Would you feel comfortable talking to your friends, or even your gynecologist, about sexual dysfunction? With endometriosis, symptoms of sexual dysfunction — such as lack of lubrication or inability to orgasm — as well as sexual pain (known officially as “dyspareunia”) are common. However, they are also incredibly isolating, since there is so much stigma attached to sexual dysfunction, and sex in general.
It’s not easy to talk about female sexuality, which is why Dr. Lyndsey Harper created the app Rosy. Rosy is an app dedicated to women’s sexual wellness. The app contains educational videos and courses, as well as erotic stories and options for telemedicine appointments with sexual health providers, to teach women how to prioritize their pleasure.
I have been on Rosy’s mailing list for some time now, but never spent much time exploring the app. So, when I got an email that the app was launching a new course related to sexual pain, I knew I had to give it a try. The course — called “From Ouch to Oh Yeah!” — is available for free in the Rosy app through August 14. I completed the course, which was about an hour long, and also had the opportunity to explore some of the other content inside Rosy.
The Rosy app itself is free to download, with some features unlocked only through a $9.99/month subscription. You can get a one week free trial of Rosy’s premium subscription in the app as well. I’ll talk more about my experience with the Rosy Premium free trial as I get deeper into my review of Rosy.
Before I start talking about my experience with the Rosy app, I want to make the disclaimer that I was NOT sponsored by Rosy to make this post. I have no affiliation with Rosy whatsoever, and simply wanted to explore the app to see if its sexual wellness content was helpful for patients with endometriosis.
I also want to make the disclaimer that some of my language in this review may seem centered on cisgendered women. While Rosy makes an effort to talk about male and female partners in its content, it doesn’t do much to address transgender womxn or non-binary folx. The app’s branding is also incredibly feminine, with the app slathered in pink backgrounds, cursive fonts, and a rose as its logo. I am obviously not trans, but based on my experience, the app could make an effort to be more inclusive of gender identities outside the binary norm.
To give it a fair review, I’m going to be talking about the app exclusively in the context of my experience with it as a cisgendered female. But, it’s still worth mentioning that the app could be perceived as alienating, in many ways, to transgender womxn and non-binary folx.
Facts About Female Sexual Dysfunction (FSD)
First thing’s first: why is an app like Rosy even necessary? To understand the “why” behind Rosy, we need to talk more about female sexual dysfunction, or FSD for short.
FSD encompasses a number of disorders that get in the way of females’ desire and enjoyment of sex. (By ‘females,’ we mean people with vaginas and vulvas, though the official medical language is, TBH, more than a little transphobic.) The word “dysfunction” refers to any impairment in normal functioning. In the context of FSD, dysfunction can affect any aspect of the sexual experience, from desire to arousal to orgasm.
FSD also encompasses sexual pain disorders. As I mentioned previously, the medical term for pain during sex is “dyspareunia.” It’s important to note that dyspareunia itself is a symptom, not a disorder. Dyspareunia can signal the presence of disorders like vaginismus (a reflexive tightening of the vaginal wall in reaction to any type of penetration), vulvodynia (chronic pain of the vulva, often due to skin sensitivity), vestibulodynia (a subtype of vulvodynia affecting solely the vestibule, or the area around the vaginal entrance), and pelvic floor dysfunction (tightness and spasming of the pelvic floor muscles).
Dyspareunia can also be a symptom of diseases like endometriosis, or a symptom of menopause. It might also be a side effect of certain medications, like birth control or breast cancer treatments. But dyspareunia is NOT a diagnosis. Do not let your doctor write “dyspareunia” on your chart and proceed never to talk about it again, as my former primary care doctor once did with me!
By some estimates, FSD affects half of all women in a typical outpatient practice. That means 50 percent of females aren’t getting the pleasure they deserve during sex, and might even be experiencing pain! If left untreated, FSD can take a harmful psychological toll on mental health and relationships.
Unfortunately, however, there aren’t many options for women to address their FSD. Many women aren’t believed by their doctors, especially when it comes to pain. Or, they may have been taught that pain during sex is “normal.” Let’s get something straight: just because dyspareunia is common, doesn’t mean that it’s normal!
The treatment options for FSD are also scarce. If you have a sexual pain disorder, there are slightly more options. Laparoscopic surgery for endometriosis might alleviate your dyspareunia. Or, if you suffer from vaginismus or pelvic floor dysfunction, physical therapy is often an effective treatment (though it often takes months to work).
But if the cause of your FSD is unclear, or perhaps psychological in origin, there are fewer choices for treatment. You can try sex therapy, but not everybody has access to a qualified sex therapist. Or, your doctor might prescribe you Addiyi, that “little pink pill” that was meant to be Viagra for women — but Addyi only works for 10 percent of women and causes dangerous drops in blood pressure when users drink alcohol.
The lack of effective help for FSD explains how Rosy came about. Dr. Lyndsey Harper, the founder of Rosy, saw lots of patients in her OB/GYN practice who had FSD. Dissatisfied with the options for treatment, she designed the app as part of a multifaceted treatment plan for FSD. Rosy is focused on self-help and can be used in the privacy of your own home. It also offers options for telemedicine appointments, though it should be used in addition to, rather than instead of, in-person appointments with your own gynecologist.
Review of Rosy’s Features
Rosy comes with a multitude of features, many of them free, that are designed to address FSD. There’s a library of free educational videos, as well as a series of several courses covering some of the most common problems behind FSD. You can also access some erotic stories for free, though most of them are included only with the premium subscription. Finally, Rosy also has a telemedicine feature that allows you to connect with sexual health providers from the comfort of your home. I won’t be reviewing the telemedicine or erotica features because I didn’t use them, but I will talk about the features that I did use.
From Ouch to Oh Yeah! Course
Rosy’s new course “From Ouch to Oh Yeah!” took me about an hour to complete, which matched up with the app’s estimate of 55 minutes of content. The course consists of videos, guided journaling prompts, and resources to help you cope with sexual pain. It’s led by Dr. Angie Stoehr, who is an OB/GYN and Pelvic and Sexual Pain Specialist who works with Rosy. For context, I have endometriosis, pelvic floor dysfunction, and vulvodynia. If you suffer from different pain conditions, or don’t know what the cause of your dyspareunia is, you might find different parts of this course more or less helpful than I did.
The course consists of five overarching “lessons,” which each have a video and action items following the video. The first lesson talks about potential causes of sexual pain, such as vaginismus, vulvodynia, endometriosis, and even interstitial cystitis, or painful bladder syndrome. It’s followed by guided journaling exercises to help you identify when your pain starts and what it feels like, which is incredibly helpful information to have if you’ve ever gotten to the doctor’s office and clammed up the minute you had to speak!
The second lesson is all about sexual pain and desire. This was my personal favorite lesson in the course, as it explains why painful sex makes us want to stop having sex. If you’ve ever felt “broken” because of your sexual pain, this video helps it all make sense again. The information Dr. Stoehr shares proves that yes, you are normal and no, you’re not crazy for wanting to avoid sex due to pelvic pain. The guided journaling exercises in this lesson were also awesome! The first was to create a list of reasons why you deserve to have amazing, pain-free sex. I’ve never really thought of myself as “deserving” of sex before, so this was an important mental shift to make. The second was to write a letter to your partner telling them everything you want them to know about your pelvic pain. If you don’t have a partner, this is obviously not applicable, but it might still be helpful to write a letter to your future partner. The idea is that writing these things down makes it easier to discuss them, allowing you to better speak up for yourself sexually.
Next, lesson three is all about reducing sexual pain. Dr. Stoehr provides some lifestyle recommendations here, mainly focused on diet and exercise. This lesson is less applicable to you if you have a pain condition that isn’t interstitial cystitis (IC). She talks a little about inflammatory foods, like refined carbs and fried foods, you might want to cut out of your diet — but mostly, she talks about the dietary recommendations for IC, which include cutting back on acidic foods and drinks, like coffee and chocolate. Dr. Stoehr’s exercise recommendations are more universal. She mentions that yoga and Pilates are both backed by tons of research showing that they’re effective for pelvic pain, due to the fact that they elongate the muscles and help you relax. Yoga is especially helpful due to its focus on deep breathing. I already enjoy yoga and Pilates, so it’s nice to know I’m doing the right kind of exercise for my body! But, I did not find the dietary recommendations in this lesson especially helpful or pertinent to my particular pain conditions.
Now, let’s talk about dilators. Lesson four is all about dilators: what they are, if you need to use them, and how to use them. The dilator protocol Dr. Stoehr recommends is primarily intended for patients with vaginismus, which is that reflexive contracting of the vaginal wall when anything attempts to penetrate the vagina. People with vaginismus often can’t even insert a finger or a tampon without these painful contractions, so dilator protocols are intended to help them retrain their bodies and brains to tolerate something inside the vagina. If you can have penetrative sex at all, even if it’s painful, you probably don’t need a progressive dilator protocol — which is why I was disappointed that Dr. Stoehr only talked about dilator use for vaginismus. As someone with pelvic floor dysfunction, dilators are also incredibly helpful to me for use in internal massage, which helps with myofascial pain related to PFD. However, Dr. Stoehr didn’t really talk about this use of dilators. She did mention the Ohnut, though — which, if you’ve read my blog at all, you know I am a huge proponent of this tool for pain-free sex!
Last but not least, lesson five talks about anatomy. Personally, I think it would have been more useful to discuss anatomy in the second lesson, right after talking about causes of pelvic pain — or even before discussing sexual pain at all. Once Dr. Stoehr is done breaking out the vulva hand puppet (yes, really!), she gets into discussing lubricants and comfortable sexual positions for different types of pain. To be completely honest, the positions she recommends aren’t ones you haven’t thought of before. She recommends missionary, doggy-style, and a side-lying position, which aren’t all that creative. I didn’t really need to watch this video to figure those out. Not to mention, the positions are pretty much made for P-in-V heterosexual sex, though she does briefly mention same-sex couples. But, more helpfully, Dr. Stoehr also talks about the differences between water-based, silicone-based, and oil-based lubricants, and which are most useful for sexual pain. For further reading on the topic of lube, I’d recommend looking into this page from Australian company Pelvic Exercises Physiotherapy.
After the five main lessons, there’s also a section called “More Help” that provides an introductory video and some further resources for addressing pelvic pain. Dr. Stoehr points you toward a helpful form from the International Pelvic Pain Society where you can log your pain over time for better discussion with your doctor. She also provides a list of vetted mental health providers who are certified in sex therapy, which can be an additionally useful resource.
Educational Video Content
Besides the courses, Rosy also offers free educational video content. The topics of these videos range from over-the-counter supplements for boosting your libido to the benefits of scheduling sex. I watched two videos — “Endometriosis” and “Exercise for Desire” — and learned a little bit, but not a ton, from each.
If you’ve never read or talked about these things before, Rosy offers a great introduction. Their videos are usually less than three minutes long, meaning they’re condensed and easy to understand, but can’t delve too deep into any particular topic. For example, as someone who already has endometriosis and knows a lot about it, I didn’t find the “Endometriosis” video helpful to me, but I feel that it would be a good introduction for anyone who’s wondering if endo could be the cause of their sexual pain.
As for the video “Exercise for Desire,” I didn’t love it. In the video, Dr. Harper talks about the benefits of exercise for boosting your libido. I do love that she says that you don’t need to run a triathalon; 10 to 15 minutes of exercise a day will do to start. But her recommendations aren’t specific as to what types of exercise are best for sexual pain or for boosting your libido. She just recommends that you do it — and if you are a woman in the healthcare system, you’ve definitely heard “just exercise!” as a one-size-fits-all solution before. That video comes across as a little tone-deaf.
Rosy also offers forums to help people facing sexual problems connect with one another to talk about their issues. There are a bunch of forums, including one specific to COVID-19, that cover different issues related to sex. I jumped into the Low Libido forum to see what was going on and share my story, and quickly found a long list of people essentially complaining about their problems, with little interaction. I was expecting to find a supportive community, but it seemed like it’s just a wall for people to vent on. People aren’t really interested in making friends or connecting with others in their situation — which sucks, because the Rosy forums were one of the first places I’ve ever “met” other 20-somethings who suffer from the same issues that I do.
I also wanted to touch on the Rosy Premium subscription, since I signed up for their one-week free trial. I’m going to level with you: I cancelled it right away. The ad for the free trial is a bit misleading, because it claims you’ll have access to 20+ courses once you sign up. However, no new courses appeared when I started my subscription. It seems like they really meant 20+ lessons, which are different from the courses themselves. I sincerely hope they will expand the course content for premium and free users, though, because this was definitely my favorite part of using Rosy.
You also get access to a plethora of erotic stories when you sign up through Rosy Premium, when before you only got access to a few. I didn’t read any of them, but I did skim the section, and I can attest that their erotica is definitely more female-focused than anything you will find on Pornhub. Erotica is also certainly more ethical than porn, since there are no “performers” to be paid (or not to be paid) and no worries of potential sex trafficking involvement. So, I fully support this feature of Rosy Premium, too. It just wasn’t the reason why I downloaded the app.
Overall, Rosy has a lot of potential to become a great resource for people suffering from sexual problems. I loved the “From Ouch to Oh Yeah!” course, and I hope that other people will say the same so they are inspired to create more of this type of content. I also hope to see more content specific to endometriosis in the future, perhaps sharing tips and tricks I might not already know for coping with endometriosis in my sex life. If erotica is your thing, the app is also an inexpensive and ethical way to access female-friendly pornography.
On the whole, I have three recommendations to improve the Rosy app:
- Make Rosy less gendered to include all people with vaginas who might suffer from sexual dysfunction. Use more inclusive language and change the branding to be less overtly feminine in nature.
- Expand the course content to offer more specific suggestions for people with sexual problems to take back into their personal lives. Make sure that if you say the premium subscription includes 20+ courses, there are actually 20+ courses to access!
- Get rid of the community feature altogether. Honestly, from my experience in the “Low Libido” forum, it seems like the Rosy community doesn’t encourage friendly interaction and is instead more of a fountain of negativity.
Rosy is free to download in the App Store and on Google Play. Check it out today to form your own opinions and learn more about female sexual wellness!