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The World's Tightest Community - A Podcast About Vulvodynia, Vaginismus & Women's Pelvic Pain
The World's Tightest Community - A Podcast About Vulvodynia, Vaginismus & Women's Pelvic Pain
This podcast focuses on chronic pelvic pain conditions like vulvodynia and vaginismus, which affect many women but are often underdiscussed. Hosted by Mathilde Olstad, a patient-turned-advocate, it features conversations with gynecologists, pelvic floor therapists, and researchers. The show aims to provide clinical knowledge, personal insights, and support for those navigating these conditions. Each episode offers language for experiences and questions for medical appointments.
Episodes
Sex Therapist on Pelvic Pain and Trauma: When the Pain Itself Becomes the Trauma
What happens when pelvic pain improves, but your body still expects sex to hurt?I'm joined by Romi Terk Brudno, a sex therapist specializing in pelvic pain and painful sex.Drawing on her own experience of ulcerative colitis and painful sex, Romi explores avoidance, feeling "broken," and the gap between progress in pelvic floor PT and feeling safe during intimacy. We discuss trauma-like responses t
48: Genitourinary Syndrome of Menopause: Why You Can Have It In Your 20s & 30s
Why do the tissue changes we link to menopause also show up in women on the pill, breastfeeding, or in their twenties?I'm joined by Dr. Sameena Rahman, OB-GYN and sexual medicine specialist, founder of the GSM Collective in Chicago and ISSWSH scientific committee chair.We unpack genitourinary syndrome of menopause (GSM), why the same hormonal mechanism drives vestibulodynia in younger women on bir
47. Vulvodynia & Gut Health: Exploring the Vaginal Microbiome Connection
In this episode, I sit down with Dr. Christina Enzmann, a board-certified OB-GYN and functional medicine practitioner specializing in vulvovaginal disorders, to explore how gut health and the vaginal microbiome connect to persistent vulvar and pelvic pain.We cover the everyday products that disrupt the vaginal barrier, why pain can persist after repeated yeast and BV treatments, how endometriosis
46. Pelvic Floor Botox: My Experience & Why My Physio Told Me to Do Less
In this solo episode I catch you up on my own treatment. I talk you through what pelvic floor Botox was actually like at a specialist vulvar clinic in Oslo, why my new physio's homework for the whole summer was to lovingly touch my thighs, and what that taught me about anticipating pain and turning even rest into something to achieve. I also explain the TTNS machine I'm using, which puts electrode
45. Postpartum Pelvic Pain: Why Sex Hurts After Birth And What Actually Helps
You had a baby, and months later something still hurts. Sex, sitting, the scar. And you've been told this is just what happens now.If that's you, this conversation is for you. I'm joined by Dr. Alexandra Dubinskaya, a urogynecologist and sexual medicine specialist in Beverly Hills. She chairs the communication committee at the International Society for Sexual Medicine and wrote the vulvodynia chap
44. Neurodivergence and Pelvic Pain: What ADHD and Autism Change in the Exam Room
Stephanie Berman has lived with vulvar pain since 2011. She spent eleven years being dismissed, misdiagnosed and told to be patient, and the referral that finally moved her forward came from an Instagram DM she sent to Dr. Corey Babb. She is also the founder of the Aziza Project, a nonprofit that pays for women in pelvic pain to physically get to the care they need.We cover her full story, and the
43. Vulvodynia Medications: Why Nothing Has Worked, and Every Option That Actually Might
Vulvodynia just means pain in the vulva. It is not a diagnosis - and Dr. Maria Uloko argues that is why treatment so often fails.Maria is a urologist trained in comprehensive sexual health, one of seven in the world doing this work. We go type by type: what causes each one, what treats it, who it will not help.SPONSORSPelva: the HydroSlix liner, a cushioning insert for more comfort during insertio
42. Supporting a Partner With Vaginismus or Painful Sex: What It Feels Like and How You Can Help
This episode started with an email from a listener: a man in his twenties whose girlfriend has lived with vaginismus and pelvic pain for years. He wanted to know how to be a good partner to someone going through this.So this one is for the partners. I talk about what this can feel like from the inside, why she might pull away when you touch her and why that is not a verdict on you, and how the two
41. Vestibulectomy on Screen: Bonnie Gross on Lady Parts and Her Second Surgery
If you are googling vestibulectomy recovery at 2am, this one is for you.Bonnie Gross has had the surgery twice, ten years apart, and she is unusually good at describing it - she wrote and executive produced Lady Parts, the award-winning comedy based on the first one. We recorded this four weeks after her second.Most of this conversation is the practical side she could not fit in the film: the pre-
40. The Only Episode You Need to Understand Pelvic Floor Strength, Tightness and Kegels
What does it actually mean to have a strong pelvic floor - and is strong even the right thing to chase?Kimberlee Sullivan is a board-certified women's health physical therapist and Head of Clinics at Origin, where she leads nationwide clinical strategy. She has spent over twenty years in pelvic floor PT and founded her own Austin clinic, Sullivan Physical Therapy, in 2005.We cover the difference b
39. Pelvic Venous Disorders and May-Thurner Syndrome: One Woman's Pelvic Pain Diagnosis
Olivia lived with chronic pelvic pain for years - a constant dull, dragging ache on her left side that worsened when she sat or bent down - while doctors dismissed her fatigue and brain fog as just being a tired mother. What finally explained it wasn't the vascular surgeon who wanted to remove a vein in her leg. It was an interventional radiologist who suspected pelvic congestion syndrome, sent he
38. Self-Hypnosis For Vulvodynia: The "Silly Fad" That Actually Ended Sheren's 10-Year Pain
Sheren Gaulbert lived with severe vulvar pain for ten years — bedridden, on high doses of amitriptyline, and told by a leading specialist to consider giving up work. What changed things wasn't a new medication or a new specialist. It was a self-hypnosis script she recorded herself off the back of a book she picked up in a bookshop, something a friend had dismissed as just the latest fad. That brea
37. Vulvodynia's $18,000 a Year Cost + a Mini Interview With Origin CEO Carine Carmy
What does it actually cost to get taken seriously when you're in pain? For the average woman with vulvovaginal or pelvic pain in the US, it's about $18,000 a year - paid entirely out of pocket.Today I'm speaking with Carmen Rising, a Brooklyn-based writer whose reporting on vulvovaginal pain has recently run in The New York Times and The Guardian. She came to this as a patient herself, and in this
36. Clitoral Nerve Mapping, Botox Update, and the Question Dr. Rachel Rubin Made Me Ask Myself
What does a groundbreaking study on clitoral nerves, a Norwegian novel about a man who moves into the forest, and one question from Dr. Rachel Rubin have in common? This week's solo episode.This episode is kindly sponsored by Pelva. Use code TWTC10 at checkout to receive 10% off your first order. (I earn a commission if you purchase through my link.)In this episode, I cover four things that have b
35. Low Desire in Women: How It Works, Why Pain Affects It, and What Can Be Done I Dr. Corey Babb
Why does desire so often disappear after sex has become painful - and is there actually anything you can do about it?In this episode, I sit down with Dr. Corey Babb, a board-certified gynecologist and one of my favorite voices in sexual medicine, whose Substack writing on desire and arousal is some of the clearest thinking on these topics out there. He returns to the podcast to set the record stra
34. ART for Pelvic Pain: Changing the Way the Brain Stores Distressing Memories in 1 to 5 Sessions
Why does the body sometimes hold onto pain long after there's a clear physical reason for it? And what would it take to actually shift that?In this episode, I speak with Brooke Bralove, a Licensed Clinical Social Worker (LCSW-C), psychotherapist, AASECT Certified Sex Therapist, and Certified Master ART Practitioner with over 20 years in private practice. After accelerated resolution therapy (ART)
33. Vulvodynia and the Partner: What the Research Reveals About the Relationship in Chronic Pain
What happens to the person standing closest to your pain - the one who witnesses it but is almost never asked about?In this episode, I speak with Linn Myrtveit-Stensrud, a clinical psychologist and postdoctoral researcher at UiT The Arctic University of Norway. Linn has spent her career studying vulvodynia in heterosexual relationships - specifically, how partners respond to pain, and how those re
32. Mast Cells and Vestibulodynia: The Inflammation Root Cause and A New Treatment Trial Dr J. Krapf
For years, the hormonal and muscular causes of vulvar pain have become easier to understand and treat. Inflammation is the part we still understand the least - and it may be one of the biggest missing pieces in provoked vestibulodynia.Dr Jill Krapf returns to the podcast for one of the most cutting-edge conversations we've had on vulvodynia. She's a gynaecologist specialising in vulvovaginal disor
31. The gap in OBGYN training: what doctors never learn about vulvovaginal pain I Tightlipped
Why do so many people with vulvovaginal pain leave their OBGYN's office feeling dismissed - or worse, like the problem is in their head? The answer might have less to do with individual doctors and more to do with what they were never taught.In this episode, I speak with Noa Fleischacker, co-founder and executive director of TightLipped, a grassroots patient advocacy organization working to change
30. Refused by 7 Clinics With a Vulvodynia Diagnosis: How Broken Women's Pain Care Really Is
I recently hit a wall that I, of all people, should not have hit. And it reminded me exactly why this podcast exists.But this episode is also about something else. I've been self-funding this podcast for about a year, and I'm now at the point where I need to figure out how to keep it going. That means sponsorships, and possibly other things too - and I want you involved in that conversation.If the
29. Vaginismus and Pregnancy: TTC Options, Birth Planning, and What Happens to Your Pelvic Floor
What happens to your body - and your pelvic floor - when you want to get pregnant, and you have a history of vaginismus or pelvic pain?In this episode, I speak with Dr. Saige Evans, an occupational therapist with a clinical doctorate in occupational therapy and the clinical director at Bloom Pelvic Therapy in Tampa Bay, Florida. She leads a team of pelvic health OTs and PTs across three clinics an
28. Vulvodynia, Desire, and the Diagnostic Odyssey: One Writer's Journey from Shamans to Sex Toys
What happens to desire when your body becomes unpredictable?Sara Sturek is a writer and founder of Writing Shamelessly, whose essay "From Shamans to Sex Toys" is published in Women's Health magazine. She has lived with hormonally-mediated vulvodynia since she was 21, and she writes about desire, sexuality, and the diagnostic odyssey with an honesty and literary precision that's rare in this space.
27. Vulvodynia, Vaginismus, and Pelvic Pain: Start Here If You're New
If you're new to this podcast - hi! I'm so glad you're here.This is the episode I want you to start with. Whether you've just been diagnosed, you've been searching for answers for years, or you typed something into Google at 2am that you've never said out loud to anyone - you're in the right place.In this solo episode, I walk you through the basics of chronic vulvovaginal and pelvic pain - what it
26. CBD for Pelvic Pain: Do Suppositories Actually Work for Vulvodynia and Vaginismus?
Can CBD help with pelvic pain - and if so, how does it actually work?In this episode, I speak with Tamar Hill, co-founder of Medroots, a company making CBD and low-dose THC suppositories for pelvic pain, vulvodynia, vaginismus, dyspareunia, and sexual health. Tamar is a former biology teacher turned entrepreneur, and she brings both the science and hard-won knowledge of navigating the CBD regulato
25. Pudendal Nerve Entrapment Surgery: One Woman's 15-Year Road to the Right Diagnosis
What does it mean to do everything right for fifteen years — and still not get to the bottom of your pain?In this episode, I speak with Carli Cutchin, a writer and disability advocate with a background as a comparative literature scholar. Carli has lived with pudendal neuralgia for fifteen years and writes about chronic pain and disability for publications including Ms. Magazine. She is one of the
24. Vulvodynia Clinical Trial: The First Drug Being Developed Specifically for This Condition
There is no medication approved specifically for vulvodynia. Not a single one. John Connell and his team are trying to change that.In this episode, I sit down with John Connell, Chief Scientific Officer at MAC Clinical Research — one of the UK's longest-established contract research organisations. John has spent over 35 years in clinical research, and has been working with Danish biotech Initiator
23. My Vulvodynia and Vaginismus Story: The Episode I've Been Afraid to Record
For a long time, I've been standing slightly to the side of my own experience on this podcast. Today, I step into the center of it.In this solo episode, I share my full story with vulvodynia and vaginismus for the first time - from the first symptoms five years ago to the rock bottom moment that broke me open, and eventually, to the unexpected thing that gave me the strength to keep going.I talk a
22. Botox for Vaginismus and Vulvodynia: Success Rates, Who It's For, and What to Expect
Can Botox really help treat vaginismus and vulvodynia - and if so, how does it actually work?In this episode, I sit down with Dr. Corey Babb, a board-certified gynecologist, ISSWSH fellow, and one of only four providers worldwide trained in the Pacik Multimodal Botox Protocol for vaginismus. Dr. Babb is the founder of Haven Center in Tulsa, Oklahoma, and co-authored the landmark research that esta
21. Women's Health Censorship: Why "Vulvodynia" Gets Flagged and What We're Losing Because of It
Social media platforms are systematically censoring medically accurate women's health content. Words like vulva, vagina, and vulvodynia are being flagged, shadow banned, and suppressed - not because they're explicit, but because the systems designed to moderate content were never built to tell the difference. This is about accurate, life-saving health information being treated as obscene.The probl
20. Painful Sex and Vaginismus: The Femtech Device Designed to Change How Treatment Feels
What if the answer to painful sex wasn't another dilator - but something genuinely novel?In this episode, Mathilde sits down with Kelley, co-founder of Pelva and a fellow woman with lived-experience who went from primary vaginismus and provoked vestibulodynia to building one of the most innovative femtech products in the vulvovaginal pain space.Kelley breaks down exactly how Pelva's hydrogel vagi
19. Vulvar Pain Recovery: The Nocebo Effect, Medical Dismissal, and What Finally Worked
In this episode, I'm joined by Heather Coppard - nurse, hypnotherapist, and author. Heather spent years navigating the healthcare system as a patient with persistent vulval pain, experiencing firsthand the dismissal, gaslighting, and harmful messaging that so many of us know all too well. One particularly devastating appointment with a specialist became the turning point that drove her to write he
18. ISSWSH 2026 Recap: The Vulvodynia and Pelvic Pain Research You Need to Know About
I just got back from the ISSWSH (International Society for the Study of Women's Sexual Health) annual meeting in Long Beach, California - and I couldn't wait to bring everything I heard straight to you. This solo episode is part conference recap, part deep dive into the research I think matters most for anyone living with vulvovaginal pain, pelvic pain, or sexual pain of any kind.In this episode I
17. From Black Box to Breakthrough: Dr. A. Goldstein on the Golden Era of Vulvodynia Research
For decades, vulvodynia was considered a mystery condition with few answers and limited treatment options. That's no longer the case.In this episode, Dr. Andrew Goldstein - Clinical Professor at George Washington University and one of the world's leading experts on vulvar and pelvic pain - explains how 25 years of dedicated research has transformed our understanding of vulvodynia from a "black box
16. Red Light Therapy for Pelvic Pain: Can It Help with Vaginismus and Vulvodynia?
If you're dealing with vaginismus or vulvodynia, you know how limited treatment options can feel - and how rarely we see real innovation in this space. That's why I was so intrigued when I discovered light therapy as a potential tool for pelvic pain relief.In this episode, I sit down with Liz Frey, a pelvic health physiotherapist and Women's Health Medical Director at Fringe, to explore how light
15. Vaginismus Recovery: The Arousal-First Dilating Routine That Finally Worked After 15 Years
After experiencing vaginismus for over 15 years, Lauren found a treatment approach that finally worked - and it looked very different from the clinical, physical therapy-style dilation she'd tried before.In this conversation, Lauren opens up about her journey from her first painful gynecologist visit at age 12 through years of inadequate medical advice ("just relax" and "have a glass of wine"), to
14. Vaginismus & Self-Worth: Why You Don't Have to Wait Until You're "Fixed" to Live Fully
This episode isn't just about dating and relationships - though we definitely talk about that. It's about how vaginismus can impact every corner of your life: your confidence at work, whether you feel like an imposter in your career, how you express yourself creatively through movement or dance, your ability to assert yourself in everyday situations, and the mental space it occupies in your mind.A
13. Year-End Update: Progress, Gratitude, and What's Coming in 2026
As the year closes, I wanted to take a moment to say thank you - to everyone who's listened, shared, and reached out.In this episode, I reflect on the journey so far, share a personal update on my own journey, and talk about about why fact-checking and accountability matter so much when it comes to information about women's bodies.Your feedback shapes this podcast. If you ever want to talk, sugges
12. Sex Therapy for Vaginismus: What It Actually Involves and Why Dilators Alone Often Aren't Enough
What happens in sex therapy for vaginismus and vulvodynia? In this conversation with certified holistic sexuality educator and embodied intimacy coach Lauren Elise Rogers, we explore how sex and relationship coaching addresses the root causes of sexual pain - beyond just the physical symptoms.Lauren shares her journey from purity culture to becoming a specialist in treating vaginismus, vulvodynia,
7. Vulvodynia Research: How Psychology, Relationships, and Stigma Shape Your Pain Outcomes
What really shapes how we live with vulvodynia, vaginismus and other pelvic pain conditions - biology alone, or also our emotions, thoughts, partner interactions and place in society?In this episode, I sit down with Dr. Claudia Chisari, one of the most cited scientists in vulvodynia research and founder of Bloume Health.Claudia shares her own journey through years of pain and medical dismissal, an
1. Vulvodynia and Vaginismus Diagnosis: Why These Conditions Get Dismissed and What to Do About It
In this first episode, we dive deep into the often misunderstood world of vulvodynia and vaginismus with Dr. Tania Adib, a leading London-based gynecologist specializing in vulvar health. Through host Mathilde's personal journey and Dr. Adib's clinical expertise, we explore why these conditions are frequently dismissed by healthcare providers despite affecting up to 1 in 5 women.Dr. Adib breaks do
6. Vaginismus and Fear: How Your Nervous System Creates the Pain Cycle - and How to Break It
Fear is one of our most powerful instincts - and it often plays a central role in vaginismus. In this episode, psychologist Dr. Seth Senecal explains how fear overrides logic, shapes our nervous system, and keeps our pelvic floor muscles from relaxing.Whether it’s a tiger chasing us or worrying that someone we love might leave, the body responds as if survival is on the line - and that signal can
8. Fascia and Pelvic Pain: Why Jaw Tension Can Show Up in Your Pelvis with Vaginismus
For so many living with vaginismus or vulvodynia, pain feels like a puzzle with missing pieces. What if one of those pieces is fascia - the thin, stringy web that connects every part of your body, where tightness in your jaw could whisper tension into your pelvis?In this episode, we unpack what fascia actually is, how it connects areas like the jaw and pelvis, and why this matters for anyone exper
3. Pelvic Pain Neuroscience: Why Anticipating Pain Makes Vaginismus and Vulvodynia Worse
In part two of our two-part series, we explore the fascinating neuroscience behind pelvic pain with pelvic health physiotherapist Jo Gipson. We cover why pain isn't just physical but a complex response to perceived threat, and how our beliefs and past experiences shape our body's reactions. Jo breaks down how pain cycles can emerge, explains why anticipating pain can make it worse, and reveals why
2. Pelvic Floor PT on Vaginismus and Vulvodynia: What You Actually Need to Know
In part one of our two-part series, pelvic health physiotherapist Jo Gipson explains the basics of pelvic floor anatomy and the relevance for vulvodynia and vaginismus. She challenges common myths about Kegel exercises, explains why both muscle relaxation and strength matter, and shares practical treatment approaches from breath work to dilator use.Connect with Jo Gipson:Instagram: @jogipsonphysio
9. Pelvic Floor and Daily Habits: The Small Things Worsening Your Vulvodynia or Vaginismus
In this conversation, pelvic floor physical therapist Dr. Julie Sarton shares the small, surprising ways our daily routines - like how we sit, breathe, carry stress, or even pee - can quietly create or maintain pelvic floor tension.We unpack why “just doing Kegels” often backfires, how breath-holding and sucking in your stomach keep your pelvic floor on high alert, and what it really means to rele
10. Thrush and Vulvodynia: The Link That Gets Missed and Why It Matters for Chronic Vulvar Pain
Thrush (aka yeast/candida infections) is common - 75% of women will experience it at some point - but for some women, it can trigger long-term vulvar pain (vulvodynia). In this powerful episode, Mathilde speaks with Philly Baines, a UK-based women’s health advocate, about her journey from repeated thrush infections to developing vulvodynia, and how years of medical dismissal led her to campaign fo
11. Acupuncture for Vulvodynia: What Traditional Chinese Medicine Actually Does for Pelvic Pain
Vulvodynia can feel mysterious, isolating, and overwhelming - especially when treatments seem to focus on symptoms instead of causes. In this conversation, acupuncturist and Traditional Chinese Medicine (TCM) practitioner Jennifer Dubowsky shares how she approaches vulvar pain through a whole-body lens built on 24 years of clinical experience.Jennifer walks us through the most common TCM patterns
4. Lubricants, Condoms, and Vaginismus: The Intimate Products That Could Be Making Pain Worse
Join us with Sam Evans, intimate health expert and co-owner of Jo Divine, a UK pleasure shop specializing in skin-safe products. Sam shares her personal experience with vaginismus and how intimate products directly contributed to her condition.In this episode, we discuss:* How common ingredients in lubricants, condoms and other intimate health products can trigger vaginal pain* Why "doctor recomme
5. Vulvodynia Root Causes: Hormonal, Muscular, Nerve, and Inflammatory I Dr. Jill Krapf
In this episode, Dr. Jill Krapf joins Mathilde to unpack the four main drivers of vulvar pain - hormonal, muscular, inflammatory, and nerve-related - and why these factors often overlap. She shares why she believes the catch-all term “vulvodynia” will eventually disappear as research continues to uncover specific root causes.We discuss how Dr. Krapf investigates these causes in her practice, from
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