373. Sexual Health: Cervix, Vulva, and Vulvodynia Research

You Are Not Broken

Kelly Casperson, MD

Health & Fitness, Medicine

4.8 • 1.1K Ratings

🗓️ 31 May 2026

⏱️ 55 minutes

🔗️ Recording | iTunes | RSS

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Summary

From the cervix to the vulva, so much of female anatomy has been understudied, misunderstood, and underserved — until now. In this episode, Dr. Kelly Casperson sits down with Dr. Andrew Goldstein, one of the world's foremost experts in vulvovaginal and cervical health, for a deep dive into the cutting edge of women's sexual medicine. We're talking new research, new treatments, and a whole lot of "why didn't anyone tell us this sooner?" energy. If you or someone you love has ever dealt with vulvar pain, lichen sclerosis, arousal difficulties, or just wants to understand their anatomy better — this one is unmissable. About Dr. Andrew Goldstein Dr. Andrew Goldstein is a board-certified OB/GYN and one of the world's leading specialists in vulvovaginal disorders, cervical health, and female sexual medicine. He is the founder of the Centers for Vulvovaginal Disorders, co-author of Reclaiming Desire, and a tireless advocate for research funding and clinical advancement in women's health. He has dedicated his career to conditions that medicine has long dismissed — and he is actively changing that. 🌐 vulvodynia.com When Sex Hurts Book In This Episode, We Cover: The significance of cervical innervation and its role in sexual pleasure — and why this is barely taught in medical school How common cervical excision procedures (like LEEP/LLETZ) can impact sexual function and urinary health Global efforts in cervical cancer prevention in resource-poor countries Surgical techniques designed to preserve nerves during cervical treatments The incredible impact of HPV vaccination on reducing cervical cancer rates worldwide A clear breakdown of vulvar anatomy and the misconceptions even providers carry Vulvodynia — causes, diagnosis, and the most exciting recent research breakthroughs Highlights from the Vulvodynia Research Summit: the top-ranked treatments from both expert and patient votes The surprising role of mast cells and allergic responses in vulvodynia Emerging therapies: topical ketotifen, localized nerve targeting, and novel chemical injections for pain relief How pelvic floor muscles contribute to vulvodynia — and what new research is showing Upcoming clinical trials on botulinum toxin for pelvic pain Lichen sclerosis — the autoimmune skin condition linked to cancer risk that far too many providers miss The game-changing potential of JAK-STAT pathway inhibitors for lichen sclerosis treatment Strata barrier cream and other topical therapies in the pipeline The road to FDA approvals and insurance coverage for these emerging treatments Topical sildenafil for female arousal disorders — the science, the promise, and how it works The drug delivery science behind why how a cream is formulated matters as much as what's in it Why advocacy and funding in women's health are inseparable from clinical progress — and what you can do Dare to Play Clinical Trials Registry Gynecologic Cancer Research Foundation National Vulvodynia Association Tightlipped Organization Dr. Andrew Goldstein: Website Listen to my Tedx Talk: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Why we need adult sex ed⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Take my ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Adult Sex Ed Master Class:⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠My Website⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Interested in my sexual health and hormone clinic? ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Waitlist is open⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ To learn more about Via vaginal moisturizer from Solv Wellness, visit ⁠⁠⁠⁠⁠⁠via4her.com⁠⁠⁠⁠⁠⁠ and get 20% off your first order. For an additional $5 off, use coupon code DRKELLY5. Clinicians can request patient materials or samples at ⁠⁠⁠⁠⁠⁠hcp.solvwellness.com⁠⁠⁠⁠⁠⁠. Thanks to our sponsor ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Midi Women's Health⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠. Designed by midlife experts, delivered by experienced clinicians, covered by insurance.Midi is the first virtual care clinic made exclusively for women 40+. Evidence-based treatments. Personalized midlife care.⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.joinmidi.com⁠ Learn more about your ad choices. Visit podcastchoices.com/adchoices

Transcript

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0:00.0	Welcome to You Are Not Broken, the podcast that challenges everything we've been taught about midlife,
0:08.3	hormones, and sexuality. I'm Dr. Kelly Casperson, board-certified gerologist, author, and a leading
0:13.7	voice in women's sexual and hormone health. Enjoy the show. Hey, everybody, welcome back to the
0:18.6	You Are Not Broken podcast. I'm here with my friend, Dr. Andrew Goldstein, who is a time traveler and a world traveler, and it's hard to nail him down. So thank you for finding the time to come back on the podcast. I'm so excited to being here. We often talk about the vulva when you are on the show, and today will be no different. We like the vulva. We like the cervix, too, though, by the way.
0:38.8	Oh, man, we never talk about the cervix.
0:41.4	Let's start with the fact that another Goldstein, Dr. Irwin Goldstein,
0:44.9	published some data on cervical innervation with sexual pleasure.
0:49.0	This is years ago.
0:50.9	And then, like, I posted that in a physician Facebook group, and a lot of Obieguines
0:56.2	were like, that's not true. They're small studies. Like, people are dismissing sexual function
1:01.4	when it comes to the cervix. Where do you want to start with that?
1:04.7	That's very important, actually. And one of the main reasons why it's so important is because
1:09.3	we do interventions to the cervix that can cause disruption of the main reasons why it's so important is because we do interventions to the cervix
1:11.3	that can cause disruption of the nerves to the cervix and therefore cause significant
1:17.6	sexual dysfunction, not in the majority of people, but it can happen.
1:22.1	And so the cervix is really interesting because it has triply innervated. So that means there are three different nerves that go to the cervix is really interesting because it has triply innervated. So that means there's three
1:28.9	different nerves that go to the cervix, a nerve that most people have no idea called the
1:36.3	vagus nerve. The vagus nerve doesn't even go down through the spine. It goes down through the
1:41.7	abdominal cavity and it goes all the way down to the cervix.
1:45.0	And that's why, interestingly, people who have spinal cord transsections, so they cut spinal cords,
1:51.8	they can even still have orgasm through the vagus innervation of the cervix.
1:58.8	But the reason we talk about that is, as you know, I spend a lot of my
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