What do you do when years of dilator therapy have helped you progress clinically - but none of that progress translates when you're actually with a partner?
Kelley Satoski is the co-founder of Pelva, a femtech company building a plant-based hydrogel vaginal liner designed to reduce concentrated pressure on hypersensitive vestibular tissue during sex. She has personal experience with primary vaginismus and provoked vestibulodynia, and her biomedical engineer husband is her co-founder. In this episode, Kelley explains the nociceptor science behind Pelva's design, who the product works best for, what beta testing showed, and the very specific challenge of fundraising in femtech as a female founder with an NIH grant.
From dilators to Pelva: why the gap between clinical progress and partnered sex is real
Dilator therapy works. For many people with vaginismus and provoked vestibulodynia, progressing through the dilator sizes produces measurable physical change. And then they try to translate that progress into a partnered context and find that it doesn't transfer the way they expected. The psychological, relational, and physical conditions of partnered sex are simply different from those of a self-directed dilator session, and the vestibular tissue responds differently.
Kelley's experience of this exact gap - the frustration of having done the work, progressed through the dilators, and still found that intimacy with her husband wasn't workable - was the direct starting point for Pelva. The question she and her husband began with was mechanical: what is physically different about partnered sex versus dilator use, and can that difference be addressed with a product?
"I was able to finally insert larger sizes, but when it actually came to being intimate with my husband, it just wasn't translating."
The nociceptor science: why concentrated pressure is the problem
The vestibular tissue in people with provoked vestibulodynia contains hypersensitive nociceptors - pain receptors that respond to pressure, friction, and force at lower thresholds than in unaffected tissue. Dilators, particularly those designed for gradual stretching, may not produce the same pattern of localised, concentrated pressure that sexual contact does. Pelva's hydrogel liner is designed to cushion and redistribute that concentrated pressure, reducing the input to those hypersensitive receptors.
The plant-based, water-hydrated hydrogel material is engineered to mimic the mechanical properties that minimise the triggering of nociceptors in sensitised tissue. Kelley explains the science clearly - without requiring a background in materials engineering - and discusses what the beta testing revealed about how this mechanism plays out in practice for real patients.
Who Pelva is for and what the evidence shows
The conditions Pelva is designed to address are primarily provoked vestibulodynia (PVD), vaginismus, and genitourinary syndrome of menopause (GSM) - any condition in which the vestibular or vaginal tissue is hypersensitive to pressure or friction. Beta testing results showed measurable reductions in pain scores during sexual activity, and the NIH grant Pelva received is a significant marker of scientific credibility for a product in a category where clinical evidence is rare.
Kelley is also honest about who the product doesn't work for and what it isn't designed to address. It is not a treatment for the underlying condition - it is a bridge, a way of making sex possible while other treatment is ongoing or while the nervous system is being trained to associate sexual activity with safety rather than pain. For people who are between those two states - past the worst but not yet at pain-free - it addresses a real and underserved need.
Femtech, NIH grants, and the reality of fundraising as a female founder
Pelva's story is also a story about what it takes to bring a women's health innovation to market. Kelley discusses the NIH grant process, what it meant to have that credibility, and the persistent difficulty of securing private funding for a product in a category that many investors don't understand, don't take seriously, or are uncomfortable discussing. The specific barriers that female founders in femtech encounter - relative to the funding landscape for comparable men's health products - are named directly.
For people who use and believe in products like Pelva, understanding the structural challenges behind building them is part of understanding why this space moves so slowly despite the scale of the need. Kelley's account is honest and specific, and it ends with a clear picture of where Pelva is and where it's heading.
