Dr Rachel Rubin Diary of a CEO is the kind of podcast episode that does not merely summarize a health topic. It detonates one. In this 1 hour 48 minute conversation with Steven Bartlett, Rubin turns women’s sexual health, menopause, hormone therapy, libido, painful sex, pelvic floor problems, orgasms and urinary tract infections into a single, urgent argument: many women are not broken, many relationships are not doomed, and many symptoms are not mysterious. The bigger problem, she argues, is that the medical system often has not been taught how to help. Apple Podcasts lists the episode as published on June 22, 2026, with the title “Dr Rachel Rubin: Women’s Sexual Health, Menopause, Hormone Replacement Therapy (HRT), and Orgasms!”
Why this podcast episode is getting attention
The reason this episode is so striking is not just the subject matter. Podcasts have covered menopause, hormones and sex before. What makes this conversation feel different is Rubin’s combination of clinical authority, anger and plain language. She does not talk about women’s health like a lifestyle trend. She talks about it as a massive medical literacy failure.
Rubin is introduced as a board-certified urologist and sexual medicine specialist. The episode description also notes that she is founder of Rachel Rubin MD and Director-at-Large of the International Society for the Study of Women’s Sexual Health, while the broader medical podcast world has also described her as a clinician, researcher and educator focused on sexual health.
The viral center of the episode is Rubin’s claim that basic, treatable problems are being missed: painful sex, low libido, recurrent UTIs, orgasm difficulties, perimenopause symptoms, postpartum hormonal changes and menopause-related genital and urinary symptoms. The episode’s official chapter list makes clear how wide the conversation becomes, moving from “Why Women’s Healthcare Is Still Neglected” to testosterone, birth control, GLP-1s, HRT, vaginal hormones, UTIs, pelvic floor dysfunction, clitoral adhesions, porn, desire, kinks, stress and communication.
This is why the episode works as a podcast discussion: it is not simply “doctor explains menopause.” It is a cultural critique of what happens when half the population is given incomplete information about their own bodies.
Episode at a glance
Podcast: The Diary Of A CEO with Steven Bartlett
Host: Steven Bartlett
Guest: Dr Rachel Rubin
Episode topic: Women’s sexual health, menopause, HRT, hormones, libido, orgasm, painful sex and UTIs
Published: June 22, 2026
Length: 1 hour 48 minutes
Format: Long-form expert interview
Best for: Women navigating hormonal symptoms, partners who want to understand women’s health better, clinicians, health podcast fans and listeners interested in sex education without embarrassment
Content note: Explicit medical discussion of sex, genital anatomy and sexual function
The YouTube version appears under the more provocative title “Dr Rachel Rubin: The Truth About HRT & Menopause Doctors Won’t Tell Women,” while Apple Podcasts uses the longer descriptive title focused on women’s sexual health, menopause, HRT and orgasms.
What happens in the episode?
The episode begins with a sentence that frames everything: Rubin tells Bartlett that she is “filled with rage.” The rage is not performative. It is not aimed at patients, partners or even individual doctors as villains. It is aimed at a system that, in her view, has left both patients and clinicians undereducated.
From there, Bartlett and Rubin build the conversation around a central paradox. Women are often told to ask their doctors about symptoms related to menopause, libido, pain, arousal, orgasm or urinary problems. But Rubin argues that many doctors never received meaningful training in these areas. Even gynecologists, she says, may not have been taught enough about the clitoris, female orgasm, vulvar pain or the hormonal basis of bladder and genital symptoms.
The first major section focuses on hormones. Rubin challenges the idea that testosterone is simply a “male hormone” and explains that women also produce testosterone. She argues that changes in testosterone, estrogen and progesterone can affect libido, arousal, lubrication, sleep, mood, bone health, urinary symptoms and sexual function. The conversation then moves into birth control, antidepressants and GLP-1 drugs, with Rubin emphasizing that many medications may have sexual side effects that are poorly discussed or under-studied.
The second major section is about menopause and HRT. Here the episode becomes especially newsworthy because hormone therapy has been undergoing a public reassessment. The Menopause Society’s 2022 position statement says that, for healthy symptomatic women younger than 60 or within 10 years of menopause onset and without contraindications, the benefit-risk ratio of hormone therapy is generally favorable for treating bothersome vasomotor symptoms and preventing bone loss. The FDA also announced in November 2025 that it was initiating removal of broad boxed warnings from many menopausal hormone therapy products, while keeping the endometrial cancer warning for systemic estrogen-alone products in women with an intact uterus.
The third major section is one of the most practical: vaginal hormones and UTIs. Rubin explains genitourinary syndrome of menopause, often abbreviated GSM, and argues that local vaginal estrogen or DHEA can be a major tool for urinary and sexual symptoms. This aligns with urology guidance: the American Urological Association guideline recommends vaginal estrogen therapy for peri- and postmenopausal women with recurrent UTIs when there is no contraindication.
The final third of the episode turns from hormones to pleasure, communication and relationships. Rubin discusses painful sex, pelvic floor muscles, orgasm, clitoral stimulation, clitoral adhesions, porn-influenced expectations, responsive desire and the difficulty couples have talking honestly about sex. Bartlett’s role here is important: he repeatedly admits what he does not know, which lets Rubin explain anatomy and sexual health without the awkwardness that often derails these conversations.
The biggest talking points from the episode
1. Women’s sexual health is treated as optional medicine
Rubin’s strongest argument is that sexual health is not a luxury topic. It is not merely about pleasure, although pleasure matters. It is also about pain, infection risk, aging, mood, relationships, identity, self-esteem and quality of life.
That point matters because sexual symptoms are often minimized. Pain during sex may be framed as normal. Loss of libido may be treated as inevitable. Recurrent UTIs may be treated with repeated antibiotics without enough conversation about prevention. Menopause symptoms may be dismissed as something women simply have to endure.
Rubin’s counterargument is simple: symptoms deserve investigation. Pain deserves a diagnosis. Arousal and orgasm difficulties deserve education. UTIs deserve prevention strategies. Menopause deserves individualized medical care.
2. The episode reframes HRT as a nuanced medical tool, not a yes-or-no culture war
One of the best things about this podcast review topic is that the episode lands at a moment when hormone therapy is being actively reconsidered. For decades, many women and doctors associated HRT with fear, especially after early-2000s interpretations of the Women’s Health Initiative. Rubin argues that those fears became overgeneralized and that many clinicians were never trained to distinguish between different hormones, routes, doses, ages and risk profiles.
This is where listeners should be careful. The episode is persuasive, but HRT is still a medical decision, not a universal recommendation. The strongest modern guidance emphasizes personalization and shared decision-making. The Menopause Society recommends considering age, time since menopause, route of administration, dose, duration, symptoms, medical history and personal risk factors.
That is also why the episode is useful. Rubin is not just saying “take hormones.” She is saying: get better information, find clinicians who understand the data, and make decisions based on risks and benefits rather than fear or silence.
3. Vaginal estrogen may be the most eye-opening part of the conversation
For many listeners, the most surprising section will be Rubin’s discussion of local vaginal hormones. She describes vaginal estrogen cream, tablets and rings as underused tools for symptoms that many women assume are just part of aging: dryness, painful sex, urinary urgency, leakage and recurrent urinary tract infections.
The AUA’s recurrent UTI guideline supports vaginal estrogen for peri- and postmenopausal women with recurrent UTIs when appropriate. ACOG also notes that many postmenopausal women get relief from UTIs with vaginal estrogen creams, tablets or rings.
The reason this section is likely to travel as a clip is that Rubin makes the issue feel both medically serious and practically solvable. UTIs are not merely annoying. In older or medically vulnerable people, infections can become dangerous. Rubin’s frustration is that a low-dose local treatment may be available, yet many patients never hear about it.
4. Testosterone is not just a “male hormone”
The episode’s hormone discussion challenges a common public misconception: that estrogen belongs to women and testosterone belongs to men. Rubin explains that women produce testosterone too, and that it can matter for libido, arousal and orgasm.
The evidence here is nuanced. A global consensus position statement concluded that the only clearly evidence-based indication for testosterone therapy in women is treatment of hypoactive sexual desire disorder in postmenopausal women after proper assessment. ISSWSH has also published clinical practice guidance on systemic testosterone for hypoactive sexual desire disorder in women.
That nuance matters because testosterone is increasingly discussed online in ways that can become exaggerated. Rubin’s episode is valuable because it opens the door to the conversation, but listeners should not take it as a reason to self-medicate. The real takeaway is that women’s testosterone should not be ignored simply because medicine has historically coded it as masculine.
5. Pain during sex is common, but it should not be dismissed
Rubin is emphatic that sex is not supposed to hurt. That may sound obvious, but it is a radical statement for anyone who has been told to relax, use lube, drink wine, tolerate discomfort or accept painful sex as normal.
Medical sources support the idea that persistent sexual pain deserves evaluation. The American Academy of Family Physicians describes dyspareunia as recurrent or persistent pain with sexual intercourse that causes distress and estimates that it affects approximately 10% to 20% of U.S. women. ACOG states that pain during sex may be linked to conditions such as ovarian cysts, endometriosis, skin disorders, infection, hormonal changes or other gynecologic issues.
Rubin’s contribution is to broaden the listener’s imagination. Pain can involve tissue, hormones, pelvic floor muscles, nerves, skin conditions, scar tissue, endometriosis, spine issues or trauma. The solution is not shame. The solution is diagnosis.
6. The orgasm gap is treated as an education gap
One of the most culturally explosive parts of the episode is Rubin’s discussion of orgasm. She argues that many women are not “broken” if they do not orgasm from penetration alone. Instead, they may simply have been taught the wrong sexual script.
This point is supported by broader research on orgasm frequency. A large U.S. national sample published in Archives of Sexual Behavior found that heterosexual men were far more likely than heterosexual women to report usually or always orgasming during sexual intimacy. A 2024 paper on the lifelong orgasm gap also reported that men’s orgasm rates were consistently higher than women’s across age groups.
Rubin’s explanation is anatomical and educational: the clitoris is central to orgasm for many women, yet sex education often overemphasizes penetration. The episode is at its best when it turns embarrassment into anatomy.
The most memorable moments
Rubin opening with rage
The most memorable moment is still the first one: Rubin’s “filled with rage” framing. It gives the episode emotional propulsion. This is not a calm explainer from a doctor who thinks the system is mostly working. It is a conversation with someone who believes patients are losing years of comfort, intimacy and health because the basics were not taught.
Bartlett admitting ignorance
Bartlett’s best hosting choice is not pretending to know more than he does. He repeatedly says he is going to ask “dumb” questions. That is exactly what the episode needs. Women’s health conversations often suffer because everyone is afraid to use basic terms. Bartlett gives Rubin room to explain the vulva, vagina, urethra, clitoris, uterus, hormones and pelvic floor in accessible language.
The vaginal estrogen demonstration
The practical discussion of estradiol cream, vaginal tablets and vaginal rings is one of the episode’s clearest “people will send this to someone” moments. Rubin explains the options in everyday terms and makes the treatment feel less mysterious.
The clitoris section
The anatomy lesson about the clitoris is another standout. Rubin’s point is not just that the clitoris matters. It is that a medical system can claim to care about women’s sexual function while failing to teach or examine the organ most closely tied to women’s orgasm.
The financial literacy analogy for sex
Rubin’s comparison between sexual literacy and financial literacy is surprisingly effective. Everyone wants good money habits and good sex, she argues, but many people are taught neither. The analogy helps turn sex from a shame topic into a skill topic: education, communication, health, practice and the right professional support.
About the podcast
The Diary Of A CEO has become one of the most influential interview podcasts because Steven Bartlett’s format is built around long, polished, emotionally framed conversations with entrepreneurs, scientists, doctors, psychologists, celebrities and cultural figures. Apple Podcasts describes Bartlett as a British entrepreneur, investor and author, and says he created The Diary Of A CEO to share lessons from “CEOs, experts, therapists, and leaders.”
This episode fits the show’s modern identity perfectly. The Diary Of A CEO is no longer only a business podcast. It has become a broad self-improvement, health, psychology and culture platform. The Dr Rachel Rubin conversation is a health episode, but it is also a relationship episode, a gender politics episode and a communication episode.
Bartlett’s strength in this format is that he asks from the position of the curious non-expert. That can sometimes lead to oversimplification, but here it works. Rubin’s topic benefits from a host who is willing to slow down and ask what HRT means, what an OB-GYN does, what a UTI is, why penetration is not the whole story, and what men misunderstand about arousal.
About Dr Rachel Rubin
Dr Rachel Rubin is a urologist and sexual medicine specialist whose public work focuses on sexual health education, hormone therapy, menopause, genitourinary syndrome of menopause, libido, pelvic pain and clinical training. Her own website highlights education through social media and a Medscape video series called “Sex Matters with Dr. Rachel Rubin,” designed to address sexual health topics often overlooked in medical practice.
That educational mission is central to why she works well as a podcast guest. She is not merely presenting information. She is trying to change what patients think they are allowed to ask. She wants people to know anatomical language, understand hormonal shifts and recognize when a clinician may not have the right training.
Her style is direct, sometimes blunt, and intentionally memorable. In another context, that could feel too provocative. In this episode, it feels strategic. Rubin is talking about subjects that have been softened, hidden or avoided for decades. Her volume is part of the message.
The larger context behind the conversation
The episode arrives during a broader mainstreaming of menopause, HRT and women’s sexual health. In recent years, menopause has moved from a private, often stigmatized topic into podcasts, workplace policy, celebrity interviews, medical debates and pharmaceutical discussions. The FDA’s 2025 action on menopausal hormone therapy labeling intensified that conversation, especially because it involved reassessing warnings that shaped prescribing behavior for more than two decades.
At the same time, the medical conversation remains contested. Many clinicians welcome a more nuanced approach to hormone therapy, especially for low-dose vaginal estrogen and for healthy symptomatic women near menopause. Others warn against turning HRT into a cure-all or overstating benefits for heart disease, dementia prevention or longevity. That tension matters because the best version of this debate is not “HRT good” versus “HRT bad.” It is: which therapy, for which patient, at which age, through which route, for which symptom, with which risk profile?
Rubin’s episode is therefore part of a cultural correction. For years, many women were told too little. Now the risk is that social media tells them too much too confidently. The sweet spot is evidence-based empowerment: enough information to ask better questions, not enough false certainty to skip medical care.
What the episode gets right
The episode’s biggest strength is that it makes hidden symptoms discussable. Many people will hear this conversation and realize that symptoms they thought were embarrassing may be medical. That is valuable.
It also succeeds because it connects sexual health to general health. Painful sex is not just a bedroom issue. Recurrent UTIs are not just an inconvenience. Menopause is not just hot flashes. Libido is not just relationship chemistry. These topics overlap with sleep, mood, hormones, medications, pelvic muscles, bladder function, self-image and communication.
Another strength is the episode’s usefulness for men. Bartlett makes this explicit: men have partners, mothers, sisters, daughters, friends and colleagues. Understanding women’s health should not be treated as women’s homework alone. That framing helps the episode avoid becoming a niche women’s health lecture. It becomes a relationship literacy episode.
The podcast also handles anatomy better than most mainstream interviews. Rubin gives names to body parts and functions without making the conversation feel gratuitous. That matters because vague language is one reason patients struggle to describe symptoms clearly.
What could have been better
The episode’s intensity is its strength, but also its limitation. Rubin’s urgency is compelling, yet listeners should remember that podcast episodes are not individualized medical consultations. Some people cannot or should not use certain systemic hormone therapies. Others may need non-hormonal options, cancer-specialist input, pelvic floor physical therapy, dermatologic evaluation, endometriosis care, mental health support or medication review.
The episode could also have spent more time separating different categories of hormone therapy. Systemic estrogen, progesterone, testosterone, local vaginal estrogen and DHEA are not the same thing. Their benefits, risks, absorption, indications and regulatory status differ. Rubin does explain this, but the most viral clips may flatten the nuance.
Another limitation is that the conversation leans heavily toward medical under-treatment, which is real, but there is also a growing online market of over-treatment: hormone clinics, supplements, expensive “sexual wellness” products and influencer-driven protocols. Rubin criticizes miracle products, but the episode could have more explicitly warned listeners against self-prescribing or chasing every symptom with a hormone.
Finally, “listener reactions” should be handled carefully. The topic is clearly built for strong responses, and Steven Bartlett’s LinkedIn post about the episode framed it as a conversation about health, relationships, confidence, aging, shame and the medical system. But without a systematic review of comments, it would be irresponsible to claim a universal audience reaction. The safest conclusion is that the episode is engineered to spark two reactions: relief from listeners who feel seen, and debate from those who worry that hormone therapy is being promoted too broadly.
How listeners are likely to use this episode
This is not just a passive listening episode. It is a “send this to your partner” episode. It is a “bring this up with your doctor” episode. It is a “why did nobody tell me this?” episode.
Women may use it as a checklist for symptoms they have normalized: painful sex, dryness, recurrent UTIs, low libido, urinary urgency, orgasm difficulty, sleep disruption, hot flashes, night sweats, brain fog, pelvic pain or feeling “not like myself.”
Men may use it as a translation guide. The episode gives them language to understand that sexual issues in a relationship may not be about attraction, effort or performance. They may involve hormones, anatomy, pain, fear, shame, medication side effects or pelvic floor dysfunction.
Clinicians may use it as a reminder that patients are increasingly arriving informed by long-form media. Whether a doctor agrees with every emphasis in the episode or not, the questions patients bring after listening are legitimate.
Is this episode worth listening to?
Yes, especially if you are interested in women’s health, menopause, sexual health, relationships or medical misinformation. This is one of the more important Diary Of A CEO health episodes because it takes a topic often trapped in embarrassment and turns it into a practical, evidence-oriented conversation.
It is not a perfect substitute for medical guidance. It is not a personalized HRT plan. It is not a reason to order hormones online or ignore contraindications. But as a conversation starter, it is excellent.
The best audience is broad: women in their 30s, 40s, 50s and beyond; postpartum women; partners trying to understand intimacy better; people dealing with recurrent UTIs or painful sex; and anyone who suspects they were never properly taught how women’s sexual health actually works.
Best quotes and ideas from the episode
Because the article should not reproduce the transcript at length, the most important ideas can be summarized rather than quoted.
The central idea: women are often not broken; they are under-informed and under-treated.
The medical idea: menopause and perimenopause are not just reproductive milestones; they can affect the brain, bones, bladder, genitals, sleep, mood and sexual function.
The relationship idea: many couples suffer because they interpret physical problems as personal rejection or sexual inadequacy.
The anatomy idea: penetration is not the main path to orgasm for many women, and understanding the clitoris is essential to understanding women’s pleasure.
The advocacy idea: patients need better language, better doctors and more permission to ask direct questions.
The practical idea: recurrent UTIs, dryness, pain and urinary symptoms may have treatable hormonal components, especially in peri- and postmenopause.
Final verdict
Dr Rachel Rubin Diary of a CEO is a standout episode because it does what the best expert interviews do: it changes the listener’s default assumptions. Before listening, someone might think menopause is mainly hot flashes, low libido is mostly psychological, painful sex is just a relationship issue, UTIs are only about bacteria, and orgasm problems are private mysteries. After listening, those same issues look interconnected, medical, teachable and often treatable.
The episode’s greatest value is not that it gives every listener the same answer. It does not. Its value is that it gives listeners better questions.
Ask why sex hurts. Ask whether recurrent UTIs have a prevention strategy. Ask whether a clinician understands GSM. Ask whether medications could be affecting libido or orgasm. Ask whether perimenopause could explain symptoms. Ask whether hormone therapy is appropriate for your specific risk profile. Ask whether pelvic floor physical therapy, sexual medicine, dermatology, urology or a menopause specialist belongs in the conversation.
That is why this podcast episode deserves attention. It is not just a podcast review, an episode summary or a set of podcast highlights. It is a public service conversation disguised as a viral interview.
FAQ
What is the Dr Rachel Rubin Diary of a CEO episode about?
It is about women’s sexual health, menopause, HRT, hormones, libido, painful sex, orgasms, vaginal estrogen, UTIs, pelvic floor problems, porn-influenced expectations and communication in relationships.
Who is Dr Rachel Rubin?
Dr Rachel Rubin is a board-certified urologist and sexual medicine specialist known for her work in women’s sexual health, hormone therapy, menopause education and advocacy.
When was the episode published?
Apple Podcasts lists the episode as published on June 22, 2026, with a length of 1 hour 48 minutes.
Is the episode only for women?
No. One of the episode’s strongest arguments is that men should understand women’s health too, especially if they have partners, family members or friends affected by these issues.
Does Dr Rachel Rubin recommend HRT for everyone?
No. The episode strongly argues that more women should have access to accurate information and trained clinicians, but hormone therapy decisions should be individualized. Major menopause guidance emphasizes shared decision-making based on age, symptoms, timing, route, dose and medical risk factors.
What is GSM?
GSM stands for genitourinary syndrome of menopause. It refers to genital and urinary symptoms related to hormonal changes, including dryness, discomfort, urinary urgency and recurrent UTIs.
Is vaginal estrogen recommended for recurrent UTIs?
For peri- and postmenopausal women with recurrent UTIs, the American Urological Association recommends vaginal estrogen therapy to reduce future UTI risk when there is no contraindication.
What is the orgasm gap?
The orgasm gap refers to the difference in orgasm frequency between groups, especially heterosexual men and women during partnered sex. Research has found that heterosexual men report orgasming more consistently than heterosexual women.
Is painful sex normal?
Occasional discomfort can happen, but persistent or recurrent pain during sex deserves medical evaluation. Dyspareunia affects an estimated 10% to 20% of U.S. women and can have many physical and psychological causes.