Dr. Ade
Welcome to the Modern Midlife Collective podcast. The place where we get unapologetically real about thriving in midlife health, hormones, and everything in between.
00:12
Dr. Jiliian
I'm Dr. Jillian.
00:13
Dr. Ade
And I'm Dr. Aday.
00:14
Dr. Jiliian
Together, we're your guides to navigating this powerful season with confidence, strength, and the wisdom you deserve. Today's conversation. It's juicy and overdue. Welcome to the Modern Midlife Collective. Today, we're talking about something that's rarely discussed out loud but deeply felt. Low desire, pain with intimacy, lack of sexual stimulation. These aren't just personal problems. They are common, they're treatable, and they're not a reflection of your worth, your womanhood, or your relationship.
00:54
Dr. Ade
Yes, this episode is for every woman who's ever thought, where did that libido go? Or why does sex feel different now? So it's not in your head. And we're going to really unpack why it is happening. What's happening. Is it your hormones, your brain? Is it your relationship? So let's drop the shame and let's talk about this. Just be real about it, you know, using our experiences, what we've seen in clinic and more. So let's get into it. So let's start with something simple but widely misunderstood. What does libido mean? Dr. Jill?
01:26
Dr. Jiliian
Yes. Libido is not just wanting sex all the time. It's your interest. It's your anticipation, your mental openness to intimacy and even fantasy as part of libido. And your libido changes. It changes with stress. It changes with medications. It changes with, you know, stress from physical stress, from illness, emotional stress, relationship stress. Your hormones, of course, affect your libido, so hormone changes will affect it better, worse, your menstrual cycle. And this is due to your hormonal changes during your menstrual cycle, before and after your actual cycle. The hormone level changes can affect your desire. We mentioned illness and we mentioned the relationship dynamics. There is a biopsychosocial model. So there's biology that affects your libido and desire. There's psychology. The brain is your biggest sex hormone. The brain is the biggest sex organ that we have.
02:33
Dr. Jiliian
So I think if our brain is right and our thought process is right, other things will fall into place. The. They may also need workflow. They may also need you to, you know, understand what's happening in these various other places. But the brain is a big one when it comes to desire. And then there's your social environment. So all of those three things, biology, psychology, and social environment, govern your libido. And your desire. And in long term relationships, spontaneous desire is not always the norm. Even in short term relationships. Some women, some men don't have spontaneous desires. Spontaneous is like, not that you're thinking of sex all the time, but you may see something and be stimulated. It's a very quick thing. You see your partner, you're ready to go, you have a stressful day, you may be ready to go.
03:28
Dr. Jiliian
The intimacy and sex may be the way to relax you. Whereas oftentimes women have more of a responsive desire to. Sometimes they may already be in the act of intimacy that they may not have initiated. But in that act of intimacy, they may then start to have more of that desire. They're responding to a situation. It may not even be in the act of intimacy, but your partner may do things or say things that then you have desire where you may not have thought about it upright. And there's nothing wrong with that. That is a normal desire. But it may have changed. So it could have been that when you were younger, you may have been more spontaneous and as you got older you may have shifted to become more responsive.
04:18
Dr. Jiliian
And then I think sometimes that causes an issue because that change, your partner may not identify as being a normal response. And then you start to think it's not normal.
04:29
Dr. Ade
I feel like sometimes it's seems a little bit more complicated for us women. Women will often say, I just don't think about it. My husband or my spouse or my partner or whatever comes to me and you know, they're ready to go. But I just, I could go without it. So I wonder sometimes, you know, is it that women just, I mean, what happened? I mean, there's like you talked about, there's so many different things like in can impact, you know, libido, you know, how your relationship is, what's happening in your relationship, you know, traumatic experiences that might be related to that subject, right? Stimulation. You know, there are certain things that can accelerate your wanting to be intimate and have sexual, you know, sip stimulation.
05:15
Dr. Ade
So what are some things that you have found, other things that you can see that may get in the way of libido or why does it feel. Feel like for us women, it's like it takes a lot more than our male counterparts. I hope I'm making sense.
05:30
Dr. Jiliian
You're making sense. And you know, I thought about this a lot and I disagree that we're more complex. I think we're just starting, you know, we're starting from behind in this game. When you think about the amount of money, research, medications, time, that's spent on this very problem in men. It's humongous. There's so much I just can't. When you compare it's ridiculous, you know, the amount of like FDA approved medications that they have for men. There are over 26 medications for men and their desire and their erectile dysfunction. Whereas women are often just dismissed. We're just starting from so far behind. Nobody looks at this. It's not life or death. Meanwhile, it's not life or death for men, but yet there are people that are helping them that specialize in this.
06:24
Dr. Jiliian
And for women, we're just told you're getting older and things change and it's just not the truth. And we haven't talked about our intimacy and our bodies in this way for so long. Our bodies were made to give birth to other lives. And that's the focus of our attention when it comes from, you know, medical professionals, is, you know, keeping us healthy to give birth. And then, you know, the attention is taken away, it seems. But if we had that time and if it had been seen as something that's just as important, their desire in a women as it is in men, we would be so much further along. We have two FDA approved medications for desire, contrary to the 26 that men have. Right, we have two. So we're not complex.
07:13
Dr. Jiliian
I mean, our bodies in general are very complex and amazing the things that we do. But in comparison, I think when it comes to our sex lives, it's more about communication and more about understanding our bodies and communicating our changes. Because these changes happen in men as well. They just can get help a little quicker if it's an issue for them.
07:35
Dr. Ade
Yeah, I think it can look different for each woman as well too. There are some women that just have a very high libido and some women don't. So I think some women might feel like something is wrong with them. Like, why don't I feel like this? And you know, I feel like if you're in that situation, of course I think it's important to really look at the whole picture. You know, is it a hormonal thing? Is it psychological? What else is going on there? If you need to see someone, of course it's happening. But let's talk a little bit more about what are some of those changes, especially hormonal, that could happen that might lead to some of those changes in libido?
08:17
Dr. Jiliian
Well, you know, we love to talk about the hormones, so you're right. So yes, let's talk about the hormones. When you're talking About a woman in midlife that may be experiencing perimenopause or someone who may already be postmenopausal. Low estrogen levels are. Can significantly affect our stress life or our sex life and our stress life. Right? Both of those things are affected. But as that estrogen level decreases, it can affect the end organ. So our vaginas are affected, but then also our brains are affected. We have estrogen receptors all over our brain, so estrogen's working everywhere. So estrogen, if it is affecting our vaginas, in the vagina, it's leading to low estrogen environment, leads to dryness, and that can lead to pain with intercourse. And if you have pain with penetration, even with touch, your body is not going to want it.
09:17
Dr. Jiliian
Your brain will not desire something that's painful, right? So that has to be corrected. You do not. Any type of pain that you have or discomfort, even slight, has to be corrected, or your brain will make a habit of not wanting it, pushing it away. And then sometimes you're gonna have more of a trauma response if you continue to try and push it without addressing the pain. And it can lead to even more pain. So that's why testosterone is also something that is really important for our brains. And testosterone is something that is shown that it increases desire and arousal. And of course, we have a more arousal that also will feed back into more desire. So if you know that something isn't painful, but also will bring you great pleasure, then you will want more of those things. And so testosterone can do.
10:13
Dr. Jiliian
Can do both of those things.
10:15
Dr. Ade
Sure. I mean, it's so interesting how the hormonal shifts can impact both men and women alike. Like you said, you know, this is not just a male thing. It can happen for women, too. It's just that we just. I think it's great that we're all talking. There's more talk about libido for women now because it's important for us. Sexual health is important for women, too. But we also know that there's other things, too that impact us, right? Like I know some women that even just body confidence, right. Feeling great in your body also can impact the way you feel about wanting to engage in any sexual activity that may not be you. And we also have things like medications that might cause problems too. One of Those are those SSRIs and SNRIs. Those are medication classes for depression, and they work great for depression.
11:04
Dr. Ade
You know, they improve your energy levels and just your, you know, overall outlook. But one of the side effects, right, are you Know it. They also blunt libido. So that's something that if you're on medications like that, you might want to see if there is any alternative that might be able to help. Because, you know, I think some of these medications, if I remember correctly, can lower your testosterone levels, too. So how you feel about your body, you know, being intimate, medications, stress, sleep, right. Chronic illnesses. We talked about mental health issues. Trauma is a huge one for women. Resentment from relationships, so many factors can come into it. So often when women come in and say, you know, they heard somebody was on hormones and it helped them, you know, it's great, that's it works.
11:53
Dr. Ade
But we have to look at the whole picture, too. It's not just optimizing your hormones that will work for you. So.
11:59
Dr. Jiliian
Absolutely. And a lot of women are on antidepressants, and especially I see in midlife, people who haven't been on antidepressants before are now on antidepressants because of mood changes that may have come from midlife, from perimenopause. They're experiencing these changes and they're put on antidepressants first instead of hormones, even. And for desire, specifically, your desire, your anticipation, like we said, you need these. An increase in some neurotransmitters and a decrease in others. The neurotransmitters come from your brain. They send signals. And dopamine is our happy pleasure signal. You know, some of the things that we do, they increase dopamine, they make us happy. And we need more of that excitatory signal and less of things that inhibit us. So we are going to be looking at norepinephrine and serotonin. These things we need less of. When someone has depression, they're getting more of those.
13:07
Dr. Jiliian
They're using these SSRIs, selectoceratonin reuptake inhibitors. So they're inhibiting, taking it up, taking it away. So you're going to have more serotonin. So you're going to feel good, but you're not going to feel like sex. So we have to figure out how we're going to feel good and feel like sex. Right. So then we have to either figure out in me, I am not a psychiatrist, or they don't treat depression or anxiety. Right. So I would be working with a professional. So I would never tell somebody to come off of their medications, their depression medications at all. That's not my place. But we would have to figure out how can we work around this and then maybe send you back to the psychiatrist to see, okay, have you tried other medications?
13:59
Dr. Jiliian
There are some that will be less likely to lead to a low desire if this is something that you find to be an issue. Or we have to think about other medications that we can add in that will be able to keep your antidepressant, but can add something else that may stimulate that receptor, your dopamine, in a different way.
14:22
Dr. Ade
Yeah, I think that's a great point. What you brought up about having women in midlife having symptoms of depression, when in actuality it is. It's probably perimenopausal changes. And again, there are. I'm not saying that there's no place for medications, but it's great to be able to talk to someone and see maybe this is, in fact, the issue, because it is possible that maybe when you do go on hormone replacement, for example, you know, those symptoms lift and you're able to wean off of those SNRIs and SSRIs, and maybe you don't. You no longer need those.
15:03
Dr. Ade
So I think it's great to be able to have someone that's willing to look for the root cause and look at your symptoms, other things that are going on with you, look at your hormones and say, hey, maybe this is something we can consider that will not only help your mood but also improve your libido as well. So great point. I'm glad you brought that up. So, yeah, I think, you know, some of the things that we hear sometimes, too, are those phrases. And, you know, maybe your doctor or somebody might have told you know, just relax. You know, if you're too stressed out and that's. You're not having a libido. What are your thoughts about that? Dr. Jill?
15:37
Dr. Jiliian
Yes, exactly. There are so many people that hear this. Just have a glass of wine and relax. It'll be okay.
15:44
Dr. Ade
Right?
15:46
Dr. Jiliian
That is actually really dismissive and oversimplified. It may sound like harmless advice, but it's really not. I think the idea likely came from just loosening up, you know, and they want the woman to, like, loosen up so she can enjoy herself and enjoy intimacy. And yes, alcohol can certainly reduce your inhibitions, and that is something important. We need lowered inhibitions in our brain and more stimulation, more desire for excitement. However, alcohol also dulls sensation, reduces blood flow, and it makes arousal and orgasm more difficult. And the same thing happens with men. The same thing happens in men. They have, after alcohol, decreased arousal. It takes longer to have, you know, an ejaculation. So that it's not good advice. I think also maybe another reason it came about was because of that response of desire.
16:46
Dr. Jiliian
And sometimes if you're getting wined and dined, right, and somebody's your partner is like paying attention to you and paying attention to your needs, that does get you more in the mood. But it's not as simple as just have a glass of wine and relax.
17:01
Dr. Ade
Right? Definitely. I think desire, I think, is multifold. It. It's not just one thing. It is, you know, that glass of wine can relax you, but, you know, think about all those other things too. Especially if you're having these hormonal changes. It can actually make some of your hormonal symptoms worse. So again, you know, don't just take one person's advice, really. If you are seeing that this is a problem for you, I think it's best to kind of get some help, some real help when somebody's looking at your symptoms as well. So let's switch gears a little bit and talk about one of those. The biggest intimacy issues, which is pain. Midlife women will come and say that they're having. I think one of the big ones is vaginal dryness, burning or irritation. You know, urinary urgency, pain with intercourse.
17:49
Dr. Ade
Maybe they've been in situations where they've had maybe frequent urinary tract infections. And they. It's just the fact that they think it's going to happen again is another reason why you don't even want to have it. Like, every time I have this, I get BV or urinary tract infections or yeast infections. So what are your thoughts about that, Dr. Jill? I'm sure you see this a lot in your practice.
18:12
Dr. Jiliian
Yes, absolutely. These are signs of genitourinary syndrome of menopause. And it's a compilation of the signs and symptoms that you just discussed. And in fact, many women during this time do start to have those frequent bladder spasms, urinary frequency, urgency. And they are often diagnosed with issues pertaining to the bladder. And they're actually not bladder issues, but rather it's a response to low estrogen. And low estrogen leads to spasming of the bladder. Your bladder, it's. Estrogen is very soothing to many parts of the body, but it's very soothing to your bladder. Your bladder has estrogen and testosterone receptors. And so when those levels go down, the bladder's irritated. When it's irritated, it squeezes. And when it squeezes, you feel like you have to go to the bathroom. And then often people are like, I had. I ran to the bathroom and like, I peed.
19:12
Dr. Jiliian
And then I went back and very little came out. But I had to pee again, but there wasn't much to void. And this is can be a sign of genitourinary syndrome of menopause. And the treatment is local estrogen. So even people who are on hormone replacement for their systemic issues, maybe their hot flashes or night sweats, local estrogen is so important for this. In fact, the American Urological Society, the big urology group and urologists, they take care of men and women, but we think of them mostly as taking care of men and we think of gynecologists as taking care of women. But in urology literature they just recently had their guidelines on the treatment of genitourinary syndrome of menopause and talk about the importance of local estrogen in women.
20:07
Dr. Jiliian
And I think this is just huge that this big society dropped these guidelines about the care of women in noticing the importance of vaginal estrogen on their organ system as well. So this is something that can be taken care of so easily. Ish, you know, and it's not just vaginal. And vaginal estrogen can be safe for those who have estrogen responsive cancers as well because it's a local estrogen with a negligible systemic uptake. So if we draw your blood, we shouldn't see any increases in your estrogen level. But there are other things. There are non hormonal treatments for the vagina as well, like dhea, which is a pro hormone, you know, that leads to testosterone and estradiol. And then there's even oral medications like ospimiphene. It's an oral medication, It's a selective estrogen receptor modulator.
21:07
Dr. Jiliian
So it increases the effects of estrogen on some organ systems like in the vagina, but decreased effect on of estrogen, decreased estrogen effect on other organ systems. So this is a medication you take by mouth that can help with this. But the best thing in my opinion is nothing like vaginal estrogen.
21:27
Dr. Ade
Yeah, I'm so glad that you mentioned that. Especially in relations to people that might think they can't have it because of their history of cancer and things like that, you know, you don't have to suffer through it. There is options. And the fact that it's local, I think that's important that you brought that up. So chronic illnesses and libido. Let's talk about it. So there's a host of chronic conditions. We can talk about so many, but I think let's hone it down to the most common ones. I think it's important to talk about Things like metabolic syndrome, diabetes, because that is very prevalent, especially women as they get older. You know, you're prone to insulin resistance if you're not really careful. So let's talk about how that can impact libido.
22:07
Dr. Jiliian
Dr. Jill well, blood flow, the blood flow, the blood vessels to the clitoris, they're very small. And if you have an illness that is going to affect circulation, those very small blood vessels are going to be very much affected. And so if you don't have blood flow going to areas, blood flow is what comes in. It engorges your genital region and gets you ready, right. It, so it engorges the region, you have the glands that are secreting lubrication and you're feeling already stimulated. And then after intercourse, you need to have your, you know, female or you don't need to, but oftentimes you may have your female ejaculation. But if you're not having that blood flow to that area, then you're going to be, you know, very affected. And then, not to mention that these issues can decrease.
23:04
Dr. Jiliian
Of course, your hormones go with getting to that area as well. You have decreased collagen, decreased elastin, and then there's other vulvovaginal issues. So if you have diabetes, many people suffer from recurrent yeast infections. And so they're just uncomfortable in that area, irritable. And, you know, it just, none of this sounds like it makes sex fun or desirable. Yeah.
23:31
Dr. Ade
And it's so unfortunate because, you know, if you have these chronic conditions, they already have their side effects. And then you have medications that can also cause those same issues too, you know, cardiovascular disease. But if you have high blood pressure and we put you on those medications for high blood pressure, that can also be a problem.
23:51
Dr. Jiliian
Right. We didn't mention that. Right.
23:54
Dr. Ade
It's like those medications is like, ugh, that's probably the problem. Right. Like that, you know, so just looking through those, the medications history, it's one of the biggest things that can really impact libido on, I think even women that have low thyroid function. You know, I don't know what the correlation is in terms of like, libido. But of course, if you have low thyroid function and you're tired and you're not, you know, you have mood issues, you know, indirectly, that can also impact, of course, libido. That's probably the last thing on your mind. If your thyroid function is not optimal, you know, autoimmune diseases, lupus, you know, rheumatoid arthritis, they all bring, you know, fatigue Pain, you know, fibromyalgia, all of those things also deplete your energy, you know, that cause pain and probably would impact your libido as well.
24:40
Dr. Jiliian
Right, Absolutely. And when do these things increase? When do these disease states, these autoimmune disease states increase? Midlife, it seems like people start to be diagnosed with these. Right. Hormones. The answer is hormones. Hormones to everything. Everyone gets hormones. But really, hormones do decrease your risk of autoimmune diseases. And yes, if you're having pain in other organs and other areas, then, yeah, that's going to interfere with the performance of your intimate act. So. Yeah, definitely. Right.
25:19
Dr. Ade
But, you know, you talked about hormones and. Exactly. And fatigue. You talked about hormones. So I think it's important to bring up the issue with birth control pills, too, and how, you know, when you have birth controls with estrogen and testosterone, how that can lead to low free testosterone levels and can cause low libido. So I'm sure you see this a lot, but oftentimes when, you know, I, I usually tell them, hey, you know what? I think you need to have a conversation with your women's health and see where you need to be in terms of if that's really impacting your quality of life, your sexual health. We talked about how that can be a problem. Beta blockers, diuretics. Diuretics is a huge one, actually. Unfortunately, that can impact blood flow.
26:04
Dr. Jiliian
So, yes, I think we have touch on that birth control a little more. I didn't mention that before, so thank you for bringing that up. Birth control, and I'm specifically talking about combined birth control. Birth control that has estrogen in it and progesterone in it. So like a birth control pill or a ring, like a nuva ring or there's even a patch. Right. All of those things they do, just as you said, decreasing our free testosterone level. And it doesn't. Just. Some people have known, yes, this can cause low desire because it does decrease that testosterone level. We know there's testosterone receptors in the brain as well, but not just that. It can cause a pain, a vulvovaginal pain.
26:52
Dr. Jiliian
So at the entrance to your vagina, it can cause something called vestibulodynia, where you have a lack of testosterone and estrogen at the entrance to the vagina. So just where your inner lips become more moist or they're. It's supposed to be more moist there and smooth right at that entrance, that area can be so painful. And so if somebody is attempting penetrative sex with. And this is a woman that's attempting to have penetrative sex by a partner, by a sex tool. Anything that goes past that area, it can feel like sharp knives. It can cause fissures, like paper cuts in that area. It can cause bleeding and tearing. It is, you know, unbearable. And this can go on with people for so long.
27:45
Dr. Jiliian
Typically they may go in and they give their issues, they describe them and they're given medication for yeast and they take that. And maybe they're better for a minute because they're not having any intercourse during that time and then they try again and it hurts again. And this is not just somebody who takes, you know, I took birth control for three months or a year. This is people who are on long term birth control. And I want to be clear, this is not everybody. There are many people that are on long term birth control that do not ever have this problem, but there are a subset of people who do. And it's lack of testosterone locally to this area. And so they need to have that testosterone replaced.
28:30
Dr. Jiliian
And better yet, maybe think of another form of birth control that doesn't decrease their testosterone levels. So maybe like a progesterone only birth control, an iud, like an intrauterine device or the nexplanon that goes in the arm or, you know, there's many forms of progesterone only birth controls out there. But this is a really important thing that I don't think a lot of people really know about. And it can be devastating if you have this problem.
28:58
Dr. Ade
Wow. I mean, that just sounds, I mean, who is going to want to have any kind of penetration going through that? And unfortunately, you know, there's a lot of places in town somewhere, maybe you go in there thinking you have a urinary tract infection and they're just giving you antibiotics and that's not solving the problem. So. Oh, I mean, there are so many different things that can cause that. So now let's kind of show shift gears into solutions. We've already mentioned a few of them. What are some other. I know for sure cognitive behavioral therapy is a great option.
29:32
Dr. Ade
If, you know, if this is something where there's a psychology behind what's happening, if it's a mental health issue, you know, there's sex therapy, some really great people that we know, we've, we know in town here that can really help with that part of things. Mindfulness. And these are all evidence based that they do work. Right. And what are some FDA approved or some other options you feel like could help us with this?
30:00
Dr. Jiliian
Absolutely. And I will say about sex therapy. This is a specific subset of therapy and these are people who are trained and they have a special certification in sex. So it's not a typical. They're typically therapists. Yes. But they have a special training in sex therapy. So they may be people who also do couples therapy and things like that, but typically they're dealing with a sexual issue which could be due to a relationship problem, but many other times it's not. It's not. So sometimes when you're told to just go to a therapist because they're assuming there's something wrong in your relationship, I will tell you, there are a lot of people in bad relationships that have some really good sex. So it's not that. It may be that if that's you, then a therapist or a couple's therapist could be very important.
30:55
Dr. Jiliian
But like Dr. Aday mentioned several times, is that sometimes people have trauma that leads to issues in their sex life. Sometimes they may have had, they may have pain that leads to issues in their sex life they may actually have had. Maybe they were raised very conservatively and so they didn't get to explore their sexuality in a way that would lead to them being able to communicate their needs to their partner. And a sex therapist can really help with that aspect too, of identifying your desires and your needs so that you could effectively communicate them with your partner. So I really like that sex therapy recommendation. I think that's great. We talked about vaginal estrogen. We talked about things that can increase estrogen in a different way. We talked about non hormonal. There are two FDA approved treatments for low desire.
31:50
Dr. Jiliian
So low desire, the clinical term is hypoactive sexual desire disorder. And there are two medications. One of them is a medication taken by mouth each night. It is called flibanserin. And this is a nightly pill that is taken that increases your desire. It does not work right away. You need to take it for four weeks. It may take up to eight weeks to begin to increase your desire. It is a non hormonal medication and it works on those neurotransmitters that we talked about in your brain. So it's increasing your. It's. These things are all kind of working on dopamine in different ways to increase your excitement, you know, increases your excitement, increasing dopamine, decreasing serotonin. So some of the side effects of this one are some mild weight loss. So that's not too bad for women at midlife.
32:44
Dr. Jiliian
It is important to note that this is FDA approved for pre menopausal women. So if you're perimenopausal, this is for you. If you're postmenopausal, it has been shown to be very effective, just as effective in you. However, if they haven't sought FDA approved approval, then most likely it's not covered by your insurance. It is not something that I found to be really cost prohibitive there. It's a special pharmacy that delivers this medication, it sends this medication to you and they do have a cash pay price that's set pretty low. So hopefully it's not cost prohibitive to the majority of people with alcohol. You think they changed the warning that if you have more than two glasses then you shouldn't take medication that night.
33:32
Dr. Jiliian
It's okay to skip that medication for a night or so because it can have a very, it can lower your blood pressure and have too much of a sedative effect, but it works pretty well. It's not like a 90% effective type of thing though. I believe it's like upper 60% maybe. It may be a little bit different. I haven't looked at those numbers for a bit, but it can be quite effective with very little downside. And then the other medication is called brimalanitide. This is an on demand injection. So about an hour, 45 minutes, an hour before you want to have your intimate experience, you give yourself this injection and it's in a like auto injector. So very similar. If people are take like an EpiPen, it's like that.
34:22
Dr. Jiliian
Or if you've taken semaglutide for weight, the semaglutide that you're taking for diabetes is different. But the one that you're taking, that you may take for weight, which they are, it's marketed as weight govy. That one is in an auto injector? Actually. Yes, that one's in an auto injector. So they have the dosage and it's already drawn up for you. So this is similar. You take this 45 minutes before you have, you want to have your experience. And it does increase your desire, not just that, and increases your arousal too. So that's pretty cool. In some of the studies it works very well with men. But I said let's focus on the women. I'm glad you have something that you know. But yeah, so it can increase desire and arousal in a woman as well. And it also, it lasts for about 12 hours.
35:14
Dr. Jiliian
I think the literature says 10 to 20 hours and, but I think it's like 10 to 12 hours is that sweet spot. So you could have your experience one evening and then the next day have another experience. The thing that I find difficult with this is that it can increase nausea. So I would maybe perhaps get a prescription for something for nausea, because to me, nausea does not seem like it would lead to more desire. But you can get something or takes. It may not happen for everyone. Right. And then you can take something to prevent nausea as well. But you can only use this eight times per month. I believe it's the max. So if you just want to have eight good experience, maybe that's what you can do. But it's good to have something. It's good to have.
35:58
Dr. Ade
It's something. There are different choices, and that's what matters. And you have mentioned so many different options, and it's great to see that there are other options and women are. It's. And recognize that there are options. We may not have as much as the Met do, but there are options. From medications to, you know, hormones to therapy, there are options. You don't have to accept the fact that it's just an aging process. If you're asking the question, am I normal? How come, you know, Susie is having the best time of her life, but I'm not? You know, you should. You deserve to have really good, quality sexual life as well. So if your desire has changed, your body has changed, that's expected. But you don't have to live in discomfort or disconnection.
36:50
Dr. Jiliian
Yes. Midlife is not a sexual endpoint. It's a transition.
36:55
Dr. Ade
That's right.
36:56
Dr. Jiliian
And if your desire has changed, if your body has changed, just like you said, that is expected. But if you do not like those changes, you can do something about it. Get the help that you need or institute some of these. These recommendations that we've given. When you understand what's going on with your body, you reclaim your intimacy, you reclaim your desire, your confidence, your pleasure that you deserve. And this period really can be your most rewarding time sexually.
37:32
Dr. Ade
Absolutely. Let's normalize it. Okay, so normalize it. Ask for help. Share with your friends. Get in those group chats. Let those ladies know they need to listen to this podcast.
37:42
Dr. Jiliian
Yes. Share it with your book club. This is great.
37:47
Dr. Ade
This is really great conversation. I know that there's probably so much more we can talk about. I'm sure we're going to have different episodes in the future. That's going to talk about this some more. If you have any questions, definitely drop it to us at our Instagram pages or you can follow us as well. You can email us as well. I'm sure all that information is going to be in a show notes, so absolutely.
38:08
Dr. Jiliian
Thank you so much for joining us for the Modern Midlife Collective and we will see you next time.
38:14
Dr. Ade
Thank you for tuning in to the Modern Midlife Collective podcast. We hope today's episode has inspired you to take bold steps towards thriving in midlife.
38:23
Dr. Jiliian
If you loved what you heard, please leave us a review and share this episode with a friend who's ready to step into their power.
38:31
Dr. Ade
We'll be back next week with more insights, strategies and real talk to help you live your best life at any age.
38:38
Dr. Jiliian
Until then, remember, thriving at 40 and beyond isn't just possible, it's your birthright. We'll see you next time.