Most women never discuss sexual health with their doctors because the doctors themselves were never trained to address it. In a revealing conversation on the Mel Robbins Podcast, board-certified urologist and sexual medicine specialist Dr. Rachel Rubin exposed a startling reality about modern medical education: the word "clitoris" doesn't appear in the curriculum that gynecologists must complete to graduate in 2026. This educational gap means millions of women are being dismissed, gaslit, or given dangerously incorrect advice about conditions that are entirely treatable. What's Missing From Your Doctor's Training? The problem isn't that individual doctors are bad at their jobs. Rather, sexual medicine simply isn't part of standard medical education for gynecologists or primary care physicians. Gynecologists learn about reproductive health, gynecologic cancers, and general gynecology, but sexual medicine is rarely included unless a doctor pursues additional training on their own. Meanwhile, urologists have historically focused on men's sexual health, leaving women's sexual concerns largely unaddressed across the entire medical system. This creates a confusing situation for patients. When a woman experiences low libido, painful intercourse, or other sexual health concerns, the logical choice seems to be visiting her primary care doctor or gynecologist. But these specialists often lack the knowledge to help. Rather than admitting this gap in their training, Dr. Rubin noted that doctors frequently dismiss concerns or provide incorrect information that can make patients feel like their problems are "all in their head". What Are Doctors Actually Telling Women That's Wrong? The advice women receive for sexual health concerns is often not just unhelpful, but actively harmful. Dr. Rubin explained that she hears the same problematic recommendations repeatedly in her clinic: - "Drink a glass of wine": Offered as a solution for low libido without addressing underlying biological causes. - "Read Fifty Shades of Grey": Suggested as a fix for pain during sex, ignoring the fact that psychological stimulation cannot resolve physical problems. - "Just have more sex": Recommended to women experiencing painful intercourse, which can worsen the problem and create negative associations with intimacy. - "This is just part of getting older": Used to dismiss concerns as inevitable rather than exploring treatable conditions. - "That part of your life is over now": Suggesting women should abandon sexual health as they age, rather than optimizing it. Every day, patients arrive at Dr. Rubin's clinic with stories of being dismissed or told their concerns couldn't possibly be real. This pattern of dismissal has real consequences: women suffer through preventable problems, miss opportunities for treatment, and internalize the message that their sexual health doesn't matter. How to Recognize Symptoms That Deserve Medical Attention Dr. Rubin emphasized that many women normalize symptoms that actually have biological causes and medical solutions. If you find yourself thinking "this is just how it is," or "my mother went through this," it's worth investigating further. Common symptoms that warrant a conversation with a knowledgeable clinician include: Dr. Rubin - Urinary changes: Waking up more frequently at night to urinate, or experiencing leakage when coughing, laughing, or sneezing. - Vaginal discomfort: Sex feeling drier, scratchier, or more painful than it used to, which can have hormonal causes that are treatable. - Orgasm changes: Orgasms becoming difficult to achieve or taking significantly longer than before. - General wellness decline: Feeling like you're "not yourself," experiencing increased anxiety or mood changes, or noticing a shift in how you feel overall. - Recurrent infections: Having multiple urinary tract infections without understanding why or exploring prevention strategies. Dr. Rubin stressed that low libido is a medical condition if it bothers you, and there are FDA-approved solutions available. The key is finding a clinician who actually understands sexual medicine. Why Sexual Medicine Doctors Are Different So what exactly is a sexual medicine doctor, and how is it different from a gynecologist or urologist? Dr. Rubin explained that sexual medicine doctors are specialists within urology who focus specifically on sexual health across the lifespan. Urologists are genitourinary doctors who treat kidneys, bladders, prostates, and yes, vulvas and penises. But sexual medicine is their primary focus, even though they're also trained as surgeons. The distinction matters because sexual medicine doctors have dedicated training in conditions affecting sexual function, desire, and satisfaction. They understand the biological basis for many sexual health concerns and have tools in their toolkit that other doctors simply don't learn about. This includes knowledge about hormonal treatments, pelvic floor dysfunction, and the connection between systemic health and sexual wellness. Dr. Rubin noted that the assumption that "gynecologists are for women and urologists are for men" doesn't make medical sense. Both men and women have bladders, kidneys, and genitals. Both experience sexual health concerns across their lifespans. Yet the medical system has historically divided care in ways that leave women's sexual health largely unaddressed. Dr. Rubin What Happens When Women Get the Right Information? Dr. Rubin's core belief is that when women receive accurate information about how their bodies work, they make excellent healthcare decisions for themselves. She emphasized that good health, mental health, community support, and access to knowledgeable clinicians enable women to optimize their lives to whatever degree they choose. This isn't about pressure to maintain a certain level of sexual activity or performance. Rather, it's about having the option to address concerns that affect quality of life. Whether you're going through puberty, childbirth, perimenopause, or menopause, sexual health matters for overall wellness. The goal is empowerment through knowledge, not judgment or expectations. The path forward requires both individual advocacy and systemic change. Women should seek out sexual medicine specialists when they have concerns their primary care doctor can't address. At the same time, the medical education system needs to recognize that sexual medicine is essential knowledge for all doctors who care for women, not an optional specialty.
