In this episode of unPAUSED, pulled from the archive because it’s one worth hearing again, Dr. Mary Claire Haver sits down with Dr. Rachel Rubin, board-certified urologist, nationally recognized expert in sexual medicine, one of the few physicians fellowship-trained in both female and male sexual health, assistant clinical professor of urology at Georgetown University, and a lead advocate behind the 2025 American Urological Association guidelines on genitourinary syndrome of menopause. The conversation starts with the number that explains everything: three training programs in the last three years even acknowledge women’s sexual health — men have more than 27. The reason your doctor doesn’t know how to talk to you about libido, arousal, orgasm, or pain is that no one ever taught them. Dr. Rubin delivers the anatomy lesson medicine skipped: why the clitoris and penis are the same tissue, why most women will never orgasm from penetration alone, why the cervix — taught as having no nerves — is actually triply innervated, and why “my orgasm changed after my hysterectomy” is biology, not psychology. They cover why sex should never hurt and pain always deserves a diagnosis, the vulvar vestibule tissue most doctors were never taught to examine, pelvic floor dysfunction, and the hormone changes behind it all — which start in your 30s, not at menopause, and can be triggered by breastfeeding and birth control too. Then the case Dr. Rubin has built her career on: vaginal estrogen and DHEA prevent more than half of UTIs — infections that kill women — and could save Medicare an estimated $6–22 billion a year. Plus the medications that quietly affect sexual function, the two FDA-approved drugs for low libido most women have never heard of, testosterone’s role, and the five hormone options every woman deserves to know are on her menu. Guest links: * Dr. Rachel Rubin (Instagram) https://www.instagram.com/drrachelrubin/ * Dr. Rachel Rubin (YouTube) https://www.youtube.com/c/DrRachelRubin * Dr. Rachel Rubin (Website) https://www.rachelrubinmd.com/ * Dr. Rachel Rubin (LinkedIn) https://www.linkedin.com/in/rachel-rubin-7433b0134/ * Dr. Rachel Rubin (Facebook) https://www.facebook.com/DrRachelRubin/ * Dr. Rachel Rubin (X) https://x.com/drrachelrubin Recommended Books: * “The New Perimenopause,” by Dr. Mary Claire Haver https://thepauselife.com/pages/the-new-perimenopause-book * “The New Menopause,” by Dr. Mary Claire Haver https://www.amazon.com/New-Menopause-Navigating-Through-Hormonal/dp/B0CKBZ4K1Z * “Vagina Obscura: An Anatomical Voyage Hardcover,” by Rachel E. Gross https://www.amazon.com/Vagina-Obscura-Anatomical-Rachel-Gross/dp/1324006315 For full show notes, please visit: https://bit.ly/4i13vDc Never miss an episode—sign up for The ‘Pause Life Newsletter: https://thepauselife.com/pages/newsletter Medical Disclaimer: The information, including opinions and recommendations, on this platform is meant for informational and educational purposes only. Mary Claire Media, LLC, the unPAUSED podcast, and The ‘Pause Life are not medical organizations. Medical advice or medical diagnosis cannot be provided to you through the platform, any associated website, or customer portals. Using this platform does not establish a patient-physician relationship.