Our job is to support it, not necessarily to suppress it or medicate it or drug it, you know, unless the circumstance is dramatic.
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So I started looking and I kind of dug out the anatomy books and I started really researching not only the anatomy, how the bladder works, the urethra et cetera, but then I started looking at the neurology of the sphincter.
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So for those who are unaware is, the bladder is essentially a balloon and off that balloon comes a straw for lack of better analogy and the straw is called the urethra and at the straw, in a male you have what's called the internal sphincter.
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So where the straw meets the bladder there's a little valve, and then on the outer part of that urethra there's another valve.
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That's called the external sphincter, but in a lady, they have one continuous little valve.
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It's called the internal sphincter.
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But when in a lady, they have one continuous little valve, it's called the internal sphincter.
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But when I looked at the nerve supply to that valve, something really profound came, and what I learned was only 30% of that valve is consciously controlled.
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So what that really means is is if we contract our bicep, our arm muscle, you're consciously contracting that muscle and then you're consciously relaxing it.
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So only 30% of that valve is controlled by you.
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So when we do Kegel exercises and those types of things, the best case scenario is we can only affect that valve around 30%.
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So that begs the next question well, where's the other 70% around 30%?
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So that begs the next question well, where's the other 70%?
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And so as you look further into neurology you come to find out the other 70% of that valve is autonomically controlled, and so what that simply means is it's unconsciously controlled.
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So just to put into perspective, is you and I sitting here right now?
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Our heart is beating at whatever pace is most effective to give blood supply to our brain?
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Our muscles are kind of relaxed, so they don't need a whole lot.
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But if we move around and we need more blood.
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Our brain tells our heart and our blood pressure and our blood vessels all to change to make sure we have the blood supply we need for that new activity.
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That's called autonomic nervous system.
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Now if we're sitting here and then all of a sudden really something really scary happens outside, well then our sympathetic nervous system takes over and now we go into protective mode and that changes us our heart rate, our blood pressure, our muscle tone, how we metabolize foods All that changes extremely quickly without us even consciously being aware of it.
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So put that into the bladder perspective is the bladder function is directly related to what's called the autonomic tone.
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That means the general tone.
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So how I explain this to patients is you and I are products of all of our life experiences.
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If you've had a whole bunch of positive life experiences, you have a general outlook on life that, hey, life's pretty safe, life's pretty cool, pretty calm, things usually work out pretty well for us.
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That affects your mental tone and your physical tone.
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Now if you change that again, say, okay, I've been in a really negative relationship or been really negative life experiences, or I've had a lot of trauma, your general tone is going to be more protective, like, hey, the world is not that safe, people are trying to hurt me or I need to protect myself.
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Well, that affects our tone and that's called the sympathetic parasympathetic balance.
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So put all this full circle, as it applies to the bladder, is our bladder, therefore our valves are controlled by our neurologic tone, which means all of our experiences, good, bad, indifferent and it's affected by the balance between what's called the sympathetic, the fight-flight nervous system, and the parasympathetic, the healing, relaxing, restoring.
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So bring it to full circle is I started looking into how do I improve neurologic balance between the sympathetic, fight flight and the autonomic heel restore.
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And so I dug into my acupuncture background and I started looking into ways how do I rebalance the autonomic nervous system and, most notably, how do I stimulate the vagus nerve, which is the primary nerve component of the parasympathetic.
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So I kind of reviewed a bunch of my patient files over the years, and any doctors out there or anyone who works with people is you usually do what's called a review of systems.
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So that means that you ask them a whole myriad of different questions to get the background of hey, have you had heart problems, have you had bladder problems?
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So I started going through some of the files of the ladies in my practice and I noticed that a huge amount of women checked off incontinence on the review of symptoms.
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I didn't even notice it.
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It wasn't really applicable to what they were coming to see me on, but they jotted it down.
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So when these ladies came in for other problems or follow-up or whatever, I asked them about the incontinence.
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And I asked them and they're like, oh, it's still there or oh, it's gotten worse, I'm just using more pads.
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So I realized this is a huge epidemic.
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So I asked several of them.
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I said, hey, do you mind being part of my research group where we can start doing my new protocol and see how it works?
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And so I took on about 100 women over a course of two to three years and we found that well, 99% of women improved, 90% of women had full resolution of their incontinence by doing a couple of things, by doing what's called biofeedback, which is using the mind to affect the body, using specific acupuncture points to help reset the autonomic nervous system, and then doing very specific exercise regimen to not only stretch the perineum, which is the under part of the groin area, but to also increase the tone of the whole pelvis.
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And so I did that.
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We did it over a few years and then I thought to myself okay, well, we have all of these people with this problem.
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The biggest barrier is talking to somebody about it and I reflect back to my wife is she felt uncomfortable sharing it with me.
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Imagine that we didn't have that relationship.
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So we have a lady who may not share it with her friend or her spouse or her doctor because of all these things that we hold on when it comes to incontinence.
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So I thought, okay, well, how do I get this to people without having them to go through barriers?
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So I think about embarrassment as a barrier.
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Seeing a doctor is a barrier.
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You're going to have to spend money.
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You may not have insurance, whatever the issue might be.
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Then treatment is also a barrier.
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Well, what are my treatment options?
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What is the cost?
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So if I could eliminate as many barriers as possible and give them the framework of my protocol and get them great results, my reasoning was that I'd be able to help a ton of people without them having to hit all these barriers which, with every barrier, the likelihood of them falling through just keeps dropping, lower and lower.
00:13:06.465 --> 00:13:06.846
I love it.
00:13:06.846 --> 00:13:15.006
So you address it from all ends, addressing the barriers and then getting down to nitty gritty as to why the urinary incontinence is happening.
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I find it really interesting that only 30% we only have 30% control over it, so the 70% is really up to the body itself.
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Yeah, and that's the tone.
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And a lot of people think that's very confusing and they think, okay, well, I just have to try harder with that 30%, I just got to do more kegels.
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Or there's this thing called an emsel chair, that you some people might have heard of, which a person would sit on and it creates a sub threshold shock that causes the muscles to contract.
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But the analogy I like to use is imagine your fist is constantly clamped.
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So imagine a hose is going through your fist and you're clamping your fist as tight as you possibly can.
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How long can you hold that?
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And if you're in the healthcare field, you realize is tissues need a break, right.
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So what happens is it'll start to fasciculate, that means it'll start to cramp or it'll start to let go.
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And there's different types of incontinence.
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There's called stress incontinence, which is more physical base, and then there's called urge incontinence, and that's where people will laugh and sneeze and cough or jump.
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And all of a sudden, as soon as there's extra pressure, like that tight fist, they just can't hold it and the urine starts to leak.
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So the key becomes is actually relaxing and retraining the background tone so that those smooth muscles can keep it from leaking, which, of course, that's the whole process yeah, now I've heard that people might experience some improvements, right, and then there might be relapse.
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Can you discuss, like, what patterns you've noticed in these relapses and how your treatment strategy evolves to prevent them?
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Well, I like to think of it this way.
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Think of any changes in habits.
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So the old story goes and this is a silly analogy I like to share with patients is I'll ask him well, how do we learn to swim?
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And the key to learning how to swim is this way is you go into a safe pool, let's say, where everything's calm, the water's shallow, and the teacher teaches you how to swim.
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So at any given time you're always safe, right, so that you become, you're relaxed and you can take on and you can practice your skill.
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That's pretty much an analogy how most things in our life and our body change.
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So my program is as we start to make changes, you start to get more proficient, like learning how to swim.
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You don't just drop into an ocean that's raging with waves and a storm and expect to swim, and I think of that as life challenges, right.
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So we're learning how to swim in the safety of our home.
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We're doing those tasks when it's convenient and relaxed to do so, and then life happens.
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So when life happens is, let's say, we get frustrated, or we have stress, or we have blood sugar changes.
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All these things challenge us in different ways.
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So I liken it to waves in the water.
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So now you're a new swimmer and instead of swimming laps, now you've got some waves and they're going to shake you a little bit.
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And if they shake you a lot, that just tells us that the overall skill level it's not so much a mental skill but a physical coordination isn't quite there.
00:16:19.855 --> 00:16:25.168
So it's expected that we're going to have the turbulence until a whole new pattern is set.
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So it's kind that we're going to have the turbulence until a whole new pattern is set.
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So it's kind of a mental shift that people have to have.
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Is they think OK, I do this, it's fixed?
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But in my experience with all natural health care is you're changing patterns.
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Patterns take consistency and then the more consistent we are, the more predictable and stable are the outcomes.
00:16:45.995 --> 00:16:47.260
That makes so much sense.
00:16:47.260 --> 00:16:48.841
So much sense, dr Breyer.
00:16:48.841 --> 00:16:54.167
Now you've mentioned I've heard you mention other interviews the Qi, ying and Yang.
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Can you give us insight into how these concepts are applied in your treatment method for bladder health?
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Sure, I don't like to use esoteric words because I've noticed people get not that I have any issue with them, but I've noticed people have attachments where they think it's kind of bizarre or weird or strange.
00:17:14.499 --> 00:17:20.855
So chi just means energy, yin and yang just means the two different types of energy.
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So for North Americans who aren't familiar with these terms, they think, oh well, that's kind of woo-woo out there.
00:17:26.539 --> 00:17:28.005
Well, let's think about it for a second.
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Our nervous system is transmitting electrical impulses.
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So just like an electrical wire is transferring electrons down a copper wire, well, instead of saying electrons down copper wire, the Chinese medicine like to call it qi energy.
00:17:45.084 --> 00:17:50.304
So everyone thinks that, oh, it's traditional Chinese medicine, then Western medicine can't speak.
00:17:50.304 --> 00:17:53.261
No, they can, they're just using different words for the same thing.
00:17:53.682 --> 00:18:00.846
And so in yin and yang, I like to think of yin and yang kind of like we talked about with the sympathetic and the parasympathetic nervous system.
00:18:00.846 --> 00:18:02.758
So there's two types of energy.
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There's expressive, which is outward energy, and then there's internal energy.
00:18:07.878 --> 00:18:26.144
When it comes to the nervous system, I like to think of it like what's called efferent, which means you're outwardly, sending information from the brain out to the body, and then afferent, meaning you're sending information from the body into the brain, and so when yin and yang comes into it, it's about balance.
00:18:26.144 --> 00:18:35.340
So let's talk about our earlier analogy of people who've had overly positive experiences and people have had overly negative experiences.
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Those are two ends of a spectrum, but the goal is the body is balanced.
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Too much of a certain food is going to create an imbalance on one end, too much of another we'll call as an imbalance.
00:18:45.962 --> 00:18:56.824
So when it comes to the energy patterns, yin and yang is, the body functions best in balance, and so the whole premise is to regain that balance.
00:18:57.335 --> 00:19:01.967
And when that balance is lost, then disease processes generally occur.
00:19:01.967 --> 00:19:08.943
Now, if you leave it long enough, it'll create a recognizable disease that your allopathic doctors will diagnose.
00:19:08.943 --> 00:19:13.259
But we don't like to wait till diseases come, because now we're reactionary.
00:19:13.259 --> 00:19:24.938
So when it comes to yin and yang, or it comes to my bladder protocol or whatever it might be, is the goal is to catch things before they become what's called pathologic, because now you have to react.
00:19:24.938 --> 00:19:36.763
So a good example would be if somebody who consumes too much simple carbohydrates or sugar over long periods of time, that's going to affect their A1C, that's going to affect their insulin levels, that's going to lead to diabetes.
00:19:36.763 --> 00:19:43.942
Well, if we see those patterns early, early, early, we could do some fine tweaks in their diet and they never have to get there.
00:19:43.942 --> 00:19:46.544
That's the same premise with yin and yang.
00:19:46.544 --> 00:19:54.387
The same premise with my protocol is to shift back to balance and then the body's natural capacity to heal starts to blossom, kind of like a clam.
00:19:54.974 --> 00:19:56.377
Yeah, I love that.
00:19:56.377 --> 00:19:58.742
I love your analogies, I love it.
00:19:58.742 --> 00:20:00.527
It brings the point home very well.
00:20:00.527 --> 00:20:01.796
Thank you Now.
00:20:01.796 --> 00:20:08.278
You mentioned stress earlier playing a role in urinary incontinence and definitely a role in relapses.
00:20:08.278 --> 00:20:14.102
What are some ways patients can manage their stress to aid in their treatment when it comes to bladder?
00:20:14.142 --> 00:20:14.402
health.
00:20:14.402 --> 00:20:25.855
Yeah, and I love this question because most people don't like to hear this, me included because whenever we have a challenge, we don't want to think that we created it, but we, so there's some tough love.
00:20:25.855 --> 00:20:27.962
Hopefully nobody dislikes me for saying that.
00:20:27.962 --> 00:20:40.108
So most of all of us, I'll say, as a human collective, is we think that outcomes are outside of our control, but really it's one of those.
00:20:40.108 --> 00:20:48.040
We reap what we sow, even when we don't know what we're sowing, and so that kind of begs or answers.
00:20:48.080 --> 00:20:50.442
Your question is how do we make changes?
00:20:50.442 --> 00:20:55.247
Well, if we don't know what we're sowing, we should probably pay attention.
00:20:55.247 --> 00:21:11.250
So how I have people do this is the first thing I encourage them to do is take out a notebook, and I'm not super computery guy, so I like paper, but some people like phones, so I have them start paying attention to first everything that they eat and drink.
00:21:11.250 --> 00:21:14.240
And people say well, how does that affect my bladder?
00:21:14.240 --> 00:21:15.903
Well, it does, kind of.
00:21:15.903 --> 00:21:21.144
You know, obtusely, I guess we should say is paying attention to what we put in our mouth and then paying attention to our symptoms.
00:21:21.144 --> 00:21:34.124
And why we do this is I want people to start first paying attention to what we put in our mouth and then paying attention to our symptoms and why we do this is I want people to start first paying attention to what they're eating, because that's going to affect their whole body and their bladder, kind of on the back end.
00:21:34.124 --> 00:21:38.113
But it's also going to help you to start making correlations.
00:21:38.113 --> 00:21:44.313
But on the next regard, and back to stress, is it also helps them understand why they do what they do.
00:21:44.673 --> 00:21:58.353
So the analogy I like to think of it is this is imagine, tamara, you were coaching a friend who was broke, said hey, tamara, I'm broke, I don't have a nickel to my name, can you help me out?
00:21:58.353 --> 00:22:03.080
And the first thing that you would say to your friend, I'm sure would be well, what are you spending your money on?
00:22:03.080 --> 00:22:08.272
And that person might say well, gosh, I don't know, it just seems to disappear.
00:22:08.272 --> 00:22:12.647
And then you, being a caring coach, you'd say well, let's start paying attention.
00:22:12.647 --> 00:22:19.479
And they'd be like okay, so write down every nickel you spend every day, and at the end of the week let's look at it and talk about it.
00:22:19.479 --> 00:22:29.259
And then a week later, you pull out that journaling for lack of better word and you look and say, oh, okay, well, you're spending like $9 on a cup of coffee.
00:22:29.259 --> 00:22:31.626
That might be a great place to start making some changes.
00:22:31.626 --> 00:22:33.449
That's going to give you nine bucks a day.
00:22:33.449 --> 00:22:34.450
Maybe you can make it at home.
00:22:34.450 --> 00:22:35.571
So it's no different.
00:22:35.592 --> 00:22:40.398
With changing patterns in ourself, it's like, okay, what am I eating on a daily basis?
00:22:40.398 --> 00:22:41.941
How are my symptoms?
00:22:41.941 --> 00:22:54.534
Oh, I seem to have less bladder control after work, or after breakfast or after lunch, or when I talk to my boss, or when I talk to my spouse, or when I go to the gym, or whatever it might be.
00:22:54.534 --> 00:23:02.076
So what that does is that first helps us to make some correlations with how are we impacting our condition.
00:23:02.076 --> 00:23:05.592
And that's enough to start to ask questions.
00:23:05.592 --> 00:23:14.095
Because in my books is when you ask questions, answers can percolate and we're kind of stuck in the mode of why is this happening to me?
00:23:14.095 --> 00:23:19.215
I feel so bad, I'm only 40 years old and I can't hold my bladder and all the judgments that go along.
00:23:19.215 --> 00:23:22.715
That's kind of a self-appreciating type of way of thinking.
00:23:22.715 --> 00:23:26.893
So the way to start making changes is to start changing our thinking.
00:23:26.893 --> 00:23:29.885
The way to start changing our thinking is to start paying attention.
00:23:30.426 --> 00:23:31.650
It makes sense and it's like.
00:23:31.650 --> 00:23:34.744
It's like taking accountability, because it starts with us.
00:23:34.744 --> 00:23:36.429
Indeed, I love that.
00:23:36.429 --> 00:23:50.214
Now, dr Breyer, with your practice evolving over 28 years, what have been some of the biggest challenges in convincing the medical community and patients alike to embrace a more integrated approach to treating urinary incontinence?
00:23:50.978 --> 00:23:53.767
I would say the biggest challenge is culturally.
00:23:53.767 --> 00:24:00.915
We've been deluded to think that there's magical fixes to lifelong problems.
00:24:00.915 --> 00:24:11.938
So we're bombarded the media, pharmacology, xyz they have a vested interest in thinking that they hold a solution.
00:24:11.938 --> 00:24:17.085
All you got to do is drop us 50 bucks or a thousand or a million, whatever the dollar amount doesn't matter.
00:24:17.085 --> 00:24:24.719
But we as individuals have been deluded to think that there's a magic solution to a lifelong problem.
00:24:25.865 --> 00:24:34.351
Now, when it comes to an infection and a strep infection, it might appear that there's a magic issue that kills a bacteria and that's fine.
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