Sex Dysfunction in the City Just Like That

Real quick, before we dive into this episode, I have a little sleep secret I want to tell you about. Look, sleep is crucial for your fitness, but it's crucial for just plain old everyday life and function. And I find I sleep great unless I have a migraine. And I've had more than my fair share since perimenopause all the way through postmenopause. My secret weapon was Blue Sky CBD sleep gels. Each gel contains 25mg of CBD and 25mg CBN for deep restorative sleep. Something about it helps to reduce inflammation, which I believe for me was key in helping me get to sleep. But the biggest thing is so many of the over-the-counter solutions, whether for sleep or migraines, can ruin gut health, and liver health. Neither one of those did I want to be problematic for me. So this option is recommended by healthcare providers worldwide and backed by thousands of happy customers, many of whom come from our Flipping 50 community. There is zero THC, so it's non-habit-forming. It's made by a trusted family-owned company that we all can feel good about. Third-party tested for purity and potency. And if you're interested, you too can try a sample for just $6. But even better, you can get 30% off forever with discount code FLIPPING50. That's FLIPPING50. Just go to flipping50.com/blueskycbd. We'll put that link in the show notes and you'll find it everywhere on Flipping 50 at My Favorites. What are you waiting for? Good night. Low libido, sex dysfunction, stress, insomnia, body confidence. We unpack a lot in this episode. Two guests today, both specializing in women's health with specific attention to libido and pelvic floor health, show up for this podcast and they bring it. Sex dysfunction is no laughing matter for couples who used to enjoy each other and now are finding it's just the same. Intimacy is a powerful part of health and also anti-aging, as you'll hear my experts talk about. Stay till the end if you want a very juicy Q&A. I'm Debra Atkinson. You're listening to Flipping 50, where I address your top struggles and concerns, and I share what to eat, how to move, and how to change your mindset so you can have the energy and the vitality that you want, need, and deserve in the second and better half. And you might be asking, if you're tuning in for the first time to a fitness podcast, why we're talking about libido. And the answer is this, my friends, that it is of 39 Flipping 50 TV episodes that I produced back in 2017, '18, It was one of the first 3 episodes because it is such a frequently asked question. And the reason I think is the nature of fitness, being that, you know, a fitness professional, a trainer, spends quite a bit of time, more time with her clients than say a doctor might with her patient. And before, before there were health coaches, and then even, even though there are health coaches, there is something about movements. And when you're moving, your body relaxes, you let down your guard a little bit. And it is conversations like that that occur with personal training that have often been the cause of my warning personal trainers as I've taught and instructed them on what is the scope of practice and how do they need to treat certain questions and how do they observe confidentiality, what they need to do, but certain conversations do come up. And when I'm asked a question that is really outside of my scope of practice, and not that I'm not willing to, you know, respond because there are ways that exercise can kill or nurture libido. Namely, if you're doing a lot of endurance activity, if you are not doing any strength training activity, and/or you're not getting enough protein in, and you're maybe having too much alcohol and sugar, you are killing your libido. And so you, before you come back to talk about more, probably need to clean up that act if you want to do everything you can to improve your libido. That would be avoiding overexercising. So it would be, if you're going to go intense with cardio, you want to keep it short and sweet. So high-intensity interval training can be beneficial, again, if you're ready for it. Strength training is also far better than any endurance activity that you'll do. And doing any movement that supports movement of the hip and circulation— now, all exercise increases circulation. However, There's certain sports and there are certain activities that encourage more body awareness and more, uh, movements and mobility around the hips. Think about pelvic tilts, think about hula, think about dancing, Zumba, swaying the hips from side to side, belly dancing, you know, things that are actually very much in tune with not only getting the blood flow to that area, but also working on the mobility. So freeing up stiff and tight. Think about what we do all day, every day. Sitting on it is probably not helpful, just saying. All right, that all was a bonus, but we're gonna get you right into our expert. And I will warn you that there is a little R-rated information here. So if you blush easily, you probably— or listening to this in the car— want to make sure that you have earbuds in and there's no one else impressionable in the car. My two guests are Dr. Diane Mueller. She's the founder of My Libido Doc, an online community dedicated to helping women reclaim their desire. My Libido Doc provides education, community, and healthcare services for women. Dr. Betsy Greenleaf is a— so many alphabet soup behind her name, I can't even begin. But she's a premier women's health expert bringing pelvic peace, hormone harmony, sexy sizzle, and crazy confidence to busy women. Dr. Betsy is a best-selling author, award-winning speaker, entrepreneur, inventor, and business leader specializing in female pelvic medicine and reconstructive surgery. For over 20 years. Between them, they answer each of my questions and knock them out of the park. So excited to have you hear this. Let's dive in. Diane, Betsy, thank you so much for being here.

Thank you so much, Debra. I'm so excited to be here.

I'm also so excited. Thank you.

Well, all right. And we said this in the green room, and I feel like it was It was actually the perfect intro, the intro after the intro, which is, you know, we said, you know, how unfair is this that a lot of times women are not even comfortable talking about sex because of maybe the way we were raised or the generation that raised us. And then about the time we get comfortable with it, we lose our libido. I mean, how unfair is that? So let's just talk about that right now. I mean, what are the root causes of low libido in women over 40 specifically?

Oh my God, we could be here for hours. Oh no, that's, that's depressing. You know, it's funny because the one thing I was just thinking off the top of my head that kind of connected to something that you just said is I was thinking about body image because I, I was just recently thinking about this. Like, I remember being in my like early 20s and that like looking back, I looked really good in my early 20s, but I was so self-conscious. And then now that I'm in my 50s, in some ways I'm self-conscious, but now, like, I have a totally different view. Like, I'm probably showing off more of my body in my 50s. I probably shouldn't be than, but then back then. But I, I do think, you know, for women, that body image, um, can affect libido because when really your partner doesn't care what you look like, you know, and I think we're harder on ourselves often Well, I often like to say that, like, no man in a room with a naked woman is really judging you all that much.

Diane, you want to weigh in on that one?

Oh yeah, oh yeah. I mean, I think there's, there's so much to say on this. And research-wise, we definitely see this body image and even genital image, you know, it's like there's so much that society and the porn industry has done for like, your vulva is supposed to look a certain way and supposed to be shaved a certain way. And, you know, all these different things that I think really have been programmed from, from, for women, anything from like magazines and all the airbrushing and that sort of thing, to the porn industry of this is what we're supposed to look like, both our body image as well as our genital image. This is what sex is supposed to look like. This is how it's— we're supposed to respond, is how we're supposed to orgasm. So I think there's just so many layers of societal programming of everybody's supposed to fit in this box. And so it's really confusing to people when of course we don't.

Yeah, I think, I think it's funny because in life we learn by example, and we're definitely not getting any examples of sex I mean, just think about that. Like, that is not something we're taught, and we're expected to just go figure it out on our own. And, and it changes. It changes from the time you're 18 to the time you're 20, 30. I mean, life situations change, health changes. So libido's gonna— libido's even gonna change day to day. I mean, one day you might be good, next day you're not. So, um, You know, I also think stress is probably one of the biggest, biggest dampeners of libido.

Yeah. Well, okay, so midlife perfect storm, we're here. And now just thinking back, I also wanted to chime in on this, that you said, you know, you think back to when you were in your 20s and you thought you looked terrible, right? You didn't have good body image. Now you're like, I would have taken a bad day right now, I'd take one of those bad days in any day. And but I think we were all, and maybe still to some effect, trying to be a size smaller than we were, you know, I mean, so how comfortable are we? And if you're feeling like that, trying to fit into jeans that are too tight or look a certain way, I mean, how sexy can you be when that's all going on?

Yeah. And I think as we get— I get older, I realize it's less and less about what I look like in the mirror., and it's more and more about confidence. Because let me tell you, you could have like a supermodel walk in the room, but if you don't feel her confidence, she's not sexy. You know, you can have a plus-size woman walk in the room with the most confidence in the world, and that is the sexiest person.

You know, feel the energy, you can feel it.

I'll chime in on that too. Betsy and I both take pole dancing classes, and Oh my gosh, so interesting in these classes, right? Because some parts of these classes, depending on upon what type of class you take, you'll learn some stuff, and then there'll be somebody that gets to be the, you know, the feature, and everybody is just watching and, and basically applauding and giving support and really building up the other women. And it's so, it's so good for confidence to just be in this room where everybody is supporting each other, no matter if they're on their first day or they're on their, you know, 500th day. But it very interesting to me to be in the observer role because exactly what we're talking about is what I've seen in these classes where sexiness, like there's women of all shapes and sizes. There's, you know, women that are extremely petite to the curviest woman in the world, right? And everybody that is confident, those are the people that have that huge amount of like sexiness to them. It's not what they look, it's how they embody, you know, their being.

I agree with you. I definitely, you know, and I have to say, I've loved taking pole dancing because it has given me more confidence in my body. Because, I mean, I remember going in thinking, oh my God, I'm in my 50s, and we got people in their 60s and 70s taking these classes with us. You know, I thought I was going to walk in with a bunch of 20-year-olds and be like, oh my God, what am I doing here? But it's— we got all shapes and sizes and the act of pole dancing, you have to be in skimpy outfits because there's ways that the skin has to like cling to the pole to get into certain positions. So we have to be in like, you know, short shorts and like bra tops. And I found that it's been really freeing and helping me with my body image because I realized nobody cares, like, and everybody's beautiful. So it's, it's been really a lot of fun.

What was that movie with Demi Moore? Oh yeah, she was a stripper. And in the, the PR for that movie, she said— she suggested that every woman should strip, should learn how to do that.

Yeah, yeah, I agree. It's very empowering, even just for yourself.

Exactly. It really— it's not about anybody else. It really wakes up something deep inside the woman. So, I think it's a huge part of amazing, amazing gift in the personal development world of just learning one's own sexuality. And really also, it's like you have to be so present, you know, to do something like pole dancing. Like, you have to be so present to every movement that you're doing. And there's a lot of different activities that will do that. But, the act of sexuality and the act of enjoying pleasure also is the act of being present inside of one's body. So, these these things, even from just like a mindfulness standpoint, are so related.

So what about the piece of being able to feel completely or to be completely vulnerable getting in the way of libido?

It's—

I mean, that's definitely also, I think, connected to what we're saying here, right? It's like, okay, if we're worried about our body, like if we don't have that self-confidence, it's it's not really super inspiring or motivational to take one's clothes off. So I think, I think all of that is wrapped up in this whole conversation.

Yeah, very cool. Okay, so I have to know, for each of you, what was it that inspired you to take pole dancing?

For me, it's— I hate, and I'm going to do air quotes— exercise. So because in my mind, exercise was going to the gym, it was tedious. And these are the words I kind of associated with it. So back in New Year's of 2022, I was like, I need to find something that's going to motivate me to move my body and be healthier. And interesting enough, I was on TikTok watching videos, scrolling through videos one day, and there was this woman who documented her weight loss journey. And she did it all through pole dancing. And I was like, this is amazing. I wonder if they have pole dancing classes near me. And I looked it up online and lo and behold, they did. So I was like, I'm going to sign up for this and see if I like it. And for me, I found that once I went to my first one, it's a lot of work. Like, I don't have the upper body strength to do— you know, for the women that do this as a profession, I'm like, they deserve every dollar they make. And more so, and to do it in heels, I'm like, oh my God. So, um, and I found that because I wasn't able to physically do a lot of the things that I wanted to do, it motivated me to now work out other times. Because now I would go home and do some weightlifting, do some more cardio to try to get better shape so that the next time I go to dance class, Maybe I can do some more.

And what has it done for your sex life?

Well, I don't know what that was, but I'm laughing because my pole dancing is far from sexy. Like, people would be taking their dollars back if I was doing this as a profession. Like, here, give me that back. Because I mean, for me, it's just, it's, it's giving me more confidence in my body. But I have to say, it's providing a lot of humor in my relationship with my husband because I come home and I show him the videos of what I've done. And it's definitely providing some hours of laughter. I think at some point, I'll probably look a little bit more like what you're supposed to look like. But in the meantime, you know, I've gotten much stronger, I'm getting more in shape, I'm more confident in my body and less, less self-conscious.

So very cool. How about you, Diane? What prompted you to take pole dancing?

For me, it was a girlfriend. So she had started taking it. I don't know what prompted her, honestly, but she was just talking to me about it and describing a lot of what we're talking about here, about the changes she was noticing in her confidence and her just body image, those sorts of things. And I was nearing my 40s at the time, and it seemed like a really good thing to do for, for myself for that reason. And so it was really just highly motivated by, by a friend telling me about all the benefits, and I like the idea of those benefits. And I'm an athlete, so I'm always looking for new and interesting ways to challenge my body as well.

Love it. Absolutely love it. Okay, so one of the things When I asked you— so I always, listeners, I pre-screen my guests and I, I cheat. I say, what questions would you like me to ask you? And this question I love, love, love, and it's, why can menopause be some of the best sex of your life? So first of all, we're, we're really laying not a bomb but a gift out there saying, you know, hey, you know, you may be tanking right now, but that is not the way it has to be. It could be some of the best. Why is that? Why, why did you lead with that?

I think there's a lot of different reasons for it. I mean, obviously, the confidence thing that we're drilling in home now. Simple things such as there's no, you know, people that are not interested in having children or more children. It takes that, you know, factor out of the equation. So that does allow people to be more present. We also see things like, I was looking at a very interesting study the other day looking at when people tried various novel sexual acts. And there was a study that was saying that in the '40s was when most people tried anal sex for the first time. So it, to me, I interpret that and I, what I get out of that is there's a level where we've already done, you know, so much of life, there's so much confidence that it's like, screw it, I'm just gonna try this thing. It might be taboo, I don't care, I'm just gonna mix it up. And I think there's just a level of willingness to not conform to what we're supposed to conform and what we're, you know, maybe more concerned about in our 20s. So I think that's a huge, huge portion of it. I also think that there's a lot more awareness, right? Like once we get to midlife time period, a lot of people are starting to think about what they want the rest of their life to look like. And, you know, we see in nursing homes, right, we see in nursing homes, there's a really high rate of STIs.

So, right, really, yeah.

Yeah, yeah, yeah. It's so interesting. So we're seeing it, and I— what I get out of that is that as we go through these periods in life, we just start saying, like, what can I— I only have so much time left on this planet. I'm going to start enjoying it in this new way and experience it in this new way. And what do I want my life to look like? Hmm.

Very cool. That is really cool.

There's definitely some challenges that come along with menopause. I mean, from the lack of hormones, we tend to get some like vaginal dryness, which can make sex painful. There may be a little bit more that we have to do to kind of get the engine running. But I think by time we're reaching that menopausal time period, like we've gone through so much and there's like this wisdom that comes with aging. And I think as women in general get older, we do. We kind of get to the point where we're like, you know what, I don't give a crap anymore. Like, I'm going to be me and do me and and like, I'm just gonna start living my life. Like, I definitely want to be like, when I— by time I reach my 80s, I want to definitely be that like little old spunky lady that like— and not even little and old, like I'm gonna be that spunky woman that's just like having the time of her life and doesn't want to have to watch what I say or do and just enjoys everything. I'm starting that now in my 50s, but by time I'm in my 80s, it's be pretty scary, but I think very enjoyable.

Such serendipity. Earlier today I was interviewing a woman who said she's 64, and she was looking back at a place in her life, she said, where she was— she had attracted, you know, a man who really— it was an abusive relationship. And she said, I have changed so much, I've evolved so much in, in my midlife, that there is no way that a man like that would even be attracted to me anymore. Anymore. It's, I've changed so much and I know who I am that that energy doesn't even find me anymore. And I applaud that. And she knew it. And that I wish for every woman, because I think a lot of women find this would be true, but they still don't say it out loud.

Mm-hmm.

Yeah. Okay, let's talk a lot about this. How is libido tied to aging, and/or is it? Is there any direct correlation, or can we say there doesn't have to be?

There definitely does not have to be. So, you know, that's one of the nicer things about being human is that our libido can carry on forever and ever and ever. And a lot of times, I know with patients, I— people think like, oh, libido, it must be hormones. Everyone, the answer to libido, everybody thinks it's hormones. So they think that like, oh, I'm having low libido, I need to come in, you need to put me on hormones. But hormones are just a tool in the toolbox. It's not necessarily the answer. I always tell everybody, your brain is your most important sex organ. So whatever it is that will stimulate your brain— and this is something that we develop over time and it changes— but focusing on brain stimulation is something that's going to just help us time and time again. And this is something that it doesn't— you know, I think sometimes we think like, oh, we're wild and crazy in our 20s and maybe 30s, but it doesn't have to be. I mean, I think sex just gets better and better as we get older. And there's ways to boost libido as we, you know, get older. And, and, you know, that's— there's just so many different techniques and things that can be done.

The other thing I would add here is that I think libido actually— or sex, I should say— actually has the power to be anti-aging, right?

Yes.

Say that because when we look at oxytocin, the hormone that not only is released with orgasm but is also the touch hormone, the cuddle hormone. So, you know, we're releasing this in embrace, and it has the power to lower stress hormone cortisol, for example. And we know that's associated with the aging process. Oxytocin has the power to balance serotonin, which is happiness and enjoyability, and also helps us to lower stress. So I really, you know, one of the reasons I'm like actually obsessed with this topic in part is because I just, I really like feeling great in my body. And I really like, as I know we all do on this call, like holistic work and how we can do things naturally. And I feel like, like, like sex is essentially a cocktail. Like, sex allows us this cocktail of hormones that we have access to for free that self-regulates, make us feel good, make us happy, make us feel connected to ourselves, our partner, sometimes even, you know, spiritually. And all of this is available for us just by engaging in pleasure.

You know, something I wanted to add to this is there is this kind of fallacy and this belief of with libido, women will come in. And I keep saying women because I'm a gynecologist. So I, you know, don't treat men. So, and they're like, well, I don't have a sex drive, or they're waiting to have a drive before they engage in sex. And this is kind of old school thought. This is the Masters and Johnson's 1960s thought, which is great at the time. Because they opened up the conversation about sex. But if you think about— if you ever learned it in biology class, this very linear grafting of female— of sexuality, where in the linear graph it goes from there's desire first, and then there's arousal, and the graph kind of comes off the horizon, and then you get like a plateau, and then there's a peak with orgasm, then it falls back down. And it's a very linear process. Well, they found out that that doesn't really explain female sexuality. There is a sex researcher who's amazing. You can look her up, Rosemary— but Dr. Rosemary Basson, and she remodeled female sexuality. And her model has all these intertwining circles. And so not that spontaneous desire can't happen, but it tends to happen a little bit more when we're younger, when we don't have as many things going on in our lives. When there's not as many responsibilities. And sometimes even like the longer you've been in a relationship, that may affect spontaneous desire. But in her, in her model, she found that willingness is the first step, that if you're willing to start going through this, the process of being intimate with yourself or with a partner, that then comes a lot of physiologic changes, we get more blood flow down below, and we get more potential lubrication. And then the arousal is coming first, and then we're getting the desire. And then all of a sudden, we're like, oh, wait, now I'm in the mood. And then you go on and, you know, do whatever, and, you know, orgasm or not orgasm, and, and people report improved sexual function with that. So I tend to explain that to my patients. Like, sometimes if you're just waiting around to be in the mood, you might be waiting forever. So this is something where either, like I said, with yourself or with a partner, be like, hey, let's, let's just try and see where it goes, with the intention that, you know, if things aren't working out, you have a way to be like, okay, you know, this just isn't working out, let's, let's, you know, table this or put a rain check on this one. But I found that most women, once they do that, they're like, oh, you know what, that worked and actually made me go, why aren't we doing this more often? So, and this may be like as something as just scheduling sex into your, into your schedule. I mean, we're all busy, you know, if we sometimes, if you're busy and stressed, you may not ever get in the mood. So that's it. It's an interesting thing because our only examples of libido and desire, or like movies and TV where people are walking hand in hand and next thing you know, they're like rolling around in the waves on the surf. And, and I always go, where's that sand getting to? But that's all.

Lovely. Yeah, lovely image. Okay, so the two of you have actually teamed up not just only to be here, but you're doing a special whole event. On, on all of this. And, and what else? Like, what other topics are you covering? And then I would love for one or both of you to answer what have been the biggest aha moments during your interview process.

There's so many different topics we're covering, you guys, but between Betsy and I, we have interviewed, I believe, 53, 55, something like that, 50-something speakers.

Yes.

On all sorts of different topics, anything on how to do a proper Kegel. And, there's so many things with this topic that are so dysfunctional on how people are tonifying their— I shouldn't say the word tonifying, building up and working with their pelvic floor. And so, how to do that properly, right? Other little things, for example, that low libido oftentimes, not just for men, but women oftentimes is a first sign of a cardiovascular disease. And that is really important since heart disease is the number one killer, right? We have really interesting topics like that. Topics on things like how to do sensual movement with your partner to get in the mood, how to use a vibrator for the first time, how to shop for a vibrator, what to do if you've been married and out of the game of sex for years, and how to actually start having conversations with your partner again. So those are some of my favorite topics. Betsy, you want to talk about any of yours?

Yeah, you know what, I thought like, I'm a gynecologist, what am I going to know? Like, what am I going to learn from this? And I have to say, every single person I interviewed, I was blown away. I was like, oh my God, I thought I knew everything. You know, I think one of the titles I love is You're Not Broken, Sex Is, and understanding how societal influences affect intimacy and arousal. I really enjoyed talking to some of the male experts that we had, because there were some things that I didn't realize, or I guess, you know, guiltily did not take the time to like understand what like what's going on with men. And I think overall, I, I found pretty interesting this general theme of communication being like a big focus for having a sec— like a really good sex life. So I was really— I really was blown away by all the people that we interviewed for this. It was all— it was tons of fun.

Love it. Love it. And I loved my interview with you. So, yes. Yeah, we won't tease the punchline, but yes. Something interesting that you should know about which sport activity gets the most action. Yeah, between the sheets. Yeah, super fun. Okay, so this— I'm gonna link to this for listeners so that you can get in on the summit. And you know, here's what I have to say about this. I think we all, you know, again, we don't talk about this. I remember reading Judy Blume's book Wifey. Yes, that was probably like my first, like, wow, okay.

Yeah, I remember that too.

And now, now I'm like, I watched— I'm a little embarrassed to admit this, but I watched And Just Like That. And I'm like, I'm so glad they're doing this because otherwise women aren't having these conversations. So she can watch this and she can get some information, at least maybe to open the conversation with a friend and say, you know, did you see that? And it's like a safe territory to, okay, come on, let's be okay talking about sex again.

Yeah, that's it. It amazes me. It's something that's so natural and so much a part of human existence. Yeah, it's something that's so hush-hush. And I'm like, come on, this is ridiculous.

Yeah, totally, totally agree. All right. I want to ask you some rapid-fire questions. And if you could see me, I'm, I'm so glad we're doing audio only. We're not on video because I would be blushing, literally. Okay, so I have— I'm going to ask you these questions. I'm going to have both of you answer. So anal sex, safe?

Safe with the— yes, safe. Proper form, technique, lubrication.

Who teaches that? And not going from one area to another.

Correct.

We don't want to spread bacteria from rectal areas to vaginal areas.

We don't want our food touching. Okay, I got it.

Yes. And that is something that I do teach my clients.

Okay. Oral sex, safe?

Oh yeah.

Yes. I mean, Well, I'm gonna say safe with all these as long as you're practicing safe sex, because you can spread STIs with any of these.

Absolutely. Okay, so when you say safe sex for oral sex, you know, um, it's gonna be—

well, officially, from a medical standpoint, it's going to be using some sort of barrier protection, which I know that doesn't sound fun, but then You know, if you're with a partner that you know and you've been tested and, you know, I think that's the other way to— periodic testing is going to be the other way to keep safe.

Yeah, usually the way to do— they have things called dental dams that can help, you know, that can provide like a barrier, but they're frankly not enjoyable for a lot of people. So testing is usually the best way to go.

Condoms still the best product protection, correct? And we're still, if I'm understanding correctly, we're going to need them in the retirement center and nursing home.

Oh my God, they're the largest group and growing of STIs in the United States.

Yeah, I have a whole new appreciation for it. Okay. And with that, I'm going to gather myself together here. Listeners, thank you so much for tuning in. If you're still with me, you got the juicy rapid-fire questions here at the end. So you heard it here first, and don't necessarily tell anybody that. But I will put in the show notes the link to join the summit. It's free, and it's obviously, it's discreet, confidential. If you don't have these conversations with anybody else, open them up here, and, and then hopefully with partner, you will have more more of that conversation, or you'll just learn to appreciate yourself. Diana and Betsy, thanks so much for being here.

Thank you so much, Debra. I really enjoyed this.

It's been a pleasure. I really appreciate you.

And listeners, show notes will be at flipping50.com/sexdysfunction. And what are you waiting for? Let's start flipping 50 today.