Ep. 42 - Vaginismus, Vibrators & Vaginal Massage

[00:12] Introduction: What Is Vaginismus?

Dr. Bawa: Welcome to the Dr. Sex Fairy Podcast. I am Dr. Kanwal Bawa, and I am here to transform your life. I like to discuss the various pandemics that go unnoticed, or in some cases, are brushed under the carpet. Vaginismus is one such issue. This is where the muscles of the vagina tighten up in response to something being inserted. Some women can tolerate a tampon, but not a penis. And some can't even insert a tampon without excruciating pain. Stress, anxiety, a history of abuse. There are many things that can cause vaginismus.

Dr. Bawa: Women don't talk about it and seldom seek help for it. I am honored, truly honored, to have Dr. Bat-Sheva Marcus on the Dr. Sex Fairy podcast today. Dr. Marcus has a PhD in human sexuality and master's degrees in public health, social work, and Jewish studies. She is also the author of the book Sex Points. The New York Times has called her the Orthodox Sex Guru. Dr. Marcus is one of the leading voices in the world on the topic of vaginismus. And I can't wait to delve into this topic together. Welcome to the Dr. Sex Fairy Podcast, Dr. Marcus.

Dr. Bawa: Thank you for being here today.

Dr. Marcus: Thank you so much for having me. I'm so excited to be here. Big fan and excited to be here.

[01:30] Defining Vaginismus and Why Women Feel Alone

Dr. Bawa: Oh, this is a mutual fan club here. So tell me, nobody discusses vaginismus more than you, so bravo. And how would you define it? And what do you think the top causes are?

Dr. Marcus: It is heart-wrenching that people don't talk about vaginismus more because the statistics will just knock your socks off. One out of 10 women, one out of 10 women suffers from vaginismus in one form or another. And sometimes it could be extremely severe, like so severe, it feels to them like there's a brick wall when they try to put something in there and they're petrified and they can't even tolerate anybody, sort of an exam or anybody getting close to that vulva area because it's so frightening and the pain is so severe.

Dr. Marcus: And for some women, they can actually tolerate penetration, but it hurts like heck, and they don't know what to do about it.

Dr. Marcus: And what is striking is that every woman who suffers from it feels like she's the only one. Like, right? Like it's kind of amazing that so many women can suffer from a condition like this, and everybody feels like they're the only ones. And what happens is, like you and I know, you can have a perfectly good sex life without intercourse. I mean, it would be complicated, but look, honestly, many, many lesbians do it, right? It is possible to have a great sex life without intercourse.

Dr. Marcus: You can have great orgasms, you can have sex in a lot of different ways.

Dr. Marcus: There's a million other parts of your body. But for women who suffer from vaginismus, it puts this black cloud over them, and usually they become petrified, petrified of having any kind of sexual activity because they're afraid it's going to lead to penetration or try to lead, the person will try, and they start to feel horrible about themselves. It starts to just create a really, really sort of frightening sense of sexuality, and often it's just almost destroys their sense of their self. Like we know, you and I know how much a person's sexuality affects themselves.

Dr. Marcus: And so when a woman feels like she can't have penetration and she feels like there's something horribly wrong with her, she feels terrible about herself. And here's the deal it is not that uncommon. I mean, I could talk about this for hours.

[03:35] Fear, Muscle Tightness and the Vaginismus Spectrum

Dr. Marcus: So you tell me. I'd love to talk about the fear and the tight muscle implications.

Dr. Bawa: Go on. I mean, we can make this a two-part episode.

Dr. Marcus: Absolutely. I don't think we'll have to go that far, but yeah, I could. Trust me, I could. So here's the deal. I like to think about this as sort of an XY axis. So you could have your muscle tightness being on the x-axis, right? Like, how tight are your muscles? And women's vaginal muscles can be incredibly tight. And people will say, like, well, why are your—well, you know, we all carry our stress in different parts of our body.

Dr. Marcus: Some people get headaches because it's in their head, some people have neck aches, some people hold their stress in their back, and some women just hold it in their vaginal muscles. So different women have different tightness to their muscles, and that's the x-axis. The y-axis is their fear, right? So they touched it, it hurt, they think it will hurt, they're afraid it's gonna hurt. And what happens is there are some women whose muscles actually aren't even that tight, but they're petrified. And there's some women whose muscles are really tight and they're not really that frightened.

Dr. Marcus: And then there's some women who have both, you know, the overwhelming fear and the tight muscles.

Dr. Marcus: Vaginismus really lives on this spectrum of tight muscles and fear. And we know that they just keep feeding off each other, right? Like if they have pain, then their muscles clench up and then there's more fear the next time. And it just becomes this continuing and sometimes worsening cycle that until that cycle gets broken, just weighs so heavily on women and makes them feel so badly about themselves.

[05:35] Sexual Abuse Is Not the Default Explanation

Dr. Marcus: So I get asked all the time, Kanwal, what is causing my vaginismus? Like I have women crying in my office saying, like, what happened? I don't remember any sexual abuse, you know, and I have to talk about that because, you know, we have this bizarre idea in our society that if you have vaginismus, you must have had sexual abuse. And that is just not true. I don't know how else to say it. I was about to use an expletive, but it is just not true.

Dr. Marcus: And you know, there's unfortunately there's too much sexual abuse in our society for sure, but there is no no zero, you've heard it here, no direct correlation between sexual abuse and vaginismus.

Dr. Marcus: It has to do with our linear way of thinking, like, oh, if she can't get something in her vagina, it must have been sexual abuse. That has not been proven in any way, shape, or form. That's not to say that you can't be sexually abused and have vaginismus, or there are some people who were sexually abused, and that really does contribute to their vaginismus. But the fear here is that women who go into therapy because of their vaginismus are told, oh, there must be sexual abuse in your history, and we're just gonna spend two years of searching for it.

Dr. Marcus: Like, which just gets my blood boiling, Kanwal. It just is so irritating to me.

Dr. Marcus: You have no idea.

Dr. Bawa: I get it.

Dr. Marcus: Right? It's like, you know, anyway, especially doctors, if they don't see anything, they go to do an exam, the woman slams her legs shut, she panics, she runs off the table, they don't see anything, they're like, oh, it must have been sexual abuse, go see a therapist, right? Like, so horrifying to me. Anyway, so what causes it then? I think it's just muscle tightness, the same way that you can have stress, like I said, in your head, in your neck, in your back. Some women hold their stress in their vaginal muscles. That's just the reality.

[07:10] Culture, Type-A Personalities and Sexual Experience

Dr. Marcus: Now, let's talk culture for a minute, because there is a cultural connection. It does seem like there's a higher, a higher percentage of women in certain conservative communities, like the Indian community, the Orthodox Jewish community, there does seem to be a slightly higher incidence of it. Again, there's not good research, but people in this field have definitely seen that. And I think that has to do with the fact that those women tend to explore their bodies less when they're young, when they're younger and start becoming sexually active when they're older.

Dr. Marcus: So if you are 15 or 16 and your muscles are still kind of pliable and you have intercourse for the first time, it's a little different than if you've been holding tension in there until you're 24, the first time you try to have intercourse.

Dr. Marcus: So I think it has a lot to do with your comfort with your body, expectations, age of, you know, when you start having intercourse. And also, honestly, we see a lot of type A personalities.

Dr. Bawa: I am Indian and you're Jewish. This is great.

Dr. Marcus: Exactly, exactly. Type A, overachievers, you know. So when you talk about causes, that's the cause for the tight muscles. And the fear, it's fascinating. I think the fear is often, you know, an early experience where it kind of hurt when somebody put something in or they tried to put something in, and then that fear kind of got bigger and bigger. And as I said, the fear and the tight muscles keep feeding off each other and really sort of creating more fear, more tight muscles, more fear, more tight muscles. So when you talk about what causes it, that's usually the cause.

[08:45] The Cycle of Fear and Tight Muscles

Dr. Bawa: So a vicious cycle of stress and tight muscles.

Dr. Marcus: Correct, and fear and tight muscles. And one of the things I will always tell vaginismus patients is one of the things we have to do is loosen the muscles and get your head and your vagina back in conversation. Like baby, be friends, you know, your brain and your vagina need to start talking again, girl.

Dr. Bawa: Love it, love it. I'm going to use that line, definitely.

Dr. Marcus: Use that line.

[09:12] Vibrators, Blood Flow and Vaginal Massage

Dr. Bawa: So we've talked about this previously. I like using, of course, some people need to start with dilators because they're just that tight. But I like using vibrators because I feel that it also brings good blood flow into the area. And you actually did your PhD thesis on vibrators. So you are the authority when it comes to them.

[09:32] How Vaginal Dilators Work

Dr. Marcus: So I did do my PhD thesis on vibrators, and yes. And now the thing with vibrators for vaginismus is that for some women, it's almost impossible to put anything that large in. And so let me let me explain what dilators are, vaginal dilators for your listeners who may have never experienced or seen vaginal dilators. They're little sticks. I don't know how to say it simply. They're very low tech, they're little plastic sticks. I mean, they come honestly as in in many things. You can, as you get bigger, there's glass, beautiful glass ones.

Dr. Marcus: I know that sounds like a shatterproof, no fear there. there's silicone ones, but the standard, you know, medical grade ones that most of us use are thick plastic sticks that start probably at the thickness of your pinky, and they're like little rods.

Dr. Marcus: And with enough coaching, anti-anxiety medication, breathing, learning to introduce that little one. Oh, and then every week or two introducing a slightly thicker one until you get to introduce a dilator that's the size of a penis, or maybe even a little bigger because we want you to stretch a little larger. That's classic treatment for vaginismus. It seems scary and overwhelming. A good pelvic floor physical therapist can be helpful. A good therapist can coach you through doing it. A good gynecologist who has time, although Lord knows most of them don't have time. They get like six minutes a patient.

Dr. Marcus: I don't know, what is it now? It's crazy. so that is what a dilator is, and it can be incredibly helpful.

[11:05] Using a Vibrator as a Dilator

Dr. Marcus: Now, Kanwal, what you're talking about is using a vibrator as a dilator. And usually at the point where you hit a medium-sized dilator, which for a lot of women is a hurdle, right? The vibrator can be so helpful because for exactly the reason you said: it vibrates and it brings blood into the area. And the more you can get the blood into the area and the muscles learning how to give and relax, you can relax. It's like a massage.

Dr. Bawa: You're massaging your vaginal muscles.

Dr. Marcus: That's exactly what you're doing.

Dr. Bawa: I love that.

Dr. Marcus: It's totally true, right? So you're softening the muscles, you're getting blood into the muscles, you're getting those muscles kind of ready for movement. And for some women, it also is a little more pleasurable than those plastic dilators. So, for all of those reasons, if you're dilating, if you're listening and you're dilating, those little internal vibrators can be super, super duper helpful.

[12:05] Internal vs. External Vibrators for Orgasm

Dr. Marcus: However, can I give you a caveat?

Dr. Bawa: Yes, ma'am.

Dr. Marcus: They are not good for orgasms. So I just want you to say that. I just feel like what women have to understand is that if you're aiming for an orgasm, you need a good external vibrator. This is coming from the vibrator queen who did her dissertation on vibrators. You need a good external vibrator, one that's meant to go outside on your clitoris. Those vibrators that go in your vagina, they are just great if you want to feel something in your vagina, if you are dilating, if you just like the feel of something vibrating in your vagina.

Dr. Marcus: But don't mix them up with the vibrators that are going to be super duper helpful for orgasm, which we could do in another episode. How's that, Kanwal?

[12:46] Sexual Health Aids and Spontaneous Improvement

Dr. Bawa: Yes, let's do that. Because I am coming out with my line of sex toys that I like to refer to as sexual health aids. And I cannot wait to start using them with my clients.

Dr. Marcus: Well, there you go.

Dr. Bawa: So have you ever seen vaginismus resolve spontaneously? I've always wondered.

[13:03] Can Vaginismus Resolve Without Treatment?

Dr. Marcus: That is such a good question. I don't think anybody's asked me that before, but the answer to that is yes. It depends what you call spontaneous. It depends what you call spontaneous. I've had women who I've spoken to who were in partnered relationships where when they started out, they had horrible pain. And over time they relaxed, their partner used their finger on them, they used their own finger. There was sort of gentle like intercourse. It kind of hurt in the beginning, but over time it resolved. So they never got professional help and the vaginismus resolved.

Dr. Marcus: And I have heard stories about that. And if you don't have severe vaginismus, that may be a way to go. But there's a big but here. I've seen many cases of that backfiring, right? People trying to sort of power through the pain. I am not a power through the pain girl. Like I just think that is not because I think when you have more pain, it just creates more spasms. So if you're having pain, it's better to actually get some professional help and try to resolve it in a way that doesn't exacerbate the pain.

Dr. Marcus: Even though some people have worked their way through small amounts of pain. Does that make sense?

Dr. Bawa: That makes complete sense. 100% sense. Right. Because you know, it's like, you know, you have a bad ankle and you're trying to power through it, you're just making it worse. Your vagina is no different.

[14:24] Pregnancy, Childbirth and Vaginismus

Dr. Marcus: Totally. I will the other place where I have seen it resolve is after childbirth. Now, what's fascinating about that? So there's so many questions that people have when I say that, like, how'd they get pregnant to start with? Right. So either they just powered through and had intercourse, even though it hurt like hell and they got pregnant, which people have done. Or I've had vaginismus patients who've gotten pregnant when the partner just ejaculated right outside of them, like in their vulva, like on the edge and they've gotten pregnant anyway, young patients.

Dr. Marcus: People assume, and not correctly, that they'll have vaginal births and then it'll all be fine.

Dr. Marcus: Vaginal births can actually make the vaginismus worse because it's a little bit of trauma on the vagina when that baby comes barreling out. So for some women, it makes it worse. But for some women, it loosens them up. And as women get older, often sometimes again, you hit menopause. It's so individual covel, it's fascinating. Some women, as they get older and they head into menopause, their muscles just tighten and they have pain and they have to deal with dilators. I'll tell you a great story about that in a minute.

Dr. Marcus: And some women, their muscles just relax and loosen up as they get older. And so that sort of self-resolves. So there's no one trajectory here, but I will say it's really important if you're having if you're having vaginal pain, vaginismus, it's so easy to treat. And we should also talk about the Botox injection. So now I have two stories I have to tell you. that you should get help. Get help. Don't don't suffer with it. You deserve better than that. You deserve better than having pain.

[15:55] Why Gynecologists Often Miss Vaginismus

Dr. Bawa: Yes. I don't know why gynecologists don't discuss it more often with their patients. It's just not a topic that comes up.

Dr. Marcus: Kanwal, I think they don't know about it. I think they don't know about it. Somebody, a a friend of mine, that a head of an OB-GYN like high risk center was just saying that that this huge medical center near us was trying to bring in a specialist because nobody in the office knew about it. And I'm like, every gynecologist, you know, and I know every gynecologist should be able to deal with this issue. So anyway, yeah.

Dr. Bawa: Agreed because when I went through medical school, I studied enough gynecology. I also did my gynecology rotations at the Cleveland Clinic where I did my residency. And through the ER, my entire time through the ER, nobody once mentioned this. I had never heard the word.

[16:43] Menopause, Tight Muscles and a Missed Diagnosis

Dr. Marcus: I am so not surprised. I it is just so not addressed. And and you know, the menopausal, this is I said there's a story. I'll so I'll tell you the story about this. Can I tell you a story about the menopausal patient? So this had to be, it had to be close to 20 years ago. So we weren't, we were using these dilators on the young women who were having pain, right? And I got a call from a 50-year-old woman or 53-year-old woman who said to me, I am having excruciating vaginal pain, and I keep going to see my gynecologist.

Dr. Marcus: And I've been to the three, I love this, I've been to the three best gynecologists in New York City. So just, you know, like rewrite that. I've been to the three most expensive gynecologists in New York City, which is pretty expensive. And she's like, and they just keep throwing estrogen at me, right? Like, I'm 53, I need estrogen, and it's not helping, and I want to know what you're gonna do for me. And I'm like, listen, listen, my dear, I'm really good, but I cannot diagnose over the phone. Like, I just don't, you know. So come on in.

Dr. Marcus: So she came in, and you know, my nurse practitioner took a look at her. And it was true she did need estrogen, but her muscles had tightened up. So, but she wasn't scared. Think about it, there was no fear here at all. This was just purely tight muscles. We started her with like maybe the small plus or the medium dilators, and just for people listening, there's seven sizes to these. and within three weeks, she was totally pain-free.

Dr. Marcus: And she came in and she said, you know, I don't know if I should laugh or I should cry because it was so easy. You know, all her three top gynecologists, none of them thought, because you don't see tight muscles, right? You just, they just it hurts. They throw estrogen at you, which she did need. She definitely needed the estrogen. But, you know, muscles often for menopausal women tighten up, and doctors do not think about the fact that their muscles may have tightened up and you don't see tight muscles. So, anyway, that's my menopausal story for you.

[18:36] A Silent Pandemic for Menopausal Women

Dr. Bawa: I think that's a great story, and it goes to my earlier point about how it's a silent pandemic all its own, and nobody talks about it. Even the people suffering from it don't often talk about it.

Dr. Marcus: That's 100% the case. I mean, I feel like menopausal women just are just suffering and suffering, and their stuff is so easy to fix with a whole bunch of like hormones and dilators. It's so treatable, and yet they just suffer. It's your pandemic, you're 100% right, Kanwal.

[19:02] Pregnancy, C-Sections and Vaginismus

Dr. Bawa: Now, you had mentioned that women manage to get pregnant even with vaginismus, and sometimes they are able to deliver vaginally and it gets better, sometimes it gets worse. But what about C-section rates? Are those higher in the subsect? I would think they are.

Dr. Marcus: I don't know. I don't, there's no research out on it. I will tell you that I've had a few patients who were who treated the vaginismus and were fine, but were petrified of the vaginal birth. And those cases I said talk to your doctor about scheduling a c-section. I think just talking about it helped them. And some of them didn't actually even need to go through with the C-section, but just knowing that was a possibility.

Dr. Marcus: I don't know the rate of the number of pregnant women who have vaginismus, but I do know we once saw a woman who'd been married for 25 years, and she had two children and she had vaginismus and she had gotten pregnant both times with artificial insemination. She went to the doctor, she couldn't have intercourse, so they just inseminated her. And after, you know, 25 years or something, it was like, I don't know, her 60th birthday, 50 for she was like, I want to give myself a gift. Maybe she was 45, 50.

Dr. Marcus: She was like, I want to give myself a gift and solve this vaginismus. And can I tell you, Kanwal, eight weeks later she was fine?

Dr. Bawa: Isn't this heartbreaking? She wasted all those years.

Dr. Marcus: Yes, yes, it's heart-wrenching. I mean, on the one hand, it's also uplifting, like to be able to finally solve something that you've been walking around with, and yet it is gut-wrenching to me that this is so treatable and people just let it go.

Dr. Bawa: So it's a couple issue. It's not just the person suffering physically, it's also the partner who has mental.

[20:47] How Vaginismus Affects Couples

Dr. Marcus: Totally, totally. We had one of the first patients I remember so strongly was a woman who came in who'd been married 11 years. and she was classic. Like before the marriage, their sex life was fine because they were putting off intercourse until they got married, which you know, so they did everything else, oral sex, you know, they used their hands, their mouths, they were having great sex. They got married, she couldn't have intercourse. She felt terrible. She felt guilty and miserable. And so slowly but surely they stopped having any kind of sex at all.

Dr. Marcus: They'd been married 11 years, her husband had an affair. That was it. She came in again. 10 weeks later, she was totally fine. Like it was, you know, it took the husband's affair for her to like push herself to come in. And the fear, you know, it's when we have nothing to fear but fear itself. The fear of talking to somebody about it and getting the treatment is often way worse than the actual treatment.

[21:40] Why Women Wait Years to Seek Help

Dr. Bawa: I see that time and again with women who come to my practice. Now, I don't do as much vaginismus as you have done in your practice, but I deal with a lot of vaginal issues. And to have women who have severe incontinence, people who have vaginal laxity, lack of pleasure, tissue is friable and easily cracked and bleeding. With even the most minimal sex and thrusting. This is a lot of suffering. And they go through this for years and years. And then finally they come in. And then darn near every time they say to me, Why did I wait so long?

Dr. Marcus: Totally. And why do why do you think women are waiting so long?

[22:17] How Bad Does It Have to Get?

Dr. Bawa: You know, I often hear, I don't think I'm that bad yet. And it blows my mind. How bad do you need things to get?

Dr. Marcus: I love that, Kanwal. I think that is so I saw a woman the other day, a young woman, she was about 25, and she clearly had vaginismus. She had really bad pain every time they had intercourse. And so I said, Have you heard of vaginismus? We're talking about it. And she said, Yes, but I don't think I'm bad enough to have vaginismus. And I'm like, See, what does what does that mean? Like I said, do you have to be so depressed that you can't get out of bed for you to consider yourself depressed?

Dr. Marcus: Like, what where did we get this idea that you have to be like dying of pain before you go ask a doctor for help?

Dr. Bawa: Yes, and the whole concept of preservation seems lost on most women because they would rather wait for things to get bad. So they feel like they're getting their money's worth for their treatment, I guess, or their time's worth. They don't understand the concept of preserving function, of staying above that point.

[23:13] Preserving Sexual Function Before It Gets Worse

Dr. Marcus: Healthy. Right, staying healthy, keeping your tissue healthy. Right. It's so, it's so interesting. And the funny thing is, I will say to you, and maybe you see this too, is I feel like with the men, they will come in the first time there's something like the first time they can't have an erection.

Dr. Bawa: Hell yeah.

Dr. Marcus: They're like, they are in that door and they will take out their checkbook and they will just be like, whatever it takes. And the women are like, Well, I don't know, I'm not so bad. Like, what?

[23:37] Why Men and Women Seek Sexual Care Differently

Dr. Marcus: Yes, and sometimes—

Dr. Bawa: Yes, yes, my God. I don't mean to speak over you. Go ahead.

Dr. Marcus: No, no, keep going.

Dr. Bawa: That's just that I am so in your shoes every day. Because a woman will come in and my heart breaks for her because she has all these problems. And, you know, I'm by no means a very expensive practice, and certainly not one of those New York gynecologists that we were just discussing. So these women will spend all kinds of money on Botox and fillers, but when it comes to vaginal health, which is impacting every aspect of their life, they'll say, you know what, let me think about it or let me speak to my husband.

Dr. Bawa: And the truth is they're never talking to the husband.

Dr. Bawa: It's not about him, it's about them. Now a man comes in, he is breaking my door down when he can't get an erection, okay? He's like, get me in the damn door, I'll come on a Saturday. Do you see people on a Friday night? Like they don't care. They are begging, they are pleading to get in the door. And if you tell them it'll be four weeks, they almost die right there and then. And then you feel bad. You're like, okay, okay, let me work something out. And then when they come in, you give them a quote.

Dr. Bawa: You have they haven't even looked at it, they're already signing it and whipping out a credit card. The the difference is incredible. And it's not that these men have more money than the women. No, it's just a matter of priorities.

Dr. Marcus: Men prioritize themselves. It makes me feel better to hear you to hear you say that because I feel that too. Sometimes I'll say to a woman, when this happens, I'll say, if this was your daughter, your grown daughter, and they'll look at me and they'll be like, Oh, of course I would do it, tell her to do it. And I'll be like, Okay, let's take care of ourselves, also. Do you know what I mean? Like, it is it is it is crazy, right?

Dr. Marcus: It's it is, I think it's a message from society about women taking care of themselves somehow, or like a little bit of pain is okay, they should put up with I it's you know my.

[25:21] Pain, Social Conditioning and Women's Expectations

Dr. Bawa: I think it's something about societal attitudes, I suppose, that we have to deal with menstruation, menstrual cramps, childbirth. We're almost in this 'I am used to pain' mindset. And I don't know if you watched that movie, Good Luck to You, Leo Grandeee, with Emma Thompson that just came out.

Dr. Marcus: No, you're the second person.

Dr. Bawa: Oh, you need to watch that. You need to watch that. I won't ruin the movie for you, but I will just tell you one line that she says in the movie. It won't ruin it for you if I say this. So she says to him before she's trying to have sex with him, she says, 'Don't worry, I'm not expecting an orgasm.' And right there you have it. She's not even expecting it. She has already given up on herself. How is a woman ever going to feel pleasure if she's convinced herself that she's not getting it?

[26:08] Women, Orgasm and the Right to Pleasure

Dr. Marcus: I agree with you. I mean, it's so interesting. And can we spend one minute on orgasm now?

Dr. Bawa: Oh, yes, please.

Dr. Marcus: Okay. So one of the things that drives me nuts is that no matter how many times people hear the statistic that only three out of ten women orgasm from intercourse, the women still feel like they're broken if they can't orgasm from intercourse. If they need a hand or a mouth or a vibrator, I'm like, you're with seven out of ten women, honey. It makes me insane. And I feel like women just get that message, and then they're like, 'Well, then I just won't have an orgasm.' And I'm like, really?

Dr. Bawa: Yes, really.

Dr. Marcus: Can you imagine him having sex with you and saying, 'Well, I just won't have an orgasm'? Really? Like, you'll have your orgasm, honey, and then you'll roll over and go to sleep. That sounds like a fabulous evening. Like, really?

Dr. Bawa: You know, it irritates me when people say, 'Oh, don't focus so much on the orgasm. Think about the experience.' No, you wouldn't tell a man that.

Dr. Marcus: A hundred percent.

Dr. Marcus: Now, I do where I get people are saying that because you don't want to be obsessed with the orgasm. No, no, no, I get it. I get it. Yes, but the orgasm is such an important part. The statistics show for sure, the data show that if you're having orgasms, your sex life is just much more stable and long term. That people who have orgasms want to have more sex. It's such an obvious, it's an obvious reality that it's like almost hard for me to say it, that the data show it, but that's what the data show.

[27:31] Faking Orgasms Teaches the Wrong Lesson

Dr. Bawa: Oh, I had a great talk with Dr. Laurie Mintzzz, someone you know very well. The author of Becoming Cliterate. Yes. And we had a great conversation about how women are dooming themselves to failure by faking it. Because most men, I think, want to please their women. So if you are rewarding his inadequate sexual performance and he doesn't think there's anything wrong, he's gonna keep doing what he thinks works.

Dr. Marcus: Right. I had a sex educator who said when she was talking to her kids, her students or 10th graders, she said, think about it as like baking chocolate chip cookies. If your friend brought you terrible chocolate chip cookies with way too much salt in it, and you tasted them and you're like, oh, you were like, oh, these are delicious. You're gonna get the same terrible chocolate chip cookies every single time. Like you need it to articulate what you need.

Dr. Marcus: You know, I'm one of the things that I'm known for is working with women to use vibrators in the context of partnered sex, because so many women can have orgasms easier, stronger that way. And yet the message in society is often like, you know, it's inappropriate that vibrators are for solo sex. And vibrators aren't great for solo sex, but they're amazing for partnered sex. And it is just time that women are willing to say, no more pain. And yes, I need pleasure. I want pleasure too, because that's gonna make you want to have sex with your partner.

[28:49] Bringing Vibrators Into Partnered Sex

Dr. Bawa: Yes. Now, some men take it personally. I had a friend whose husband found her vibrator kit. I mean, like a treasure chest. I shouldn't call, I should call it not a kit. I mean, it was a chest of vibrators. So the poor man was traumatized. He didn't know she had one, and then she had this whole sex shop in their house. So the poor man for a long time was a little traumatized. And he was very quiet one time I met them. And I said, What's wrong with him? Oh, he found my vibrators.

Dr. Marcus: So I love, I love that story, and I'm gonna try to use that story, but I will say I have a chapter in my book about vibrators, and one of the things I talk about is how to talk to your partner about it because my experience, when I did my one of the things I did with my PhD dissertation is how the partners reacted to the vibrators.

Dr. Marcus: And in my experience, when you bring it up in a positive, appropriate way, as in, I love you, I love having sex with you, I want to make the sex with you better, and I want to use a vibrator, the partners get with the program really quickly because frankly, it is so hot to see your female partner get really turned on, have a strong orgasm. Like that is so hot. And between you and me, makes our life easier. You know how tired your hand your mouth can get, otherwise, or your penis?

Dr. Marcus: Like, you know, it just so my experience is when the women bring it up and own it, the partners really get with the program. It's when the women aren't feeling ashamed of it in a certain way and keep it hidden, and then the husbands kind of find it exactly like what you described, and then they're like, it's almost like when the women find the stash of porn, like they're all insulted, as opposed to if everybody could just own it and talk about it, it just takes the shame out of the closet. So yeah.

[30:31] Sex, Shame and a Vibrator Success Story

Dr. Bawa: No, shame and sex are a big thing. In fact, we have a lot of friends in common. Dr. Jacobson and I did an episode about sex and shame. Great episode.

Dr. Marcus: Oh, really?

Dr. Bawa: Yeah, on my podcast.

Dr. Marcus: I gotta go back and find it. That's amazing. Yes, we do have a lot of, of course, we have friends in common. We're in the sex world, you know?

Dr. Bawa: We are, and we're incestuous.

Dr. Marcus: We totally polyamorous in the sex world. Yes, yes. We we I had a patient, I love this. Oh, this story. She was she was, she had to be 53 years old, probably married at least 30 years. the African-American, lovely woman who had never had an orgasm. You know, I gave her a vibrator, she used it by herself, she had orgasms for the first time, and she said, There's no way I'm never ever gonna be able to bring this in with my husband because I've been pretending for 30 years, right? Like, I mean, we saw I saw her a few times.

Dr. Marcus: We talked through options and had to discuss it. Anyway, finally, on and she was like, There's no way, there's no way.

Dr. Marcus: She comes in one day and she says, I told him, I just flat out told him. And she said, he didn't talk to me for two days. And then I was in the bedroom and he comes in and he says to me, Okay, let me see it. And she at this point didn't even know what he was talking about. She was like, What? What are you talking about? He's like, You're darn vibrator, let me see it. And she pulled it out and she used it with him. And she said they were having the best time since then.

Dr. Marcus: She said they were having the best sex of their lives. They were like having so much fun. And and I don't know, I feel like if she could do it, like anybody could do it, right? Like it's there. You just have to be able to own your pleasure and own your experience. And, you know, there's people out there like you, Kanwal and me. Like, it is so possible to reclaim your sex life. Women just like, I don't think they feel like non-entitled, like we were talking about.

[32:19] Owning Pleasure and Believing Change Is Possible

Dr. Bawa: Yes, they need to own their pleasure, like you said, and they need to realize that they're worth it. You know, that L'Oreal commercial we've all seen, you're worth it.

Dr. Marcus: Yes. No, I think that is you're worth it. And I wonder sometimes if they don't really believe it could be made better. Like maybe they don't really believe it could be made better. Because the number of times that women have come in and been like, oh my God, do you know what I'm saying? Like, it's I didn't really believe I could get rid of the pain. I really didn't believe I could have an orgasm. I really didn't believe I could get my desire back again.

Dr. Marcus: Like maybe they just I wonder sometimes if they just, and you know, I can say and from here till the cows come home, like, yes, you can make it better, but until they experience it, it's really, it's kind of hard to believe that.

[33:02] When a Partner Wants Help but the Woman Does Not

Dr. Bawa: Now, let me tell you something very interesting that I've had happen to me twice over the past couple of days at work. I've had my assistant come to me and say to me, I have a man on the phone. He wants to talk about his wife, he wants treatment for his wife, but he won't give her name, her phone number, any of her contact information. She doesn't want to be involved in this at all.

Dr. Bawa: She wants no part of this, and he wants to help her, except how am I supposed to set up an appointment for you to talk to him if she's not coming? And I said, Well, I can't do anything without her there. So this is a big issue.

Dr. Marcus: Yeah, I mean, I will I feel bad for the husbands when that happens, and I will say, I am really sorry, but unless she is invested enough to come and talk either on the phone to start with, because sometimes it's scary. Sometimes you can just say, you know, do it. I sometimes I'll do it, I'll do a 10-minute free consultation just because sometimes when they meet me for 10 minutes, their stress level drops.

Dr. Marcus: Like they realize I'm not this, like, I think people think of sex therapists as being these like super hot, you know, you know, flirtatious people using language all over the place that's super uncomfortable, asking really questions. And when they meet me and I'm a grandma, you know, I mean, like it's just I think it's easier. So, but yes, if the woman doesn't want it, it can't, or the man.

Dr. Marcus: I mean, if the person doesn't want to change, you can't, but the but if you can infuse them with the belief that that there won't be shame and that change is possible, then it changes the whole world.

Dr. Bawa: I try. And sometimes I'll get on the phone personally to talk to these people because I know they're traumatized in different ways and I know they're seeking help. And I try to explain to them why it's important that I at least talk to their wife or girlfriend. And sometimes they'll just hang up. It's the craziest thing I've ever seen. They just get so frustrated.

[34:54] Sex as a Vital Part of a Relationship

Dr. Marcus: They just don't know. They just, yeah, it's just right. If a person doesn't want to change, they can't. But sometimes it and sometimes, you know, I'll have a husband call and then maybe a few months later the wife will call.

[35:55] When a Partner Refuses to Work on the Sex Life

Dr. Marcus: But this gets to a different heart of the matter, which is, you know, people will often say to me, like, why did you go into this field? And I'll say, like, I didn't go in because I'm so excited about part body, part A and fitting into body part B. Like, that's fine and good. And there's a lot to say about that. I don't have to talk about that, but I'm I'm much more interested in the quality and the tenor of the relationship that occurs when the sex life is really good between the couples.

Dr. Marcus: And so when somebody comes to me and says, like, our sex life is terrible, and my partner will do nothing about it, then and they feel terrible and they're thinking about leaving the relationship, but they're trying to figure out what to do. And I'll say, Look, I certainly can't tell you whether to leave the relationship or not. I certainly can't. Like that, you have to make a decision.

Dr. Marcus: But I can tell you something, which is that if you were in a relationship where the sex was fine, but there was no communication, the person wouldn't talk to you at all. And you said, I need we need to work on their like, I'm not talking to you. I'm just not talking to you. And that that's just no, I'm not working on it. Nobody would say to you that you that you were not in your rights to either decide to leave the relationship or have another relationship outside, right?

Dr. Marcus: Sex is just as important and vital a part of relationship as the verbal communication. I know our society privileges verbal communication, but if somebody says, I am not interested in sex, don't want to have sex, and I'm not planning on having sex with you ever again, it is not selfish or horrible of you to say, I can't live like this.

Dr. Marcus: So my options are I can live like this. This is my choice. That's option one. I'll look for other relationships outside of the this relationship for that, or I'm gonna leave. And that doesn't make you a bad person any more than it would make you a bad person to say, I can't live with somebody who will not talk to me, right?

Dr. Marcus: I don't know if you agree, but I feel like I need to give permission to people to say, yes, sex is a really important part of your relationship, and you have a right to want it and expect it and fight for it. It's a it's not just an important part of your relationship, it's an important part of who you are as a human being in this world.

[37:06] Future Conversations: Sexless Relationships

Dr. Bawa: Yes, in fact, I agree with you so much. I got another episode idea. We need to have you back to discuss sexless relationships. All right, vibrators.

Dr. Marcus: Right, yes, absolutely. We're we could just talk forever, you and me, yes, yes.

Dr. Bawa: Do you have any words of advice for women who are suffering from both vaginismus and perhaps a not so great sex life?

[37:27] Advice for Women With Vaginismus

Dr. Marcus: Yes, I have a lot of words of advice. The first one is you can change it. I want you to know and hear me, and I've seen it hundreds and hundreds of times. You can take control and you can change it. you can try getting my book, it can be very helpful. It's called Sex Points. And I wrote it specifically for people who are struggling. And I tried to make it really, you've seen it. It's like I've tried to make it really easy to use. It's like choose your own adventure, like figure out what's not working and figure it out.

Dr. Marcus: So you I really do feel like that could be helpful. But the most important message, I think, is to get help. Like find somebody who can be your spirit guide through this, right? You can make things better.

Dr. Marcus: Vaginismus is a slam dunk. You know, when people call me with, you know, sexual issues, low desire, problems with arousal or orgasm, I can usually say, I'm pretty confident we can make it better. When somebody calls me with vaginismus, I'm like, honey, that is a slam dunk. If you follow along one way or another, you can cure vaginismus. It is 100% curable. So try not to get discouraged. Believe and know that you can have the sex life you deserve and a real, honest to God, good sex life.

[38:42] You Deserve a Better Sex Life

Dr. Bawa: Hear, hear. I think that is so, so inspirational because we as women sell ourselves short on so many levels, be it in the workplace, be it in the bedroom. Enough is enough. I mean, we are worth it, we deserve it. And there's help out there. There are people like you, people like me. There's enough technology out there. We can make this happen. So why the hell not? What are we waiting for? So you go out.

Dr. Marcus: Yes, ma'am.

Dr. Bawa: So how can people find you? I mean, you mentioned your book, but you have so much out there. And as I mentioned to you the other day when we spoke, I was going to dinner with my friend Carmen. Carmen and I were listening to your videos the entire way to the restaurant. And as I was waiting to be seated, she looked at me a little cross-eyed because, you know, there was all kind of sex talk on my phone. But it's okay, people got over it. I was very enthralled by the conversation that you were having.

Dr. Bawa: I wasn't going to turn it off.

[39:36] Where to Find Dr. Bat-Sheva Marcus

Dr. Marcus: Oh my God, that means the world to me.

Dr. Bawa: Such great videos. So where can people find those?

Dr. Marcus: The best place, I would say, is Instagram @drbatsheva, D-R-B-A-T-S-H-E-V-A, or TikTok @thedrbatsheva, because honestly, they threw off Dr. Batsheva, so now I'm a little more careful and it's @thedrbatsheva. Or my website, which is drbatsheva.com.

Dr. Bawa: Thank you so much. And, you know, we are so similar because I had Dr. Sex Fairy on Instagram and then it disappeared. So I then made D-O-C-T-O-R Sex Fairy. That disappeared. So now I'm currently @therealdrsexfairy, like celebrities. So far, I'm there. And so far, TikTok, my account on TikTok is a huge hit, @drsexfairy. Hopefully they don't kick me off.

Dr. Marcus: Oh my God, I'm gonna go follow you right now.

Dr. Bawa: You have to. It's the most fun I've had in a long time. Oh my God, we should do some lives together.

Dr. Marcus: We should do some duets.

[40:33] Social Media, Sex Education and Reaching Millions

Dr. Bawa: I have such a good time with TikTok. And you know what? It's the same idea as anything else we're discussing. I had assumptions about TikTok and about social media, and my son said to me, 'Why aren't you on TikTok?' And I said, 'I don't think I'm a TikTok person.' He said, 'Well, you should be,' and now I have the best time.

Dr. Marcus: How old is your son?

Dr. Bawa: 12.

Dr. Marcus: I think it's amazing. I, you know what I realized? I get to do sex education with hundreds of thousands of people, and that it makes my day because TikTok and Instagram let me reach so many people. And so between you and me, and you know, you know, Dr. Jacobson, like I just feel like we can reach thousands of people and maybe change the world and the attitude to the world.

Dr. Bawa: We're reaching millions. My account in three months has reached over 32 million people.

Dr. Marcus: That's amazing.

Dr. Bawa: Amazing.

Dr. Marcus: I'm so happy to be getting to know you.

Dr. Bawa: And see, this was meant to be. You and I are going to do good things together.

Dr. Marcus: Hallelujah. We are sex fairies.

Dr. Bawa: Yes, we are, Dr. Bat-Sheva. So thank you again. Thank you so much for being on the podcast and for helping educate people and letting them know that they're worth it. Thank you so much.

Dr. Marcus: Thank you so much for having me.

[41:44] Recorded Outro

Dr. Bawa: Until next time. I hope you enjoyed the Dr. Sex Fairy podcast today. I would love to continue this conversation with you. If you would like to get in touch with me, email me at askme@drsexfairy.com. Don't forget to follow this podcast and leave me a five-star review. And make sure you follow my blockbuster hit TikTok account, Dr. Sex Fairy.