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Lisa Fitzpatrick

Australian pelvic and sexual health physiotherapist, yoga teacher, and author of "Sexy Menopause" with 30+ years of clinical experience in women's midlife health.

Oct 6, 2026

11:20
... um, how do we look after it?
11:23
Absolutely.
11:24
So with the changes in our hormones, including estrogen, um, that slowly winds up if we're in a fairly well-supported environment.
11:35
If we're in a, a, a fairly erratic, stressful environment, estrogen can often do a lot of roller-coasting.
11:42
But in either case, um, estrogen as a hormone is a very, um, fluid-retaining, juicy kind of a hormone that allows us a lot of our excessive energy when we're younger.
11:56
It actually comes from a Latin word called, um, oestrus, which means gadfly, which is kind of like a dragonfly that busy buzzies itself around the place.
12:07
Now, when we start to lose estrogen or it starts to become erratic, it does change tissue in the body, so we start noticing more wrinkles on our face, and I also, um, would liken what happens to the face to what happens to the vulva and vagina as well [laughs] that we have these tissue changes.

11 MINS LATER

23:28
Yep.
ShamiHOST
8:49
So I'd love for you to just clarify, you know, what is the difference between libido, arousal? Because I think we loosely use all of those words.
8:58
Yes, for sure.
9:00
For sure.
9:01
Libido really is that, the key in the door for desire to be triggered either spontaneously or with a more conscious and considered effort.
9:13
And I think with libido in particular, menopause brings about the need for a more conscious effort to be made to stoke the fires of libido.
9:24
Because libido, when it does leave the building, you know, a lot of women do say, "Yes, I feel quite content about this." And then the biggest travesty of justice I think I see as a result of that is when a woman then decides she wants to reengage, it's often quite uncomfortable to reengage.
9:44
But also, the pelvic health side of things is very overlooked with the libido loss being accepted.

8 MINS LATER

ShamiHOST
17:36
... expect if they do see someone like you?
5:11
point, I just would never
5:13
have.
5:13
ever have believed you because I was really putting on a lot of weight.
5:19
I felt like I had every menopause symptom in the book.
5:21
I was boiling alive.
5:24
I felt as though all of my youthful vigor and bloom had packed up and left the building and that I would be washed up, old, bitter, twisted, and incredibly non-sexual.
5:37
And that was devastating to me because I've always enjoyed being in my body.

28 MINS LATER

33:55
And if somebody comes to, and I'm sure this happens all the time, comes to you specifically with that issue of saying, I've lost my libido, I've lost my mojo, what are some of the things that you might say to her, some of the advice that you might give her?
15:16
kind of physiological changes that do happen as we age? And what are some of the things that we can be doing, like you suggested, that help us not reverse them, but support them?
15:29
Yes, absolutely.
15:31
I think tissue change is a very gradual process that takes a long period of time.
15:37
But like you said, not until it reaches a critical mass point do we start then feeling sometimes the symptoms are too strong to ignore.
15:46
And unfortunately, with menopausal change, often there's a peak in symptoms around that menopausal turning point where we are noticing that something like a birth scar or even a mild pelvic organ prolapse will feel more pronounced as we lose estrogen.
16:03
And there's actually a couple of things that I think are really easy correlations.
16:09
And one of them for a lot of women is that the tissue's ability to feel plump and hydrated changes.

26 MINS LATER

42:10
Yes.
4:07
... as women?
4:08
Yeah, great question.
4:10
It started with me being on the floor, sobbing my heart out, completely heartbroken, um, with the news that my fiancé and partner of nine years had decided that he was in love with me, but not in love with me anymore, and he was leaving me.
4:30
And it was about three months in for me without a cycle.
4:34
So I was 51, and I was, you know, just about sort of like facing that menopausal year where we hopefully clock 12 months, 13 months without a cycle.
4:44
And I was thinking, "Yeah, this has been quite harrowing for me, this menopausal shift," um, in that I've been feeling overweight, I've been feeling frumpy, I've been feeling unsexy.
4:57
I've been feeling, um, all of the things that, um, women, I guess, face, and not knowing how to manage them.

14 MINS LATER

18:51
How do we start to repair that relationship, not just to our bodies, but to spirit, to source, to our purpose? How do we begin to cultivate that?
19:48
to listen through to what the issues are and hopefully be able to give some advice and guidance.
19:54
Yeah, just to add to what Lynn said, I was just thinking through, you know, some of the scenarios and the discussions, recent discussions.
20:05
It's just important, I think, to remember and for employers to remember, because they often forget, in my view, that social workers have needs too.
20:17
So social work of what...
20:20
So in A&R, what's important is that our main role is to work with formal processes that exist, that are set down by policy and are interlinked with law as well.
20:34
So, for example, sickness absence meetings that are also linked to... you know workers have rights around if they've got health and disability issues we've got the equality act to work with alongside so it's just so we work with formal processes and we work with policy and we work alongside law um and and social workers have needs too in that what we know is that um We work with many social workers who are often, not always, but often, sometimes they've been off sick, they're off at home, they feel isolated, they feel alone.
21:19
They have HR departments that they can only send online forms to, they can only email.

24 MINS LATER

45:15
What would you say to social workers listening to this just now who can identify with this problem?
12:31
Mm-hmm
12:31
... a lot of our organ function can be compromised by that alone.
12:35
Um, and the pelvic floor muscles are like a hammock, and if we tend to be in a lot of lordosis or a, or a diminished lordosis, that's a, a lumbar curve, we are absolutely at risk of, um, tipping the pelvic physiology into a state of, um, uh, imbalance, which will actually affect its function.
12:56
So that's one part of the posturing, um, equation, and then the other part of posturing is about whether or not we hold posture inside our muscle physiology.
13:06
So when we're holding a lot of stress and tension, so this is where the nervous system really comes in, if we hold a lot of stress and tension, um, quite often our breath pattern might come into the upper body.
13:18
We might end up with a bit of an anxious breath style.
13:22
Our respiratory diaphragm no longer then descends on the inhalation, and we tend to breathe up instead of down.

34 MINS LATER

47:06
What's one thing that you wish you knew when you started this journey?

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