Hidden Causes of Pain ‘Down There’ with Dr. Andrew Goldstein (Ep 148)

2025-06-05

What if the pain you’ve been told to ignore… was actually coming from your hips, your spine—or your immune system? In this deep-dive episode, Dr. Linda Bluestein is joined by Dr. Andrew Goldstein, an expert in sexual pain disorders, to unravel the misunderstood causes of vulvar and pelvic pain in people with EDS (Ehlers-Danlos Syndrome), MCAS (Mast Cell Activation Syndrome) , and POTS (Postural Orthostatic Tachycardia Syndrome). Dr. Goldstein reveals why the traditional diagnosis of “vulvodynia” might be missing the real problem, and how factors lik...

What if the pain you’ve been told to ignore… was actually coming from your hips, your spine—or your immune system? In this deep-dive episode, Dr. Linda Bluestein is joined by Dr. Andrew Goldstein, an expert in sexual pain disorders, to unravel the misunderstood causes of vulvar and pelvic pain in people with EDS (Ehlers-Danlos Syndrome), MCAS (Mast Cell Activation Syndrome) , and POTS (Postural Orthostatic Tachycardia Syndrome).

Dr. Goldstein reveals why the traditional diagnosis of “vulvodynia” might be missing the real problem, and how factors like labral tears, pudendal nerve compression, Tarlov cysts, pelvic organ prolapse, endometriosis, nerve proliferation, and mast cell disorders can all converge into debilitating pain—and be completely overlooked. He explains why pelvic floor physical therapy sometimes fails, when Botox is a game-changer, and how stigma and misinformation continue to prevent EDS patients from receiving proper care.

If you've ever been told "it's all in your head"—this episode proves it’s not. And it might be the roadmap you've been searching for.

Takeaways:

You might not feel hip pain at all—but your clitoris, rectum, or vulva will.
A cyst that’s left off your MRI report could be ruining your life.
That pain during intimacy? It could be nerve sprouting—and it's not your fault.
When physical therapy fails, it may not be the therapy’s fault.

He’s performed 1,300+ surgeries. Here’s how he decides if you really need one.

Reference Links:

Ep 130 with Dr. Goldstein: https://youtu.be/csiK_Zmb_hk

Ep 116 with Dr. Feigenbaum: https://youtu.be/Uq4OrVa6deM

https://www.gyncancer.org/

https://www.amazon.com/shop/hypermobilitymd/list/2LQLPARJY3CDS?ref_=aipsflist

https://pubmed.ncbi.nlm.nih.gov/23875629/

https://pubmed.ncbi.nlm.nih.gov/23577645/

https://www.isswsh.org/

Want more Dr. Andrew Goldstein?

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Connect with YOUR Hypermobility Specialist, Dr. Linda Bluestein, MD at https://www.hypermobilitymd.com/.

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