July 30, 2025 • 50 mins
In this episode of Talk Sex with Annette, we’re diving into the surprising ways sex toys are revolutionizing sexual health—and why more medical professionals are finally taking pleasure seriously.
You’ll learn:
- Why vibrators are being recommended by doctors and therapists
- The science behind using pleasure tools to treat conditions like pelvic pain, low libido, and arousal disorders
- How integrating toys into your health routine can improve intimacy, confidence, and connection
- What to look for in a “therapeutic” toy—and where to start
Whether you're navigating postpartum sex, menopause, erectile dysfunction, or just want better orgasms—this episode is packed with insight, guidance, and the kind of real talk your doctor should be having.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:19):
Do the sex pleasure and desire Around here.
Nothing's off limits.
These are the kinds ofconversations we save for our
boldest group chats, our mosttrusted friends and, of course,
the women's locker room.
Think raw, honest and sometimesunapologetically raunchy.
If you've been here from thebeginning, thank you, and if
(00:40):
you're new, welcome to mypodcast.
Where desire meets disruptionand pleasure becomes power.
Now let's talk about sex Cheers.
Today's Talk Sex with Annette.
Topic is Prescribe the Vibe,why Sex Toys Belong in the
Doctor's Toolkits.
(01:02):
Today we are cracking open ataboo that should never have
been a taboo in the first place.
I want you to imagine thisYou're at your OBGYN's office,
they're going down the checklistpap smear, hormones, blood
pressure and then they say haveyou tried a vibrator?
Not for fun, though?
Yes, that too, but as part ofyour actual healthcare plan?
(01:24):
Sounds radical, but itshouldn't, because once upon a
time, vibrators were part ofmedicine, literally.
They were invented by doctors,used in clinics and prescribed
to treat what was called femalehysteria.
And while the diagnosis wasbullshit, the solution orgasm
was not.
So what happened?
(01:44):
This was bullshit, the solutionorgasm was not.
So what happened?
How did the vibrator go frombeing a medical device to
something wrapped in shame andshoved to the back of the sex
shop.
Today's guest is here to answerthat and so much more.
I'm joined by Rachel Gelman,pelvic floor physical therapist,
sexual health expert and fierceadvocate for bringing the
vibrator back into the clinicaltoolkit.
(02:05):
We're talking about painful sex, postpartum numbness, trauma
recovery and why vibratorsbelong in your first aid kit
just as much as they belong inyour nightstand.
But before we dive in, I wantto remind you I'm over on
OnlyFans where I am sharing mysex and intimacy, how-tos,
demonstrations and audio-guidedself-pleasure meditations and so
(02:26):
much more all designed to helpyou experience and start
enjoying more pleasure in yourown life and relationship.
Tonight you can find me thereunder my handle at
TalkSexWithAnette.
You can also find me over onSubstack where I'm doing a whole
lot of the same same handle atTalkSexWithAnette.
But if you want to find me, youcan scroll down to the notes
below and you're going to findlinks to all the places I am
(02:50):
where you can get a hold of meand find out more about what I'm
offering.
Now I would love for Rachel,could you take a moment to tell
my listeners just a little bitmore about who you are and why
you're here.
Speaker 2 (03:02):
Yes, Thank you so much for having me.
So I am Dr Rachel Gelman.
My doctorate is in physicaltherapy, but I specialize in
pelvic floor dysfunction,primarily in chronic pelvic pain
and sexual health concerns forall genders.
People are often surprised tohear that half of my patients
have a penis or identify as men,but I'm also an ASEC certified
(03:24):
sexuality counselor.
So I really have honed in andspecialized in sexual health
concerns.
And as a result of that, andbeing that I am in San Francisco
, where you know the tech at thecenter tends to be, I've become
more involved in companies inwhat's known as the sex tech
(03:44):
industry, so helping companiesthat are developing different
types of devices for people whohave sexual health concerns.
And then I also teach as anadjunct professor at Samuel
Merritt University, where Iteach the doctoral students all
about pelvic floor dysfunction.
Speaker 1 (04:04):
So this conversation is inclusive of all people and
ways in which sex tech I hatethe word toys, we'll get to that
in the conversation but thesedevices can be used to enhance
overall health for all humans.
So, whether you're a man,someone with a penis, a woman,
someone with a vulva or all ofthe other genders, right yeah,
(04:29):
this conversation is for you,and so stay to the end, because,
of course, we'll do ourtakeaways, so you will know by
the end, and you'll get yourtakeaways on how you can start
using devices sex toys if youwill to improve your life beyond
, just as part of your sex life,which you know, I am an
(04:50):
advocate for, but in other areasof your life.
So if you need an excuse to goget a sex toy, you're going to
have one by the end of thispodcast.
So I'm really excited aboutthis conversation because this
is something I've myself feltvery strongly about.
So thank you for joining me andguys, get ready to talk about
(05:12):
sex and sex toys in the doctor'soffice, which sounds a little
kinky, but we're talking aboutthe doctor's office, so cheers
her office, so cheers.
So where I want to start with inthis conversation is sort of
the origin story of the vibratoras it pertains to being used in
the medical industry, if youwill, or by doctors much earlier
(05:35):
in our history.
We do know that doctors usedorgasm for women's hysteria, to
calm the hysterical female.
There is some mythology therearound the vibrator being
created to help with that,because their hands got tired.
Now that has been arguedagainst and sometimes people
(05:59):
will say it's been debunked.
Other people will argue that ithasn't been debunked, but what
we do know is that vibratorswere used for different things,
correct, and by doctors earlierin history, and then there was a
shift that happened, and can wetalk about that a little bit?
Speaker 2 (06:17):
Yeah, for sure I'm not a historian, so I always
feel like I need to kind of saythat I'm sure there's people who
have really studied this andwould be better equipped to talk
more about the history ofvibrators and sex toys, because
we know they've been around fora long time, whether they're
used just for pleasure's sake orin medical offices.
But we do know that they werebrought in to help treat
(06:41):
different things like headaches,insomnia, this kind of, like
you said, bullshit, diagnosis ofhysteria, whatever that kind of
encompassed.
For women, there's this idea ofit being used to help with
period pain.
So it did get brought into thedoctor's office, but then it
kind of became more and moretaboo and kind of got pulled,
(07:02):
and now we're seeing sort of aresurgence in the research about
the benefits of these devicesto help people who are having
sexual dysfunction and pelvicpain.
Speaker 1 (07:14):
I know that I have talked to some doctors who want
to and know that vibrators andvarious again sex toys I hate
the word toy because it makes itsound and various again sex
toys.
I hate the word toy because itmakes it sound.
I don't know like it does youknow like it's just for you know
shits and giggles.
I don't know why I hate thatword.
But sex pleasure devices I'vegot to come up with something
(07:35):
cool.
Speaker 2 (07:36):
Yeah, it's interesting because I feel like
I talk to some people who arevery anti-toy but then I talk to
other people who are verypro-toy because they want it to
seem fun and they feel like ifyou say device, that sounds too
clinical.
So it is interesting how thereis a lot of there's kind of two
sides, I guess, to how peoplewant to talk about these.
(07:58):
I say devices, I sometimes saytoys, I kind of like switch it
up depending on my mood that day.
But yeah, it is interesting howthere's some people who really
hate the term toy or dislike theterm toy, and then there's some
people who really want to usedevice but don't like device.
So I think we'll continue totry to struggle with what the
(08:18):
best term will be.
Speaker 1 (08:20):
There's got to be something in between.
Or we just do two differentbrands.
There's got to be something inbetween.
Or we just do two differentbrands, the one the doctors feel
comfortable giving theirpatients, and it can be in a
neutral, boring color, and thenwe can do the sex toys and all
the fun colored hands.
But I know that there isknowledge, a basic knowledge for
many different medical doctors,whether physical therapists or
(08:43):
OBGYNs.
They know that vibrators anddifferent sex toys can be used
to help people who areexperiencing sexual dysfunction
or pain or many, many differentthings, but they can't prescribe
them.
Isn't that correct at thispoint?
Speaker 2 (09:03):
Well, I guess it depends on what you mean by
prescribe.
Like we can recommend and thereare some devices out there now
that you can use like your FSAor HSA for.
But if we're talking about like, is it going to be covered by
an insurance company as amedical device?
You know, I don't think that'swhere we're at yet, but then
(09:27):
that gets us into a whole notherconversation about like the
insurance companies andhealthcare in our country and
just why that's a huge, a hugeproblem.
But yeah, they can definitelybe recommended, suggested and
you know, for some people thatwould fall under the umbrella of
prescribe.
So I think it just kind ofdepends on what you mean by that
(09:48):
.
But there are a lot ofproviders out there who work in
sexual medicine or pelvic healththat are recommending these
devices.
Like I can say for myself, Irecommend them every day.
Speaker 1 (10:01):
Well, that's great.
Let's talk about that.
Speaker 2 (10:15):
Well, that's great, let's talk about that.
Can you tell my listeners whatdevices you prescribe for
different conditions?
Maybe do you have a favoritedevice.
This is why I really enjoyworking in sexual health,
because what I like might bevery different from what you
like and what you know one of mypatients likes, and also it
might change in three or fouryears.
What that person likes mayshift and evolve, and so there's
(10:37):
so much variety and room toexplore.
And I think that's something Ireally encourage my patients and
people to understand is thereis no, you know, linear path or
one you know kind of like.
This is what you should bedoing this week and then by next
week you should be using thisvibrator.
It's like you can explore anddiscover what works well for you
(10:58):
and what you enjoy, instead offeeling like we all have to fit
into this one little sexual boxof like we're all just going to
use the rabbit and I feel likefor a long time that's what all
the magazines and shows weretalking about and I think
everyone felt like they had toenjoy and use that one device.
So that was a very long windedway of saying yes, I do have
(11:20):
some favorites and things that Ikind of encourage people to
maybe look at, especially ifthey're just starting out and
have never gotten a vibrator.
For people who have a vulva Ialways talk to them about most
of them require some sort ofclitoral stimulation to feel
pleasure and to experience anorgasm.
(11:41):
So trying to find somethingthat really focuses on clitoral
stimulation and usually I talkabout something that I call the
mini vibe.
It typically is referred to asa bullet vibe.
I really try to stay away fromthat language, but a mini vibe
is usually like.
It looks almost like a lipsticktube, so it's small, I feel
(12:02):
like.
It seems very like notintimidating.
You can use it externally.
It's pretty discreet.
So that's kind of usually whereI encourage people to start.
There are other devices outthere that are called clitoral
stimulators or clitoral suction,even though most of them don't
actually have an actual suctionto them, but they typically look
(12:25):
like a little suction cup, soit's very kind of focused on
clitoral stimulation.
So those are kind of the placesI usually start.
But I also really encouragepeople to go to websites.
Or I'm in San Francisco.
We have a shop here called GoodVibrations, which is this very
beautiful boutique typeenvironment where people can go
(12:47):
and look at all of these devicesand see what they feel like,
see how strong the vibration isand really be able to find
something that works best forthem.
So it usually is all aboutexploration and discovery, but,
like I said, the kind of minivibe or a clitoral stimulator is
often where I start, withpeople.
Speaker 1 (13:10):
My question that I should have asked before this
should have been are yourecommending essentially using a
vibrator or sexual stimulationfor people as part of their
health routine?
Can you talk about that?
Speaker 2 (13:29):
Yeah, for sure.
And I think the first thing Ialways ask people.
First I always ask like, dothey masturbate?
And then I usually then ask ifthey have a vibrator, if they've
ever used one, and depending onthe answer, I ask are they
comfortable maybe exploring thator trying one of those devices
or getting a toy?
(13:49):
Because if someone says rightoff the bat, like no, I don't
feel like I'm going to betelling them like oh well, you
should, you have to, like weneed to have other conversations
about ways that might behelpful to maybe get them to
that point or what kind of thebarriers are there.
But for the most part mostpeople say yes to the first,
(14:11):
saying that they do masturbate,and then it's probably like half
and half of people saying likethey have a vibrator or they
don't.
But most people are open toexploring, using some sort of
device to help whatever's goingon.
And especially when I explainto them why and I think that's
kind of a good kind of segue fora moment is to explain why I
(14:34):
recommend these things.
So if we look I'm going to pullmy model out here, just because
I feel like it's a little bithelpful If we look at this model
and this is the model.
So for my list.
Speaker 1 (14:45):
I'm going to interrupt you for a second.
For my listeners, you're goingto need to go over to the
YouTube channel to see the model, and we will do our best to
describe what the model is.
It's a pelvis.
We're looking at the model of apelvis?
Speaker 2 (15:02):
Yes, and this is a vulva, the pelvic floor of
someone with a vulva, and sothere's the bones are in white,
and then there's all this redwhich is the pelvic floor
muscles, and these muscles wraparound the vaginal opening and
then they attach at the base ofthe clitoris, which is this
(15:23):
little yellow part right here.
Speaker 1 (15:26):
There she is.
So for my listeners right nowshe is pointing to the clitoris,
where it's located.
So many of you may want to gosee that at TalkSucksWithAnette.
That's the button right there.
Speaker 2 (15:38):
Yeah, so this is the glands of the clitoris that we
can see.
Right, all this bean, if youwill, you can see there's
actually the internal part ofthe clitoris is underneath this
red.
So the pelvic floor muscles arecovering the internal part of
the clitoris and are very muchinvolved in what's going on with
(16:00):
the internal and externalportion of the clitoris, which
is where a lot of the nerveendings are.
Speaker 1 (16:06):
Right, so for listeners, this is interesting
because I actually have neverseen where the internal clitoris
on a model like that is.
It almost sort of it looks likea wishbone for sure that wraps
around sort of it looks likeit's setting up kind of inside
the inner thighs yeah Deeper.
(16:26):
Can you explain?
Speaker 2 (16:29):
Yeah, a little bit deeper.
Speaker 1 (16:30):
So pelvic bones are up here and your hips are here,
hip, all right Pointing to thehip Hip bones.
Speaker 2 (16:39):
Sit bone, sit bone, sit bone, sit bone, yeah, and so
then, if we're looking, this isthe anus Right, vaginal opening
, urethra, glands of theclitoris Right.
So this is really just all thevulva right here.
Speaker 1 (16:59):
Okay, all right, yeah , inner thigh would be kind of
up here, and where are the armsof the internal clitoris?
Can you point to them?
Mm-hmm, so there's, they'rethere.
Speaker 2 (17:09):
It kind of has legs, so it goes out like that.
But then there's also kind ofthe erectile tissue or spongy
tissue is through here.
Speaker 1 (17:20):
Right.
So that's why when, if you'rerubbing kind of on the outside
of the lips right, you canreally hit the pressure point of
the internal clitoris andcreate pleasure there.
Yeah, okay.
Yeah, this is super importantinformation, is just listening
(17:46):
and really wants to understandhow big the structure is and how
you can access it outside ofjust the clitoris and when I say
clitoris I mean the peekabooone, the beam that shows the
external clitoris.
This model is excellent forthat.
Speaker 2 (17:57):
Yeah, yeah, because we do have for people who aren't
able to access the video or see.
The internal clitoris isbasically like below the labia,
the skin of the labia, and thendown, kind of the pelvic bones,
going towards the sit bonesRight On either side of the
urethra and the vaginal opening,and that gives just such a
(18:31):
broad area for pleasure andsensation if you know where it
is and you can figure out how tostimulate it.
Correct, mm-hmm, exactly.
So the first step is justknowing and learning this
anatomy and understanding wherethings are, because most people
don't know there's an internalportion of the clitoris.
Most people don't know anythingabout these pelvic floor
muscles.
So just understanding that andrecognizing like, oh, if I can't
(18:51):
tolerate internal penetrationright now or I don't want to be
having penetrative sex, I canstill be experiencing pleasure,
because a lot of what I canaccess for pleasure is external,
outside of the vagina.
So I do find that to be reallyhelpful for people.
No-transcript and so kind ofexplaining that is usually
(19:17):
pretty empowering for people tounderstand.
So going over that andexplaining that to someone and
then saying like, hey, if you'rewanting a smaller version of
the, that's the vulva and theclitoris, the internal.
Speaker 1 (19:34):
There we go, just the internal portion, great.
Speaker 2 (19:44):
Perfect.
So you know I'm like if we'rethinking we want to try to
increase blood flow into thesemuscles, into the nerves that go
to the clitoris maybe someone'sexperiencing vaginal dryness,
go to the clitoris, maybesomeone's experiencing vaginal
dryness and we want to get moreblood flow into the vaginal
canal because that's what helpscreate the natural lubrication
(20:04):
that occurs.
Vibration is a great way to dothat, and so I tell people I'm
like that's why I want you totry to use one is to help really
stimulate blood flow into allthose areas, because it can
really help get these musclesmoving, it can get blood flow
into these structures and that'sgoing to help potentially with
(20:26):
a lot of the symptoms someonemight be describing.
Speaker 1 (20:30):
Right, and I know when I masturbate and I really
like last night not to tell youguys too much, but I do all the
time I was exhausted.
I went to bed at 1030 and I wasjust like I got in bed I
thought I was going to go tosleep but I was like I'm like I
should probably knock one out, Ishould give myself an orgasm.
It had been a couple of daysand then it was so good that it
(20:54):
lasted an hour.
I have extended sex with myself, but you will see like it's
really sometimes shocking, likethe vulva and the lips will get
like so full of blood when it'sgood.
I'm my own best lover, I'mtelling you guys, and sometimes
though, it's shocking just howswollen that area will get when
(21:14):
it fills up with blood and getsengorged.
Right, and it helps you have.
If I were just using my hand,well, first of all for an hour,
that would be a long time.
I don't think I've ever gottenmyself quite that engorged, but
like with a toy, and I use acombination of vibration and I'm
kind of an expert in the use ofnoise, but use the combination
(21:38):
of like the internal vibrationand external pleasure air tech.
the puppy blowies.
Yeah, you know, the engorgementwas is pretty shocking.
Sometimes I'm like oh my God.
Speaker 2 (21:51):
Well, yeah, and I think you're bringing up a good
point and I think people don'trealize this is the penis and
the clitoris are analogousstructures and so one of the
examples I always give to peoplewho are like kind of confused
why I'm talking about clitoralstimulation so much as I'm like.
Well, if you thought of someonewith a penis and we said, like
what if every time someone witha penis went to have sex or
(22:13):
stimulate themselves but theydidn't touch their penis, they
only touched maybe theirtesticles or their inner thigh
and expect them to orgasm, andmaybe some people could, but
probably not a lot.
And that's kind of what I say.
I'm like when you're tellingsomeone they should just be
having penetrative sex and justclimaxing from vaginal
(22:36):
penetration.
Yes, some people maybe can,because there is that internal
portion of the clitoris and fora lot of people, vaginal
penetration is very pleasurable,but if they're not getting
their clitoris stimulated, it'sthe same as not stimulating a
penis and the same engorgementhappens to both structures.
Speaker 1 (22:56):
You get this increase in blood flow no-transcript
(23:20):
that are with people who havevulvas, like, if you can start
to think in those terms, it'sgoing to make it easier to be a
better lover, right?
I mean, I always say I'mpansexual, bisexual.
I'm more confident in bed withwomen because I know what
they're experiencing, Eventhough we like different things,
(23:42):
I understand the setup, if youwill.
When I'm with a man or someonewith a penis, I'm like I hope
this feels good, but I don'thave a dick.
You know, I don't have aprostate.
So for me it's like guessworkand feedback and it does help if
I can try to match it up withmy own body, like it just makes
(24:03):
it easier for me to sort of feelwhat they might be feeling and
give them the pleasure I want togive.
So that's super useful.
So I understand that somepeople, when you ask them, may
say I don't masturbate.
Do you think that it's a goodpart of a regular health
(24:27):
practice to have a regularmasturbation practice and if so,
why would you recommendintegrating masturbation into
your health routine?
Mm-hmm.
Speaker 2 (24:39):
Yeah, no, I definitely think it should be a
part of someone's health routine.
For sure I always say, as apelvic floor specialist, people
always assume what I'm tellingpeople to do is Kegels, and I
probably prescribe or recommendmasturbation way more often than
I talk about Kegels, because itis so important and I loved
(24:59):
what you said that you feel likeyou are your best lover, and I
think that's what everyoneshould strive for, because how
can someone expect to tellanother person what they want
and what they found pleasurableand communicate those difficult
things?
It's hard to have theseconversations with someone else.
How can you expect to have thatdifficult conversation if you
(25:21):
don't know, if you haven't spenttime with yourself to learn
what feels good for you?
So that's the first reason isto really help people understand
what they enjoy and what theyfind pleasurable.
But also that we know there'sthese health benefits.
You know, know you get thisnice release of dopamine which
(25:41):
makes you feel good.
We know masturbation andorgasms can help improve blood
flow to these structures, whichis really important.
It can help with pain relief.
So for a lot of my patients I'mseeing are seeing me for pelvic
pain and so that can be a niceway to help, kind of give them
some pain relief.
It can help with sleep.
(26:02):
So we know there's a lot ofthese good benefits to solo sex
or masturbation, whatever youwant to call it, and I just
think it's really good forpeople to know and understand
their body and that's.
I think masturbation is just areally great way to do that.
Speaker 1 (26:20):
Do you feel that's accurate in my, because I preach
this all the time you need tohave orgasms regularly and a
sexual life with yourselfregularly to maintain these
basic pillars of health beingthe physical, the mental I would
say the spiritual, if you will,and also the sexual.
Speaker 2 (26:38):
Yeah for sure.
And the thing is too I wouldsay the spiritual, if you will,
and also the sexual, yeah forsure.
And the thing is too I alwayssay, like it may not even need
to be having an orgasm becausethey're just getting blood flow
into the pelvic floor muscles,into these nerves, into the
clitoris, into all thesestructures, into the vaginal
canal.
All of that is really importantfor overall health.
(26:59):
Yes, I agree, I definitely agreethat I think it's important for
all aspects of health and justmental health, and just like I
also think we, we deserve tohave pleasure as human beings.
I mean, and I think that's whysometimes people do like saying
sex toys or talk referring tothem as toys, is because I think
(27:20):
I don't know why we are so kindof like oh, we need to always
be productive, we need to beachieving, we need to be doing
things to like achieve someoutcome, but why can't we just
like have an enjoyable time?
That doesn't have to be makingmoney or achieving some goal or
(27:41):
hitting some benchmark.
So I think pleasure isimportant just because we have
that capacity, and I think it'sjust important for our quality
of life.
Speaker 1 (27:54):
I agree fully.
Yeah, can you talk aboutspecific conditions?
Now Can we shift to specificmedical conditions?
Someone might experience,regardless of gender, where a
vibrator or a sex toy could beand should be suggested to help
(28:16):
treat it.
I'd like to go over sort of thebreadth of conditions.
Speaker 2 (28:20):
Yeah, there's a lot, and I think probably the first
big one that I treat most oftenis either pain with sex, which
is medically known asdyspareunia but that's just like
a fancy word for pain with sexor pain with penetrative sex.
And then within that there'sanother condition known as
vaginismus, which is theinability or difficulty to have
(28:43):
anything inserted vaginally, sothat could be a penis, a dildo,
a finger, a tampon, a speculum,all of the above.
And with vaginismus and withdyspareunia, with these
conditions, it can be due to avariety of things and most often
it's due to pelvic floor muscledysfunction, where the muscles
(29:04):
have become tense, guarded, orwith vaginismus, they
involuntarily just spasm andprevent anything from entering.
So with all of those conditions, we're trying to work on
teaching someone to relax thosemuscles, get them to not be so
tense, not be so guarded.
And again, one of the thingsthat can really help with that
(29:25):
is increasing blood flow to thearea.
And when someone has an orgasm,pelvic floor muscles have to
relax to let blood flow in,contract to maintain the
clitoral erection and thenrepetitively contract, relax,
contract, relax.
So it can be a good way to getmuscle movement to happen to
(29:46):
allow for relaxation.
But the other reason I reallyenjoy or talk about masturbation
for pain with sex or vaginismusis so many people start to fear
sex because it's painful and solike rightfully so.
If something's painful oruncomfortable we won't want to
do it, we'll avoid it.
(30:07):
So masturbation using vibratorsis a great way to help someone
start to associate that part ofthe body and sex with feeling
good, versus it being painfuland again doing it alone.
Because when you have anotherperson there that you
technically maybe can't control,I mean you can communicate and
(30:29):
hopefully tell your partnerwhat's going on, but you're not
inside their head, whereas ifyou're by yourself having sex
with yourself, you're in controlof the whole thing.
So it allows someone to helptheir brain stop associating sex
with pain and have a morepositive experience.
(30:50):
So that's kind of the firstcondition that's most common
that I treat, as well as kind ofhow and why.
I would incorporatemasturbation and something like
a vibrator for that specificpatient population.
But if we're thinking about,let's say, someone with a penis
who has erectile dysfunction,they might be someone that I'm
(31:11):
talking about using, you know, avibrating ring because that can
be at the base of their penis.
It can help maintain theerection.
It helps provide constant kindof stimulation which can also
help maintain their erection.
So there's a lot of differentways we can kind of incorporate
it for all gender identities.
Speaker 1 (31:32):
Right.
So it's funny because when westarted this conversation, I was
just thinking about using toyssex toys with all of the issues
that vulva owners had, but ofcourse there's also.
There are a variety ofconditions.
People with penises can alsoexperience with penises can also
(31:59):
experience, and what you'resaying is similarly for them.
Speaker 2 (32:00):
these devices can help enhance their sexual health
and well-being, yes, and I seea lot of men who have sex with
men, who have pain withreceptive anal sex, and so for
them I'm talking to them a lotabout, you know getting some
sort of either vibrator that'sinserted rectally that they can
help sort of learn to relaxaround and that can be really
(32:23):
beneficial for them.
So there's yeah, there's a lotof different, I think, ways
these devices or toys can beused and again, I think we're so
, I guess, programmed to bethinking about sex toys or
vibrators as just a woman,female, specific thing, but
(32:45):
really there's so many differentpeople who can benefit from
them and people I work with thatI talk to about these different
types of devices.
Speaker 1 (32:56):
Right, I hadn't even thought about the anal sex issue
and somebody asking for help sothat they could have a
satisfying sex life with theirpartner.
So what you're saying is thereare things that you can actually
do with the use of toys to helpmake being, you know, the
receiver of anal sex like moreenjoyable.
(33:17):
Because we know like, once youget you know, once you can
receive, once you learn how tosort of let go and open up for
both gender or for all genders,it can be very enjoyable Like.
I know that some of the mostintense orgasms I've had is like
during anal sex with a partner,and then, of course, for people
(33:39):
who have penises, they have theprostate, so they can have like
my understanding is probablyeven more intense orgasms than I
would experience through analpenetration.
Speaker 2 (34:09):
But it's not necessarily an easy thing and
it's not something that I feellike I am probably a little bit
spoiled, being that I'm in SanFrancisco and we are a pretty,
you know, open, progressiveplace.
So I have a lot of patients whocome in who are like oh yeah, my
doctor told me I should getthis prostate stimulator or
(34:31):
suggested this.
So I always have to remindmyself that I'm like maybe if I
wasn't where I am geographically, I'd probably be having maybe
more difficult conversations ormight not be as accepted by
people.
But I do have patients whoseproviders urologists, primary
care doctor is talking to themabout it, which is always nice
(34:54):
to hear, or they know they'relike oh yeah, I already went and
bought this.
Or I have even male patientsthat are in heterosexual
relationships that ask me forprostate stimulators or where
they can get them or what myrecommendations are.
So you know, I think it doesdepend on where people are in in
(35:17):
the world.
But, yeah, definitely like the,a prostate simulator I think is
really helpful for people of aprostate because they can have a
really intense and powerfulorgasm that way I've also heard
that, uh, prostate stimulationis actually can improve the
health of the prostate is.
Speaker 1 (35:35):
Is that true?
Yeah, right, right.
I thought I had seen researcharound it, lowering the risk of
prostate cancer and all of thosekinds of things.
I didn't throw that because,again, I don't have the studies
in front of me.
So I want to be really careful.
Speaker 2 (35:50):
But I mean yeah, I mean any.
I guess I should say likemasturbation or ejaculation in
general is going to help achievethat Like.
So the data shows that regularmasturbation can be, or may be,
helpful in reducing the risk ofprostate cancer.
Obviously, there's so manyother factors that would impact
(36:11):
someone's risk, but yeah,because the prostate creates the
prostatic fluid that's involvedin semen, you're going to get
the prostate involved.
Whether you're doing prostatemassage or prostate stimulation
or just you know kind of penilestimulation, whatever gets
ejaculation to happen is goingto impact the prostate in some
(36:32):
way.
Speaker 1 (36:33):
So how prevalent do you think at this point the
recommendation of sex toys is inthe medical community?
Speaker 2 (36:42):
I don't have the specific numbers but my guess
would be low, just given.
Again, if we're thinking abouthow our health system works and
what reimbursement rates are andlike how we're very much
focused on like medication, um,and that's kind of where the
money is from, like thepharmaceutical companies, um.
(37:04):
So you know, I, I, and there isdefinitely a place for
medication, to be clear, but I,I don't think vibrators and sex
toys are being discussed orprescribed as much as they
should be, partly because ofthat.
But also there's a few otherissues in that most doctors
don't have a lot of time withtheir patients.
(37:25):
So, like I said, I always tryto have these conversations of
asking first getting theircomfort level before I even go
down that path.
Most doctors don't have thattime to be able to do that, so
they probably don't feelcomfortable just suddenly being
like oh, you should go get avibrator.
(37:46):
Okay, bye, I'll see you in sixmonths or I'll see you in a year
.
That can be kind of off-puttingfor someone.
You need to have more of aconversation.
So I think that's a big elementof it is just kind of the lack
of time.
But again, also there's stillthis taboo, I think, around what
sex toys are, why people mightuse them.
(38:06):
And then the other big reasonthat we do have a lot of
education on sex, and thestudies have shown that most
doctors hope that their patientsdon't ask them about sex
(38:27):
because they're like I don'tknow how to even talk about it,
I don't feel comfortable.
And so I think there is thislack of education and being
comfortable even having theseconversations with patients.
Speaker 1 (38:41):
Right.
Yeah, they don't know how tohave them, and also, I'd imagine
there's some risk aroundtalking about sex or prescribing
something that's sexual to apatient as well, depending on
where you are.
My question is this then forlisteners, if they are
(39:02):
struggling with, could you givea list of things where, if
you're struggling with this andyou're going to your doctor,
these are the conditions you canbring up to your doctor?
Hey, what kind of sex toy mighthelp me with this condition?
If your doctor isn't bringingthat up to you?
(39:22):
Here's where you can yourselfask them would this help me, or
what do you think about this?
Speaker 2 (39:31):
Yeah, so there's a lot of good resources out there.
The first would be theInternational Society for the
Study of Women's Sexual Health,or ISHWISH, and that would be a
good place to find a providerwho's specialized in women's
sexual health.
There's also the InternationalSexual Medicine Society, or ISSM
(39:54):
, and that again they have awhole provider list.
So if you're trying to findsomeone to talk to to get
recommendations and getinformation, that would be a
good place to go for all genders.
Um, the asect, which is theamerican sorry, I'm trying to
remember the acronyms here um,the american society for
sexuality educators, counselorsand therapists.
So they again have a acronymshere the American Society for
(40:15):
Sexuality Educators, counselorsand Therapists.
So they again have a providerlist.
They have a lot of resources.
Places even like PlannedParenthood I'm a huge fan of
because they, I think, have alot of good information.
Bed Cider is another one.
So there's a lot of differentassociations that I think are
(40:36):
doing a good job in providingresources and providers who are
experienced and know how to talkabout sex and sex toys and
vibrators.
Speaker 1 (40:47):
Right, and then what would be some of the conditions
that you would recommend apatient bringing up sex toys to
their provider?
Speaker 2 (40:58):
Gotcha, so yeah, so if someone's experiencing pain
with sex, whether it's withpenetration deeper, thrusting
all of the above afterwards,pain with orgasness, erectile
dysfunction, premature or rapidejaculation or the opposite,
(41:22):
delayed ejaculation, pain withreceptive anal sex, pain with
erections, any type of vulvar orvaginal pain, all of those
things would be reasons to talkto your doctor.
Speaker 1 (41:36):
Pain All of those things would be reasons to talk
to your doctor Right, and askthem about the possibility of a
sex toy being helpful with the,you know, with the alleviation
of the frustration.
I do agree with you.
(41:56):
Oftentimes it's the answer isto go straight to meds, when
actually slowing down and takingtime to work with your own body
and give it pleasure and teachit pleasure is a better
long-term solution, right.
Speaker 2 (42:17):
I think there can be a place for all of the above,
because the thing I always tellpatients is, when we're looking
at the pelvis and this area ofthe body, there's so many things
that live inside the pelvis, sowe have to be thinking about
multiple systems.
You know, you have the bladder,you have the uterus or the
prostate, you have the rectum,so those are right there, three
different systems that requireoften three different doctors,
(42:37):
because our medical system isvery siloed.
So you need to go see aurologist, a gynecologist and a
colorectal doctor right there,like, and then we have the
pelvic floor muscles, you haveall these nerves, you have the
blood vessels and then the brainis controlling all of it.
So typically when people cometo see me, which might involve
(42:58):
medication, might involveacupuncture, might involve
(43:19):
dietary changes and it candefinitely involve a vibrator.
So I think recognizing that itmight not just be one thing
that's going to help.
Speaker 1 (43:31):
Right and check it out, guys.
If you get a vibrator, it'spart of your health routine and
your play routine.
This is like you know.
This is going to feed everypart of your life.
Yeah, it's just not one.
It's not only enhancing yoursex life which will definitely
do that, but also your physical,mental, emotional health as
(43:53):
well.
And you now have heard it froma legit doc over here.
It's not just me.
It's not just me flinging toysat you for no reason, so thank
you so much for that.
So if you are experiencing anyof those conditions and
struggling to find the answer orget results, this is something
you can bring up to your doctor.
(44:15):
I also want to mention I amvery familiar with Good Vibes
and so I'm going to be runningthe website for them.
Below you can check them out,and I believe I also have a
discount code for their stores.
So if you want to go and checkout, we've got a doctor for
(44:36):
their stores.
So if you want to go and checkout, we've got a doctor, like
you know, here saying that theproducts they offer are high
quality and they are.
So feel free to check that outbelow and check out Good Vibes.
But can you tell my listenerswhere they can find you if they
want to know more about what youdo or reach out to you?
How can they get a hold of you?
(44:56):
You?
Speaker 2 (44:57):
if they want to know more about what you do or reach
out to you.
How can they get a hold of you?
Yeah, so the best way is to gothrough my website, which is
pelvicwellpt, or they can searchpelvic wellness and physical
therapy.
That's the name of my clinic.
My email address is right there.
They can also search RachelGellman, pelvic floor physical
therapist, if that's easier.
My main social media is throughInstagram.
(45:17):
I'm Pelvic Health SF and peoplecan reach out to me because I
also have many, many discountcodes to a variety of different
vibrators, sex toy options, andI do have a list of different
ones I recommend.
So I'm happy to provide that toanyone if they want to reach
out to me either on social mediaor through email.
Speaker 1 (45:42):
Perfect.
So I brought this topic on and,of course, our expert here
because I'm hoping that hearingmore people talk about the
benefits of pleasure, of sextoys, of being your own best
lover, is going to help give youpermission, because the way in
(46:03):
which most of us are brought upin this society is with shame
around any and all of it, andwe've been separated from our
own pleasure and all of thebenefits that come with it.
It's integral to our quality oflife, to our health, to our
longevity, and more and morepeople, even in the medical
(46:25):
community, are embracing thatand trying to spread the news.
So this episode is about givingyou permission.
If you have anxiousness aroundthe idea of a sex toy and feel
like it's a frivolous thing andsomething to hide, know that it
is not and that you havepermission to explore and
(46:46):
improve your life in all areas.
And now you've heard it fromthe expert, not just me.
So, rachel, thank you so muchfor joining me today.
I really appreciate you takingthe time to tell my listeners
about this.
So, of course, happy to be hereand to my listeners, I'll see
you in the locker room.
Cheers.
Speaker 2 (47:07):
Cheers.
Do the sex pleasure and desire Around here.
Nothing's off limits.
These are the kinds ofconversations we save for our
boldest group chats, our mosttrusted friends and, of course,
the women's locker room.
Think raw, honest and sometimesunapologetically raunchy.
If you've been here from thebeginning, thank you, and if
(00:40):
you're new, welcome to mypodcast.
Where desire meets disruptionand pleasure becomes power.
Now let's talk about sex Cheers.
Today's Talk Sex with Annette.
Topic is Prescribe the Vibe,why Sex Toys Belong in the
Doctor's Toolkits.
(01:02):
Today we are cracking open ataboo that should never have
been a taboo in the first place.
I want you to imagine thisYou're at your OBGYN's office,
they're going down the checklistpap smear, hormones, blood
pressure and then they say haveyou tried a vibrator?
Not for fun, though?
Yes, that too, but as part ofyour actual healthcare plan?
(01:24):
Sounds radical, but itshouldn't, because once upon a
time, vibrators were part ofmedicine, literally.
They were invented by doctors,used in clinics and prescribed
to treat what was called femalehysteria.
And while the diagnosis wasbullshit, the solution orgasm
was not.
So what happened?
(01:44):
This was bullshit, the solutionorgasm was not.
So what happened?
How did the vibrator go frombeing a medical device to
something wrapped in shame andshoved to the back of the sex
shop.
Today's guest is here to answerthat and so much more.
I'm joined by Rachel Gelman,pelvic floor physical therapist,
sexual health expert and fierceadvocate for bringing the
vibrator back into the clinicaltoolkit.
(02:05):
We're talking about painful sex, postpartum numbness, trauma
recovery and why vibratorsbelong in your first aid kit
just as much as they belong inyour nightstand.
But before we dive in, I wantto remind you I'm over on
OnlyFans where I am sharing mysex and intimacy, how-tos,
demonstrations and audio-guidedself-pleasure meditations and so
(02:26):
much more all designed to helpyou experience and start
enjoying more pleasure in yourown life and relationship.
Tonight you can find me thereunder my handle at
TalkSexWithAnette.
You can also find me over onSubstack where I'm doing a whole
lot of the same same handle atTalkSexWithAnette.
But if you want to find me, youcan scroll down to the notes
below and you're going to findlinks to all the places I am
(02:50):
where you can get a hold of meand find out more about what I'm
offering.
Now I would love for Rachel,could you take a moment to tell
my listeners just a little bitmore about who you are and why
you're here.
Speaker 2 (03:02):
Yes, Thank you so much for having me.
So I am Dr Rachel Gelman.
My doctorate is in physicaltherapy, but I specialize in
pelvic floor dysfunction,primarily in chronic pelvic pain
and sexual health concerns forall genders.
People are often surprised tohear that half of my patients
have a penis or identify as men,but I'm also an ASEC certified
(03:24):
sexuality counselor.
So I really have honed in andspecialized in sexual health
concerns.
And as a result of that, andbeing that I am in San Francisco
, where you know the tech at thecenter tends to be, I've become
more involved in companies inwhat's known as the sex tech
(03:44):
industry, so helping companiesthat are developing different
types of devices for people whohave sexual health concerns.
And then I also teach as anadjunct professor at Samuel
Merritt University, where Iteach the doctoral students all
about pelvic floor dysfunction.
Speaker 1 (04:04):
So this conversation is inclusive of all people and
ways in which sex tech I hatethe word toys, we'll get to that
in the conversation but thesedevices can be used to enhance
overall health for all humans.
So, whether you're a man,someone with a penis, a woman,
someone with a vulva or all ofthe other genders, right yeah,
(04:29):
this conversation is for you,and so stay to the end, because,
of course, we'll do ourtakeaways, so you will know by
the end, and you'll get yourtakeaways on how you can start
using devices sex toys if youwill to improve your life beyond
, just as part of your sex life,which you know, I am an
(04:50):
advocate for, but in other areasof your life.
So if you need an excuse to goget a sex toy, you're going to
have one by the end of thispodcast.
So I'm really excited aboutthis conversation because this
is something I've myself feltvery strongly about.
So thank you for joining me andguys, get ready to talk about
(05:12):
sex and sex toys in the doctor'soffice, which sounds a little
kinky, but we're talking aboutthe doctor's office, so cheers
her office, so cheers.
So where I want to start with inthis conversation is sort of
the origin story of the vibratoras it pertains to being used in
the medical industry, if youwill, or by doctors much earlier
(05:35):
in our history.
We do know that doctors usedorgasm for women's hysteria, to
calm the hysterical female.
There is some mythology therearound the vibrator being
created to help with that,because their hands got tired.
Now that has been arguedagainst and sometimes people
(05:59):
will say it's been debunked.
Other people will argue that ithasn't been debunked, but what
we do know is that vibratorswere used for different things,
correct, and by doctors earlierin history, and then there was a
shift that happened, and can wetalk about that a little bit?
Speaker 2 (06:17):
Yeah, for sure I'm not a historian, so I always
feel like I need to kind of saythat I'm sure there's people who
have really studied this andwould be better equipped to talk
more about the history ofvibrators and sex toys, because
we know they've been around fora long time, whether they're
used just for pleasure's sake orin medical offices.
But we do know that they werebrought in to help treat
(06:41):
different things like headaches,insomnia, this kind of, like
you said, bullshit, diagnosis ofhysteria, whatever that kind of
encompassed.
For women, there's this idea ofit being used to help with
period pain.
So it did get brought into thedoctor's office, but then it
kind of became more and moretaboo and kind of got pulled,
(07:02):
and now we're seeing sort of aresurgence in the research about
the benefits of these devicesto help people who are having
sexual dysfunction and pelvicpain.
Speaker 1 (07:14):
I know that I have talked to some doctors who want
to and know that vibrators andvarious again sex toys I hate
the word toy because it makes itsound and various again sex
toys.
I hate the word toy because itmakes it sound.
I don't know like it does youknow like it's just for you know
shits and giggles.
I don't know why I hate thatword.
But sex pleasure devices I'vegot to come up with something
(07:35):
cool.
Speaker 2 (07:36):
Yeah, it's interesting because I feel like
I talk to some people who arevery anti-toy but then I talk to
other people who are verypro-toy because they want it to
seem fun and they feel like ifyou say device, that sounds too
clinical.
So it is interesting how thereis a lot of there's kind of two
sides, I guess, to how peoplewant to talk about these.
(07:58):
I say devices, I sometimes saytoys, I kind of like switch it
up depending on my mood that day.
But yeah, it is interesting howthere's some people who really
hate the term toy or dislike theterm toy, and then there's some
people who really want to usedevice but don't like device.
So I think we'll continue totry to struggle with what the
(08:18):
best term will be.
Speaker 1 (08:20):
There's got to be something in between.
Or we just do two differentbrands.
There's got to be something inbetween.
Or we just do two differentbrands, the one the doctors feel
comfortable giving theirpatients, and it can be in a
neutral, boring color, and thenwe can do the sex toys and all
the fun colored hands.
But I know that there isknowledge, a basic knowledge for
many different medical doctors,whether physical therapists or
(08:43):
OBGYNs.
They know that vibrators anddifferent sex toys can be used
to help people who areexperiencing sexual dysfunction
or pain or many, many differentthings, but they can't prescribe
them.
Isn't that correct at thispoint?
Speaker 2 (09:03):
Well, I guess it depends on what you mean by
prescribe.
Like we can recommend and thereare some devices out there now
that you can use like your FSAor HSA for.
But if we're talking about like, is it going to be covered by
an insurance company as amedical device?
You know, I don't think that'swhere we're at yet, but then
(09:27):
that gets us into a whole notherconversation about like the
insurance companies andhealthcare in our country and
just why that's a huge, a hugeproblem.
But yeah, they can definitelybe recommended, suggested and
you know, for some people thatwould fall under the umbrella of
prescribe.
So I think it just kind ofdepends on what you mean by that
(09:48):
.
But there are a lot ofproviders out there who work in
sexual medicine or pelvic healththat are recommending these
devices.
Like I can say for myself, Irecommend them every day.
Speaker 1 (10:01):
Well, that's great.
Let's talk about that.
Speaker 2 (10:15):
Well, that's great, let's talk about that.
Can you tell my listeners whatdevices you prescribe for
different conditions?
Maybe do you have a favoritedevice.
This is why I really enjoyworking in sexual health,
because what I like might bevery different from what you
like and what you know one of mypatients likes, and also it
might change in three or fouryears.
What that person likes mayshift and evolve, and so there's
(10:37):
so much variety and room toexplore.
And I think that's something Ireally encourage my patients and
people to understand is thereis no, you know, linear path or
one you know kind of like.
This is what you should bedoing this week and then by next
week you should be using thisvibrator.
It's like you can explore anddiscover what works well for you
(10:58):
and what you enjoy, instead offeeling like we all have to fit
into this one little sexual boxof like we're all just going to
use the rabbit and I feel likefor a long time that's what all
the magazines and shows weretalking about and I think
everyone felt like they had toenjoy and use that one device.
So that was a very long windedway of saying yes, I do have
(11:20):
some favorites and things that Ikind of encourage people to
maybe look at, especially ifthey're just starting out and
have never gotten a vibrator.
For people who have a vulva Ialways talk to them about most
of them require some sort ofclitoral stimulation to feel
pleasure and to experience anorgasm.
(11:41):
So trying to find somethingthat really focuses on clitoral
stimulation and usually I talkabout something that I call the
mini vibe.
It typically is referred to asa bullet vibe.
I really try to stay away fromthat language, but a mini vibe
is usually like.
It looks almost like a lipsticktube, so it's small, I feel
(12:02):
like.
It seems very like notintimidating.
You can use it externally.
It's pretty discreet.
So that's kind of usually whereI encourage people to start.
There are other devices outthere that are called clitoral
stimulators or clitoral suction,even though most of them don't
actually have an actual suctionto them, but they typically look
(12:25):
like a little suction cup, soit's very kind of focused on
clitoral stimulation.
So those are kind of the placesI usually start.
But I also really encouragepeople to go to websites.
Or I'm in San Francisco.
We have a shop here called GoodVibrations, which is this very
beautiful boutique typeenvironment where people can go
(12:47):
and look at all of these devicesand see what they feel like,
see how strong the vibration isand really be able to find
something that works best forthem.
So it usually is all aboutexploration and discovery, but,
like I said, the kind of minivibe or a clitoral stimulator is
often where I start, withpeople.
Speaker 1 (13:10):
My question that I should have asked before this
should have been are yourecommending essentially using a
vibrator or sexual stimulationfor people as part of their
health routine?
Can you talk about that?
Speaker 2 (13:29):
Yeah, for sure.
And I think the first thing Ialways ask people.
First I always ask like, dothey masturbate?
And then I usually then ask ifthey have a vibrator, if they've
ever used one, and depending onthe answer, I ask are they
comfortable maybe exploring thator trying one of those devices
or getting a toy?
(13:49):
Because if someone says rightoff the bat, like no, I don't
feel like I'm going to betelling them like oh well, you
should, you have to, like weneed to have other conversations
about ways that might behelpful to maybe get them to
that point or what kind of thebarriers are there.
But for the most part mostpeople say yes to the first,
(14:11):
saying that they do masturbate,and then it's probably like half
and half of people saying likethey have a vibrator or they
don't.
But most people are open toexploring, using some sort of
device to help whatever's goingon.
And especially when I explainto them why and I think that's
kind of a good kind of segue fora moment is to explain why I
(14:34):
recommend these things.
So if we look I'm going to pullmy model out here, just because
I feel like it's a little bithelpful If we look at this model
and this is the model.
So for my list.
Speaker 1 (14:45):
I'm going to interrupt you for a second.
For my listeners, you're goingto need to go over to the
YouTube channel to see the model, and we will do our best to
describe what the model is.
It's a pelvis.
We're looking at the model of apelvis?
Speaker 2 (15:02):
Yes, and this is a vulva, the pelvic floor of
someone with a vulva, and sothere's the bones are in white,
and then there's all this redwhich is the pelvic floor
muscles, and these muscles wraparound the vaginal opening and
then they attach at the base ofthe clitoris, which is this
(15:23):
little yellow part right here.
Speaker 1 (15:26):
There she is.
So for my listeners right nowshe is pointing to the clitoris,
where it's located.
So many of you may want to gosee that at TalkSucksWithAnette.
That's the button right there.
Speaker 2 (15:38):
Yeah, so this is the glands of the clitoris that we
can see.
Right, all this bean, if youwill, you can see there's
actually the internal part ofthe clitoris is underneath this
red.
So the pelvic floor muscles arecovering the internal part of
the clitoris and are very muchinvolved in what's going on with
(16:00):
the internal and externalportion of the clitoris, which
is where a lot of the nerveendings are.
Speaker 1 (16:06):
Right, so for listeners, this is interesting
because I actually have neverseen where the internal clitoris
on a model like that is.
It almost sort of it looks likea wishbone for sure that wraps
around sort of it looks likeit's setting up kind of inside
the inner thighs yeah Deeper.
(16:26):
Can you explain?
Speaker 2 (16:29):
Yeah, a little bit deeper.
Speaker 1 (16:30):
So pelvic bones are up here and your hips are here,
hip, all right Pointing to thehip Hip bones.
Speaker 2 (16:39):
Sit bone, sit bone, sit bone, sit bone, yeah, and so
then, if we're looking, this isthe anus Right, vaginal opening
, urethra, glands of theclitoris Right.
So this is really just all thevulva right here.
Speaker 1 (16:59):
Okay, all right, yeah , inner thigh would be kind of
up here, and where are the armsof the internal clitoris?
Can you point to them?
Mm-hmm, so there's, they'rethere.
Speaker 2 (17:09):
It kind of has legs, so it goes out like that.
But then there's also kind ofthe erectile tissue or spongy
tissue is through here.
Speaker 1 (17:20):
Right.
So that's why when, if you'rerubbing kind of on the outside
of the lips right, you canreally hit the pressure point of
the internal clitoris andcreate pleasure there.
Yeah, okay.
Yeah, this is super importantinformation, is just listening
(17:46):
and really wants to understandhow big the structure is and how
you can access it outside ofjust the clitoris and when I say
clitoris I mean the peekabooone, the beam that shows the
external clitoris.
This model is excellent forthat.
Speaker 2 (17:57):
Yeah, yeah, because we do have for people who aren't
able to access the video or see.
The internal clitoris isbasically like below the labia,
the skin of the labia, and thendown, kind of the pelvic bones,
going towards the sit bonesRight On either side of the
urethra and the vaginal opening,and that gives just such a
(18:31):
broad area for pleasure andsensation if you know where it
is and you can figure out how tostimulate it.
Correct, mm-hmm, exactly.
So the first step is justknowing and learning this
anatomy and understanding wherethings are, because most people
don't know there's an internalportion of the clitoris.
Most people don't know anythingabout these pelvic floor
muscles.
So just understanding that andrecognizing like, oh, if I can't
(18:51):
tolerate internal penetrationright now or I don't want to be
having penetrative sex, I canstill be experiencing pleasure,
because a lot of what I canaccess for pleasure is external,
outside of the vagina.
So I do find that to be reallyhelpful for people.
No-transcript and so kind ofexplaining that is usually
(19:17):
pretty empowering for people tounderstand.
So going over that andexplaining that to someone and
then saying like, hey, if you'rewanting a smaller version of
the, that's the vulva and theclitoris, the internal.
Speaker 1 (19:34):
There we go, just the internal portion, great.
Speaker 2 (19:44):
Perfect.
So you know I'm like if we'rethinking we want to try to
increase blood flow into thesemuscles, into the nerves that go
to the clitoris maybe someone'sexperiencing vaginal dryness,
go to the clitoris, maybesomeone's experiencing vaginal
dryness and we want to get moreblood flow into the vaginal
canal because that's what helpscreate the natural lubrication
(20:04):
that occurs.
Vibration is a great way to dothat, and so I tell people I'm
like that's why I want you totry to use one is to help really
stimulate blood flow into allthose areas, because it can
really help get these musclesmoving, it can get blood flow
into these structures and that'sgoing to help potentially with
(20:26):
a lot of the symptoms someonemight be describing.
Speaker 1 (20:30):
Right, and I know when I masturbate and I really
like last night not to tell youguys too much, but I do all the
time I was exhausted.
I went to bed at 1030 and I wasjust like I got in bed I
thought I was going to go tosleep but I was like I'm like I
should probably knock one out, Ishould give myself an orgasm.
It had been a couple of daysand then it was so good that it
(20:54):
lasted an hour.
I have extended sex with myself, but you will see like it's
really sometimes shocking, likethe vulva and the lips will get
like so full of blood when it'sgood.
I'm my own best lover, I'mtelling you guys, and sometimes
though, it's shocking just howswollen that area will get when
(21:14):
it fills up with blood and getsengorged.
Right, and it helps you have.
If I were just using my hand,well, first of all for an hour,
that would be a long time.
I don't think I've ever gottenmyself quite that engorged, but
like with a toy, and I use acombination of vibration and I'm
kind of an expert in the use ofnoise, but use the combination
(21:38):
of like the internal vibrationand external pleasure air tech.
the puppy blowies.
Yeah, you know, the engorgementwas is pretty shocking.
Sometimes I'm like oh my God.
Speaker 2 (21:51):
Well, yeah, and I think you're bringing up a good
point and I think people don'trealize this is the penis and
the clitoris are analogousstructures and so one of the
examples I always give to peoplewho are like kind of confused
why I'm talking about clitoralstimulation so much as I'm like.
Well, if you thought of someonewith a penis and we said, like
what if every time someone witha penis went to have sex or
(22:13):
stimulate themselves but theydidn't touch their penis, they
only touched maybe theirtesticles or their inner thigh
and expect them to orgasm, andmaybe some people could, but
probably not a lot.
And that's kind of what I say.
I'm like when you're tellingsomeone they should just be
having penetrative sex and justclimaxing from vaginal
(22:36):
penetration.
Yes, some people maybe can,because there is that internal
portion of the clitoris and fora lot of people, vaginal
penetration is very pleasurable,but if they're not getting
their clitoris stimulated, it'sthe same as not stimulating a
penis and the same engorgementhappens to both structures.
Speaker 1 (22:56):
You get this increase in blood flow no-transcript
(23:20):
that are with people who havevulvas, like, if you can start
to think in those terms, it'sgoing to make it easier to be a
better lover, right?
I mean, I always say I'mpansexual, bisexual.
I'm more confident in bed withwomen because I know what
they're experiencing, Eventhough we like different things,
(23:42):
I understand the setup, if youwill.
When I'm with a man or someonewith a penis, I'm like I hope
this feels good, but I don'thave a dick.
You know, I don't have aprostate.
So for me it's like guessworkand feedback and it does help if
I can try to match it up withmy own body, like it just makes
(24:03):
it easier for me to sort of feelwhat they might be feeling and
give them the pleasure I want togive.
So that's super useful.
So I understand that somepeople, when you ask them, may
say I don't masturbate.
Do you think that it's a goodpart of a regular health
(24:27):
practice to have a regularmasturbation practice and if so,
why would you recommendintegrating masturbation into
your health routine?
Mm-hmm.
Speaker 2 (24:39):
Yeah, no, I definitely think it should be a
part of someone's health routine.
For sure I always say, as apelvic floor specialist, people
always assume what I'm tellingpeople to do is Kegels, and I
probably prescribe or recommendmasturbation way more often than
I talk about Kegels, because itis so important and I loved
(24:59):
what you said that you feel likeyou are your best lover, and I
think that's what everyoneshould strive for, because how
can someone expect to tellanother person what they want
and what they found pleasurableand communicate those difficult
things?
It's hard to have theseconversations with someone else.
How can you expect to have thatdifficult conversation if you
(25:21):
don't know, if you haven't spenttime with yourself to learn
what feels good for you?
So that's the first reason isto really help people understand
what they enjoy and what theyfind pleasurable.
But also that we know there'sthese health benefits.
You know, know you get thisnice release of dopamine which
(25:41):
makes you feel good.
We know masturbation andorgasms can help improve blood
flow to these structures, whichis really important.
It can help with pain relief.
So for a lot of my patients I'mseeing are seeing me for pelvic
pain and so that can be a niceway to help, kind of give them
some pain relief.
It can help with sleep.
(26:02):
So we know there's a lot ofthese good benefits to solo sex
or masturbation, whatever youwant to call it, and I just
think it's really good forpeople to know and understand
their body and that's.
I think masturbation is just areally great way to do that.
Speaker 1 (26:20):
Do you feel that's accurate in my, because I preach
this all the time you need tohave orgasms regularly and a
sexual life with yourselfregularly to maintain these
basic pillars of health beingthe physical, the mental I would
say the spiritual, if you will,and also the sexual.
Speaker 2 (26:38):
Yeah for sure.
And the thing is too I wouldsay the spiritual, if you will,
and also the sexual, yeah forsure.
And the thing is too I alwayssay, like it may not even need
to be having an orgasm becausethey're just getting blood flow
into the pelvic floor muscles,into these nerves, into the
clitoris, into all thesestructures, into the vaginal
canal.
All of that is really importantfor overall health.
(26:59):
Yes, I agree, I definitely agreethat I think it's important for
all aspects of health and justmental health, and just like I
also think we, we deserve tohave pleasure as human beings.
I mean, and I think that's whysometimes people do like saying
sex toys or talk referring tothem as toys, is because I think
(27:20):
I don't know why we are so kindof like oh, we need to always
be productive, we need to beachieving, we need to be doing
things to like achieve someoutcome, but why can't we just
like have an enjoyable time?
That doesn't have to be makingmoney or achieving some goal or
(27:41):
hitting some benchmark.
So I think pleasure isimportant just because we have
that capacity, and I think it'sjust important for our quality
of life.
Speaker 1 (27:54):
I agree fully.
Yeah, can you talk aboutspecific conditions?
Now Can we shift to specificmedical conditions?
Someone might experience,regardless of gender, where a
vibrator or a sex toy could beand should be suggested to help
(28:16):
treat it.
I'd like to go over sort of thebreadth of conditions.
Speaker 2 (28:20):
Yeah, there's a lot, and I think probably the first
big one that I treat most oftenis either pain with sex, which
is medically known asdyspareunia but that's just like
a fancy word for pain with sexor pain with penetrative sex.
And then within that there'sanother condition known as
vaginismus, which is theinability or difficulty to have
(28:43):
anything inserted vaginally, sothat could be a penis, a dildo,
a finger, a tampon, a speculum,all of the above.
And with vaginismus and withdyspareunia, with these
conditions, it can be due to avariety of things and most often
it's due to pelvic floor muscledysfunction, where the muscles
(29:04):
have become tense, guarded, orwith vaginismus, they
involuntarily just spasm andprevent anything from entering.
So with all of those conditions, we're trying to work on
teaching someone to relax thosemuscles, get them to not be so
tense, not be so guarded.
And again, one of the thingsthat can really help with that
(29:25):
is increasing blood flow to thearea.
And when someone has an orgasm,pelvic floor muscles have to
relax to let blood flow in,contract to maintain the
clitoral erection and thenrepetitively contract, relax,
contract, relax.
So it can be a good way to getmuscle movement to happen to
(29:46):
allow for relaxation.
But the other reason I reallyenjoy or talk about masturbation
for pain with sex or vaginismusis so many people start to fear
sex because it's painful and solike rightfully so.
If something's painful oruncomfortable we won't want to
do it, we'll avoid it.
(30:07):
So masturbation using vibratorsis a great way to help someone
start to associate that part ofthe body and sex with feeling
good, versus it being painfuland again doing it alone.
Because when you have anotherperson there that you
technically maybe can't control,I mean you can communicate and
(30:29):
hopefully tell your partnerwhat's going on, but you're not
inside their head, whereas ifyou're by yourself having sex
with yourself, you're in controlof the whole thing.
So it allows someone to helptheir brain stop associating sex
with pain and have a morepositive experience.
(30:50):
So that's kind of the firstcondition that's most common
that I treat, as well as kind ofhow and why.
I would incorporatemasturbation and something like
a vibrator for that specificpatient population.
But if we're thinking about,let's say, someone with a penis
who has erectile dysfunction,they might be someone that I'm
(31:11):
talking about using, you know, avibrating ring because that can
be at the base of their penis.
It can help maintain theerection.
It helps provide constant kindof stimulation which can also
help maintain their erection.
So there's a lot of differentways we can kind of incorporate
it for all gender identities.
Speaker 1 (31:32):
Right.
So it's funny because when westarted this conversation, I was
just thinking about using toyssex toys with all of the issues
that vulva owners had, but ofcourse there's also.
There are a variety ofconditions.
People with penises can alsoexperience with penises can also
(31:59):
experience, and what you'resaying is similarly for them.
Speaker 2 (32:00):
these devices can help enhance their sexual health
and well-being, yes, and I seea lot of men who have sex with
men, who have pain withreceptive anal sex, and so for
them I'm talking to them a lotabout, you know getting some
sort of either vibrator that'sinserted rectally that they can
help sort of learn to relaxaround and that can be really
(32:23):
beneficial for them.
So there's yeah, there's a lotof different, I think, ways
these devices or toys can beused and again, I think we're so
, I guess, programmed to bethinking about sex toys or
vibrators as just a woman,female, specific thing, but
(32:45):
really there's so many differentpeople who can benefit from
them and people I work with thatI talk to about these different
types of devices.
Speaker 1 (32:56):
Right, I hadn't even thought about the anal sex issue
and somebody asking for help sothat they could have a
satisfying sex life with theirpartner.
So what you're saying is thereare things that you can actually
do with the use of toys to helpmake being, you know, the
receiver of anal sex like moreenjoyable.
(33:17):
Because we know like, once youget you know, once you can
receive, once you learn how tosort of let go and open up for
both gender or for all genders,it can be very enjoyable Like.
I know that some of the mostintense orgasms I've had is like
during anal sex with a partner,and then, of course, for people
(33:39):
who have penises, they have theprostate, so they can have like
my understanding is probablyeven more intense orgasms than I
would experience through analpenetration.
Speaker 2 (34:09):
But it's not necessarily an easy thing and
it's not something that I feellike I am probably a little bit
spoiled, being that I'm in SanFrancisco and we are a pretty,
you know, open, progressiveplace.
So I have a lot of patients whocome in who are like oh yeah, my
doctor told me I should getthis prostate stimulator or
(34:31):
suggested this.
So I always have to remindmyself that I'm like maybe if I
wasn't where I am geographically, I'd probably be having maybe
more difficult conversations ormight not be as accepted by
people.
But I do have patients whoseproviders urologists, primary
care doctor is talking to themabout it, which is always nice
(34:54):
to hear, or they know they'relike oh yeah, I already went and
bought this.
Or I have even male patientsthat are in heterosexual
relationships that ask me forprostate stimulators or where
they can get them or what myrecommendations are.
So you know, I think it doesdepend on where people are in in
(35:17):
the world.
But, yeah, definitely like the,a prostate simulator I think is
really helpful for people of aprostate because they can have a
really intense and powerfulorgasm that way I've also heard
that, uh, prostate stimulationis actually can improve the
health of the prostate is.
Speaker 1 (35:35):
Is that true?
Yeah, right, right.
I thought I had seen researcharound it, lowering the risk of
prostate cancer and all of thosekinds of things.
I didn't throw that because,again, I don't have the studies
in front of me.
So I want to be really careful.
Speaker 2 (35:50):
But I mean yeah, I mean any.
I guess I should say likemasturbation or ejaculation in
general is going to help achievethat Like.
So the data shows that regularmasturbation can be, or may be,
helpful in reducing the risk ofprostate cancer.
Obviously, there's so manyother factors that would impact
(36:11):
someone's risk, but yeah,because the prostate creates the
prostatic fluid that's involvedin semen, you're going to get
the prostate involved.
Whether you're doing prostatemassage or prostate stimulation
or just you know kind of penilestimulation, whatever gets
ejaculation to happen is goingto impact the prostate in some
(36:32):
way.
Speaker 1 (36:33):
So how prevalent do you think at this point the
recommendation of sex toys is inthe medical community?
Speaker 2 (36:42):
I don't have the specific numbers but my guess
would be low, just given.
Again, if we're thinking abouthow our health system works and
what reimbursement rates are andlike how we're very much
focused on like medication, um,and that's kind of where the
money is from, like thepharmaceutical companies, um.
(37:04):
So you know, I, I, and there isdefinitely a place for
medication, to be clear, but I,I don't think vibrators and sex
toys are being discussed orprescribed as much as they
should be, partly because ofthat.
But also there's a few otherissues in that most doctors
don't have a lot of time withtheir patients.
(37:25):
So, like I said, I always tryto have these conversations of
asking first getting theircomfort level before I even go
down that path.
Most doctors don't have thattime to be able to do that, so
they probably don't feelcomfortable just suddenly being
like oh, you should go get avibrator.
(37:46):
Okay, bye, I'll see you in sixmonths or I'll see you in a year
.
That can be kind of off-puttingfor someone.
You need to have more of aconversation.
So I think that's a big elementof it is just kind of the lack
of time.
But again, also there's stillthis taboo, I think, around what
sex toys are, why people mightuse them.
(38:06):
And then the other big reasonthat we do have a lot of
education on sex, and thestudies have shown that most
doctors hope that their patientsdon't ask them about sex
(38:27):
because they're like I don'tknow how to even talk about it,
I don't feel comfortable.
And so I think there is thislack of education and being
comfortable even having theseconversations with patients.
Speaker 1 (38:41):
Right.
Yeah, they don't know how tohave them, and also, I'd imagine
there's some risk aroundtalking about sex or prescribing
something that's sexual to apatient as well, depending on
where you are.
My question is this then forlisteners, if they are
(39:02):
struggling with, could you givea list of things where, if
you're struggling with this andyou're going to your doctor,
these are the conditions you canbring up to your doctor?
Hey, what kind of sex toy mighthelp me with this condition?
If your doctor isn't bringingthat up to you?
(39:22):
Here's where you can yourselfask them would this help me, or
what do you think about this?
Speaker 2 (39:31):
Yeah, so there's a lot of good resources out there.
The first would be theInternational Society for the
Study of Women's Sexual Health,or ISHWISH, and that would be a
good place to find a providerwho's specialized in women's
sexual health.
There's also the InternationalSexual Medicine Society, or ISSM
(39:54):
, and that again they have awhole provider list.
So if you're trying to findsomeone to talk to to get
recommendations and getinformation, that would be a
good place to go for all genders.
Um, the asect, which is theamerican sorry, I'm trying to
remember the acronyms here um,the american society for
sexuality educators, counselorsand therapists.
So they again have a acronymshere the American Society for
(40:15):
Sexuality Educators, counselorsand Therapists.
So they again have a providerlist.
They have a lot of resources.
Places even like PlannedParenthood I'm a huge fan of
because they, I think, have alot of good information.
Bed Cider is another one.
So there's a lot of differentassociations that I think are
(40:36):
doing a good job in providingresources and providers who are
experienced and know how to talkabout sex and sex toys and
vibrators.
Speaker 1 (40:47):
Right, and then what would be some of the conditions
that you would recommend apatient bringing up sex toys to
their provider?
Speaker 2 (40:58):
Gotcha, so yeah, so if someone's experiencing pain
with sex, whether it's withpenetration deeper, thrusting
all of the above afterwards,pain with orgasness, erectile
dysfunction, premature or rapidejaculation or the opposite,
(41:22):
delayed ejaculation, pain withreceptive anal sex, pain with
erections, any type of vulvar orvaginal pain, all of those
things would be reasons to talkto your doctor.
Speaker 1 (41:36):
Pain All of those things would be reasons to talk
to your doctor Right, and askthem about the possibility of a
sex toy being helpful with the,you know, with the alleviation
of the frustration.
I do agree with you.
(41:56):
Oftentimes it's the answer isto go straight to meds, when
actually slowing down and takingtime to work with your own body
and give it pleasure and teachit pleasure is a better
long-term solution, right.
Speaker 2 (42:17):
I think there can be a place for all of the above,
because the thing I always tellpatients is, when we're looking
at the pelvis and this area ofthe body, there's so many things
that live inside the pelvis, sowe have to be thinking about
multiple systems.
You know, you have the bladder,you have the uterus or the
prostate, you have the rectum,so those are right there, three
different systems that requireoften three different doctors,
(42:37):
because our medical system isvery siloed.
So you need to go see aurologist, a gynecologist and a
colorectal doctor right there,like, and then we have the
pelvic floor muscles, you haveall these nerves, you have the
blood vessels and then the brainis controlling all of it.
So typically when people cometo see me, which might involve
(42:58):
medication, might involveacupuncture, might involve
(43:19):
dietary changes and it candefinitely involve a vibrator.
So I think recognizing that itmight not just be one thing
that's going to help.
Speaker 1 (43:31):
Right and check it out, guys.
If you get a vibrator, it'spart of your health routine and
your play routine.
This is like you know.
This is going to feed everypart of your life.
Yeah, it's just not one.
It's not only enhancing yoursex life which will definitely
do that, but also your physical,mental, emotional health as
(43:53):
well.
And you now have heard it froma legit doc over here.
It's not just me.
It's not just me flinging toysat you for no reason, so thank
you so much for that.
So if you are experiencing anyof those conditions and
struggling to find the answer orget results, this is something
you can bring up to your doctor.
(44:15):
I also want to mention I amvery familiar with Good Vibes
and so I'm going to be runningthe website for them.
Below you can check them out,and I believe I also have a
discount code for their stores.
So if you want to go and checkout, we've got a doctor for
(44:36):
their stores.
So if you want to go and checkout, we've got a doctor, like
you know, here saying that theproducts they offer are high
quality and they are.
So feel free to check that outbelow and check out Good Vibes.
But can you tell my listenerswhere they can find you if they
want to know more about what youdo or reach out to you?
How can they get a hold of you?
(44:56):
You?
Speaker 2 (44:57):
if they want to know more about what you do or reach
out to you.
How can they get a hold of you?
Yeah, so the best way is to gothrough my website, which is
pelvicwellpt, or they can searchpelvic wellness and physical
therapy.
That's the name of my clinic.
My email address is right there.
They can also search RachelGellman, pelvic floor physical
therapist, if that's easier.
My main social media is throughInstagram.
(45:17):
I'm Pelvic Health SF and peoplecan reach out to me because I
also have many, many discountcodes to a variety of different
vibrators, sex toy options, andI do have a list of different
ones I recommend.
So I'm happy to provide that toanyone if they want to reach
out to me either on social mediaor through email.
Speaker 1 (45:42):
Perfect.
So I brought this topic on and,of course, our expert here
because I'm hoping that hearingmore people talk about the
benefits of pleasure, of sextoys, of being your own best
lover, is going to help give youpermission, because the way in
(46:03):
which most of us are brought upin this society is with shame
around any and all of it, andwe've been separated from our
own pleasure and all of thebenefits that come with it.
It's integral to our quality oflife, to our health, to our
longevity, and more and morepeople, even in the medical
(46:25):
community, are embracing thatand trying to spread the news.
So this episode is about givingyou permission.
If you have anxiousness aroundthe idea of a sex toy and feel
like it's a frivolous thing andsomething to hide, know that it
is not and that you havepermission to explore and
(46:46):
improve your life in all areas.
And now you've heard it fromthe expert, not just me.
So, rachel, thank you so muchfor joining me today.
I really appreciate you takingthe time to tell my listeners
about this.
So, of course, happy to be hereand to my listeners, I'll see
you in the locker room.
Cheers.
Speaker 2 (47:07):
Cheers.
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