S1E21 Painful Sex Isn't Normal with Rachel Gelman, DPT, CSC

I didn’t know sex isn’t supposed to hurt.Did you know that? Penetrative sex is supposed to be free of any unwanted pain. ANY UNWANTED pain.That’s what I learned from Rachel Gelman, physical therapist and sexuality counselor, in this week’s episode.I also learned that 75% of women will have painful penetrative sex in their lifetime. 👀Painful sex can be a result of invisible, chronic illness, pelvic floor dysfunction, or a lifetime of dogmatic messaging about sex.THE TABOOThe taboo we reveal in this episode is that many people — particularly people with vulvas — have had and continue to have painful penetrative sex.Women in our patriarchal culture are often conditioned to anticipate or accept pain as a part of intimacy, and spend years (decades!) not knowing their experience is not normal (but dreadfully common), and treatable.LINKS + RESOURCESThe Pelvic People - on a mission to end painful sex* 🛒 The Ohnut depth-limiting ringsThe International Society for the Study of Women’s Sexual Health (ISSWSH)* 🏥 Find a providerPelvic Wellness + Physical Therapy* 🗓️ Schedule a virtual visit with Rachel Gelman, DPT, CSCTIME STAMPS* 02:30 – Why patients come to pelvic floor therapy (often self-referred through Reddit)* 04:45 – Your pelvic floor muscles and how they affect sex and pain.* 13:50 – How media and culture condition women to expect sex to be painful.* 16:30 – Why people push through pain: duty, stigma, survival.* 18:45 – Texas sex toy laws and why female pleasure is still taboo.* 23:20 – Vaginal dryness: causes, hormones, and why lube helps but isn’t always enough.* 28:10 – Endo, adeno, PCOS, and fibroids: A quick overview and relevance.* 32:30 – What to expect in a pelvic floor therapy session* 41:45 – How to talk to your partner about painful sex.THE GUEST EXPERTDr. Rachel Gelman’s mission is to make women/people with vulvas aware that certain life events (pregnancy and menopause) can impact their sex life but that there are options to address their sexual health concerns and common issues, like pain with sex or low desire do not need to be accepted as normal.* 📍 San Francisco, California* 🛜 Pelvic Wellness + Physical Therapy: Promoting wellness for anyone with a pelvis* ✍🏻 Rachel’s blog: The Pelvic Post* 📱 Follow Rachel on Instagram: @pelvichealthsfKEY TAKEAWAYS* Sex should be pain free to the extent you want it to be* Painful penetrative sex can be the result of conditions like endometriosis, adenomyosis, fibroids, or PCOS, pelvic floor dysfunction like vaginismus (which can be a side effect of trauma and/or fear of sex).* Sex toys, lube, sexuality counseling, and pelvic floor physical therapy are ways to treat painful sexHow to talk to your partner about painful sex“Hey, I was listening to this podcast and they were talking about pain with sex.“It's interesting because I've actually had pain with sex and I always thought it was normal, but this lady said, it's actually not normal and it's actually really common, but there's things that can be done about it. I didn't know that, and I didn't realize there were things I could do about it, but I would like to try _.“I wanted to tell you that I have been having pain.”P.S. I made you this silly quiz to find out which feminist banned book you are:🔮 Which Banned Feminist Book Are You?Other episodes you might like: This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit micahlarsen.substack.com