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Rachel Rubin on Sexual Health, Desire, and What Medicine Gets Wrong
Dr. Rachel Rubin, urologist and sexual medicine specialist, joins Dr. Sherry Ross and Dr. Tammy Nelson to expose the gaps in how medicine approaches sexual health — particularly for women. The conversation covers desire, arousal, pain, hormones, and the treatments that exist but that too few patients are ever told about.
About This Episode
Dr. Rachel Rubin is a urologist and one of the leading sexual medicine specialists in the United States. She has made it her mission to close the gap between what medicine knows about sexual health and what patients are actually told.
The Sexual Health Knowledge Gap
Topics covered in this episode include the staggering lack of sexual health education in medical training — and what this means for patients. Dr. Rubin discusses the ways healthcare providers routinely fail to ask about sexual health, dismiss patients' concerns, or simply don't know what treatments are available.
Desire and Arousal: The Science
One of the most illuminating topics covered in this episode is the science of desire and arousal — including the ways these experiences differ between individuals and across the lifespan. Dr. Rubin discusses the dual control model of sexual response, the factors that accelerate and inhibit desire, and why understanding this model can transform how people think about their own sexuality.
Pain During Sex: Causes and Treatments
Topics covered in this episode include the causes of pain during sex — including vulvodynia, vaginismus, pelvic floor dysfunction, and the effects of hormonal changes — and the treatments that are available. Dr. Rubin is direct: pain during sex is not normal, it is not something to accept, and it is almost always treatable.
Hormones and Sexual Health
A significant portion of this episode is devoted to the role of hormones in sexual health — including testosterone, estrogen, and progesterone, and how changes in these hormones affect desire, arousal, and physical comfort. Topics covered include the evidence for testosterone therapy in women and the use of local estrogen for genitourinary symptoms.
Advocating for Your Sexual Health
The episode closes with practical guidance on how to advocate for your own sexual health in the medical system. Topics covered include what questions to ask, how to find a provider who specializes in sexual medicine, and why Dr. Rubin believes that every person deserves a healthcare provider who takes their sexual health seriously.
5 Key Takeaways
- 1
Sexual health is a legitimate medical concern that deserves the same attention as any other aspect of health — and most healthcare providers are undertrained in this area.
- 2
Pain during sex is not normal and is almost always treatable; patients should not be told to simply accept it.
- 3
The dual control model of sexual response — understanding what accelerates and inhibits desire — can transform how people think about their own sexuality.
- 4
Hormones play a significant role in sexual health; testosterone therapy for women and local estrogen for genitourinary symptoms are evidence-based treatments.
- 5
Advocating for your sexual health means knowing what questions to ask and being willing to seek out providers who specialize in this area.
Frequently Asked Questions
What is sexual medicine, and what does Dr. Rachel Rubin specialize in?
Sexual medicine is a medical specialty focused on the diagnosis and treatment of sexual health conditions. Dr. Rubin is a urologist who specializes in sexual medicine, with a particular focus on women's sexual health, desire, arousal, and pain.
What causes pain during sex?
Topics covered in this episode include the causes of pain during sex, including vulvodynia, vaginismus, pelvic floor dysfunction, and hormonal changes. Dr. Rubin and Dr. Ross discuss diagnosis and treatment options.
Can women take testosterone for sexual health?
Topics covered in this episode include the evidence for testosterone therapy in women, including its effects on desire, arousal, and energy. Dr. Rubin discusses the research and the clinical considerations.
Where can I listen to this episode?
This episode is available on Spotify, Apple Podcasts, and YouTube. Links are at the top of this page.
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