Medical Whistleblower: What Your Doctor Doesn’t Know Is Hurting You | Dr Rachel Rubin
Women's testosterone drops significantly in their 30s—not at menopause. This decline can cause low libido, difficulty with arousal, and delayed orgasm. If you're experiencing these changes, don't assume you're 'broken' or 'too young' for hormonal support. The biology matters. Talk to a knowledgeable
1h 47mKey Takeaway
Women's testosterone drops significantly in their 30s—not at menopause. This decline can cause low libido, difficulty with arousal, and delayed orgasm. If you're experiencing these changes, don't assume you're 'broken' or 'too young' for hormonal support. The biology matters. Talk to a knowledgeable doctor about testosterone therapy, which can help with libido, arousal, orgasm, and even body image when dosed appropriately (typically 1/10 the male dose).
Episode Overview
Dr. Rachel Rubin, a urologist and sexual health specialist, discusses the widespread gaps in women's health education—from medical training that omits the clitoris to misinformation about hormone therapy. She explains how hormones like testosterone, estrogen, and progesterone affect sexual health, libido, and overall well-being across different life stages, and why even affluent women struggle to get proper care.
Key Insights
Doctors Aren't Trained in Women's Sexual Health
The word 'clitoris' doesn't exist in OB/GYN training checklists. Most gynecologists receive no education about the clitoris, vulva, sexual pain, libido, arousal, or orgasm. This means women are going to specialists expecting expertise on topics those doctors were never taught.
Testosterone Drops in Your 30s, Not at Menopause
Women's testosterone levels begin falling significantly in their 30s—years before menopause. This decline can cause low libido, reduced arousal, delayed orgasm, and decreased engorgement. Many women in their 30s notice these changes but assume they're 'too young' for hormonal issues.
Birth Control Pills Lower Testosterone
Birth control pills work by tricking the body into not ovulating, which shuts down the ovaries. While the pill provides synthetic estrogen and progestin, it doesn't replace testosterone—leading to potential side effects like low libido and painful sex in up to 27% of users.
The Menstrual Cycle Hormone Pattern
During menstruation, estrogen and progesterone are at their lowest. Estrogen rises first half of the cycle until ovulation (when the egg releases). Then progesterone increases in the second half. If there's no fertilization, both hormones drop, triggering a period. Testosterone peaks around ovulation—nature's way of increasing sex drive when pregnancy is most likely.
Hormone Therapy Misinformation Harms Women
A 2000s study on hormone therapy was catastrophically misinterpreted, leading to decades of fear and withheld treatment. The same researchers recently published findings showing hormone therapy below age 70 has no increased cardiovascular risk. Women have been denied beneficial treatment due to flawed communication of science.
Notable Quotes
"I am filled with rage because people are limiting their ability to have great sex, great relationships, and great health because they aren't having access to all the information that they could, and they're going to see doctors who actually don't know how to help them with these problems."
"The word clitoris today in 2026 does not exist in the checklist for what an OB/GYN has to learn in their training. The word doesn't exist."
"Men are constantly asking about they want their penises bigger, harder, straighter, girthier, lasting longer. But none of that has anything to do with how women experience pleasure and satisfaction in the bedroom."
"We fundamentally don't give a crap about women's sexual health, about their menstrual cycles, pregnancy, menopause, hormones, pain with sex, libido. But we actually do have a lot of information that we are not using because everyone forgot to teach your doctor."
"We put a sheet over you like we are mechanics looking under the hood. So, we put a sheet to keep you comfortable, to keep you modest, but we hide your genitalia from you and we don't teach as we go."
Action Items
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1
Ask Your Doctor to Use a Mirror During Exams
Request a mirror during pelvic exams so you can see and learn about your anatomy as the doctor examines you. Dr. Rubin uses inexpensive Amazon mirrors to teach patients about their labia majora, labia minora, clitoris, and urethra during examinations.
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2
Track Your Hormonal Patterns and Symptoms
Monitor how you feel throughout your menstrual cycle, noting changes in libido, energy, mood, and physical symptoms. This data helps you identify patterns and have more informed conversations with healthcare providers about potential hormonal issues.
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3
Advocate for Testosterone Testing in Your 30s
If you're experiencing low libido, reduced arousal, or delayed orgasm in your 30s, ask your doctor to check your testosterone levels. Don't accept 'you're too young' as an answer—testosterone decline begins in this decade, not at menopause.
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4
Find Doctors Who Specialize in Sexual Health
If your current doctor dismisses your concerns about libido, sexual pain, or hormonal issues, seek out specialists who have pursued additional training in sexual medicine. Not all gynecologists have this expertise, so finding the right provider is crucial.