Dr Rachel Rubin: Women’s Sexual Health, Menopause, Hormone Replacement Therapy (HRT), and Orgasms!

The Diary Of A CEO with Steven Bartlett

FlightStory

Business, Society & Culture, Education

4.5 • 18K Ratings

🗓️ 22 June 2026

⏱️ 109 minutes

🔗️ Recording | iTunes | RSS

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Summary

Women’s sex lives are being quietly destroyed, and their doctors don’t even know it… Sexual medicine specialist Dr Rachel Rubin reveals the hidden hormone crisis, how prescription drugs can impact sex, and the treatments most doctors aren't prescribing like Hormone Replacement Therapy. Dr Rachel Rubin is a board-certified urologist and sexual medicine specialist, and one of only 80 doctors in the US trained to treat both male and female sexual health. She recently played a pivotal role in the removal of the FDA's boxed warning on menopausal hormone therapy - one of the most significant healthcare policy changes affecting midlife women in decades. She is also the Founder of Rachel Rubin MD and Director-at-Large of the International Society for the Study of Women's Sexual Health. She explains: ◼️ Why most doctors fail women on sexual health, and how to build a team that won't ◼️ Why menopause is a whole-body hormone event, and the treatments that actually help ◼️ The physical barrier blocking orgasm in 1 in 4 women, and how to fix it ◼️ How a tight pelvic floor could be ruining your sex life ◼️ Why your sexual pain and low libido are physical problems your doctor keeps missing Chapters 00:00:00 Why Women's Healthcare Is Still Neglected 00:04:17 If Men Had These Symptoms, Would Medicine Be Better? 00:07:02 Why Even Gynaecologists Misunderstand The Clitoris 00:08:03 What You'll Learn From This Conversation 00:11:07 The Question Women Ask Most 00:11:32 Why Testosterone Matters For Women 00:13:41 How Birth Control Can Kill Libido 00:16:25 How GLP-1s And Antidepressants Affect Sex Drive 00:18:26 Should Women Take Testosterone? 00:19:30 Understanding The Menstrual Cycle 00:23:11 Why Perimenopause Starts Earlier Than You Think 00:25:19 What Is HRT And How Does It Work? 00:26:01 Does Estrogen Increase Cancer Risk? 00:27:27 Why HRT Got A Bad Reputation 00:29:24 The 4 Types Of HRT Explained 00:31:19 What Really Causes UTIs? 00:33:22 Vaginal Hormones Explained 00:37:19 Does Cranberry Juice Actually Help UTIs? 00:38:31 When Should You Start HRT? 00:40:36 A HRT Success Story 00:44:43 Ads 00:46:47 Is Pain During Sex Normal? 00:49:28 How To Have Better Sex 00:51:54 What Your Pelvic Floor Actually Does 00:53:48 Signs You Have Pelvic Floor Problems 00:55:24 Is It Normal Not To Orgasm? 00:57:30 What Is A Clitoral Adhesion? 00:58:55 How Sex Toys Can Improve Intimacy 01:00:07 What Men Get Wrong About Arousal 01:01:57 What Happens To Women After Orgasm? 01:02:55 Do Women Get Anything From Penetrative Sex? 01:04:40 How Porn Changed Our Expectations 01:06:58 What Healthy Porn Looks Like 01:08:12 How Porn Can Damage Relationships 01:10:12 Ads 01:12:21 Why You Should Change Up Your Sex Life 01:13:35 Why We Hide Our Sexual Struggles 01:17:17 Responsive Vs Spontaneous Desire Explained 01:19:58 The Question Every Couple Should Ask 01:20:51 What If You Want Different Things In Bed? 01:23:10 How To Tell Your Partner About Kinks 01:24:28 The Secrets People Hide From Their Partners 01:25:42 How To Tell If She's Faking Orgasms 01:27:46 How Stress And Dopamine Influence Libido 01:29:33 Should Sex Be Scheduled Or Spontaneous? 01:31:24 How Self-Esteem Affects Sex 01:33:04 The Most Important Thing We Missed 01:35:06 Better Communication, Better Sex 01:42:51 Why This Work Matters So Much 01:43:57 What Needs To Change In Your Own Life? Independent Research: https://stevenbartlett.com/wp-content/uploads/2026/06/DOAC-Rachel-Rubin-Independent-Research-Further-Reading.pdf Follow Dr Rachel: Instagram - https://link.thediaryofaceo.com/AYkgAOV YouTube - https://link.thediaryofaceo.com/1TQZeri X - https://link.thediaryofaceo.com/FxZbK5x Website - https://link.thediaryofaceo.com/4ZKqH2l The Diary Of A CEO: ◼ Join DOAC circle here - https://doaccircle.com/ ◼ Buy The Diary Of A CEO book here - https://smarturl.it/DOACbook ◼ The 1% Diary is back - limited time only: https://bit.ly/3YFbJbt ◼ The Diary Of A CEO Conversation Cards: https://linkly.link/2hm7r ◼ Get email updates - https://bit.ly/diary-of-a-ceo-yt ◼ Follow Steven - https://g2ul0.app.link/gnGqL4IsKKb Sponsors: HeyGen - https://heygen.com/DOAC Flightcast - Check out https://www.flightcast.com/DOAC6 Ketone - Go to https://ketone.com/steven to enter to win! no purchase necessary, terms and conditions apply.

Transcript

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0:49.9	vanta.com.com slash diary. You rub it inside the walls of the vagina like this. And just rub it in like you would rub sunscreen on your face. And if you do that twice a week, it makes sex not painful and dry. It helps with arousal and orgasm. It's literally better than Viagra. And it's cheap. And I'm telling you all this as a urologist that this cream can also help prevent death from urinary tract infections. But more than 75% of people in large database collections are not
1:16.5	getting prescriptions for this. And so women are not getting access to generic medications
1:21.4	that could save their lives and also really improve quality of life. And so I am filled with
1:26.3	rage because people are limiting their
1:28.5	ability to have great sex, great health, because they aren't having access to all the information
1:33.3	that they could. For example, women are not orgasming as much as men. The data is very clear there.
1:38.5	And women come to see me all the time as I'm a sex doctor. And they say, I'm broke and you have to fix
1:42.2	me. I'm not orgasming during sex. And I think the majority of problem is education. Women think that orgasm comes from penetration.
1:49.8	But the clitoris is how most women orgasm, and yet most women do not know where their clitoris is.
1:56.0	And in fact, the word clitoris today in 2026 does not exist in the checklist for what an OBGYN has to learn in their training.
2:04.7	And as men, what are we getting wrong in heterosexual relationships when we're trying to arouse our partners?
	...

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