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unPAUSED with Dr. Mary Claire Haver

Menopause, Hormones and Women’s Sexual Health with Dr. Rachel Rubin

unPAUSED with Dr. Mary Claire Haver

Mary Claire Media, LLC

Medicine, Health & Fitness, Society & Culture

4.81.2K Ratings

🗓️ 27 January 2026

⏱️ 109 minutes

🧾️ Download transcript

Summary

In this episode Dr. Mary Claire Haver is joined by Dr. Rachel Rubin, a board-certified urologist and nationally recognized expert in sexual medicine, fellowship trained in both female and male sexual health. As assistant clinical professor of urology at Georgetown University and former education chair of the International Society for the Study of Women's Sexual Health, she brings unique insight into the stark disparities in how sexual dysfunction is treated across genders. Dr. Rubin founded the Sexual Medicine Research Team, and her advocacy work has been instrumental in changing FDA labeling on hormone therapy and advancing the American Urological Association Guidelines on genital urinary syndrome of menopause. During the conversation, Dr. Haver and Dr. Rubin explore the intersection of menopause, hormones and women's sexual health, revealing why most doctors, including OB-GYNs, receive virtually no training in sexual health despite sexual dysfunction affecting millions of women. Dr. Rubin explains how men's sexual health benefits from 27 fellowship programs while women's sexual health has only three, and why erectile dysfunction research receives billions while female orgasm research gets nothing from the NIH. She breaks down the complete anatomy of the clitoris that most medical professionals never learned, explaining why understanding this matters for surgical outcomes, pleasure, and treating conditions like vulvar vestibule pain that affects penetration, tampon use, and pelvic exams. Dr. Rubin discusses how the vulvar vestibule, the hormone sensitive tissue surrounding the urethra, becomes a source of pain for many women during perimenopause, on birth control pills, or postpartum due to low estrogen and testosterone. Guest links: Dr. Rachel Rubin (Instagram) Dr. Rachel Rubin (YouTube) Dr. Rachel Rubin (Website) Dr. Rachel Rubin (LinkedIn) Dr. Rachel Rubin (Facebook) Dr. Rachel Rubin (X) Books “Vagina Obscura: An Anatomical Voyage Hardcover,” by Rachel E. Gross “The New Perimenopause,”⁠ by Dr. Mary Claire Haver ⁠"The New Menopause"⁠ by Dr. Mary Claire Haver Articles Sexual function after hysterectomy according to surgical indication: a prospective cohort study (Sexual Health) The human cervix: Comprehensive review of innervation and clinical significance (Clinical Anatomy) Brain activation during vaginocervical self-stimulation and orgasm in women with complete spinal cord injury: fMRI evidence of mediation by the vagus nerves (Brain Research) The Impact of Glucagon-like Peptide-1 Receptor Agonists on Erectile Function: Friend or Foe? (Biomolecules) Effect of Saw Palmetto Extract on Erectile Dysfunction and Libido in Patients with Lower Urinary Tract Symptoms Because of Benign Prostatic Obstruction (International Journal of Applied Research on Medicinal Plants) “Not feeling like myself” in perimenopause — what does it mean? Observations from the Women Living Better survey (Menopause) Updates on Therapeutic Alternatives for Genitourinary Syndrome of Menopause: Hormonal and Non-Hormonal Managements (Journal of Menopausal Medicine) Menopausal Hormone Therapy and Cardiovascular Diseases in Women With Vasomotor Symptoms: A Secondary Analysis of the Women’s Health Initiative Randomized Clinical Trials (JAMA Internal Medicine) To learn more about listener data and our privacy practices visit: https://www.audacyinc.com/privacy-policy Learn more about your ad choices. Visit https://podcastchoices.com/adchoices

Transcript

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0:00.0

And let me just say, as a urologist, nobody expects me to take care of all of a man's health needs.

0:06.7

No man comes to see me for all of his medical care, and he shouldn't.

0:10.1

He should have several different doctors that take care of him.

0:13.2

So the mere fact that we have OBGYNs and they are expected to take care of a woman once a year for 15 minutes with your legs up in stirrups, and that's medical care for the rest of your life is unconscionable. And so women have to stop expecting their OBGYNs to know everything about their bodies because they simply don't. Why does an OBGYN know about your heart? I don't know about a man's heart as a urologist to the level that OBJN is expected to know about breast

0:38.2

cancer and heart disease and bone health. It makes no sense.

0:49.7

The views and opinions expressed on unpaused are those of the talent and guests alone and are provided for informational and entertainment purposes only.

0:58.7

No part of this podcast or any related materials are intended to be a substitute for professional medical advice, diagnosis, or treatment.

1:07.6

Today's guest is not only one of the most influential voices in sexual medicine, but someone I'm lucky enough to call a friend.

1:15.1

Dr. Rachel Rubin is a board-certified urologist and a nationally recognized expert in sexual medicine.

1:20.8

She is one of the few physicians fellowship trained in both female and male sexual health,

1:25.4

and she serves as an assistant clinical professor of urology

1:29.2

at Georgetown University. She has shaped the field through her leadership as the former education

1:34.1

chair and current director at large for the International Society for the Study of Women's Sexual

1:39.7

Health. She also serves on the editorial boards of the Journal of Sexual Medicine and the Video Journal of Sexual Medicine.

1:46.7

And she is a contributor and vocal advocate for the 2025 American Urological Association Guidelines on the genital Urinary Syndrome of Menopause.

1:57.2

Her work extends far beyond the clinic.

1:59.8

Rachel founded the Sexual medicine research team,

2:02.7

a collaborative initiative advancing clinical research in sexual health. Their work has pioneered our

2:08.1

understanding around advocacy and around clitoral adhesions, gender to urinary syndrome of lactation,

2:14.2

and many other rarely discussed sexual health conditions. But before I ever knew the full depth of her

2:20.4

credentials, I knew her fire. I knew her honesty. I knew her relentlessness. Rachel and I have shared

2:28.1

stages, compared notes from clinic, and cheered each other on through the exhausting work of changing health care for women.

...

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