What They Didn’t Tell You: From Core to Floor

Can You Become Addicted to Your Vibrator?

• Millie • Season 1 • Episode 3

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Welcome back to What They Didn’t Tell You: From Core to Floor! In this fiery third episode, Dr. Millie Schweky and certified sex coach Galya Falkson dive into some of the most under-discussed and misunderstood topics in women’s sexual health.

What’s inside:

  • How history of a c-section can lead to pelvic floor dysfunction, scar tissue pain, and nerve sensitivity and what you can do about it
  • Busting myths: Why painful sex is never normal, and what to do if it’s been your reality for years
  • “Vibrator addiction”? Not a thing. We break down the science of desensitization vs. dependency
  • Jewish perspectives on sex toys and why pleasure doesn’t have to come with guilt
  • Moisturizer vs. lube: The real MVP of vaginal health (hint: hyaluronic acid is your new bestie)

Plus: Learn how stress, hormones, and even your contraceptives could be affecting your sex life, and why a holistic approach is the only way forward.

Don’t miss this empowering, honest, and oh-so-necessary conversation that every woman deserves to hear.

Mentioned in this episode:

Warning: This episode contains candid discussions around painful sex and reproductive health. Not for little ears...headphones recommended.

[Dr. Millie Schweky]

Hey sis, and welcome to What They Didn't Tell You from Core to Floor. I'm your girl, Dr. Millie Schweky, your favorite pelvic floor physical therapist, and today on season one, episode three of our sex Q&A season, I'm here with sex coach Galya Falkson, and we're going to continue to answer your burning sex Q&A. Just a disclaimer, this season is not for little ears, so if you're listening with your kids in the car or cooking in the kitchen, I recommend switching to headphones or putting this on later.

Today's episode is real good. We're going to talk about having sex after a c-section, how hormones can change our sexual pleasure. We're going to answer if we can become addicted to vibrators, and we'll also talk about vaginal health.

 [Galya Falkson]

 All right, here's the first question for today. So someone asked you, she said, I've been married many years and have five children via c-sections. I had painful sex from the beginning of my marriage.

What should I do? We need to take a deep breath before answering this. 

 [Dr. Millie Schweky]

 I don't know what to say first. Like, should I give you a standing ovation for the five c-sections first, or should I like, or should I hug you? Like, what's first? But really, you are, you know, you're an Olympic-level mother dealing with all of this, but you shouldn't have to be a warrior.

You shouldn't have to be an Olympic-level warrior, you know what I mean? Like, you don't have to go. So let's start unpacking this. Painful sex from the beginning usually points to an underlying issue that's been there from the start, and with your history, there's probably a few potential culprits I'd want to investigate.

So the first one is going to be pelvic floor dysfunction. So even though you had c-sections, pregnancy alone puts a massive load on the pelvic floor. So your muscles might be holding tension, kind of like they're stuck in clench mode.

So like, imagine trying to stretch a muscle that's already locked in a spasm. That's what can happen during sex. So a pelvic floor PT can assess if your muscles are overactive and teach you how to release that tension.

And then another big one is the scar tissue, right? So after five major abdominal surgeries, there are going to be adhesions which are basically to water it down. It's a sticky tissue that can restrict movement, cause tightness, and even lean to pain during sex. So when your scar heals, it doesn't just heal on the scar area.

It kind of throws down those cells that help repair the area, kind of to the general area. So they could also be near the uterus, the bladder, and everything's connected to the scar tissue can tug on other structures and cause discomfort. So we do things like scar massage, myofascial release, and visceral manipulation, which are all just different techniques we use in physical therapy to help with that kind of discomfort.

Of course, we have to say that depending on if you're on birth controller hormones, that's also going to change after pregnancies or if you're approaching perimenopause, which I don't know because I don't know what your story is. But if you're experiencing dryness or thinning tissue, just remember that estrogen plays a role in keeping those tissues stretchy and well lubricated. So if things are feeling like sandpapery instead of silky, that's when we would look into using some, you know, some help.

I'll just talk about like nerve sensitivity or vestibulodynia because basically the nerves that they cut when they do a c-section do overlap with the nerves that innervate the pelvic floor. So that's just something else to keep in mind because I think a lot of women think like, oh, my baby didn't come out of my vagina. So like we're all good in that area, but it's not necessarily true.

So, yeah. 

 [Galya Falkson]

 I think that's one of the biggest misconceptions that I even learned that like women who have c-sections are like just free from all the issues that people have when they have vaginal births. And I know like women who opted for c-sections so that they didn't have the same issues as women who had with vaginal delivery.

They were like stuck with these same issues because not all the same issues, obviously, but there are a lot of things that do overlap or come out in different ways. Because in the end of the day, like you're actually going through this incredible, amazing, beautiful, life-changing experience of giving birth, but it's still literally going to have an incredible experience on your body. And there is almost like, I don't think there's a single woman in the world that shouldn't go for pelvic floor therapy after giving birth.

Like it should be part of the six weeks you go to your gynecologist and then you go to your pelvic floor therapist. Like it should be part of the recovery. I don't think most women do, which is probably quite unfortunate.

But also I just want to touch on the fact that this woman said she had been married for many years and she's had painful sex from the beginning. Like that to me, let's put the c-section aside. Like you said, this woman's incredible that she's done so much and her body's done incredible things.

But she's had painful sex from the beginning. What was it that allowed her to think that it was okay to be in this space and not have it checked out? Like, I know it's the media. I know it's the world.

I know it's everything that we've grown up with, the thoughts and the, like we said earlier, you know, that it's people just push through pain because they think it's going to go away. But in the end of the day, like we're, we have to do better for our friends and we have to do better for the people around us. We have to do better for the woman in this world to like think about how painful sex is never okay.

And that one time is more than enough for you to have it checked out and not to push through and not to wait for things to get better. Because it's so unfair that you have to go through such horrible situation for so long. And I feel so sad that you could get to a point of five C-sections in, which is obviously a long time because that's many years.

And like, it hasn't changed for you. And that's, yeah, I found that really heartbreaking. And I just hope that women know that there is help and that they can get the help.

And, you know, you're asking the question five C-sections in, but I really hope that you're in already a space where you're getting the help that you can and you're in a healing on the way to healing process at least. 

 [Dr. Millie Schweky]

Well said. Well said. Well said. Okay. So someone wants to know, does Judaism have anything against sex toys? Can you get addicted? Can a woman use them alone? How often is too much? Asking for a friend, she said.

 [Galya Falkson]

I love it. You can tell your friend that Judaism doesn't have anything against sex toys. Can someone get addicted? No.

I hate that people think that. Yeah. No, you can't get addicted.

It is something that might create a little bit of a desensitization if you use it too often or on a higher speed or whatever it is. And then what you do is you just literally go down a speed or you take a break for a little bit and then your body will resensitize. Like, it's never going to completely, it won't desensitize your body.

 I hate, like I said before, I just kind of hate it when people say that, like, something that's good, you can just, because it's good, you're going to get addicted to it. Like, food is good, so therefore we're all addicted to food. And they'll, and you know, our phones are something that we're addicted to.

Deaths. There is real things that we can have addictions to and addictions are only necessarily considered an addiction if it's affecting our life. So I don't think you can get addicted to a sex toy.

However, if you find that you're using your sex toy seven times a day and now you're not getting work done and you're not doing the things that you're supposed to do and it's affecting how you function, then yes, maybe you should just look at, like, why is your behavior affecting how you function? But to be honest, I don't think it's, I think it's coming out through the toy, but it's obviously deeper than that. Like any other addiction, that's the truth. 

[Dr. Millie Schweky]

I like what you said before, that the brain is our largest sex organ and the brain loves pleasure.

And, like, you get, like, a dopamine hit from it. It's like a little, it's like nature's reward system. So, like, if you're using it every time you need stress relief, then, like, your body might get used to that.

So I kind of look at it as, like, when you drink coffee, you know, like, you drink coffee for a long time and then it just, like, kind of stops working. And then you just, like, take a break for a little bit. And when you come back, like, you're good.

So it's not, like, an addiction, but it's more like a desensitization. 

[Galya Falkson]

Yeah, absolutely. And of course, like, there is, you know, there are things that can be negative or harmful in our lives.

But I think everything is about, you know, where does your brain go? And if you find that you get addicted to things that create pleasure for you, whether it's a toy or it's your phone or it's whatever it is that you're finding is impacting your life negatively because you're continuously going for that thing, then maybe that's something you should address. But I don't like when people, like, almost tell, like, I've seen this just even in just the religious world, where, like, a color teacher will tell girls, you know, we don't use sex toys because women get addicted to them or they're bad or they desensitize you. As if, like, it's this terrible thing.

But for so many women, it's literally what helps them enhance their experience and make the experience pleasurable and good. So therefore, like, we don't have to make it into this terrible bad thing just because someone's afraid of it. We can just say, be careful if you have addictive tendencies.

And what does addictive tendencies look like for you? And why do you have them? Again, then you should be dealing with that as well outside of this. But I think I'm digressing. There's so much to say on this, and I think that it's a much bigger topic.

[Dr. Millie Schweky]

Yeah, I think it's the purposes of that question. I think we pretty much answered it. Yeah.

[Galya Falkson]

I'm happy if you want to do the last one.

[Dr. Millie Schweky]

Okay, go for it. 

[Galya Falkson]

So there's one more question, which says, sex is super painful.

My pelvic floor PT said I'm not tight, only slightly weak, and that is hormonal and tissue related. She gave me moisturizer. Does that make sense? 

 [Dr. Millie Schweky]

So it actually does make sense.

So let's start with this. And I've said this before, that painful sex doesn't always come from tight muscles. Sometimes it's more about the tissue itself.

Specifically, the vaginal tissues, they're supposed to stretch and glide during penetration. So when hormones like estrogen are low, those tissues become thinner, drier, less elastic. So instead of smooth and stretchy, it's kind of like trying to stretch a dry or cracking rubber band.

So obviously, that's not going to feel good. Also, this tissue thinning and dryness can happen if you're on hormonal birth control, breastfeeding, if you're close postpartum, perimenopausal, or even just from stress. Estrogen is a big player here.

It keeps the vaginal walls thick, juice, plumpy, well-lubricated. So if you don't have enough of it, it's like losing a protective cushion. And then the nerve endings get extra sensitive.

So it does make sense that your PT gave you a vaginal moisturizer. I don't know what exactly she gave you. They're not all created equally. 

Some are better than others. Some of them are specifically designed to help restore hydration and elasticity to the vaginal walls, which is different from lube, which just kind of helps in the moment. Moisturizers work long-term.

It's like face cream for your vagina. So just if you want to know what to look out for, the main ingredient you want in a moisturizer is hyaluronic acid, which is something you might actually recognize from whatever's in your face serum. But basically, it's a humectant, which means it retains and attracts water like a sponge.

So in a vaginal moisturizer, it helps the tissue stay hydrated, elastic, more resilient to friction. So like if thrusting hurts, it helps with that. And there's studies that show that it could even improve tissue thickness and reduce inflammation without the use of hormones.

So it's a really good option if you're breastfeeding and you don't want to use vaginal estrogen. I know like topical estrogen is being offered to my patients a lot, and sometimes they just don't want to take something hormonal, even though it is technically local. But you're putting it on the skin.

You're putting it in a vaginal mucosa. So like I'm not going to get into the debate of like, is it local? Is it systemic? Is there such thing as local hormones? I'm not getting down that rabbit hole now. But if you don't want to put topical hormones on your body, I love hyaluronic acid for that.

So it totally, like what your PT said, absolutely tracks. It's not just about muscle tone. It's also about tissue health.

So try the moisturizer and don't hesitate to follow up if you're not seeing results. 

[Galya Falkson]

Yeah, I think I would have just added that like, yes, it tracks. But in the end of the day, it kind of sounds a little bit to me like you're putting on chapstick on cracked lips, but then you're not drinking water and moisturizing needs more than just putting chapstick on.

So yes, depending on what the problem is, absolutely different creams, especially estrogen cream, like you said, will help with that elasticity and the tissue. But in the end of the day, if it is hormonal, an estrogen cream might not be enough. If it's deeper than that, it might need something more.

So I think it's always just important that like, just because your pelvic floor PT or your gynecologist or whoever gave you advice, if that advice doesn't work, go back. Like we, as women, often think that like, it's okay, this is what they told us to do. And then we, even with my clients, it will be like, oh, but we went home, we tried this and it didn't work.

And I'm like, okay, so then you're different to every, you know, other people. Like there's not one way that works for everyone. And there's certain things that when it's medical, of course, there's actual interventions that need to be in place in order to heal.

But I think just always question if it doesn't necessarily track. And if it doesn't give you the results that you're looking for, or if you're still struggling, like it doesn't mean that your pelvic floor therapist is not doing their job. It just means that maybe they didn't see all the parts at that point, or maybe they couldn't give you different hormonal contraceptive because they're not a gynecologist.

 So there is like a bit of a relationship between your pelvic floor therapist, then going back to them, getting advice. If you need to go to a gynecologist, like actually having a holistic approach is really key to this. And speaking to someone like myself as well, because when these things affect our physiological experience, our emotional and mental experience is also affected.

 And we can't just ignore a whole side of ourselves, you know?

[Dr. Millie Schweky]

Completely agree. I see the person as a full person. Like I'm giving this therapist the benefit of the doubt that like she's understanding the stress this patient's under, her work-life balance, her relationship with her husband, with her kids, with her parents, like what's going on in her life that made her come to the conclusion that it's hormonal, right? And it's not emotional, and it's not like something deeper.

Because just like chalk it all up to hormones kind of seems like a cop-out. So I'm giving this therapist the benefit of the doubt. Maybe I shouldn't, but I am giving her the benefit of the doubt that she did enough digging to know like, okay, it is hormonal.

This is a stage of life you're in because you're maybe low on estrogen. So, you know, you could take something, you could apply something that's going to help with that estrogen production. And it's not a band-aid when it's warranted because like physiologically, if you're nursing, you can't help it.

You know what I mean? 

 [Galya Falkson]

Okay, yeah. From that perspective, sure. I just, I've seen too many people being told like, use this cream, but it's not just enough to use the cream.

Like there is something else going on that caused the lack of estrogen. So if you're not dealing with that, like obviously you need to wait out until you finish breastfeeding. You can't change that cause. 

But if you're not necessarily taking a holistic approach, it often doesn't have the results that you're looking for because these things aren't just lack of specific. And sometimes it does require a deeper look. Obviously, sometimes the band-aid is all you need to heal the wound and that's how band-aids exist.

But if it's not, well, I hope is that women are empowered enough to realize that like, it's okay if you have to go back. And sometimes it's not so simple to get like a simple, this is the answer and everything works out. Like, unfortunately it's not always so easy and I'm sorry.

And it really is hard that some women have to go, you know, on processes that take really long and are difficult. But I just hope that they found the healing that they're deserving of and the pleasure that they're deserving of and the space that. Yeah.

 [Dr. Millie Schweky]

 I heard that you deserve it. You deserve it. Wow.

 I'm so happy we covered everything that we just covered. Thank you so much. We're going to sign off and we'll see you guys next time.

 [Dr. Millie Schweky]

If you can relate to some of the pain and struggles in this episode, I just want you to know that you're not alone and help is available. My Better Sex Online program walks you through why you may be experiencing this pain and what exactly you should do step-by-step to work through it. We start with breathing, we go into mobility work, we go through manual therapy, we go through stretching and exercises.

It really does lay the foundations for hopefully less painful sex and more pleasure in the bedroom. So take a look at the show notes. The link is there and you could get started from the privacy of your own house before going to pelvic floor therapy.

If you could do me a favor before you log out of this app and just quickly rate this podcast five stars of me review that would be awesome and it's going to help us continue to make more episodes for you. So don't forget to also share this with your friends and basically everyone you know. This season's real juicy and we're so excited to have you.

See ya!