128: How to Have Great Sex in Perimenopause and Menopause with Dr. Bat Sheva Marcus

Hi, everyone.

Welcome back to the Integrative Women's Health Podcast.

I'm your host, Dr. Jessica Drummond, and I'm here with Dr. Batsheva Marcus, and we are going to dive right into talking about the sexual health and libido challenges of perimenopause and menopause, because that is one of the biggest challenges that a lot of our patients and clients are coming to us with.

So where do we begin when our clients are finding that therapy or medications are not alone, individually aren't enough, they're not working well? How could we help combine essentially a mind-body therapeutic approach when it comes to low libido, low desire, sexual pain even in this phase?

Yeah, I feel like that is the question, right? And it's the question I've spent my life working on, this intersection between the brain and the body and how they do not work independently.

And so I'll have physicians who I'm giving grand rounds to say, but I've used testosterone, it hasn't done anything.

Or I've had therapists say, I've done behavioral work with the client or I've done some more psychological work with the client and it's not doing anything.

And my entire approach is that you really need to identify where the problems are stemming from.

And usually you can and use them both.

And if you're using both properly, the results are staggering.

They're just different.

They're fundamentally different.

Just in case people need an indication of how true this is, I always like to talk about an article that was in The New York Times years ago about men who have children, their wives give birth to children, and they stay home with the children and their testosterone levels drop.

People don't realize how dramatically our brain and what's going on in our head affects our body.

We have a better understanding of what our body is doing, but I don't think people even, they're like, if I'm not interested in sex with my husband, I'm not interested in my husband.

How could it possibly be a testosterone issue about Cheva? Like, how is that possible? And so the trick is unpack that and understand how they all interact with each other.

Because very often, if you use one without the other, you're not going to necessarily get anywhere.

And the truth is that's true about pain also.

But let me just, in terms of low desire, I will say if your hormones are very low, it makes it harder to respond to things that you would have otherwise responded to.

Again, if you think of two 17-year-olds that you see waiting for the bus or in line for a movie theater and they cannot keep their hands off each other, they're like climbing up, your first thought is not, they must've had a really intense, lovely conversation, right? That's not your first thought.

Or he must've brought her flowers.

Your first thought is their hormones are raging, right? So then when we don't feel like that, we just don't realize how much of that is hormonal.

And the second piece is that once the hormones start to drop, you start turning off parts of your brain that you've used.

So we can talk about that.

But I feel like in addition to the fact that sometimes women's hormones are low, they also often have stopped doing the things that will allow them to be and feel sexual.

Hi, everyone.

Welcome back to the Integrative Women's Health Podcast.

I'm your host, Dr. Jessica Drummond, and I'm here with Dr. Batsheva Marcus, and we are going to dive right into talking about the sexual health and libido challenges of perimenopause and menopause, because that is one of the biggest challenges that a lot of our patients and clients are coming to us with.

So where do we begin when our clients are finding that therapy or medications are not alone, individually aren't enough, they're not working well? How could we help combine essentially a mind-body therapeutic approach when it comes to low libido, low desire, sexual pain even in this phase?

Yeah, I feel like that is the question, right? And it's the question I've spent my life working on, this intersection between the brain and the body and how they do not work independently.

And so I'll have physicians who I'm giving grand rounds to say, but I've used testosterone, it hasn't done anything.

Or I've had therapists say, I've done behavioral work with the client or I've done some more psychological work with the client and it's not doing anything.

And my entire approach is that you really need to identify where the problems are stemming from.

And usually you can and use them both.

And if you're using both properly, the results are staggering.

They're just different.

They're fundamentally different.

Just in case people need an indication of how true this is, I always like to talk about an article that was in The New York Times years ago about men who have children, their wives give birth to children, and they stay home with the children and their testosterone levels drop.

People don't realize how dramatically our brain and what's going on in our head affects our body.

We have a better understanding of what our body is doing, but I don't think people even, they're like, if I'm not interested in sex with my husband, I'm not interested in my husband.

How could it possibly be a testosterone issue about Cheva? Like, how is that possible? And so the trick is unpack that and understand how they all interact with each other.

Because very often, if you use one without the other, you're not going to necessarily get anywhere.

And the truth is that's true about pain also.

But let me just, in terms of low desire, I will say if your hormones are very low, it makes it harder to respond to things that you would have otherwise responded to.

Again, if you think of two 17-year-olds that you see waiting for the bus or in line for a movie theater and they cannot keep their hands off each other, they're like climbing up, your first thought is not, they must've had a really intense, lovely conversation, right? That's not your first thought.

Or he must've brought her flowers.

Your first thought is their hormones are raging, right? So then when we don't feel like that, we just don't realize how much of that is hormonal.

And the second piece is that once the hormones start to drop, you start turning off parts of your brain that you've used.

So we can talk about that.

But I feel like in addition to the fact that sometimes women's hormones are low, they also often have stopped doing the things that will allow them to be and feel sexual.