Intimacy and Pain
Intimacy + Pain
October 04, 2022
In this episode, Lyndsay Soprano opens the episode by talking about intimacy and briefs on her sex life. But how as she has been aging it can sometimes be a little harder to hit the sheets than it used to be. Between CRPS, perimenopause, and aging…all three of those coupled together can be a reason to just give up on intimacy. That is not the case with Lyndsay. Not for one minute.
Hormonal changes, perimenopause, menopause, sexual trauma, and pain can all be contributors to issues in the bedroom. But there is help available if you find the right practitioner to love up on your body and help with sexual pain and intimacy.
Lyndsay speaks with her guest, Dr. Steven Rabin, OBGYN who has been practicing gynecology for 29 years out of his space in Burbank, CA.
One of the reasons why he is so effective as a doctor is his bedside manner. He makes each patient feel safe and secure and creates a space for you [patient] to have a place to speak openly and honestly about what is happening with your body. If you don’t talk about your body and what is happening with it, you will never get results. Hard stop.
Dyspareunia aka painful intercourse — about ten or 20% of women will have it at some point in their life, and it’s not just about menopause and the hormone declining at that time of life.
There’s a lot of other reasons and causes for pain with sex. And the biggest elephant in the room for Dr. Rabin is that it’s either the patient is too embarrassed or worried about being judged to bring it up with the doctor or the nurse practitioner or the PA.
But even worse is a patient who gathers up enough courage to start talking about it, and then the provider is uncomfortable to talk about it not trained, not prepared, not comfortable, or even has their own hang-ups or issues about the topic. It’s kind of a squishy topic, and yet it’s central to most of our lives. Not everybody. Sex is not a central part of everybody’s relationship, everybody’s life. But it becomes a problem, not just for his patient, the person, but also for the person who loves them.
It becomes a couple’s problem. And besides, it is a pain issue and your podcast, The Pain Game Podcast, it sometimes becomes a blame game. And the patient themselves will feel broken or deficient or something’s not working, something’s wrong with me. And then the partner, for lack of understanding what’s going on, will either blame themselves or blame their partner for not being into it, not understanding that sex could even be a painful thing.
And it becomes a couple’s problem, and it really can erode intimacy and confidence and just the relationship overall, even though this is just a part of a relationship, it’s an important part, and it means different things to different people. So, Dr. Rabin thinks it’s important that a patient be comfortable like Lyndsay said, to bring up topics that might be uncomfortable or if you feel unsafe, to bring them up or it brings back old memories, but it’s an important topic to bring up, and there are diagnoses and treatments and there are ways to test for it. And it’s not just all in your head.
Dr. Rabin speaks about the different types of treatment that are available. Well, going to the root causes of it, there are physical factors, there are hormonal factors, there are medical conditions and there are psychological factors.
And these can happen at any phase of life.
It could happen with a young woman at her first sexual experience. It can happen after you have a baby and you’re breastfeeding and there are some really funky low hormone levels at that time.
And then it can happen in menopause when the hormone levels drop and there’s vaginal dryness and atrophy. There are conditions that have nothing to do with age having sexually transmitted infections, having fibroids or endometriosis or scar tissue and adhesions from previous surgery. So, there’s such a long list of things that can cause pain with sex. Many, many patients come to see me because it’s part of the menopausal transition and that’s a time when women seem most comfortable talking about it.
But it’s something that Dr. Rabin brings up at all visits. Birth control pill use can lead to some vaginal dryness and atrophy and sometimes he can see it on a physical exam. But sometimes as a doctor, you must ask are you having any pain or problem with sexual activity, with enjoying sex?
Dr. Rabin asks questions of his patients. He looks at your body holistically. He asks questions. And the right ones.
You can find Dr. Steven Rabin on his social media and his website. All are in the resources below.
Let’s get to the heart of how to heal. With you by my side.
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