HOW TO GET HER WET AGAIN: A GYNECOLOGIST'S FIX FOR MIDLIFE SEX

[00:00:01]Do the sex.

[00:00:05]>> Today's Talk Sex with Annette topic is why sex falls apart in midlife and the fix most couples never hear about.

[00:00:14]Somewhere in midlife sex changes. She starts avoiding it and he starts taking it personally. Neither of them says a word because we've all been taught that sex is a nice to have, not a pillar of health. And here's what makes it worse.

[00:00:29]When his equipment stops working, medicine hands him a pill. When her body changes, they tell her it's all just part of getting older. That divide has a name for it. It's called the bedroom gap. And the woman who coined the term is here today. Dr. Maria Sophocles is a boardcertified gynecologist with 30 years specializing in menopause and female sexual health. She is the founder of Women's Healthcare of Princeton, a menopause society certified practitioner, and author of The Bedroom Gap. Her TED talk on what happens in sex in midlife has had over 1.3 million views. And today she's breaking down exactly what's happening in her body, the estrogen myths that keep couples suffering, and how to bring pleasure back to the bedroom. Welcome, Maria.

[00:01:20]Before we dive in and before Maria tells us a little bit more about her, I'm going to remind y'all that I'm over on Only Fans and there I am sharing my sex and intimacy how-tos, demos, and audioguided self-pleasure meditations and so much more. You can also ask me all those oneoff questions you have.

[00:01:37]Over there, you can find me on Substack doing a whole lot of the same. And both places you'll find me with my handle @talk sexwithette and then you'll find both Maria and I everywhere you want to find us with the links I've dropped below in the notes section of this episode. But for now, Maria, can you tell my listeners a little bit more about you?

[00:01:58]>> Sure. Just to be brief so we can get into the fun stuff. I'm a a gynecologist by trade and a sexual counselor. And I love love talking to men and women about sex and about what's wrong and how to jumpstart things and get things back to where they used to be or get things to where they never have been. I really, as I wrote this book, thought I was writing it just for midlife couples, but realized that people of all ages and stages have sexual issues. often based on misinformation. Either they don't know their body, they don't know their partner's body, they don't know what gives them pleasure, or they're stuck in a rut of mediocre sex, and they just keep repeating it. And that a lot of the dissatisfaction was just coming from a lack of understanding, a lack of education, a lack of communication. So, the book aims to open that all up for people, and I hope we'll get into some of that today.

[00:02:58]>> Oh, I'm positive we will. And folks, again, why you want to stay to the end is for those takeaways that we will give to you. So, if you are a couple, a man, a woman, any gendered person in a midlife relationship who is struggling right now, this is going to be a great episode for you. We are going to help you navigate your way to improving your situation. Now, if you are someone who's not in midlife, maybe you're younger, this is a good prep course for you because guaranteed, you're on your way there, and you're going to have some tools to help you so that when you get there, you don't run into some of the problems that so many of us older folks have hit along the way. So, stay till the end. We're going to walk you through a lot of stuff you've never heard about that, but is key to having a fantastic sex midlife. I am ready to talk about sex midlife. How about you?

[00:03:56]>> Totally ready.

[00:03:58]>> So, let's get ready to talk about having amazing sex during midlife. Cheers.

[00:04:07]>> Cheers.

[00:04:08]>> So, you coined the term the bedroom gap.

[00:04:12]>> What is it and what does it look like inside a real couple's bedroom? Yeah, it's super common. And we've all heard of the orgasm gap, right? Which is the discrepancy in orgasm frequency, the biggest discrepancies between heterosexual couples, men and women. But the orgasm gap is just a tiny part of sex and intimacy and relationships. And what I noticed in in my practice was that so many women in midlife were coming to me parmenopausal or after menopause saying I don't have interest and when I do have sex it's dry. I can't get wet. I can't orgasm. I don't get aroused. I don't have desire. Take your pick. Some of them had all of that. And at first I just thought, well, I guess the easy answer is just to tell them it's menopause. And then I realized it is so much more complicated than that.

[00:05:08]So I I started digging in first to the anatomy and the physiology. What happens to us when you take away the estrogen, when the ovaries aren't making it anymore? And that was the first part of the bedroom gap, which is that our bodies age and change. I kind of knew it, but I wanted to know exactly what happened. And I started learning more about erectile dysfunction because things happen to men, too. And it it turns out that as we age and we have fewer blood vessels and our blood flow slows and our metabolism changes, changes happen in the penis, in the vagina, in the clitoris, in the labia. I mean all everything is affected. And that as you mentioned for men, Viagra was discovered and beautifully marketed initially for men with erectile dysfunction and then for all men was like you want it, you got it. You can practically get it on the street corner.

[00:06:08]It was the fastest drug launch in the history of pharmaceuticals at that time.

[00:06:13]It was one of the first drugs widely advertised on TV. So, it just became this household word. And what Viagra did as it entered into midlife bedrooms is it created a discrepancy. It meant that midlife men who maybe were struggling and were going to kind of struggle sexually with their partners or maybe just agree that sex was different suddenly had this ace in their back pocket. Women had nothing. And then women started just feeling broken.

[00:06:42]What's wrong with me? Or why did he leave me for his 32-year-old secretary?

[00:06:46]And it was like well what's wrong with me? So they kept coming into me saying, "I'm broken. Fix me. I'm broken." And so I started looking at how often does this happen? And it turns out most of the time, 70 to 80% of all women who go through menopause, and remember any human being with ovaries and a uterus and a vagina is going to go through menopause. The ovaries, we outlive them.

[00:07:09]Menopause is just it's not just the end of periods. It's the end of the production of estrogen, progesterone, and testosterone. And it affects our brain, our heart, our skin, our eyes, our teeth, everything. But it also affects the vagina, vulva, clitoris, all of that. So when you take estrogen away, and if anyone feels like seeing a funny TED talk, we'll put the QR code in a link to my TED talk, and you'll see in that TED talk a beautiful animated video, you will never forget it, of what happens in the vagina when you take estrogen away. And when you see it, you realize women are really up a a creek without a paddle. They lose the blood vessels, which means they lose the ability to bring moisture into the vagina, whether they're aroused or not.

[00:07:58]They just can't get wet. They the collagen breaks down. So, it's not just that we get wrinkles in our face and our skin gets dry. in the vagina, the collagen actually degrades and it gets replaced with a shabier kind of collagen that just isn't as elastic. So sex starts to hurt. So even if you're attracted to your partner, even if you want to have comfortable sex, you have a lot stacked against you. And when you pair that with a penis that now has Viagra, that orgasm gap increases. But it's a bigger gap than that because, as you said, women feel broken. They feel ashamed. their male partners are not sure what's going on. Women often don't talk about it cuz we've been trained as women not to complain, not to talk about sex. Sex is dirty. Don't even talk about your private parts. I mean, there's a lot of that in this country and in other countries. It's really not not as open and progressive as your listeners might be as a whole. So, you get this lack of communication and it just leads to a mess in the bedroom. And I I found this to be way more common than I wished. I found that it crossed all socioeconomic levels, all religions, all races. I've gone all around the country and then all around the world to five different continents interviewing people. And the bedroom gap is universal. It's totally universal.

[00:09:25]And so the people at TED thought, you know what, this is a universal message.

[00:09:29]There are a billion menopausal women in the world right now, over a billion. So if 70 or 80% of them are having this, that's 7 or 800 million women suffering silently. And their partner is going, I want to help you, but I don't know what to do. Is lube okay? And it's really a much bigger issue than lube. It's it's really about communication and stuff like that. So, so that's a super long definition of the bedroom gap. The difference in expectations and abilities between partners can be same sex by the way because there can be communication issues. There can be different ages or different abilities. There can be women the same age who one has libido, one doesn't. One has vaginal dryness, one doesn't. So, I definitely see this in same-sex couples and they have their own unique set of challenges because they may be going through menopause at the same time. So, it's it's a lot. So, that's what I wrote about. I wrote about what it is and the forces that shape it, right? Because we are not just our bodies. We're the society we live in, culture that we grow up in, the religion we grow up with, the sex ed that we get, excellent and progressive or crappy and rigid. And in the United States, 47 out of 50 states still do not have progressive sexed where they teach consent and they teach sexed for the LGBTQ community and they teach pleasure.

[00:10:59]Believe it or not, sexual pleasure not taught in most sexed courses, right?

[00:11:05]Mind-blowing, right? So, I my mission is really to to close this gap for people who have the bedroom gap, but also to really revamp sex ed for young people so that they're getting the right information, the right messaging. So, when they begin to have sex, they already know that female pleasure needs to be prioritized as much as male pleasure. And they understand that very, very small percentage of women orgasm from penis and vagina sex. Hollywood would tell you otherwise. Porn would tell you otherwise. Your cousin, your uncle's hustler magazine probably all tell you otherwise. So, we have a lot of misinformation out there and it leaves people feeling either unsatisfied sexually or feeling like it's their fault and they're broken. So, that's all within the bedroom gap. And the book does a nice job of walking you through it so you can go, "Oh, yeah. Yeah, that would make sense." Okay. And then what can I do? Which we'll get to.

[00:12:05]>> Yeah. I I think a couple of things struck me from what you said. First of all, you brought up the fact that he has erection problems. They give him medication that makes him now be able to be super hard for a long period of time.

[00:12:22]Well, at the same time, her vaginal skin is getting thinner and more more it tears easier. It's often times painful.

[00:12:33]Even if she's in the mood, it can hurt.

[00:12:36]So now he's thrusting at her longer cuz he's look at this incredible hard on I have. And he thinks his job is like, see, look, I'm still a man who can go.

[00:12:45]So he's pounding away at her while she's literally experiencing what feels like tearing inside.

[00:12:52]>> Yeah. Yeah.

[00:12:53]>> And so the way that those have been dealt with, the fix for him is actually what's probably >> making it worse.

[00:13:01]>> Making it worse. Because I can tell you from experience that when I'm having sex that's uncomfortable and I can't seem to get my partner to understand or it they just keep approaching it in a way that's painful.

[00:13:18]I stop wanting to be there. Even if I'm really into them, even if I love them, I start finding excuses not to have sex. I can also tell you this brings me to another point that you brought up that I think is super important when we say this is for couples. This also happens in queer relationships. I have been in relationships with women who really like to finger hard or as they get excited they do. And I am 52 so I too have been struggling with this thinning skin and figuring out how to get it healthy. I have had times where I'm avoiding sex because I'm like, uh, it's probably going to hurt again. I'm going to have to correct them again. I'm going to have to bring it up. They're not having this problem. And I have felt many times less of a sexy woman, less of a attractive woman because of the pain I experienced regardless of who my partner was. And finally, something important that I want to address that you brought up was that you may not even know that your partner is having pain in the vaginal area. And I can tell you from my own very recent experience because I'm on my own hormone journey. I started having like pain not even during sex, just sitting and walking around. And I didn't want to say anything to anyone because there's this part of me. I was brought up in the '8s like the rest of you. And I know you're you're all going to be like, "Oh, but you're an intimacy coach or a sex educator." I know I'm also a human. And I instantly it made me feel dirty or oh, if I say something, people are going to question if I have an STD or people are going to, you know, it was my brain just went back to that even though I knew that wasn't the case. But I was like, I'm just sitting and it feels like sandpaper and I didn't want to talk about it.

[00:15:13]>> And these go back to those gendered defined whether you're queer or not roles that women are taught not to talk about sex or if you do or you have too much interest in sex, are you [ __ ] Are you what are you sleeping around?

[00:15:28]It's crazy the double standard. But also that pain is something we're supposed to just quietly deal with. And that's actually in medicine now. We're doing research into women and pain and finding that women are actually dismissed a lot by doctors when they have painful things and told maybe you're tired, maybe you're stressed, maybe are you kind of anxious? Are you a little hysterical kind of person and it's like are you kidding me? This no this is real pain and pain with sex. There's just nowhere on the planet except for intentional pain with sex which is its own thing and I'm no judgment. that's fine. But unwanted, undesired, unplanned pain with sex should be off the table and and you should be able to communicate that to your partner. And you should be communicating that to a doctor. And if the doctor doesn't have answers for you, time for a new doctor. I don't care how nice they are. I don't care if they delivered your baby. You can still go to that doctor for your papsmears if you want. Have at it. But find someone who knows how to help you regenerate that vaginal tissue. It does not. It is safe and easy and we should talk about that the the options.

[00:16:38]>> Absolutely. One one question before we get to some of the solutions.

[00:16:43]Let's make it clear to my listeners who are in relationship right now. What are some of the clues, if you will, that perhaps your partner, a woman or someone with a vulva is experiencing issues when issues arise in the relationship. Because what I hear often times, men often come to me and they're like, "She doesn't want to have sex anymore." her. I've been trying to get her to talk about it. What I want, especially middle-aged people, to understand is some of the signs that point to it's not that she's just a frigid [ __ ] that she's really struggling and no one's addressing it.

[00:17:29]>> Yeah. I mean, I think someone who who had a healthy interest in sex and and again, I would say it's age irrelevant because I have 80-year-olds with a healthy interest in sex and 20-year-olds who have no interest. But in general, by decade, couples have sex more often, right? More often in your 20s than your 30s, more often in your 30s than your 40s, etc. But even into the 70s, people still have regular sex when they're in long-term relationships. When you see a change in that pattern, let's say you and your partner are a three time a week, we have sex Monday, Wednesday, Fridays, and now she wants to have sex like once a month and she's getting it over with. Or you have sex once a week for years and now it's no. So, it's it's important to open the conversation up in a very non-judgmental way and just say, "Hey, I noticed things are different and I own it." Don't point the opposite. Do the opposite of pointing the finger.

[00:18:25]Don't say, "I've I've noticed you aren't interested in sex." The first thing they're going to do is get defensive or not want to talk. You want to make it almost your problem or a we problem.

[00:18:35]I've noticed we haven't been intimate in a while. And I just want to make sure is is it something I did? What What did I do? Is it not what, but is it something that we could talk about or is it me?

[00:18:48]Yeah, you've started snoring and I really hate it. or I don't know what it is, but your breath just bothers me or whatever the answer is. You have to be ready for it because you don't know. It could be, "Yeah, I'm having pain when we have sex and I don't like it and I just don't want to do something that's painful." The answer to that, the only answer to that is, "I am so sorry. That would be awful. I want to be involved in helping you. And I know I'm not a gynecologist and I know I'm not a woman." Or maybe you are a woman, but let's do this together. Do you want to go shopping for lube? Do you want to go see a gynecologist? Do you want to look on Chat GPT? Just showing interest is a version of empathy, right? And once someone feels you are empathetic to what's going on, they don't they're not as ashamed to share. So you want to talk to them in a way that makes them want to open up. And the worst thing is to point the finger and go, "What's wrong with you?" because it's too hard to say my body is aging or broken or dry. All those are images that are yucky and nobody wants to nobody wants to face that. I mean, so I think and remember cancer if your partner has breast cancer and there are 4 million breast cancer survivors right now in America. If your partner has breast cancer and she or he is on an anti-estrogen medication to prevent that cancer from coming back, the vagina will age much more quickly.

[00:20:19]So you guys are all thinking breast and cancer and secretly there's a terrible destruction happening in the vagina. So it's not that she doesn't want to have sex because she had breast cancer. It's because the vagina went from age 40 to 70 and that's hard. So, it's okay to say, "I didn't know. I didn't know."

[00:20:38]Nobody's born knowing that. So, >> that's Does that help a bit? I think >> absolutely. But now, let's get into some of the solutions. What are some things that can help fix this bedroom gap and narrow it at least?

[00:20:53]>> Yeah. Well, we already started with probably the most important thing, which is communication. The communication sounds easy the way you and I are talking, but you and I know it's hard.

[00:21:04]It's really hard to have that first talk. And I've had patients tell me they've been waiting 30 years to have it. And that's really sad, right, to have 30 years of something wrong. So, think about how you're going to have it because communication is one of the strongest things that'll carry you forward. And I've had partners go do all the research and work themselves once the communication happens. So, communication is a huge part of closing the bedroom gap. I talk in the book also about the five M things that can help it. And you can read the book to get the details on how they help it. But, but massage, media, masturbation, mindfulness, and medications all have a role. Not for everybody. Everybody doesn't need all five. But some people respond very well to erotic stimuli.

[00:21:58]Either someone touching them, massaging them, or them touching their partner, massaging their partner, touching your partner. We know that the female and the male brain store erotic input, whether it's watching porn, reading a trashy beach novel, listening to something called audio porn, which is just apps that of stories. They're wonderful and you have to find you. There's a whole lot out there, right? Only fans, of course. So, there's so much out there.

[00:22:31]Find what's right for you. Don't be turned off by something. If you're turned off by this, go look at that. And if masturbation is part of that, wonderful. If you don't masturbate or have never masturbated, the the book helps you baby step into that. Believe it or not, Annette, I I have patients who've never masturbated.

[00:22:51]Their their mom or their Sunday school teacher told them it was awful and dangerous and worse and bad, and you're a bad person, and they've just they're 56-y old woman, and they've never done that. And then there are medications and I think we should talk about those. Not not my first choice, not a common thing we use, but they're out there.

[00:23:10]>> I'm currently on my own HRT journey. I'm taking Estradile >> orally, vaginally a couple of times a week because apparently oral doesn't get to the vagina.

[00:23:23]>> Correct. Correct.

[00:23:25]Well, it gets there, but in such a tiny amount, by the time it dilutes in your whole body, it's just not quite enough to make the change or keep things healthy on its own.

[00:23:37]>> And then recently, I added progesterone and testosterone. I'm like a week and a half in. But I for me, I I'm feeling confident that this is going to be a solution. I'd like you to talk to my listeners a little bit about that.

[00:23:52]>> Sure. I mean, HRT or we now call it HT hormone therapy is something that we use either after the ovaries have stopped making estrogen, progesterone, testosterone. So that because now we live a third of our lives longer than the ovaries live. We actually outlive our ovaries. And once the ovaries stop making those hormones, we get a lot of negative health changes. And so hormone therapy can really extend our health and delay whether it's delaying the onset of dementia or Alzheimer's or reducing the development of heart disease or very obviously slowing down the development of osteoporosis. There are health benefits that have now been documented a lot. People worry a lot about cancer fears. Turns out those cancer fears are very misplaced. The studies that suggested that have since been disproven. And it turns out that what we know now is women who use HT like yourself, like me, have actually about a 30% lower risk of breast cancer than women who don't. Totally the opposite of what many women believed or used used to believe. So you have to unhook that fear. The reason Annette needs systemic HT is to help her bones, her brain, her heart, all kinds of parts of her body, but the doses are very tiny. They're much smaller than say a birth control pill. And so, by the time it dilutes throughout your body, there's just very little that gets to the vagina. And as we said earlier in the show, the vagina really takes a hit. It really loses blood flow and collagen and and needs more help. So twice a week, either an estradile cream, a tablet, a ring, a little suppository. There's several companies that make it used forever. By the way, it's not like an antibiotic.

[00:25:52]You use it forever, just like we use sunblock forever. Nobody goes, "You only need sunblock till you're 50 and then you'll never get wrinkles." And we all know the sun damages the skin and you have to use sunblock when you're in the sun. Same with vaginal estrogen. It's a forever thing. So, does that help?

[00:26:10]>> Yeah, that's I I've been wondering >> like who am I doing this for?

[00:26:15]>> You're doing it for bladder health and sexual health and just overall gyn health. So, you're doing it because guess what? The bladder sits just above the vagina and the opening to the bladder is in the vagina. So, the reason much older women get urinary tract infections, which send them to an emergency room and are sometimes fatal for real, is that there's no estrogen in the vagina or bladder, and bad bacteria can get in there. So, you taking this now and continuing to take it is going to keep you healthier in a bladder sense in the next several decades of your life. That's pretty stunning. And it makes sex so much more pleasurable.

[00:27:00]>> That's right. You make moisture on your own just sitting here. But you also with arousal make more moisture. The clitoris gets more blood flow. The labia get more blood flow. It's all around just sexual gold. It really It really is. Now remember, you don't use it right before sex. It's not like Tums with a greasy meal. You use it twice a week. So, and it lasts about half a week so that the cells are making all those beautiful new blood vessels and collagen. So, when you need them when you are having sex, they respond, >> right? And you so for listeners, >> so that's estrogen, but testosterone.

[00:27:42]So, the progesterone, by the way, you only need progesterone if you have a uterus. If you had a hyerectomy, you actually don't need the progesterone. We use progesterone as the ying to the yang of estrogen. It prevents the uterus from growing tissue in women who take estrogen. It also helps with sleep. The test >> Yeah. I mean, I was going to say, so I started taking progesterone. I have an IUD that no is no longer serving its purpose. But and right away it I take it at night and I which I can never I never feel like sleeping and I instantly felt like sleeping. But the other thing that was interesting about it, I mean, the first couple of days I was like, I feel dead inside. And then what I I realized is I don't feel dead inside. I'm just not anxious all the time.

[00:28:31]>> Like I'm anxious all the time. And now this is is this what people who aren't anxious all the time feel like. And it has brought my overall outlook on everything way. I'm like, did I need this my whole life? It's really calmed my anxiety which is I I mean it can't be placebo because I am a pretty high anxiety person. So that has been interesting for me and and of course we know with sex if you are anxious >> it really kills the mood.

[00:29:02]>> Yeah anxiety does. Depression does shame does body image a lot of bodies change and and you have to learn to to love the body you have. I mean, that's that's part of the five M's. The mindfulness is clearing your head so you can so you can have the sex you want.

[00:29:22]>> So, clearing that head and mindfulness techniques. It sounds all woowoo and silly. It's not. It's very simple. And in the book, we even give you some links to some easy places you can go to learn some simple mindfulness tricks to just clear your mind. And the other thing is clearing your bedroom. making your bedroom a place you want to have sex, not full of your laptop and your folded laundry and your kids stuff and your dog stuff. And you have to prioritize it.

[00:29:51]Like people who prioritize exercise, some people say, "I just don't have time. I just don't have time." But people who carve the time and are intentional about exercise do it and reap the rewards of it. And I would say it's the same for sex. So that's why I list sex as the fifth pillar of health.

[00:30:08]sleep, nutrition, movement, social connectivity or community, and sex. And I think when you optimize all those, you don't need a lot of fancy meds or supplements or anything. I'm not saying you you might need them for something, but if you work on those five, including sexual health, you you end up living longer and staying healthier longer. We call that health span.

[00:30:35]>> So, let's talk about testosterone. This is new for women hearing about women taking testosterone. I would say about a year and a half, two years now. I've known people who have started on testosterone replacement and I just finally started. I think I'm on a week two. But I would like to give you an opportunity to speak to that, why someone would choose to and what they can expect.

[00:30:59]>> Sure. And then I want to ask you what you're are you getting cream or do or injections or how are you taking it?

[00:31:06]Right now I'm taking it's like a cream gel I put on the back of my knees is the place I've chosen and I am a week and a half in.

[00:31:14]>> Awesome. Awesome. I I'd love to talk to you in six weeks and see how you're doing because it takes a little while for it to really get the maximum effect.

[00:31:22]It's it's new in the public eye and in the masses and on social media for as one of the early testosterone users and experts in this country. Not new to me.

[00:31:33]I've been using it for 20 years with my patients. That's the good news is we have a lot of experience with it. I have a lot of experience with it. The bad news is there's no FDA approved testosterone. That just means there's no testosterone for women that's been studied in FDA approved. For men, there are over 30 different formulations. So, we need to close this gap, too. And we're fighting for that right now. So, what do women do? They use a compounded formulation. We send it to a compounding pharmacy. They mix up a little tiny female strength amount of testosterone and you put it on the back of the knee or your inner thigh and a teeny bit of that goes into the bloodstream, goes to the brain and it wakes the brain up.

[00:32:19]That's the easiest way I can say. It's like opening up these little areas in the brain that are receptive to erotic input. So, remember earlier I said a great way to to your sex life and kickstart it is to bring erotic content into the brain. Watch something on Netflix that does turn you on. But if you're using testosterone, it seems to just hit that much better. And so when you lie down next to your partner to go to sleep at night and you put your head on his or her shoulder, it just feels more sexual. you you notice their smell more, the the scent of their hair, their shampoo, or whatever it is, their jawline, whatever it is that you're you used to be turned on by, or you still are, you you notice it more. I've had patients tell me, "I never noticed my neighbor mowing his lawn yesterday. He's actually really attractive." And I'm like, "Oh, that's great. Have have sex with your partner." Not your neighbor, but or or have sex with your neighbor if you want, but it's cool. It's almost like someone puts rainbows and sparkles in your eyes a little bit. Now, the doses in that compounding stuff are really tiny. So, sometimes it's a very subtle little gentle nudge. We do have stronger versions of it. And the stronger versions are as follows. We use the male FDA formulated stuff and we have women use less, a tenth of the dose. And that's a little tricky to squirt out the tiniest little bit, but that tends to give a little more bang for buck, pun intended. And then we also do injections once a month. We can do that. They they come in pellets. I'm not a fan of pellets only because they don't you can't get it out of your body. So if you're not happy, you're in trouble.

[00:34:04]Also, the doses are so high that we just don't have a lot of data on that safety.

[00:34:09]It's probably safe because we, you know, how we know it's probably safe from trans men, meaning biological women who used high high doses of testosterone to get beards and body hair, didn't they didn't have in the studies, they didn't have higher rates of cancer, stroke, heart disease, all that. So, that's good news.

[00:34:31]That means that if they can take huge amounts and be safe other than the side effects that they're trying to get, you and I can take teenytiny amounts and be safe. So, we really do believe it's safe. But now, we need someone to pay for really good studies so the FDA will approve gyno testosterone or whatever, whatever we want to call it. So, I love it. I use it with my patients. They're really happy with it. So, a big thank you out to the trans community for doing some nice footwork for the rest of us.

[00:35:02]Love you.

[00:35:03]>> Absolutely. Absolutely.

[00:35:05]>> Right. Absolutely. I am only a week and a half in and I can tell you it was it was my first week was really kind of woo woozy. I had hormones going everywhere.

[00:35:14]But >> by day four and I didn't know I I mean I was really just looking at testosterone to >> make me feel sexier basically. I was like look I want to be juicy again. I want to be my hot self and I feel sleepy sort of. And the only way I can describe it, because it's only been a short time, so I'm very optimistic, is it's kind of when you are wearing a prescription glasses, right? And you don't go get your eyes checked and pretty soon everything gets kind of dim and you're struggling and it takes more energy just to read a book and then suddenly you get a new prescription and you're like, "Oh, I didn't realize how how much I was struggling and how hard I was time I was having reading." It's like that's what my life feels like. I get up in the morning and I put it on and I'm like, "Oh, hello world. I feel brighter and more." I also have pretty severe ADHD that's gotten worse through pmenopause.

[00:36:15]And look, I'm not saying use it for that, but I'm saying I have conversations now that I'm like long conversations that I would usually have to be like, "Pay attention, Annette. Pay attention." Cuz my brain wants to go everywhere. And I'll be like in a very long conversation. I'll be like, "Holy [ __ ] I am still dialed in."

[00:36:32]>> Yeah.

[00:36:33]Just beginning to tap into the potential of testosterone. Again, we need really good studies because it could be really become part of HT. So, when you go get HT, it's part of the conversation. Now, it's a it's popular on social media, but it is still rare in terms of finding a doctor who has experience with it. And and that's the problem. But the other thing I want to say is because the testosterone isn't in standardized formulations, you have to we we check your levels six weeks after you start and then we check twice a year. So while you don't necessarily need your estrogen levels drawn, you do need your testosterone levels drawn for that reason.

[00:37:14]>> Okay.

[00:37:14]>> Okay.

[00:37:15]>> Good to know.

[00:37:16]>> Well, we are at that time where I want you to give my listeners some takeaways.

[00:37:21]We've thrown a lot at them. We've thrown the the the challenge, the pro. It's a problem, the bedroom gap problem and all the pieces that go into it >> where we've talked about how it's affecting them in the bedroom and then we've given them a bunch of solutions.

[00:37:36]But what I want you to do is give them three things right now that they can do tonight after they get done and and that will start helping them tonight or tomorrow morning in their relationship.

[00:37:48]So let's start there.

[00:37:50]>> Okay. So, first thing is again, let's meet you where you are, right? If you're having regular sex and it's good, but you'd love to just it can always be better, right? Olympic skiers still take ski lessons, right? Just throw this out to your partner and say, "I really loved when we did this or that, or I really loved how we had sex when we were camping or in Aruba or whenever it was."

[00:38:17]sometime you actually really did remember the great sex and get the courage to say, "You know what? I loved I loved how you blah blah blah or you licked my hair or you rubbed my back or whatever it was you did and say, "I just I just wanted you to know how much I appreciated that and that I really enjoyed it and that I hope we do that again." Your partner will not forget that. Your partner will act on that either immediately or we'll store that and save that. So, that's always a good win. If you're having sex that's really gotten me, that works for that, too, because it's saying, you know, how we went to Aruba last year, I'm not sure we you're not going to say we haven't had great sex since then, but you can say in a positive way, I really love the sex we had because of these things. And it's an entry to a little conversation about about how to have better sex. So, so finding communication. Second thing, know your body. If you don't really know your body, especially if you're female, get a mirror and look. If you're really not sure, get one of these little puppets and and figure it out. If you're still not really sure, you can follow me on Instagram or buy the book and you'll figure it out. It's it's important. And you think you kind of know your body because you've lived in it all your life, but very few women really take the time to to know it. The third thing is know what gives you pleasure. What gives you pleasure may not be the same thing that gives the porn star pleasure or may not be the same thing that your girlfriend said gives her pleasure. And so it's okay to figure out what that is.

[00:39:47]And if you're not sure, I think self-love or masturbation or self-pleasure, whatever you want to call it, is a great way to figure that out.

[00:39:57]So very simple things. I mean, we can I can come back and it we can talk about all the crazy toys that are out there and we can talk about all the different kinds of lubes and how to find the lube you want. We can talk about virtual reality porn. There's so many things we can talk about, but I think for this today, it's important to distill it down to some basic things that people can leave tonight and say, "Okay, where's room for improvement?" And if your bedroom gap is because of bigger things, a partner who's an alcoholic, a partner who's a sex addict, a porn addict, a partner who's who's left you because there's something pulling them away, man, that's bigger than this conversation. And that you probably need some professional support with. You can find that at act.com.

[00:40:43]The American Association of Sex Educators and Certified Therapists.

[00:40:47]That's one place. Zette, you probably have other places, too. But don't don't be afraid to go looking for help.

[00:40:52]Everything isn't just I think I'd like to have a little better orgasm. I mean, by the way, topical testosterone on the clitoris itself will make for better orgasms with repeated use. So, we'll save that for another episode or something. But that's a that's a little hack that you should probably know.

[00:41:13]>> I'd heard about that. We will have to have a conversation about that. Also, folks, I highly recommend this. I have been getting I mean many messages from listeners and it's one of the things that makes me the most happiest in my life saying that they shared this episode with their partner or that they're watching with their spouse and doing the things together, which was my dream come true and it's actually happening. I've got I've got the testimonies. So if you are struggling, take this episode and send it to your partner or say, "Hey, will you sit with me for an hour and watch this episode and get cute little drinks and make it a date night movie night and have conversation?" Yeah, it might feel awkward, but when I give >> talks and I'll do book events and there'll be women in the audience and they always come up and say, "I actually read this book with my partner and he said to me, I am so glad to have read this. I wish I had read this 20 years ago." And same with this episode. I think people could really get a lot of really good basic stuff. It's there's there's nothing wrong with going back to basics and making sure basic stuff and and how your partner is aging and changing and that's okay. That's just life, right? But doesn't have to be the end of sex. In fact, for many couples, it's a reset and it's like a reclamation. I mean, I have couples who tell me they have the best sex of their lives because they don't have the performance pressure that they had as younger people. They just are in it for helping their partner have pleasure and for their own pleasure which is great.

[00:42:50]Great.

[00:42:50]>> Wonderful. Well, can you tell my listeners where they can find you?

[00:42:54]>> Absolutely. So, on Instagram, Mundy, you can also look up TEDtalk Maria Sophocles or you can go to I'm working on a documentary film called Hot Ho T exclamation point. So, it's produced by some a company called The Milkhouse. So, so take a look. It's coming. It's not out yet, but that'll be fun. And then my website is the same thing. Maria Sophocles MD or Substack like you.

[00:43:19]>> Well, make sure to go and check her out, folks. You don't have to accept how things are if they aren't what you both want them to be. There are so many opportunities out there to help not only improve your sex life, but to help improve your health and longevity. And you've heard a lot about them today.

[00:43:37]Thank you so much for joining me today, Maria.

[00:43:39]>> Oh, my pleasure. It was so much fun.

[00:43:41]Cheers to you. Thank you for taking this important subject to the masses together. Let let's let's help more people.

[00:43:49]>> Let's do it. Cheers to that. And to my listeners, until next time, I'll see you in the locker room. Cheers.