September 4, 2024 • 44 mins
For the fourth year in a row, Therapy For Black Girls invites you to join us in celebrating Sex Positive September, a month in which we center the importance of Black women’s pleasure, agency, and sexual liberation. And there's no better way to kick off this month’s programming than with a conversation with returning guest Dr. Janelle Frederick, also known as the Vagina Rehab Doctor. Dr. Janelle is a pelvic floor physical therapist who uses social media to produce shame-free, entertaining, and high-quality sex education.
In our conversation, we discussed some of the overlooked contributors to sexual pleasure, the ways in which anxiety and depression can impact a person’s ability to have pleasurable sex, and what we wish our parents would have taught us about sex.
About the Podcast
The Therapy for Black Girls Podcast is a weekly conversation with Dr. Joy Harden Bradford, a licensed Psychologist in Atlanta, Georgia, about all things mental health, personal development, and all the small decisions we can make to become the best possible versions of ourselves.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:11):
Welcome to the Therapy for Black Girls podcast, a weekly
conversation about mental health, personal development, and all the small
decisions we can make to become the best possible versions
of ourselves. I'm your host, doctor joy Hard and Bradford,
a licensed psychologist in Atlanta, Georgia. For more information or
(00:32):
to find a therapist in your area, visit our website
at Therapy for Blackgirls dot com. While I hope you
love listening to and learning from the podcast, it is
not meant to be a substitute for a relationship with
a licensed mental health professional. Hey, y'all, thanks so much
(00:57):
for joining me for session three seventy five of the
Therapy for Black Girls podcasts. We'll get right into our
conversation after a word from our sponsors.
Speaker 2 (01:06):
Hi, you guys. I'm doctor Janelle, the Vagina Rehab Doctor,
and I'm on the Therapy for Black Girls podcast. I'm
in the session today unpacking all things about anxiety and sex.
Speaker 1 (01:28):
For the fourth year in a row, Therapy for Black
Girls invites you to join us in celebrating sex Positive September,
a month in which we center the importance of black
women's pleasure, agency and sexual liberation. What better way to
kick off this month's programming than with a conversation with
returning guests, Doctor Janelle Frederick, also known as the Vagina
(01:49):
Rehab Doctor. Doctor Janelle, is a pelvic floor physical therapist
who specializes in helping individuals and couples overcome vaginismus, volvadinia,
and painful sex via remote one on one vaginal fitness
coaching and online education. She uses social media to produce
shame free entertaining and high quality sex education. In our conversation,
(02:12):
we discussed some of the overlooked contributors to sexual pleasure,
the ways in which anxiety and depression can impact a
person's ability to have pleasurable sex, and what we wish
our parents would have taught us about sex. If something
resonates with you while enjoying our conversation, please share with
us on social media using the hashtag tpg in session
(02:32):
or join us over in the sister circles to talk
more about the episode. You can join us at community
dot therapy for blackgirls dot com. Here's our conversation. Well,
thank you so much for jointing us again today, Doctor Janelle.
Speaker 2 (02:49):
Absolutely, I am so so excited to be here and
just honored that she would have invited me back again.
So thank you so much, Doctor George for having me today.
Speaker 1 (02:58):
Yes, we had such a great conversation for our sex
past September episode in twenty twenty two.
Speaker 2 (03:03):
Is that we wanted to have you back.
Speaker 1 (03:04):
But I want to hear what's been up with you
since we last chatted.
Speaker 2 (03:08):
Oh my gosh, I feel like a whirlwind of things
have happened. I got married two months ago, so that
was a huge, huge transition with the wedding and not
calling my now husband my fiance. As soon as I
got used to saying fiance, then he was husband. So
it's like a lot of changes that have gone on.
(03:29):
We moved, we're still in Chicago, but we're living together
obviously now and mainly just work changes. I'm glad that
we're growing. I just hired another public floor therapist to
come and work with us at VRD, So just career
stuff and a little bit of family changes. But that's
the biggest thing that has changed for me.
Speaker 1 (03:49):
Nice, Nice, Well, congratulations on all of those transitions, though,
I'm sure it has kept you plenty busy.
Speaker 2 (03:54):
Oh my gosh. Absolutely. So.
Speaker 1 (03:57):
The last time we chatted, we talked about the vagina
will meant to be flexible. And today we're gonna talk
more about fear and anxiety and how that actually impacts sex.
So can you say a little bit about why you
think that that's important for us to talk about and
think about.
Speaker 2 (04:11):
Absolutely over the past couple of years, as I've been
evaluating women that have sexual pain or that have pellic
floor muscle tightness, which is really common, or just pellic
floor dysfunction, because a lot of people don't know whether
their pellic floor is tight to begin with. So just
like the urinary changes, like if you always have the
(04:32):
rush of the bathroom, these things are honestly, so so common.
But one of the common trends that I saw among
I would say at least eighty to ninety percent of
my patients was that many of them would say that
they've always struggled with anxiety and even have a therapist
for anxiety and or depression. And so I was getting
a lot of clinical expertise seeing that there was this
(04:55):
strong relationship between sexual pain, sexual dysfunction, peblic flord dysfunction,
and anxiety, and I really have just gathered more appreciation
for the mental health side of how pelvic florid dysfunction
can be healed, because that's honestly just a big part
of it. And I'm really appreciative of the collaboration that
(05:18):
we're starting to see of it more in this space.
So that's really what intrigued me to just seeing it
amongst so many of my clients saying that they were
struggling with anxiety, and then eventually I started reading more
about the connection between the two.
Speaker 1 (05:31):
Got it. Can you say, well, there's some kind of
common themes that were coming up for your clients around
any anxieties of fear and is it related mostly to
sake or just general anxiety.
Speaker 2 (05:43):
I would say that most of the people that I
see for either vaginistness, which can mean that intercourse or
vaginal assertion is not possible, like whether tampon, finger pelvic
exam are intercourse or sexual pain, they do have generalized anxiety,
but it also tends to show up in their sex life.
(06:06):
So then a fear of sex or a fear of pain,
or just a fear of things going into the vagina.
And so I think that it's hard to say which
one comes first or what's causing what, but generally it
seems that people tend to discover it like twelve or
thirteen when they're trying to put in a tampon, or
(06:26):
as they get a little bit older and they're going
to get that peblic exam and they realize that they
have a fear in addition to pain. And of course,
if you're having pain, that can make you afraid, because
no one just welcomes pain, that can be some anxiety
with that. So I do think it's interdependent, like they're
both interacting with each other. But I would say that
(06:47):
anxiety for sure can directly lead to peblic floor dysfunction
and sexual pain, which can create this cycle of fear. Right,
fear of sex are fear of pain.
Speaker 1 (06:58):
So can you say a little bit of a like
how you would then work with a client like that
when you discover that there is this anxiety around it.
Speaker 2 (07:05):
Absolutely, So a lot of what we will do is
we have to of course resolve the physical dysfunction because,
like we've talked about, that could be driving the fear. Right,
So if we go to have intercourse and as soon
as insertion is attempted there's a burning, stinging type pain,
then we want to resolve that so that when attempts
(07:27):
are made, their nervous system is not so jarred, right,
So just bringing the pain down generally does have such
a positive effect on their fear because they're gonna not
be as guarded, right, They're not gonna be as afraid,
and so their nervous system begins to calm down with that.
But then a lot of the other things that we
can do is exercises and activities that directly lower just
(07:51):
the state of the nervous system that is on guard.
So diaformatic breathing and not just diaformatic breathing, but getting
our clients to and I say our clients because I
don't do all of the one on one coaching anymore myself,
so I have people working with me, and so I
think my brain is in that our mode. But what
we would do is even have them to touch the
(08:12):
pelic floor while they're breathing, so that they can see
that when they breathe in a certain way, their pelic
floor muscles actually relax, right, So doing things that help
them to connect with their peblic floor and their sexual
anatomy and also just reinforcing that insertion is not bad. Right.
So one of the things that we use is dilators,
(08:34):
and that's especially helpful for anyone who's having sexual pain
or inability to have intercourse. And when we're inserting those dilators,
even if there is pain, what we try to do
is retrain how they react to that pain. So instead
of clenching and guarding and closing the muscles because they're
scared or they're afraid they're making themselves worse, we try
(08:56):
and teach them to keep those muscles relaxed, to stay
breathing right, to not close the hips or the thighs,
and so a lot of it is honestly retraining how
they think about pain and even letting them know that
pain is not always bad. Sometimes it's just like a
siren that's going off and it needs to be calmed.
So those are some of the things that we like
(09:17):
to do with our clients who are struggling with fear, anxiety,
and pain with sex.
Speaker 1 (09:23):
And I would imagine that for some people, you know,
the difficulty and the tension comes from a history of
sexual trauma or sexual abuse. Can you say a little
bit more about how this impacts your sex life and
how you would work with them. I would imagine at
some point. I think we talked about this for your
last visit, Like working with a therapist also as a
part of the care team for these kinds of concerns.
Speaker 2 (09:44):
We can be sensitive to certain things. Right, We definitely
want to include regular and frequent communication. Right, So how
are you doing with this? I may instruct them to
use a pelvick Won, which is like a tool that's
used to get out tension inside the vagina and some
times even the anus. But if that's bringing up memories
of the past or it's making them feel afraid, that
(10:06):
communication is so important, like how are you doing with this?
Are you feeling pain? Are you worry? How are you
feeling in your mind? That communication is important. But also
I'm just very thankful that we have you. Right, we
have psychologists, we have sex therapists, we have mental health therapists,
and generally a lot of the clients that we work
with have either already been so that's like thank you.
(10:29):
They've already been and they've done a lot of the
mental work and now it's more so that they're trying
to work through the physical pain and the physical tension.
So collaboration is still a key part. I remember last
year I worked with a woman who was having a
difficult time reaching an orgasm, and she definitely had a
lot of pelic floor muscle tightness, difficulty breathing, like when
(10:51):
she would inhale, her belly really wouldn't expand very much.
And that's a whole other topic because we're told a
lot that our way should be small and you should
suck it in and wear waste trainers and all these
things that restrict you. But that was actually contributing to
why she couldn't orgasm. And we were doing all of
the things, working on the public floor, working on her breathing,
(11:13):
working on the pain inside of the vagina, and she
was still having a lot of difficulty with orgasming. Towards
the end of our time working together, thankfully, she did
get to the place where she could orgasm. But she
actually just reached out to me yesterday and she said
she's so thankful for the work that we did because
it opened up her eyes to a lot of things
about her body. But she said she wasn't able to
(11:36):
completely be present because of our history with sexual trauma.
So that reinforced me the importance of you really got
to collaborate with other healthcare providers. I mean, that's just
not our scope as public floor physical therapists. So we
could do all the things, but if they're not present right,
they're reminded, or they're scared, or they're clinching because of
(11:57):
that history or those trauma responses, then it can still
be difficult, and even sometimes focusing more on what's going
to help them relax as opposed to immediately going to
physical interventions like internal release are using these invasive tools.
Sometimes just focusing on exercises, mobility, breathing is appropriate if
(12:22):
someone is still in a phase where they're I don't
want to say stuck, but still reminded by those traumatic experiences.
So it's not always easy, but I definitely think that
there's so much room for growth even if there is
a history of trauma involved.
Speaker 1 (12:38):
So that's just now. I do want to hear more
about it, because you mentioned like the process of breathing
and like how much that is a part of your work,
and if you could say more about the connection between
breathing and the ability to orgasm. What is the connection there.
Speaker 2 (12:52):
The first one is just the way that your diaphragm,
which is the main muscle of breathing interacts with your
vagus nerve. Right, so our vegus nerve pierces the diaphragm
and it has offshoots that go to the glitterists that
go to the pelvis. It helps with our breathing rate,
it helps with our blood pressure. It's a nerve that's
(13:12):
really responsible for calming us down, for calming anxiety, and
for helping us to feel pleasure. So if your body
is in a state of hypervigilance, if your body is
in a state of anxiety, one of the ways to
help activate that nerve is through proper breathing, because every
time you take a diaphramatic breath, you stimulate that vegus nerve,
(13:34):
And so that's why it's important for us to be
mindful of how we're breathing, and also if we're even
relaxing our belly, because if we're restricting our abdominals inward
and sucking in all the time, you're limiting the movement
of your diaphragm, which then limits the activation of that
vagus nerve. So that's the first way. It is just
(13:57):
the way the nervous system is interacting with the main
muscle of breathing. The second way is that the diaphragm
and the pelic floor works simultaneously. So when we take
a nice, big belly breath in, when we breathe in,
our belly should get nice and big, right, I tell
why people let it all hang out. When you breathe in,
(14:17):
the pelic floor also naturally relaxes and it opens not
a huge amount. And even if you take a big breath,
if you do have a lot of pelic floor muscle tightness,
you may not feel a whole bunch And that's okay,
But that's the other way. So that means then if
someone always has their belly sucked in, or if their
breathing habits are not ideal, that their pelic floor muscle
(14:38):
could be restricted. And this is gonna limit blood flow
that riches your glitterist. It's gonna limit blood flow that
obviously gets to the vagina, and it can make it
difficult for the muscles to contract and relax for an orgasm,
because essentially that orgasm is that contraction, that relaxation, contraction
and relaxation, and so trying to get that pelic the
(15:00):
floor and the diaphragm to open up is so crucial
when it comes to just overall pelic health, not just
orgasmic potential, but overall pelic health and helping someone to
feel pain free sex. So that's I would say the
two major things that I see in relationship to breathing
and sexual and peblic health.
Speaker 1 (15:21):
Got it, I wonder, doctor Janelle. I think we talked
the last time about like water and how important that
was in terms of orgasm, well the other things that
we might be overlooking or missing as it released to
sexual pleasure.
Speaker 2 (15:33):
Absolutely, I would say that one of the things is
just preparing our body for pleasure and even for orgasm,
and a lot to think of it as when we
go to sleep at night. Right, we're planning to have
this amazing night where we're relaxed and we're just out
for the count. But a lot of people notice that
(15:54):
if they prepare for their sleep, they sleep better. So
if you put on your pajamas, or if you take
a warm bath, or if you drink something relaxed, or
if you take your melatonin, right, So that's preparing. If
we're going into this eight hour activity, we can't just
be on our phone scrolling off of the night and
then try and go to sleep. So I like to
(16:15):
think of orgasms and pleasure as like this activity that
we have to prepare for. So thinking of how relaxed
do you feel before sex, right, do you feel anxious?
Do you feel stressed or tired? Your vagina gonna be
tired too. There's no way that you're gonna be exhausted, tired,
stressed and then expect your vagina to be all wet
(16:38):
and you to be having these great orgasms because your
vagina is connected to your body. So I think that's
a huge part of it, is just checking in with
your overall state for play. I think we talked about
that a lot generally in terms of pelic health and
sexual wellness especially. I do think that's underrated quite a bit.
I don't know if it's because we are typically having
(16:59):
sex with men, and so men are more excited to
get to the penetration and so foreplay is not valued.
But we need about twenty to thirty minutes. And that's
so important because in order for us to really get
that clitteral blood flow, which is the erection, so we
have erections too. That's not going to happen as well
(17:20):
if we're not being aroused, and so I think that's
a huge part of it, and just your emotional state, right,
how do you feel are you feeling connected to your partner?
Some people are turned on just by conversations, you know.
So I think that again, the connection between the mental
emotional and then with the Pelvican sexual is so intimate
(17:41):
that we have to constantly remind ourselves of that and
look to see how we are generally feeling and address that.
Speaker 1 (17:49):
So I wonder if you could give us some suggestions
about how we might talk with a partner if we
do have some anxiety around sex, like how might we
bring this up? And when do we bring this up?
Speaker 2 (17:59):
That is such a great question. I think that any
conversations about your pleasure, just sexual communication are so important
to have, and I would say that having the conversations
outside of the bedroom is best. I think a lot
of times when you try and tell someone they may
be trying to, I don't know, go down on you
(18:20):
or y'all in the middle of sex, and you're trying
to tell them and give them instructions. They're like in
this performance mode, right, they want to do everything right,
and so coming to them was what you want them
to do. Differently, I think that time is not ideal.
So I would say maybe the day before sex, or
when you anticipate sex to happen, or just at any
time where you think the person is a little bit
(18:42):
more softened. So let's say that you're watching a movie together,
or you're just having dinner, or let's say that you're cuddling.
I think these are great times to actually bring up
what are the issues that you're having number one? And
then two, what are the expectations that you have for them? Right?
And I did this in my stories, and I did
this mainly as a demonstration because I do have a
(19:05):
lot of women telling me that they don't know how
to tell their partners like what they like in bed,
or what they're having issues with like pain or anxiety,
and so a lot of times it's honestly just being
as specific as possible regarding what you want. And so
I did a scripted scene where again I was doing
(19:26):
it mainly for the people watching my stories. But I
went into my husband's office yesterday after knocking on his door,
and I said, baby, can you give me an orgasm tonight?
I mean, it was very straightforward, right to the point,
and he's like, what, of course, He's all confused, like
you're what you're talking about? And I said, I don't
(19:46):
really want to work for my own orgasm tonight. I'm
just really would love for you to do that for
me tonight, and he said sure. So a lot of
times it's just being willing to be open, right. My
tone of voice wasn't demanding aggressive, right, because sometimes people
can be more defensive if we come to them with
something they're doing wrong. But even the same with anxiety
(20:06):
and pain, we can say, hey, I've been struggling with anxiety.
Whenever we have intercourse or whenever we're intimate, do you
mind just spending some time with me, just breathing for
maybe five to ten minutes before we have sex tonight.
I think most partners who care about you would be open,
especially if you're asking them at a time where it's
a good time. I think the timing is everything, and
(20:28):
also in a non sort of aggressive way, and I
think that that would work well and see how they
respond to that.
Speaker 1 (20:36):
More from our conversation after the break, but first, a
quick snippet of what's coming next week on TVG.
Speaker 3 (20:42):
Sexuality at sixty is not what it was at thirty. Okay,
that's what it is, but it doesn't mean that it's over.
And if there are things that are getting in the way,
like you don't feel well, like you can't sleep, like
you have vaginal dryness, like you have painful sex, then
(21:02):
go fix those things. Go fix them. It's easy and
it involves hormones. So no, it ain't over till it's over.
You know when that time is. But don't let the
things that are fixable get in the way.
Speaker 1 (21:31):
So, doctor Janelle, something else that has come up in
conversations in the community. Is there a way to like
actually increase your libido? So is that possible?
Speaker 2 (21:41):
You know what? It's such a huge topic just libido,
and I think it definitely is a way. Sometimes it
seems to happen naturally, Like with some of our clients
they do tell us after being able to have pain
for sex, is that they're libido naturally spiked. I mean,
your brain is not really going to tell you to
(22:01):
do something that hurts, right, unless you like pain, right,
some people do like kling pain. But if you don't,
then your brain is going to sort of put up
a wall to try and guard you from what it
thinks is harming you. Right, So just that alone can
decrease your libido. Another thing that is actually super important.
(22:22):
I was just reading about this the other day is
vitamin D. This vitamin, I think is like the powerhouse
vitamin because number one, it helps with their mental health.
If you are depressed, the dopamine, the serotonin, the oxtatocin
levels are not where they need to be, you're not
going to be craving play because really that's what sex is.
(22:44):
That's a playful activity, right, and reproductive of course, but
just getting where vitamin D can actually help your body
to make sex hormones. So testosterone is one of the
primary ones that helps us to feel horny, and so
getting out and getting that souff Like as simple as
it sounds, it's so so important. Another thing that we
(23:05):
can do, I think, to support our sex drive is
making sure that we're getting enough sleep so we actually
get clitteral erections when we go to sleep at night.
When I found out about this, I was like, what
we get mourning wood too. That is so amazing that
you're not really gonna see it because our stuff is hidden.
But all genders have the same thing that happens a
(23:27):
few times of the night. There's an erection. But if
you're not getting enough sleep, you're not going to be
getting that same amount of blood flow to those organs
to create more sensory awareness of that body part. I
think another thing that we can do is go check
our hormone panel. So when was the last time you've
gone to your doctor and ask them to look at
(23:47):
your progesterone, your testosterone, your estrogen, your insulin. All of
this is so so important because hormones essentially tell the
body what to do. So I think that it's a
great way. We don't want to underestimate the power of
just checking the facts right using the tools that our
doctors have. And I don't want to underwrite the importance
(24:10):
of also just being overworked. I mean, this is therapy
for black girls. We work hard, like we really do it. Generally,
we have to work harder than other people to get
to the same place. And so I think just giving
yourself permission to do nothing. I remember someone said that
you have to get unbusy to get busy, like the
(24:32):
more relaxed you are. We saw what happened with the pandemic,
more people were getting pregnant one much to do so
like you like on vacations, your lobido maybe higher. So
of course we can't go on a vacation every two weeks,
But what can you do to just slow down? I mean,
you really can't even feel your sex drive if you're
stressed out and you're always running around. So just slowing
(24:55):
down more to be in tune to your desires is
I think an important one. I know for me, if
I'm too busy, I can forget to eat, right. It's
not that I don't get hungry, I just couldn't even
pay attention to the fact that I need to eat,
And so I think it's a similar thing with sex.
If you're always on the go, always working, always checking
your emails, your body just is not going to be
(25:17):
prioritizing pleasure. So I think that's a direct way to
increase your libido, a slowing down.
Speaker 1 (25:23):
Yeah, thank you so much for those suggestions, Doc Jel.
I'm curious to know if you hear from your patients
who may be struggling with depression of anxiety, and we
know one of the common treatments for that is an SSRI,
and unfortunately sometimes a common side effect of SSRIs is
decrease libido. So I'm curious if you are working with
patients who describe that and what suggestions people have or
(25:46):
you would have to help to combat that temptom.
Speaker 2 (25:49):
Ooh, that's a good question, girl, you want to strike
to it. I love this question because I'm also getting
more messages and questions about this, and not just about libido,
but about inability to organ at all after getting on
an SSRI. I think it's posts SSRI syndrome something to
that effect. Even after coming off, some of these people
(26:09):
are saying that they still cannot reach an orgasm. So
one of the first things I always recommend is asking
about dosage right. Again, this is not my expertise, so
just disclaimer there, but asking your psychiatrist, can we play
with the dosage right? Are we able to decrease this
one medication that maybe making it more difficult to have
(26:31):
a sex drive or making it more difficult to orgasm,
and maybe work with a different medication a little bit
more that doesn't have as much of an impact on
my sex drive. Another thing is the type of SSRIs.
There are tons of them, so some people try one
and it does not impact their libido, and then another
one does. So I think being willing to investigate and
(26:54):
have some patients with the process. And another one, honestly
is trying sex toys because you may just need a
little bit more stimulation because of the way these drugs
are impacting how serotonin binds with your sex organs, like
your glitterists and stuff. So that is impacting the way
the receptors interact with your vagina and your clitters. You
(27:15):
can't really change that, right, That's what the medication is doing.
But then can we use something that stimulates us a
little bit more that can make it a little bit
easier to orgasm, And the same thing with your libido,
because sometimes just getting more satisfaction and pleasure with sex
will increase your drive, right, because I can't tell you
how many times women tell me that they don't feel
(27:37):
anything during sex, So why are you going to want
to do that if it's not feeling good? Those are
some of the things I think are helpful.
Speaker 1 (27:44):
No, that's helpful, you know, doctor Denail's something you said,
just maybe think so. I feel like the last time
we talked, you were preparing for a masterclass something about
like maybe all your mama didn't teach you about sex.
I don't do you remember the name of it.
Speaker 2 (27:57):
Yes, yes, things your mama couldn't say about sex, got it?
Speaker 1 (28:01):
Okay? Something you just said made me think about, like
how maybe our moms and aunties and grandmother's. It made
me think about what kinds of conversations you're even having
with patients about what sex should feel like, because I
think only now are we really having conversations about women's pleasure,
and like that it isn't just something that you have
to do, right, that women deserve to have pleasure also,
(28:23):
So I'm curious to hear if you can say more
about the kinds of conversations you're having with clients about
what sex can actually feel like.
Speaker 2 (28:31):
Girl, I just love your questions. Doctor. Sorry, I didn't
mean to call you, but I really just I love
that question because I think a lot of times my
mind thinks about the physical the sexual, but you brought
that generational insight into it, which is so huge, especially
for sex. I'm gonna call my mom out a little
bit here since I'm into this whole sexual wellness femling floor,
(28:53):
jazz I said, Mom, what's one thing you wish you
would have taught me about sex? Now? What you know,
doctor joy, I am now full on married with a
whole husband, and you want to know what she said.
She said, I wish I would have tasted you more
to wait. I'm like, what, I am full of married?
I'm trying to get a sex lesson from you. I
(29:15):
literally got a whole husband in this same apartment, and
you are telling me that the most important thing is
to wait, like I couldn't believe. So that just goes
to show all the generational differences, because listen, if my
daughter asked me that, it would be a whole different conversation.
But I think many of the conversations that we're having
is that pleasure is good. I think it's a great
(29:35):
place to start. Many of us have been told that
if you get horny, it's bad, or you're like evil,
and we even call sex dirty, like you nasty, You're
about to go get some dirty, you know. We have
this connotation that sex is like this dirty, nasty thing.
So I think starting from a place of embracing that
(29:56):
sex is good. This is a part of our health,
and we know that because when sex is not working well,
we see how it impacts relationships, how it impacts people's
mental health. And so starting from there, I think is
a great way, and then also letting people know that
a lot of the message you've seen about sex are fake.
(30:16):
So a lot of people think that their libido has
to be raging for it to be working, right, you know,
Like we've seen the TV shows. You literally run in
the house, you're throwing the person against the wall, and
you're like having sex with your coat halfway on. Most
people are not that horny. So I think just accepting
and normalizing even when you have that small inkling of
(30:37):
a thought like ooh, I wish I could do that
right now, that's part of your libido, right your partner
Walt's values. Smack them on the butt. That's sexual attraction.
So I think one of the things that I love
to do, especially when people are struggling with sexual fear
and low libido, is creating more of a positive relationship
(30:57):
with sex. So when you have those thoughts, even if
it's just like a sexual flirtation thought or a fantasy,
write it down right, emphasize that text your partner. You
really want to hype it up and remind yourself that hey,
you do have this sexual energy in you, but we
have to water it, we have to celebrate it and
(31:18):
I think that's a big part. And then reminding them
also that they have agency. You don't have to have
sex if it hurts, you can say no. In the middle,
you can say stop like right before they or cast
You can do whatever you want to do. And I think,
especially as women, we have to reinforce that because sexual
(31:38):
activity should be a choice, a happy choice, you know,
not like a reluctant choice. It's gould be something that
you're excited to do. And just letting people know that
they have that agency, I think it's so so helpful
as we're looking to heal the relationship that we have
with sex.
Speaker 1 (31:56):
More from our conversation after the break, I wonder if
there are some other lessons from that master class that
you want to share, Like what other things came up
that you were surprised, Like, oh okay, people are still
wondering about this.
Speaker 2 (32:16):
I think we talked about vaginal librication, like my mom
may never talk to me about librication. Some of it
was not even like super erotic, crazy things, but just
providing the platform for us to talk about these things.
Another thing that I think is important is advocating for
your sexual pleasure in a relationship. Right. And I think
(32:38):
that a lot of times we sort of just accept
the way that things are instead of saying, hey, this
is something that I need to stand up for, you know,
like same way that we vote for who we want
to be president, like vote for what you want to
happen in your sex life. Right. So let's say that
your partner is the one that's always pleased every single time,
(32:59):
they're leaving the situation happy and satisfy. But there are
some things that you don't like. Maybe you don't like
the amount of time that they give you for play,
or maybe you don't like how as soon as they're
done they act like the whole experience is done right,
Or maybe you don't like that you don't have any aftercare,
you want to cuddle after sex, or you want to
have a conversation. I think just understanding that's something that
(33:20):
we have to intentionally stand up for. It's not going
to be like this easy, natural happenstance without us actually
taking the effort to do it. The other thing that
we talked about in the masterclass was not being afraid
of your clutterists. I think this is a controversial topic
just because of religion and different things we may believe
about sexual activity before marriage, and so especially for me,
(33:45):
I'm a religious person. I do believe in God. I
believe in Jesus all the things. However, I believe that
science is real. And one of the things that we
know is that when a body part is not used,
it atrophies. Right, So it's a thing. And so bring
those things up, like, even if you don't feel comfortable
with masturbation, right, your moral decisions are your moral decisions.
(34:09):
But we should feel comfortable checking on that body part,
making sure that the c litteral hood still moves when
you have a shower cleaning that area was water. You
don't even really need salp right there. But just saying
that openly and without shame, I think is so important.
If you just touch your clutterest, that is not bad, right,
If you touch your knee that's not bad either. Just
(34:32):
giving people permission to take care of their sexual health essentially.
Speaker 1 (34:36):
Yeah, yeah, And I really appreciate you bringing in and
answering these questions because I do think these intergenerational conversations
around sex are so important. So to expand on the
conversation or the question that you ask your mom, I'm
wondering what kinds of things do you wish you would
have asked her when you were younger, or what kinds
of things would you have liked to hear when you
were younger from older women in your life about six.
Speaker 2 (34:58):
Yeah, so I kind of did badge mom a little
bit more. So maybe I should share what she ended
up saying. So she actually told me that she wished
she would have taught me that sex is not really
something that you have to do right now. Isn't important
in a marriage. Absolutely? Can it be beautiful, yes, but
it's not something that you have to do to keep
(35:19):
the marriage quote unquote running or the relationship healthy. And
she says she wished that was something that she learned
and also taught to me. It's like, you can decide
to not engage today and you don't have to have
this elaborate reason every single time. So that was one
thing that she ended up saying. So sorry. I had
to give her a little props there, just in case
(35:40):
she listens to this episode. And then what I would
suggest if I had a daughter of my own is
that I would let them know that number one pleasure
is not bad. And I'm sorry if I feel like
a broken record. But I think it's a common theme
even in marriage. Right, So let's say that you're religious,
(36:02):
unlearning a lot of those things that say like sex
is bad, or is evil or it's dirty can be
so difficult. There's a lot of sexual shame going around
even for non religious people, and so I think that's
number one thing that I would discuss, but then also
creating an open platform for us to talk about it.
I would start with sexual anatomy. First of all, I
(36:23):
would get my whole clitterists out, not my own literous
let my clitteral model, my pelvic model, the puppets, because
there's people that don't even know where their clitterist is.
How can we talk about orgasm and pleasure when we
have women and people and men who don't even know
where to find the glitterists. So I think starting with
(36:46):
a good foundation definitely consent right that this is something
that you have to vote for. You have to actively
say I want this for sex to happen. Sexual anatomy
and just celebrating pleasure. I think pleasure is under rate
it and not just sexually, not sexually as well. And
that's something that I where so many people could learn it.
(37:06):
Embrace is that, Hey, this is something we get to
do every day by yourself. Flowers right, relax for the evening.
You don't always have to be working. These things are
so so important. And I'm not sure if I'm gonna
have kids because I have like the whole PCOS thing
going on, but if I do, that would be something
that I would love to pass on.
Speaker 1 (37:27):
Thank you so much for that. So, doctor Janelle, I
wonder if you have some affirmations that you could share
maybe or that you have shared with clients who may
be having some anxiety around sex.
Speaker 2 (37:37):
So one of the affirmations that I really love for
pleasure is this one here and I have it listed
in my affirmation Bible. It's free, I have it in
my shop. And this one says my body is my
home and I deserve to feel good in the home
I live in. And a lot of people really love
(37:58):
this one, and I think it just just feel cozy.
It's like, wow, my body is my home, Like there's
nothing wrong with seeking to feel good and my home.
So that's one that I really love. And then another
one is about sort of the definition of sexy. Right.
We all may have different definitions, but This one says,
sexy is not a body, Sexy is not lingerie. Sexy
(38:20):
is in me and I get to exude it. And
so this one is I think helpful to remind people
that regardless of what body you're in or regardless of
how you look, sexy is sort of something that you
get to release, right, It's like an aroma that you
get to release, and just feeling empowered to do that.
This other one says, pleasure is my birthright and I've
(38:43):
decided to embrace it and explore it. Of the word explorer,
I love exploring. I like traveling, going all over and
I like to think of pleasure in that same way.
It's something that can continually be explored more and more.
Like big cities. I don't know where, where do you live, doctor, Atlanta?
Atlanta's perfect. Have you seen the entire city? Like have
(39:06):
you gone to all the neighborhoods? And say, right, it
just continues to be able to explore more. In Chicago's
the same way. I've been here for four years and
there's still so many things that have not seen our experience.
So I think if we're looking at pleasure in that
same way, it's like, oh wow, this is something we
get to explore. I think that's an empowering and inspiring
(39:27):
way to look at our bodies. And so those are
a few affirmations that I enjoy.
Speaker 1 (39:33):
I love that one more question before we read from
doctor Janelle, because you've introduced this whole piece around sometimes
how faith and spirituality and religion kind of impact our
relationship to pleasure. And I also think that there are
some like pop culture kind of just things that people
throw around that also impact our relationship to pleasure. And
one of those is like body count or even the
idea of virginity. Can you say a little bit about
(39:56):
how those kinds of terms maybe impact our anxiety and
our relationship to pleasure.
Speaker 2 (40:01):
That's a great question. I think understanding the difference between
truth and what society says is crucial. Society will tell
you that you have to look a certain way, you
have to have a certain job, you have to have
a certain income, your waistline has to be a certain size.
Those things generally are created to make someone else profitable. Listen,
(40:24):
a lot of them really profitable businesses and industries. They
profit off of our insecurities. Right, Let's think about even
how feminine hygiene was started, right, That was started to
tell women that they needed to use disinfectant actually lifesol
to clean their vaginas, right, and now the feminine hygiene
industry is one of the biggest industries. And you talk
(40:45):
to doctors, they'll tell you that you actually don't even
need help down there. So I think understanding that what
society says is not truth, right, but then looking at
who you are and your past, what you've done on
already does not define you. And in the same breath,
your quote unquote purity doesn't determine your value either. We're
(41:08):
all valuable, right, every single one of us, and understanding
that we still get to embrace pleasure. Right, whether you
have a STI, or whether you are after a certain age,
or whether you are a virgin, right, we all have
access to pleasure. And I think coming to the space
(41:28):
knowing that what society says generally is harmful generally, and
so recognizing that and then trying to help yourself come
to a place of truth, whether you believe in God
or whether you don't, what is that healthy narrative about
your body and then looking to embrace and believe that,
I think is what is going to help you when
(41:51):
it comes to your sexual and peblic wellness.
Speaker 1 (41:53):
Thank you so much for that, Doctor Janelle. So where
can we stay connected with you? What is your website
as well as any social media handles you like to share?
Speaker 2 (42:01):
Absolutely, so, Vagina Rehab Doctor dot com. That's my website.
And I am all always on Instagram, so you can
find me on Instagram. Even when I'm trying to not post,
I end up posting. I'm on there posting exercises. I
go live quite frequently to explain and go deeper on
(42:22):
certain topics. And then also I have a podcast now
I don't think I had one when I last talked
to you. Yeah, so the podcast name is the Vagina
Rehab Doctor Podcast, and I love to talk about all
things pleasure, sex, peblic floor and even sexual fear because
that's a big thing surrounding like volvidinia, vaginismus, pelvic pain
(42:45):
and so all the things sex education. You can find
me over there. But yeah, those are the two ways
my podcast and also Instagram.
Speaker 1 (42:53):
Perfect We be sure to include all of that in
the show notes. Thank you so much for spending some
more time with us today, Doctor Janelle.
Speaker 2 (42:59):
Absolutely, thank you for having me back.
Speaker 1 (43:01):
Of course, I'm so glad doctor Janelle was able to
join me again for this conversation. To learn more about
her and the work she's doing. Be sure to visit
the show notes at Therapy for Blackgirls dot com slash
Session three seventy five, and don't forget to text two
of your girls right now and tell them to check
out the episode. If you're looking for a therapist in
(43:22):
your area, visit our therapist directory at Therapy for Blackgirls
dot com slash directory. And if you want to continue
digging into this topic or just being community with other sisters,
come on over and join us in the Sister Circle.
It's our cozy corner of the Internet designed just for
black women. You can join us at community dot Therapy
for Blackgirls dot com. This episode was produced by Elise
(43:44):
Ellis and Zaria Taylor. Editing was done by Dennison Bradford.
Thank y'all so much for joining me again this week.
I look forward to continuing this conversation with you all
real soon. Take good care, what
Welcome to the Therapy for Black Girls podcast, a weekly
conversation about mental health, personal development, and all the small
decisions we can make to become the best possible versions
of ourselves. I'm your host, doctor joy Hard and Bradford,
a licensed psychologist in Atlanta, Georgia. For more information or
(00:32):
to find a therapist in your area, visit our website
at Therapy for Blackgirls dot com. While I hope you
love listening to and learning from the podcast, it is
not meant to be a substitute for a relationship with
a licensed mental health professional. Hey, y'all, thanks so much
(00:57):
for joining me for session three seventy five of the
Therapy for Black Girls podcasts. We'll get right into our
conversation after a word from our sponsors.
Speaker 2 (01:06):
Hi, you guys. I'm doctor Janelle, the Vagina Rehab Doctor,
and I'm on the Therapy for Black Girls podcast. I'm
in the session today unpacking all things about anxiety and sex.
Speaker 1 (01:28):
For the fourth year in a row, Therapy for Black
Girls invites you to join us in celebrating sex Positive September,
a month in which we center the importance of black
women's pleasure, agency and sexual liberation. What better way to
kick off this month's programming than with a conversation with
returning guests, Doctor Janelle Frederick, also known as the Vagina
(01:49):
Rehab Doctor. Doctor Janelle, is a pelvic floor physical therapist
who specializes in helping individuals and couples overcome vaginismus, volvadinia,
and painful sex via remote one on one vaginal fitness
coaching and online education. She uses social media to produce
shame free entertaining and high quality sex education. In our conversation,
(02:12):
we discussed some of the overlooked contributors to sexual pleasure,
the ways in which anxiety and depression can impact a
person's ability to have pleasurable sex, and what we wish
our parents would have taught us about sex. If something
resonates with you while enjoying our conversation, please share with
us on social media using the hashtag tpg in session
(02:32):
or join us over in the sister circles to talk
more about the episode. You can join us at community
dot therapy for blackgirls dot com. Here's our conversation. Well,
thank you so much for jointing us again today, Doctor Janelle.
Speaker 2 (02:49):
Absolutely, I am so so excited to be here and
just honored that she would have invited me back again.
So thank you so much, Doctor George for having me today.
Speaker 1 (02:58):
Yes, we had such a great conversation for our sex
past September episode in twenty twenty two.
Speaker 2 (03:03):
Is that we wanted to have you back.
Speaker 1 (03:04):
But I want to hear what's been up with you
since we last chatted.
Speaker 2 (03:08):
Oh my gosh, I feel like a whirlwind of things
have happened. I got married two months ago, so that
was a huge, huge transition with the wedding and not
calling my now husband my fiance. As soon as I
got used to saying fiance, then he was husband. So
it's like a lot of changes that have gone on.
(03:29):
We moved, we're still in Chicago, but we're living together
obviously now and mainly just work changes. I'm glad that
we're growing. I just hired another public floor therapist to
come and work with us at VRD, So just career
stuff and a little bit of family changes. But that's
the biggest thing that has changed for me.
Speaker 1 (03:49):
Nice, Nice, Well, congratulations on all of those transitions, though,
I'm sure it has kept you plenty busy.
Speaker 2 (03:54):
Oh my gosh. Absolutely. So.
Speaker 1 (03:57):
The last time we chatted, we talked about the vagina
will meant to be flexible. And today we're gonna talk
more about fear and anxiety and how that actually impacts sex.
So can you say a little bit about why you
think that that's important for us to talk about and
think about.
Speaker 2 (04:11):
Absolutely over the past couple of years, as I've been
evaluating women that have sexual pain or that have pellic
floor muscle tightness, which is really common, or just pellic
floor dysfunction, because a lot of people don't know whether
their pellic floor is tight to begin with. So just
like the urinary changes, like if you always have the
(04:32):
rush of the bathroom, these things are honestly, so so common.
But one of the common trends that I saw among
I would say at least eighty to ninety percent of
my patients was that many of them would say that
they've always struggled with anxiety and even have a therapist
for anxiety and or depression. And so I was getting
a lot of clinical expertise seeing that there was this
(04:55):
strong relationship between sexual pain, sexual dysfunction, peblic flord dysfunction,
and anxiety, and I really have just gathered more appreciation
for the mental health side of how pelvic florid dysfunction
can be healed, because that's honestly just a big part
of it. And I'm really appreciative of the collaboration that
(05:18):
we're starting to see of it more in this space.
So that's really what intrigued me to just seeing it
amongst so many of my clients saying that they were
struggling with anxiety, and then eventually I started reading more
about the connection between the two.
Speaker 1 (05:31):
Got it. Can you say, well, there's some kind of
common themes that were coming up for your clients around
any anxieties of fear and is it related mostly to
sake or just general anxiety.
Speaker 2 (05:43):
I would say that most of the people that I
see for either vaginistness, which can mean that intercourse or
vaginal assertion is not possible, like whether tampon, finger pelvic
exam are intercourse or sexual pain, they do have generalized anxiety,
but it also tends to show up in their sex life.
(06:06):
So then a fear of sex or a fear of pain,
or just a fear of things going into the vagina.
And so I think that it's hard to say which
one comes first or what's causing what, but generally it
seems that people tend to discover it like twelve or
thirteen when they're trying to put in a tampon, or
(06:26):
as they get a little bit older and they're going
to get that peblic exam and they realize that they
have a fear in addition to pain. And of course,
if you're having pain, that can make you afraid, because
no one just welcomes pain, that can be some anxiety
with that. So I do think it's interdependent, like they're
both interacting with each other. But I would say that
(06:47):
anxiety for sure can directly lead to peblic floor dysfunction
and sexual pain, which can create this cycle of fear. Right,
fear of sex are fear of pain.
Speaker 1 (06:58):
So can you say a little bit of a like
how you would then work with a client like that
when you discover that there is this anxiety around it.
Speaker 2 (07:05):
Absolutely, So a lot of what we will do is
we have to of course resolve the physical dysfunction because,
like we've talked about, that could be driving the fear. Right,
So if we go to have intercourse and as soon
as insertion is attempted there's a burning, stinging type pain,
then we want to resolve that so that when attempts
(07:27):
are made, their nervous system is not so jarred, right,
So just bringing the pain down generally does have such
a positive effect on their fear because they're gonna not
be as guarded, right, They're not gonna be as afraid,
and so their nervous system begins to calm down with that.
But then a lot of the other things that we
can do is exercises and activities that directly lower just
(07:51):
the state of the nervous system that is on guard.
So diaformatic breathing and not just diaformatic breathing, but getting
our clients to and I say our clients because I
don't do all of the one on one coaching anymore myself,
so I have people working with me, and so I
think my brain is in that our mode. But what
we would do is even have them to touch the
(08:12):
pelic floor while they're breathing, so that they can see
that when they breathe in a certain way, their pelic
floor muscles actually relax, right, So doing things that help
them to connect with their peblic floor and their sexual
anatomy and also just reinforcing that insertion is not bad. Right.
So one of the things that we use is dilators,
(08:34):
and that's especially helpful for anyone who's having sexual pain
or inability to have intercourse. And when we're inserting those dilators,
even if there is pain, what we try to do
is retrain how they react to that pain. So instead
of clenching and guarding and closing the muscles because they're
scared or they're afraid they're making themselves worse, we try
(08:56):
and teach them to keep those muscles relaxed, to stay
breathing right, to not close the hips or the thighs,
and so a lot of it is honestly retraining how
they think about pain and even letting them know that
pain is not always bad. Sometimes it's just like a
siren that's going off and it needs to be calmed.
So those are some of the things that we like
(09:17):
to do with our clients who are struggling with fear, anxiety,
and pain with sex.
Speaker 1 (09:23):
And I would imagine that for some people, you know,
the difficulty and the tension comes from a history of
sexual trauma or sexual abuse. Can you say a little
bit more about how this impacts your sex life and
how you would work with them. I would imagine at
some point. I think we talked about this for your
last visit, Like working with a therapist also as a
part of the care team for these kinds of concerns.
Speaker 2 (09:44):
We can be sensitive to certain things. Right, We definitely
want to include regular and frequent communication. Right, So how
are you doing with this? I may instruct them to
use a pelvick Won, which is like a tool that's
used to get out tension inside the vagina and some
times even the anus. But if that's bringing up memories
of the past or it's making them feel afraid, that
(10:06):
communication is so important, like how are you doing with this?
Are you feeling pain? Are you worry? How are you
feeling in your mind? That communication is important. But also
I'm just very thankful that we have you. Right, we
have psychologists, we have sex therapists, we have mental health therapists,
and generally a lot of the clients that we work
with have either already been so that's like thank you.
(10:29):
They've already been and they've done a lot of the
mental work and now it's more so that they're trying
to work through the physical pain and the physical tension.
So collaboration is still a key part. I remember last
year I worked with a woman who was having a
difficult time reaching an orgasm, and she definitely had a
lot of pelic floor muscle tightness, difficulty breathing, like when
(10:51):
she would inhale, her belly really wouldn't expand very much.
And that's a whole other topic because we're told a
lot that our way should be small and you should
suck it in and wear waste trainers and all these
things that restrict you. But that was actually contributing to
why she couldn't orgasm. And we were doing all of
the things, working on the public floor, working on her breathing,
(11:13):
working on the pain inside of the vagina, and she
was still having a lot of difficulty with orgasming. Towards
the end of our time working together, thankfully, she did
get to the place where she could orgasm. But she
actually just reached out to me yesterday and she said
she's so thankful for the work that we did because
it opened up her eyes to a lot of things
about her body. But she said she wasn't able to
(11:36):
completely be present because of our history with sexual trauma.
So that reinforced me the importance of you really got
to collaborate with other healthcare providers. I mean, that's just
not our scope as public floor physical therapists. So we
could do all the things, but if they're not present right,
they're reminded, or they're scared, or they're clinching because of
(11:57):
that history or those trauma responses, then it can still
be difficult, and even sometimes focusing more on what's going
to help them relax as opposed to immediately going to
physical interventions like internal release are using these invasive tools.
Sometimes just focusing on exercises, mobility, breathing is appropriate if
(12:22):
someone is still in a phase where they're I don't
want to say stuck, but still reminded by those traumatic experiences.
So it's not always easy, but I definitely think that
there's so much room for growth even if there is
a history of trauma involved.
Speaker 1 (12:38):
So that's just now. I do want to hear more
about it, because you mentioned like the process of breathing
and like how much that is a part of your work,
and if you could say more about the connection between
breathing and the ability to orgasm. What is the connection there.
Speaker 2 (12:52):
The first one is just the way that your diaphragm,
which is the main muscle of breathing interacts with your
vagus nerve. Right, so our vegus nerve pierces the diaphragm
and it has offshoots that go to the glitterists that
go to the pelvis. It helps with our breathing rate,
it helps with our blood pressure. It's a nerve that's
(13:12):
really responsible for calming us down, for calming anxiety, and
for helping us to feel pleasure. So if your body
is in a state of hypervigilance, if your body is
in a state of anxiety, one of the ways to
help activate that nerve is through proper breathing, because every
time you take a diaphramatic breath, you stimulate that vegus nerve,
(13:34):
And so that's why it's important for us to be
mindful of how we're breathing, and also if we're even
relaxing our belly, because if we're restricting our abdominals inward
and sucking in all the time, you're limiting the movement
of your diaphragm, which then limits the activation of that
vagus nerve. So that's the first way. It is just
(13:57):
the way the nervous system is interacting with the main
muscle of breathing. The second way is that the diaphragm
and the pelic floor works simultaneously. So when we take
a nice, big belly breath in, when we breathe in,
our belly should get nice and big, right, I tell
why people let it all hang out. When you breathe in,
(14:17):
the pelic floor also naturally relaxes and it opens not
a huge amount. And even if you take a big breath,
if you do have a lot of pelic floor muscle tightness,
you may not feel a whole bunch And that's okay,
But that's the other way. So that means then if
someone always has their belly sucked in, or if their
breathing habits are not ideal, that their pelic floor muscle
(14:38):
could be restricted. And this is gonna limit blood flow
that riches your glitterist. It's gonna limit blood flow that
obviously gets to the vagina, and it can make it
difficult for the muscles to contract and relax for an orgasm,
because essentially that orgasm is that contraction, that relaxation, contraction
and relaxation, and so trying to get that pelic the
(15:00):
floor and the diaphragm to open up is so crucial
when it comes to just overall pelic health, not just
orgasmic potential, but overall pelic health and helping someone to
feel pain free sex. So that's I would say the
two major things that I see in relationship to breathing
and sexual and peblic health.
Speaker 1 (15:21):
Got it, I wonder, doctor Janelle. I think we talked
the last time about like water and how important that
was in terms of orgasm, well the other things that
we might be overlooking or missing as it released to
sexual pleasure.
Speaker 2 (15:33):
Absolutely, I would say that one of the things is
just preparing our body for pleasure and even for orgasm,
and a lot to think of it as when we
go to sleep at night. Right, we're planning to have
this amazing night where we're relaxed and we're just out
for the count. But a lot of people notice that
(15:54):
if they prepare for their sleep, they sleep better. So
if you put on your pajamas, or if you take
a warm bath, or if you drink something relaxed, or
if you take your melatonin, right, So that's preparing. If
we're going into this eight hour activity, we can't just
be on our phone scrolling off of the night and
then try and go to sleep. So I like to
(16:15):
think of orgasms and pleasure as like this activity that
we have to prepare for. So thinking of how relaxed
do you feel before sex, right, do you feel anxious?
Do you feel stressed or tired? Your vagina gonna be
tired too. There's no way that you're gonna be exhausted, tired,
stressed and then expect your vagina to be all wet
(16:38):
and you to be having these great orgasms because your
vagina is connected to your body. So I think that's
a huge part of it, is just checking in with
your overall state for play. I think we talked about
that a lot generally in terms of pelic health and
sexual wellness especially. I do think that's underrated quite a bit.
I don't know if it's because we are typically having
(16:59):
sex with men, and so men are more excited to
get to the penetration and so foreplay is not valued.
But we need about twenty to thirty minutes. And that's
so important because in order for us to really get
that clitteral blood flow, which is the erection, so we
have erections too. That's not going to happen as well
(17:20):
if we're not being aroused, and so I think that's
a huge part of it, and just your emotional state, right,
how do you feel are you feeling connected to your partner?
Some people are turned on just by conversations, you know.
So I think that again, the connection between the mental
emotional and then with the Pelvican sexual is so intimate
(17:41):
that we have to constantly remind ourselves of that and
look to see how we are generally feeling and address that.
Speaker 1 (17:49):
So I wonder if you could give us some suggestions
about how we might talk with a partner if we
do have some anxiety around sex, like how might we
bring this up? And when do we bring this up?
Speaker 2 (17:59):
That is such a great question. I think that any
conversations about your pleasure, just sexual communication are so important
to have, and I would say that having the conversations
outside of the bedroom is best. I think a lot
of times when you try and tell someone they may
be trying to, I don't know, go down on you
(18:20):
or y'all in the middle of sex, and you're trying
to tell them and give them instructions. They're like in
this performance mode, right, they want to do everything right,
and so coming to them was what you want them
to do. Differently, I think that time is not ideal.
So I would say maybe the day before sex, or
when you anticipate sex to happen, or just at any
time where you think the person is a little bit
(18:42):
more softened. So let's say that you're watching a movie together,
or you're just having dinner, or let's say that you're cuddling.
I think these are great times to actually bring up
what are the issues that you're having number one? And
then two, what are the expectations that you have for them? Right?
And I did this in my stories, and I did
this mainly as a demonstration because I do have a
(19:05):
lot of women telling me that they don't know how
to tell their partners like what they like in bed,
or what they're having issues with like pain or anxiety,
and so a lot of times it's honestly just being
as specific as possible regarding what you want. And so
I did a scripted scene where again I was doing
(19:26):
it mainly for the people watching my stories. But I
went into my husband's office yesterday after knocking on his door,
and I said, baby, can you give me an orgasm tonight?
I mean, it was very straightforward, right to the point,
and he's like, what, of course, He's all confused, like
you're what you're talking about? And I said, I don't
(19:46):
really want to work for my own orgasm tonight. I'm
just really would love for you to do that for
me tonight, and he said sure. So a lot of
times it's just being willing to be open, right. My
tone of voice wasn't demanding aggressive, right, because sometimes people
can be more defensive if we come to them with
something they're doing wrong. But even the same with anxiety
(20:06):
and pain, we can say, hey, I've been struggling with anxiety.
Whenever we have intercourse or whenever we're intimate, do you
mind just spending some time with me, just breathing for
maybe five to ten minutes before we have sex tonight.
I think most partners who care about you would be open,
especially if you're asking them at a time where it's
a good time. I think the timing is everything, and
(20:28):
also in a non sort of aggressive way, and I
think that that would work well and see how they
respond to that.
Speaker 1 (20:36):
More from our conversation after the break, but first, a
quick snippet of what's coming next week on TVG.
Speaker 3 (20:42):
Sexuality at sixty is not what it was at thirty. Okay,
that's what it is, but it doesn't mean that it's over.
And if there are things that are getting in the way,
like you don't feel well, like you can't sleep, like
you have vaginal dryness, like you have painful sex, then
(21:02):
go fix those things. Go fix them. It's easy and
it involves hormones. So no, it ain't over till it's over.
You know when that time is. But don't let the
things that are fixable get in the way.
Speaker 1 (21:31):
So, doctor Janelle, something else that has come up in
conversations in the community. Is there a way to like
actually increase your libido? So is that possible?
Speaker 2 (21:41):
You know what? It's such a huge topic just libido,
and I think it definitely is a way. Sometimes it
seems to happen naturally, Like with some of our clients
they do tell us after being able to have pain
for sex, is that they're libido naturally spiked. I mean,
your brain is not really going to tell you to
(22:01):
do something that hurts, right, unless you like pain, right,
some people do like kling pain. But if you don't,
then your brain is going to sort of put up
a wall to try and guard you from what it
thinks is harming you. Right, So just that alone can
decrease your libido. Another thing that is actually super important.
(22:22):
I was just reading about this the other day is
vitamin D. This vitamin, I think is like the powerhouse
vitamin because number one, it helps with their mental health.
If you are depressed, the dopamine, the serotonin, the oxtatocin
levels are not where they need to be, you're not
going to be craving play because really that's what sex is.
(22:44):
That's a playful activity, right, and reproductive of course, but
just getting where vitamin D can actually help your body
to make sex hormones. So testosterone is one of the
primary ones that helps us to feel horny, and so
getting out and getting that souff Like as simple as
it sounds, it's so so important. Another thing that we
(23:05):
can do, I think, to support our sex drive is
making sure that we're getting enough sleep so we actually
get clitteral erections when we go to sleep at night.
When I found out about this, I was like, what
we get mourning wood too. That is so amazing that
you're not really gonna see it because our stuff is hidden.
But all genders have the same thing that happens a
(23:27):
few times of the night. There's an erection. But if
you're not getting enough sleep, you're not going to be
getting that same amount of blood flow to those organs
to create more sensory awareness of that body part. I
think another thing that we can do is go check
our hormone panel. So when was the last time you've
gone to your doctor and ask them to look at
(23:47):
your progesterone, your testosterone, your estrogen, your insulin. All of
this is so so important because hormones essentially tell the
body what to do. So I think that it's a
great way. We don't want to underestimate the power of
just checking the facts right using the tools that our
doctors have. And I don't want to underwrite the importance
(24:10):
of also just being overworked. I mean, this is therapy
for black girls. We work hard, like we really do it. Generally,
we have to work harder than other people to get
to the same place. And so I think just giving
yourself permission to do nothing. I remember someone said that
you have to get unbusy to get busy, like the
(24:32):
more relaxed you are. We saw what happened with the pandemic,
more people were getting pregnant one much to do so
like you like on vacations, your lobido maybe higher. So
of course we can't go on a vacation every two weeks,
But what can you do to just slow down? I mean,
you really can't even feel your sex drive if you're
stressed out and you're always running around. So just slowing
(24:55):
down more to be in tune to your desires is
I think an important one. I know for me, if
I'm too busy, I can forget to eat, right. It's
not that I don't get hungry, I just couldn't even
pay attention to the fact that I need to eat,
And so I think it's a similar thing with sex.
If you're always on the go, always working, always checking
your emails, your body just is not going to be
(25:17):
prioritizing pleasure. So I think that's a direct way to
increase your libido, a slowing down.
Speaker 1 (25:23):
Yeah, thank you so much for those suggestions, Doc Jel.
I'm curious to know if you hear from your patients
who may be struggling with depression of anxiety, and we
know one of the common treatments for that is an SSRI,
and unfortunately sometimes a common side effect of SSRIs is
decrease libido. So I'm curious if you are working with
patients who describe that and what suggestions people have or
(25:46):
you would have to help to combat that temptom.
Speaker 2 (25:49):
Ooh, that's a good question, girl, you want to strike
to it. I love this question because I'm also getting
more messages and questions about this, and not just about libido,
but about inability to organ at all after getting on
an SSRI. I think it's posts SSRI syndrome something to
that effect. Even after coming off, some of these people
(26:09):
are saying that they still cannot reach an orgasm. So
one of the first things I always recommend is asking
about dosage right. Again, this is not my expertise, so
just disclaimer there, but asking your psychiatrist, can we play
with the dosage right? Are we able to decrease this
one medication that maybe making it more difficult to have
(26:31):
a sex drive or making it more difficult to orgasm,
and maybe work with a different medication a little bit
more that doesn't have as much of an impact on
my sex drive. Another thing is the type of SSRIs.
There are tons of them, so some people try one
and it does not impact their libido, and then another
one does. So I think being willing to investigate and
(26:54):
have some patients with the process. And another one, honestly
is trying sex toys because you may just need a
little bit more stimulation because of the way these drugs
are impacting how serotonin binds with your sex organs, like
your glitterists and stuff. So that is impacting the way
the receptors interact with your vagina and your clitters. You
(27:15):
can't really change that, right, That's what the medication is doing.
But then can we use something that stimulates us a
little bit more that can make it a little bit
easier to orgasm, And the same thing with your libido,
because sometimes just getting more satisfaction and pleasure with sex
will increase your drive, right, because I can't tell you
how many times women tell me that they don't feel
(27:37):
anything during sex, So why are you going to want
to do that if it's not feeling good? Those are
some of the things I think are helpful.
Speaker 1 (27:44):
No, that's helpful, you know, doctor Denail's something you said,
just maybe think so. I feel like the last time
we talked, you were preparing for a masterclass something about
like maybe all your mama didn't teach you about sex.
I don't do you remember the name of it.
Speaker 2 (27:57):
Yes, yes, things your mama couldn't say about sex, got it?
Speaker 1 (28:01):
Okay? Something you just said made me think about, like
how maybe our moms and aunties and grandmother's. It made
me think about what kinds of conversations you're even having
with patients about what sex should feel like, because I
think only now are we really having conversations about women's pleasure,
and like that it isn't just something that you have
to do, right, that women deserve to have pleasure also,
(28:23):
So I'm curious to hear if you can say more
about the kinds of conversations you're having with clients about
what sex can actually feel like.
Speaker 2 (28:31):
Girl, I just love your questions. Doctor. Sorry, I didn't
mean to call you, but I really just I love
that question because I think a lot of times my
mind thinks about the physical the sexual, but you brought
that generational insight into it, which is so huge, especially
for sex. I'm gonna call my mom out a little
bit here since I'm into this whole sexual wellness femling floor,
(28:53):
jazz I said, Mom, what's one thing you wish you
would have taught me about sex? Now? What you know,
doctor joy, I am now full on married with a
whole husband, and you want to know what she said.
She said, I wish I would have tasted you more
to wait. I'm like, what, I am full of married?
I'm trying to get a sex lesson from you. I
(29:15):
literally got a whole husband in this same apartment, and
you are telling me that the most important thing is
to wait, like I couldn't believe. So that just goes
to show all the generational differences, because listen, if my
daughter asked me that, it would be a whole different conversation.
But I think many of the conversations that we're having
is that pleasure is good. I think it's a great
(29:35):
place to start. Many of us have been told that
if you get horny, it's bad, or you're like evil,
and we even call sex dirty, like you nasty, You're
about to go get some dirty, you know. We have
this connotation that sex is like this dirty, nasty thing.
So I think starting from a place of embracing that
(29:56):
sex is good. This is a part of our health,
and we know that because when sex is not working well,
we see how it impacts relationships, how it impacts people's
mental health. And so starting from there, I think is
a great way, and then also letting people know that
a lot of the message you've seen about sex are fake.
(30:16):
So a lot of people think that their libido has
to be raging for it to be working, right, you know,
Like we've seen the TV shows. You literally run in
the house, you're throwing the person against the wall, and
you're like having sex with your coat halfway on. Most
people are not that horny. So I think just accepting
and normalizing even when you have that small inkling of
(30:37):
a thought like ooh, I wish I could do that
right now, that's part of your libido, right your partner
Walt's values. Smack them on the butt. That's sexual attraction.
So I think one of the things that I love
to do, especially when people are struggling with sexual fear
and low libido, is creating more of a positive relationship
(30:57):
with sex. So when you have those thoughts, even if
it's just like a sexual flirtation thought or a fantasy,
write it down right, emphasize that text your partner. You
really want to hype it up and remind yourself that hey,
you do have this sexual energy in you, but we
have to water it, we have to celebrate it and
(31:18):
I think that's a big part. And then reminding them
also that they have agency. You don't have to have
sex if it hurts, you can say no. In the middle,
you can say stop like right before they or cast
You can do whatever you want to do. And I think,
especially as women, we have to reinforce that because sexual
(31:38):
activity should be a choice, a happy choice, you know,
not like a reluctant choice. It's gould be something that
you're excited to do. And just letting people know that
they have that agency, I think it's so so helpful
as we're looking to heal the relationship that we have
with sex.
Speaker 1 (31:56):
More from our conversation after the break, I wonder if
there are some other lessons from that master class that
you want to share, Like what other things came up
that you were surprised, Like, oh okay, people are still
wondering about this.
Speaker 2 (32:16):
I think we talked about vaginal librication, like my mom
may never talk to me about librication. Some of it
was not even like super erotic, crazy things, but just
providing the platform for us to talk about these things.
Another thing that I think is important is advocating for
your sexual pleasure in a relationship. Right. And I think
(32:38):
that a lot of times we sort of just accept
the way that things are instead of saying, hey, this
is something that I need to stand up for, you know,
like same way that we vote for who we want
to be president, like vote for what you want to
happen in your sex life. Right. So let's say that
your partner is the one that's always pleased every single time,
(32:59):
they're leaving the situation happy and satisfy. But there are
some things that you don't like. Maybe you don't like
the amount of time that they give you for play,
or maybe you don't like how as soon as they're
done they act like the whole experience is done right,
Or maybe you don't like that you don't have any aftercare,
you want to cuddle after sex, or you want to
have a conversation. I think just understanding that's something that
(33:20):
we have to intentionally stand up for. It's not going
to be like this easy, natural happenstance without us actually
taking the effort to do it. The other thing that
we talked about in the masterclass was not being afraid
of your clutterists. I think this is a controversial topic
just because of religion and different things we may believe
about sexual activity before marriage, and so especially for me,
(33:45):
I'm a religious person. I do believe in God. I
believe in Jesus all the things. However, I believe that
science is real. And one of the things that we
know is that when a body part is not used,
it atrophies. Right, So it's a thing. And so bring
those things up, like, even if you don't feel comfortable
with masturbation, right, your moral decisions are your moral decisions.
(34:09):
But we should feel comfortable checking on that body part,
making sure that the c litteral hood still moves when
you have a shower cleaning that area was water. You
don't even really need salp right there. But just saying
that openly and without shame, I think is so important.
If you just touch your clutterest, that is not bad, right,
If you touch your knee that's not bad either. Just
(34:32):
giving people permission to take care of their sexual health essentially.
Speaker 1 (34:36):
Yeah, yeah, And I really appreciate you bringing in and
answering these questions because I do think these intergenerational conversations
around sex are so important. So to expand on the
conversation or the question that you ask your mom, I'm
wondering what kinds of things do you wish you would
have asked her when you were younger, or what kinds
of things would you have liked to hear when you
were younger from older women in your life about six.
Speaker 2 (34:58):
Yeah, so I kind of did badge mom a little
bit more. So maybe I should share what she ended
up saying. So she actually told me that she wished
she would have taught me that sex is not really
something that you have to do right now. Isn't important
in a marriage. Absolutely? Can it be beautiful, yes, but
it's not something that you have to do to keep
(35:19):
the marriage quote unquote running or the relationship healthy. And
she says she wished that was something that she learned
and also taught to me. It's like, you can decide
to not engage today and you don't have to have
this elaborate reason every single time. So that was one
thing that she ended up saying. So sorry. I had
to give her a little props there, just in case
(35:40):
she listens to this episode. And then what I would
suggest if I had a daughter of my own is
that I would let them know that number one pleasure
is not bad. And I'm sorry if I feel like
a broken record. But I think it's a common theme
even in marriage. Right, So let's say that you're religious,
(36:02):
unlearning a lot of those things that say like sex
is bad, or is evil or it's dirty can be
so difficult. There's a lot of sexual shame going around
even for non religious people, and so I think that's
number one thing that I would discuss, but then also
creating an open platform for us to talk about it.
I would start with sexual anatomy. First of all, I
(36:23):
would get my whole clitterists out, not my own literous
let my clitteral model, my pelvic model, the puppets, because
there's people that don't even know where their clitterist is.
How can we talk about orgasm and pleasure when we
have women and people and men who don't even know
where to find the glitterists. So I think starting with
(36:46):
a good foundation definitely consent right that this is something
that you have to vote for. You have to actively
say I want this for sex to happen. Sexual anatomy
and just celebrating pleasure. I think pleasure is under rate
it and not just sexually, not sexually as well. And
that's something that I where so many people could learn it.
(37:06):
Embrace is that, Hey, this is something we get to
do every day by yourself. Flowers right, relax for the evening.
You don't always have to be working. These things are
so so important. And I'm not sure if I'm gonna
have kids because I have like the whole PCOS thing
going on, but if I do, that would be something
that I would love to pass on.
Speaker 1 (37:27):
Thank you so much for that. So, doctor Janelle, I
wonder if you have some affirmations that you could share
maybe or that you have shared with clients who may
be having some anxiety around sex.
Speaker 2 (37:37):
So one of the affirmations that I really love for
pleasure is this one here and I have it listed
in my affirmation Bible. It's free, I have it in
my shop. And this one says my body is my
home and I deserve to feel good in the home
I live in. And a lot of people really love
(37:58):
this one, and I think it just just feel cozy.
It's like, wow, my body is my home, Like there's
nothing wrong with seeking to feel good and my home.
So that's one that I really love. And then another
one is about sort of the definition of sexy. Right.
We all may have different definitions, but This one says,
sexy is not a body, Sexy is not lingerie. Sexy
(38:20):
is in me and I get to exude it. And
so this one is I think helpful to remind people
that regardless of what body you're in or regardless of
how you look, sexy is sort of something that you
get to release, right, It's like an aroma that you
get to release, and just feeling empowered to do that.
This other one says, pleasure is my birthright and I've
(38:43):
decided to embrace it and explore it. Of the word explorer,
I love exploring. I like traveling, going all over and
I like to think of pleasure in that same way.
It's something that can continually be explored more and more.
Like big cities. I don't know where, where do you live, doctor, Atlanta?
Atlanta's perfect. Have you seen the entire city? Like have
(39:06):
you gone to all the neighborhoods? And say, right, it
just continues to be able to explore more. In Chicago's
the same way. I've been here for four years and
there's still so many things that have not seen our experience.
So I think if we're looking at pleasure in that
same way, it's like, oh wow, this is something we
get to explore. I think that's an empowering and inspiring
(39:27):
way to look at our bodies. And so those are
a few affirmations that I enjoy.
Speaker 1 (39:33):
I love that one more question before we read from
doctor Janelle, because you've introduced this whole piece around sometimes
how faith and spirituality and religion kind of impact our
relationship to pleasure. And I also think that there are
some like pop culture kind of just things that people
throw around that also impact our relationship to pleasure. And
one of those is like body count or even the
idea of virginity. Can you say a little bit about
(39:56):
how those kinds of terms maybe impact our anxiety and
our relationship to pleasure.
Speaker 2 (40:01):
That's a great question. I think understanding the difference between
truth and what society says is crucial. Society will tell
you that you have to look a certain way, you
have to have a certain job, you have to have
a certain income, your waistline has to be a certain size.
Those things generally are created to make someone else profitable. Listen,
(40:24):
a lot of them really profitable businesses and industries. They
profit off of our insecurities. Right, Let's think about even
how feminine hygiene was started, right, That was started to
tell women that they needed to use disinfectant actually lifesol
to clean their vaginas, right, and now the feminine hygiene
industry is one of the biggest industries. And you talk
(40:45):
to doctors, they'll tell you that you actually don't even
need help down there. So I think understanding that what
society says is not truth, right, but then looking at
who you are and your past, what you've done on
already does not define you. And in the same breath,
your quote unquote purity doesn't determine your value either. We're
(41:08):
all valuable, right, every single one of us, and understanding
that we still get to embrace pleasure. Right, whether you
have a STI, or whether you are after a certain age,
or whether you are a virgin, right, we all have
access to pleasure. And I think coming to the space
(41:28):
knowing that what society says generally is harmful generally, and
so recognizing that and then trying to help yourself come
to a place of truth, whether you believe in God
or whether you don't, what is that healthy narrative about
your body and then looking to embrace and believe that,
I think is what is going to help you when
(41:51):
it comes to your sexual and peblic wellness.
Speaker 1 (41:53):
Thank you so much for that, Doctor Janelle. So where
can we stay connected with you? What is your website
as well as any social media handles you like to share?
Speaker 2 (42:01):
Absolutely, so, Vagina Rehab Doctor dot com. That's my website.
And I am all always on Instagram, so you can
find me on Instagram. Even when I'm trying to not post,
I end up posting. I'm on there posting exercises. I
go live quite frequently to explain and go deeper on
(42:22):
certain topics. And then also I have a podcast now
I don't think I had one when I last talked
to you. Yeah, so the podcast name is the Vagina
Rehab Doctor Podcast, and I love to talk about all
things pleasure, sex, peblic floor and even sexual fear because
that's a big thing surrounding like volvidinia, vaginismus, pelvic pain
(42:45):
and so all the things sex education. You can find
me over there. But yeah, those are the two ways
my podcast and also Instagram.
Speaker 1 (42:53):
Perfect We be sure to include all of that in
the show notes. Thank you so much for spending some
more time with us today, Doctor Janelle.
Speaker 2 (42:59):
Absolutely, thank you for having me back.
Speaker 1 (43:01):
Of course, I'm so glad doctor Janelle was able to
join me again for this conversation. To learn more about
her and the work she's doing. Be sure to visit
the show notes at Therapy for Blackgirls dot com slash
Session three seventy five, and don't forget to text two
of your girls right now and tell them to check
out the episode. If you're looking for a therapist in
(43:22):
your area, visit our therapist directory at Therapy for Blackgirls
dot com slash directory. And if you want to continue
digging into this topic or just being community with other sisters,
come on over and join us in the Sister Circle.
It's our cozy corner of the Internet designed just for
black women. You can join us at community dot Therapy
for Blackgirls dot com. This episode was produced by Elise
(43:44):
Ellis and Zaria Taylor. Editing was done by Dennison Bradford.
Thank y'all so much for joining me again this week.
I look forward to continuing this conversation with you all
real soon. Take good care, what
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