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Dr. Sadaf on Transforming Sexual Health Conversations

Dr. Sadaf on Transforming Sexual Health Conversations

Have you ever wondered if you need Sex Coaching? Join me as we delve into the complexities of sexual health and stigma with our incredible guest, Dr. Sadaf who is an OB/GYN and Sex Coach.

We’ll explore cultural beliefs, sexual concerns, and the urgent need for comprehensive sex education. We’ll confront the discomfort in society and among physicians when discussing sexual health, advocating for a world where these vital conversations are normalized.

Understanding the Role of Sex Coaches and Therapists:

Let’s dive deep into the overlap and differences between sex coaching and therapy. I stress the importance of addressing both psychological and physiological aspects using a multimodal approach to female sexual dysfunction.

Both Dr. Sadaf and I emphasize the significance of eradicating shame and ignorance surrounding sexuality. This candid conversation encourages us to step into advocacy, embrace empowerment, and pursue education for ourselves and our communities.

If Dr. Sadaf’s insights resonate with you, follow her journey on the Muslim Sex Podcast. For ongoing inspiration, remember to subscribe to Gyno Girl Presents: Sex, Drugs, and Hormones, and check our treasure trove of resources, including our website, Instagram, YouTube channel, and our ever-insightful newsletter!

We aspire to empower you with the knowledge that defies taboos and emboldens your journey toward comprehensive sexual wellness. Your voice is part of this movement. Share your thoughts, questions, and personal stories with us. Together, we’re rewriting the narrative on sex, drugs, and hormones.

Extend this conversation with someone who needs to hear it. Share this episode and spark enlightenment!

Your reviews and feedback light up our world! If you’re enjoying the podcast, please take a moment to rate us and share your thoughts. Your support means everything.

Highlights:

Cultural Influences on Sexual Health

– The impact of cultural beliefs on perceptions of sex and personal hygiene.

– Meeting individuals where they are in terms of sexual health understanding.

Discomfort in Discussing Sexual Health

– General societal and medical professional discomfort with sexual health topics.

– Dr. Sameena’s insights on clinicians’ discomfort despite training in sexual health.

Empowerment and Advocacy in Sexual Health

– Dr. Rahman’s commitment to empowering and educating on stigmatized health issues.

– Dr. Lodi and Dr. Rahman’s shared experiences in addressing taboo issues.

Dr. Sadaf’s Sex Coaching Practice

– The role of coaching in treating the mind-body connection.

– Use of coaching to shift limiting beliefs and address conditions like vaginismus.

– The multimodal approach involves medical and therapeutic aspects.

Importance of a Biopsychosocial Approach

– Acknowledgement of how sex coaching and therapy contribute to treating sexual dysfunction.

– Dr. Sadaf’s approach to combining sex therapy and coaching in her practice.

Educational Gaps and Cultural Taboos

– Reflections on the lack of sexual medicine education during medical training.

– Addressing the discomfort among physicians in discussing sexual issues.

– The importance of education and empowerment in culturally sensitive contexts.

Historical Research on Female Sexuality

– Legacy of neglect in medical research on women’s sexuality.

– Recent advances and recognition in the field.

Get in Touch with Dr. Sadaf:

Website

Podcast

Instagram

Get in Touch with Dr. Rahman:

Practice

GynoGirl Website

Instagram

Youtube

Transcript

Dr. Sameena Rahman [00:00:01]:

Hey, y'all, it's Dr. Samina Ramon Gynogirl. I'm a board certified gynecologist, a clinical assistant professor of OBGYN at Northwestern Feinberg School of Medicine, and owner of a private practice for almost a decade that specializes in menopause and sexual medicine. I'm a south asian american muslim woman who is here to empower, educate, and help you advocate for health issues that have been stigmatized, shamed, and perhaps even prevented you from living your best life. I'm better than your best girlfriend and more open than most of your doctors. I'm here to educate so you can advocate. Welcome to Gynogirl presents sex, drugs, and hormones. Let's go.

Dr. Sameena Rahman [00:00:48]:

Hey guys, it's me, Dr. Smeener Raman Gynogirl. I'm so excited. I just recorded a podcast with Dr. Sadh Lodi. She is a board certified gynecologist and she is a sex coach as well. She has a podcast called the muslim Sex podcast and she is opening her own practice for sex med and menopause in Westchester, New York. And we talk about sex coaching and how that's really important for the biopsychosocial approach for treating sexual dysfunction in women.

Dr. Sameena Rahman [00:01:19]:

So she gave some great insight into that. So I'm really excited for you guys to hear this. She's a friend of mine and she has a lot to say about how important coaching is, which it is. And she's a friend of mine, and I hope you guys enjoyed the podcast. Please like subscribe, write a review if you like it, and also share it with a friend. I think they'll all enjoy this podcast today, so thank you so much. Come to another episode of Gynogirl presents sex, drugs, and hormones. I am so excited today to have my friend and colleague joining us today to talk about sexual medicine in general.

Dr. Sameena Rahman [00:01:52]:

But we're going to dive deep into what sex coaching looks like and how that is so helpful in sort of the biopsycle social approach to female sexual dysfunction. And so, without any hesitation, I'm going to bring to you Dr. Sadaf Lodi. She is a board certified OBGYN and a sexmed specialist as well as a menopause specialist. She will be opening a practice very soon. Woohoo. In New York. Westchester area.

Dr. Sameena Rahman [00:02:24]:

Westchester area. And she has her own wonderful podcast for the last few years, the muslim Sex podcast. She's also a certified sex counselor through ASECD as well as a sex coach. And we are going to talk about sex coaching because we don't hear a lot about that. Or we don't hear enough about that. So welcome, Dr. Sadaf Lodi.

Dr. Sadaf [00:02:45]:

Thank you so much for having me on, Dr. Raman. So I'm so excited to be on your podcast. I've had the pleasure of having you on my podcast. I don't know. I think maybe like three, four times.

Dr. Sameena Rahman [00:02:57]:

Right. Those in the notes we talked about, I think. Was it vaginismus one time? No. Or muslim sexual issues around vaginismus.

Dr. Sadaf [00:03:06]:

Yeah, the first one maybe. Was it vaginismus? And then we've talked about genital arousal. Yes. Persistent genital arousal. And then we talked about the updates in menopause.

Dr. Sameena Rahman [00:03:17]:

Yes. We were lost. Not the North America, the Menopause Society. Now it's called in Philadelphia. That was in. Yeah.

Dr. Sadaf [00:03:27]:

Yep. So you've been on a few times. Just for clarification, I am a sexual counselor and educator. I actually have to turn in my paperwork to get Asex certified. I'm a little bit delinquent on that, but I am a sex counselor and educator. I took the course through the University of Michigan that actually runs for a whole year. And I did that course, which is really amazing. And that's where I did my first SAR that we were just talking about before we started recording.

Dr. Sadaf [00:03:58]:

And so that was really a mind blowing experience. Really interesting and really helps you to check your biases. In sexual medicine, we always say, don't yuck my yum. Right. So that's what it is. That was like the mantra in our sexual counseling and education course. So it's really important.

Dr. Sameena Rahman [00:04:19]:

And I think based on our background, we're both pakistani Muslims and having grown up with all the stigma around and sex shaming and all this stuff, that the SARs are pretty important for people like us because we always do try to check our biases, but sometimes we struggle more than others.

Dr. Sadaf [00:04:35]:

Absolutely. A lot of times you just haven't, like, I definitely was not exposed to any of the stuff that I was watching. And so for me, it was really an enlightening experience. And what's really interesting about. Yes. And I was really just taken aback. And we are actually divided into cohorts. And so the people that were in my SAR group were all therapists.

Dr. Sadaf [00:05:01]:

So they're all now sex therapists. And so it's so funny because after the first date, they're all like, Sudha, are you okay? That was quite a lot. I said, I'm going to need some therapy after this. But, yeah, no, it's really interesting. And you just really see where it lands in your body and how you're feeling, and it's just really an eye opening experience. So for anyone that hasn't done it that is interested in sexual medicine, I really highly recommend it just because it really is a mind blowing event. I mean, there's no other way to describe it. It's very different.

Dr. Sadaf [00:05:37]:

And really, where else are you going to spend 16 hours watching? That's really interesting. So, yes, I'm a sex counselor and educator through the University of Michigan, and I also am a board certified OBGYN. I'm an ishwish fellow with. I'm an ishwish member, like Dr. Aman. But Dr. Aman is, like, the Og of all know, female sexual educators. She's like, everyone knows Dr.

Dr. Sadaf [00:06:07]:

Aman. She's awesome. I love her. And also, yes, I'm a menopause society certified practitioner.

Dr. Sameena Rahman [00:06:15]:

So I always get asked, like, do you know anyone in this area? That area? So we're going to have someone great to refer to in Westchester, New York. So hopefully in spring of this year.

Dr. Sadaf [00:06:28]:

Yes. Inshallah.

Dr. Sameena Rahman [00:06:29]:

Yep.

Dr. Sadaf [00:06:29]:

April.

Dr. Sameena Rahman [00:06:30]:

So let's talk about, like. Okay, so we all have our know, most people that listen to this podcast or listen to your podcast or even hear any of us talk about sex med, realize that we get really no sex med education in medical school or residency, actually, at all. And so our experiences into sexmed as we dived into it or dive into it usually come from either personal issues that we've had or patient issues that we're trying to investigate. I know for me, it was both. I talked about that in previous podcasts about having a patient I couldn't within the first week of my practice ten years ago, trying to figure out what to do with her. And then I learned about ishwish, and I learned about Erwin Goldstein, and I figured it out from there and has been doing it since. But I feel like we all have our stigmas that we've grown up with and the shame around it. What about you? Tell us about.

Dr. Sadaf [00:07:25]:

Yeah, thank you. It's funny that you should ask that, because when I look back as to why I got into sexual medicine and now into menopausal medicine is because I just felt like there was a huge void in medicine, right? Patients would come to me and ask me about their libido. They'd ask me about painful intercourse, and I didn't have the answer. I would just tell them. Sometimes I'd be like, oh, I don't know. Maybe you just need a new partner. Like something silly like that. Because when you don't know, you don't know what you don't know.

Dr. Sadaf [00:07:54]:

And then once you start learning, you're like, wow, that was a really ignorant answer.

Dr. Sameena Rahman [00:07:59]:

Oh, my God. I can just remember some of the things that I thought or maybe have said to patients. But it's an evolution. Medicine is always evolving. And the last ten years, we learned so much more in sexmed than we ever knew before.

Dr. Sadaf [00:08:14]:

Yeah, it partly came because of that and also partly because of the fact that I myself knew nothing. I would say, being a board certified gynecologist, you would think that we would get something in our residency, which we don't. We don't get anything about menopause either. And so I was like, gosh, I don't know anything about sexual medicine.

Dr. Sameena Rahman [00:08:37]:

That great TED talk where you met, I was listening to your TED talk about it.

Dr. Sadaf [00:08:40]:

Yeah, it's sexual medicine for physicians. Lessons from a muslim gynecologist. Yes, that was my TEDx talk. And that was. Right. That's what I talk about, is just how physicians don't get the education that we need to help our patients out and that most physicians feel pretty uncomfortable talking about sex, because, again, we don't get that knowledge. We don't know how to treat. We don't know how to examine.

Dr. Sameena Rahman [00:09:05]:

Right?

Dr. Sadaf [00:09:06]:

We don't know how to examine. We just take a look at the vulva and put a speculum in and say, like, oh, everything looks fine. I don't know. We're having this pain.

Dr. Sameena Rahman [00:09:13]:

Do you remember learning how we shouldn't examine the clitoris in med school? Like, don't touch the. I remember people saying that.

Dr. Sadaf [00:09:19]:

I don't even think I learned the word clitoris. I cannot remember. And I'm like, gosh, where has this been my whole life? I feel, like, just so clueless about this whole thing. And I was just telling you offline that, honestly, I was calling the whole vulva region the vagina forever. And I'm a gynecologist, so lots of lapses in our education, and I think that that really was my passion. And also because a lot of times in our cultures and the way that we're raised, sex is seen as dirty, shameful, wrong. And if you have a high libido, what's wrong with you? Why do you have a high libido? It's just crazy. Like, oh, you're sex crazed or something like that, and it's not the case.

Dr. Sadaf [00:10:03]:

And if you're curious about sex and, oh, you don't have any shame, and why would you even talk about this? Why would you even want to know about this? Right? And there's so much taboo and stigma around it that I was like, you know what? I'm just going to own it. Yes, I want to know. I want to learn more about it. I want to help patients. I want to help my muslim community. I want to be the role model that I never had. And I want to know that there's nothing wrong with learning about sexual education. There's nothing wrong with if somebody experiences pleasure, there's nothing wrong with that.

Dr. Sadaf [00:10:38]:

Somebody wanting pleasure. I mean, there's so much. And I'm going to write a book soon, hopefully, inshallah, and it's going to be called give yourself permission to experience pleasure.

Dr. Sameena Rahman [00:10:48]:

Right?

Dr. Sadaf [00:10:49]:

Just give yourself permission. I mean, I think oftentimes we just hold ourselves back because of all the sex and negativity that perhaps either we were raised in or have embodied through culture and through friends or whatever, that we don't give ourselves permission. And even when you talk about it with, say, like, another friend, they may be like, wow, actually, I have to tell you the story. So I had this friend of my really good friend, somebody that I grew up with, and we were talking about it, and I said, oh, I'm going to do this podcast called the muslim Sex podcast, because I'm genuinely interested in sex and I just want to know more and stuff like that. And she said to me, she goes, yeah. So I just assumed that you like sex or you want to know more about it just because of who you are. And I just thought that was such a strange thing to say. I think it's just because if somebody automatically wants to learn more about sex, is all of a sudden that, oh, they must just really like, deprived.

Dr. Sameena Rahman [00:11:47]:

I mean, we were deprived of the like, I think that's very like, we didn't know anything. I think I have a similar story from college. Like, my good friends would always be like, oh, my God, you're going to be like the muslim Dr. Ruth one day, aren't guess.

Dr. Sadaf [00:12:04]:

Well, you are.

Dr. Sameena Rahman [00:12:06]:

A couple of my friends used to laugh about that, but I think know it's the same thing. We were just so deprived of the education around it, and you shouldn't make something so taboo. It makes you want to know more.

Dr. Sadaf [00:12:16]:

About, you know, honestly, Samina, I will say that it's really after having met somebody like you, like a kindred spirit, that you normalize it, right? It's not like you're like a sex fiend or like somebody that's just insatiable or something. No, it's somebody that is educated, smart, wants to know more, help others so that they don't grow up with the same stigmas and taboos and don't think that there's something wrong with them because they want to know more. It's about education. It's about empowerment, it's about sexual agency. It's about all of that.

Dr. Sameena Rahman [00:12:57]:

And advocacy. Absolutely. I think that that's one of the biggest things that both of us kind of strive for because we didn't have that and we didn't grow up with that. And I always tell my kids, at the end of the day, whatever you choose to be, just remember, at some point, you want to have a legacy. You want to be remembered for something that you contribute positively to the world or society or to somebody. So that gives you a purpose and a drive. And I think that's kind of been ours as mutual.

Dr. Sadaf [00:13:28]:

Absolutely. Yeah. Everyone has a why. Everyone has a why of why they do anything. And I think that my why is to empower and educate women throughout the world. I mean, that's always been my goal is know, global. And I'm sure yours is know, just having the background that you have. Both of us know of pakistani descent.

Dr. Sadaf [00:13:51]:

We have a strong connection to Pakistan, and we want to empower the women that are there and so that they know about their own education. I just recently had on a woman on my podcast who's a professor at St. John University in New York, and I don't know if you listen to that podcast, but she talks about how she was speaking to somebody in Pakistan, and that woman told her that her husband told her that she could not have a baby unless a wife performed.

Dr. Sameena Rahman [00:14:20]:

Oral sex on weird.

Dr. Sadaf [00:14:24]:

And I just sat there with my mouth open, like, wow. But that's what's so sad, right? There's so much in that that's just so sad. One, that she didn't know her own anatomy, she didn't understand the physiology, she didn't understand her body. The fact that he had so much control over her that he could tell her that and she would believe him, and that for him, it was about his own pleasure and not hers. I mean, there's just so much there to impact in that one statement that I was just floored by that, and I was, you know, we have so much work to almost.

Dr. Sameena Rahman [00:14:59]:

It's ridiculous, honestly, that someone would say that, and then people believe it because they don't know. The lack of education is so prominent. I mean, we talk about the lack of education in America, right? We get sex ed when we're learning about puberty, and maybe when you learn about STI prevention, and that's it. And a lot of times, people have never had sex. When you're in puberty or before puberty, you have no desire. I mean, I gave the talk for my girl in fifth grade about puberty. She's like, what is this? I don't want to talk about this. Why are you talking about this? You do gross things.

Dr. Sameena Rahman [00:15:29]:

And I'm trying to normalize it for her so she doesn't have the same hiccups that I have. But you get it a couple of times, and then when you're actually doing it or having issue with it, no one tells you anymore. They don't tell you anything. The same thing we always talk about with menopause. Like, nobody tells you any of that, and so you just suffer.

Dr. Sadaf [00:15:45]:

We don't learn know, Samin, I will actually say that. So I actually did a talk on sex education here in the United States, and we go a little bit into that with that course that I took through the university of. And I know you're not going to be surprised about this at all, but really, how much sex education you get is really dependent on your zip code and where you grow up and who is in control of the board of education, even in your district. And what you're learning. And most kids, right, most kids are getting their sex education either through school, through their churches, or through their friends or something like that. And most of the information that they get, depending on where they're raised, is either abstinence or it's about they're pathologizing sex, like prevention of diseases, or they're learning how to not get pregnant, right? But you don't learn about consent. You don't learn about domestic violence. You don't learn about pleasure.

Dr. Sadaf [00:16:46]:

None of those things. And even the who in, I believe it was 2019 passed a statement that said that pleasure should be, is part of sexual education and patients should learn about it. And people are entitled. It's a human right to have, you know, the fact that here, even in the US, the sexual education is so lacking. Know, we have patients. I'm sure you have patients. I have patients that come to me that were raised here and don't realize they have three holes, right? That there's a urethra, a vagina, and a rectum, that they think that they pee and they have a baby through the same hole, all of those things. And it's because of the lack of education.

Dr. Sadaf [00:17:31]:

The lack of education of our own bodies that we don't even know that those things exist, really.

Dr. Sameena Rahman [00:17:38]:

I mean, I grew up in the south, so, I mean, we were heavily not told about anything.

Dr. Sadaf [00:17:43]:

Right. And I'm sure probably your sex education was about abstinence.

Dr. Sameena Rahman [00:17:47]:

Absolutely. I'll tell you.

Dr. Sadaf [00:17:50]:

I never even went. My parents didn't sign the paper. I knew nothing. Nothing. And then I thought, like, maybe when I go to med school, I'll learn something.

Dr. Sameena Rahman [00:17:59]:

Yeah.

Dr. Sadaf [00:18:00]:

And I learned 2 hours. And it was like masters and Johnson, like, linear sexual response cycle. And that was research done in the 1960s on white man.

Dr. Sameena Rahman [00:18:12]:

Right.

Dr. Sadaf [00:18:12]:

And then it wasn't until Kaplan in the 1970s that included desire in that sexual response cycle. And it wasn't until 2001 that Rosemary Bassen came along and she is in British Columbia and came up with that female circular sexual response cycle. And it wasn't until then that women were actually included in the sexual response cycle. And we learned that emotional intimacy was important, and we learned about spontaneous and responsive desire. We learned about the biopsychosocial model and how so many different things can affect our sexual response and depending on what's going on in our lives and whether or not we feel into it or not, and that arousal and desire don't have to happen at the same time, and that one can come before the other, and that's okay. And the degree of how much we enjoy sex has to do a lot with what our relationship looks like with our partner and how safe we'd feel with them and what type of emotional intimacy we have with them. So it's a lot.

Dr. Sameena Rahman [00:19:05]:

Yeah. To us now, it seems like that's obvious, right? Sex is not just like, whatever, but I think it was actually a revolutionary thing to come out and teach this and for people to learn this, that it's not. That it's not based on. Women are not small men. It was 1993 until that we even were allowed into medical research. Right. So that's not that long ago.

Dr. Sadaf [00:19:32]:

Right? It's not, right.

Dr. Sameena Rahman [00:19:34]:

That's crazy.

Dr. Sadaf [00:19:35]:

It's true. And, yeah, we have so much so far to go yet.

Dr. Sameena Rahman [00:19:41]:

Totally. And I think we're just at the tipping point. But bringing up all that with the biopsychosocial approach that we always talk about. Let's talk about coaching and how that fits into it.

Dr. Sadaf [00:19:50]:

Yeah. So, definitely. So coaching is all know. So I did coaching through Rutgers University. And coaching is all about helping patients move forward in their lives.

Dr. Sameena Rahman [00:20:01]:

Right.

Dr. Sadaf [00:20:02]:

It could be that they're stuck in whatever situation they feel and how do we move forward? So as it relates to sex and sexual intimacy, it's about how to move patients from, say, sex negativity or thoughts that they have about sex and how to get them to move forward so that they, if not sex positive, at least sex neutral. Right. And then eventually they get to sex positive, because to move from sex negative to sex positive is a huge leap. And it takes time, and it takes time to work through your thoughts, and then how those thoughts affect you and those turn into feelings and how, based on our feelings, we act.

Dr. Sameena Rahman [00:20:46]:

Right.

Dr. Sadaf [00:20:47]:

So if we're thinking in our head that sex is wrong, it's shameful, it's dirty, then the feelings we may get, we may feel ashamed, we may feel guilty. And then the way that we act is perhaps we don't engage in sex, or perhaps we pull away when our partner or our spouses want to engage in sex. Or maybe we have vaginismus, right, where we were taught for so long that sex was wrong, that you don't learn about it. You don't even look at your own anatomy. And then when it comes time to consummate that marriage, then all of a sudden you just can't because your body is reacting to those thoughts that you've kept and you've held on for so long.

Dr. Sameena Rahman [00:21:27]:

Right.

Dr. Sadaf [00:21:27]:

So the job of a sex coach is almost similar, I would say, to a sex therapist, but really we're not the same. Therapists will really delve into the past, right. And kind of untangle the trauma, perhaps that patients may have had or the abuse or whatever that they may have had in the past and then kind of stick to the past.

Dr. Sameena Rahman [00:21:47]:

Right.

Dr. Sadaf [00:21:47]:

Because they're dealing with all of the past trauma, whereas coaches will maybe dip their toes into the past a little bit, but really focus on how can I help this patient, this client, move forward in their life so that they can have, in this case, the sexual life that they want? How can they be more present for their partner? How can they engage more fully in their sexual relationship?

Dr. Sameena Rahman [00:22:11]:

That's wonderful. And you do have a sex coaching practice as well. So I should mention that, that you are taking clients for sex coaching. And so I think that's a very interesting perspective because I think a lot of times people do get stuck in how they have traditionally believed or whatever the case may be, and they don't know how to move forward. It's really learning those tools that you talk about and what kind of things do you usually work with them? Is it like mind body?

Dr. Sadaf [00:22:43]:

It is a lot of mind body. It has to do with, really, the thoughts that we've had. I think one of the best things that a former coach of mine told me is that, and also, like, a book that I've read that it's called soundtracks, and I'll get into that a little bit. But former coach that I used to use, she used to say to me, which I thought was so helpful, is that we get to choose our thoughts, right? A lot of times we have, like, a gazillion thoughts going through our head racing, and we're so busy, and we don't stop to think. We just think that these thoughts come and we don't have any control over them. But that's not true. What we can do is that the thoughts that come, we can actually stop them and we can change them. For example, a lot of people experience impostor syndrome, right? So, like, when they're about to go speak on a stage or something like that, something in their head may be saying, like, oh, you're not meant to be on the stage, or you're not good enough, or your education's not good enough.

Dr. Sadaf [00:23:33]:

Right. At that point is where you stop. You have to stop yourself, your thoughts, and say, know, and you can call your thoughts that are always holding you back. You can make a name for them, like, I don't know, Diana or something like that, right? And you can be, you know, I understand that you're there, but you're not going to inhibit what I'm going to do today. So you can have your seat and you can be there, but I'm not going to let your voice tell me what's going to happen and what's going to be my reality.

Dr. Sameena Rahman [00:23:57]:

Wonderful, right?

Dr. Sadaf [00:23:58]:

And so then that's how you kind of move past those thoughts. So at least you acknowledge, because sometimes you can't get rid of those thoughts, right? They're just going to be there, but it's okay. You just give them a backseat. They don't have to be the one in the driver's seat telling you where you're going to go and how things are going to show up, right? You get to choose. And I think that's what's so empowering with a coaching is that you get to choose your thoughts. You are not a reflection of your thoughts. You get to choose your thoughts. You get to decide how you are present.

Dr. Sadaf [00:24:28]:

You get to decide where they play in your life, right? And I think that that is really what's empowering. And oftentimes I think that, for example, I had another patient or a client come in, and she was talking. She was experiencing vaginism. She was actually from a conservative christian background. She and I were talking, and so in her head, so she was having actually secondary vaginism. So she was always able to have sex before when she was married and in a relationship where she was married, but now that she was divorced and now in this new relationship, she was experiencing vaginismus, and she couldn't figure it out. So then she and I started to talk, and I asked her, were you able to ever have a relationship where you were able to have sex without pain, without your muscles tightening up? And she said, yes, when I was married before she has children, whatever. And she said, it was never a problem before.

Dr. Sadaf [00:25:25]:

And I said, well, what are your thoughts right now about sex? And she said, well, I guess I feel like it's wrong. And I said, well, why do you feel that it's wrong? And she said, well, the way that I was raised is that I believe that sex is only for marriage. And right now, she wasn't married. She was dating this individual. And she said that because in my mind that sex is only for marriage, and I'm trying to have sex with this individual, her body is, like, taking over, right? So her thoughts in her head are like, this is wrong. This is shameful, this is dirty. I shouldn't be having this because I'm not married to this individual. So then her body is reacting to those thoughts, right? And so when we started to talk about that, she had this huge aha.

Dr. Sadaf [00:26:09]:

Moment where she realized where her thoughts were coming from. And for her, it was important, because it was so important, that was, like, a core value of hers. And she realized that for her, she wasn't acting according to her core values. And because there was a disconnect between her actions and what her values were, her body was stopping it. So then what she decided is that she was actually going to wait until she got married. And so she said that for her, it was important to be true to her values and true to her religion and whatever she was experiencing, and just that knowledge of why she was experiencing, because she thought there was something wrong with it. She was older now. She was in menopause.

Dr. Sadaf [00:26:52]:

She thought maybe that's why. And it could be right. As you and I both know, you have decreased lubrication. There's decreased blood flow. She wasn't on her vaginal estrogen. There were other things going on as well. So of course, I asked her to meet with her gynecologist to be evaluated of course, going back to the biopsychosocial model. And this is why I'm so grateful for all my education, because I understand the whole picture.

Dr. Sadaf [00:27:16]:

And so I asked her to be evaluated by her gynecologist to make sure there was nothing going on with the vulva and any type of infection or anything like that that she was having. And then to also meet with a pelvic floor therapist who could slowly try to help her with dilation so that she wouldn't experience pain with dilation, but then also to work with that cognitive aspect of it, to see where her thoughts were coming from and see how they were playing out in her body and in her relationship. And once she understood that, because for her, the biggest thing was that she just couldn't understand why she was always able to have sex before and why now in this new relationship, she just couldn't have sex.

Dr. Sameena Rahman [00:27:55]:

Right.

Dr. Sadaf [00:27:56]:

And to her, it was this huge disconnect and just not making sense. So she and I together were able to put the pieces together for her to understand. And so now she was living more closer to her own values, what was important for her, not for me or anyone else, but for her. And she decided that she would obviously continue to see her boyfriend and now her fiance, but only go as far as she felt it was right to go, and that she wanted to actually wait until she got married, even though she was older, she was in her 60s, so that she would be in concordance with her own values.

Dr. Sameena Rahman [00:28:37]:

Yeah.

Dr. Sadaf [00:28:39]:

That's how that coaching helped her.

Dr. Sameena Rahman [00:28:41]:

That's amazing. Yeah. Again, we always talk about the biopsychosocial, so we know it's a multimodal approach, and we have to address all the issues when it comes to sexual function. And the coaching element is really big. I think some people need sex therapists, some people need sex coaching, some people need both. And I think both can work concurrently with each other as well. Many issues. But I think that's wonderful that you're able to do this for your patients and clients that you see and maybe both.

Dr. Sameena Rahman [00:29:08]:

I don't know how you navigate that in your new practice.

Dr. Sadaf [00:29:11]:

I know, yeah. There is a coaching aspect of it which is separate from, because we do have to separate the medical aspect of it from the coaching aspect. So I actually do have two separate businesses, but that sometimes it is. And just to even talk to patients, I'll just ask them about their thoughts regarding certain things, especially when I see that there's nothing anatomically wrong, but just that they may have thoughts that something is wrong for example, I had a patient come and she's experiencing infertility, and she was actually of pakistani descent, and she told me that. And she wondered why she kept getting bacterial vaginosis over and over again. So we were talking about sex, and I asked her, I said, so what do you do after you have sex? How are you cleaning up and stuff like that? So she was telling me that she was using detol to clean her vulvar region. And so I told her, please don't do that. You're changing the flora of your vagina, and that's why this bacteria is overgrowing.

Dr. Sadaf [00:30:14]:

But she didn't know that, and she was taught that after you have sex, you're dirty. And so you really need to clean with something very abrasive and really clean all that stuff out.

Dr. Sameena Rahman [00:30:26]:

Get that. Unless you're trying to get.

Dr. Sadaf [00:30:30]:

Yeah, exactly. But it's like things like that where you really have to meet individuals, where they are and what they're thinking about and how you can help them move forward. And sometimes patients don't think of it as a problem, which is fine. Again, it's all up to patient preference and what they want and what they don't want, but they really do want to move forward in their lives and in the way that they perceive sex. I mean, so many of my friends that I know, right. They don't talk about sex. Definitely not. Definitely not amongst friends.

Dr. Sadaf [00:31:08]:

Right. I mean, nobody's telling you to talk about specifics, but even in generalities, they don't talk about because they have so much stigma and taboo and shame around it, and they feel it's wrong and dirty that they don't. And I would say that it's not just people grown up in conservative cultures. I would say that society in general is very uncomfortable talking, discussing sexual health.

Dr. Sameena Rahman [00:31:31]:

Yeah, exactly. Yeah.

Dr. Sadaf [00:31:33]:

And most physicians. Right. Like, I would say that a lot of physicians, because we're just not trained, and so they just feel uncomfortable.

Dr. Sameena Rahman [00:31:38]:

And some of them are truly uncomfortable, so they won't talk about it even if they got the training, I think. And I think that's the problem that most of our patients experience. Right. They're six, seven, eight providers later clinicians, and they finally maybe get help, but it's always. Yeah. Well, thank you. So know, we've learned so much about coaching today, so that's wonderful. If you want to see Dr.

Dr. Sameena Rahman [00:32:00]:

Sadha floaty as a patient in Westchester or as probably remotely too right as a can, we'll have her information in the show notes, so that will be helpful. For you to get access to her, please tune into her podcast as well. The muslim sex podcast. You always say you're a Muslim and you want to talk about sex, and that's why it's called the muslim Sex podcast.

Dr. Sadaf [00:32:25]:

Yeah, that's right. I just happened to be.

Dr. Sameena Rahman [00:32:27]:

We don't want muslim topics or sex. Yeah, right.

Dr. Sadaf [00:32:30]:

Exactly. That's what I definitely want people to know, that it's not about Islam. It's not really about Muslims, although I do touch on that, of course, because I am Muslims. But it's just really, the podcast itself is about relationships. It's about intimacy, it's about sexual health and how all of those things come together.

Dr. Sameena Rahman [00:32:49]:

Right.

Dr. Sadaf [00:32:50]:

And it's really like a holistic approach to sexual health. And I've had multiple physicians on, I've had great physicians on, like yourself, talking about really important topics such as persistent gender arousal disorder. We've talked about vaginismus. We've talked about menopause. I've had other physicians. Come on. Talk about how depression or anxiety relates to relationships. I've had people talk about how GI disorders and diseases can affect intimacy.

Dr. Sadaf [00:33:18]:

I mean, there's so many things. I've had a sex therapist. Come on, talk about ink. I've had another sex therapist. Come on today, talk about purity, culture, and how that affects individuals sense of self and their sexual agency, which was really interesting. And I just recently also had a director. Come on. That created the documentary periodical where she talks about periods and menstrual health and how taboo that a and I'd had Dr.

Dr. Sadaf [00:33:47]:

Blooming, come on, talk about menopause. So it's really an all encompassing podcast. It just happens to be called the muslim Sex podcast because I am a muslim woman that talks about sex.

Dr. Sameena Rahman [00:33:56]:

Yes. All right, so thank you for coming on today. It was very helpful, and I think my audience will really enjoy that and will hopefully tune into your podcast as well.

Dr. Sadaf [00:34:05]:

Thank you so much for having me on Gyno Girl.

Dr. Sameena Rahman [00:34:08]:

Absolutely. Again, I'm here to educate so you can advocate for yourself. Thanks for joining me in. Gyno girl presents sex, drugs, and hormones. And please tune in next week for my next episode.

Dr. Sameena Rahman [00:34:19]:

If you have a second, please subscribe to this podcast. I'd love for you to be a follower and learn as much as you can about the things that we're going to talk about with all the people on our journey. Please review us on Apple or Spotify or wherever you listen to podcasts. These reviews really help review us, comment. Tell me what else you want to hear to get more information. My practice website is ww cgccago.com. My website for Gynogirl is ww gynogirltv.com. My Instagram is gynogirl so please follow me for some good content.

Dr. Sameena Rahman [00:34:54]:

Additionally, I have a YouTube channel, Gynogirl TV where I love to talk about all these things on YouTube and please subscribe to my newsletter Gynogirl News which will be available on my website. I will see you next time.