Goodness gracious, y’all. Hello, and welcome back to the vocal pelvic floor. I have ⁓ an amazing guest with me today, Dr. Laurie Mintz. Welcome, Laurie.

Laurie Mintz PhD (00:11)

Thank you so much for having me.

Dr. Ginger Garner PT, DPT (00:13)

My face is like cracking, I’m smiling so much. I’m just so excited to have you on. You guys know that I read ⁓ from all the list of accolades in the beginning, so I’m going to do that because I want you all to get to know her better. And then we’re going to talk about all her amazingness. So first up.

Dr. Laurie Mintz is an author, therapist, professor, and nationally recognized speaker dedicated to helping people live more authentic, joyful, and sexually satisfying lives. She is an emeritus professor at the University of Florida, a fellow of the American Psychological Association, and a 2023 Forbes 50 over 50 honoree. She is the author of Becoming Cliterate Love that title so much. And A Tired Woman’s Guide to Passionate Sex.

Laurie Mintz PhD (01:02)

Thank

Dr. Ginger Garner PT, DPT (01:05)

which is All the Patients That I See, Need That Book, and her TEDx talk on orgasm equality, which has been viewed over two million times, just a couple. For more than 30 years, she’s worked clinically with individuals and couples combining science, compassion, and sex positive education to empower people and their bodies and relationships. So before we begin, just a quick note. Today’s episode includes just

Frank’s science-based conversations about sex, desire, pleasure, and the body. We’re gonna talk about topics like exhaustion, pelvic pain, and sexual disconnect. So I just wanna say to everyone, please take care of yourself and listen in a way that feels safe for you. We live in a culture that tells people, especially women, that if they’re tired, stressed, in pain, or not interested in sex, something is wrong with them. That low desire is a problem.

I’m air quoting, if you’re just listening on the podcast, to fix. And that pleasure is optional and that good enough sex is enough. But what if that story is backwards? What if the issue is not broken bodies, but broken education? What if low desire is sometimes a perfectly healthy response to chronic stress and emotional labor, pain, or being disconnected from how our bodies actually work? And on the vocal pelvic floor,

Y’all know we talk about the voice, not just about the literal voice, but the ability to listen to your body, to speak to your needs and to trust what you’re feeling, not just the literal connection between the voice and the pelvic floor, because people lose their voice sexually. And when they do that, they often lose it in their bodies too. So today’s conversation is about changing that. And it’s for penis owners, vagina owners, whatever, everyone alike.

pleasure grounded in anatomy and nervous system science and reclaiming sexual health without shame, without pressure and performance. So again, my guest today is Dr. Laurie Mintz and whether you’ve ever wondered if you’re broken or the system has failed you, like, ⁓ this conversation is for you. So welcome again, Laurie.

Laurie Mintz PhD (03:21)

What a beautiful introduction to the topic. Thank you. I love the the preface and the care and the you telling women you’re not broken culture is broken. Yes.

Dr. Ginger Garner PT, DPT (03:32)

Yeah,

yeah. Ooh, that was the first mic drop. You are not broken. A culture is broken around it. And I’m sure that’s the passion with which you brought forward. Like if you’re watching this on YouTube, I’m just going to hold up one of Laurie’s amazing books, Becoming Cliterate ⁓ Love that so much. I’m sure that’s where the passion to pen those books came from. ⁓ All about

Laurie Mintz PhD (03:36)

Thank you.

Dr. Ginger Garner PT, DPT (04:01)

you know, orgasm equality and exhausted desire as connected problems. So tell me a little bit about, you know, how those were born. How are those books born?

Laurie Mintz PhD (04:12)

Well, the first book that I wrote was A Tired Woman’s Guide to Passionate Sex, and it was born from a personal situation. ⁓ I was a licensed psychologist and I was a professor and I was, you know, seeing clients and teaching courses and I had two little kids and I was really stressed out and all of sudden like, poof, this woman who used to be pretty interested and horny was like,

Dr. Ginger Garner PT, DPT (04:33)

hash.

Laurie Mintz PhD (04:42)

my desire, it’s gone. Gone, bye, good, go, boop. And I thought, what’s happening? And I started talking to friends and relatives and it was like, everyone was experiencing the same thing. No one was talking about it. And that’s when I had the insight that my training had failed me in this way, that I trained at a really good graduate program for my PhD. And the word sex was never uttered. I was never…

Dr. Ginger Garner PT, DPT (04:43)

gone.

Hmm

Laurie Mintz PhD (05:11)

ever taught to help people with sex. I was very comfortable personally with the topic. ⁓ So I thought, well, I know how to talk to people and I know how to read science. So I’m going to go to the scientific literature and I’m going to find out what I missed, what I wasn’t taught. And of course, there was an entire body of literature that I had never been taught that I taught myself.

And I started applying to myself. I started applying to other women, clients, friends, and it worked. Like understanding the root of the the lost desire and using some, you know, tried and true psychosocial strategies. So then I thought, well, if this works for me and my clients and my friends, I’m going to write it up in a book. And that was a Tired Woman’s Guide to Passionate Sex.

And then the scientist in me panicked and said, what if it’s not helpful? So I commissioned some randomized clinical trials and found out, yes, indeed, people who read the book get their desire back. They have better sex. And that really just sold me on people need information and there is information that can be put out there in a consumable way.

And then I just got further and further into the field of human sexuality, sex therapy, taking trainings, giving trainings. And then I got an opportunity to teach the psychology of human sexuality at the University of Florida. And that’s when I learned that an entire body of knowledge had been lost to young women, young women today. And that was because of the lack of sex ed coupled with porn.

Dr. Ginger Garner PT, DPT (06:57)

you

Laurie Mintz PhD (06:57)

None of

the young women in my class knew about their clitoris. They all felt broken from not orgasming from penetration. Like it was so striking that I sort of revamped the whole course and started teaching to women’s pleasure. And it was very successful. The students in my class told me like, thank you, because of your class, I’m having orgasms. Because of your class, my girlfriend’s having orgasms. And I thought.

Dr. Ginger Garner PT, DPT (07:00)

Hmm.

Yay!

Laurie Mintz PhD (07:24)

I am certain this problem is not limited to undergrads at the University of Florida and hence was born Becoming Cliterate

Dr. Ginger Garner PT, DPT (07:30)

right.

my gosh, that’s fantastic story and how lucky your students are to have had ⁓ you in that way in class. It’s amazing. So I want to touch on like the biggest, I think, elephant, you will, in the room on why people are still being told they’re just low libido instead of being taught, well, how their bodies and nervous systems actually work. And also that

we are, particularly women, are functioning in a society that hasn’t really valued them or taken care of them.

Laurie Mintz PhD (08:07)

Yeah, that is, yes. not mic drop on my end here. mean, honest, bless you. ⁓ I mean, honestly, the sexism and patriarchy that surrounds women’s sexuality is so baked into the very fabric of our culture that we don’t even notice it.

you know, we just this myth that women lose their desire. Well, women are they they might not want sex because it’s so bad. It’s not designed for them. Like that’s one possibility. Right. I mean, you know, ⁓ they might as you well know, a lot of women are having sexual pain. So of course they don’t want sex. That’s the huge driver of a huge driver of diminished desire. I mean, if you

Dr. Ginger Garner PT, DPT (08:52)

Yeah.

Laurie Mintz PhD (09:05)

hurt your knee, you wouldn’t want to walk as often, right? So, but women are gaslit medically when they show up with sexual pain. And then what you were talking about, we, like women think, I’m stressed, but I should power through it. I’m caretaking, but I should power through it. But social neuroendocrinology, which is the study of how our hormones, how our social environment affects our hormones tells us,

Dr. Ginger Garner PT, DPT (09:08)

Hmm.

Laurie Mintz PhD (09:32)

We can’t just power through it. Chronic stress and chronic caretaking changes our hormonal system to the point where we are not responsive to sex. And so like we need to address the root causes. ⁓ And then of course, add to that sexual myths that desire means being horny. And that, you know, like I always think about like, yeah, when I was

Dr. Ginger Garner PT, DPT (09:56)

you

Laurie Mintz PhD (10:01)

Like when most of us, when we were like in our twenties and just meeting someone, of course we were horny, but like that goes away and people say, what’s wrong with me? What’s wrong with my relationship? It’s like we age in these other ways really gracefully. Like the example I use is I just recently got cataract surgery because my eyes don’t function the way they used to. And so I had to find a new way for them to function. And the same with hearing aids and whatever else.

Dr. Ginger Garner PT, DPT (10:26)

Thank

Laurie Mintz PhD (10:29)

We seem to understand our bodies will change in other ways, but somehow we also culturally hang on to this idea that we should feel the same when we’re 40, 50, 60 as we did, you know, 18, 20. So ⁓ there’s so many broken things that lead us to not want sex.

Dr. Ginger Garner PT, DPT (10:43)

Mm-hmm.

Yeah. And so what happens then in our society, I mean, we hear this culturally in our healthcare system, the very places in GYN offices, UroGYN ⁓ PT in my office, they’ll come and sit down and they’ll say, well, they just said I had low libido instead of saying, well, you have a healthy body in an unhealthy setup, culturally or socially.

And so I find that our own healthcare system is perpetuating this, which you alluded to already when you mentioned medical gaslighting, that people are coming in, women are coming in, especially women, are coming in and being medically gaslit in the very arenas where you would think they could go and speak safely about sexual health.

Laurie Mintz PhD (11:40)

Absolutely, absolutely. then, you know, gaslighting and also an astonishing lack of knowledge too. Like, you know, I can’t tell you, I mean, I am not a physician, but I’ve attended enough conferences that I have some pretty basic understanding, right, of things like menopause and generative urinary syndrome of menopause in the pelvic floor.

Dr. Ginger Garner PT, DPT (11:50)

Mm-hmm.

Laurie Mintz PhD (12:08)

Nothing like you have, nothing like doctors have, but enough to know when a woman comes to me and is told something completely wrong by a physician, and I see that a lot.

Dr. Ginger Garner PT, DPT (12:21)

Yeah, yeah, it is unfortunately the norm. think if I, you talking to you and other podcast guests and then colleagues in the healthcare space, and of course I have loads of friends that are all in the pelvic and sexual health space, that is the most common thread that we hear. You know, patients come in, are you talking to family members or just friends? And they’re getting really bad information. And I’m wondering at what point that we started to expect

sexual desire to override stress, caregiving, pain, and basic biology.

Laurie Mintz PhD (12:58)

Yes, exactly, exactly. It’s really crazy when you think about it. Women are stressed, they’re chronically caretaking, they’re often having untreated pain, undiagnosed pain, being told there’s nothing wrong when there are things wrong, but they’re just not at the right specialist. Who would feel like having sex in that circumstance? ⁓

Dr. Ginger Garner PT, DPT (13:01)

Ugh.

Right.

Laurie Mintz PhD (13:27)

That is a sane reaction to an insane situation.

Dr. Ginger Garner PT, DPT (13:30)

Exactly. Exactly. It’s if we think about the sympathetic nervous system and the options for stress processing there, of course we can have the rest and digest response. That’s not always possible. But if you think about the sympathetic reactions, fight, flight, freeze, or fawn, ⁓ if someone is feeling like they’re running from a tiger, they’re not going to stop and say, you know, I think I have sexual desire right now. I’m in the middle of running from a tiger, right?

Laurie Mintz PhD (13:55)

Thank you.

Dr. Ginger Garner PT, DPT (13:59)

And running from the tiger can mean a number of things, all the things that we just talked about with stress and caregiving and mental labor and emotional load and all that stuff. So I think one of the things that would help shift the conversation is this is obviously we’re breaking stigma here. We’re just talking about it. We’re talking about vaginas and penises and the clitoris and all that stuff. think that if we, and I tell patients this all the time when I’m working with them through some situation.

I said, you know what my biggest desire would be, I think, is that if in high school you could actually have a health oriented class that actually discuss how a body functions, how do you manage stress, right? What happens when you’re overloaded with caregiving? What happens to your digestive system, et cetera? So that we wouldn’t get to this point where someone is just like, I just need a pill for low libido or whatever. They would be able to take care of their bodies in a way that would allow.

sexual desire to be sustained in some way. if we talk about anatomy and basic science, so we’ve got clitoral anatomy, orgasm science, et cetera, that is, and I’m going to hold this book up again, that is what you really write a lot about in Becoming Cliterate, is delivering concrete, correct anatomy education early and often.

Laurie Mintz PhD (15:22)

And I’ll tell you what, it was very hard to find the right, like I, the anatomy chapter, I’m writing a third book now, I just finished it in the third book and it was better this round, but Ginger, I cried many times writing that anatomy chapter because ⁓ even in reliable sources, I found conflicting information on women’s genital and clitoral anatomy.

Dr. Ginger Garner PT, DPT (15:39)

Hmm.

Ugh.

Laurie Mintz PhD (15:52)

So, and at one point, and I wrote this in a sidebar to that chapter, I wrote about it. I was finding all this conflicting information. I was struggling so much. I like called my editor and this was me being sort of gaslighting myself in a way from culture. I called my editor and I said, I can’t write this book. I’m not qualified because I can’t figure this out.

Dr. Ginger Garner PT, DPT (16:12)

Hmm.

Laurie Mintz PhD (16:19)

you know, and I was like, this book says this, this book says this. And she was like, and you think that’s your fault? like, that’s the reason the book is needed that in at the time 2016 or 17 when I was writing it, there was still not adequate information out there. And so, you know, so I did the best I can. And I’m so I’m delighted that someone like you found it.

Dr. Ginger Garner PT, DPT (16:26)

⁓

Yeah.

Laurie Mintz PhD (16:47)

accurate and informative.

Dr. Ginger Garner PT, DPT (16:49)

Yeah,

absolutely. Let’s talk about it a little bit more. And I just realized I have my little 3D ⁓ clitoris is not behind me where it usually is. So I might actually ⁓ have to fetch it for the the watchers on YouTube in just a second. most people still think that the clitoris is just a small external structure. ⁓ You and I know that’s not true, but let’s talk about it a little bit because

you know, A, what does it actually look like and why does that understanding matter? That misunderstanding really matters so much.

Laurie Mintz PhD (17:23)

Yeah. And you know, the clitoris and I just realized too, I have some models and I have my vulva puppet and I also left them in my closet. So I might have to go open the closet and bring out my puppet too. But why does it matter? It is because we have to understand our bodies first and foremost. And people think when they think of the clitoris, right, they think of this

button on the outside under a hood. That’s the clitoris glands in the hood. that is a very, do not get me wrong, that is a very important part of our genital anatomy as are our inner lips, which really in a way should be considered part of the clitoris because when embryos, as you all know, develop, some develop with penises, some develop into

Dr. Ginger Garner PT, DPT (17:54)

Mm-hmm.

Laurie Mintz PhD (18:19)

clitorises and inner lips and female prostate glands. Like I’m getting a little complicated here, but the bottom line is we have erectile tissue. We have all of this same, every part of a penis, there’s an analogous part, either inside our pelvis or outside on our vulva. And ⁓ we have to understand that for our arousal, we have to understand

Dr. Ginger Garner PT, DPT (18:29)

Absolutely.

Hmm?

Laurie Mintz PhD (18:47)

that most of us need some form of external vulva outside stimulation to experience pleasure, to experience orgasm. And we have to, the whole idea that women are broken because they don’t orgasm from something in their vagina, if we understand anatomy, we will understand nobody’s broken.

That is not, except for these clitoral bulbs that surround it, which could account for some women orgasming from vaginal stimulation, there is not enough of the erectile tissue ⁓ activated. And it’s really important. I love for women to understand A, why do you need outside stimulation? And B, like, not only when you’re stimulating the outside,

You’re also stimulating the internal clitoris when you’re certain parts outside. But nobody gets that, right? Because even we call our entire genitals a vagina. We call our genitals, not you and me, but the general population, we call our genitals for the part that’s more sexually useful to men than women themselves.

Dr. Ginger Garner PT, DPT (19:48)

Mm-hmm.

That’s right. We’ll do that.

Ooh, that’s another mic drop right there. Yeah, that’s true. And that is probably some of that maybe internalized misogyny ourselves is because you see it on Instagram influencers calling, they’re leaving out the vulva altogether and they’re just saying, know, vagina, vagina, vagina. This is probably a good moment. I’m going to grab my model so we can talk about it for the viewers. I’ll be right back.

Laurie Mintz PhD (20:33)

Amazing.

Dr. Ginger Garner PT, DPT (20:38)

Okay, we are back.

So for the viewers, ⁓ I ordered this lovely little 3D printed ⁓ clitoris from Berlin a few years ago that actually fits the model that I have, the pelvic model.

⁓ quite well.

when you hold them up. So that’s what we’re really looking at with the clitoris. So, so Laurie, tell our viewers a little bit about that, what I’m holding up now.

Laurie Mintz PhD (21:18)

Okay, so what you’re holding is the clitoris and how it over how the vulva lays over it basically and how the pelvic floor and I’m gonna I’m gonna take my puppet and kind of go and Correct me if I’m wrong because some of this science is still its its infancy, right? So this is the vulva. It’s the outside area of our genitals

These are the inner lips. I’m not going to go through all the parts, but they are hairless. They’re chock full of erectile tissue. You know that the seam on the underside of the penis, its name is the penoraphy. If you look at a penis on the underside, it has a seam. Well, the seam is where the inner lips come apart. So these are really underrated sexual organs. You follow them up and they form the clitoral hood.

and the hood is analogous to the foreskin of the penis. Under the hood is the glands, ⁓ very about, varies across women, but about the size of a pencil eraser and about 10,000 nerve endings. Ouch! Most cannot touch her directly, stimulate her through the hood or through indirect stimulation the lips, but there’s more to the story as you just showed.

The in, this is the tip of the clitoris. And as you can see in the model and the shaft or the body of the clitoris runs through what’s called the man’s pubis, the area where there’s hair growing. A few years ago, a video went viral on TikTok saying, do you know you can orgasm by pushing on your stomach? It wasn’t the stomach. It.

the mons pubis because inner clitoris runs through here. So that’s why a lot of women like to push there. And also to under the inner lips, under the outer lips, even surrounding the vaginal canal is the rest of the clitoris. And it’s where most of the erectile tissue is, even more than the hood and the glands. And in fact,

Dr. Ginger Garner PT, DPT (23:11)

Hmm.

Laurie Mintz PhD (23:38)

You know, I watched a Betty Dotson video. I don’t know if you know Betty Dotson’s work, but she was a major force in women’s masturbation and sexuality. She has videos showing herself teaching women how to orgasm. And I remember this aha moment, Ginger, where Betty was teaching a woman to kind of put her hands in and rub. And I thought, she’s not just rubbing the vestibule, the skin.

stimulating the internal clitoris that lays beneath. And it’s our entire erectile tissue that is what gives us pleasure. Did I make any mistakes?

Dr. Ginger Garner PT, DPT (24:07)

Mm-hmm.

That’s beautiful. That is beautiful. And so if you are listening to this on a podcast, you might want to just scroll on over to YouTube and watch these few minutes somewhere around the 23 minute segment or so, so you can see the visuals because that is just so helpful. And of course, picking up the book as well. So why do you think penetration centered sex education persists despite what we know now about anatomy?

Laurie Mintz PhD (24:48)

Patriarchy.

Dr. Ginger Garner PT, DPT (24:51)

Thank

Laurie Mintz PhD (24:52)

And I want to be really clear for listeners and for everyone. I am not blamed, just like individual women are not broken. When I say patriarchy, I am not blaming men, okay? I am, yes, very much. I personally, I’m heterosexual. I’ve been married to the same lovely man for over 40 years. I am not.

Dr. Ginger Garner PT, DPT (25:02)

Right.

Right, because it hurts men too.

Hmm.

awesome.

Laurie Mintz PhD (25:18)

I have son-in-laws. I have friends I love. I’m not blaming men. They are as harmed by this as women. But if you think about what we… We don’t have sex ed. So where do people get their information from movies, from videos? The way we do it in the US at least, it’s analogous to putting a kid in front of a Fast and Furious movie and say, this is now how you learn to drive.

Dr. Ginger Garner PT, DPT (25:48)

Ooh, that’s a good one. I like that. Yeah.

Laurie Mintz PhD (25:49)

I mean,

and what do they see? They see women having fast and fabulous orgasms from penetration alone. And that is only the studies they used to ask women, can you orgasm from penetration? And about 25 % of women would say so. And they were like, well, that’s still not very many, right? But then they said, wait a minute, let’s ask a different question.

Can you orgasm from just a thrusting penis if you’re not also getting your clitoris, meaning the external part, stimulated? 15 % of women said yes. And I started thinking, you know, we’re asking people, can you do this idealized thing? So I changed the question. And at this point, I’ve asked about 10,000 women this question across the years. What’s your most reliable?

Dr. Ginger Garner PT, DPT (26:29)

yeah.

Yeah.

Laurie Mintz PhD (26:47)

root to orgasm in zero to five percent say penetration alone.

Dr. Ginger Garner PT, DPT (26:54)

That’s good information because that’s a lot of asks, you know? Yeah. That’s very relevant.

Laurie Mintz PhD (26:59)

Yeah, yeah,

yeah. But that’s not what we see in the movies. so, and men feel a lot of pressure because of this.

Dr. Ginger Garner PT, DPT (27:12)

Right, then they have this whole performative pressure, ⁓ not understanding maybe what their partner wants. And if they’ve allowed themselves to become kind of suppressed by society’s ⁓ strange attitude towards sex, then they may feel like they can’t talk about it or they’re embarrassed. And then that leads to loss of erection, et cetera. Yeah, all kinds of stress points tied up in that performative aspect ⁓ for men. And again,

With patriarchy, everybody loses. Nobody’s winning with that at all. So we have this whole orgasm gap, basically, which is what you describe. You go over it so well in your book. That is an education failure. And it is not something that I see an immediate remedy to unless we just keep having these conversations and you keep writing fantastic books.

Laurie Mintz PhD (27:46)

No, no.

Dr. Ginger Garner PT, DPT (28:08)

And people can pick up that information that way because it’s not going to change at a basic educational level. So I guess we have the problem of, know, orgasm inequality persisting even in long-term loving relationships. So maybe you could speak to that a little bit ⁓ and how that lack of literal literacy, if we get just to use fancy terms for a second, ⁓ fuel self-

blame? How can we shift that towards curiosity and get out of this self blame mode? You know, whatever the type of relationship is in, because again, they could be in a long term loving relationship and still have this giant, you know, orgasm inequality.

Laurie Mintz PhD (28:51)

Yeah, no, I love that. just, you know, in orgasm and inequality just to take a step back, it’s a consistent finding over 30 years of research, right? That when women and men, cisgender women and men get it on, the women are having way fewer orgasms. And it happens in all sexual contexts. It’s biggest in hookup sex, but it never closes altogether, even in loving committed relationships. And

⁓ It is not about our bodies. It is about the way we do heterosexual sex. And we know that, and then I will, I’m taking a little route to answer your question. The way we know it’s not our bodies is when women pleasure themselves 95 % orgasm easily and with minutes. Why? Because they’re stimulating externally.

When women get it on with women, they have more orgasms. Why? There’s more external stimulation and a few other reasons I’ll come back to. When women are in hookups versus relationships, they have more orgasms. Why? Clitoral stimulation is more likely to occur in relationships. But so this isn’t about bodies. It’s about how we do sex. Here’s what we know about women who have sex with women.

and all the reasons they orgasm more. They have engaged in more clitoral stimulation. They have more communication. They take more time with the whole encounter. ⁓ They have more varied sex acts. I don’t know if I remember I said this, they take turns giving and receiving pleasure instead of having it occur at the same time, the same act.

The people involved have an attitude, my orgasm is central to this experience and they expect their partner to pursue an orgasm. So those are not about who you have sex with. Those are behaviors and attitudes that would benefit everyone. So to answer your question, what do we do about it? We educate people to have those attitudes and behaviors in

their relationships and ⁓ that would be a problem.

Dr. Ginger Garner PT, DPT (31:12)

Yeah, that’s brilliant.

Can you give us a highlight of that again? Because I love that research of what comes out of women being with women. So you listed like five things really. Yeah.

Laurie Mintz PhD (31:23)

Yeah, five things. So

more clitoral stimulation, more taking turns. I’m going to give you pleasure than you’re going to give me pleasure rather than in heterosexual sex trying to do it at the same time, right? More varied sex acts. ⁓ So like the menu is bigger of the whole. The whole thing takes more time overall.

Dr. Ginger Garner PT, DPT (31:44)

Yeah.

Laurie Mintz PhD (31:50)

And then there’s two attitudes, one of orgasm centrality, my orgasm is important to this encounter. And the other attitude of I expect my partner to pursue my orgasm. I expect them to consider it important.

Dr. Ginger Garner PT, DPT (32:04)

Yeah. All right, everybody. I hope you heard all those points. Go jot those down. That’s important. I think one I’d like to come back to, because we certainly don’t have time to talk about all of them, but the one that I know you could probably elaborate on a little bit is then types of clitoral stimulation, because I think one of the biggest orgasm-to-gap problems that I see ⁓ with patients coming in with pelvic pain,

and painful intercourse, painful sex, whatever they define that as, which we call dyspareunia, ⁓ is that they only know about, let me pull my pink model back up here, they only know about the little tiny external pencil eraser tip size. So what are some of the typical things, go-tos that should be considered when they’re talking about learning different methods for stimulation?

Laurie Mintz PhD (33:00)

Yeah, so I mean, it’s stimulating a lot of the areas, not just the tip, right? And sometimes that is painful in and of itself. so using the Mons pubis, stimulating the inner clitoris through here, stimulating the inner lips, even stimulating through the entire external, know, ⁓ squeezing. ⁓

you know, if they don’t have skin, you know, this is a, the inside is a very delicate area of skin. It’s a, it’s a source of great pleasure for many and also great irritation and pain. So that’s not for everybody, but also stimulating inside here because you’re, you’re, you’re can kind of massage the internal clitoris stimulating around the vaginal opening.

not just going inside, but around the opening. And also huge, huge plug for clitoral vibrators. Huge, huge plug. We know that our vulvas have special receptors on them for vibration, Kraus core puzzles. They are, and in a great twist of fate, these core puzzles were discovered a long time ago, but we only understand how

Dr. Ginger Garner PT, DPT (34:06)

Hmm, yeah.

Laurie Mintz PhD (34:25)

they function sexually now, and they really respond the best to about the hertz of typical vibrators. And we know that that is really juicy, really erotic. And we know women who use vibrators have more orgasms. They have less pain. They have better pelvic floor health. This is all research-based. If they use them with male partners,

or any partner, they have more relationship satisfaction and sexual satisfaction. Women who have partners whose men like their vibrator use more sexual satisfaction. And this benefits men too, because remember, penises and volvus came from the same embryonic tissue. They have cross-corpuscles too. So I always tell my couples, especially the men who are afraid of vibrators,

If your penis is down here anywhere while the vibrator is going, you’re gonna catch some vicarious vibes and you’re gonna love it. they do. Yeah.

Dr. Ginger Garner PT, DPT (35:34)

I love the way you put that.

Catching the vicarious vibes. Don’t be afraid of vibrators, everybody. Yeah, it’s important.

Do you remember? And you may not, and that’s okay because I think that research is emerging and more research needs to be done on Hertz frequency. So for those of you listening, you’re like, what’s a Hertz frequency? It’s our voices, it’s listening to song music, it’s a vibrator, it is all kinds of things. It’s ultrasound imaging, there’s Hertz frequency in everything. ⁓ So do you recall what the particular Hertz frequency was? Because I know in pelvic health, we have

⁓ I call them pelvic health toys. There’s just lots of devices. I have a whole toy box, you know, in the clinic and they all have different Hertz frequencies for different things.

Laurie Mintz PhD (36:28)

Yeah, and honestly, I would love to learn more from you on this. do recall because I just read the article yesterday because I’m writing another book and I was talking about it. And so I looked up, I read the article that says Kraus corpuscles respond to about 40 to 80 Hertz. And then I looked up what a lot of vibrators are. And a lot are in that range. A lot are stronger.

than that range. So I would love to learn from you about how those core puzzles work with stronger vibrations.

Dr. Ginger Garner PT, DPT (36:55)

Yeah.

think it’s an area that, gosh, we’ll have to continue this conversation after we hit the stop button because this is an area like ripe for research. And when we talk about how the voice plays into that as well, because I use a lot of ultrasound imaging in practice and I will see really interesting things happen when someone is voicing versus not voicing with their ability to A, be aware of their pelvic floor,

and B, even be able to control their pelvic floor. Sometimes even introducing the Hertz frequency of your own voice is, you’re not able to manage the pressure that, the intra-abdominal pressure that goes downward as someone is talking using incorrect techniques. And so I think a lot of the work that I do is motor repatterning. How can we unload the pelvic floor and…

whether it’s loading the voice or loading the pelvic floor in a sexual encounter in a way that’s actually going to have a positive pressure management reaction. And of course, then the research question is, well, what is the best Hertz frequency for that? And sometimes I’ll use the voice just like we do, you know, with sex, right?

Laurie Mintz PhD (38:22)

Yeah, it’s so interesting. And what I find, because I don’t have all that. I don’t have the details hurts. I just got a drawer full of vibrators and my friends have drawers full of vibrators. What I find is everybody’s different. Like I might have a vibrator and this my friend and I were talking about this. I have one I love. I mean, I love her. And, you know, she’s pretty powerful. My friend hates her because she’s too powerful.

Dr. Ginger Garner PT, DPT (38:32)

Yeah.

Yeah.

Too

much, yeah.

Laurie Mintz PhD (38:52)

You know, I have another friend who loves the type that gives sonic waves or air pulses. I have another friend who hates that. Like, I think what I can tell you that I know is that every woman’s genital nerves are a little bit different. And we have to honor what ours want.

Dr. Ginger Garner PT, DPT (39:02)

Mm-hmm. Mm-hmm.

And that’s where the curiosity comes in. Because just like if I am imaging a patient, I always tell them, I wish there was only one cue to get you where you needed to be. But there isn’t, there’s not one type of stimulation or one type of cue that’s going to do it for everyone. Otherwise, this would be much easier with dealing with pelvic pain and sexual dysfunction. But when we look at how their body responds, how does your pelvic floor respond to that input?

Laurie Mintz PhD (39:16)

Yeah.

Dr. Ginger Garner PT, DPT (39:42)

And then you begin to add those other variables, which may mean the voice, particular types of touch, ⁓ superficial stimulation versus deep stimulation, low frequency versus high Hertz frequency. That is where that they want to please your partner and curiosity is going to pay off. ⁓ now that, a listener, now that you know some of the science, the encouragement, the call to action is being more curious and determining.

how your nerves do respond to that, because every nervous system is different.

Laurie Mintz PhD (40:14)

And that

means into the take home messages by a few vibrators and some lube and see what you like, you know, and yeah, with a curious mind.

Dr. Ginger Garner PT, DPT (40:27)

Yeah. And we shift it from an orgasm being this part of what happens during this event to a neurological ⁓ kind of evolution, right? As you begin to understand yourself a little bit better and what you do like, then we move away from self-blame. We move away from performance towards embracing the ⁓ science of it and realizing that everyone’s going to be a little bit different.

Laurie Mintz PhD (40:58)

Yes.

Dr. Ginger Garner PT, DPT (40:59)

I know what isn’t different though is women being tired. That’s going to be universal problem. You may like 120 Hertz and somebody else may like 40 Hertz. However, I am certain that at some point if you are caregiving as a woman or as a man or whatever your gender is that we have to reframe desire using not some morality conversation using science. In your book,

Laurie Mintz PhD (41:03)

Very true.

Dr. Ginger Garner PT, DPT (41:27)

A Tired Woman’s Guide to Passionate Sex addresses a lot of that. I would say my top question might be, what misunderstood piece of science about desire have you seen in all of your years of therapy practice? Because it’s the tissue.

Laurie Mintz PhD (41:42)

Yeah, I think that

we talked about two of them already that you should just be able to power through the stress of caretaking and ⁓ chronic stress. No, there’s a great, great scientific paper called the heteronormativity theory of low desire in women partnered with men. And it goes into the social neurobiology of how chronic caretaking and chronic stress dampen desire. So

Dr. Ginger Garner PT, DPT (41:51)

Thank

Laurie Mintz PhD (42:12)

and women think, no, I just need to power through. I’m just not strong enough. So that’s one. But the other one is the difference between spontaneous and responsive desire. And I see this over and over. And spontaneous desire is, ooh, I see something and I’m horny. I see someone and I’m horny. But what’s really interesting about horniness, that’s not actually desire. That’s the beginning stages of arousal.

Dr. Ginger Garner PT, DPT (42:40)

Mmm. Yeah.

Laurie Mintz PhD (42:41)

If you think about it, right, you’re lubricating,

you’re, you know, and then there’s this other desire, responsive desire, meaning I’m interested in my mind. And there was a study of why people have sex and they gave 237 reasons. Being horny was only one of those and they categorized it into different types, but maybe because you know it’ll be good when it gets going, maybe because you want to feel close to a partner.

Dr. Ginger Garner PT, DPT (42:58)

How?

Laurie Mintz PhD (43:10)

maybe for a goal attainment. You want to ask your partner something that you know they’re not going to really like, but you know they’re going to be more generous after so many reasons. And so people have sex for reasons other than physical desire. And as they engage sexually, the desire emerges with the arousal or after the arousal. Yet so many women call that duty sex.

My advice is if it’s fun when it gets going, it’s not duty sex. You are simply using your responsive desire. And if you aren’t using your responsive desire, you don’t have to wait to be horny to have sex. You can have sex for other reasons, not ones of duty, not ones of, you know, and sometimes it’s hard to tell apart, you know.

But if it’s really because you know you will enjoy it when it gets going, you know you will feel closer. That’s not duty sex. That’s using responsive desire.

Dr. Ginger Garner PT, DPT (44:19)

Yeah. So we’ve got this spontaneous desire model that kind of dominates sex advice and fits so people, few people long-term and then responsive desire. Can you give the listener kind of an action, like a take home item so that I want everyone to feel less broken, you know? Yeah.

Laurie Mintz PhD (44:39)

Yeah,

yeah. The biggest advice I can give women who aren’t interested in sex physiologically, they’re not getting horny, right? ⁓ Don’t wait to be horny. Sex is so beautiful. if now, if there’s two caveats, I want you to schedule sexual encounters, I want you to have trysts, a planned meeting between lovers.

and not at night when you’re exhausted, when your testosterone is low and your cortisol is high at a time that’s good for you. I want you to take the time during that encounter to build arousal. I want you to not rush through it. I want you to be mindful, which we haven’t even talked about, putting your mind and body in the same place. And if it’s good when it gets going, problem solved. If, however, it’s not good when it gets going, it’s painful.

you don’t get aroused, then you need to seek sex therapy, a sexual medicine physician, or a pelvic floor physical therapist, or all three, but start with one, and they’ll help lead you to the others to make it less overwhelming.

Dr. Ginger Garner PT, DPT (45:51)

Yeah. Yeah.

Yeah, that is such good advice because I think what ⁓ everyone, see lots and lots of women and I think that women are going to struggle with this the most because they’ve kind of been, well, we’ve talked about all the reasons why that’s happened, because chronic stress is going to do a lot of things. You’ve already alluded to this when you were like, cortisol is high, testosterone is low, cortisol is queen and king, it’s all the things.

when you talk about regulation of hormones, it’s still not something scientifically that’s well understood exactly how cortisol is going to dampen and negatively impact hormones, but we do know that happens no matter where you are in the lifespan spectrum. So chronic stress, what does it do to arousal, to orgasm, to pelvic blood flow? ⁓ That’s the first question.

I think the second piece of that was, well gosh, how does emotional labor show up in the body? I see that all the time as a pelvic floor PT. ⁓ But that fine line between what we feel psychologically and how it manifests physically is incredibly important. So I know that what we do has a lot of overlap.

Laurie Mintz PhD (47:09)

Yeah, and I want to be clear. mean, I’m not saying like, I am also, I want you also to address the stress. I want you to address the chronic caretaking. But I think there’s a little adjustment you can make if you’re not in pain, if you’re aroused, if you’re orgasming that sex is a good stress reliever. Stress is something for you. And re-looking at that,

Dr. Ginger Garner PT, DPT (47:32)

Yeah.

Laurie Mintz PhD (47:38)

and then scheduling it at a time that works. And remember to be mindful too. What’s mindfulness, right? Mind, body in the same place. We rarely do that. Our thoughts, ⁓ there she goes. I forgot to return that email. Oops, how do I look? And to really cultivate body awareness, mindfulness in daily life. The next time you’re brushing your teeth, here’s a call to action. The next time you’re brushing your teeth.

Really focus on the sensations, the taste, the toothpaste, the bristles. And when your mind wanders, and she will, don’t get all like, uh-oh, I’m not doing this right. You’re doing it perfectly because the practice is noticing, there she goes, and bringing her back to sensation. And practice that when you’re brushing your teeth, when you’re washing your hands, and then apply it to sex.

Dr. Ginger Garner PT, DPT (48:34)

Yeah, being present and aware. I think oftentimes, I think a common example of pelvic pain, let’s just say someone has pelvic pain, pelvic pain can mimic a lot of things. It can feel like back pain, it can feel like hip pain. And then someone coming in and sitting down, we are able to really drill down and say, oh, that’s actually a pelvic floor muscle that’s like radiating everywhere. it’s just.

creating a level of awareness that you might not have had before because fatigue, mental load, and kind of the sexual nervous system are all going to show up and manifest themselves in real ways beyond things that we’re just thinking. They’re going to manifest themselves physically. That’s why you can’t just say, just relax, you know, ask sex advice. That’s horrible. It’s horrible. It makes me very angry because that’s what most of my patients get. have a…

Laurie Mintz PhD (49:20)

Yeah.

No, that’s terrible advice. Yeah.

Dr. Ginger Garner PT, DPT (49:32)

glass of wine or something. Yeah.

Laurie Mintz PhD (49:33)

Have a glass of wine, which by the way,

wine is alcohol. It’s a central nervous system depressant. It’s going to make orgasm less likely. The opposite advice is more sound. Get some exercise. Get your blood flowing. Yes, exactly. Yes.

Dr. Ginger Garner PT, DPT (49:38)

present.

Drink a glass of water.

Yeah. Practice your lifestyle, medicine, get good sleep, eat well, have a glass of water, take a walk. So I think that being aware of when someone is guarding is important because from a pelvic floor perspective, and I know you touch a little bit about this on both of them really, ⁓ if your mind is racing,

Laurie Mintz PhD (49:54)

Yep.

Dr. Ginger Garner PT, DPT (50:19)

if your body is going to hold that somewhere, which affects pleasure, not just creation of pain. ⁓ So I think that’s important to realize because it’s not just about arousal, right? There’s so much more that actually goes into that. ⁓ Desire, having good pelvic health and also self-trust as well. So let’s talk a little bit about then replacing

that performance with sustainability? What’s sustainable? What’s the cost of defining, you know, passionate sex as performance rather than connection or pleasure or whatnot?

Laurie Mintz PhD (51:01)

No,

a huge cost. Like Jennifer Vensel, who wrote a book recently called Desire with Lauren Fogel, she has this beautiful diagram. one is a circle and it’s next to a staircase, right? And the staircase is like kissing, petting, oral sex, intercourse, orgasm. It’s like this, you gotta get up the staircase. It’s a goal, go, go, go. Whereas the circle is touching, connecting, kissing, loving.

It’s really, you know, the greatest irony for me as a sex therapist helping women experience orgasm is that pressure to do so is counterproductive to what we’re trying to do. the pressure, focus on that. That’s why mindfulness works. Focus on the sensations. Focus on the pleasure, not pressure.

Dr. Ginger Garner PT, DPT (51:59)

Yeah. And that also requires expanding what counts, know, as sex and, know, to support long-term desire.

Laurie Mintz PhD (52:06)

absolutely. Yes.

Yes.

Dr. Ginger Garner PT, DPT (52:11)

⁓

Oh, here’s one more question that I think we need to tease out is, what’s the difference between wanting sex and wanting the sex you’re having?

Laurie Mintz PhD (52:26)

that’s, that we could start the conversation all over and have an hour here. But a lot of women are having bad sex, right? Because they’re not having orgasms. And there is a difference between, you know, being too tired of sex and tired of the sex you’re having. Yeah, and that, yeah, and also even couples.

Dr. Ginger Garner PT, DPT (52:31)

Ha

Yes. I’m into that.

Laurie Mintz PhD (52:52)

who both are at orgasming. Usually couples develop a sexual routine because it works. I do this to you, you do this to me, I do this to you, you orgasm, I orgasm. But even orgasmic sex can be monotonous. So it’s really important to mix things up, communicate, try new things. They might be a flop, but just try them with open communication and curiosity.

and that the sex needs to be, not every encounter is equally ⁓ good for both partners, but if there’s a pattern where one person is always getting worse sex than the other, we’ve got to…

Dr. Ginger Garner PT, DPT (53:37)

Yeah, absolutely. Absolutely. So I think that…

Education is obviously liberation here. That’s been the whole point of the conversation. It’s the whole point of this season focusing on sexual health. ⁓ If sexual health education reflected real anatomy and real nervous systems, what do we stop blaming people for then?

Laurie Mintz PhD (54:04)

everything we were out of jobs, which would be great. Great, great by me. Great by me. Yeah. I mean, yeah, I mean, we really need to people do not know their body. And if you don’t know your body, you’ve got a problem you blame yourself. And EU and so many of the problems are about culture about misinformation.

Dr. Ginger Garner PT, DPT (54:06)

Yeah, yeah, absolutely.

Laurie Mintz PhD (54:28)

And also they’re salvable with the right information. But the other sad thing I find is people get the wrong information or take a really long time to seek help. And by that time that happens, there’s other problems layered on top.

Dr. Ginger Garner PT, DPT (54:43)

Yeah, I would say that the threads pull out here is of course we’ve talked a lot about clitoral anatomy. We’ve touched on the relationship of pelvic health and whether it’s holding tension in your mind or holding tension in your pelvic floor, they can have the same negative impact. And also being able to speak up, which is literally using your voice. ⁓ Obviously we could…

explore so much about what using your voice in sexual encounters feels like or looks like, but just having the courage to be able to speak up, speak to your partner, ⁓ voicing what you want has such a positive impact at the nervous system level.

Laurie Mintz PhD (55:28)

interesting. Yeah, so, so well said. So important. Yeah.

Dr. Ginger Garner PT, DPT (55:32)

So what

permission would you say? Because I think sometimes the psychological side of this is, ⁓ in my day-to-day job, I treat all this physical side of pelvic pain, but the psychological side can be, I think, sometimes so much harder to overcome. And you almost need to, almost need like a mantra, like something spoken to yourself to give yourself permission. So what would you say that would be to tired, disconnected people?

that need to give themselves a break about sex and all the pressure around it, like what permission do they need to give themselves? What would you have them practice saying or doing?

Laurie Mintz PhD (56:12)

That’s a, what a, what a challenging question because it would depend on the woman. For some, I could see the message being, you don’t have to do anything you don’t want to. Just relax, take care of yourself. ⁓ But you need to talk to your partner about that because if you are in a long-term, monogamous relationship, it is definitely not cool for one person to say this is over without a conversation. Right? I mean, that’s just not okay. No matter who’s saying it.

Dr. Ginger Garner PT, DPT (56:37)

Yeah.

Laurie Mintz PhD (56:41)

it takes a conversation for another woman, would be enjoy sex, take the time. Like that is me time. Like you deserve that. So it really is gonna be dependent on me sitting and talking to a woman, but like either the conversation is gonna be take a break and talk to your partner about being gracious about that.

while you figure out this pain, while you work on the PT, whatever it is, or it’s gonna be like, remember when you used to love sex? Like, that was so fun, let’s get back there. You can do that again. So it really depends, but it’s somewhere one of those two would be the message depending on the woman.

Dr. Ginger Garner PT, DPT (57:22)

Yeah. Yeah.

Yeah, and giving yourself permission to hear that message and to then speak that back to yourself and say, it’s okay for me to fill in the blank, right? Whatever that needs to be, yeah. What’s one sentence, this is kind of a lightning round here. What’s one sentence every exhausted person needs to hear or deserves to hear about sex?

Laurie Mintz PhD (57:42)

Yeah, exactly.

Boy, that’s a challenging one. Let’s see if we can first figure out why you’re so exhausted and alleviate some of the burden.

Dr. Ginger Garner PT, DPT (58:18)

Yeah, yeah, because I think fatigue is such a common thread in almost everybody. If they’ve been through pain or trauma or just existing in the mundane, know, groceries are expensive and so is gas world that we’re living in right now, everybody’s tired, you know.

Laurie Mintz PhD (58:22)

Yeah.

Yeah.

Yeah,

so let’s figure out and let’s see what we can address and get rid of what stressors what we can cope with, you know, and what we can manage.

Dr. Ginger Garner PT, DPT (58:38)

Yeah.

validating that experience and then looking for root cause. Like, why is that happening? Which I want the listener to then, like, I want you to really appreciate that you should have a team working for you, with you, to figure out where that fatigue is coming from. You know, whether it’s emotional or physical or driven by some other systemic thing so that you can get back to what you enjoy again. All right, maybe one more question. I have so many others, but…

Laurie Mintz PhD (59:10)

Yeah.

Dr. Ginger Garner PT, DPT (59:15)

⁓ What do you think the most harmful myth is about the clitoris?

Laurie Mintz PhD (59:20)

⁓ It’s not a myth about it, it’s the cultural silence around it.

Dr. Ginger Garner PT, DPT (59:26)

Ooh,

ow, that’s so good. I love it. Yeah. Yeah.

Laurie Mintz PhD (59:29)

We don’t even talk about it.

I mean, look at them. Look at even women’s magazines or men’s magazines, best sex position for her orgasm. And by sex, they mean intercourse and they don’t even mention the clitoris at all. So it is our cultural silence and ignorance that is the problem.

Dr. Ginger Garner PT, DPT (59:39)

Okay.

Like drop. So good. And how about desire? What’s the most ignored factor in desire, you think?

Laurie Mintz PhD (59:55)

⁓ then it changes over the time in the course of our lives and relationships. And it doesn’t mean, you know, I I don’t know if you know the, ⁓ the song by, Brad Paisley and Carrie Underwood. And it’s, for those, it’s like, remind me and they go through this song, like, remember how we would turn out the lights and we didn’t just sleep. Like I would be late for work. We even missed a plane one time.

Dr. Ginger Garner PT, DPT (1:00:23)

on.

Laurie Mintz PhD (1:00:24)

they want to get back to that and it’s like no that is a stage of life and it’s a beautiful stage of life for many but you don’t your goal isn’t to get back to that your goal is to create desire and intimacy and connection for the stage you’re in now

Dr. Ginger Garner PT, DPT (1:00:29)

Ha ha ha.

I love that. That’s such a beautiful finisher right there. So, Laurie, ⁓ where can everyone find you these days?

Laurie Mintz PhD (1:00:54)

You

can find me on my website, is www.DrLaurieMintz.com. You can find my books wherever books are sold. And I’m very active on social media, especially Instagram and Facebook. And my handle is Dr. Laurie Mintz. So I’m pretty easy to find. Put it in Google. You’ll find me and I hope you come join me in one of those spaces.

Dr. Ginger Garner PT, DPT (1:01:24)

Yeah, and go give her a TEDx talk, listen as well. Dr. Laurie Mintz, thank you enormously. Just so much, so much, so much for being on the show today and taking time to talk to me about this really important topic.

Laurie Mintz PhD (1:01:35)

Thank you so much for having me.

Thank you.