Breaking the Silence: Women's Pain and Pleasure

This week's episode has been sponsored by Oh My Bod, shifting the evolution of pleasure. Hi, I'm Suzanne, and you're listening to Sex Advice for Seniors. And today, all the way in LA— I love it when I get to speak to people on the other side of the world— I'm speaking with Susanna Weiss, who's written a couple— well, she's written a few books, actually. She's a psychotherapist, she's a sexologist, she's written over 9,000 articles. Suzanne Noble, you don't even look old enough to have written 9,000 articles, um, which include Teen Vogue. So I'm just assuming that you started writing when you were like 12. Um, and she's also a marriage and family therapist. But what we're going to talk about today is a couple of the books that she's written because one of them, the most recent one called Eve's Blessing, which came out quite recently, talks a bit about older people and especially their encounters with healthcare professionals that everyone knows is a bit of a, is a bit of a bedbug of mine. I love to talk about that because my experience of it has been so interesting. To put it mildly. But I know that so many other people have had far more interesting experiences than I have, and not always positive. So Suzanne, welcome to Sex Advice for Seniors. And what led you to write Eve's Blessing? And just tell me a little bit more about the background to that book.

Let me write it with personal experience. Growing up and receiving a poor sex education and learning the theme of this book, which is that women's bodies are associated with pain. So women often learn, for instance, that it's normal to have painful periods, PMS, pain during first-time sex, painful childbirth, which is the most surprising that there are women who have pleasurable and orgasmic births. But I basically interviewed some of these women, women who had ecstatic births, women who had chronic health issues that they worked through, women who dealt with pain during sex and overcame it, and, um, just argue that women's lives can be a lot more pleasurable and less painful than we usually believe. And one topic covered in there, there's a chapter called Sexy But Not Sexual, which is a quote from Paris Hilton where she was asked about her own sex life and she said, well, I'm sexy but not sexual. And how this broader idea of women, um, that we're expected to always perform sexiness, but our sexuality is not taken seriously, how that shapes healthcare. And one way is in which older women are not considered quote unquote sexy, and so their sexuality is not considered important, when in reality, often it's in its postmenopause that women rediscover their sexuality and can actually have great sex lives. So that's one thing I talk about. I draw from the sex educator Joan Price, who I interviewed. I don't know if you've heard of her.

Yeah, I've interviewed her. Yeah, twice, actually. Yeah, she's amazing.

Yeah.

And it's funny, I never really had put our pain associated with sex in the broader context of pain. But of course, there is a famous statistic that women's pain is not taken generally as seriously as men's pain. And often, especially when we experience heart attacks, apparently, I don't know if you talked about this because that was quite a shocking story that I heard, that when we experience heart attacks, sometimes we don't even know that we're experiencing them because we're so used to experiencing pain in general that we're like, oh, it's just another pain. Yeah.

And women's symptoms of heart attacks specifically are taken less seriously because they're different from men's. And most of the research is on men. So women actually end up waiting longer for treatment when they're having heart attack symptoms.

Yeah, it is shocking. But you know, I've spoken to so many people who, and myself included, I mean, it took me quite a significant amount of time to get testosterone treatment, but that wasn't really involved with pain. And actually it was a friend, I've quoted this a lot, it was a friend who told me about vaginal estrogen when lube just wasn't really cutting it for me. Said, oh, you know, that, that'll sort out the pain side of sex. And I thought, oh, why is it that no doctor ever told me this? But I guess, as you said, it's because we're not considered sexual. So it's not something that we need to be concerned about.

Yeah, it's the convergence of women not being considered sexual and also older people not being considered sexual. And there is a large myth around that because there is research showing that actually, if, if people continue their sex life in older ages, they have more confidence, they have better communication with their partner. They know what they like better. There's actually a lot of opportunities to improve your sex life if, if it's taken seriously. And if you can go to a doctor and get treatment for things like vaginal dryness or atrophy. And also redefine your idea of sex. I know Joan Price talks about this, just knowing, okay, penetration is no longer pleasurable than non-penetrative activities. I interviewed one couple who say they love going in the hot tub together, and they slow down, and now like their lovemaking is more sensual. And we don't always hear about these ideas.

Yeah, for sure. And I'm curious to know, did you actually get to speak to healthcare professionals as well about this? Or was it purely from the point of view of the case studies?

Not specifically about aging, but yes, I spoke to some OB-GYNs specifically just about, um, how many women's health issues go undiagnosed or misdiagnosed, such as endometriosis, which can cause painful periods and painful sex. And a lot of women are taught, you know, periods are just really difficult, just take Midol, just Tylenol or whatever it is.

Yeah.

Um, there are other conditions that just are not well understood, like chronic urinary tract infections are very common in women, and often they're diagnosed with a condition called interstitial cystitis, which is incurable, when actually they have an infection. There are many things like this due to a lack of research on women's health and a normalization of women's pain.

And do you think that part of the reason for the lack of information is, aside from the fact that there's less money being spent on researching female health issues just in general, I mean, that's just across the board, not, not necessarily to do with sex, but just generally female health issues often are under-researched. What was your experience of, you know, how much training do doctors get? Because I think some of it has to do— they can't be entirely to blame because I've spoken people who have said, look, we just didn't get any training in this.

Yeah, there was one fact I found, I don't want to misstate it, but I think it wasn't until the '80s or '90s that there was even detailed explanations of the clitoris in textbooks. There was like maybe a vague outline, but you did not get like the nerves and vasculature like you do with seen it. There's— and there is one, one woman I interviewed actually experienced a botched labiaplasty where one of her clitoral nerves were cut and it like interfered with her sexual response and the surgeon didn't even know. And yeah, so it's a broader issue with regard to education, what's in books, what's in curricula. And that's, that's why it's good we have the internet at least, and we can look these things up. But yeah, a lot of doctors don't have time to do extra research, especially as new research comes out, which is very frustrating.

Yeah, for sure. And what's been the reaction to the book in general? Were you— is it published through like a mainstream publisher?

Yeah, the publisher is Paladi, an academic publisher. I'm not sure if I've gotten any reviews yet because it just came out. It's gotten some press coverage and yeah, just a lot of women I think can relate to it. A lot of women have in some way had their pain normalized or had their pleasure treated as unimportant. So that's the main feedback I've gotten.

Yeah, I mean, I've also had friends who have gone to see doctors in severe pain, mainly because of endometriosis, as you acknowledged, and the doctors have dismissed them as being, you know, oversensitive or exaggerating what was going on. And it was actually in one circumstance, my friend's husband who stepped in and said, she's in real pain. Can you please sort it out? Because I hate to see my wife in so much pain. And it was only until that happened that it was taken seriously. And now she's much better as a result of that. So I think often it's not just women having to advocate for our own you know, health and getting the treatment that we deserve, but also using men as allies to, to try and support us. Because sometimes, sadly, I think it's, it's our partners who are able to express what we are— seem unable to, or just perhaps being gaslit, you know, like, oh, just, yeah, you're, you're just exaggerating. So was that also your experience when speaking to people? Did you, did you find that people often used their male partners as allies to express how much pain they were actually in.

Yeah, one of my interview subjects, Abby Norman, author of Ask Me About My Uterus, talked about having endometriosis and doctors not taking her seriously until her partner came in and attested she couldn't have sex, which is a testament to how much we value men's pleasure over women's pain.

That's, that's outrageous. I have to say, that's outrageous. So tell me about your other book, Subjectified, because I'm curious about the content. And if you could let us know a little bit about that.

Yeah. So this is Eve Blessing. This is Subjectified. This is a broader book on sexual empowerment, on my experiences as a sex and relationship writer. Of sexual self-discovery, particularly around the theme of objectification, growing up feeling like many women do today, objectified, you know, being sexually harassed, seeing depictions of women in the media as sexual objects, and just feeling disempowered in my sexuality and how I gained that empowerment back through many experiences, including sex clubs, clothing-optional resorts, masturbation workshops. It sort of takes readers through my adventures posing nude for a figure drawing class, different things that I did to empower myself sexually and overcome objectification. And just— and it lays out this framework for what I call subjectification, which means putting women in the subject role. So rather than just being wanted, we can focus on what we want. Rather than just being looked at, we can focus on what we like to look at. And it's sort of uses wordplay and language to flip these sentences where women are objects, like man desires woman, and help women focus on and look at what it is they desire and how to form a sex life where you assert your desires and communicate them.

And I'm curious, having experienced many of these places myself and reached my own conclusions as to how much of that, those experiences, I was in control, or, or how much, um, yeah, how much I was being objectified or not. What were, what were your, some of your more unique observations?

I observed that in many settings that are said to empower women, women are still being objectified. Um, one striking experience I had was at a clothing-optional resort called Hedonism in Jamaica. Have, have you been there?

No, I go on holiday to a French naturist town called the Cap d'Agde, which is like Hedonism on speed.

Wow.

40,000 naked swingers, essentially.

That sounds like fun. I, I did have fun there. There was, um, just a dynamic I noticed there where the guide who walked me around told me women there have the power. And what I noticed was that power was often defined in this narrow way it often is for women, like the power to be desired. Um, there was just a lot of— like, I remember just walking in, there was a photo of a woman with one of her boobs out. There was a sculpture of a woman's upper body by the salad bar. Like, I walked into my room, there was porn on, and it was like two women giving a guy a blowjob. And I noticed like the women would all dress really sexy and the men would dress kind of plain. And there was this uneven dynamic where we were objects of the gaze and not subjects. They also talked a bit about— some of the guests talked about how like woman-on-woman action was very normalized, guy-on-guy action was still kind of stigmatized. And I don't think there's anything wrong with a woman getting off on being looked at. I'm one of those women who does, but I also get off on looking. And I noticed an inequality there where like women's, women were being quote unquote empowered by like just having their beauty and desirability affirmed rather than, and there was also sexual harassment that I experienced there, which I wasn't surprised by, but it was disappointing and kind of reflected that overall culture. I've also been to much, yeah, like, more feminist environments where there was an emphasis on consent and on female-driven interactions. One of my favorite sex clubs is NSFW in New York City. They're very consent-forward, and they like women, they like women taking charge. And I think there should be more of that. We're just— and like, where LGBT people are welcome, and where there's not just this dynamic of like, man looks man wants, woman gets looked at and wanted.

Yeah, I mean, I think that what you've said about hedonism is very similar to what I experienced in France. And in fact, this year when I— no, I didn't go this summer. I went last summer. I decided not to go this summer even though I was invited because I kind of got to this stage with it. And it was really interesting because it's really interesting to I don't know how old you are, but are you in your 30s or something?

I'm 35.

Yeah. So I went when I was like in my very early 40s for the first time.

And then—

and it was super fun and it was, you know, really kind of hot. And then I, I, I stopped going for over a decade and then I re-engaged with it at this age. I'm 64. And it was really interesting to see the difference in A, the way that I was or was not objectified. So, so obviously I got a lot more attention when I was a younger woman and then I did when I was an older woman. But that's not to say I didn't get attention because I still did. But I found that the level of harassment was just really— it bothered me in a way that I kind of shrugged off when I was younger. Like I kind of, I guess because it was more, it happened with greater frequency. So I was a bit more blasé about it. And when I was older, I just was like, I don't want to put up with this anymore. Like, I'm not interested in this and I'm not interested in all of the, yeah, I just, I just had a kind of different perspective on the whole thing. I don't know if it's true about Hedonism though, but certainly true about the C.A.P. Tag is there are a lot of older people there. And I do know lots of people my own age who do go to Hedonism. So I expect there are, at least there's more of a balance in terms of age. Is that true? That there's more older people, that there's older people at Hedonism, it's not full of young, gorgeous things all the time.

That's true. I think, well, no, there were a few, there was some kind of like bisexual women's week. So I think there were some younger couples who trickled in at that. Time that there was a mix.

Yeah, but I'm saying it's mixed. It's not— people often think of sex parties as being something that just young people do, but actually, I always say to people, mostly it's older swinger couples.

Yeah, it depends on the venue, but that's what I've seen the most of.

Yeah, yeah. So I always say to people, you know, like, there's no age limit when it comes to experimentation of this kind. You can do it, you can do it whenever you want. You know, if you're, if you're up for it, but you know, not, not everybody is. And, and you said that you went to— now see, I'm going to New York City, so my ears, my ears are perking up here. I'm like, oh, there's clubs in New York City. That's good to know because, yeah, I haven't experienced that for a long time. And what were the other aspects of your, of the book that really shocked you or surprised you?

Well, I got to write about my experience with sexual assault, which was very healing. Um, it was very healing to actually have my own narrative, like, heard, because so often sexual assault survivors, like, the traumatic part of it is that their perpetrator, uh, tries to convince them what they did was normal or okay. And, um, I learned this framework called embodied consent where you truly tune into your body and figure what messages it's sending you in terms of how comfortable you feel in a situation, as opposed to using your head and thinking, you know, this person says it's okay, so I guess it's okay. Or, you know, I should like this person, I should want to do this. And it was very empowering for me to write about it in that context because I experienced something where the perpetrator was very manipulative and told me that basically He was touching me in ways I was not comfortable with, and he told me it was part of a spiritual healing. And it was, um, that's something that I've actually heard happening quite a bit. And it was, um, the lesson that I came to after writing about it was basically it does not matter what reason you give for saying no. You can always say no. You never even need a reason. Because in that instance, I remember trying to reason with that person and thinking like, well, he's saying that this is important to do. He's saying that I'm resisting because I like have something that needs to be healed. But like, ultimately, if I don't feel good, that's it. And I really— I also write about my experiences as a cam model and running into a lot of boundary pushers, just people trying to get sessions for free, trying to manipulate me into doing more than I originally, you know, said I offered. And you just have to like, be really good with boundaries. And I think doing sex work actually made me very good at just saying it's completely unacceptable to even try to change my boundaries. That's something like I find myself doing over and over, not even just in situations, but in just like sexual interactions, just being really firm in, nope, this is not what I want. Even if you want it and I'm okay with it, I want to be more than okay. Like, I want to be excited about it. And that's something that I teach is if it's not a hell yes, it's a no.

Yeah, and I think that one of the things that I certainly learned as well from my time going to clubs and things is the same. It's like I learned to be really confident around saying no. And during— and it's not in— within a— within a relationship, there's a lot of noise going on, by the way, with your glass, just saying. Um, yeah, um, there's, there's a tendency within a long-term relationship, I think, sometimes to not really, um, assert yourself in the way that you want to because of the risk of rejection. And I think that one of the things I learned in going to clubs and places like that was that You have to assert yourself. Otherwise, the risk of being, you know, of something terrible happening is quite— potentially can be quite high, right? There's, as you say, there's just people that can be really assertive, quite aggressive, harassing you and stuff like that. So the only way to get through that is, well, one, make sure that— for me anyway, I would— I never went alone anywhere until I became incredibly confident. I don't know if you did these experiences on your own, because I think that's incredibly brave to go into some of these environments if you've not, if you've not done it before. But so I went in with somebody that, that looked after me. And that made a humongous difference to my ability to be confident about saying no.

Yeah, some people assume that if you're in a setting that's very sex positive and sexually open, that you're just open, you're just down to do anything with anyone. And that's not okay. And I really find it empowering to report whatever I can, like any kind of unwanted touch, any kind of comment that makes me uncomfortable, especially at an event, you can always report that to the people running it. I just always say something, because that's like the worst part of experiencing a sexual violation is having your voice taken way. Yeah, like a big advocate for reporting.

Yeah, I think, and I think also with a lot of these places now, they really encourage you to do that because they don't want people coming to these sorts of parties and clubs that are going to make women feel uncomfortable because we are still the prize. I think in most, in most of those places, people, a lot of men, well, especially if you go to places where they allow in single men, those single men are hoping to have sex usually with a woman, and if they don't behave themselves and get chucked out, that's not going to happen. So, you know, it's, it's to everyone's benefit to just behave and make sure that everyone is consenting to whatever they want to do or don't want to do, for that matter. How do you think— just moving on to the topic of post-menopause, how do you want to have it? What's your perspective on how women can go about having better sex? In those later years?

Yeah, don't be afraid to explore new avenues to pleasure. Using sex toys, focusing on external stimulation, even some tantric things. You could look up tantric massages. I think just getting adventurous and learning about new ways to explore your sexuality that might be more enjoyable or more comfortable for you. And definitely tell a healthcare provider if there's any kind of sexual issue, especially pain during sex. Some, some might say like, yeah, this just happens as you get older, but it can actually point toward health issues like infections, or even cardiovascular issues if you cannot get wet or aroused. And so make sure you find a healthcare provider who takes you seriously. I think pelvic explore, uh, physical therapy is also very helpful. Often they know more than gynecologists do. Not that it's a substitute, but, um, like, that's just for relaxing your pelvic muscles and making sure you have pelvic tone. That's very important. Um, and yeah, not being ashamed if things are different, knowing that your partner may be experiencing the same thing, and working together to find whatever is enjoyable for you both, not making assumptions Maybe penetration is not your favorite thing or their favorite thing, but talking about it and, you know, valuing the emotional connection as well as the physical.

Yeah, I think they're all really, really good points. I mean, I think it takes a lot. In my experience, it takes a lot to switch healthcare professionals. Sometimes we want to believe that somebody that we've been seeing for years, and I know this one, I speak They're like, but I've been seeing this person for like, you know, 20 years and they know me so well. And I can't believe that they would tell me something that just isn't right. And I just go, look, you know, they don't all know everything. And sometimes if, like you say, if you're not being taken seriously, then you got to find somebody else that is because life's too short to have someone that's just, you know, not giving you good advice. And I know that because I've heard that from so many people who have just stuck with their healthcare professional for, in my opinion, far too long, just because they've had a very long relationship with them and they just don't want to leave them. It's a bit like a hairdresser, right? It's just somebody, you know, you get a few bad haircuts and you think maybe they had a bad hair day or something and you don't want to go to somebody different because you love them. But you know, sometimes you just got to make that switch. And I think for so many women I know, they, they're putting up with pain when they don't have to.

Yeah, someone can always get a second opinion or even go someplace like Planned Parenthood. They're really good without necessarily needing to abandon their healthcare provider if that's an issue for them.

Yeah, no, it's a good point. I mean, we're in a different healthcare situation in the UK, so, you know, we, we, we get access to— thankfully, everything that I've had that has helped me and supported me so far has just been a free doctor with a free referral. And, uh, you know, thankfully we're still in a nationalized healthcare system that sometimes works.

Sometimes.

But anyway, it has been absolutely lovely to talk to you. And, um, is there anything else you'd like to add to our conversation?

I don't think so. Thanks so much. I want to mention that I'm also a psychotherapist and sex therapist, and so you can contact me if that's something you're looking for. I provide coaching throughout the world, therapy in California. You can find out more at SuzanneNoble.com. Thank you so much.

No, I will put that in the summary. Thank you and have a lovely day.

Thank you.