Vaginismus is often described as “pain with penetration,” but that definition misses the bigger picture. In this episode, couples and sex therapist Dr. Rebecca Howard Eudy and pelvic floor physical therapist Dr. Alexandra DiGrado unpack what vaginismus really is, why it happens, and how it affects far more than just sex.

Together, they explore the role of the nervous system, pelvic floor muscles, fear-avoidance patterns, and past experiences—and why advice like “just relax” can actually make things worse. This conversation offers clarity, compassion, and an evidence-based path forward for anyone navigating pelvic pain or supporting someone who is.

What You’ll Learn:

• Why vaginismus is a protective nervous system response—not a psychological failure or conscious choice
• How the fear–tension–pain cycle develops and reinforces ongoing pain
• Why vaginismus can affect more than penetration, including exams, tampon use, sitting, and bowel function
• What effective treatment actually looks like, including pelvic floor PT, education, and nervous system regulation
• How healing focuses on safety, choice, and gradual progress—not pushing through pain

Tune in if you’ve ever thought:

• “Everyone keeps telling me to relax, but I literally don’t know how.”
• “Can this ever get better, or will it always hurt like this?”
• “How do I explain this to my partner, and what does it mean for our relationship long-term?”
• “I feel embarrassed talking about this — am I the only one?”
• “How do I get help without forcing myself through more pain?”

Helpful Resources

• Intimate Rose anal/vaginal dilators (use code ALEXANDRA1 for 20% off - affiliate link)
• The Postpartum Essentials Virtual course
• Sex After Baby Mini-Course
• Find a pelvic floor PT near you: pelvicrehab.com or Pelvic Global Directory
• Under the Hood Newsletter (Boston Pelvic PT)
• Parents in Love Newsletter by Dr. Rebecca Howard Eudy
• Parents in Love: A Guide to Great Sex After Kids by Dr. Rebecca Howard Eudy

Connect with us:

Dr. Rebecca Howard Eudy

• Website: https://www.rebeccaeudy.com
• Instagram: https://www.instagram.com/rebeccahowardeudy/
• Newsletter: https://substack.com/@parentsinlove

Dr. Alexandra DiGrado

• Website: https://www.bostonpelvicpt.com
• Instagram: https://www.instagram.com/bostonpelvicpt/
• Newsletter: https://bostonpelvicpt.myflodesk.com/underthehood

Podcast

• Instagram: https://www.instagram.com/underthehooddocs/
• Website: http://www.underthehoodpod.com

In this episode, Dr. Rebecca Howard Eudy (couples and sex therapist) and Dr. Alex DiGrado, DPT, PRPC (pelvic floor physical therapist) discuss how your nervous system, muscular habits, and past experiences (including trauma and chronic stress) are all connected to chronic pelvic pain. Whether you’ve been dismissed by the healthcare system, or are looking to better understand the connection between your body and brain, this conversation will leave you feeling informed, seen, and empowered to seek relief for yourself and your loved ones.

What You’ll Learn:

• The 10-Year Delay: Why conditions like endometriosis take so long to diagnose and how these conditions contribute to chronic muscular pain.
• The Ab Gripping Habit: How chronic ab-tightening (often thanks to diet culture and fitness trends) can lead to a chronically tight, painful pelvic floor.
• The Fire Alarm Analogy: Why your body continues to send very real, strong pain signals even after an infection (like a UTI) or injury has been treated.
• Lifestyle Optimization: The often-overlooked connection between pelvic tension, low back pain, bowel movements, and overall wellness.

Tune in if you’ve ever thought:

• “I feel like I'm going crazy—I know my pain is real, but my doctor keeps telling me everything ‘looks normal’.”
• “Why does it seem like I constantly have a UTI even though my tests are negative?”
• “How can pelvic floor PT help my chronic pain when it’s caused by a disease like endometriosis (or PCOS, IBS, and more), rather than a specific injury?"

Resources

• Explain Pain by Lorimer Moseley
• The Body Keeps the Score by Bessel van der Kolk
• Nancy's Nook (Endometriosis education + resources)
• Beating Endo by Dr. Iris Kerin Orbuch and Amy Stein
• Find a pelvic floor PT near you: pelvicrehab.com or Pelvic Global Directory
• Under the Hood Newsletter (Boston Pelvic PT)
• Parents in Love Newsletter by Dr. Rebecca Howard Eudy
• Parents in Love: A Guide to Great Sex After Kids by Dr. Rebecca Howard Eudy

Connect with us:

Dr. Rebecca Howard Eudy

• Website: https://www.rebeccaeudy.com
• Instagram: https://www.instagram.com/rebeccahowardeudy/
• Newsletter: https://substack.com/@parentsinlove

Dr. Alexandra DiGrado

• Website: https://www.bostonpelvicpt.com
• Instagram: https://www.instagram.com/bostonpelvicpt/
• Newsletter: https://bostonpelvicpt.myflodesk.com/underthehood

Under the Hood Podcast

• Instagram: https://www.instagram.com/underthehooddocs/
• Website: http://www.underthehoodpod.com

Most people hear “pelvic floor PT” and think, “So…Kegels and an awkward exam?” But here’s what most people don’t realize: good pelvic floor physical therapy is full-body, trauma-informed care that connects your bladder, bowel, sexual function, posture, breathing, and stress levels—not just your vagina, penis, or “down there.”

In this episode, Dr. Rebecca Howard Eudy (couples and sex therapist) and Dr. Alex DiGrado (pelvic floor physical therapist) pull back the curtain on what actually happens in a pelvic floor PT visit. From the intake questions to the internal exam (always optional, always consent-based), they walk through how a skilled PT looks at your whole body, your nervous system, and your real life to understand what’s going on.

Whether you’re leaking when you sneeze, dealing with constipation, dreading sex because it hurts, or just wondering if your “weird” symptoms are normal, this conversation will leave you informed, de-shamed, and more confident about getting the help you deserve.

What You’ll Learn

• What really happens at a pelvic floor PT appointment
• Why training and approach matter so much in the PFPT you choose
• The truth about Kegels (and why tight muscles are weak muscles)
• How your whole life shows up in your pelvis
• Signs that pelvic floor PT could help you

Tune in if you’ve ever thought:

• “Isn’t pelvic floor PT just Kegels?”
• “I had a weird pelvic floor PT experience—do I really want to try again?”
• “Why am I leaking, in pain, or running to the bathroom all the time?”
• “Is it normal that sex hurts (or feels numb) after childbirth or surgery?”
• “What actually happens in an internal exam—and do I have to do one?”

Resources

• Pelvic floor + postpartum support & courses
  • The Healthy Pelvis Project – virtual pelvic health and postpartum support:
    https://thehealthypelvisproject.podia.com/
• Find a pelvic floor physical therapist near you
  • Pelvic Rehab Provider Directory:
    http://pelvicrehab.com/
  • Pelvic Global PT Directory:
    https://directory.pelvicglobal.com/
• Sex & Relationships
  • Parents in Love: A Guide to Great Sex After Kids by Dr. Rebecca Howard Eudy

Connect with Us

• Dr. Rebecca Howard Eudy
  • Website: https://www.rebeccaeudy.com
  • Instagram: https://www.instagram.com/rebeccahowardeudy/
  • Newsletter: https://substack.com/@parentsinlove
• Dr. Alexandria DiGrado
  • Website: https://www.bostonpelvicpt.com
  • Instagram: https://www.instagram.com/bostonpelvicpt/
  • Newsletter: https://bostonpelvicpt.myflodesk.com/underthehood
• Podcast
  • Instagram: https://www.instagram.com/underthehooddocs/
  • Website: http://www.underthehoodpod.com

This is the second episode in our series exploring Dr. Rebecca Howard Eudy’s new book, Parents in Love: A Guide to Great Sex After Kids.

Desire differences are one of the most common struggles couples face—especially after becoming parents. One partner may want sex more often, while the other feels overwhelmed, pressured, or disconnected. Underneath those stuck places, both people are usually reaching for the same thing: closeness, emotional safety, and reassurance that they matter.

In this episode, Dr. Rebecca Howard Eudy (couples and sex therapist) and Dr. Alex DiGrado (pelvic floor physical therapist) dive into the sexual cycle—how pursuit and withdrawal show up in the bedroom, how gender conditioning shapes desire, and the real difference between spontaneous vs. responsive desire.

They explore why pressure shuts everything down, how resentment quietly builds, and why willingness—not immediate desire—is often the true starting point for connection.

What You’ll Learn

• How emotional patterns influence sexual patterns
• The difference between spontaneous and responsive desire
• Why pressure and resentment shut down intimacy
• How gender conditioning affects how people express desire
• What is sensate focus and how can it help couples reconnect

Tune in if you’ve ever thought:

• “Why do we want sex at such different times?”
• “Is something wrong with me if I only feel desire after things get started?”
• “Why does my partner take it so personally when I’m not in the mood?”
• “How can we get out of this cycle of pressure, shutdown, and misunderstanding?”
• “How do we bring back intimacy after having kids?”

Resources

Sex & Relationships

• Parents in Love: A Guide to Great Sex After Kids by Dr. Rebecca Howard Eudy
  https://substack.com/@parentsinlove

Pelvic floor + postpartum support & courses

• The Healthy Pelvis Project – virtual pelvic health and postpartum support:
  https://thehealthypelvisproject.podia.com/

Find a pelvic floor physical therapist near you

• Pelvic Rehab Provider Directory:
  http://pelvicrehab.com/
• Pelvic Global PT Directory:
  https://directory.pelvicglobal.com/

Connect with Us

Dr. Rebecca Howard Eudy

• Website: https://www.rebeccaeudy.com
• Instagram: https://www.instagram.com/rebeccahowardeudy/
• Newsletter: https://substack.com/@parentsinlove

Dr. Alexandria DiGrado

• Website: https://www.bostonpelvicpt.com
• Instagram: https://www.instagram.com/bostonpelvicpt/
• Newsletter: https://underthehood.myflodesk.com/o9qfr16q1v

Podcast

• Instagram: https://www.instagram.com/underthehooddocs/
• Website: http://www.underthehoodpod.com

What happens to love, sex, and connection when kids enter the picture? In this episode, Dr. Alex DiGrado (pelvic floor PT, Melrose, MA) interviews Dr. Rebecca Howard Eudy (sex & couples therapist, Boston) about her new book Parents in Love: A Guide to Great Sex After Kids. They unpack why couples feel like roommates in early parenthood, how to navigate late-night fights, and what it really means to “Do No Harm” when no one’s sleeping or thriving. You’ll also learn how the Notice–Own–Connect framework helps couples move from blame to repair, and how small gestures can rebuild intimacy long before you’re back in the bedroom.

What You’ll Learn

• What the “Do No Harm Agreement” is and when to use it
• How stress, exhaustion, and unmet expectations create conflict cycles—and how to pause before they spiral
• About rupture and repair in relationships (and why repair never happens by accident)
• A crash course in attachment theory and why every couple gets stuck in predictable cycles of disconnection
• How to “blame the cycle, not each other” to turn fights into opportunities for closeness

Tune in if you’ve ever thought:

• “We love each other, so why do we keep fighting about stupid stuff like the dishwasher?”
• “Are we broken, or just exhausted?”
• “How do we reconnect when there’s no time, no sleep, and no spark?”
• “Is it possible to repair after the baby years… and actually feel in love again?”

Resources

• Parents in Love: A Guide to Great Sex After Kids. by Rebecca Howard Eudy
• Secure Love by Julie Menanno
• The Postpartum Essentials Virtual course
• Sex After Baby Mini-Course
• Find a pelvic floor PT: pelvicrehab.com or Pelvic Global Directory
• Under the Hood Newsletter by Boston Pelvic PT
• Parents in Love Newsletter by Dr. Rebecca Howard Eudy

Connect with Us:
Dr. Rebecca Howard Eudy → rebeccaeudy.com | Instagram @rebeccahowardeudy
Dr. Alex DiGrado → bostonpelvicpt.com | Instagram @bostonpelvicpt

Join the Conversation
If this episode helped you rethink love and connection after kids, share it with a friend or tag us: @underthehooddocs

Want more?
Subscribe wherever you listen (please rate & review the show!) and visit underthehoodpod.com for show notes, transcripts, and resources.

It’s time to talk about the most misunderstood organ in the human body: the clitoris. In this eye-opening episode, Dr. Rebecca Howard Eudy (sex & couples therapist, Boston) and Dr. Alex DiGrado (pelvic floor PT, Melrose, MA) pull back the hood to bust myths about female pleasure, anatomy, and the “orgasm gap.” From the hidden structure of the clitoris to why most women don’t orgasm from penetration alone, this candid conversation explores what real sex education missed, how partners can communicate better, and why knowing your body is the foundation for better pleasure and connection.

What You’ll Learn

• The true anatomy of the clitoris—far beyond “the button”
• Why 95% of women need clitoral stimulation (not just penetration) to orgasm
• How cultural scripts around sex create confusion, pressure, and fake orgasms
• The difference between clitoral and “G-spot” orgasms—and why they’re connected
• Why “tight” isn’t better: how pelvic-floor coordination (not just Kegels) supports pleasure
• How arousal, blood flow, and relaxation affect orgasm potential
• Practical ways to explore your body, communicate with partners, and close the orgasm gap

Tune in if you’ve ever thought:

• “Why can’t I orgasm from sex like in the movies?”
• “What’s the deal with the G-spot—is it real?”
• “Am I broken if I need clitoral stimulation?”
• “How do I tell my partner what actually feels good?”

Resources

• Come As You Are — Emily Nagoski, PhD
• Becoming Cliterate — Laurie Mintz, PhD
• Dipsy app — erotic audio stories for women
• The Postpartum Essentials Virtual course
• Sex After Baby Mini-Course
• Find a pelvic floor PT: pelvicrehab.com or Pelvic Global Directory
• Under the Hood Newsletter (Boston Pelvic PT)
• Parents in Love Newsletter by Dr. Rebecca Howard Eudy

Connect with Us:
Dr. Rebecca Howard Eudy → rebeccaeudy.com | Instagram @rebeccahowardeudy
Dr. Alex DiGrado → bostonpelvicpt.com | Instagram @bostonpelvicpt

Join the Conversation
If this episode helped you understand your body or rethink pleasure, share it with a friend or tag us: @underthehooddocs

Want more?
Subscribe wherever you listen and visit underthehoodpod.com for show notes, transcripts, and resources.

“Six weeks and you’re good to go” is not the whole story. In this candid conversation, Dr.

Rebecca Howard Eudy (sex & couples therapist, Boston) and Dr. Alex DiGrado (pelvic floor PT,

Melrose, MA) break down why postpartum sexual health is complex. From scar care, pelvic-floor

coordination, breastfeeding-related dryness, and smart lube choices to identity shifts,

“touched

out” fatigue, and how to ease back in (think: first base, then second), you’ll get a realistic,

compassionate roadmap for reconnecting with your body and your partner.

What You’ll Learn

• Why the 6-week “all clear” ≠ fully healed, and what realistic timelines look like
• Pelvic floor changes after birth: tension + weakness + trigger points, and how
• coordination beats “just Kegels”
• Hormones and how they affect sexual and pelvic health and desire
• How to re-start intimacy gently: kissing-only nights, pressure-free progression, and
• broadening what “counts as sex”
• When to see a pelvic floor PT and why early help prevents pain/tension cycles
• The “touched out” paradox, and how communication and scheduling actually boost desire

Tune in if you’ve ever thought:

• “We got the 6-week clearance, so… why doesn’t sex feel okay yet?”
• “Is this pain normal, or should I see a pelvic floor PT?”
• “Why is my orgasm MIA after birth?”
• “How do we feel close again when we’re exhausted and ‘touched out’?”

Resources

• The Postpartum Essentials Virtual course
• Sex After Baby Mini-Course
• Find a pelvic floor PT: pelvicrehab.com or Pelvic Global Directory
• Under the Hood Newsletter (Boston Pelvic PT)
• Parents in Love Newsletter by Dr. Rebecca Howard Eudy

Connect with Us:

Dr. Rebecca Howard Eudy → rebeccaeudy.com | Instagram @rebeccahowardeudy

Dr. Alex DiGrado → bostonpelvicpt.com | Instagram @bostonpelvicpt

Join the Conversation

If this episode helped you rethink postpartum sex, share it with a friend or tag us:

https://www.instagram.com/underthehooddocs/

Want more?

Subscribe wherever you listen and visit http://www.underthehoodpod.com for show notes,

transcripts, and resources.

Mixed & Edited by Next Day Podcast

info@nextdaypodcast.com

Erectile dysfunction is very common and it’s rarely only about erections. In this episode, Dr.

Rebecca Howard Eudy (sex & couples therapist, Boston) and Dr. Alex DiGrado (pelvic floor

physical therapist, Melrose, MA) team up to unpack ED from both sides: the psychology and

relationship dynamics that drive performance anxiety, and the physical, pelvic-floor, and lifestyle

factors that affect blood flow, coordination, and climax. From “spectatoring” to cycling, to

diaphragmatic breathing and practical tools like pumps, rings, and meds, this is a

compassionate, evidence-informed roadmap to getting sexual function back on track.

What You’ll Learn

• Why a “bad erection moment” can snowball into anxiety, and how to break the loop
• Physical culprits behind ED: pelvic floor tension, breath-holding with heavy lifting, cycling
• compression, prostatectomy changes, meds, and more
• Coordination: why lengthening/relaxing the pelvic floor is as vital as strengthening.
• Simple, at-home strategies: 360° breathing, posture/mobility tweaks, partner-focused
• pleasure to exit “spectator mode”
• When tools help: pumps, rings, Viagra/Cialis (and why a safety-net pill can reduce pressure)
• How to broaden “what counts as sex” so intimacy thrives while you heal

Tune in if you’ve ever thought:

• “I can get morning/masturbation erections, but lose it with a partner, what gives?”
• “Is cycling/weightlifting messing with my erections?”
• “How do we keep sex fun if penetration isn’t reliable right now?”

Resources

• The Postpartum Essentials Virtual course
• Sex After Baby Mini-Course
• Find a pelvic floor PT: pelvicrehab.com or Pelvic Global Directory
• Under the Hood Newsletter (Boston Pelvic PT)
• Parents in Love Newsletter by Dr. Rebecca Howard Eudy

Connect with Us:

Dr. Rebecca Howard Eudy → rebeccaeudy.com | Instagram @rebeccahowardeudy

Dr. Alex DiGrado → bostonpelvicpt.com | Instagram @bostonpelvicpt

Join the Conversation

If this episode gave you a new way to think about erections, anxiety, or pleasure, share it with a

friend or tag us on Instagram: https://www.instagram.com/underthehooddocs/

Want more?

Subscribe wherever you listen and visit http://www.underthehoodpod.com for show notes,

transcripts, and resources.

Mixed & Edited by Next Day Podcast

info@nextdaypodcast.com