The Truth About Menopause & Better Sex in Midlife

Article Written by Bennett Aguirre 

In a recent episode of Pleasure Project: Sex and Relationships, Dr. Jenn engages in an empowering and organic discussion on menopause with Dr. Kelly Casperson, a urologist and advocate for women’s sexual health. They explore various topics surrounding menopause, including hormone replacement therapy (HRT), sexual health, the dynamics of couples’ relationships during this stage of midlife, and debunking popular myths.

Dr. Kelly Casperson is a board-certified urologic surgeon, author, and top-tier podcaster. You can find all of her incredible resources including her book, online course, podcast, and more here. Dr. Kelly does a great job in combining not only science and humor into her work, but also this notion of an open dialogue that makes it easy to talk openly on these sensitive subjects.

Demystifying Cultural Taboos & Myths Around Sexual Wellness

Dr. Kelly and Dr. Jenn discuss various myths in this episode. For example the notion of quantity and quality when it comes to the “right” amount of sex one should be having raises questions. Dr. Jenn argues that, “let’s go for quality, let’s go for actually having a really good time and feeling good rather than getting in as fast and as frequently as possible” (Kennedy, 07:06). Instead of focusing on the amount of times one is having sex, focus on how good it’s making you feel. Another important myth to mention is that menopause is just hot flashes, and that you’re over it once they’re gone. But this is far from true. Menopause is more than this, it’s an absence of hormones in the body. More specifically an absence of estrogen, which allows for the connections to be made between this absence and things like pain with sex, lack of arousal and orgasms, and complications with your pelvis. Understanding these connections helps one to understand the effects of menopause, more than just the agonizing hot flashes.

Lifestyle Preventions Matter & Importance of HRT

HRT, hormone replacement therapy, is a crucial part in the comfortability of the symptoms that come along with menopause. Of the many different versions of administering this, pills and vaginal estrogen are to name a couple that come up in this episode’s conversation. By using HRT in midlife, this can bring about many benefits including a reduction in urinary tract infections. But when it comes to hesitation for starting HRT, along with other lifestyle changes in mid to later life, Dr. Kelly points out that, “I think we should focus on prevention and preservation a lot more because once you’re 84 and you’ve broken your hip, it’s too late to start hormones” (Casperson, 12:04). This notion of preventative measures are vital, now that we know the many benefits that they bring along as we age. Lifestyle preventions span beyond just HRT and rather there are other things individuals can consider. For example, Dr. Casperson mentions pelvic floor physical therapy and sex therapy as important considerations to deal with the pain during sex.

Relationship Dynamics in Couples

When it comes to relationship dynamics in couples, there is a tendency for lack of sex education and lack of lube usage. There tends to be a lot of pain during sex because there is a disconnection between the arousal component and desire component. Women need to be aroused to be able to have penetrative sex, just as men need to be aroused as well to have an erection. But this can come with complications in older age. Dr. Kelly points out that, “you’ve got a woman that tends towards dryness, and you’ve got a man that tends towards erectile dysfunction” (Casperson, 26:54). On one hand, women need to be treated with hormones for their menopause symptoms, and on the other, men need to be treated for their erectile dysfunction. But people don’t often realize this and expect their bodies to function as they did when they were younger, which can cause a hurdle in relationships. As far as both younger and older couples, the lack of using lube is a problem. Using lube can quickly mitigate issues such as dryness and inability to reach an orgasm.

In this enlightening episode, Dr. Kelly Casperson and Dr. Jenn both offer invaluable insights into navigating menopause with confidence and clarity. From hormone therapy to embracing changes in sexual health and relationships, the conversation provides empowering knowledge that every woman can benefit from. Be sure to tune in and learn more from this discussion by listening to the full episode here.

Dr. Jenn hosts this podcast to provide informative discussions to topics around sex and relationships, which you can find more of on her website here. Along with many skilled therapists, she is also the head of Riviera Therapy, which provides individual and couples counseling in Santa Barbara. If this episode brought up any feelings of discomfort or curiosity, please don’t hesitate to reach out to Riviera Therapy for non-judgmental and expert guidance in navigating your own experiences.

More to Consider

Check out these episodes for more discussions on related topics!

“Pelvic Floor and Sexual Health with Dr. Chris Pieton, PT, DPT”

Dr. Jenn interviews a pelvic floor physical therapist about how the pelvis can have a impact on sexual health.

“Women’s Medication & Intimacy with Cre Chritz”

For a more in depth conversation on struggles regarding women’s sexual health, such as usage of medications like antidepressants and their effects on libido.

“Pleasure vs. Desire”

This episode dives into the differences between pleasure and desire, two aspects of sexuality that are important to distinguish.

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