The “Shameful” Nerve: Sugar, Sex & the Female Microbiome

What do sugar, nerve compression, recurrent UTIs, the vaginal microbiome, and a nerve whose name literally comes from the Latin word for “shame” have in common?On this episode of Sugar Crush: The Rest of the Story, Dr. Rick Jacoby ventures into a subject that doesn't get nearly enough attention: the relationship between metabolic health, the nervous system, and women's pelvic health.Inspired by a recent conversation surrounding longevity enthusiast Bryan Johnson and the vaginal microbiome, Dr. Rick turns his attention to the pudendal nerve - a major pelvic nerve responsible for sensory and motor functions involving the perineum, vulva, clitoris, and surrounding structures. Its name even traces back to the Latin pudendus, meaning “to be ashamed.” Drawing on his background in peripheral nerve surgery and his work with diabetic neuropathy, Dr. Rick explains his global compression theory and explores whether some pelvic symptoms can be viewed through the same nerve-compression framework he applies elsewhere in the body. He discusses glycation, circulation, nerve compression, microbiome changes, itching and burning, pelvic pain, and recurrent urinary and vaginal symptoms. The conversation also examines the complicated relationship between antibiotics, bacteria, yeast, medications, diet, and recurrent UTIs, while Dr. Rick challenges conventional thinking about whether treating symptoms alone always addresses their underlying cause. It's an unconventional - and at times deliberately provocative - look at women's health through the lens of nerves, metabolism, and microbiology.