Painful Sex & Vaginismus: What Every Woman Should Know | Ep. 602

Episode 602

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F -A -M -M -L -I -V -E. This is the Fertility Friday podcast, episode number 602.
Today’s episode dives into an incredibly important topic that has not really been one
that we’ve talked about on the podcast a whole lot. I think the only time this
topic came up, the topic of painful sex or pretty much the only time was an
episode quite a while ago and it was related to one of the lesser known side
effects of hormonal birth control, which can be painful sex. But in today’s episode,
we are talking about painful sex and vaginismus with Dr. Janelle Frederick,
also known as the vagina rehab doctor. One of the main themes that came out in
today’s episode was how common an issue
can be surrounded by shame and silence, something that people may be experiencing but
not talking about. So I’m really thankful to have this conversation with Dr.
Frederick and to bring it out into the light to normalize it so that couples who
are experiencing this type of difficulty know that they’re not alone, but also know
that there’s hope. And I think for me, especially the message that I hope shines
through is that it’s not normal for sex to be painful. And if it is, it shouldn’t
be that way. And there is support out there. And we should be seeking that. It
shouldn’t ever be expected that we should be, especially as women, it should never
be expected that we’re just supposed to continue to endure something that is painful.
So before we jump into today’s episode, I want to share a little bit more about
Dr. Janelle. So Dr. Janelle Frederick, known as the vagina rehab doctor,
is a world -renowned pelvic floor specialist dedicated to helping individuals
others. So without further ado, let’s go ahead and dive into today’s conversation
with Dr. Janelle.
I’m excited to be here today with Dr. Janelle Frederick. Welcome to the show. Thank
you so much, Lisa. I’m very excited to be here. And I can’t believe that I’m here.
I used to listen to your podcast and I’ve heard about you for years. So thank you
so much for having me. Oh, Of course. I was really thrilled to have you because
we’re going to be talking about something that I haven’t talked a lot about. I feel
like if I think about all the different episodes, even over 11 years, I feel like
this is not something that we’ve talked about a lot. It might have come up in
passing. And so I know there’s a lot of things we can talk about today, but I did
want to ask you about pain with sex, painful sex. So I’m really excited to talk
about that with you. But Before we get into that, I’d love to hear a little bit
about your background. So for those of us in the audience who aren’t as familiar
with your work, share a little bit about what you do and why you ended up focusing
on this area in particular. Sure. So I’m a pelvic floor physical therapist. I
actually went to Oakwood University in Alabama. It’s like Huntsville, Alabama.
And that’s actually where I just moved back to. So started off with my bachelor’s
there, went to California in like Northern California, a school called the University
of the Pacific. And that’s where I did an accelerated doctor and physical therapy.
So it was just two years, super quick and stressful. But once I finished, I started
doing traveling physical therapy. And I remember vividly when my recruiter told me
about a women’s health physical therapy position. And this was going to be just
about bladder dysfunction. So it was like urinary incontinence, frequent urination,
urgency, so feeling like you won’t make it to the bathroom. And I was only supposed
to be there for three months for a contract. And I was so in love with what I
was doing there that I just kept renewing it until I was there for a year. And so
I was like, okay, this is something I need to look more into. And so that’s when
I decided to go ahead and specialize as a women’s health physical therapist. Now,
it’s no longer called women’s health physical therapy. It’s called pelvic health
physical therapy, just to be more inclusive. But I then went to Chicago, and that’s
where I did a residency at Loyola. I then started working at Northwestern, and
that’s when I got exposed to, like, more sexual dysfunction. So I started seeing
that a lot of women were struggling with sexual pain and their relationships and
intimacy. And I just really want to help women have pain -free sex.
I feel that that’s something everyone should experience, especially when there is a
partner involved. I mean, that can drastically influence the relationship. So instead
of trying to be the expert on everything, like pain your pants, prolapse, pregnancy,
I was like, let me just choose something. And So that’s what I tend to focus on,
just helping women to feel free and satisfied with their sex life.
Well, I mean, I’ve been following you for a while on Instagram. We were just
talking about the Grans. And I feel like the content that you pay is super fun,
but it hits on such an important issue. So one of the questions I wanted to ask
is just about prevalence. I mean, how common is this issue?
Based on even just following you for a little while, I’m like, I feel like,
the most. So we see it a lot. It’s not talked about enough, but you just never
know. There could be people that have babies and have not had sex. We also work
with that. Like they’ve had a vaginal birth. They have never had intercourse. And so
this is common and you can’t just look at someone and know whether or not they are
struggling in that department or not. So we absolutely love to make this more known
so that women can feel comfortable getting help, talking about this, and not feeling
like so isolated or strange. Well, you said a lot there. One thing I just want to
touch on before I ask you more about vaginism is that you said women who’ve had a
baby vaginally birth even and have not had sex. And so are you referring to like
the IVF scenario where they’ve, okay, please explain. So I mean,
I want to sort of take a few steps back. We work with various types of pelvic
floor dysfunction. We still get the incontinence, occasionally prolapse or someone
preparing for pregnancy. They want to prepare their pelvic floor. But most, I would
say 70 % of the patients that we have, it’s either I can have sex, but it hurts
way too much, or I can’t have sex at all because nothing can get inside. He’s just
hitting a brick wall. And so when that is happening for five years in your
marriage, I mean,
to get the sperm or whatever it is. Is it the sperm or the embryo? Child,
you know better than I do, Lisa. This is fertility. If they’re doing the IUI,
they’re kind of inserting it in there. If they’re doing IVF, so yes, they definitely
have to go in. Yeah. So a lot of our patients sometimes struggle with a finger,
inserting a Q -tip, inserting a tampon. So there is something called the splash
method, where if your partner just ejaculates around the vaginal opening, even if
there’s no penetration, the sperm can just swim up. So in the charting world, we
call that like a contact pregnancy where like it’s kind of one of the teachings.
Like if you want to try to avoid pregnancy, it’s like, don’t let it get it on its
hands. And because if you get to see your hand, yeah, this is very interesting
because I’ve never like heard this as a method of conception. So that is very
interesting. Or we have some people where maybe their partner can get in very
impartially, like just the tip of the penis can get in. And somehow they get the
sperm up there. But no full penetrator sex has taken place. And so we’ve even
worked with women who are like, they got the three -year -olds running around, but
they’re now experiencing pain free sex for the first time after they go through like
our coaching program, which is pretty detailed on how to actually release those
pelvic floor muscles so that intimacy is not.
really struggling with this, but I’m glad that the word is getting out there, that
there are solutions, and you don’t just have to, like, suffer through this problem.
Okay, so I want to ask, what is vaginismus, and why is this happening? My brain is
going to all these places, but I want you to tell me, and then I will ask them
follow -ups. I’m so curious, like, where’s her brain going? Okay, so vaginismus is a
pelvic floor disorder that can make penetration either completely impossible or very
excruciating. And the reason why this is happening is because of three primary
factors. One, there is significant pelvic floor tightness.
Okay, so this is a medical grade level of tightness. We hear a lot that people
think it’s good to be tight. So we’re not talking about that type of tightness
where your partner goes, ooh, you’re so tight. That’s not medical grade level of
tightness. We’re talking about hypertonicity, which means your muscles are essentially
held in a key goal all day long. Like your muscles don’t know how to let go of
restriction. That is the level of tension that we’re talking about to where even
acute it may hurt or be painful. After the tension, the other thing is pain.
There is true physical pain. It’s not just in their head. It’s not just, I’m afraid
or we haven’t done enough foreplay, there is pelvic pain that is preventing the
insertion to be tolerated. And then also at vaginesis, there is usually,
but not always a fear component. And what we tend to see a lot of is women who
are scared of pain. They’ve been told that it’s going to hurt. There’s going to be
bleeding. They’re going to rip their hymen. Just prepare to just grit through it and
just hold on. I mean, so a lot of women come with either.
sad to hear. And one and four religious women have it. One and four. So, I mean,
when I was saying, like, where my mind is going, I’m an interviewer, I’ve got
questions, right? So part of it is that, and you kind of already said, like, it’s
beyond just not enough foreplay, but like, is this related to sometimes a lack of
information about female anatomy and how it works or even a lack of understanding of
the sexual process, what is going on, right? Okay, I love this.
Yes, it is that, but also we see that anyone can have vaginousness. While we do
see it more common in more conservative cultures, more religious women, we’re also
seeing it in women who didn’t grow up going to church. And maybe their parents were
pretty liberal and they’re sex positive and they can’t have sex. It also happens to
women who have very high sex drives and they’re erotic and all of this. So it’s
not one thing, but I would say a common thread that I’m seeing is a lot of
avoidance to where, okay, you wait until marriage and you try and have sex on your
wedding night, but literally nothing has been tried before then. You haven’t tried to
insert a finger. You haven’t gotten a pap smear. There’s never been a tampon put
in. So those muscles have essentially been unused for about 30 years or 25 years,
whatever. So that’s one of them. The other factor is poor sex education to where
some people don’t know where their vagina is at all. Again, they think that this
process of intercourse doesn’t even make sense. How is that penis going to fit
inside of my small vagina? Why is this not going to be painful? Oh, it has to be
painful. So there’s a lot of that. And then there’s a lot of sort of religious
silencing to where just in your upbringing, you just didn’t talk about it. Sex is
dirty. Sex is nasty. You can’t do it until you’re married. And then all of a
sudden when you’re married, you’re supposed to be able to just bust it wide open.
So it’s definitely a lot of factors involved. But sometimes there’s no trauma in the
background. There’s no conservative religion. Some women, they don’t know why they
have it. Or maybe they had an abortion. Some women develop it after very stressful
life events. But the fact remains that those muscles just don’t have the mobility
required to allow comfortable intercourse. And then also,
sometimes there is fear and anxiety where we have to work with them on calming
their nervous system too. And it’s not just the physical.
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Right. And so something else that kind of came to mind, let me see if I can,
like, word it. So working over the years with women of reproductive age,
various ages, right, like in the 20s, into 40s and that kind of thing, even into
50s, sometimes when I’m working with a younger population, right, like the 20
-somethings, and the caveat is…
many situations where you just kind of get into a conversation and ask about it.
And then they kind of mention that sex is painful sometimes and that kind of thing.
And sometimes it seems to be a situation where they’re not saying anything. Like the
sex is painful, but they’re not saying anything. And it’s like once you have a
conversation and you talk a little bit about how the body works and you talk about
how long it takes for the vagina to relax and lengthen and lubrication and like all
that kind of stuff, then the lights start to go off. And,
we want to fulfill. Like we want to be able to say that our partner is pleased in
the sexual department or maybe they feel like they are being needy,
you know, if they’re complaining that something hurts or they need to stop sex
early. I think there was a study that showed 40 to 50 percent of women that deal
with painful sex haven’t even told their partners. And I remember a very clear
situation. This is when I used to work in person at Northwestern in Chicago. There
was a woman in her mid -40s. She came in for pelvic floor therapy for painful sex.
And when I tell you, her vagina was so tense and tight, I could barely get my
finger inside to do the assessment and release her pelvic floor muscles.
Because she’s been married for like seven years and she said she’s been having sex
the whole time. I’m trying to figure out how is sex even possible, number one. She
goes on to say that she was having sex with her husband because she felt like it
was her job, like she had to do that in order to be married. And we can judge
her and sit here and say, oh, he sucks and you should have said some, but a lot
of women feel that same way. What you were saying about how your client, like you
could barely insert a finger, but she felt like it was her duty to have sex. I
mean, we have so much work to do. I don’t know. And I feel like I’m jumping
around a little bit, but I think that’s what’s going to happen with this
conversation because of the nature of it. But what’s the solution? Like, how did we
change that? I mean, from my perspective and my views and values and all those
things, like sex is something very special. It’s kind of the most intimate you can
be with someone in many ways. And, you know, in the context of a loving
relationship, for example, you know, it can be such a beautiful thing. So it’s sad
to think of married couples going almost a decade without being able to fully enjoy
it, like for both of them to fully enjoy this. And for one partner to feel like
it’s just a duty they have to do and not even to realize it’s supposed to be
enjoyable. Oh, yeah. I think that there are so many layers to the work that needs
to be done. On my side, me being a pelvic floor physical therapist, I’m really into
the trenches of like the actual physical healing work, right? The nervous system and
the pelvic floor muscles and women knowing that those muscles even exist and that
that can be causing someone’s pain. But I think even further than like the physical
and clinical work is the education that we get. What are we being taught about our
bodies? And what are we being told as women? Is sex about pleasing your partner? If
you’re a wife, is it about just submitting and making sure that your husband is
happy? Or is it a mutual experience where both people should feel safe and satisfied
and not in pain? Because it’s only taboo if we talk about it for women.
If a man comes to you and says, I’m an excruciating pain during sex, you would
think something is very wrong with him. But we don’t think that way for a woman.
We think that she should be bleeding, it should be painful, her first several times.
And that’s the other thing. Women are confused. They’re waiting for this first time
sex to go away because we’ve been told that, oh, if you’re a virgin, you’re just
supposed to be in a lot of pain because you’re going to be really tight. So it’s
a lot of myths. There’s a lot of
production. It’s also done for just bonding and feeling close and connected to your
partner. There’s so much work. I mean, I think it’s improving, but it’s work to be
done from several angles. Well, so I have another question, and I feel like
depending on the perspective of the listener, it could be controversial, but I’m not
really that concerned. I’m not a big fan of modern day porn. I just feel like it’s
a really big problem. So I know that not everybody would agree with that
perspective, but I feel like it’s like warfare material. Like I grew up in the 80s
and 90s and like whatever they call porn today is like a whole other level. I
think a lot of older people who don’t know how far. And I don’t watch it.
I’m just aware of the categories. But like they don’t know how far it’s gone. Like
it’s just not even sex. Like what is happening, right? So the question obviously out
of that is because when you’re talking about like,
of signs of tenseness. And I mean, I could be demonizing him. He could have been
the whole time, like, are you okay? And years of her saying, I’m fine, I’m fine.
So it could have been like that too. But like, do you feel like that’s playing a
role at all? And is that changing the expectation of what this interaction is
supposed to look like? Is that poisoning? In some cases, it could be helping because
at least then you know where to put it. But like, you know. So what I’m saying is
I’m seeing a lot of torn relationships where, okay, now there’s a divorce or there’s
a breakup. And it was just too distressing to deal with, the no sex, the painful
sex, the whatever. But then I’m also saying men that just are very patient caring,
they wait through it, they want to help their partner, they find creative ways to
have pleasure because penetration is not the only way. But then I also see that
women feel sort of on their own an obligation to please their partner.
And so even if their partner is asking, are you okay? I think historically,
we have sort of been taught as women that we need to make sure our man is pleased
or he’s going to go out and get it from somewhere else. And so that narrative of
hearing that, I think, I mean, even from like your aunties and people older. Like,
girl, make sure you take care of your husband, you know, or else he might step
out. Just different things that is not helpful. Sometimes it’s also just wanting to
fit in. I also hear a lot of women say like they don’t feel like their friends
can relate to them. When they talk about their sexual stories or their rendezvous
with their husband, whatever, I think we want to feel whole, like we want to be
normal. We want to be able to say we can have sex with our partner. And so there
is pressure.
wrong or keep our partner happy. Yeah, I know that makes a lot of sense. Well, so
now I want to shift into like more of the solutions and the muscle, what’s going
on there. And so why don’t you talk a little bit about how you address this?
Like, we’ve really hashed the problem, I think. We can hash the problem for two
more days, but like we’ve hashed the problem quite a bit. And so where does someone
start when they have these these types of issues? Great question. One of the best
places to start is just believing that they can heal because we work with a lot of
women that have had this problem chronically or either their whole life. Even if it
wasn’t sex, they’ve never been able to insert a tampon or they’ve never been able
to get a pap smear or the pap smear was causing them to jump off the table.
Someone like that who knows pain more and they know comfort and pleasure, it starts
with just believing, like, your body doesn’t have to stay this way because we can
give you the best clinical treatment, but if your mind is still stuck in, I’m never
going to get better, then it won’t work. So that’s where it starts. But then also,
it also goes to relearning new narratives about your body. Yes,
you may be experiencing pain now, but just like any other muscle in your body,
those muscles can be retrained. The same way we can strengthen our butt muscles. We
can strengthen our arms and get strong.
but that is a process. So in that process, we are doing it as a pelvic floor,
physical therapist, I can say, we’re looking at how much tension is being held
inside, right? Because many times there is some internal work that needs to be done.
The same way, if you have a tight shoulder, you may go to a massage therapist and
they’re like almost digging into the muscle to release that knot, the pelvic floor,
the muscles inside of the vagina can be so restricted that a stretch or just
breathing is not enough. And so we teach our patients because we do everything
remotely how to use tools at home. Dilators, they’re cylindrical tools that look like
small penises. It starts from a really small thing that looks like maybe a finger.
And we show them how to use these tools, how to use them to release pain,
to release tension. There’s also things like pelvic wands, which are tools that help
more with sort of the angle because the pelvis is not a straight line. Like your
vagina is just not this straight line. There’s a bowl. And let’s say you’re trying
to have sex in a different position. You may need to release tension in a different
angle of your pelvis. So we’re teaching women how to use their own hands, how to
use tools, and how to include other exercises and nervous system calming methods that
help them to not be so afraid of their body. Because a lot of this is also
learned fear because it has always hurt. So that is typically the route we go is
we want to address your nervous system, but we also want to help you with the
actual muscles, because if we don’t open up those muscles, then sex will continue to
be painful or difficult. Well, and I have another question on those lines.
I mean, how can the partner be involved in this? I’ll just try to stream of
thought this question. So if there’s a lot of fear, whether it’s, I don’t know if
there’s shame or concern or discomfort, I would imagine that, first of all,
if this is an issue about sex within the context of a relationship. I mean, it
can’t just be thought of as like her issue, her problem. It’s like she can’t have
sex by herself. So anyways, I’m curious about the implications of like bringing in
the partner if that’s a thing that happens and like how that works. Or is there
resistance to that? Is it more of like I have to sort this out on my own? Oh, so
I find that it doesn’t really go well when the women feels that way. I have to
sort this out on my own. I will say that culture plays a big role in how
comfortable the man is with this healing process. I would say in my experience,
I want to say that my experience is limited and not everyone in one culture will
be the same. But in my experience, I’ve seen that African husbands, they’re a little
bit more closed off to like this process where they sort of just want to go and
have sex. And sex is the sacred thing. They don’t want to use dilators. They don’t
want to see you struggling to get pain out of your vagina. And so sometimes I’m
saying like, okay, if the man is not willing to help you use dilators or if he
doesn’t want to go to the physical therapy session, we at least need him to just
be supportive. Like, I believe you can heal. I believe we can get through this. We
can get to the other side because culture does play a big part on how people see
things. And I’m just the pelvic floor therapist. I’m not going to change your
husband’s mindset on different things. We also do offer like couples coaching.
So if someone actually wants to do each and every session with their partner, we
actually will show their partner how to aid their partner in releasing the pain.
We can show them hands -on tactics where they can physically release the problem for
their partner so they can actually relax a little bit more. But generally what we
do, if it is the woman that we’re helping in each session, we show her what to do
in these hands -on sessions. So every session is hands -on. But towards the end of
the program, we do eight sessions typically. And if someone needs a little bit more
sessions, they can book a couple more. But by visit five, six, seven, we start
prescribing partnered homework. So that’s when we’re like, okay, we want you to do
some foreplay first with your partner. Then we want them to use the dilator with
you. And here are the strategies that we want your partner to use on you so that
you can start relaxing, start feeling a little bit more unity sexually, and feel
prepared to make the transition to actual sex. And so that’s not required,
but I do think it is helpful when the partner is willing to sort of
believes in you and is willing to help out. Well, and what are your thoughts on,
like, I mean, there’s, there’s a lot of information out there for anything you want
to learn. Like, if you want to learn about sex, like, there’s a lot of books.
There’s even courses. There’s courses that you can buy. There’s people that sell
courses on, you know, how to please your partner and all the kind of stuff. And
what are your thoughts on some of those things? I mean, you know what I’m saying?
Like, the education around the way that the body works? This is a great question. I
will say because, again, we’re saying, I would say at least 50 to 65 percent of
our clientele comes from a more religious background. Sometimes there is a little
less knowledge or exposure to pleasure and sexual anatomy. I mean,
I have people that are like, where’s my clitoris? Where’s my vagina? Is he putting
it in the right hole? Right. So I get that occasionally, but I think a lot of the
women and couples that we’re working with are so focused on just being able to have
impossible. But I encourage people to learn, like, make sure that whoever is the
instructor that their views sort of align. I did a pleasure course one time online,
and it was interesting for me to say the least. It was about blowjobs, and I’m not
judging on blow jobs. It’s just the way that the course was taught. And I was just
like, I think I’m going to leave this to, I’m going to leave this to everyone
else. So be comfortable and familiar with who the instructor is first, because if
you’re going to just be sort of weirded out the whole time, you’re not going to be
learning anything. And so you want to make sure that you’re learning from someone
who is sex positive and knowledgeable, but also does their style of teaching and
their belief system sort of align with what your goals are as well. So that is my
encouragement there. Learn as much as you can, though. Absolutely.
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ahead and jump back into today’s episode.
Well, and one question that, you know, I mean, surprisingly that we haven’t even
touched on it a whole lot, I think you mentioned it a little bit, is, you know,
for women who are dealing with these issues, because you did mention, it was like,
oh, just drink some wine or just Blah.
have both social support and expert support. So everyone who has a white coat isn’t
an expert in painful sex or vaginismus. And so when you go to your doctor and they
start recommending things that you could be recommended from a group chat. So have a
glass of wand, relax or use more loop. That’s not really skilled advice. I mean,
you don’t have to get a degree to go tell someone that, right? So I would say
once you realize that that’s the most advice that you’re getting from your doctor,
you want to look and do some research to figure out, can you work with a pelvic
floor therapist that actually focuses in on vaginismus or sexual pain? Because that’s
the number one proven expert to treat sexual pain.
First and foremost, it is a pelvic floor physical therapist. And it’s the most non
invasive route. There’s no surgery involved in that. So that’s the number one.
Try if you can to work with a pelvic floor therapist who studies sexual pain.
And then the other side is you don’t want to just do the clinical. Is there a
support group? Is there a friend or a girlfriend you can talk to that is not going
to shame you or act like you’re just this weirdo or say, oh, I’ve never had that
problem. I don’t know what’s going on with you. Someone who can provide support
emotionally, more than just your partner. I think we do put a lot of pressure on a
partner. We want our partner to be our everything. But especially as a woman, I
think we thrive on relationships and community. And so find someone who you can open
up to and someone who can help you be consistent with what you’re doing. Even if
you can’t afford pelvic floor therapy or you can’t get to a doctor, doing some
pelvic floor stretches and pelvic floor relaxation exercises can drastically help and
reduce pain. So there’s something that everyone can do, regardless of your economic
level or capacity, just do something. If you truly want to see this change,
then, you know, we have to put forth the effort to allow our bodies to heal. Well,
and one other question along these lines that I thought of is the hope piece.
So for women who have identified this issue, they’re willing to jump in and figure
it out. They’re learning. They’ve got their dialators, their partners on board. He’s
super supportive, right? It’s working out. So typically, like, how long do you see
it take before, you know, these women start to feel that relief and actually start
to be able to enjoy sex with their partners again. So this is where I get
extremely geeked out and happy because when I used to work in person, it would take
me maybe six to eight months to help women overcome this. Currently, our average
amount of time is eight to ten sessions, which equals out to just about two to
three bucks. And we always say two to three months because we’re women. I mean, we
have periods. Maybe we get sick. Maybe we travel. So I don’t like to say only
eight weeks. And then if something comes up, it’s longer and someone’s disappointed.
But we really only need that length of time. If someone’s coming every single week
to their sessions, they’re doing the homework. They’re not just going home and like,
I don’t want to do anything. Then it doesn’t take that long because your body is
created for this. We’re not teaching you how to fly. We’re teaching you how to do
something that your body was made to do. and so generally to
think it’s three major things. One is what we’ve already discussed. I’ve been
studying vaginismists for a while. I mean, there are people who believe that this
problem of impossible intercourse is because of this random spasm. There’s this muscle
spasm and it’s just stopping your partner from getting in. But that is from a
research study from like umpteen years ago. It’s so old. It’s disproven that they
have now even changed the name. So So technically vaginismists consider the old name,
and it’s now lumped into a condition called genital pelvic pain penetration disorder.
And so that is because vaginismus means spasm of the vagina. So that’s now been
debunked. And so I think number one is we just understand the condition a little
bit better. Number two, we’re showing women how to take ownership over their healing
by teaching them hands -on tools they can do at home. instead of when you go into
a clinic and
my own pelvic floor. So we’re seeing more ownership. There’s way more accountability.
There’s no option of you to do your homework because we’re not touching you at all.
So you either have to do the homework and see the results or you’re not going to
get the results. And then lastly, we’re able to include more non -clinical things.
Like we talk about pleasure. We talk about sex positivity. We talk about
understanding your pain and what pain science is. And so I think women are feeling
more coached and guided with our program instead of just like, okay, go home, do
these exercises, and that’s the end of it. It’s very hands -on. It’s very actionable.
And women are able to learn how to feel like the CEO of their body. And so to
me, that’s what’s making the difference. But I have to say that physical therapy is
still helpful for a lot of people and it’s still beneficial. It’s just for this
specific problem, we’re saying that the virtual route tends to work a little quicker
or a lot quicker. You know, that makes a lot of sense. It makes a lot of sense
that if you kind of figure out it, kind of ease into this in your own home and
then eventually involve your partner. I mean, it is, you’re gearing toward intimacy.
And it’s not intimate. I don’t know how to say it, but like if you’re sitting at
a table with like kind of like a sort of stranger, I mean, you can get to know
your physical therapist quite well, but I mean, they have their fingers in your
vagina. It’s just not the same level. It’s a white room. Yeah. Yeah. Exactly. You’re
at home in your comfortable space. And then you have women that have been through a
lot of trauma. And sometimes the home and like just feeling like no one else has
to navigate –
because they saw the title. No, I just wanted to say that, like, don’t forget about
your pelvic floor as you pursue pregnancy and as you think about your fertility
because generally fertility planning and trying to grow your family and does involve
sex. And so, and it’s after pregnancy too. Your pleasure matters before you get
pregnant during and even after as you become a mom. you’re going to eventually want
to return to sex, right? So don’t forget about that piece. We’ve seen so many women
get pregnant soon after finishing treatment because now they can actually get through
the act. And so remember that your comfort matters. It’s not just for your partner.
It’s for you and that there is healing available. Like there is hope and you can
do this. That is amazing. It’s still, like I said, when you first kind of laid it
out, it just made me sad because this is a really big issue. And, I mean, it has
the potential, obviously, to tear apart relationship, you know, and fidelity to enter
and just lots of confusion that there’s a solution, though. It doesn’t have to be
this way, right? So, so happy that you’re out there. You’re healing the world, one
vagina at a time, do anything. Oh, my gosh, Lisa. Thank you so much. So why are
you share with us where people can go to learn about you, your Instagram, TikTok,
all the things.
And then if you are interested in one -on -one coaching with us, you can set a free
consultation at VaginaRehabdoctor .com. And again, everything is spelled out.
Amazing. Well, we will make sure to link all of those places in the show notes.
Thank you again for being with us today and enlightening us on vaginismists, which
is now, now we know that is even the old title because I do remember learning it’s
the spasms. Everything you said made so much sense. So thank you for enlightening us
and for giving a hope, especially for couples that have been struggling with this.
Yeah. Thanks for having me, Lisa.
Thank you for listening. If you enjoyed today’s show, please share it with a friend.
You’ll find the show notes page over at fertility friday .com slash 602.
I hope that you enjoyed today’s episode with Dr. Frederick as much as I did.
I mean, wow. I have heard of a lot of issues in my time, but I’m still going to
need a minute to kind of digest what she said about the splash method.
I mean, that is something that as you were listening, you probably heard me like,
what, say that again? What did you say? What did you mean when you said that don’t
even think that if a person has had a baby, even a baby, a vaginal delivery that
they have actually had sex before, because there are couples for whom sex is such a
significant issue, challenge problem, causes such significant pain that there’s an
actual, quote, method of conception that doesn’t involve penetration so that couples
can still conceive, even if they’re not able to have penetrative sex. I mean, that
was something that was certainly new to me. So I really appreciate this conversation
today because there are various aspects of this conversation that I have heard before
when it comes to education around sex and intimacy. And it’s really tragic when you
hear stories of couples who are married, newly married, or have been married for a
fairly significant period of time. But they lack education around sex, sexual
activity, to the point that it’s interfering with their ability to actually have
intercourse, right? So this is important for women to know, for couples to know.
Education is so important. But it’s also important for practitioners to be aware of
this. And this is one of the themes that often comes up in FAM, which is, I
always say you can’t assume anything. When you’re working with a couple, you never
want to just assume things. You don’t want to assume that, for example, if they
say, oh, yeah, I use condoms, like, you don’t want to assume that that means that
they know how to use them correctly. Like, you want to just investigate that a
little bit more. And even a reminder that if you’re working with couples that have
fertility challenges, you don’t want to assume anything. Sometimes you have to
actually get down to the nitty gritty with sex happening and when is it happening
and things like that. And how is it happening? And because there’s an actual real
issue of a small percentage of couples who are really not having penetrative sex for
one reason or another. And so I think the bottom line biggest takeaway that I had
from today’s episode is that, of course, there’s hope. And it’s really important not
to kind of suffer in silence. If you’re having certain challenges, it’s really
important to seek out support. And it’s so comforting to know that there is help
out there. And what I always say for specific issues, you will have in any area
best results when you’re working with someone who truly specializes in that issue,
where this is what they do all day long, this is their clientele, because those are
the situation where you’re really going to be helped when your provider really knows.
So I’m glad that Dr. Janelle is out there supporting couples and she’s really fun
to follow on Instagram because she really just kind of puts this issue out there in
the open and addresses it, I think, with humor and with grace and with the
intention to really destigmatize these topics and to normalize it to some degree so
that if you or someone that you know has experienced something like this, that you
know that you’re not alone. She gave some pretty heavy stats. This is more common
than we would think. And it’s so important to be breaking those barriers and
bringing this knowledge to women and couples. So with that said, I hope you have a
wonderful weekend whenever you’re tuning into the show. And of course, as always,
until next time, be well and happy charting.
And that’s a wrap. If you’ve been loving the podcast and you’ve been thinking about
ways to incorporate fertility awareness into your women’s health practice, then I know
we’ll love our fertility awareness mastery mentorship certification program. It’s a
nine -month immersive experience.
bringing in your charts and clients’ charts and seeing real -life charts because they
don’t look like what the textbooks tell you. So what this has really given me is
the confidence to then go and teach people this method for whatever their desired
uses and then be able to tailor the treatment to exactly where they’re on their
cycle rather than kind of be like, do you think you’re populated? Like, oh, I don’t
know. Like, er. So, like, it’s made it really specific. I I just have this wealth
of knowledge now and this ability to teach people exactly where they are in their
cycle and for them to understand exactly what’s going on. And there’s like, there’s
no assuming anymore. But I just assumed I ovulated on day 14 because that’s where
everything told me. Actually, that first chart, what was day 20 or something? Like,
just because I had a 28 day cycle, it was far from what I thought it was. And I
think I’ve got the data now to back that up. And I’ve done courses before where
I’m like, they’re just,
head over to fertility friday .com slash fan live to apply today. That’s fertility
friday .com slash F -A -M -M -L -I -V -E.