Low Libido in Midlife: You’re Not Broken. Your Body Is Keeping Score | Hotness Ep 10

Podcast Introduction 0:05

Welcome to Hotness, the podcast that Welcome to Hotness, the podcast that brings you practical tools to balance brings you practical tools to balance brings you practical tools to balance your hormones and rekindle connection, your hormones and rekindle connection, your hormones and rekindle connection, confidence, and desire in midlife and confidence, and desire in midlife and confidence, and desire in midlife and beyond. I'm your host, Dr. Liz beyond. I'm your host, Dr. Liz beyond. I'm your host, Dr. Liz Listister. Hotness is a safe space for Listister. Hotness is a safe space for Listister. Hotness is a safe space for honest conversations about menopause, honest conversations about menopause, honest conversations about menopause, sex, identity, love, loss, reinvention, sex, identity, love, loss, reinvention, sex, identity, love, loss, reinvention, and desire. Because you can embrace your and desire. Because you can embrace your and desire. Because you can embrace your hotness at every age. Welcome to hotness at every age. Welcome to hotness at every age. Welcome to Hotness, the podcast where hormones, Hotness, the podcast where hormones, Hotness, the podcast where hormones, confidence, and desire come back online.

confidence, and desire come back online. confidence, and desire come back online. This is our first spicy science episode.

Understanding Low Libido in Midlife 0:43

This is our first spicy science episode. This is our first spicy science episode. And we are going to talk about that And we are going to talk about that And we are going to talk about that topic that everybody talks about over topic that everybody talks about over topic that everybody talks about over cocktails, but not necessarily at the cocktails, but not necessarily at the cocktails, but not necessarily at the doctor's office. and that is not having doctor's office. and that is not having doctor's office. and that is not having any libido any libido any libido especially in midlife. Now I will tell especially in midlife. Now I will tell especially in midlife. Now I will tell you some things I've heard my patients you some things I've heard my patients you some things I've heard my patients say. One thing they say is Dr. Liz, say. One thing they say is Dr. Liz, say. One thing they say is Dr. Liz, honestly I would be fine if I never had honestly I would be fine if I never had honestly I would be fine if I never had sex again.

sex again. sex again. Sometimes they say my partner is so Sometimes they say my partner is so Sometimes they say my partner is so understanding. What I don't say out loud when someone What I don't say out loud when someone tells me that is I think to myself, tells me that is I think to myself, tells me that is I think to myself, yeah, they're understanding for now. yeah, they're understanding for now. yeah, they're understanding for now. But libido is not only about sex and But libido is not only about sex and But libido is not only about sex and even sex is not only about sex. It's even sex is not only about sex. It's even sex is not only about sex. It's about intimacy and connection in a about intimacy and connection in a about intimacy and connection in a partnership partnership partnership and also intimacy and connection with and also intimacy and connection with and also intimacy and connection with ourselves as individuals.

ourselves as individuals. ourselves as individuals. Now, first let me just be clear about Now, first let me just be clear about Now, first let me just be clear about something. If sex is uncomfortable, if something. If sex is uncomfortable, if something. If sex is uncomfortable, if you have vaginal dryness, if it's you have vaginal dryness, if it's you have vaginal dryness, if it's painful, there's pain at the entrance or painful, there's pain at the entrance or painful, there's pain at the entrance or pain deep inside like pelvic pain and pain deep inside like pelvic pain and pain deep inside like pelvic pain and your body's not responding the way it your body's not responding the way it your body's not responding the way it used to or it's not responding well.

used to or it's not responding well. used to or it's not responding well. It's normal not to want to do something

Pain, Dryness, and Hormonal Changes 2:11

It's normal not to want to do something It's normal not to want to do something that hurts. that hurts. that hurts. I often say that to women and they go, I often say that to women and they go, I often say that to women and they go, "Oh, yeah. "Oh, yeah. "Oh, yeah. Okay. So, I'm reminding you and I'm Okay. So, I'm reminding you and I'm Okay. So, I'm reminding you and I'm telling you that it is normal to not telling you that it is normal to not telling you that it is normal to not want to do something that hurts. That want to do something that hurts. That want to do something that hurts. That means your brain and your libido are means your brain and your libido are means your brain and your libido are perfectly appropriate.

perfectly appropriate. perfectly appropriate. So, what's going on in midlife with the So, what's going on in midlife with the So, what's going on in midlife with the physiology? physiology? physiology? We're wired to avoid pain and to move We're wired to avoid pain and to move We're wired to avoid pain and to move toward pleasure. However, in midlife, a toward pleasure. However, in midlife, a toward pleasure. However, in midlife, a lot of hormonal changes include a drop lot of hormonal changes include a drop lot of hormonal changes include a drop in really all of our hormones in really all of our hormones in really all of our hormones eventually. Once we go completely into eventually. Once we go completely into eventually. Once we go completely into menopause, menopause, menopause, we have most hormones at very low we have most hormones at very low we have most hormones at very low levels.

levels. levels. All kinds of hormones influence libido All kinds of hormones influence libido All kinds of hormones influence libido and sexual function. Progesterone and sexual function. Progesterone and sexual function. Progesterone influences sleep and influences mood. influences sleep and influences mood. influences sleep and influences mood. And without enough progesterone, we can And without enough progesterone, we can And without enough progesterone, we can feel anxious. We can have sleep feel anxious. We can have sleep feel anxious. We can have sleep disruption. And that's not necessarily a disruption. And that's not necessarily a disruption. And that's not necessarily a woman who is in the mood for sex.

woman who is in the mood for sex. woman who is in the mood for sex. Estrogen directly affects the tissues of Estrogen directly affects the tissues of Estrogen directly affects the tissues of the vulva, the vagina, even the bladder. the vulva, the vagina, even the bladder. the vulva, the vagina, even the bladder. Okay? So sometimes women midlife are Okay? So sometimes women midlife are Okay? So sometimes women midlife are having issues around those tissues. having issues around those tissues. having issues around those tissues. And it's not just a dry surface. It's a And it's not just a dry surface. It's a And it's not just a dry surface. It's a loss of elasticity loss of elasticity loss of elasticity underneath the surface. Okay? Sometimes underneath the surface. Okay? Sometimes underneath the surface. Okay? Sometimes I talk about the example of I'm trying I talk about the example of I'm trying I talk about the example of I'm trying to organize a drawer and I pull the to organize a drawer and I pull the to organize a drawer and I pull the drawer all the way out and I look behind drawer all the way out and I look behind drawer all the way out and I look behind it and something fell down like a pair it and something fell down like a pair it and something fell down like a pair of leggings and I try to see if I can of leggings and I try to see if I can of leggings and I try to see if I can wear them and I stretch the elastic wear them and I stretch the elastic wear them and I stretch the elastic waistband and like it makes a sound of waistband and like it makes a sound of waistband and like it makes a sound of crackling and sometimes the dust crackling and sometimes the dust crackling and sometimes the dust actually comes off in my hands. That is actually comes off in my hands. That is actually comes off in my hands. That is a loss of elasticity.

a loss of elasticity. a loss of elasticity. So once that happens, So once that happens, So once that happens, it could be painful to help fix it,

Desire, Safety, and Responsive Libido 4:10

it could be painful to help fix it, it could be painful to help fix it, right? So maybe right? So maybe right? So maybe at one point sex may have felt good. at one point sex may have felt good. at one point sex may have felt good. Hopefully it may have helped feel Hopefully it may have helped feel Hopefully it may have helped feel connection, uh maybe even fun. Uh and it connection, uh maybe even fun. Uh and it connection, uh maybe even fun. Uh and it starts to feel like an effort, right? Or starts to feel like an effort, right? Or starts to feel like an effort, right? Or worse, something to avoid. And in my worse, something to avoid. And in my worse, something to avoid. And in my experience with at least with experience with at least with experience with at least with heterosexual couples, the man feels heterosexual couples, the man feels heterosexual couples, the man feels terrible and does not want to do terrible and does not want to do terrible and does not want to do something that will hurt his partner.

something that will hurt his partner. something that will hurt his partner. So also to add to that, loss of So also to add to that, loss of So also to add to that, loss of elasticity, loss of blood flow, very elasticity, loss of blood flow, very elasticity, loss of blood flow, very important. And again, anticipating a important. And again, anticipating a important. And again, anticipating a painful experience is going to lower painful experience is going to lower painful experience is going to lower your desire. That makes sense.

your desire. That makes sense. your desire. That makes sense. Then there's an emotional layer, right? Then there's an emotional layer, right? Then there's an emotional layer, right? That's the physical. Now the emotional That's the physical. Now the emotional That's the physical. Now the emotional a woman might sort of say to herself, a woman might sort of say to herself, a woman might sort of say to herself, maybe I don't need sex anymore. Maybe maybe I don't need sex anymore. Maybe maybe I don't need sex anymore. Maybe I'm not a sexual person anymore. Maybe I'm not a sexual person anymore. Maybe I'm not a sexual person anymore. Maybe that part of my life is over.

that part of my life is over. that part of my life is over. And I would like to gently challenge any And I would like to gently challenge any And I would like to gently challenge any thoughts. If you're having any thought thoughts. If you're having any thought thoughts. If you're having any thought like that, I would like to gently like that, I would like to gently like that, I would like to gently challenge that because in many cases challenge that because in many cases challenge that because in many cases it's not that the desire is gone. It's it's not that the desire is gone. It's it's not that the desire is gone. It's just the conditions to support desire just the conditions to support desire just the conditions to support desire have changed. Okay. Another thing I have changed. Okay. Another thing I have changed. Okay. Another thing I always say is that libido is not only always say is that libido is not only always say is that libido is not only about sex. It's about life energy.

about sex. It's about life energy. about sex. It's about life energy. It is about desire and motivation. It is about desire and motivation. It is about desire and motivation. All right? It includes getting up off All right? It includes getting up off All right? It includes getting up off the couch to go do things you enjoy. the couch to go do things you enjoy. the couch to go do things you enjoy. Might be go to the gym, might be go for Might be go to the gym, might be go for Might be go to the gym, might be go for a walk. All right? So, it's not only a walk. All right? So, it's not only a walk. All right? So, it's not only about sex. So, that's why it's so about sex. So, that's why it's so about sex. So, that's why it's so important and I'm really passionate important and I'm really passionate important and I'm really passionate about this topic. So, we have this about this topic. So, we have this about this topic. So, we have this software that goes out of date and we software that goes out of date and we software that goes out of date and we don't have the update for the system.

don't have the update for the system. don't have the update for the system. Why do we want to reboot? What happens Why do we want to reboot? What happens Why do we want to reboot? What happens when we have great libido? Sex can when we have great libido? Sex can when we have great libido? Sex can become pleasurable again. The body can become pleasurable again. The body can become pleasurable again. The body can be supported hormonally. You can feel be supported hormonally. You can feel be supported hormonally. You can feel comfortable and connected in your body.

comfortable and connected in your body. comfortable and connected in your body. And you can feel confident. And you can feel confident. And you can feel confident. Self-confidence is a huge ingredient in Self-confidence is a huge ingredient in Self-confidence is a huge ingredient in that type of sexual that type of sexual that type of sexual and sensual interactions and not just and sensual interactions and not just and sensual interactions and not just with other people, but with yourself. with other people, but with yourself.

with other people, but with yourself. reestablishing reestablishing reestablishing faith in yourself, confidence in faith in yourself, confidence in faith in yourself, confidence in yourself, love for your body. yourself, love for your body. yourself, love for your body. When all this happens, desire can come When all this happens, desire can come When all this happens, desire can come back online. back online. back online. One more thing I want to say about One more thing I want to say about One more thing I want to say about libido for right now libido for right now libido for right now is that the model of you have to think is that the model of you have to think is that the model of you have to think about sex first, then pursue it, then about sex first, then pursue it, then about sex first, then pursue it, then have it, and then recover from it. That have it, and then recover from it. That have it, and then recover from it. That is an old model. Masters and Johnson's is an old model. Masters and Johnson's is an old model. Masters and Johnson's came up with that decades ago and it was came up with that decades ago and it was came up with that decades ago and it was revolutionary at the time. Nobody had revolutionary at the time. Nobody had revolutionary at the time. Nobody had even thought about putting these types even thought about putting these types even thought about putting these types of important human phenomena into words.

of important human phenomena into words. of important human phenomena into words. So it was groundbreaking at the time. So it was groundbreaking at the time. So it was groundbreaking at the time. But what we now know is that's a very But what we now know is that's a very But what we now know is that's a very male or masculine linear model. And what male or masculine linear model. And what male or masculine linear model. And what we have now is a model from Dr. Shirley we have now is a model from Dr. Shirley we have now is a model from Dr. Shirley Basson, which is a circle Basson, which is a circle Basson, which is a circle and into the circle are all the and into the circle are all the and into the circle are all the different factors that affect how women different factors that affect how women different factors that affect how women feel. Feeling safety, feeling feel. Feeling safety, feeling feel. Feeling safety, feeling psychological safety, feeling emotional psychological safety, feeling emotional psychological safety, feeling emotional and physical safety, feeling that you and physical safety, feeling that you and physical safety, feeling that you have a relationship with someone that have a relationship with someone that have a relationship with someone that you can trust, that you have good you can trust, that you have good you can trust, that you have good communication, that you work together on communication, that you work together on communication, that you work together on household chores and caring for others household chores and caring for others household chores and caring for others that might be on your plate, right? All that might be on your plate, right? All that might be on your plate, right? All of that becomes this circle and we of that becomes this circle and we of that becomes this circle and we distinguish between spontaneous desire distinguish between spontaneous desire distinguish between spontaneous desire which is that linear model or responsive which is that linear model or responsive which is that linear model or responsive desire. One of the questions I always

Hormone Support and Treatment Options 8:23

desire. One of the questions I always desire. One of the questions I always ask women is all right I understand that ask women is all right I understand that ask women is all right I understand that you're really not having sex very often you're really not having sex very often you're really not having sex very often at all. But when you do have sex of at all. But when you do have sex of at all. But when you do have sex of course first I ask does it hurt? And we course first I ask does it hurt? And we course first I ask does it hurt? And we talk about that and how to improve that talk about that and how to improve that talk about that and how to improve that and completely resolve that because sex and completely resolve that because sex and completely resolve that because sex should not hurt.

should not hurt. should not hurt. But also when you do have sex, for But also when you do have sex, for But also when you do have sex, for example, sometimes a couple does not example, sometimes a couple does not example, sometimes a couple does not have as much sexual interaction because have as much sexual interaction because have as much sexual interaction because of kids around the house or parents that of kids around the house or parents that of kids around the house or parents that they are caregiving.

they are caregiving. they are caregiving. And so then I ask, well, when you're And so then I ask, well, when you're And so then I ask, well, when you're away from your own home environment and away from your own home environment and away from your own home environment and you don't have all the tasks and you you don't have all the tasks and you you don't have all the tasks and you don't have all the distractions, don't have all the distractions, don't have all the distractions, do you have more desire for sex with do you have more desire for sex with do you have more desire for sex with each other? The answer is often yes.

each other? The answer is often yes. each other? The answer is often yes. Okay, so that's one piece. And the other Okay, so that's one piece. And the other Okay, so that's one piece. And the other piece is when you do have sex, does your piece is when you do have sex, does your piece is when you do have sex, does your body respond? Do you lubricate in order body respond? Do you lubricate in order body respond? Do you lubricate in order to enough to make sex comfortable? If to enough to make sex comfortable? If to enough to make sex comfortable? If you do, that's what we call good you do, that's what we call good you do, that's what we call good responsive desire. And that's just as responsive desire. And that's just as responsive desire. And that's just as valid. It's become it's a little bit of valid. It's become it's a little bit of valid. It's become it's a little bit of a a masculine point of view to value a a masculine point of view to value a a masculine point of view to value only the spontaneous desire. The only the spontaneous desire. The only the spontaneous desire. The response of desire is just as valuable.

I see this all the time in my practice. I see this all the time in my practice. Women who thought maybe that part of Women who thought maybe that part of Women who thought maybe that part of their life is over. I created a midlife guide that I'll link I created a midlife guide that I'll link to in the show notes and it walks you to in the show notes and it walks you to in the show notes and it walks you through all of these types of changes through all of these types of changes through all of these types of changes and what you can do about them. In other and what you can do about them. In other and what you can do about them. In other episodes, we will talk and I have done a episodes, we will talk and I have done a episodes, we will talk and I have done a great deal of material and videos on the great deal of material and videos on the great deal of material and videos on the safety of the right kinds of hormones.

safety of the right kinds of hormones. safety of the right kinds of hormones. And that's really important. And that's really important. And that's really important. Even women who aren't ready to use any Even women who aren't ready to use any Even women who aren't ready to use any kind of systemic hormones can use local kind of systemic hormones can use local kind of systemic hormones can use local treatment of the vulva, the vagina, treatment of the vulva, the vagina, treatment of the vulva, the vagina, which also helps the base of the which also helps the base of the which also helps the base of the bladder. All of those tissues are very bladder. All of those tissues are very bladder. All of those tissues are very important and you can use tiny microgram important and you can use tiny microgram important and you can use tiny microgram doses of estrogen. Sometimes you can use doses of estrogen. Sometimes you can use doses of estrogen. Sometimes you can use very low doses of a compounded cream or very low doses of a compounded cream or very low doses of a compounded cream or product made by a compounding pharmacy product made by a compounding pharmacy product made by a compounding pharmacy that can also contain a little bit of that can also contain a little bit of that can also contain a little bit of testosterone. Talk about that in a

Closing Thoughts and Resources 10:50

testosterone. Talk about that in a testosterone. Talk about that in a separate segment. separate segment. separate segment. But I will say very quickly that But I will say very quickly that But I will say very quickly that testosterone for women is an ingredient testosterone for women is an ingredient testosterone for women is an ingredient in libido. It's not the main issue for in libido. It's not the main issue for in libido. It's not the main issue for most women. most women. most women. It often helps, but it is often not the It often helps, but it is often not the It often helps, but it is often not the only thing. If there isn't a feeling of only thing. If there isn't a feeling of only thing. If there isn't a feeling of safety, if there isn't good safety, if there isn't good safety, if there isn't good communication, if there isn't a good communication, if there isn't a good communication, if there isn't a good environment for a woman to be able to environment for a woman to be able to environment for a woman to be able to feel sexual desire, testosterone's feel sexual desire, testosterone's feel sexual desire, testosterone's probably not going to make the probably not going to make the probably not going to make the difference to help. And in some cases, difference to help. And in some cases, difference to help. And in some cases, it could even cause a problem. Okay. If it could even cause a problem. Okay. If it could even cause a problem. Okay. If a partner is having medical issues and a partner is having medical issues and a partner is having medical issues and they cannot have as much sex, I don't they cannot have as much sex, I don't they cannot have as much sex, I don't want to do anything that's going to want to do anything that's going to want to do anything that's going to cause what we call a libido mismatch.

cause what we call a libido mismatch. cause what we call a libido mismatch. All right? But for this discussion today All right? But for this discussion today All right? But for this discussion today about low libido, about low libido, about low libido, there is so much that can be done about there is so much that can be done about there is so much that can be done about it. And I really encourage you, it. And I really encourage you, it. And I really encourage you, it's normal to not want to do something it's normal to not want to do something it's normal to not want to do something that doesn't feel good, but being able that doesn't feel good, but being able that doesn't feel good, but being able to help your body support it harmony and to help your body support it harmony and to help your body support it harmony and be able to be intimate in whatever way be able to be intimate in whatever way be able to be intimate in whatever way works for you, especially in the context works for you, especially in the context works for you, especially in the context of a partner relationship of a partner relationship of a partner relationship is really valuable.

is really valuable. is really valuable. valuable in a partnership but also valuable in a partnership but also valuable in a partnership but also valuable for just you. Libido is not valuable for just you. Libido is not valuable for just you. Libido is not only sexual desire, it is desire for only sexual desire, it is desire for only sexual desire, it is desire for life. It is vitality. It is life energy. life. It is vitality. It is life energy. life. It is vitality. It is life energy. And if you are And if you are And if you are not feeling like your libido is where not feeling like your libido is where not feeling like your libido is where you would like it to be, there's so much you would like it to be, there's so much you would like it to be, there's so much that can be done. And I want you to know that can be done. And I want you to know that can be done. And I want you to know that you can pursue it and you can feel that you can pursue it and you can feel that you can pursue it and you can feel better and you can have that aspect of better and you can have that aspect of better and you can have that aspect of your life again.

your life again. your life again. Thanks for listening to Hotness. Help Thanks for listening to Hotness. Help Thanks for listening to Hotness. Help more women find these practical tools by more women find these practical tools by more women find these practical tools by liking, sharing, and following the show liking, sharing, and following the show liking, sharing, and following the show as well as leaving a review. As a gift as well as leaving a review. As a gift as well as leaving a review. As a gift for listening, go to drlismd.com/hotness for your free midlife guide filled with for your free midlife guide filled with powerful support for your mind, body, powerful support for your mind, body, powerful support for your mind, body, and soul. Because you can embrace your and soul. Because you can embrace your and soul. Because you can embrace your hotness at every age.