In this episode, I'm joined by Heather Coppard - nurse, health visitor, hypnotherapist, and author.

Heather spent years navigating the healthcare system as a patient with persistent vulval pain, experiencing firsthand the dismissal, gaslighting, and harmful messaging that so many of us know all too well. One particularly devastating appointment with a specialist became the turning point that drove her to write her book, set up a vulval pain support group, and dedicate her work to ensuring no other woman walks away from a consultation feeling the way she did that day.

In this episode we cover a lot of ground - from the nocebo effect and how the language healthcare providers use can directly worsen pain outcomes, to the biopsychosocial model of persistent pain and why a multidisciplinary approach was the key to Heather's own recovery jigsaw. We also talk openly about hypnotherapy - a modality Heather was initially skeptical of as a clinician - and how it became one of the most powerful tools in her healing process alongside pharmacological intervention, CBT, pelvic floor physiotherapy, and mindfulness-based stress reduction.

This is a hopeful episode. Heather recovered, and she has a lot of wisdom to share about what that journey looked like and what she wishes she had known at the start.

Show Notes:

🔗 Find Heather Coppard: Website: www.heathercoppard.com Instagram: @heather_coppard

📖 Heather's Book: Optimising Recovery for Vulval and Vaginal Pain — available globally on Amazon and to order from all major bookstores including Barnes & Noble (US) and Waterstones (UK)

🏥 Organisations & Resources Mentioned: The Vulval Pain Society — www.vulvalpainsociety.org The British Society for the Study of Vulval Disease (BSSVD) — www.bssvd.org NICE guidelines on hypnotherapy for IBS — www.nice.org.uk

📲 Connect with me: on nstagram @meet.baubo or at mathilde@baubo.org

I just got back from the ISSWSH (International Society for the Study of Women's Sexual Health) annual meeting in Long Beach, California - and I couldn't wait to bring everything I heard straight to you. This solo episode is part conference recap, part deep dive into the research I think matters most for anyone living with vulvovaginal pain, pelvic pain, or sexual pain of any kind.

In this episode I cover:

• What sexual medicine actually is - and why a whole field exists around it
• Vulvodynia subtypes and treatment matching - new data showing that hormonally-driven vulvodynia has a 70% response rate to estrogen/testosterone therapy, and why getting the wrong treatment for the wrong subtype may be why nothing has worked for you
• Endometriosis and neuroproliferative dyspareunia - a newly validated subtype of deep endo pain that is nerve-driven and needs an entirely different treatment approach
• Pelvic venous disorder (PEVD) - essentially varicose veins inside the pelvis, and why almost no one is being checked for it despite its links to chronic pelvic pain and conditions like POTS, MCAS and hypermobility
• The vaginal estrogen update - why the removal of the black box warning on low-dose vaginal estrogen is such a big deal, and why these symptoms aren't just a menopause issue
• Why women's pain is still being dismissed - a powerful presentation on the clinical gaze, pain measurement, gendered bias in medicine, and the feedback loop between underfunding and misdiagnosis. Plus: the dismissal of women's pain is not evenly distributed, and we need to talk about that.
• Access and equity - new data showing Manhattan has 60x more pelvic floor physios per capita than the Bronx, with only 21% of practices accepting Medicaid

I also share something personal about privilege, what it means to be in a room like this, and who I'm really doing this for.

Resources & links mentioned:

• 🔗 ISSWSH — International Society for the Study of Women's Sexual Health
• 🔗 @painsdownthere / @ThrushSupport - follow her on Instagram for important work on the link between recurrent thrush and vulvar nerve damage
• 📖 When Sex Hurts: Understanding and Healing Pelvic Pain by Goldstein, Pukall, Goldstein & Krapf - the book on vulvodynia subtypes I recommend bringing to your doctor
• 🔗 My Instagram: @meet.baubo

If anything in this episode resonated, please reach out - I read every message. And if you're finding this podcast helpful, sharing it with someone who needs it is the biggest thing you can do.

For decades, vulvodynia was considered a mystery condition with few answers and limited treatment options. That's no longer the case.

In this episode, Dr. Andrew Goldstein - Clinical Professor at George Washington University and one of the world's leading experts on vulvar and pelvic pain - explains how 25 years of dedicated research has transformed our understanding of vulvodynia from a "black box" into a condition with identifiable causes and effective treatments.

In this episode, you'll learn:

• Why vulvodynia wasn't part of standard medical training (and what's changing)
• The real causes behind vulvar pain - from mast cell inflammation to hormonal triggers
• How birth control pills can cause vulvodynia in some women (and the genetic reasons why)
• Why the majority of pelvic pain patients have been gaslit - and the JAMA study that proves it
• The truth about vestibulectomy surgery: who needs it (only 7% of patients) and the 97% success rate
• Exciting new treatments on the horizon, including ketotifen for mast cell stabilization

Dr. Goldstein, past president of the International Society for the Study of Women's Sexual Health, has published over 170 peer-reviewed articles and co-authored 8 books on female sexual pain. He shares the revolutionary research from the 2023 Vulvodynia Therapeutics Summit and explains why vulvodynia is no longer a mystery condition - it's a solvable problem with tailored treatments.

Whether you're living with vulvodynia, vestibulodynia, vaginismus, or other forms of pelvic pain, this episode offers validation, answers, and hope for your healing journey.

🎧 Topics covered: vulvodynia causes, hormonally mediated vulvodynia, provoked vestibulodynia, vestibulectomy surgery, pelvic floor dysfunction, mast cell activation, birth control and vulvar pain, gaslighting in healthcare, new vulvodynia treatments

🔬 WANT TO HELP ADVANCE VULVODYNIA RESEARCH?

Dr. Goldstein emphasizes that clinical trials are crucial for developing new treatments. If you're interested in participating in vulvodynia research studies, including trials for ketotifen (mast cell stabilizer), resiniferatoxin (nerve desensitization),and Xeomin (for vulvodynia due to secondary hypertonic pelvic floor muscle dysfunction), reach out to research.cvvd@gmail.com.

Your participation could help create the breakthrough treatments of tomorrow.

RESOURCES & LINKS:

Dr. Andrew Goldstein:

• Centers for Vulvovaginal Disorders: www.vulvodynia.com

Organizations mentioned:

• International Society for the Study of Women's Sexual Health (ISSWSH): www.isswsh.org
• National Vulvodynia Association: www.nva.org
• Tight Lipped (Patient Advocacy): https://www.tightlipped.org/

Dr. Goldstein's Books:

• When Sex Hurts (2nd edition, 2022)
• Female Sexual Pain Disorders: Evaluation & Management (2nd edition, 2020)

• Reclaiming Desire (2nd edition, 2009)

Connect with the podcast: @meet.baubo or mathilde@baubo.org