Pelvic floor dysfunction and UTI symptoms go hand in hand for many people. I didn’t know it at the time, but pelvic floor therapy was the key to regaining my health. Here is my story…
We all know the feeling. The first signs that another UTI is coming.
Burning when you pee.
The constant urgency to find a bathroom RIGHT NOW just to be disappointed with a small trickle.
The constant pain at the tip of your urethra.
Pressure in your lower abdomen.
Cramping.
Sometimes even a fever and chills.
Story Quick Links
- The UTI To End All UTIs. >>>>
- First UTI Appointment Of Many. >>>>
- Emotional Roller Coaster. >>>>
- Pelvic Floor Dysfunction And UTI: Finally A Diagnosis! >>>>
- Physical Therapy For Pelvic Floor Dysfunction And UTI Symptoms. >>>>
- Other Fun Side Effects Of Pelvic Floor Dysfunction And UTI. >>>>
How It All Began
My journey started in July of 2019. I had a few UTIs in college, or at least what I thought were UTIs, and usually they went away with copious amounts of water and over-the-counter AZO for pain relief.
I say “what I thought were UTIs” because I refused to go to the doctor at that age. Not the wisest decision, I know. But I was a full-time student and working two jobs, and I had no idea how much an appointment would even cost.
The supposed UTIs always went away though. It got to a point where I could predict their onset (usually after not voiding after sex or having sex with a new partner).
The symptoms would appear about a day later, and then go away on their own within 3 days. I never thought much about them except that they were incredibly annoying and yet another thing that people with vaginas just had to deal with.
The UTI To End All UTIs
Let’s fast-forward a couple of years to last summer. I had just had sex with my boyfriend, but his bathroom was taken by his roommate. I had to just awkwardly wait an hour, yes a full hour, for his roommate to get out of the bathroom.
The entire time I just KNEW what I had ahead of me: another UTI. Sure enough, 24 hours later to the minute I started feeling that familiar urgency and pain.
I didn’t think much of it. I had thought this would probably happen and hoped I could just flush it out of my system like I used to.
But this was different.
I had a gut feeling that this was the start of a longer battle.
The pain was worse than I’d ever felt, I had the chills, and I couldn’t leave the bathroom. I took extra-strength AZO and chugged cranberry juice hoping for the best. While the AZO did help dull the pain, I knew this was the UTI that would finally send me to the doctor.
First UTI Appointment Of Many
I went to my primary care physician’s office, gave them my pee sample, and waited for the nurse practitioner. My first test did come back positive, (luckily, although as you’ll see I wasn’t so lucky later).
She prescribed me Macrobid, which she described as a “low-key antibiotic” that I’d barely notice and that would do the trick. It sounded good to me!
I took the antibiotic for 5 days, and while the pain did lessen for a couple of days, it did not give me full relief. Less than 2 weeks later, I was back to the high pain level I experienced at the beginning, except now I was confused and terrified as to what it could mean that the medication didn’t work.
I went back into the doctor’s office, this time seeing my primary care physician.
Have you ever gone to the doctor’s and ended up feeling belittled, embarrassed, and like you were being dramatic?
That is how my doctor made me feel. I could see it on her face, she didn’t believe I was in as much pain as I was describing.
She took another urine culture, and it came back negative, so that must mean I was exaggerating, right?
No offense to any doctors reading, but my experience is that sometimes they tend to be quick to look at the results in front of them without realizing there is a fairly large margin of error, especially with UTI tests.
I knew something wasn’t right, and that should have been all that mattered.
My doctor explained why she is conservative with prescribing antibiotics with negative test results, and then tested me for vaginitis and multiple STIs, all of which came back negative.
She then basically insinuated she could not help me, and asked if I wanted to see a specialist. At the time I said no because the idea of seeing a specialist scared me and I did not have the financial means to see more doctors.
I left the office discouraged, embarrassed, and still in a great deal of pain.
The Emotional Roller Coaster Of Pelvic Floor Dysfunction And UTI
I continued living my life the best I could through the constant pain, with very little relief, and crying every night because of how much the situation was hurting me physically and emotionally.
I was exhausted and I just wanted answers. I called my doctor’s office again as a last ditch effort and asked to talk to a nurse or doctor again, insisting that something was wrong.
I talked to probably the rudest nurse I’ve ever talked to, who angrily asked, “have you tried eating yogurt?”
She was insistent I was just experiencing flora imbalance from the antibiotics I took. I gave up trying to talk to my doctor and went to urgent care for a second opinion.
Urgent Care For UTIs
At this point it had been about two months of constant pain. I walked into urgent care determined to get answers. My urine culture came back negative, yet again, but the doctor at urgent care was very sympathetic and gave me a different antibiotic, Bactrim, to try.
This antibiotic is much more intense than Macrobid, and the doctor said that it should wipe out any bacteria causing me pain.
Unlike the short relief I felt from the Macrobid, the Bactrim gave me no relief. If anything, I felt as though my symptoms were getting worse. The cultures kept coming back negative, and I was so disheartened that nobody could explain what was going on with my body.
I called the urgent care center and they said to come back in, so I returned a week later, after my last dose of Bactrim, and took another culture.
The nurse practitioner that saw me this time prescribed me with Cipro, a third kind of antibiotic commonly used to treat bladder infections.
She explained that they usually treat UTIs with Macrobid first, then Bactrim, and Cipro if absolutely necessary. With all of the antibiotics I was taking, I was nervous that antibiotic resistance would develop, but I was desperate to try anything.
I also left with a referral for a urologist, because at that point I accepted that it was the only way I could possibly get relief. The next day I tried to get an appointment for the urologist, but there wasn’t anything available for two months.
I took the first available appointment and tried to accept the fact that I was going to be in pain for even longer.
The Urologist
The day of my urologist appointment finally came, and I was terrified. I was the youngest person in the waiting room by about 30 years, and I was the only one alone (my boyfriend could not get work off to come, as hard as he tried).
Once I went in, they took a urine sample and did an ultrasound right after to make sure that my bladder emptied completely (it did).
The doctor then saw me, and listened to my full story. I didn’t hold back on my frustrations, and I expressed my feelings that I hadn’t been taken seriously. It was the first time I actually felt heard throughout this whole experience.
I presented her with the avid research I had conducted, telling her that I suspected I was experiencing recurrent UTIs. I’m sure you are all familiar with recurrent UTIs if you are here reading this.
She apologized that I had been through something so frustrating, painful, and confusing, and then told me it was time for her to examine me.
She did a full pelvic exam, pressing on certain parts and asking if it hurt. I’m not going to sugar-coat it, there were moments of pretty intense pain during the exam.
It didn’t seem much more invasive than a standard pap-smear, so I was confused about the pain.
Pelvic Floor Dysfunction And UTI: Finally A Diagnosis!
After she finished my pelvic exam, I got dressed and awaited her verdict. She said that I was experiencing something known as Hypertonic Pelvic Floor Muscle Dysfunction.
Basically, the muscle tone in my vagina is too high, and I had been experiencing spasms that mimic the symptoms of a UTI.
This was not something I had come across in my research and I honestly did not fully believe her at first.
I had so many questions, but my biggest one was: Has this always been an issue and did the initial UTI trigger it?
Do pelvic floor dysfunction and UTI frequently occur at the same time?
Pelvic Floor Dysfunction And UTI: Causes And Treatment
There are many things that can cause an overactive pelvic floor, and in my case my doctor believes it was a combination of stress, anxiety, and the initial UTI.
I held my urine for an hour after sexual intercourse, and then continued clenching those muscles throughout my experience with the symptoms, and my muscles were just perpetually clenched at that point.
We all have different places that we carry our stress. Some people grind their teeth, some people get migraines, and apparently I carry it in my pelvic floor.
My doctor referred me to a pelvic floor physical therapist (yes, those exist!) and said that if that didn’t work we would go back to the drawing board. She was pretty convinced though, and that was good enough for me.
Physical Therapy For Pelvic Floor Dysfunction And UTI Symptoms
The next day I received a call for my referral to physical therapy (PT). There was nothing available for, surprise, at least two months.
There is an ongoing theme in this story, and it is my dissatisfaction with the U.S. healthcare system. I won’t go into numbers, but this whole ordeal has cost me a lot of money due to a less-than-stellar health insurance plan by my employer.
Waiting for specialists is a nightmare, and my average wait time of about 2 months per specialist was actually pretty miraculous.
I am pointing this out to say that while issues with UTI symptoms can potentially be costly and not exactly timely, it was absolutely worth it to pursue this and find out the root of my issues.
What Is Physical Therapy For Pelvic Floor Dysfunction Like?
The day of my first PT appointment I was even more terrified than when I saw my urologist.
Was it going to hurt?
Would I be able to trust them?
Would it be physically challenging?
When the PT got into the office and greeted me, I immediately felt at ease. She answered all of my questions, and she sang high praises of my urologist, with whom she had a professional relationship.
She discussed consent with me, and potential triggers that could occur in our time together if I have had a history with sexual assault, which unfortunately I had.
I hadn’t even thought of that coming up, but I am so glad that she addressed it before we proceeded.
She then conducted a thorough examination, similar to the one at urology, and confirmed my urologist’s diagnosis.
She gave me some education about the urinary tract, and discussed the fact that we would be doing one major exercise together: kegels.
Except with the kegel exercises I was doing, I was focusing on the letting go part of it, rather than the tightening of the muscles.
She told me to work on those, and to start trying to recognize moments of stress where I was holding it. Sure enough, in huge traffic jams or before final exams, I noticed I was clenching all of the muscles in my core and was able to start correcting it.
I went to 10 sessions with her, the first 6 on a weekly basis and the rest biweekly, and I have already noticed a huge difference.
My pain is completely gone and I’ve made much more of an effort to manage my stress.
Other Fun Side Effects Of Pelvic Floor Dysfunction And UTI
While this is not part of the UTI symptoms I experienced, I did want to include this because it is relevant to my story. The emotional, physical, and mental exhaustion that I suffered from this experience did unfortunately lead to me carrying stress in other parts of my body.
I am currently on the tail end of something known as “telogen effluvium” which is acute, temporary hair loss after a shock occurs to the body.
Over the last 6 months I have lost about half of the hair on my head, and while it will grow back, it was devastating. I mention this because…
“…if you are struggling through your UTI symptoms and feel like your feelings are not valid, whether that be a doctor being dismissive or friends/family not believing the gravity of the pain you are experiencing, I promise that everything you are feeling IS valid.”
Telogen effluvium is usually triggered by traumatic incidents like a car accident, divorce, death of a loved one, or even childbirth. So that puts into perspective how much my UTI symptoms impacted me emotionally and physically.
Final Thoughts On Pelvic Dysfunction And UTI
It feels like another lifetime ago when all of this started happening to me. I have seen many stories online of people who suffered for much longer than I did, and I consider myself fortunate that I was able to find a urologist who could help me figure it out so quickly.
Every person reading this deserves answers and deserves a life free of the horrible pain these symptoms can cause you.
If you are hesitant to go to a doctor or a specialist because you don’t believe it will help, I highly encourage you to try anyway.
My quality of life has drastically improved since I found the right treatment for me. I acknowledge that it is not always that simple for everyone, and I encourage every one of you to advocate for yourself and fight until you find the answers you are looking for.
Share your own story by getting in touch, or comment below.
Comments
Hello I’m a 56 year old lady who had a hysterectomy thirteen years ago but the last three years I keep getting UTIs , I eat berries and have soya milk to drink and have flax seeds every day on my cereal , I try to eat healthy and never smoked or drink alcohol. I drink five to six pints of water a day plus herbal teas, I’m on nitrofaurtion low dose but when I come off them I get another infection, I’ve tried topical hrt but when it gets in my system I get faint and nearly pass out and dizzy spells so now I’m at a loss what to do, I’m afraid to have sex with my lovely husband and I’m under a urologist but he says it’s my Estrogen level, I’m scared that I will be on antibiotics forever or worse bladder cancer, please can you advise me I’m so fed up , many thanks.
Hi Mandy, I just sent you an email with links to some resources that I hope you find helpful. Melissa
The way I got rid of my UTI /I am post menopausal also. It was difficult. I fasted immediately for periods of time. No food until late afternoon. During this time I drank Linden berry tea that had cooled. I used the actual leaves from the countryside. I then took lactobaccillus pills, ate fermented pickles, sour kraur, vit. c., hemp seeds ground myself and goat yogurt and loads of diluted cranberry and pomegranate juice. At the end of 2 to 3 weeks, I took collodial silver 30ppm *tsp in 8 ounces of water with all the fermented food. It left slowly but surely! I am staying on the fermented food train because it also gave me loads of energy.
Hi Laura, it’s great to hear you found something that worked for you! Melissa
I was just diagnosed with pelvic prolapse. Which aggravates my tendency to get UTIs I think. Trying physical therapy for the prolapse. The E-String estrogen causes pelvic pain and had a reaction to the estrogen cream. Are there natural bioidentical estrogens that can help?
Hi Jan, we have heard from a handful of people that switching to a different cream has helped, however, it’s always best to speak with your clinician about alternatives. Melissa
What about estrogen dominance?
Hi Catherine, that is a really great question. As far as we know there hasn’t been any work done regarding estrogen dominance and the microbiome. We’ll certainly keep an eye out for new research in this space and let you know if we find anything! Susy
My urologist would like me to start Hiprex for frequent UTI’s. I am skeptical about drug as heard it turns urine to formaldehyde? Any comments about this drug?
Hi Jean, it is true that Hiprex goes through a process that forms formaldehyde in the urine, and that this contributes to its known antimicrobial properties. Hiprex is commonly used as part of one long term treatment protocol utilised in the UK. I just sent you an email with some notes on this. I hope it helps. Melissa
Hi
I am post menopausal, have BV and IC with a high PH in my vagina. My IC symptoms are lower abdominal pain and severe urethral burning. I am due to do the urine broth test next month to check for embedded bacteria . I have discussed oestrogen therapy with my specialist ( Dr Anderson, I live in the UK) who has said it is my choice whether to start this before the broth test. I am very unsure what to do first, oestrogen or treatment for bacteria, if found ? Any thoughts ?
Thanks very much
Susan
What an EXCEPTIONAL piece of work! Thank you for your time and great efforts!
Thank you! 🙂
Hi Susan, I just sent you an email as I’m not sure if you’re receiving comment notifications. Melissa
I am using estriol/ovestin cream. How long can I use it and can I use it everyday? I have been having recurrent UTIs. Thanks
Hi Rose, the studies linked to above indicate that its use should be safe for most people but it’s best to speak with your prescribing doctor about this. Melissa
I suffer from recurring UTIs. My question is: how long can I safely continue using Hormone therapy if I apply it daily
Hi Mary, that’s a great question. I have added it to our list for the experts. We share expert insights by email whenever we can. If you’d like to join our mailing list so you can stay informed, you can sign up here. Melissa
I have at least a 15 year history of recurrent uti’s and have tried everything. The only long periods without infection have been when I am on a long term low dose antibiotic but as soon as I stop the uti’s return. I am currently on macrobid which my ob feels is safe because it mainly effects the bladder and not the whole body. I am also on Premarin applied to the urethra. I have been feeling great the past few months but read that low dose antibiotics have bad effects over time. Can you comment on this strategy?
I have been on macrobid and always get a bout of colitis while I am on it
Hi Pat, we do hear from some people that antibiotics cause digestive issues for them, however it varies from person to person, so it’s best to work with a practitioner through your options. If you’re looking for a practitioner, send us a direct message with your location and we can share some names. Susy
Hi Nita, as we aren’t clinicians we can’t comment specifically on a strategy, but we have covered the research into prophylactic antibiotic use here, if you’d like to read more. Melissa
I had recurrent UTIs for about 3 years after menopause. I started using Premarin vaginal estrogen cream and haven’t had a UTI since. It’s been at least four years since my last one. My question is, how long can I safely continue? I’m going to be turning 60 in a couple months. If I eventually stop using the HRT will the UTIs return? I’m not sure I could live through that again. I was getting them every 3 months, almost like clockwork. But, I don’t want to put my long term health in jeopardy.
Hi Marie, as mentioned in the article, it does appear that use of topical estrogen is safe for the majority of people, however, it’s always best to discuss with a doctor. The link shared above leads to a systematic review of research into the use of vaginal estrogen, so it has a lot of helpful information. Melissa
Thank you, Melissa!
I’m desperate for help, these reoccurring UTI’s are taking over my life and making me miserable constantly. I’ll take an antibiotic, feel good and then it’s back again, try another regimen of antibiotics and back. Sometimes I’ll go for a routine checkup and won’t have symptoms but a uti shows up anyways. I’ve had a bladder lift 10 years ago. I’m 51 and have been in menopause for a while.
Hi Michelle, I sent you an email with some information. You might also like to read our article about recurrent vs. chronic UTI, if you haven’t already. Melissa
I am wondering of any more holistic ways to treat infections. Currently with a bad bug Klebsella Pneumonae.. I have been on and off abx this year which I feel has killed my gut.. Looking for hope… also of any success stories with the use of tge Urmune vaccine
Hi Shannon, we aren’t aware of how the Uromune vaccine can be accessed in the US. If you have information on that can you please let us know by direct message? Many people will be interested. We have heard some success stories with the vaccine from Europe. I saw you also sent us an email so I’ve replied there with more information. Melissa
Hi,
Thanks so much for the great article. Since menopause I unfortunately suffer from UTIs, mostly after intercourse. I try to stay away from antibiotics and use D mannose which helps me quite a bit. I’m wondering if probiotic pills would also be helpful as a preventative measure?
Hi Ruth, research indicates that certain strains of probiotics may be beneficial and that these strains may be different for pre- and post-menopause. We’ve covered this in more detail and you can read more here. Melissa
The estrogen cream was terrible for me. I’d completed menopause almost twenty years previously. After using the estrogen cream for about ten days my vulva swelled up like a cauliflower, causing horrible pain. It took well over two weeks after I stopped the cream for it to return to normal. For a week I could actually feel my uterus, as if I had resumed menstrual cramps. I think maybe it would work better in women who still had estrogen in their systems.
I’ve e had utis throughout my life. I have been through breast cancer in last year which put me into menopause. I am taking tamoxifen for next 5 years. As my oestrogen levels deplete i am experiencing constant pressure on my bladder that often leads to utis. The samples sent to lab often come back negative but i am given antibiotics anyway and it feels like an infection. I am taking vaginal oestrogen but this doesn’t seem to make any difference to getting infections. I dont want to face a future with this its debilitating and i worry about becoming resistant to antibiotics. I would love to hear about your regime… I take d-mannose tablets too
Hi Emma, can you send me a direct message and let me know where you’re based so I can email you relevant information? Thanks! Melissa
My.mother is suffering from recurrent utis..its not curing..we have done everything..and now my mother is antibiotic sensitive..my mother have e.coli..which is not eliminating..if someone have sure shot solution plz plz plz rply me..its very imp for the life of my mom..plz helo
Hi Singh, there is no sure shot solution but I hope we can share information that will help. I just sent you an email. If you don’t see it, please check your spam folder. Melissa
Hi Tobi, sorry to hear you experienced that! I also got your direct message so I’ve replied by email with more information. Melissa
I’m new to utis. I’ve gone through 3 courses of antibiotics and it has come back again. I’m nervous about this. Any advice would be appreciated. I think I’m very close to menopause.
I’ve suffered with UTI since a teenager. I always get given antibiotics but they always say no bacteria. I’ve been clear for a good few years now but had a UTI in December. Thought it had cleared and had another beginning of June. Had antibiotics but gp said culture was clear. I take probiotics and gp has agreed to use vaginal oestrogen. I am on day ,8 of the initial two week dose. It was all good until today when my symptoms returned. I’m hoping it’s just a glitch
Hi Sharon, if you haven’t already, you might like to read our information on why UTI test results could be negative, even when you have a UTI. Melissa
Hi Kimberly, can you send us a direct message and let us know where you’re based, so we can share any appropriate resources via email? Melissa
My doctor had me on estrogen but stop it when I was still getting UTI’s even on the estorgen
vagifem vaginal suppository twice weekly seems to keep the utis under control. However switching to generic form did not work!
Hi Ellen, that’s great to hear you’ve found something that works for you. If you have any questions, you can always reach out directly. Melissa
I use estrogen pessaries twice a week but am suffering with recurrent UTIs. This has gone on for nearly 3 years since I had a bladder repair following VVF after hysterectomy. Urologist wants me to try Hiprex for 6 months. Does anyone have any experience of this medication? Also I was told I had painful bladder syndrome but urologist now wants to do cystoscopy under GA to rule this out. I’m so fed up. I just want to be symptom free!
Hi Liz, I just emailed you some information about Hiprex. I hope it helps. Melissa
I am new to this UTI issue, and the fact you went 4 years is beyond crazy. It all started with UTI symptoms urgency, pain, burning, and a horrible yeasty smell urine. No blood in the UTI. I want to my Gyno Dr. My apt was fine pee in cup get Pap test. But when I was leaving he did not give me a prescription for a UTI he said the dipstick did not show one but they were sending out to lab. I should take OTC AZO drug that causes your pee to be bright orange. This did not work. I finally called the Dr office back after 2 weeks and they said I did have an infection they called in a prescription. Sulfa but it was only oddly a 5 day prescription which seemed very short. It worked but came back I called my Dr to get more medicine. The tinge of UTI still lingers and burning.
Hi Heather, I see you also sent us a direct message so I’ve replied there. Melissa
Hi Dena, I hope you can find another solution. I see you also sent us an email and we’ve shared some more info there. Melissa
D-Mannose used to stop a bout of cystitis if I took it early enough. But now I’ve read that there might be side effects.
Hi Xenia, we’ve covered D-mannose in more detail here, if you’d like to read further information about it. Melissa
This article makes perfect sense to me. I have been supplementing with probiotics on a daily basis for many years now but it’s been a couple of months since I started getting flatulence so I included kombucha and enzymes in my diet thinking that i might have dysbiosis due to antibiotics that I’d taken for cystitis. I had been using Estradiol 25mcg 3 times a week for a couple of years then the doctor reduced it to 10mcg 3x a week and I noticed discomfort during intercourse. I had no idea that this could be related to more bouts of cystitis.
Hi Xenia, we hear from a lot people with similar experiences that have found estrogen cream helpful. It’s clear that we need more research into this area! Melissa
WOW. I have no history of UTIs and suddenly got one that I cannot get rid of. The bacteria that continuously coming back is enterococcus faecalis and it will not eradicate!!! I’ve been on 5 different rounds of antibiotics all of which it was supposed be sensitive to but it remains and my symptoms persist. Strangely, this happened two months after I got off my birth control pill that I had been on for years! Any advice for me? My husband and I were wanting to start a family but now… I feel I have to wait until I get healthy but the likelihood feels like it is slipping away…
Hi Lizzy, can you send us a direct message with this information and let us know where you’re based? Melissa
Great info here. What is the opinion on Utiva? Thank you.
Hi Sarah, we don’t provide information about specific products, though we do have some info about cranberry for UTI, which I believe Utiva is based on. Melissa
I used estrogen suppositories to soften the tissues of my Urethra, but found it to difficult to keep up with, so my doctor prescribed eString which is inserted and left inside the urethra. Could not decide whether that was helping much, but it had a bad effect on my mammograms, so I was told to remove the eString. I haven’t gone back to it, and want nothing more to do with estrogen.
Hi Emily, thanks for sharing your experience. More research is definitely needed into recurrent UTI treatment approaches and who they may or may not be suitable for. Melissa
Great article. Thank you! Could this apply to women with PCOS also?
Can having the Marina(I think that’s how you spell it !) coil fitted for menapausal problems be a cause of a U T I ?
Hi June, we haven’t seen any research into this, but we have received similar questions from others who are speculating whether it may be linked to symptoms they are experiencing. If you have any other questions, you can always get in touch directly. Melissa
Hi Antonia, that’s an excellent question. I haven’t seen any studies specifically linking this, so I’ve added it to our list of questions to ask an expert. Given the hormonal link to recurrent UTI, it seems plausible. Melissa
What is the role of testosterone treatment
( small daily dose of cream) in relation to UTI for post menopausal & naturethroid women /patients?!!
Hi Cathy, we don’t yet have any information regarding testosterone treatment for UTI. If you have any useful resources we can start looking into, can you send us a direct message? Thanks, Melissa
As always very informative and in a format that is understood,thank you
Can you tell me the differences with compounded estriol cream and the regular estrogen creams like estrace? I’m being treated for e faecalis and citrobacter in urine with antibiotics. Suffered with painful bladder syndrome for 7 years. Also given compounded estriol( I’ve had breast cancer) the estriol is weaker, I’ve been told so may take 3 months to work. My oncologist also told me about a new product Imvexxy which has a lower estrogen content than estrace and premarin. Obviously considering my history I want the lowest estrogen possible but still need it to work. Any thoughts? Thanks
Hi Lesley, that’s a great question and I’ve added it to our list for the experts. We share their answers periodically via our mailing list. If you’d like to join the list, you can do so above, at the bottom of the article. If you have any other questions, feel free to send them to us directly. Melissa
Hi Maria, thanks for your positive feedback! Melissa
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