Ground Floor: on vaginismus, vulvodynia, and other ways we brace

Vaginismus and vulvodynia affect far more women than most doctors realise, and with almost three-quarters of a million women on UK gynaecology waiting lists, most are left to cope alone. In this episode of Ground Floor, holistic pelvic care practitioner, somatic educator and doula Naomi Gale explains why she's bringing back the Vagina Circle, and what it really means to tend to your vagina without it being a massage.

In this episode:

- What vulvodynia and vaginismus actually are, and why "just relax" is not an answer

- Why the pain is real: nerves, muscles and brain all involved, and why you should still get assessed

- The gynaecology waiting list crisis: RCOG figures, year-long waits, A&E visits and widening inequalities

- Why so many GPs have never been trained in vulval pain, and why women see doctor after doctor before a diagnosis

- Fertility, falling birth rates, rising IVF, and Naomi's own IVF and IUI story

- vagina massage touch that asks for nothing: coming back into relationship with your pelvis, with a short guided practice

- Why shame, stigma and isolation need spaces outside the clinic, and the relief of finding out you're not the only one

Pelvic health support doesn't replace medical care. If you have vulval pain or painful sex, push for a referral and ask for a pelvic health physiotherapist.

JOIN THE GROUND FLOOR CIRCLE

Online, monthly. First circle £45, then £29 a month, cancel any time. Or come once for £45.

[www.thiisisnaomigale.co.uk/vagina-workshop]

Sources: RCOG waiting list data (Jan and Oct 2026), ONS births 2025, HFEA Fertility Treatment 2024.

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"Do you know how I view my vagina? I see it as a cactus." Anne Hathaway wants to write the bible of the pelvic floor, The Times is selling Kegels as the fix, and every postpartum woman gets the same tick-box line from her midwife: do your Kegels. But if Kegels genuinely worked for everyone, why are so many of us still in pain and still pissing ourselves. A question that needs asking more versus- do your kegals.

In this solo episode of Ground Floor, holistic pelvic care practitioner, somatic educator and doula Naomi Gale draws on a decade of hands-on work to explain why vaginismus and vulvodynia are usually a pelvis that's guarding, not a pelvis that's weak.

In this episode:

- Where Kegels came from, and what they're actually for (yes a man was involved)

- The postpartum tick-box, and Naomi's own "PMSL" story after twins

- Why so many women doing Kegels aren't moving their vaginal muscles at all

- The Kegel as a check-in, not a workout

- Vaginismus, fear, cultural messaging and the constant bracing of being a woman

- Vulvodynia, misdiagnosis, and being told it's "in your head"

- The client who stopped her Kegels for three months and got her best pelvic floor result yet

- Mummy MOTs, and moulding yourself to fit the system

- What the research says about physio, mindfulness and CBT

- Botox, and why it's worth getting assessed

Free pelvic floor meditation: search Naomi Gale on Insight Timer.

If this episode helped, please leave a review and some stars. It helps other women find the show.

This episode is education, not medical advice. If sex or penetration hurts, see your GP, a gynaecologist or a pelvic health physiotherapist to rule out other causes.

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Painful sex after birth is common, often long-lasting, and rarely explained. In a large Australian study, 86% of first-time mums said sex hurt the first time after giving birth, and nearly one in four still had pain at 18 months. If that’s you, it isn’t a “you” issue...!

In this episode of Ground Floor, holistic pelvic care practitioner and doula Naomi Gale looks at the episiotomy: what it actually is (a surgical cut through skin and muscle, not a tear), why it became routine in the 20th century before the evidence existed, and why the Cochrane review, the WHO and NICE now say routine episiotomy isn’t justified.

She also covers the forceps exception, where a cut can protect against severe anal sphincter tears, and why the real question is why so many of us end up with assisted births in the first place.

Naomi then widens the lens on why sex can hurt or feel different after any birth, including caesareans:

• The six-week check myth and how long postpartum pain really lasts
• Tears vs episiotomy, scar tissue, tight stitching and the “husband stitch”
• Lost sensation, numbness and difficulty reaching orgasm
• Breastfeeding hormones, low oestrogen and the genitourinary syndrome of lactation
• The vestibule, where much postpartum pain actually lives
• Vaginismus after birth and why the body braces
• Pudendal nerve stretch and pudendal neuralgia
• Informed choice, the cascade of intervention and writing consent into your birth preferences

Naomi shares her own births (an induction, forceps and an episiotomy with her son; induction, epidural and ventouse with her twins), her postpartum incontinence and painful sex, and the holistic pelvic care journey that changed it.

Naomi is a holistic practitioner, not a medical professional. This episode is for information and informed choice, not a diagnosis.

If this helped, please leave a rating or review. It really helps other women find the show.

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"I found a vaginismus-friendly partner" is all over TikTok. But what does that actually mean? And why isn't a "vaginismus-friendly" partner just… a woman-friendly one?

In this episode of Ground Floor, Naomi Gale takes apart the vaginismus partner fantasy. She explains why the right person won't magically fix painful sex, and why vaginismus can show up for the first time once you're finally with someone safe. Then she gives you the real list: the PVP (Perfect Vaginismus Partner) checklist, a word-for-word script for telling someone new you have vaginismus, and seven steps any partner can take to help you feel held, not tolerated.

In this episode:

• What vaginismus is through a holistic lens, and why it's armour, not rejection
• Why 1 in 13 UK women find sex painful, and why that number is too low
• How vaginismus can start with birth, stitches, speculums, or childhood UTIs
• The 7-point PVP checklist for dating with vaginismus
• A script for telling a new partner, and what their face tells you
• Guilt, counting, and pressure when you already have a partner
• 7 steps for partners, from taking penetration off the table to "no need to rummage for the last Pringle"
• Why Botox and dilators sit outside the work that actually needs doing

If you have vaginismus, this one's for you. If you love someone who has it, this one's especially for you. Send it to them.

This podcast is free, and it stays free. If it helped, leave a rating or review. It's how this information reaches the people searching for it at 2am.

This episode is educational and sits alongside medical care, not in place of it.

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If the thought of a smear test feels a world away from your reality, this episode is for you. On this episode of Ground Floor I talk about cervical screening when there's pain, fear, vaginismus or vulvodynia in the picture. I cover why so many of us avoid it, why the person holding the speculum often can't help, and the practical and somatic tools that let you go in on your own terms.

This video shares holistic and somatic perspectives and personal experience. It isn't medical advice. Please speak to your GP or a qualified health professional about your own screening and care.

I start with a quick word on choice. Whether you screen at all is your call, and this episode is for anyone who wants to go but is finding it hard. Then I share where I've landed with my own smear test after the reminder text reached me in Morocco. I talk about my family history of cancer and what it means to be a bridge between medicine and holistic care.

From there we get into the body and the room:

• Why so many women cancel, and why a leaflet isn't the answer
• Why vaginismus and vulvodynia get glossed over at screening level, and why GPs and nurses often have little or no gynae training
• Vaginismus vs vulvodynia: bracing against a threat vs persistent, unexplained pain
• A dentist's chair, my eight-year-old and a flippant remark: how pain gets downplayed from childhood onwards, and how humming and the vagus nerve help us regulate
• Before the appointment: book unrushed time, ring ahead for the smallest speculum, time it for when your cervix sits lowest, and practise your words
• Mapping your vaginal opening like a clock face so you meet your own bracing before a stranger does
• In the room: what actually happens, asking for a female practitioner, agreeing a stop signal, grounding and breath
• Aftercare: vaginal steaming, journaling or voice notes, and treating a flashback as information, not a setback
• When it doesn't go to plan, and why it's never your body's fault

I finish with support for anyone who has experienced sexual violence, including the My Body Back Project, and a reminder that asking for what you need isn't being difficult. It's taking an active part in your own care.

CHAPTERS

00:00 Welcome to Ground Floor

00:25 Your choice: a quick word on screening

01:45 "If everyone had a leaflet": why so many women cancel

02:46 My own smear test decision

05:57 Why avoiding it makes sense

06:47 Why vaginismus and vulvodynia get glossed over

10:02 Vaginismus vs vulvodynia

12:14 The dentist's chair: how pain gets downplayed

17:59 Before the appointment: practical tips

20:52 The clock face: mapping your own bracing

24:14 In the room: what actually happens

25:55 Aftercare and vaginal steaming

26:28 None of this is you being difficult

26:55 When it doesn't go to plan

29:41 Resources: My Body Back Project

30:52 Closing thoughts

RESOURCES

📖 Ground Floor the Book: https://www.amazon.co.uk/dp/1066910901

🗝 The Community Circle: https://thisisnaomigale.co.uk/vagina-workshop/

🪶 My website: https://thisisnaomigale.co.uk/homepage/

🎙️ Ground Floor, the podcast: https://podcasts.apple.com/gb/podcast/ground-floor-on-vaginismus-vulvodynia-and-other-ways/id1498365947

My Body Back Project: cervical screening for people who have experienced sexual violence: https://mybodybackproject.com/

Did this episode help? Leave a five-star review on Spotify or Apple Podcasts, and a comment earns extra points. Send it to a friend who's been putting hers off. You can also find me on Beehiiv.

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Vaginismus, Explained: What Actually Shifted for Elena. Why the body sometimes waits until it's safe enough to finally speak A fictional case study, built from repeated patterns Naomi's seen in her practice: Eleanor, 34, eighteen months into the healthiest relationship she's ever had, whose body started saying no to penetration around month eight with no obvious trigger, and a partner who's patient, attentive, and safe. Why this timing isn't cruel or confusing, it's logical: vaginismus emerging inside a safe relationship is often the nervous system finally pausing long enough to let something it's been holding all along surface, not a malfunction caused by the relationship itself. Practical first steps that don't start with penetration: separating touch from "touch always leads to sex," and building felt safety outside the bedroom before addressing what happens inside it. It's the only vaginismus podcast episode you're going to need if you are feeling safe in your relationship but still have vaginismus.

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A deep, thorough return to vaginismus and vulvodynia both understood as bracing. Here we discuss why we have to work not just physically but holistically with the body. Vaginismus is held in the pelvis for reasons ranging from sexual assault and childhood abuse to something like an ongoing tension in an unaligned relationship. The insight worth sitting with: pain and tightening sometimes appear only once you're finally safe enough for your body to stop overriding them: which is why "I have a great relationship, so why is this happening now?" is one of the most common and most misunderstood questions Naomi hears. On why dilators and Botox treat the symptom without the holding pattern underneath, and the real place of vagina massage, fascia work, and nervous system regulation alongside, not instead of, medical care.

Also: this podcast has a new name, Ground Floor, after Naomi's book was suppressed on Amazon and rebuilt from scratch to escape it.

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If your period pain has gotten worse, your cycle's shifted, or sex doesn't feel the way it used to, your nervous system might be the reason. In this episode, Naomi unpacks why chronic stress and hypervigilance show up in the body as literal pelvic bracing with delayed ovulation, flare-ups of period pain, changes in arousal, lubrication, and discharge, even leaking, and walks through her own experience of catching this in real time, mid-hypervigilance, living in a van across Morocco and Spain. Why "just rest" doesn't work when your nervous system doesn't feel safe enough to receive it, and what actually helps instead.

• What is your body's default setting when you finally stop?
• When you land in rest, do you feel relief, numbness, or something else?
• What actually brings you back into your body?
• What would your body need in order to truly receive rest?

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Resentment isn't a character flaw instead it's a signal. In this episode, Naomi unpacks why so many "fine, functioning" women are quietly furious, and why that resentment so often shows up as bracing in the pelvic floor rather than as something named out loud. Through the story of Claire: a composite of women Naomi's worked with we discuss what happens when a body that's been gripping and holding for years is finally asked what it's actually carrying. This isn't about Kegels or a quick fix; it's about what gets released once resentment is acknowledged instead of managed.

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Naomi on the link between digital overwhelm and a nervous system stuck on high alert: flip phones, paper books, Swatch watches, and why she quit Instagram all recorded from a beach in Morocco mid-van-life. The deeper thread: what "analogue" actually does for a body that's been bracing for years, and why healing sometimes looks like less, not more.

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