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

Rachel Rubin (0:00)

So the reason your doctor doesn't know how to talk to you about libido, arousal, orgasm or pain is no one ever taught them. Three programs in the last three years that even acknowledge women's sexual health, we have more than 27 for men's sexual health.

Mary Claire Haver (0:12)

How many times I would blank stare at a patient and feel horrified that I didn't know how to help her that she was complaining of some type of sexual dysfunction that was affecting her life.

Rachel Rubin (0:22)

I had a patient come to see me, she was 16 years old, and she said, I need a specific vulvar surgery for pain. She said, I watched a show called Sex Education. In that show, there was a character who had vulvar pain, and she saw a doctor and she learned about X, Y, and Z. So I went on Google and I looked this up, I examined myself and I said, holy shit, am I excited for the future.

Mary Claire Haver (0:51)

The views and opinions expressed on unPAUSED are those of the talent and guests alone, and are provided for informational and entertainment purposes only. No part of this podcast or any related materials are intended to be a substitute for professional medical advice, diagnosis, or treatment.

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. Dr. Rachel Rubin is a board certified urologist and a nationally recognized expert in sexual medicine. She is one of the few physicians fellowship trained in both female and male sexual health. And she serves as an assistant clinical professor of urology at Georgetown University. And she is a contributor and vocal advocate for the 2025 American Urological Association guidelines on the genital urinary syndrome of menopause. Rachel is one of the rare physicians who combines rigorous scientific expertise with compassion, clarity, and courage. She is tireless in making sure no woman is ever left in the dark about her own anatomy, her hormones, or her sexual health. I'm Dr. Mary Claire Haver, a board certified obstetrician and gynecologist and certified menopause practitioner. I'm also an adjunct professor of obstetrics and gynecology at the University of Texas Medical Branch. Welcome to unPAUSED, the podcast where we cut through the silence and talk about what it really takes for women to thrive in the second half of life.

Welcome to unPAUSED.

Rachel Rubin (2:27)

Oh my gosh. How cool that we're finally doing this.

Mary Claire Haver (2:29)

Oh my God.

People don't know that we actually know each other. So when we're like, who should we have on the podcast? Your name was at the top.

Rachel Rubin (2:37)

Oh my gosh.

Mary Claire Haver (2:38)

They want to talk about sex, they want to talk about sexual health, and here we are doing it. Why urology? For our listeners, most women do not choose urology as a profession.

Rachel Rubin (2:49)

Yeah, every little girl dreams of being a penis doctor, actually, as part of a live stream. It is strange how I got here. Sometimes I wake up, I say, how did I end up here?

About 10 percent of practicing urologists are women, so we are a small but mighty group. We are very funny, we're very silly, and we can say as many bad words as we want. It's actually something we all like each other very much. But urology is a fascinating field where you can take care of women, nobody realizes this, you can take care of women, you can take care of men.

Mary Claire Haver (3:21)

Because women actually have kidneys and ureters and, yeah, bladders.

Rachel Rubin (3:23)

Shocking, women have kidneys and bladders and genitals, and urologists are sex doctors. We care about quality of life, we care about sexual health, and people assume that their gynecologists know everything about sex, and it turns out they don't.

And so it was a really fun field where I didn't have to deliver babies and be up all night, and I could do women's health without being an obstetrician. Three programs in the last three years that even acknowledge women's sexual health, we have more than 27 for men's sexual health. And so the reason your doctor doesn't know about how to talk to you about libido, arousal, orgasm, or pain is no one ever taught them.

Mary Claire Haver (3:58)

I learned nothing, like literally nothing.

Rachel Rubin (4:02)

And say it louder for the people in the back because it's not your fault.

Mary Claire Haver (4:06)

I never learned the framework of addressing sexual dysfunction until I decided to open my menopause clinic.