The World's Tightest Community - A Podcast About Vulvodynia, Vaginismus & Women's Pelvic Pain

Mathilde Olstad
  • 5.0 (2)
  • SEXUALITY
  • UPDATED TWICE WEEKLY

Chronic pelvic pain doesn't have great PR. Vulvodynia, vaginismus, painful sex, pelvic floor dysfunction - conditions that affect 1 in 4 women and still get treated like a secret. This podcast is trying to change that. The World's Tightest Community is a weekly podcast hosted by Mathilde - a patient-turned-advocate who built this space out of her own experience with vulvodynia and vaginismus. Each episode goes deep into the conditions that millions of women live with but few feel safe naming: vulvodynia, vaginismus, vestibulodynia, pudendal neuralgia, and the wider landscape of chronic pelvic pain and painful sex. Mathilde speaks with gynecologists, pelvic floor physiotherapists, sex therapists, psychologists, and researchers working at the front edge of women's sexual health - translating clinical knowledge into something actually usable, alongside honest conversations about diagnostic delays, medical gaslighting, and what it really costs to navigate these conditions. You'll leave each episode with more language for your experience, clearer questions to bring to your next appointment, and the specific relief of knowing someone has thought carefully about this. New episodes every week. Follow wherever you listen, and find the community on Instagram. You are not alone in this. Not even close.

  1. Vulvodynia, Desire, and the Diagnostic Odyssey: One Writer's Journey from Shamans to Sex Toys

    4 MAY

    Vulvodynia, Desire, and the Diagnostic Odyssey: One Writer's Journey from Shamans to Sex Toys

    What happens to desire when your body becomes unpredictable? Sara Sturek is a writer and founder of Writing Shamelessly, whose essay "From Shamans to Sex Toys" is published in Women's Health magazine. She has lived with hormonally-mediated vulvodynia since she was 21, and she writes about desire, sexuality, and the diagnostic odyssey with an honesty and literary precision that's rare in this space. In this episode, Sara walks me through her full journey — from the first gynecologist appointment that sent her home with Advil and a bath suggestion, through months of worsening pain she kept trying to push through, to the pelvic floor PT who finally identified a hormonal component. We also cover the long search for answers beyond the physical: the Valium suppositories, the CBD lube, the Reiki, the shaman in New Mexico who told her she was abused in a past life. And we spend real time on what this journey did to her relationship with desire — the fear that slips in before sex, the dissociation during it, the moment she realized she was the only person in the gynecologist's office who cared about her pleasure. A sex therapist helped her find a new framework: starting over, lowering the heat, and extending herself a lot more grace. Whether you're still in the thick of your own odyssey or have been looking for someone to put words to what this does to your sexuality — I think this one will stay with you. In this episode: How Sara's vulvodynia started — and why it took months to realize something was seriously wrongThe hormonal component: going off birth control and what shiftedThe diagnostic odyssey — from Reddit threads to pelvic floor PT to a shaman in New MexicoWhat desire and arousal actually feel like when you live with vulvodyniaThe dissociation that happens during painful sex — and what helped Sara stay presentWhy her gynecologist visits kept glossing over her libidoThe "boiling pot" framework her PT gave her for understanding flaresWhat sex therapy added that physical treatment couldn'tWriting Shamelessly: Sara's creative writing consultancy Connect with Sara Sturek: Instagram: @sassyy_assEssay: "From Shamans to Sex Toys" — Women's Health: https://www.womenshealthmag.com/sex-and-love/a70848271/vulvodynia-sexual-dysfunction-personal-essay/ Website: writingshamelessly.com Connect with Mathilde: Instagram: @theworldstightestcommunity Website: theworldstightestcommunity.com• Email: mathilde@theworldstightestcommunity.com

    51 min
  2. Vulvodynia, Vaginismus, and Pelvic Pain: Start Here If You're New

    27 APR

    Vulvodynia, Vaginismus, and Pelvic Pain: Start Here If You're New

    If you're new to this podcast - hi! I'm so glad you're here. This is the episode I want you to start with. Whether you've just been diagnosed, you've been searching for answers for years, or you typed something into Google at 2am that you've never said out loud to anyone - you're in the right place. In this solo episode, I walk you through the basics of chronic vulvovaginal and pelvic pain - what it is, the conditions that fall under this umbrella (vulvodynia, vaginismus, vestibulodynia, pudendal neuralgia, interstitial cystitis, lichen sclerosus, endometriosis +++), why so many of us go undiagnosed for years, and the one statistic that changed how I see all of this: 1 in 4 people with vulvas will experience pelvic or vulvovaginal pain at some point in their lives. I also share why I started The World's Tightest Community in the first place, what this podcast can be for you as a resource, and the most important thing I can tell you if you're in the thick of it right now: pain down there is not a black box. There are root causes. There are treatments. There are people on the other side of this. And you are nowhere near as alone as you feel. If you're scared, exhausted, or just looking for somewhere to start - this one is for you. Connect with me! Instagram: @theworldstightestcommunityWebsite: theworldstightestcommunity.comEmail: mathilde@theworldstightestcommunity.com In this episode: The 1 in 4 statistic and why it mattersThe most common chronic vulvovaginal and pelvic pain conditions explainedWhy pain down there is not a black box - and the real root causes behind itWhy most doctors aren't trained in vulvovaginal pain (and what that means for you)How to start advocating for yourself in medical appointmentsWhy "the world's tightest community" - and what this space is really aboutHow to use the podcast as a resource and where to go next• A reminder that people do get better, and what that actually looks like

    13 min
  3. CBD for Pelvic Pain: Do Suppositories Actually Work for Vulvodynia and Vaginismus?

    21 APR

    CBD for Pelvic Pain: Do Suppositories Actually Work for Vulvodynia and Vaginismus?

    Can CBD help with pelvic pain - and if so, how does it actually work? In this episode, I speak with Tamar Hill, co-founder of Medroots, a company making CBD and low-dose THC suppositories for pelvic pain, vulvodynia, vaginismus, dyspareunia, and sexual health. Tamar is a former biology teacher turned entrepreneur, and she brings both the science and hard-won knowledge of navigating the CBD regulatory landscape. We cover the endocannabinoid system and why our bodies have cannabinoid receptors concentrated in reproductive tissue - and what that means for people managing chronic pelvic pain conditions including vulvodynia, vaginismus, endometriosis, interstitial cystitis, and dyspareunia. We talk through how CBD suppositories work, why delivery method matters for pelvic pain specifically, how low-dose THC differs from high-dose, how magnesium supports muscle relaxation alongside CBD, and the research barriers that make formal clinical studies on CBD cost-prohibitive. Tamar also walks through exactly how to evaluate a CBD product - including the one test that separates a quality product from a marketing play. I also share my own experience using Medroots' suppositories for penetrative pain, and what I noticed. Whether you've been curious about CBD suppositories for pelvic pain, tried CBD without much guidance, or want to understand the science before you decide - this one is worth your time. Want to try the Medroots CBD suppositories? Head to this link and use code TWTC20 for 20% off at checkout. In this episode: CBD for pelvic pain - what the evidence actually saysThe endocannabinoid system explained - and why it matters for vulvodynia and vaginismusWhy CBD suppositories may work better for pelvic pain than oils, gummies, or tincturesLow-dose THC for pain and pleasure - why dosage is everythingCBD and vaginismus - how muscle relaxation and anticipatory pain connectMagnesium in CBD suppositories - what it does for hypertonic pelvic floorCBD for endometriosis, interstitial cystitis, dyspareunia, and IBSHow to read a CBD product label - full panel third-party testing explainedFull spectrum vs broad spectrum vs CBD isolate - what the difference means for youThe legal status of CBD and hemp in the US - and what's changingMathilde's personal experience using CBD suppositories for penetrative pain Connect with Tamar Hill / Medroots: Website: medroots.comEmail: info@medroots.comInstagram: @medrootscbd  Connect with Mathilde: Instagram: @theworldstightestcommunityWebsite: theworldstightestcommunity.com

    43 min
  4. Pudendal Nerve Entrapment Surgery: One Woman's 15-Year Road to the Right Diagnosis

    13 APR

    Pudendal Nerve Entrapment Surgery: One Woman's 15-Year Road to the Right Diagnosis

    What does it mean to do everything right for fifteen years — and still not get to the bottom of your pain? In this episode, I speak with Carli Cutchin, a writer and disability advocate with a background as a comparative literature scholar. Carli has lived with pudendal neuralgia for fifteen years and writes about chronic pain and disability for publications including Ms. Magazine. She is one of the sharpest thinkers I've come across on this topic, and this conversation goes well beyond the personal story. We go into Carli's full fifteen-year journey — from the initial onset of pain, through years of PT, nerve blocks, and conservative treatments that provided only partial relief, to a devastating relapse in 2020 that left her mostly bedridden. We cover the eventual diagnosis of pudendal nerve entrapment, what that actually means and how it differs from pudendal neuralgia, and the decompression surgery with Dr. Hibner that she wishes she'd known about much earlier. We also dig into the ideas underneath all of it — how medicine frames chronic pain, the language it uses for these conditions, and what Carli sees as the specific cost of those frameworks for women. Her constructivist perspective on this is something I found myself thinking about long after we finished recording. Whether you're navigating pudendal neuralgia yourself, wondering whether entrapment might be relevant to your situation, or just someone who likes to think carefully about the bigger picture — I think you'll take a lot away from this one. In this episode: How Carli's pain started and why it took so long to get the right diagnosisThe difference between pudendal neuralgia and pudendal nerve entrapmentWhat decompression surgery involves and what recovery looks likeThe trauma and somatic work Carli did — and why she's clear it didn't cause her painHer critique of how medicine talks about chronic pain in womenWhat she wishes she'd been told in year one• The word "pudendal" — and what it means that it comes from the Latin for shame Connect with Carli Cutchin: Instagram: @carlicutchinWebsite: carlicutchin.com Connect with Mathilde: Instagram: @theworldstightestcommunity• Website: www.theworldstightestcommunity.com

    1hr 9min
  5. Vulvodynia Clinical Trial: The First Drug Being Developed Specifically for This Condition

    6 APR

    Vulvodynia Clinical Trial: The First Drug Being Developed Specifically for This Condition

    There is no medication approved specifically for vulvodynia. Not a single one. John Connell and his team are trying to change that. In this episode, I sit down with John Connell, Chief Scientific Officer at MAC Clinical Research — one of the UK's longest-established contract research organisations. John has spent over 35 years in clinical research, and has been working with Danish biotech Initiator Pharma for the past six or seven years to develop pudafensine: a first-of-its-kind drug being investigated specifically for vulvodynia. Pudafensine works by increasing dopamine levels in the brain — a chemical messenger most people associate with pleasure and reward, but one that also plays a crucial role in pain modulation. Unlike the treatments many of us are already on (think amitriptyline or SNRIs), pudafensine is not repurposed from another condition. It is being specifically developed with this type of pain in mind. Preclinical studies showed early promise, and in a subsequent study on healthy volunteers using a capsaicin pain model, a single dose reduced allodynia more effectively than pregabalin — and with fewer side effects. We get into the science of how the drug works, what the preclinical and early human data is showing, and what it actually looks like to take part in the trial. John also speaks to the bigger picture: why vulvodynia has been so chronically under-researched, why this study is pivotal for the future of drug development in this space, and what it would mean for the field if a positive signal is found. If you're in the UK, aged 18–65, and have experienced vulvar pain for 12 months or more (with or without a formal diagnosis), you may be eligible to take part. Participants can receive up to £1,730 plus reasonable travel expenses. Clinics are in Manchester and Blackpool. Find out more and sign up here: https://researchforyou.co.uk/vulvodynia-clinical-trial-mac212?utm_source=Mathilde_Influencer&utm_medium=Podcast&utm_campaign=MAC212_MathildePodcast_V1_001 In paid partnership with @mac_clinicalresearch In this episode: Why there is still no approved drug for vulvodynia — and why diagnosis can take yearsWhat pudafensine is and how it targets the dopamine system to interrupt pain signallingHow it differs from amitriptyline, SNRIs, and other treatments many listeners are already onThe capsaicin pain model study: what it showed, and why the results were so significantWhat the current clinical trial actually involves, from first contact to final visitWho is eligible to take part and what would exclude someoneWhy this particular study is a pivotal moment for vulvodynia drug developmentWhat it would mean — for patients, for the industry — if this works

    45 min
  6. My Vulvodynia and Vaginismus Story: The Episode I've Been Afraid to Record

    31 MAR

    My Vulvodynia and Vaginismus Story: The Episode I've Been Afraid to Record

    For a long time, I've been standing slightly to the side of my own experience on this podcast. Today, I step into the center of it. In this solo episode, I share my full story with vulvodynia and vaginismus for the first time - from the first symptoms five years ago to the rock bottom moment that broke me open, and eventually, to the unexpected thing that gave me the strength to keep going. I talk about what it was like to be dismissed by doctors, to spend years in a treatment rabbit hole trying everything from pelvic floor physiotherapy and nortriptyline to somatic therapy and psychedelic-assisted healing. I share something I've never spoken about publicly before - a trauma history that surfaced at almost exactly the same time as my pain, and how the two were more connected than I understood at the time. I also talk about shame, about the grief of feeling like your body is working against you, about the isolating silence that so often surrounds these conditions - and about the Reddit thread that cracked something open in me and became the unexpected seed of this podcast. And I share something significant: why this podcast now has a new name. This episode doesn't have a clean ending. My story doesn't either - not yet. But if any part of what I've described sounds familiar, this one is for you. In this episode: My first symptoms and the dismissal that delayed everythingA diagnosis of vulvodynia - and what was missing from itThe trauma history I've never spoken about publiclyYears of treatment-hopping and why I couldn't stick to my dilator routineThe rock bottom moment that broke meFinding community on Reddit and what shiftedWhy I started this podcast - and its new name Connect with me: @theworldstightestcommunity or theworldstightestcommunity.com 3

    37 min
  7. Botox for Vaginismus and Vulvodynia: Success Rates, Who It's For, and What to Expect | Dr Corey Babb

    23 MAR

    Botox for Vaginismus and Vulvodynia: Success Rates, Who It's For, and What to Expect | Dr Corey Babb

    Can Botox really help treat vaginismus and vulvodynia - and if so, how does it actually work? In this episode, I sit down with Dr. Corey Babb, a board-certified gynecologist, ISSWSH fellow, and one of only four providers worldwide trained in the Pacik Multimodal Botox Protocol for vaginismus. Dr. Babb is the founder of Haven Center in Tulsa, Oklahoma, and co-authored the landmark research that established the five-point grading scale for vaginismus, now used internationally. We go deep into how Botox works physiologically, how it relates to the pain-fear-spasm cycle, who is a good candidate for it, and what the treatment and recovery process actually looks like. Dr. Babb also shares the success rates he's seeing at his clinic (around 95% of patients achieving pain-free penetration within three months), how desire is impacted after years of painful sex, and how Botox can also be used for vulvodynia patients with hypertonic pelvic floor dysfunction. We also discuss trauma-informed care and the importance of patient agency when undergoing this type of procedure. This is one of the most detailed and practical conversations on Botox as a treatment for vaginismus and vulvodynia that you'll find anywhere. Whether you're someone navigating one of these conditions, a partner trying to understand, or a clinician - I think you'll take a lot away from this one. Connect with Dr. Corey Babb:  Haven Center: https://havencenter.com  Instagram: @dr.coreybabb  Research paper: Pacik PT, Babb CR, et al. "Case Series: Redefining Severe Grade 5 Vaginismus." Sexual Medicine, 2019 - https://pmc.ncbi.nlm.nih.gov/articles/PMC6963107/ Connect with Mathilde IG: @theworldstightestcommunity or mathilde@theworldstightestcommunity.com Timestamps: 00:00 - Welcome & introduction 01:00 - Dr. Babb's origin story (from music theory to sexual medicine) 03:09 - The patient case that changed everything 04:08 - The 2019 research paper & the five-point vaginismus grading scale 07:49 - Walking through grades 1-5 10:27 - Measuring hypertonicity vs. psychological distress 13:11 - How widely adopted is the grading scale? 15:05 - The GPPPD debate and why vaginismus deserves its own classification 16:36 - What is Botox and what does it do in the body? 18:22 - How Botox works for vaginismus (muscles, dilution, injection technique) 20:49 - Breaking the pain-fear-spasm cycle 23:32 - Success rates and Botox as an "accelerator" 25:16 - The missing piece: desire after years of painful sex 27:18 - Traditional Botox injections vs. the Pacik protocol 34:36 - Trauma-informed care and patient agency during treatment 37:34 - The post-procedure protocol (dilators, timelines, what to expect) 39:56 - Long-term outcomes: why most patients don't relapse 41:51 - Botox for vulvodynia: who it's for and how it differs 46:38 - The future of vulvovaginal pain treatment & mast cell activation

    50 min
  8. Women's Health Censorship: Why "Vulvodynia" Gets Flagged and What We're Losing Because of It

    16 MAR

    Women's Health Censorship: Why "Vulvodynia" Gets Flagged and What We're Losing Because of It

    Social media platforms are systematically censoring medically accurate women's health content. Words like vulva, vagina, and vulvodynia are being flagged, shadow banned, and suppressed - not because they're explicit, but because the systems designed to moderate content were never built to tell the difference. This is about accurate, life-saving health information being treated as obscene. The problem with this is it is enforcing the deep-rooted societal stigma around topics like menstruation, menopause and sexual wellbeing - the very stigma that advocates, clinicians and educators are working to dismantle. In this episode, I break down what's actually happening: the data behind the censorship, the companies and creators being penalized, the double standards baked into platform advertising policies, and why self-censorship might be the most damaging consequence of all. I also look at the historical context - how shame was literally built into the language of female anatomy centuries ago, and how that legacy is still shaping what we're allowed to say online today. If you've ever wondered why health creators use asterisks in place of vowels or write "s*x" on Instagram, this episode is for you. Connect with Mathilde IG: @theworldstightestcommunity or mathilde@theworldstightestcommunity.com Referenced in this episode: Dr. Aziza Sessai - UK-based GP and women's health advocate, founder of the "They Are Not Bad Words" campaignDr. Philippa Kaye - GP and women's health advocateJackie Rotman - Founder of the Center for Intimacy Justice, whose investigation was published in the New York Times (2019) and later cited in US Senate hearingsCensHERship - Coalition focused on the censorship of women's health content, authors of the "Censorship Revealed" white paper and the Women's Health Visibility AllianceRachel E. Gross - Author of "Vagina Obscura"Intimate Rose - Pelvic floor dilator company whose products were classified as adult content by MetaDaye - Diagnostic tampon company for HPV screening whose ads were rejected under adult nudity policiesHanx - Women's libido supplement available in Boots, repeatedly penalized by Meta advertising• Hims, Xseed, Mojo - Men's health companies whose equivalent ads were approved without issue

    26 min
See All (28)

Ratings & Reviews

5
out of 5
2 Ratings

About

Chronic pelvic pain doesn't have great PR. Vulvodynia, vaginismus, painful sex, pelvic floor dysfunction - conditions that affect 1 in 4 women and still get treated like a secret. This podcast is trying to change that. The World's Tightest Community is a weekly podcast hosted by Mathilde - a patient-turned-advocate who built this space out of her own experience with vulvodynia and vaginismus. Each episode goes deep into the conditions that millions of women live with but few feel safe naming: vulvodynia, vaginismus, vestibulodynia, pudendal neuralgia, and the wider landscape of chronic pelvic pain and painful sex. Mathilde speaks with gynecologists, pelvic floor physiotherapists, sex therapists, psychologists, and researchers working at the front edge of women's sexual health - translating clinical knowledge into something actually usable, alongside honest conversations about diagnostic delays, medical gaslighting, and what it really costs to navigate these conditions. You'll leave each episode with more language for your experience, clearer questions to bring to your next appointment, and the specific relief of knowing someone has thought carefully about this. New episodes every week. Follow wherever you listen, and find the community on Instagram. You are not alone in this. Not even close.

Information

  • Creator
    Mathilde Olstad
  • Years Active
    2025 - 2026
  • Episodes
    28
  • Rating
    Explicit
  • Copyright
    © 2025 Mathilde Olstad

You Might Also Like