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Good Inside with Dr. BeckyGood Inside with Dr. Becky

The Truth About Sex After Parenthood (And Why Some Couples Feel Closer)

**Why Some Couples Have Better Sex After Kids** After kids, a lot of couples assume intimacy is supposed to disappear. You’re exhausted, touched-out, overwhelmed by logistics, carrying invisible mental load — and somewhere along the way, sex can start to feel complicated, distant, or impossible to even talk about. But what if the story is more nuanced than that? In this episode, Dr. Becky talks with board-certified OB/GYN, sexual wellness expert, and Chief Medical Officer at Hers, Dr. Jessica Shepherd, about new survey data exploring what actually happens to intimacy in long-term relationships and parenthood. They discuss: - why some married couples report *better* sex after kids - how vulnerability changes intimacy - the connection between mental load and desire - hormones, perimenopause, and libido - why “whose fault is this?” is often the wrong question - what it means to approach intimacy from a same-team perspective This conversation is honest, practical, funny at times — and ultimately hopeful. Because intimacy is about feeling seen, understood, connected, and able to locate yourself inside your relationship again. Thank you to our partners for making this episode possible: - Play-Doh: http://walmart.com/playdoh: Shop Play-Doh at Walmart for a summer of imaginative play - Skylight: https://myskylight.com/becky: Get $30 off a 15-inch Skylight Calendar at myskylight.com/becky - LMNT: https://partners.drinklmnt.com/free-gift-with-purchase?utm_medium=sponsor&utm_source=goodinside&utm_campaign=agwp&utm_content=&utm_term=&rfsn_cn=EXCLUSIVE+GIFT+FOR+Dr.+Becky%27s+COMMUNITY: Get a free 8-count sample pack with your purchase at LMNT.com/goodinside](https://partners.drinklmnt.com/free-gift-with-purchase?utm_medium=sponsor&utm_source=goodinside&utm_campaign=agwp&utm_content=&utm_term=&rfsn_cn=EXCLUSIVE+GIFT+FOR+Dr.+Becky%27s+COMMUNITY - Oso & Me: https://www.osoandme.com/ Use the code OSOGOOD15 for 15% off clothes newborn through age ten

Dr. Jessica Shepherdguest
May 26, 202636mWatch on YouTube ↗

EVERY SPOKEN WORD

  1. 0:00 – 1:27

    Sex after kids: challenging the “fire goes out” myth with new survey data

    1. BE

      Today we're talking about sex life after having kids. We're going to be talking about what happens to desire, connection, and sexuality once people become parents. Now, I know what you might be thinking. In TV, books, media, it tends to always be the same caricature. Kids arrive and the fire goes out. Sex life is nonexistent. And that can happen sometimes, but new data from Hims and Hers suggests the story might need an amendment, or at least it's more complicated, and in some ways it's a lot more hopeful than we've assumed. Joining me today is Dr. Jessica Shepherd. She's a board-certified OB/GYN, women's health and sexual wellness expert, menopause specialist, and the Chief Medical Officer at Hers. We're going to look at what their new survey reveals about the evolving landscape of American intimacy, but also through a Good Inside lens, how emotional connection, identity, vulnerability, stress, self-knowledge, the ability to locate yourself, and even mental load around parenting shape our relationships to desire, to intimacy, to sex, and to ourselves. I'm Dr. Becky, and this is Good Inside. I'm so glad you're here. [gentle music] You just released a study, and I'm hearing that some results were surprising.

  2. 1:27 – 2:26

    Surprising stat: married people report more sex than singles

    1. JS

      Even surprising to me, you know, being a parent, married, is that what we found through the survey was how many times couples were having sex a week.

    2. BE

      Hmm. The stat itself, 'cause we're gonna go over a few numbers I want-

    3. JS

      Mm-hmm

    4. BE

      ... 'cause I, I love digging behind the numbers.

    5. JS

      Yeah.

    6. BE

      But let's start with what the numbers are. So you're saying married respondents in your survey-

    7. JS

      Yeah

    8. BE

      ... were having almost twice as much sex per month-

    9. JS

      Correct

    10. BE

      ... as singles. They were having sex nine times a month-

    11. JS

      Yes

    12. BE

      ... versus five times a month. And for anyone listening, I, and I know we agree on this, there's no magic number. Uh, there, there's no, like-

    13. JS

      There's no magic number

    14. BE

      ... there, if you're like, "I'm under nine, I'm over nine, I'm under five," it, no, no, no. Intimacy is so many-

    15. JS

      Yeah

    16. BE

      ... things. It, it's really about what works in your home. But I think the point of this conversation is to maybe, I don't know, untangle some myths. So this idea that passion kind of fades in long-term relationships-

    17. JS

      [laughs]

    18. BE

      Right? I mean, I think this is something people have been saying.

    19. JS

      Oh, I-

    20. BE

      So, yeah, what, that's not what you guys found.

    21. JS

      No, we did not find that.

    22. BE

      Yeah.

  3. 2:26 – 4:41

    Redefining passion: consistency, changing forms, and parenthood’s constraints

    1. JS

      And I think passion is underestimated-

    2. BE

      Hmm

    3. JS

      ... or undervalued to the sense of what we think. I think we think of it in polarity, right? Passion has to be what we see when we're maybe first dating someone or when we're first married, and that is, like, where passion needs to be at all times.

    4. BE

      Mm-hmm.

    5. JS

      And what we do find is that passion actually can stay consistent, but might have different forms in how it appears.

    6. BE

      Hmm.

    7. JS

      And because we have this idea of what passion is, we sense that if it's not at that level, then it's lost. Now, parenthood-

    8. BE

      Hmm

    9. JS

      ... obviously does throw in some other obstacles to-

    10. BE

      Yeah

    11. JS

      ... how we view our partner-

    12. BE

      Mm-hmm

    13. JS

      ... how we interact, the time that we have together, and how that time is spent, and so that can somewhat shift what that view is on passion, but it doesn't necessarily mean that the passion is gone.

    14. BE

      Yeah, and I think, look, you know, passion and familiarity, spontaneity and predictability-

    15. JS

      [laughs]

    16. BE

      Like, these are all the things we're all wrestling with-

    17. JS

      Yeah

    18. BE

      ... in our relationships, right? To some degree, those of us who have decided to get married or commit to one partner and have kids-

    19. JS

      Mm-hmm

    20. BE

      ... we're saying that part of me that's looking for predictability and stability and a foundation, um, that part of me is strong, right?

    21. JS

      Mm-hmm.

    22. BE

      That's, like, a big part of our lives, and that's why we talk about logistics all the time with our partners-

    23. JS

      Yeah

    24. BE

      ... right, when we have kids. "Okay, well, who's doing soccer, and what time are you home, and, you know, who's gonna pick up our kid at childcare?" Whatever it is, right? Um, but, but what I think is so interesting is that doesn't have to be at odds with our desire to be spontaneous or to also have passion.

    25. JS

      Right.

    26. BE

      And maybe there's something about the comfort of the structure and the familiarity that allows us to maybe say for the first time different things to our partner around, I don't know, our intimacy or sexual desires.

    27. JS

      I think it gets really real and raw when-

    28. BE

      Hmm

    29. JS

      ... parenthood is thrown into the equation, and when that happens, it really takes on a different role in how we play as partners, how we interact as partners. And you said that before, the spontaneity is sometimes lost, and so maybe it needs to be focused on again. But that spontaneity is lost because you do have a human that requires full attention and all hands on deck-

    30. BE

      Yeah

  4. 4:41 – 6:53

    ‘Wild, best ever’: why some parents report better sex amid the unsexy reality

    1. BE

      Yeah, exactly. Well, related to that nine times a month versus five times a month, something else you found, and I just have to s- read this, 'cause I wanna make sure I got it right.

    2. JS

      Mm-hmm.

    3. BE

      "Married respondents in your survey were almost twice as likely to describe their sex life as wild, the best it's ever been."

    4. JS

      Yeah.

    5. BE

      Did that strike you as surprising? [laughs]

    6. JS

      I think that struck me as, you know, as an individual married, as something that was, oh, well, wow, but when you actually think-

    7. BE

      Yeah

    8. JS

      ... of the time that you have to devote to sexual intimacy-

    9. BE

      Yeah

    10. JS

      ... and the unsexiness, I guess you could put it, as, you know, parenthood and child rearing, those moments do become more passionate, because many times in your day or the time that you spend in the day raising children is not maybe, you know, as you're walking around with maybe banana in your hair or, [laughs] you know, with throw-up on your shirt, is those moments do become more vivacious and- It creates that spontaneity of a, a moment where the passion is high.

    11. BE

      But tell me more about that. So I'm walking around, I have banana in my hair, I have, like, spit up on my shirt. Right? I maybe say to myself, honestly, like, "I actually forgot to shower today and maybe yesterday, too." Um, and then I, I actually... Help me connect the dots from there to best sex I've ever had. Like I, I'm even struggling to connect the dots.

    12. JS

      Well, many times before parenthood was thrown into the equation, we had time to prep, we had time to-

    13. BE

      Yeah

    14. JS

      ... look our best and, and maybe, you know, spend two hours in the mirror before, and now we don't. But the fact that we have someone who's still there available, who still can see us in our worst with banana in our hair [laughs] throw up on our shirt, but still is available for you emotionally and-

    15. BE

      Mm-hmm

    16. JS

      ... in a way that there is desire still there-

    17. BE

      Mm

    18. JS

      ... and intimacy, right?

    19. BE

      Mm-hmm.

    20. JS

      So the closeness of you spending with that person, albeit you don't necessarily look the same, and maybe your hair-

    21. BE

      Yeah

    22. JS

      ... is not perfectly, uh, curled, and you're not wearing stilettos-

    23. BE

      Right

    24. JS

      ... is that you still have that connection, and the connection, that it can be strong even though it's not sensed in that way-

    25. BE

      Yeah

    26. JS

      ... as you're, you know, maybe peddling kids off to school.

    27. BE

      Yeah.

    28. JS

      You're there.

  5. 6:53 – 10:44

    Comfort + vulnerability: how ‘we’ve been through real stuff’ improves communication

    1. BE

      Uh, so question, is part of maybe an explanation for the data, I'm just playing around with this so tell me, maybe I got it wrong, is okay, if I can have banana in my hair and spit up on me and, you know, maybe even my partner, like, saw me give birth, saw me bleed-

    2. JS

      Yeah

    3. BE

      ... through many pads, you know, all, all the things, you know, that happen after we have a baby, um, maybe I'm also more comfortable saying to my partner, "Hey," I'm just ma- y- I've never actually liked... I don't know. I've never actually liked missionary. That's not like a thing for me.

    4. JS

      Mm-hmm.

    5. BE

      I wanna tell you, like, never actually had an orgasm that way. Or, I, i- is, is that... I'm trying to connect this comfort, this what we've been through, to best sex of my life where I think some of, you know, having the best sex is about your comfort knowing what you like, knowing what you want, then feeling like I have someone I can say that to who might receive it, right? Like, none of this is magical. A lot of it comes from knowing yourself and communication and being with someone who you're comfortable enough to say it to. So is, is that part of the connecting of the dots?

    6. JS

      There's comfort, but you know what also comes-

    7. BE

      Yeah

    8. JS

      ... from this is vulnerability.

    9. BE

      Mm.

    10. JS

      The vulnerability that now that you have had a child, and, you know, as an OB/GYN, I know how that goes. All of a sudden, you know, in labor, you know, it may be nice and quiet with maybe you brought some background music, and then when it's time to deliver, now there's 28 people in the room.

    11. BE

      Mm.

    12. JS

      You are now being seen, you know, in a different way.

    13. BE

      Yeah.

    14. JS

      Now your partner is possibly, you know, how much they saw the delivery or, you know, whether it was C-section or not, there is a veil that has been removed-

    15. BE

      Yes

    16. JS

      ... and vulnerability now becomes a, a different part of the language in how you communicate.

    17. BE

      Yeah.

    18. JS

      So yeah.

    19. BE

      And, and just for anyone listening, I think there's a way you can make that link if you haven't yet where, you know, there's this narrative, I'm noticing it in my brain as we're talking, where, okay, how can you still have great sex with someone after they've-

    20. JS

      [laughs]

    21. BE

      ... seen you give birth, after they've seen you had diarrhea, like [laughs] whatever the things that happen when, you know, you've been married for a while-

    22. JS

      Yeah

    23. BE

      ... or you're cleaning up your kid's vomit together. You're like, how does that relate? Right? But I think there's this alternative narrative which is I can start a conversation with my partner very honestly saying, "Look, we've been through some real stuff together."

    24. JS

      Yeah.

    25. BE

      Birth, you watched it all, cleaning up, you know, Sally's vomit the other day.

    26. JS

      Mm-hmm.

    27. BE

      We've been through some real stuff, and that makes me think we're ready for a conversation maybe we've avoided, right? About, hey, what is our intimacy and sex life like for you? What do you want to be different? What are the things you think I think you enjoy and you're actually like, "No, I don't," and vice versa. And given how much we've been through, I feel like we have a foundation to say let's jump into that conversation.

    28. JS

      And we also have less time in the sense that before when kids weren't really necessarily on the scene-

    29. BE

      Yeah

    30. JS

      ... and we had more time to, you know, primp and-

  6. 10:44 – 12:03

    Mental load as a desire-killer—and how to talk about it without blame

    1. BE

      No, no, no, let's be honest. Let, let's talk about mental load-

    2. JS

      Mm-hmm

    3. BE

      ... and how it relates to, I don't just wanna say sex, it's to desire, to connection-

    4. JS

      Mm-hmm

    5. BE

      ... to what... And it, I'm sure it could be men, too, but I think about as a woman who's often the, often, not always, but the default mental load carrier-

    6. JS

      Mm-hmm

    7. BE

      ... if they're in a relationship with a man, how... I think that's kind of, it's not directly in the study results-

    8. JS

      Mm-hmm

    9. BE

      ... but I, I think you and I know there's something there in terms of at night-

    10. JS

      Oh, I know it's there

    11. BE

      ... or on the weekend. Okay, yeah, yeah, yeah. So tell us. Tell us.

    12. JS

      I mean, mental load, I didn't even really know that I was carrying it because, again, conditioning, right?

    13. BE

      Yep.

    14. JS

      So I think there needs to be a lot more honest conversation without blame, I think once you put blame into the category, then we're not gonna get anywhere, of what mental load really means, and as, as an emotional being for women who re- usually tend to tie-

    15. BE

      Yeah

    16. JS

      ... that mental load to their desire-

    17. BE

      Yes

    18. JS

      ... for their partner-

    19. BE

      Yes

    20. JS

      ... in a heterosexual, uh, relationship is very profound. And I think the more that we enlighten, without blame, I will always say that-

    21. BE

      Yes

    22. JS

      ... is that we can have a better understanding of what mental load means. But even for women who are listening, I had to learn this myself, over-functioning and not setting boundaries makes the mental load harder.

    23. BE

      Mm.

    24. JS

      And so I've had to learn to set boundaries.

  7. 12:03 – 14:26

    Concrete boundary shifts: stop over-functioning so resentment doesn’t build

    1. BE

      Can, can you give me an example of that?

    2. JS

      Yeah. Is when we realize that sometimes things may have to fall apart- And we can't fix everything will actually decrease our mental load.

    3. BE

      Ooh. So example, I'm just thinking 'cause this seems, you know, like something that can happen. You're thinking, let's say I'm married to my husband, and he's like, "Yeah, I'm taking the kids to soccer. I'm taking our son to soccer." And I'm thinking, "Yeah, but I found out that he needed new shin guards. I went to get them. I packed them. I got the water bottle ready with ice because if Bobby doesn't have ice in his water-

    4. JS

      Mm-hmm

    5. BE

      ... it's a total conniption, and I have the water bottle ready over here, and I also old school printed out MapQuest directions."

    6. JS

      [laughs]

    7. BE

      That probably didn't happen, but shout out to MapQuest days. Um, you know, I just like-

    8. JS

      Yeah

    9. BE

      ... I gave you the address, right? I, I, by the way, I might have even packed you a snack because you get cranky, my lovely husband, when you're out for too long. Okay. And my husband's like, "But I took him to soccer."

    10. JS

      Mm-hmm.

    11. BE

      Okay? So I'm thinking about that situation as what I might need to say to myself if I'm over-functioning, right, is I might say to my husband before I'm too resentful, "You know, I know soccer's your thing. It feels like it's both of our things. Like, I get it."

    12. JS

      Mm-hmm.

    13. BE

      "You take Bobby. I'm not there, but I get the water bottle ready. I do this. I know those things seem like tiny things, but it ends up where we're splitting the task and I'm holding a lot. I wanna let you know, by the way, for the sake of our relationship, I, I don't wanna keep doing things that lead me to feel resentful of you. You might not even know them-"

    14. JS

      Right

    15. BE

      "... so I should stop doing it. I'm not gonna do that anymore. And so a couple things might happen. Either you could transition to taking over the water bottle and the snacks, or you're gonna have Bobby on the sports field, and he's gonna be like, 'I don't have a water bottle,' and, like, I just actually believe you can handle that, so wanted to talk about that with you." Is that, that-

    16. JS

      That is exactly what I mean when we have to release some of that mental load.

    17. BE

      Yes.

    18. JS

      Or in my instance, when it... I don't know what my, my issue is, but stacking dishes in the, in the sink, like, they have to be stacked properly. And so when they're not stacked properly, then I found myself having to go rearrange the dishes in the sink to be stacked properly. So I was creating mental load.

    19. BE

      Mm.

    20. JS

      And so in order for me to stop that, I had to step away, push away from the table-

    21. BE

      Yeah

    22. JS

      ... of having the dishes perfectly stacked in the sink.

    23. BE

      Yeah.

    24. JS

      Mm-hmm.

    25. BE

      I, I, I think that's really, really important.

    26. JS

      Yeah.

  8. 14:26 – 16:59

    Reframing the nightly mismatch: sex vs mental load as the same need underneath

    1. BE

      And I always like to make it one more level concrete because look, I think I, I do hear this one dynamic, and I don't think this explains all of the he wants to have sex and I don't-

    2. JS

      Right

    3. BE

      ... dynamic. It's way too complicated, right? Sometimes it's the opposite. But what I do hear come up a lot in that dynamic anecdotally, both from Instagram, from my friends, is some version of I'm ha- I'm handling the mental load all day. Like, I'm thinking about, oh, we have to sign up for camp or else my kid's never gonna be in camp, and I'm thinking about the next set of bathing suits and clothes that need to be ordered now-

    4. JS

      Mm-hmm

    5. BE

      ... because if we get to a hot day, everything's too small from last year, and I'm thinking about the teachers' gifts, and I'm thinking about all the things. Then my husband's like, "Why don't you wanna have sex?" And I'm like-

    6. JS

      [laughs]

    7. BE

      ... "Are you kidding me?"

    8. JS

      You kidding me. [laughs]

    9. BE

      But I think the, the almost playful and same-team approach could be like, "Hey, we've been in this dance a lot. It gets to the end of the night. You wanna have sex. And I think it's one of your ways of saying-

    10. JS

      Mm-hmm

    11. BE

      ... I wanna be close to you."

    12. JS

      Yeah.

    13. BE

      I say, "Are you kidding me?" Which probably feels like I'm saying to you, "I don't want to be close to you." And I, I just... I think there's a way we can work through this, where I think for me one of the dynamics, beyond what I'm learning about my hormones, is there's so many little things that if I say any of them, they almost seem absurd, but it's the accumulation of managing them all, mostly in my mind, not even in the execution, that leads me to feel so depleted. I don't even have any energy to connect with you in that way. And I actually would like fewer of those to be on my list. But, but I'm also kind of, "Put this on a tray for you, okay? I'm gonna put this on a tray, hu- lovely husband. If you would think about the camp signups or the doctor's appointments or food on the weekends for our children who seem to eat-

    14. JS

      Mm-hmm

    15. BE

      ... every 90 seconds. Um, if you, if you wanna pick up one of those, I, I feel like we're both gonna win," [laughs] okay? Like-

    16. JS

      Yeah. Giving options, too

    17. BE

      ... and, and I do feel like that. Like, I wanna say to the person who has more desire at night, if, if you proactively say to your partner, "Hey, this is a crazy idea. Do you want me to help more, not with the execution and logistics of things-

    18. JS

      Yeah

    19. BE

      ... but in thinking about things? Do you wanna give me a couple categories?" Can you imagine if a partner-

    20. JS

      I know

    21. BE

      ... said that to you? I'd be like, "Right here, right now-

    22. JS

      Wouldn't that be-

    23. BE

      ... this is gonna happen"

    24. JS

      ... exactly.

    25. BE

      [laughs] Right here.

    26. JS

      Be like, "Right here."

    27. BE

      Right now.

    28. JS

      "Wherever we are."

    29. BE

      Yeah.

    30. JS

      "I don't care."

  9. 16:59 – 18:39

    Scheduling sex as a ‘container’ to rebuild rhythm (without killing spontaneity)

    1. JS

      ... and not getting frustrated. The other thing that I've heard from, um, a sex therapist-

    2. BE

      Mm

    3. JS

      ... was that sometimes to get us back into the rhythm-

    4. BE

      Yeah

    5. JS

      ... of what we would like to do sexually-

    6. BE

      Yeah

    7. JS

      ... schedule it.

    8. BE

      100%.

    9. JS

      Put it on the calendar. It sounds so-

    10. BE

      No

    11. JS

      ... weird, but really when you prioritize and you are like, "This is how I have to make time for it-"

    12. BE

      That's right

    13. JS

      ... eventually it won't be that you're scheduling it.

    14. BE

      That's right.

    15. JS

      But you may have to schedule it to get it back into the schedule.

    16. BE

      Uh, Esther Perel always says that, and I think about, you know, scheduling sex, scheduling anything. It's just saying this is a container.

    17. JS

      Yeah.

    18. BE

      What happens in that container can be whatever you want it to be.

    19. JS

      Mm-hmm.

    20. BE

      So people think, "Oh, that means we're so boring. We're so lame." No, you've just set up a container.

    21. JS

      Yeah.

    22. BE

      You can do whatever you wanna do inside the container, right? And, and I think going back to this mental load, sex, who has desire, who doesn't, what will it take for both people to be on the same page, in some ways I think this dynamic can get enacted where sometimes one partner's saying, "Hey, I wanna feel seen and important to you, and one way I experience that is through sex."

    23. JS

      Mm-hmm.

    24. BE

      And actually the other person's saying, "I wanna feel seen and important to you in a way that would actually Be true for me is if you take on some of the things in the family.

    25. JS

      Yeah.

    26. BE

      So in some ways, it's very, very different on the surface, mental load and sex, how does that relate?

    27. JS

      [laughs]

    28. BE

      But underneath, it's probably about feeling seen, feeling important-

    29. JS

      Yeah

    30. BE

      ... feeling real in the moment, feeling close. And so in that way, I find it's really, really possible as a couple to work through these things, 'cause y- you're actually kinda speaking the same language underneath.

  10. 18:39 – 20:09

    Ad break: hydration and LMNT electrolyte drinks for the parenting ‘mid-afternoon dip’

    1. BE

      There's a very specific moment in the day a lot of parents hit, usually in the afternoon, where you're still going, but everything feels harder than it should. You're answering questions, making decisions, trying to stay patient, and suddenly simple things feel complicated. Like, why does choosing a snack suddenly feel like a high-stakes decision? And most of us, me included, have the tendency to just push through it, power through. But I've started to pay more attention to those in-between moments and how something as basic as hydration can actually help. And that's what I like about LMNT's sparkling electrolyte drinks. They're designed for those exact moments, not just workouts, but real life, school drop-off, the transition between soccer and coming home, that mid-afternoon dip around 4:07 PM, and it's a simple grab-and-go can, no mixing, no prep, something I can just reach for when I need a small reset for me. No sugar, no artificial ingredients, just a way to support yourself a little better in the middle of a long day. If you wanna try it, LMNT is offering a free gift with any purchase. Just go to drinklmnt.com/goodinside. That's drink L-M-N-T .com/goodinside. [gentle music] Okay, something else you find

  11. 20:09 – 23:12

    Identity shift: why parents more often identify as ‘sexual people’

    1. BE

      is parents are significantly more likely than non-parents to identify as sexual. Do you identify as a sexual person? Parents say yes at 41.5%, and non-parents say yes at 29%.

    2. JS

      That is a big jump.

    3. BE

      Yeah.

    4. JS

      That is actually... Those, that, I was more surprised at that than maybe the first statistic-

    5. BE

      Yeah, so-

    6. JS

      ... that we went over. And-

    7. BE

      Tell me

    8. JS

      ... there are so many things that we encounter as parents-

    9. BE

      Mm-hmm

    10. JS

      ... that we have to be sure of what we're saying.

    11. BE

      Hmm.

    12. JS

      And we have to have more ability to make a stance and have the substance behind it-

    13. BE

      Hmm

    14. JS

      ... um, than when we didn't have to necessarily be as sure.

    15. BE

      Hmm.

    16. JS

      There is a certainty that comes with being a parent, that you have to show up a little bit more for yourself because-

    17. BE

      Hmm

    18. JS

      ... there are other people involved-

    19. BE

      Mm-hmm

    20. JS

      ... that also require your time and your effort.

    21. BE

      Mm-hmm.

    22. JS

      And that actually, so it's kind of like as you have to do that for someone else, it puts an impetus on you as well-

    23. BE

      Yeah

    24. JS

      ... to show up as that person-

    25. BE

      Mm-hmm

    26. JS

      ... in addition.

    27. BE

      Yeah.

    28. JS

      And it's, it's kinda like the domino effect.

    29. BE

      Yeah.

    30. JS

      When one domino's kind of pushed down, it kind of creates this, uh, momentum and shift to you as an individual as well.

  12. 23:12 – 25:42

    Hormones 101: perimenopause, desire vs arousal, and why HRT can help

    1. BE

      ... let me appreciate that insight," you know? Okay, um, 95% of parents reported that hormone treatment positively impacted their sex life. This is all me and my girlfriends are talking about, okay?

    2. JS

      Yes.

    3. BE

      Obviously-

    4. JS

      Mine too

    5. BE

      ... I'm in that age range.

    6. JS

      Yeah.

    7. BE

      Okay? The perimenopause-

    8. JS

      Mm-hmm

    9. BE

      ... range, and everyone is like, "Hormones. No. HRT." And so, uh, give me s- maybe just give me and anyone listening a little bit of a foundation of what that is, and then how, you know, maybe even the biological sense-

    10. JS

      Mm-hmm

    11. BE

      ... medical sense, how that relates to desire and sexuality and intimacy.

    12. JS

      Yeah, desire and sexual intimacy are, are two different things-

    13. BE

      Mm-hmm

    14. JS

      ... in a sense when we think of the mind and the body, right? So the body can be pleasured, and it has the ability to do that through our sexual organs, but the mind really plays a big part in that as well when we think of desire. We usually like to separate them, which we should not, and we really should interact with them-

    15. BE

      Hmm

    16. JS

      ... as one whole, holistic kind of interaction and experience. So we're born with all the hormones that we'll ever have, right? But they do start to increase in da, da, da, adolescence-

    17. BE

      Hmm

    18. JS

      ... which is why we have puberty and then You know, they're, they're sky high at that point

    19. BE

      Oh, yes they are

    20. JS

      But the body is this beautiful machine where it already is going to do what it's gonna do hormonally. So when we think of our, and I hate terming them this, but our sex hormones, for both male and female-

    21. BE

      Yeah

    22. JS

      ... will heighten at puberty, but then they will start to decrease-

    23. BE

      Yeah

    24. JS

      ... from a reproductive standpoint, when we're in our latter 30s for women, you know, typically; men have a different curve; and into our 40s.

    25. BE

      Mm.

    26. JS

      So if our desire, right-

    27. BE

      Is men's curve later? I just wanna clarify.

    28. JS

      Yeah. They actually, their testosterone starts to... It does decrease-

    29. BE

      Yeah

    30. JS

      ... but not at the rate that we see for women.

  13. 25:42 – 29:22

    Moving from fault to understanding: different hormonal curves and relationship mismatch

    1. BE

      Why do so many people, is it... I was gonna say women. I think it is more women, but maybe you can correct me, kind of suffer through hormonal changes kind of silently

    2. JS

      Yeah, because we've been pretty much taught that. You know, for me as an OB/GYN and Chief Medical Officer at Hers, we can do something really powerful for you as far as hormones. I've noticed that even as an OB/GYN, it is very hard for me to get women to say the thing of what they need.

    3. BE

      Huh.

    4. JS

      And so what we're able to offer for both men when we think of ED, that was very, very, like, I'm not gonna talk about that with my doctor, we were able to fill that gap with providing that.

    5. BE

      Yeah.

    6. JS

      And then for women going through perimenopause and menopause, having the ability to have a platform that offers estrogen and progesterone, but we also want to help you understand how important it is for you to take part in this message for yourself-

    7. BE

      Mm-hmm

    8. JS

      ... which also will help your relationship.

    9. BE

      Yeah. And so f- for, for, let's say there's a woman listening to this, 'cause I do think what I hear a lot in relationships where a woman is married to a man is like, I don't know, people are in, like, their 40s, let's say. I'm just piecing this together in my head. My husband wants to have sex all the time. I, like, I, I love my husband, I wanna be close in other ways, cuddle on the couch. I just don't want it. There's such a mismatch.

    10. JS

      Mm-hmm.

    11. BE

      Is part of that maybe related to the differing hormonal curves?

    12. JS

      Completely. Changing the narrative really has helped when we look at the hormonal shift of, like, what happens biologically.

    13. BE

      Mm.

    14. JS

      Like, you have, you have no control over that. Your ovaries are your ovaries, and how your brain tells your body to release hormones changes. But also, going back to the brain, which I love always making the connection between mind and body, is that the brain also has neurotransmitters, like our serotonin and our dopamine and our feel-good hormones, that are impacted by estrogen and testosterone and progesterone.

    15. BE

      Hmm.

    16. JS

      So if we're already in a biological decline of those, of course the interaction and communication between our feel-good hormones of serotonin and norepinephrine and dopamine are also gonna be impacted.

    17. BE

      Yeah.

    18. JS

      So when you make that connection and you're, you take away the blame from yourself, I do find that women can sit more in, "I'm gonna be okay. It's not my fault. I didn't do anything bad. Now what can I do?" Like, move to the next step and being like, "What can I do to help myself?" Especially now that we have ways to do that, and we're talking about it more.

    19. BE

      Yeah. And I think also it's really helpful, you know, if there's a partner who has a different hormonal curve, let's say it's the man-

    20. JS

      Mm-hmm

    21. BE

      ... to know, oh, this isn't rejection necessarily.

    22. JS

      Uh-huh.

    23. BE

      Like, right, this doesn't... I, I keep thinking about this one line that I repeated the other day, which is, can be used in so many contexts, like, sometimes hard things happen and it's nobody's fault.

    24. JS

      Yeah.

    25. BE

      Doesn't have to be her fault, doesn't have to be his fault.

    26. JS

      Yeah.

    27. BE

      There, there can be a biology to this. And for anyone listening, I also know sometimes it's not just biology.

    28. JS

      Right.

    29. BE

      Sometimes, you know-

    30. JS

      It's multifactorial

  14. 29:22 – 32:20

    ‘Sexual performance improves with age’: redefining performance, orgasms, and options

    1. BE

      100%. Okay, something else you found is that 51% of married respondents to your survey said their sexual performance improved with age. Now, I just first, like, uh, what does that mean, sexual performance? Like, I didn't know I was getting graded, so I need some information about what the grade is based on.

    2. JS

      Like, tell me what this meant.

    3. BE

      Yeah.

    4. JS

      Sexual performance really has to do with ease and comfort.

    5. BE

      Mm. Does performance mean likelihood to have an orgasm? Does performance mean-

    6. JS

      No, performance doesn't always have to mean-

    7. BE

      ... maintaining an erection? Like, what, yeah

    8. JS

      ... no, 'cause I will tell you-

    9. BE

      Okay

    10. JS

      ... with those two things, those actually decrease when we think of hormones, both erection and I guess you could say climaxing or having an orgasm.

    11. BE

      Now you're getting to the stuff everyone's like, "I'm sorry, Becky, do not let her move away from the subject."

    12. JS

      [laughs]

    13. BE

      I hear it. So can you tell me-

    14. JS

      Yeah, so that, that to me is a physicality or an, a, a outcome

    15. BE

      But that changes as-

    16. JS

      That absolutely changes for both men and women, which is why hormones are actually important, 'cause as we age and as we start to decline in hormones, both men and women, our organs don't necessarily do the same thing that they did when we were 20 Performance really is from a holistic standpoint of outcome of did I actually get the pleasure that I was looking for?

    17. BE

      Mm.

    18. JS

      Was I able to, uh, have connection with my partner? Was I able to, uh, have a, a better holistic experience than when you're younger and you actually don't even know what you're doing? Yeah, but you may have a great, [laughs] a great erect penis and lots of orgasms, but did you really truly have a great performance?

    19. BE

      Mm.

    20. JS

      And I think that's different. And how we look at sex, again, typically in the Westernized world, is not connection. It's actual, for, for lack of a better term for when we think of, uh, heterosexual, [clicks tongue] uh, relationships, is penis and vagina.

    21. BE

      Mm-hmm.

    22. JS

      That's really all we relate it to, but we don't relate it to connection.

    23. BE

      Got it.

    24. JS

      Yeah.

    25. BE

      Okay, so that's performance. But tell me more about orgasms as you get older, men and women.

    26. JS

      Ooh, I love this topic. Um, I think if we were able to, again, not always look at penile-vaginal sex and clitoral sex, there are ways to actually have good outcomes of sexual intimacy-

    27. BE

      Mm. Mm-hmm

    28. JS

      ... without looking at it that way, but that does happen.

    29. BE

      Mm.

    30. JS

      But there are ways to kind of, uh, redirect in how that happens, the duration of, of what happens using vaginal estrogen.

  15. 32:20 – 36:17

    Final takeaways: integrate sex into whole-life health and use ‘same-team’ conversations

    1. BE

      Mm. Yeah, so helpful. All right, if there's a, kind of to sum it up, like a TLDR-

    2. JS

      Mm-hmm

    3. BE

      ... on kind of what you were left with around this study.

    4. JS

      Mm-hmm.

    5. BE

      Like, what's the thing that y- that kind of keeps ringing in your brain?

    6. JS

      I think that there are two things that I wanna, you know-

    7. BE

      Yeah

    8. JS

      ... kind of, um, for me personally. Like, for me as an individual who deals with patients who come to me and see this all the time, and then even in my own personal life going through perimenopause, is that there is so much that happens to women, and I'm gonna single out women for this particular statement, that we inherently are not privy to or we're not told. And I, and I say that as a physician. And I think that how we're taught to actually treat women in midlife for so long was not encompassing, one, sex as part of that transition, and two, looking at the mind-body of women going through perimenopause and menopause in that the brain and the body play a big part in that.

    9. BE

      Mm-hmm.

    10. JS

      So I think we need to change that messaging and looking at it just as, "Oh, your ovaries just start, you know, stop giving off estrogen, and, and here we are," is that it's a whole body type of transition that we need to account for.

    11. BE

      Mm-hmm.

    12. JS

      Specific to the study, I would say if I were to leave a message for anyone listening, is to actually take a step back and look at your sexual health and sexual life as part of your entire life.

    13. BE

      Mm.

    14. JS

      'Cause clearly from this, we have seen from the statistics that maybe the connection part of sexual intimacy is much more of a whole body and a mind-body connection than we ever thought.

    15. BE

      Yeah.

    16. JS

      And that comes with what we were talking about earlier when we started, is the connection and the vulnerability of having a safe person there, or a person who's seen you in your best and your worst, can actually enhance the performance and actual sexual intimacy. [gentle music]

    17. BE

      There were so many things about that conversation that are sticking in my mind. I think the biggest thing I'm thinking about is the multitude of reasons why intimacy might be better or might feel a little off after kids. And if you're listening to this thinking, "Great, all the data is that all these people feel better. I am not in that percentage," nothing's wrong with you. And my hope is that there's something from this episode that makes you feel a little less ashamed, a little more empowered, maybe moves from fault mindset, whose fault is this, to understanding mindset, huh, what's really going on, and what is this all really telling me, right? If intimacy feels off, maybe there's something going on on the hormonal level. Maybe there's something going on around the mental load level. Maybe there's something going on around communication. There's so many factors, which actually means there's so many roads in. You know, I wanted to put something together to make this even more usable for anyone who listened to this and [laughs] is thinking, "Okay, this makes me wanna have a different kind of conversation with my partner. Maybe we can actually talk about this stuff from same-team perspective instead of enemies." And so I'm putting together my kind of top three tips around how to talk about intimacy and sex life with your partner. I'm gonna link to it in the show notes so it's easy for you to just go click, get it. Maybe you and your partner can even just look at it together. After all, when you say someone else made it, "Hey, this Dr. Becky woman put this together. What do you think?" Now, all of a sudden, it's the two of you on the same team, a little bit against me, that's fine, instead of you guys just kind of being apart from each other. All right, let's end the way we always do. Place your feet on the ground. Place your hand on your heart. [inhales] Let's remind ourselves, even as I struggle on the outside, [gentle music] I remain good inside. I'll see you soon.

Episode duration: 36:36

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