Hi! It’s Micah from Modern Hysteria, your newsletter and podcast revealing the taboos of women’s brains, bodies, and healthcare (subscribe and listen on Spotify and Apple Podcasts!).
I’m gonna be real vulnerable here, okay?
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. 👀
After I donated my eggs in 2014, and especially after I had my son in 2019, penetrative sex hurt. After 2019 it was deeply painful, like in my organs, and I usually bled during and after.
It seems crazy to me, now, but I was used to it. I had grown accustomed to the pain that increased with every big transition in my body and was disconnected from the signals it was trying to send me.
When I had a hysterectomy in 2022, I got some clarity about why I had so much pelvic pain; my uterus was “oversized and boggy,” according to the surgeon. When he poked it with his gloved fingertip, the indent remained.
I’ll write more about this in the future, but for now, know that you do not have to have had a boggy womb for sex to be painful.
Painful sex can be a result of invisible, chronic illness, pelvic floor dysfunction, or a lifetime of dogmatic messaging about sex.
The Taboo
The 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 + Resources
The Pelvic People - on a mission to end painful sex
The International Society for the Study of Women’s Sexual Health (ISSWSH)
Pelvic Wellness + Physical Therapy
Time 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 Expert
Dr. 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
📱 Follow Rachel on Instagram: @pelvichealthsf
In Rachel’s Bag
Key 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 sex
How to talk to your partner about painful sex
A script from Dr. Rachel:
“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.”
Share this episode with your partner here:
That’s it for this episode. Did it resonate? Tell me in the comments (I read every single one)
Coming up on Season 1 of Modern Hysteria:
Season 1 Ep. 22: Menopause x Misogyny x Body Image with
Season 1 Ep. 23: The Clitoris x Orgasm x Pleasure with Cindy Scharkey, RN
Season 1 Ep. 24: The Fawn Response with
Season 1 Ep 25: Normal versus Abnormal Vaginas x Vulvas x Pelvic Red Flags with Carla Carpenter, OBGyn
… and that’s it for Season 1!
I’ve already got a bunch of experts queued to bust taboos on Season 2 … Can’t wait to share.
‘Til then, subscribe on Apple Podcasts and Spotify. ☺️
Talk soon,
Micah
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:
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