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 cover:

• What sexual medicine actually is - and why a whole field exists around it
• Vulvodynia subtypes and treatment matching - new data showing that hormonally-driven vulvodynia has a 70% response rate to estrogen/testosterone therapy, and why getting the wrong treatment for the wrong subtype may be why nothing has worked for you
• Endometriosis and neuroproliferative dyspareunia - a newly validated subtype of deep endo pain that is nerve-driven and needs an entirely different treatment approach
• Pelvic venous disorder (PEVD) - essentially varicose veins inside the pelvis, and why almost no one is being checked for it despite its links to chronic pelvic pain and conditions like POTS, MCAS and hypermobility
• The vaginal estrogen update - why the removal of the black box warning on low-dose vaginal estrogen is such a big deal, and why these symptoms aren't just a menopause issue
• Why women's pain is still being dismissed - a powerful presentation on the clinical gaze, pain measurement, gendered bias in medicine, and the feedback loop between underfunding and misdiagnosis. Plus: the dismissal of women's pain is not evenly distributed, and we need to talk about that.
• Access and equity - new data showing Manhattan has 60x more pelvic floor physios per capita than the Bronx, with only 21% of practices accepting Medicaid

I also share something personal about privilege, what it means to be in a room like this, and who I'm really doing this for.

Resources & links mentioned:

• 🔗 ISSWSH — International Society for the Study of Women's Sexual Health
• 🔗 @painsdownthere / @ThrushSupport - follow her on Instagram for important work on the link between recurrent thrush and vulvar nerve damage
• 📖 When Sex Hurts: Understanding and Healing Pelvic Pain by Goldstein, Pukall, Goldstein & Krapf - the book on vulvodynia subtypes I recommend bringing to your doctor
• 🔗 My Instagram: @meet.baubo

If anything in this episode resonated, please reach out - I read every message. And if you're finding this podcast helpful, sharing it with someone who needs it is the biggest thing you can do.

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" into a condition with identifiable causes and effective treatments.

In this episode, you'll learn:

• Why vulvodynia wasn't part of standard medical training (and what's changing)
• The real causes behind vulvar pain - from mast cell inflammation to hormonal triggers
• How birth control pills can cause vulvodynia in some women (and the genetic reasons why)
• Why the majority of pelvic pain patients have been gaslit - and the JAMA study that proves it
• The truth about vestibulectomy surgery: who needs it (only 7% of patients) and the 97% success rate
• Exciting new treatments on the horizon, including ketotifen for mast cell stabilization

Dr. Goldstein, past president of the International Society for the Study of Women's Sexual Health, has published over 170 peer-reviewed articles and co-authored 8 books on female sexual pain. He shares the revolutionary research from the 2023 Vulvodynia Therapeutics Summit and explains why vulvodynia is no longer a mystery condition - it's a solvable problem with tailored treatments.

Whether you're living with vulvodynia, vestibulodynia, vaginismus, or other forms of pelvic pain, this episode offers validation, answers, and hope for your healing journey.

🎧 Topics covered: vulvodynia causes, hormonally mediated vulvodynia, provoked vestibulodynia, vestibulectomy surgery, pelvic floor dysfunction, mast cell activation, birth control and vulvar pain, gaslighting in healthcare, new vulvodynia treatments

🔬 WANT TO HELP ADVANCE VULVODYNIA RESEARCH?

Dr. Goldstein emphasizes that clinical trials are crucial for developing new treatments. If you're interested in participating in vulvodynia research studies, including trials for ketotifen (mast cell stabilizer), resiniferatoxin (nerve desensitization),and Xeomin (for vulvodynia due to secondary hypertonic pelvic floor muscle dysfunction), reach out to research.cvvd@gmail.com.

Your participation could help create the breakthrough treatments of tomorrow.

RESOURCES & LINKS:

Dr. Andrew Goldstein:

• Centers for Vulvovaginal Disorders: www.vulvodynia.com

Organizations mentioned:

• International Society for the Study of Women's Sexual Health (ISSWSH): www.isswsh.org
• National Vulvodynia Association: www.nva.org
• Tight Lipped (Patient Advocacy): https://www.tightlipped.org/

Dr. Goldstein's Books:

• When Sex Hurts (2nd edition, 2022)
• Female Sexual Pain Disorders: Evaluation & Management (2nd edition, 2020)

• Reclaiming Desire (2nd edition, 2009)

Connect with the podcast: @meet.baubo or mathilde@baubo.org

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 therapy is being used to treat vaginismus, vulvodynia, and pelvic floor hypertonicity.

Liz breaks down the science of photobiomodulation and explains how different wavelengths of light - red, near-infrared, and blue - work at the cellular level to promote tissue healing, reduce inflammation, and support pelvic floor recovery.

In this episode, we discuss:

• What light therapy actually is and how it differs from sunlight exposure
• The science behind red light and near-infrared therapy for tissue healing
• How light therapy can help with vaginismus, vulvodynia, and pelvic floor hypertonicity
• Blue light therapy for vaginal microbiome health and bacterial vaginosis
• The Fringe Pelvic Wand: combining light therapy with gentle vibration
• Use cases for postpartum recovery, menopause, and pelvic atrophy
• Contraindications and safety considerations
• How to integrate light therapy into your pelvic pain treatment plan

Resources mentioned:

• Fringe website: FringeHeals.com
• Instagram: @FringeHeals
• Use discount code BAUBO10 for exclusive savings

Connect with the podcast: @Meet.Baubo or mathilde@baubo.org