Chronic pelvic pain doesn't have great PR. Vulvodynia, vaginismus, painful sex, pelvic floor dysfunction - conditions that affect 1 in 4 women and still get treated like a secret. This podcast is trying to change that.
The World's Tightest Community is a weekly podcast hosted by Mathilde - a patient-turned-advocate who built this space out of her own experience with vulvodynia and vaginismus. Each episode goes deep into the conditions that millions of women live with but few feel safe naming: vulvodynia, vaginismus, vestibulodynia, pudendal neuralgia, and the wider landscape of chronic pelvic pain and painful sex.
Mathilde speaks with gynecologists, pelvic floor physiotherapists, sex therapists, psychologists, and researchers working at the front edge of women's sexual health - translating clinical knowledge into something actually usable, alongside honest conversations about diagnostic delays, medical gaslighting, and what it really costs to navigate these conditions.
You'll leave each episode with more language for your experience, clearer questions to bring to your next appointment, and the specific relief of knowing someone has thought carefully about this.
New episodes every week. Follow wherever you listen, and find the community on Instagram. <3
Site
RSS
Apple
Data updated on 14/10/2026
Recent rankings
Latest chart positions across Apple Podcasts and Spotify rankings.
Shared links between episodes and podcasts
Links found in episode descriptions and other podcasts that share them.
Sex Therapist on Pelvic Pain and Trauma: When the Pain Itself Becomes the Trauma
Season 1 · Episode 49
Monday, October 12, 2026 • Duration 47:42
What happens when pelvic pain improves, but your body still expects sex to hurt?
I'm joined by Romi Terk Brudno, a sex therapist specializing in pelvic pain and painful sex.
Drawing on her own experience of ulcerative colitis and painful sex, Romi explores avoidance, feeling "broken," and the gap between progress in pelvic floor PT and feeling safe during intimacy. We discuss trauma-like responses to pain, sexual motivation, and how diagnostic labels and research gaps can shape access to care.
For anyone whose pain has improved but who still feels on guard, or who's wondered whether their experience deserves support.
Sponsors: The Pelvic People, makers of the Ohnut and the Kiwi. 15% off with code TWTC15 at thepelvicpeople.com/twtc Origin, in-network pelvic floor PT. Get your first month of On Track free with code TWTC at theoriginway.com/twtc
Romi Terk Brudno: Instagram: @thepelvicpress Website: romiterk.com
00:00:00 Introduction, Romi Terk Brudno 00:02:12 Pain, Trauma, Gaps in Care 00:03:53 Vulvodynia, Medical Dismissal 00:05:58 Romi's Story, Ulcerative Colitis 00:07:10 Pain Without Sexual Trauma 00:09:02 Avoidance, Bracing, Isolation 00:10:40 Supporting the Podcast 00:11:10 Gut Pain, Pelvic Floor Tension 00:12:57 Pain, Learned Threat 00:13:55 Anger, Missed Screening 00:14:41 Therapy, Persistent Bracing 00:16:03 PT Progress, Intimacy 00:17:39 Chronic Pain, Trauma Responses 00:18:47 PTSD Criteria, Core Beliefs 00:19:49 Pain Reprocessing, The Way Out 00:21:39 Sexual Pain, Identity 00:22:22 Sex, Pressure, Motivation 00:23:32 Pleasure, Connection 00:24:47 Sponsor: Origin 00:27:01 Sponsor: The Pelvic People 00:29:48 Diagnosis, Access to Care 00:31:58 Trauma-Informed Care 00:33:18 Trauma, Agency, Safety 00:34:20 Modern Life, Stress 00:35:50 Nervous System, Stress Relief 00:37:32 Research Gaps 00:39:21 Self-Worth, Deserving Care 00:40:02 Persistent Pain, Self-Blame 00:41:45 Social Support, Protective Factors 00:43:01 Pain Validation 00:44:15 Tool: Trusting Your Experience 00:45:14 Tool: Self-Compassion 00:45:50 Working With Romi 00:46:54 Staying Connected
48: Genitourinary Syndrome of Menopause: Why You Can Have It In Your 20s & 30s
Season 1 · Episode 48
Monday, October 5, 2026 • Duration 59:20
Why do the tissue changes we link to menopause also show up in women on the pill, breastfeeding, or in their twenties?
I'm joined by Dr. Sameena Rahman, OB-GYN and sexual medicine specialist, founder of the GSM Collective in Chicago and ISSWSH scientific committee chair.
We unpack genitourinary syndrome of menopause (GSM), why the same hormonal mechanism drives vestibulodynia in younger women on birth control or spironolactone, and how vaginal estrogen, vaginal DHEA and estradiol-testosterone cream are used. We also cover the removed boxed warning on estrogen, why under 5% of women are offered a treatment linked to fewer UTIs and deaths, blood work, mast cells, and medical gaslighting.
For anyone told their hormones are "normal" when something clearly isn't - and the clinicians who treat them.
Sponsors:
- The Pelvic People, makers of the Ohnut and the Kiwi. 15% off with code TWTC15 at thepelvicpeople.com/twtc
- Origin, in-network pelvic floor PT. Get your first month of On Track free with code TWTC at theoriginway.com/twtc
Dr. Sameena Rahman:
Instagram: @gynogirl
Website: thegsmcollective.com
Book: "Brown Girls' Disease”? coming out October 6
47. Vulvodynia & Gut Health: Exploring the Vaginal Microbiome Connection
Season 1 · Episode 47
Monday, September 28, 2026 • Duration 01:21:23
In this episode, I sit down with Dr. Christina Enzmann, a board-certified OB-GYN and functional medicine practitioner specializing in vulvovaginal disorders, to explore how gut health and the vaginal microbiome connect to persistent vulvar and pelvic pain.
We cover the everyday products that disrupt the vaginal barrier, why pain can persist after repeated yeast and BV treatments, how endometriosis and gut inflammation may be linked, which tests are worth doing, and when probiotics can backfire.
Sponsors:
- The Pelvic People, makers of the Ohnut and the Kiwi. 15% off with code TWTC15 at thepelvicpeople.com/twtc
- Origin, in-network pelvic floor PT. Get your first month of On Track free with code TWTC at theoriginway.com/twtc
46. Pelvic Floor Botox: My Experience & Why My Physio Told Me to Do Less
Season 1 · Episode 46
Tuesday, September 22, 2026 • Duration 33:07
In this solo episode I catch you up on my own treatment. I talk you through what pelvic floor Botox was actually like at a specialist vulvar clinic in Oslo, why my new physio's homework for the whole summer was to lovingly touch my thighs, and what that taught me about anticipating pain and turning even rest into something to achieve. I also explain the TTNS machine I'm using, which puts electrodes on my ankle to target pelvic pain.
We've now passed 10,000 listeners a month, so I share what I'd love to build next for this community, and how I got past the embarrassment of talking about vulvar pain in public :)
45. Postpartum Pelvic Pain: Why Sex Hurts After Birth And What Actually Helps
Season 1 · Episode 45
Monday, September 14, 2026 • Duration 27:15
You had a baby, and months later something still hurts. Sex, sitting, the scar. And you've been told this is just what happens now.
If that's you, this conversation is for you. I'm joined by Dr. Alexandra Dubinskaya, a urogynecologist and sexual medicine specialist in Beverly Hills. She chairs the communication committee at the International Society for Sexual Medicine and wrote the vulvodynia chapter in Taking Care of You. Much of her work is with women who come to her months or years after giving birth, still in pain, told there was nothing wrong. Her view is that women don't need protecting from information, they need it to make their own decisions.
We talk about why sex can hurt after birth, starting with genitourinary syndrome of lactation, the hormonal drop that happens while breastfeeding. We get into tearing and episiotomies, granulation tissue that won't heal, and how the pudendal nerve gets stretched during pushing. She explains why that can cause numbness rather than pain. We also cover what to plan for if you already live with pelvic pain, and when a planned C-section is reasonable.
If you're pregnant and want to know what to ask for, or already living with pelvic pain and weighing up a birth, this one is about having enough information to choose.
Sponsors:
- The Pelvic People, makers of the Ohnut and the Kiwi. 15% off with code TWTC15 at thepelvicpeople.com/twtc
- Origin, in-network pelvic floor PT. Get your first month of On Track free with code TWTC at theoriginway.com/twtc
Connect with Dr. Alexandra Dubinskaya:
- Instagram, TikTok, YouTube: @DrUrogyn
44. Neurodivergence and Pelvic Pain: What ADHD and Autism Change in the Exam Room
Season 1 · Episode 44
Friday, September 11, 2026 • Duration 54:48
Stephanie Berman has lived with vulvar pain since 2011. She spent eleven years being dismissed, misdiagnosed and told to be patient, and the referral that finally moved her forward came from an Instagram DM she sent to Dr. Corey Babb. She is also the founder of the Aziza Project, a nonprofit that pays for women in pelvic pain to physically get to the care they need.
We cover her full story, and then something I have never covered on this show: what it actually takes to advocate for yourself in a clinical room when you are neurodivergent, and what clinicians could be doing differently.
For anyone who has been told their tests look fine, and for the clinicians who want to do better.
Thank you to our sponsors:
The Pelvic People - makers of the Ohnut and the Kiwi. Get 15% off with code TWTC15 at thepelvicpeople.com/twtc
Origin - in-network pelvic floor PT. Get your first month of OnTrack free with code TWTC at theoriginway.com/TWTC
43. Vulvodynia Medications: Why Nothing Has Worked, and Every Option That Actually Might
Season 1 · Episode 43
Monday, August 31, 2026 • Duration 01:18:23
Vulvodynia just means pain in the vulva. It is not a diagnosis - and Dr. Maria Uloko argues that is why treatment so often fails.
Maria is a urologist trained in comprehensive sexual health, one of seven in the world doing this work. We go type by type: what causes each one, what treats it, who it will not help.
SPONSORS
Pelva: the HydroSlix liner, a cushioning insert for more comfort during insertion. pelva.com, code TWTC10 for 10% off your first order.
Origin: the largest in-network pelvic floor PT provider in the US, most patients pay under $36 a visit. theoriginway.com/TWTC, code TWTC for your first month of OnTrack free.
42. Supporting a Partner With Vaginismus or Painful Sex: What It Feels Like and How You Can Help
Season 1 · Episode 42
Monday, August 24, 2026 • Duration 35:07
This episode started with an email from a listener: a man in his twenties whose girlfriend has lived with vaginismus and pelvic pain for years. He wanted to know how to be a good partner to someone going through this.
So this one is for the partners. I talk about what this can feel like from the inside, why she might pull away when you touch her and why that is not a verdict on you, and how the two of you can become a team around this instead of letting it come between you. I go through Natalie Rosen's research on the three ways partners respond, including the surprising finding about which kind of support is linked to more pain rather than less. And I talk about you, because you are in this too and you are allowed to be struggling.
One in four women and people with vulvas experience this. There are real mechanisms behind it, there are treatments, and people do get better.
SPONSORS
Pelva: the HydroSlix liner, a cushioning insert for more comfort during insertion. pelva.com, code TWTC10 for 10% off your first order.
Origin: the largest in-network pelvic floor PT provider in the US, most patients pay under $36 a visit. theoriginway.com/TWTC, code TWTC for your first month of OnTrack free.
41. Vestibulectomy on Screen: Bonnie Gross on Lady Parts and Her Second Surgery
Season 1 · Episode 41
Monday, August 17, 2026 • Duration 01:07:58
If you are googling vestibulectomy recovery at 2am, this one is for you.
Bonnie Gross has had the surgery twice, ten years apart, and she is unusually good at describing it - she wrote and executive produced Lady Parts, the award-winning comedy based on the first one. We recorded this four weeks after her second.
Most of this conversation is the practical side she could not fit in the film: the pre-surgery shopping list, the recovery timeline week by week, the insurance denial, the graft taken from inside her cheek, and what dilator work is really like afterwards.
40. The Only Episode You Need to Understand Pelvic Floor Strength, Tightness and Kegels
Season 1 · Episode 40
Monday, August 10, 2026 • Duration 51:29
What does it actually mean to have a strong pelvic floor - and is strong even the right thing to chase?
Kimberlee Sullivan is a board-certified women's health physical therapist and Head of Clinics at Origin, where she leads nationwide clinical strategy. She has spent over twenty years in pelvic floor PT and founded her own Austin clinic, Sullivan Physical Therapy, in 2005.
We cover the difference between strong and healthy, what the 0 to 5 strength score does and does not measure, why tight is not the same as strong, and how a constantly contracted pelvic floor gets weaker over time. Kimberlee also walks through relaxation versus lengthening, reverse kegels and straining, breath work, at-home tools, and why she does not have a five out of five herself.
If you are dealing with hypertonicity, postpartum, or have only ever been told to do your kegels - start here.
Kimberlee demonstrates much of this on camera, so watch on YouTube or Apple if you can.
Discover shows related to The World's Tightest Community - A Podcast About Vulvodynia, Vaginismus & Women's Pelvic Pain, based on actual content similarities. Explore podcasts with similar topics, themes, and formats, backed by real data.
