Learn The Truth About Sex, Orgasms & Self-Pleasure

Sharon Stills, ND

Hi, ladies. Welcome back to Mastering The Menopause Transition. I am your host, Dr. Sharon Stills. Pleasure. Pleasure. It’s great to see you here today. We’re going to be talking about pleasure X release. Each has a good word. I wasn’t even thinking about it until I said it. I was, Oh, pleasure. This is going to be a pleasure-talk. If you are on the shy side or you are not used to talking about sex, masturbation, orgasms, or anything like that, you might want to put some headphones in or go to a place where you feel comfortable and can receive this conversation. If you are not in that place right now, then hit pause, and you can catch it later. But this is a really, really important topic. I did not want to have this summit without really going here again because it is so very important. 

The topic of masturbation, of sex, of orgasms, of pleasure, of just feeling good with yourself—one of our sponsors is Mystery Vibe, who makes these really fun toys that are also medicinal. They are awesome. They have an awesome doctor who works for them. Dr. Harper, she is on their advisory board, and she is a big voice if you check her out on Instagram in the menopause space. I am excited too, because I get to talk to her today and ask her all these questions about one of my favorite topics. She’s got this lovely accent because she is from England, and I am just thrilled to have you here. I forgot to ask you before we went live, so I am going to have to ask you to say your first name for me so I do not butcher it. If I use it here, I will just call you Dr. H. It is really lovely. Thank you for taking time out of your busy schedule to be here and to have this conversation with the women who are listening.

Dr. Shahzadi Harper

Oh, thank you, Sharon. Yes, I am Dr. Shahzadi Harper, and I am based here in London, and I am pleased to talk to you about a subject that often women in midlife and especially around menopause shy away from or find that their sex life and their libido have fallen off a cliff. I am a medical doctor, and in the UK we are called GPs, the ones who are in family medicine, but about eight or nine years ago, I really took it upon myself to become that menopause expert. I am the eldest of six sisters, and I knew I was going to enter that phase before everybody else. I saw how a lot of women seemed to change almost overnight, and I was single and still wanting to mingle, and I thought, This cannot happen to me. This cannot happen to me. I did not understand why we could not have a fulfilled sexual life, or if we wanted to. It is about choices. For me, it is very much about women having choices, having options, and not being forced into one route or the other. That’s why, as part of my menopause and perimenopause consultations, I talk a lot about sex, libido, energy, and stamina.

This is how I got to meet the Mystery Vibe team because I was looking for a way to help women get their mojo back, to get them feeling sexy and confident, and to get that mind-body connection going. One of the beauties of the Mystery Vibe’s vibrators and sex toys is that they are medical devices. I am very much about you getting your mojo back on your own first and masturbating for self-pleasure. But it is not just about creams, lotions, and potions. It is about getting that awareness back in your body and reconnecting and reigniting that mind-body connection before you go into a couple’s or partner’s play. I think masturbation is really healthy. It shouldn’t be seen as a dirty word. Even if I did not know about yourself, Sharon, if I thought about my upbringing, which was a very traditional Muslim upbringing, it would not have been part of the conversation. It is not something you get taught about in medical school. Yet here I am now with my patients, sending them away with a prescription for links to ethical porn sites, apps, and erotic apps that they can hear, and teaching them how to use a sex toy.

Sharon Stills, ND

I love you already. I could not agree more with everything you said. Yes, I was raised in New York in a nice Jewish family, but we did not talk about these things. I do not know. I think you have to be in a real hippie, outward-looking family to be talking about these things. I raised my kids as a hippie. It was always an open conversation. I always think to even infants or toddlers who are exploring and touching themselves: what’s the normal response? Do not touch yourself. They are: No, no, no, no, Jimi, do not be a bad boy. Do not touch them. instead of just taking the taboo away from it and taking the charge away from it and just being, Oh, yes, you are exploring. Yes, that does feel good there, because these are our bodies. I love what you say about our turn, on our terms, and with our choices. Let us talk a little for the women who need to hear about the medical reasons. Let us talk about why masturbation is healthy, why orgasms occur, and what the benefits are—physical, emotional, and mental.

Dr. Shahzadi Harper

You have to understand that at this time during that menopause transition, there are physiological and biochemical changes going on in a woman’s body, and the change in hormones and the drop in hormones, and particularly that hormone estrogen, mean that there are functional physical changes that are going on to our vulvas and vaginas that make them less plump, have less lubrication, and are more dry. You may, like me, have heard the terms vaginal atrophy or vulvovaginal atrophy. There is a decline in testosterone. While many women may have thought of testosterone as a male hormone, it is actually very important for us, including our drive, sex drive, and libido. The other hormone that declines is progesterone, which is really important for things like our mental health and also for sleep. Around this time, many women may be sleep deprived and lacking energy. There are so many physical changes going on that even if they do want to have sex, they are feeling dry and uncomfortable. Sometimes I hear the terms: duty sex, or it feels like barbed wire or shards of glass. Orgasms are important because not all women are at this point in their lives. Intimacy is important because not all women are at this point in their lives. I mean, after a 20–30-year relationship. Many women may be embarking on new relationships and new partnerships, and sex is intimacy. There is that bonding. It is communication. There is a release of hormones. The oxytocin, which you talk about as that love hug hormone. Also, we know that when you have an orgasm that is good from the point of view of your mental health, it helps you sleep better. It is calming, but also from a physical health point of view, because, as you may have heard people say before, use it or lose it. If you do not use your vaginas, if you do not have penetrative sex, then, often, the vagina can contract, it can shrink, and there could be dryness. The more activity we have and the more orgasms we have, in a way, can help to improve that lubrication and the mucosal environment. All the contractions help with our pelvic floor muscles as well. There are many different aspects. Looking at it medically from a point of view rather than just from a joyful sexual experience. Ultimately, it does lift you; it lifts your wellbeing.

Sharon Stills, ND

Yes. I mean, truly right. The mind-body, if sex really covers the mind and the body connection. One of my favorite things to write on my prescription pad because I do not prescribe pharmaceuticals. But I like to write on a prescription pad to drive it home: orgasms, love yourself, pleasure yourself. Because, like you said, I love that you said, starting with you first. Because before you go into a relationship and expect someone else to understand how to make you feel good, it is, I think, really important that you understand yourself first, that you understand what makes you feel good in what you like and what you do not, and that you feel comfortable doing that, that you can actually masturbate and look in the mirror at the same time and connect to yourself and not be disconnected. Let us talk about ways to masturbate, tools to use, and what is so medicinal about that. Because you think, Well, I am just going to go to a sex shop and get one of those big things and stick it in me. What is medicinal about that?  But there is something about the way these tools are created that’s just phenomenal.

Dr. Shahzadi Harper

For me, sometimes, when you look at it, first of all, stepping into a sex shop can be quite daunting. Yes, you can buy all of these things online, but they can look very daunting, and no one really explains to you how to use them. The reason I like the Mystery Vibe is because, particularly, it is not the poker; the main device is that it is created like two fingers. I often start women off with no penetration at all, even with that device, because it has different settings and vibrations. I almost get them to start off by pressing against the nipples just to familiarize themselves with those feelings that may have been switched off. I often think that libido drops around this time of menopause as part of a protective mechanism for women because you’ve only got a certain amount of energy in the tank and you are going to prioritize it. Maybe children, those things. It is almost self-preservation. When it comes to masturbation, sex, or orgasms, you really have not got much energy left; you might have switched off. It is about reigniting those nerve endings again. starts off by just pressing those vibrations up against your nipples and making yourself aware of what’s going on. Then, because it is like two fingers, I often sort of bend it and sit on it like a saddle. There is no penetration. Underside that perineum, you are just placing it there and pressing it up against your clitoris. This is exactly what I do. My consultation, I say, just pressed up against the clitoris because we notice clitoral changes as well. You can get clitoral atrophy when your clitoris shrinks. What we want to do is get blood flow coming to it; we want to reignite it, and then you can just gently, because it is nice and malleable, the device. You can insert a small, a little bit inside, just around the vaginal opening.

Then you can go at your own pace. often combining that with nice music and making some time for yourself. If you want to put on candles, an erotic app, or something. It is about making that time. I often say, You do need to have to put me homework in because it’s not just suddenly going to be like a magic wand is going to wave over you and everything is going to reignite again. Because it is almost this reawakening process going on. That’s why I particularly like the devices, because they are not intimidating. You can use or insert as much or as little as you want, and you can start slowly and just gently build up over time. I almost say to women who are in relationships: tell your partner that penetrative sex is off the table for the next set of months, six weeks, or so, while you rediscover yourself. Then, when you have that confidence back in your body and be aware also, that changes have gone on. You may need to use a good lube or a moisturizer; you may need to understand that it takes a little bit longer to get fired up; it may take a little bit longer to reach orgasm; but enjoy the journey and get that confidence in yourself before taking it into that couple-play situation. The other thing is that, especially with a Mystery Vibe, because they’ve got an app, it is always in a couple-play setting, so you can both play it and use it as the third party in your couple-play.

Sharon Stills, ND

That can be a lot of fun. I have a couple of questions just from what you said. You mentioned a loss of libido. Obviously, the hormones are part of preservation. Are there other things that women should be looking for from a medical perspective or an emotional perspective, things that can contribute to a declining libido as they are going through the perimenopausal menopausal transition?

Dr. Shahzadi Harper

Well, this is a really busy time for many women. Many women are juggling a lot of balls at this point in their careers—children, a lot of things. There are environmental factors and the layers of life themselves, and one in three of us will experience a loss of libido at any point in our lifetime. That has nothing to do with your perimenopause and your menopause because of financial strains or because a relationship is due. If there are things within your relationship—maybe there are unsaid things that are going on there that you haven’t communicated with each other about—then your libido is not going to bounce back until you can resolve some of these things. Understand that libido is multifactorial. It is not just hormonal. There are lifestyle factors involved. There are environmental factors involved. There are relationship and lack of communication issues going on. Maybe you have just had a baby, and you are tired because of that reason. Maybe you got young children; you might be a single mom; depression; those things can also impact libido as well. Those are things to be aware of.

Sometimes I think that perimenopause is a great time to have this medical check-in, just to hone in on yourself and break it down. You may need me to get bloodwork and blood tests done. Maybe you’ve got an underactive thyroid, which is making you feel tired. Maybe you’ve got an overactive one, which is making you feel anxious. There could be a number of things going on, and a lot of women experience things like iron deficiency anemia from heavy periods or because they are eating so much of a plant-based diet, vitamin B12 deficiency, and vitamin D deficiency. That could be all of these micro-level of things going on that you need to address to optimize yourself, rather than feeling that life is hard work and you are climbing up the hill all the time.

Sharon Stills, ND

For someone, and I love interviewing you because, Gosh, she said everything, it is like listening to myself talk. Listening to you is fun. I just want to re-emphasize that you made a lot of good points. But yes, I find that we, as women, get intimate on a social and emotional level first. Looking at what is unsaid in your relationship can often be, but men are the opposite. They connect, and they just want to go for it. But we need that emotional safety. Having those conversations, getting me help, or whatever you need to do. What do you think about women who just say, in general, I have always had a low libido and have never really been interested? What do you think about the range of libidos? Do you think that exists, or is it always a deficiency?

Dr. Shahzadi Harper

No, I mean, I think there is a range. We’re all individuals, and we all have different needs. Your partner may have different needs as well. I think problems can arise when there is that disparity in libido. But often, some women love the fact that, at this point, his is declining and now matching up with hers. She was never that interested in sex. She may get her dopamine high from running, but she likes to hang out with her friends more, do those kinds of things, or go to art galleries. I do not think anybody should be judged on their level of libido. It is when it feels like it is bothering you. Sometimes I see women because it is impacting their relationships, and that’s when the issues arise. I think everybody’s just different. Everybody wants different things in a relationship. I think we need to respect that and those choices. But I think what I would hope that women would understand from this as well is that there is hope out there. If you are worried that this is not quite you and that this is not how you want to live the next 30, 40, or 50 years of your life, there are potential choices, options, and treatment options out there for you.

Sharon Stills, ND

Yes. Agreed. What about, and we’re not going to be able to do it justice. But I just feel we can have this talk without just paying attention and acknowledging women who have been sexually abused and are dealing with that in their history. What would you say? Any words of advice on how to handle that?

Dr. Shahzadi Harper

I think this is often a time when trauma bubbles to the surface. I think many women who may have experienced a level of abuse or trauma in the past have often been able to put a lid on it. Then, when the hormones start to change and you start to feel a bit more vulnerable and emotional, these things can bubble to the surface. I would say, Go and seek some help, because there are many more women out there than you probably think that are experiencing similar things and understanding that it is not your fault. You are not responsible. Just maybe talking it through with someone who is a professional may help you move forward, or at least get an understanding and grasp of it, and for you to be in control.

Sharon Stills, ND

Yes. Yes. If that is you, know that there is help, and what we’re saying is that diving into playing with your toys may not be the first step for you. I just wanted to make sure we acknowledged that. Now we are going to go to orgasms. What a lead-in! But I do want to talk about orgasms; we tend to think sex is about reaching the orgasm. Then there are me, a woman who has never had an orgasm, and there are many powerful benefits of orgasms. It is one of my favorite sleep time prescriptions: have an orgasm and do not take Ambien. Have an orgasm that can help you sleep just as well, with no side effects except for feeling good. What are your thoughts on orgasm in general and what I just mentioned?

Dr. Shahzadi Harper

Well, I think for women, there is not just one type of orgasm; I think that is also important for men. They hit climax, and then they seem to have more and more of one type of orgasm that builds up to peak climax, and that is it. I think for some women, there can be much more of a plateau. The journey can be just as exciting. It does not mean you have to have this massive peak. Obviously, there is the peak, the climax, and then the decline, and for some women can have multiple types. But I think, again, understanding that our bodies are slightly different, it can take longer to reach that peak. But that does not mean to say that we have to reach our peak too; we should not always be aiming for it in a way, we just enjoy the journey. Do not overthink it or overplay it. Otherwise, it brings a level of anxiety into the moment as well. I think that even men feel pressure these days to think that if the woman has not achieved an orgasm, there is something wrong with them.

If you are in a heterosexual relationship, there can often be that scenario where she starts to feel anxious that, Oh my goodness, is it going to happen? Is it going to happen? He picks up on that anxiety, and he is then thinking, Am I not good enough?  Then suddenly, one party can end up faking it. Just let us get it over and done with. I think you should just communicate with your partner. I really enjoyed that. Yes, you may not have had an orgasm, but that does not mean to say that you did not enjoy the experience, because I think it is about intimacy more than orgasm, which is what I am going to say intimately. With that, you can still sleep well as long as you are not frustrated and you did want to reach that orgasm thing. But I think that going back to that bonding, that intimacy, and that release of oxytocin, I think that can be just as good from a sleep benefit as from a wellbeing benefit.

Sharon Stills, ND

I love that intimacy over orgasm. I think that’s a banner or new kitchen mat.

Dr. Shahzadi Harper

Yes, let us do that. Yes. That’s a great idea.

Sharon Stills, ND

But it is really true. I mean, I know, just personally, I love a good orgasm, but there are times where, as you said, I am just enjoying it and I do not need to have an orgasm. You need to tell your partner that they do not have to feel like they have to do that for you. then it becomes right. What you said is that life is always about communicating.

Dr. Shahzadi Harper

Do you not have to feel like you have to, but do you feel that there is that pressure from men these days? Sometimes, I have to explain to my boyfriend. I have to say to him, You were just this; did you have an orgasm? I’d say, Well, no, but I really enjoyed our time together. It is almost like you have to calm them down a little. It is okay. It is okay that I did. It is okay.

Sharon Stills, ND

Yes, I would say, in the moment, do not worry. I do not need to have an orgasm. I am perfectly happy. It really is about communicating that. I am curious if you could just take us through, briefly. I do not know, but what is it going to be like to see you for a consult? Because it sounds like you do lots of fun things and ask lots of fun questions.

Dr. Shahzadi Harper

I think and I would say that I asked some of the questions that maybe you would like your doctor to ask, but they do not ask, and maybe you are too afraid to bring them to the surface yourself. When someone comes in, they are often different. People have different priorities. It is important to recognize what her priority is—what is it that she wants to get out of the first consult? Because not everything will be resolved in one consultation. It is going to take a little bit of time to get there. Yes, I mean, I will always ask things like, Well, how is your libido? Does it bother you? Many a time in the first consult, women will say, No, it really does not bother me because, honestly, they do not have the energy. They are more worried about not sleeping, feeling anxious, maybe their hot flushes, or their brain fog. I am okay. We address things in different stages. 

The second time, she comes because she’s got this energy and she’s feeling back to her usual self, or more like her usual. Then again, ask the questions. Yes, I really had, and I would not mind having some of that back. Or that women come in and say, I do not want to feel like brother and sister in my relationship or flatmate, avoiding each other, going to bed. It is very much a personalized and tailored consultation to talk to you when you come in. But it is bringing all of those years of experience and also, me unabashedly start asking these questions in a safe space. We will talk about sex parties, we will talk about sex toys, and we will talk about different types of relationships. I think more and more of us at this point in our lives are thinking slightly differently about our sexual lives than we ever were before. You are not pushing the boundaries a bit. I think women are pushing the boundaries a bit more for couples.

Sharon Stills, ND

I agree. I see that too, in practice, and that is the way physiology is, right? The body is going to first focus on survival before it is going to focus on procreation, having babies, and so forth. Yes, as you get your energy back in your sleeping because who wants to have sex if you cannot even sleep and you are exhausted? That’s a great point. The last thing I want to just ask you is, because you mentioned it earlier and probably some women heard it, but you said ethical porn. I think I would love for you to talk, because I love that. I think we tend to make blanket statements like porn is bad. Porn is an addiction. Get it off your computers. There is this whole movement of ethical porn, and I’d love for you to just introduce it to the listeners who haven’t heard of it before.

Dr. Shahzadi Harper

To be honest, maybe about six or seven years ago, I would have been in a similar place, as were many of the listeners, thinking, Hang on, what is she talking about, this ethical porn?  I think, when we often think about it as degrading and derogatory to women, but ethical porn is consensual. I mean, often they are female directors making porn for women. It was and is, for women in that stronger place, in that more controlling place, an enjoyable place. There are lots of different types of it out there. For me, it is about women feeling respected, safe, and choosing, rather than being maybe the old-school type of porn that has that more demeaning side to it. I think, when I particularly signpost women to one site that I am familiar with, which is the Erica Lust Cinema, which is one that I tend to use, and I send women links to it, I would often have tried everything before I passed it on to my patients. I think it can add another dimension to that relationship. Again, the same thing happens with having a sex toy, bringing another dimension into the relationship. That’s why I will safely advise Mystery Vibe. I will safely advise  Lost Cinema to my patients because I have gone down and explored it and I can share it with them.

Sharon Stills, ND

I love that, yes. I believe in pretty much whatever I prescribe to patients. I like to experience myself unless it is just something that is not possible.  .

Dr. Shahzadi Harper

Actually.

Sharon Stills, ND

When I was, Oh, Mystery Vibe is coming on board and they said they want to send me some samples. I was, Yes, this is going to be fun, indeed. The best kind.

Dr. Shahzadi Harper

Yes

Sharon Stills, ND

More fun than, eating something healthy or right. Well, this has been fantastic. Where can the listeners find you and Mystery Vibe and learn more.

Dr. Shahzadi Harper

I am on Instagram; as you mentioned, I am Dr. Shahzadi Harper. @DrShahzadiHarper, and my website is www.theharperclinic.com. I also have a book, The Perimenopause Solution, for women entering that stage. Also, Mystery Vibe is on Instagram, @MysteryVibe, as well. Yes, do connect with us. If you’d like to know anything or ask questions, DM away, I like to interact with my followers.

Sharon Stills, ND

Wonderful. Well, thank you very much. This is the first time I am interacting with you, and I am a raving fan now. This was phenomenal. I think what you shared is really helpful for the audience, so go follow her and just digest everything we talked about. I love what you said because it is very true from the physician’s standpoint that not everything is going to be handled in a consult. It is the physician’s job to figure out what’s most important and to create a plan. I think for those of you listening, you can take that same approach to everything we discussed. We do not expect you to turn off this interview and go watch ethical porn, change your relationship, play with toys, or do all of these things. But just sit with, Ooh, that really felt like something I wanted to follow or that interested me, and just go along your own path, discovering because, as Dr. Harper said, it is all about the destination we see. We hear that a lot. It is really, really true in this situation. It is about the journey. Be present, enjoy the journey, and get my oxytocin flowing. It is only going to do the body good. Thank you much, Dr. Harper, for being here and sharing and for the work that you are doing in the world. It is phenomenal. Thanks to everyone for listening, and we will see you in the next interview.

Dr. Shahzadi Harper

Thank you.