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What's Normal in Intimacy with psychologist and neuroscientist Dr. Melissa Farmer and physio Dr.

Dr. Melissa Farmer is an Assistant Professor in the Physiology Department of the Northwestern University School of Medicine in Chicago. She is a clinical psychologist and neuroscientist, who loves the study of pain and decipher unexplained pain, as well as the emotions that underlie the chronic pain experience.

Dr. Sandy Hilton is co-hosting today! Today's episode we discuss so much stuff! I couldn't cut it down anymore and at times it can be heavy (at least for me) and as always, we could have talked for a lot longer. The main discussions surround defining concepts surround "what is normal sex". How can we help people who have pain with sex have "normal" sex if we don't really know what "normal" Sandy and Melissa attempted to provide some guidance in a short span of time.

We also discussed nociception in more general terms and relating to pelvic pain (if you don't know what that is, you have to listen), the importance of distinguishing between pain mechanisms in the brain versus spinal cord, and I threw in the heavy topic of her latest research in multimodal neuroimaging, just for fun. Yes, my brain was full and you may have to listen to this in parts :).

Melissa was extremely generous with her time and she put this extra info together for you all as well:

1. A YouTube link to the mouse “vigor” testing used for the study on sex differences in pain-induced changes in sexual motivation (Farmer et al., 2013, attached), which was used to determine mate preference so that all mouse “couples” that entered into the mating studies showed similar levels of mouse-to-mouse attraction and sexual behavior. Link:

2. I recently wrote a chapter on mechanisms of pelvic and visceral pain for the International Society for the Study of Women's Sexual Health, and it is like Nociception 101 (Farmer In Press file, click to receive).

3. I mentioned Ted Price’s pain research and the topical cream he’s developed that combines resveratrol with salicylic acid to greatly enhance the bioavailability of resveratrol. This combination interferes with the two molecular pathways needed to induce nociceptor sensitization (i.e., increase nociceptor excitability to enhance its neural firing rate—which is the basis for “peripheral sensitization” of nociceptors). In his animal studies, this compound reduces interleukin-6 and pain with normally innocuous levels of touch (called mechanical allodynia). In the pain literature, interleukin-6 is of the cytokines that most robustly correlates with reported pain experience in humans (in terms of direct correlations between degree of inflammation and perceived pain in the inflamed body site). The original papers that discovered this resveratrol mechanism are available for download here:

I strongly encourage listeners to follow Price’s research, as he conducts high quality research that will be changing the pain field over the next few decades! On his website, there is a link to the National Public Radio’s (NPR’s) interview of him regarding the clinical relevance of his research, which describes this research in a very clear way:

4. In regards to the discussion on brain changes in men and women with urological pain that may reflect postural adaptions, etc, I've attached Huang et al 2016 if listeners want to check that out.

I strongly suggest that listeners look into the following researchers to get extremely high quality info on pain and emotional memory:

-The most accurate information on central sensitization, from the man who discovered it in 1983: Clifford Woolf (Harvard) – his 2011 review is dense but lucid and should be the basis of your understanding of this phenomenon

-Brain neuroplasticity with chronic pain (and where the rest of the pain field will be in 5 years): A. Vania Apkarian (almost all of his papers are freely available here:

Attached is a recent review paper of his that examines chronic pain as an emotional phenomenon (Vachon-Presseau et al., 2016)

-Cognitive neuroscience of pain: Tor Wager (University of Colorado at Boulder) and Tim Salomons (University of Reading)

-Neuroscience of Interoception: Micah Allen (University College London), check out his blog/lab website:

-Where the pain field is heading: Giandomenico Iannetti (University College London)

-For a lucid review of the clinical use of memory reconsolidation, Bruce Ecker is the best (see his 2013 paper, attached)

The episdoes will be available in iTunes, Stitcher and Soundcloud.

Enjoy and Merry Christmas 2017!!!!

#fionarogers #loriforner #pelvicfloor #pelvicfloorexercise #australia #pelvicpain #incontinence #prolapse

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