47. Pain with intercourse: Looking beyond the pelvic floor muscles with Dr. Lori Brotto

In this episode, I sit down with Dr. Lori Brotto a Professor in the UBC Department of Obstetrics and Gynaecology, and a Registered Psychologist as well as PHD student, Natalie Brown who is currently conducting research related to treatment of vaginismus to discuss:

• The relationship between our emotional brain and physical body
• The pelvic floor’s involvement when vaginal penetration is painful
• Common themes with discomfort and lack of enjoyment with intercourse
• The role that context including culture, spirituality, beliefs, history, stress play in vulvovaginal pain 
• Messages and advice women are commonly given
• The role of medications and hormones
• Pelvic health physiotherapy approach
• Dr. Brotto’s research on mindfulness-based interventions for women with sexual dysfunction and those who experience chronic genital pain
• Current research being conducted using erotica as a form of treatment for vaginismus 

Dr. Lori Brotto is a Professor in the UBC Department of Obstetrics and Gynaecology, and a Registered Psychologist in Vancouver, Canada.  She has been the Executive Director of the Women's Health Research Institute of BC located at BC Women’s Hospital since 2016. Dr. Brotto holds a Canada Research Chair in Women's Sexual Health. She is the director of the UBC Sexual Health Laboratory where research primarily focuses on developing and testing psychological and mindfulness-based interventions for women with sexual dysfunction and those who experience chronic genital pain. Dr. Brotto is an Associate Editor for the Archives of Sexual Behavior, has >200 peer-reviewed publications, and is frequently featured in the media on topics related to sexuality. Her book, Better Sex Through Mindfulness: How Women Can Cultivate Desire (2018) is a knowledge translation product aimed at sharing the science of sexual desire with a broad audience, and the accompanying Workbook will be published by Greystone in October 2022. She is a strong advocate for empowering women to take on leadership roles.

Natalie is a PhD student in the UBC Clinical Psychology program, working under the supervision of Drs. Lori Brotto and Alan Kingstone. She completed her BA in Psychology at Queen’s University in 2017, and her MA in Clinical Psychology at UBC in 2020. Natalie's research examines the use of virtual reality erotica as a clinical tool in the treatment of Genito-pelvic Pain and Penetration Disorder (GPPPD), with a focus on Vaginismus. Overall, her research program aims to improve our understanding of sexual difficulties and develop evidence-based interventions for individuals with distressing sexual concerns

Links mentioned in episode:

Netflix special series : Principles of Pleasure 

UBC Faculty of Medicine Sexual Health Research Lab

Details to participate in Natalie’s research on vaginismus

Book:   Better Sex Through Mindfulness: How Women Can Cultivate Desire 

Episode 27 - Vulvovaginal pain