Welcome to the well and worthy life podcast. I’m your host, Deanna Pizitz a certified integrative nutrition health coach. This podcast is designed to inspire and motivate you to become a better you through sharing solutions, to your biggest struggles and concerns. In this second half of life, let’s change how we age by focusing on creating a positive mindset that allows us to flourish.
Nourishing our bodies for longevity, optimizing our hormone health for better balance movement that keeps us feeling young and active, and managing our stress to improve our mental health. Things are different now in our second half, and we have to do things differently. Welcome back to Well and Worthy Life Podcast. I’m so excited. I’ve got another great guest for you guys, and I’m gonna try and get this name right, but it’s Dr. Bat Sheva, like Be Shiva in the Bible, Marcus. So Dr. Marcus and she is a certified sex therapist. She’s the author of Satisfaction Guaranteed How to Have the Best Sex You’ve Always Wanted.
She has spent her life helping women reclaim pleasure in their bodies and spirit and her career has been dedicated to bridging the gap between the medical and a psychological in women’s sexual health. For nearly 25 years, she served as the clinical director of one of the largest sexual health centers in the us.
Dr. Marcus earned her master’s in public health as well as a PhD in human sexuality at the Institute for the Advanced Study of Human Sexuality. She also holds master’s degree in social work from Columbia University and a Jewish studies from the Jewish Theological Seminary. She’s also a certified bariatric c.
In the past, Dr. Marcus has served as executive director of a not-for-profit institution and corporations medical practice and laboratories. She is lectured internationally on women’s issues, gives frequent ground rounds to healthcare providers, as well as lecturing to sex therapists around the world.
She has been a guest on numerous radio and television shows, including C N B C, cbs. News, Huffington Post Live and N P r and been profiled in the New York Times Magazine, time Magazine and Westchester Magazine, among others. And now on, well, unworthy Lies . Oh my God, I cannot believe you read that whole bio.
That was very sweet, sweet of you. Was very sweet. Wanted because. I think that, you know, so many times I have people on here and that I probably don’t give them the proper introduction, but there’s just so many things in there that I was like, well, I don’t wanna leave that out. Well, I don’t wanna leave this out.
And so anyway, thank you so much Dr. And I promise your listeners it’s gonna get more interesting from here. And my bio is . I know, I know. I did think about that. I thought, oh, but I love this topic. Well, first of all, I love the title of your book, satisfaction Guaranteed. How to Have The Sex You’ve Always Wanted, I think that I’m right here in Alabama and we’re in the Bible belt and I re was really taught that we don’t talk about.
I mean, it happens, but just don’t talk about it . And, and I don’t really know that anybody taught me at a young age that we were supposed to enjoy it. We just really didn’t get good conversations. And then somehow we found our way through it, or I found my way through it, maybe good, baby bad, and then, then I hit menopause like.
What’s happening? I had really kind of gotten into my sexuality really in my thirties and forties and felt really good about it. And then my fifties hit and menopause hit and oh my gosh. So I think this is such a great topic. I think the whole book, it’s not just for menopausal women, you guys, it’s for all women.
But we’re going to focus on the Menopausal woman because that’s who my audience. Can I just say before we start that if I didn’t know that you said that you were in your fifties , I would fall off my chair cuz you look so much younger. I just need to say that to you. Okay. So, oh, thank you. Thank you, thank you.
You’re so sweet. I don’t feel like, you know, it’s funny because I’m 57 and have a granddaughter and we have so much fun together. So half the time I don’t even feel like I’m that old. And now all my friends are turning 60, but But anyway. It is, it is. It is kind of funny. I do think though, that this sex can keep you young and I think that’s what, to be honest with you, when I hit menopause, and, we know menopause is actually just one day, but it’s, that was that perimenopause and then it was, for me, it actually, I think it was more postmenopausal that my arousal and desire went, I mean, She just dipped her hands down really low.
So if you’re listening and you’re not watching, she’s like, they disappeared. . Yeah, exactly. It just went awful. And I just, and it bothered me so bad. And so I have talked about this a lot in my in my balance groups. I have different women’s groups that we, we talk about all these different subjects that we go through, but I really haven’t talked about this a ton on my podcast, but I think we need to be talking about this more because , I think so many women feel like they are the only ones.
They’re alone out. I am so glad you’re talking about this on this podcast because can I just tell you how often I’ll get a client who’s a woman who’s either perimenopausal or menopausal and she’s almost afraid to have set up the appointment cuz she doesn’t think I’ll be able to help her cuz we’re she’s so convinced that her sex life is over.
Right? Like, , and of all of my clients whose problems are easiest to solve, to be honest with you. , it’s perimenopause and menopause. Like, it just, you just need information to turn things around. And it’s like, it’s almost like a home run. Like for me it’s like, woo-hoo. Like, let’s get a client and make sure that they’re happy after three or four appointments, because that’s usually what happens.
So but I think you, you pointed something even more fundamental, which is that, Most of us sort of start out our sex life and kind of blunder our way through until it’s working. And then when everything changes, we feel like it’s over. As opposed to saying, no, things are just constantly changing and we need to constantly change with it.
But almost every problem that comes up is solvable. So I feel like you hit, you described that, so like poignantly is like perfectly, you know, like you got, you had things going and you kind of hit your stride in your thirties and your forties, and then menopause had like this ton of bricks and now what the hell do you.
Right, exactly. So let’s go back and talk about that. I will say, one of the things that I want to make sure the audience does is take the quiz that you have and will you tell them where to go to take that? We, well, here’s the story if you, okay.
I have a mini, the, the, the entire book is built on a quiz. Right. Deanna and I were just talking about that. The the, the mi, the book is built on a quiz because, For lots of different women, different problems, sort of, you know, sort of, you know, poke out in different ways. And so by taking the quiz, it really makes it easier for you to hone in on what the problem is.
Like, am I not wanting to have sex cuz it’s painful or is it painful because I don’t really wanna, and therefore I’m not having sex, you know, you know, is my orgasm a problem because I’m also not getting turned on? Or am I not getting turned on cuz I’m not having orgasm? , it helps you kind of narrate. So I have a mini, mini quiz that’s online, that’s for free.
And you can just, if you go to my website, dr b chava.com, you can find it to take the full quiz and get the actual description of what you need to be looking for. It’s in the book satisfaction guaranteed. So you need to kind of buy the book. And in there is the link for the full que quiz, but it is online, so you can, you don’t have to use that stupid paper and pencil.
I’ll do your math. Like I never hates that. Right. You need to click away. And you can do it a number of times, like if you can do it and then after a few months you could do it again or a year or two later cuz things are always changing. And once you have your score and the score is built on four areas, four areas that women, that usually problems rare their heads in, and those are problems with pain, problems with desire.
I don’t wanna have. problems with arousal, which is different. Which is, I wanna have sex, but I don’t get turned on. Mm-hmm. and problems with orgasm. So what, so you get scores in all those four quadrants, and then it’s like choose your own adventure. It’s like, okay, if your scores are really low in this area, try chapter six.
Eight and 12 or if you more interested in this area, Chi chapter nine and 13. So that’s the way the quiz is built. But if you wanna just do, do a mini quiz to kind of see how it works and kind of get some sense, try go to my website, Dr. Cheva, Dr. B a t s h g v a, and just go to the book and it has the mini quiz right there for you to give it a, give it a shot, give it a whirl and you can let me know how you do.
Cause I’d love to. Yeah, so I love that. So I did the quiz and and I felt like my, my score was pretty good. I got I think it was 110, so I felt I was like, like one, yeah, 100 is sort of the threshold that I’m looking for. But yeah, if I had taken it a few months ago, I would’ve scored very low. So this is something that I’ve been really focused on.
What did you change? I’d be so curious. Like what do you feel like you change? And also you wanna do two things. You wanna score that’s like over a hundred, but you also wanna know if it’s sort of even, because if you end up with like a 35 and one and a 12 and another not so great. Okay. So I think it was my hormones.
Were low. And so I’ve really focused on the hormones and and really really, I guess to me that was probably the biggest thing. That was the biggest change in just continually working on it, shifting my mindset, trying to get myself in the mood because my, my thing was not. But it was more that arousal and and desire.
It was like, I remember at one point thinking I could go the rest of my life and never have sex again. That to me, when I thought that, I thought, no. I am too young. I wanna be having sex way into my eighties and nineties. I know the health benefits of intimacy and sex with my partner. I mean, there are just so many health benefits plus the oxytocin and all the things that we need.
So when I, when I started feeling like that, that was when I was like, no, I want to work on. No, and and I’m so glad you’re saying that cuz it has to do with, it gives you so many health benefits for you, your relat. But it also makes me feel differently about yourself. Oh, yeah. Like, think about yourself when you feel like you’re a, you know, actively sexual being and you don’t have to have a partner to be a sexual being.
Right? Like you could have solo sex, right? Mm-hmm. . So I wanna make sure people listening realize that when you’re feeling like you are a sexual being and you still want sex, get turned on by sex can still have orgasms. , you feel differently. You walk through the world in a different kind of way than you do if you’re somebody who’s sort of like cut out that part of your life.
Like I think that that, and I’m so curious, so did you go after the estrogen, the testosterone? Tell me a little about the hormones. Can you do that? So yeah, so I’m on a bioidentical cream, so I I worked on, I. Yeah, I’ve worked with my doctors over and over, so I have est, it’s estrogen and and testosterone and D H E A in my cream, but I also upped just my taking the D H E A.
And honestly, I think that helped tremendously. I really think that was the thing that really, cuz I really have started doing that in the last six months. You’re taking the D H E A, like orally? Yes. Mm-hmm. , you’re taking 50, what are you take, can I ask what you’re taking? No. So should I take 50? I, I’ve got this five milligrams, so I take two in the morning.
So that’s 10. And then ipl, I take two more in the afternoon, so that’s 20. And then I’ve got, I’ve got some of it already in my, so I probably am getting close to 50. But I don’t know, is that the recommended doses? You know what, this is the kind of thing people have to talk to their doctor about. But I would say, you know, some people do really well on 25.
Some people do well on 50. You know, it’s very dependent. . I also feel like the testosterone your on is probably extraordinarily helpful. Those you just hit it like you just like took my little speech away about hormones. The three that as a woman you really need to focus on as you hit perimenopause and menopause are estrogen.
I can say what each of them do to for you. Testosterone and D H E A and whoever your doctor is, kudos to them because many, many. I don’t know if this is your gynecologist, but many of them it’s not functional medicine doctor. Oh, yeah, yeah. Many, many gynecologists have misinformation about estrogen, testosterone, and D H A, and many of them aren’t comfortable using ’em.
So it’s really important to find somebody who feels comfortable with those medications. , right? Because there was a, a lot of people are scared of hormones and I, I’ve done some podcasts on that, you know, that women’s initiative study that was done so wrong and that it’s all such a disservice. so we know that, you know, Some of us really need hormones and not really needed hormones, though You Not really yet.
I think, I think people don’t realize, so estro, can I spend this minute just through them? Yeah. I love to, yeah. The, the perimenopausal and menopausal hormones that you probably need. So let’s just talk about estrogen first, and that’s the one that everybody’s scared of because of that study that you said that was just so horribly done.
and there is a wonderful book if anybody’s interested in reading more about it, called Estrogen Matters. Mm-hmm. Excellent, excellent review of estrogen. Easy to read, kind of fun and helpful. But what estrogen does and what people I think don’t realize, estrogen affects your whole body, right? Like your brains, your skin, your hair, your bones, your whole body, but in particular your vagina.
your vulva in your vagina are extremely hormonally mediated. They’re very affected by hormones. That’s gonna be the, those are gonna be the first places that start to feel it when you don’t have enough estrogen. And so, and there’s so much miscommunication about this, you can replenish your estrogen in two different ways.
You can replenish it just in your vulva, in your vagi, in your vagina, which is local estrogen. Or you can replenish it for your whole body, which is systemic estrogen. Right. And you, there’s a whole myriad of ways you can do that. You can do that with creams, you can do that with like little inserts. You can do that with like what do you call them?
The, the, the rings that you put in, like birth control rings, but they’re not birth control. It’s estrogen rings. There’s patches that you can use, there’s puffers you can use. But it, I am a very, very big fan of women who are eating . Getting in systemic estrogen. Estrogen to save their whole body, right?
Like to go after your bones and your brain. That brain fog that we hate and like, you know, that sort of like really dryness of all your skin and your hair that sort of, you know, people’s fear of their bones, beaking, all of that stuff is really affected by estrogen. If for whatever reason you don’t wanna use a systemic estrogen, you’re nervous about it, your doctor’s nervous about it, you have very serious history of breast cancer.
Then local estrogen, which is just estrogen that goes into that little vulva and vagina because you don’t realize how thin the tissue there gets when it doesn’t have enough. Estrogen, it gets like what they call erythema. It’s like tissue paper. It cracks really easily, it bleeds easily. And lubricant isn’t gonna do it for you.
You need to actually like puff up that area. Mm-hmm. . So so estrogen. So, so important. And the truth is, I’m gonna say one more thing and then I’m gonna shut up and move on to Sao Noah is if you can’t do estrogen, if you, for whatever reason, you just are not allowed to, you’re too panicky about it. There are now lasers that you can use on your vagina instead of estrogen.
Even if you’re somebody who doesn’t, just doesn’t wanna use the estrogen. Cause it’s a pain in the butt to be using it regularly in your vagina. There are now lasers that work. So what are these laser. Because that’s all that chapter in your book. Yeah. So it’s, it’s fascinating. Actually. They’re not really lasers, we just call them lasers.
They’re like they, they, they’re, they, because they’re not using light waves using radio waves. So the, the most famous one, but there’s a few of them, is the Mona Lisa, I don’t know if you’ve heard of it. Mm-hmm. Yes. A half part of that. Mm-hmm. and I, and this is not cosmetic. Okay. So, cuz I am not a huge fan of cosmetic.
Stuff being done on your vuln vagina. However your vuln vagina looks, you go, girl. They all look different. I am not a big fan of that. This has nothing to do with cosmetics. The Mona Lisa is a, is a, basically a, a, an implementer of a a laser unit that they put into your vagina and they, you run it for about 10 minutes.
That’s it. Honestly, it feels like the best way I can describe it is it feels like thumping in your vagina and what it’s doing. It sounds horrible, but it’s really not painful. It is. , it’s destroying the layer of the mucosa that’s in the vagina. And by doing that, it basically, the body then regenerates new mucosa, and you have this plump firm mucosa in there.
And usually it lasts for a year or two and you have to do two or three treatments, but usually it lasts for a year or two, and then you may have to do these touchups on it. So if you’re somebody who really doesn’t like to use cream on a regular basis and you just like get, let me get in there. It is, your vagina does feel raw for a couple of days afterwards.
I’m not gonna lie to you. It, you know, like, but it’s not super painful. And it’s like, like one of these, like one and done or three and done situations. Yeah. And it, you know, when you start feeling that like discomfort in your vagina, it just, even if it’s not painful, like who wants to have intercourse, when it’s gonna feel sandpapery, that doesn’t feel good.
Who wants that? Right? So people should just know that that’s an. Yeah. I love that because I, I definitely, I started feeling it was, it felt different than, and I was like, , I’d heard about this going on, but why, why, why? I’m like, I’m not different. I’m still 25. Why is my vagina different? Right, exactly.
Totally, totally. Okay, so then tell us about what testosterone. So testosterone is a hormone that has so misunderstood and has really just been starting to be used for women. It people think of it as a male hormone, but women have it and need it. And so women have usually about a 10th of what men start with, but it seems like we really need it, and so.
It’s usually like highest in our late teens and our early twenties. Believe it or not. It gets a boost. All these hormones get boosted. When you’re in a new relationship, your brain starts of starts sending out chemicals, right? Yeah. Yes. So it’s not in your head. You know, it’s so funny, Deanna. We have the we, this weird thing, like when we see two 17 year olds on a bus or whatever, and they cannot keep their hands off each other.
Do we look at each other and say, oh, they must have had a really deep, meaningful conversation. . No, no, not at all. Right. Or he must have just sent her flowers. No, we say their hormones are raging. Right? Right. And then when we turn 45 or 50, and we’re not really interested in sex, nobody says, oh, it must be hormones.
They’re like, oh, go see a marriage counselor. Like, talk about it. You need to have more time to get . It kind of pisses me off if you wanna know the truth, like I feel like it’s very, very unfair. So testosterone starts to go down generally. in your mid thirties after you have children, it starts to go down and down.
And that doesn’t mean there’s anything wrong with you. It doesn’t mean you cannot eat better and have better testosterone, light. I will say light on your skin, certain light will help, but it’s small amount. Mm-hmm. . And the difference that I see with women who have like low desire and problems with arousal once they get on testosterone is really dramatic and usually it’s given as a cream.
Of some sort that you put on your leg. If, if you go to see a practitioner and they suggest a cream on your vulva, you just didn’t do that. Right? Where do you put your cream? No, I put my cream. It’s all mixed together and I put it on my leg. The inside of my thigh. Yeah, it your leg. Exactly. So it goes into your bloodstream that way?
Yeah. Every once in a while I see somebody who’s their doctor had to put it in their vulva. I would say to you like, that is not okay. Like you should mm-hmm. , maybe find another doctor. . . Cuz the mucosa there is just very thin. Is not a good idea. So testosterone will make you think about it takes months sometimes for it to work.
It’s not like an overnight, it’s not like antibiotics, right? But the idea of testosterone is that it’s a hormone that’s running into your brain that then says your brain. I’m thinking about sex. I’m thinking I may be dreaming a little bit more about sex. It’s easier for you to fantasize and we should talk about fantasy, cuz I think women need to focus on that.
But having testosterone makes it easier to access. your sexual being. So I like to think of it as like the base coat paint. Mm-hmm. , like, if you don’t have it, it makes it very hard to get your brain into the game. And that’s what ultimately will affect your desire and it will also affect your arousal on your orgasm.
Mm-hmm. . So it’s a cream. You wanna bio identical ones just like they gave you, but that doesn’t mean it can’t. from a company, right? Like companies, like there are products out there, they’re all from, and of course at this point that are bioidentical and you can just use a small percentage of it and doctors can give you those as well.
So you don’t necessarily need something that’s being compounded, especially for you. So estrogen and testosterone are super duper important. Mm-hmm. . And what do you think of testosterone shots and the pellets? Okay. . I am not a fan of the shots because they don’t stay steady. You know, first of all, people don’t like shots.
Yeah. But you know everybody’s individual again. So I wanna be really clear. As long as your doctor says it’s safe and good for you, and you feel comfortable with it and it’s working for you, go for it, girl. Right? Like that’s why. Okay. But in general, the shots, because they’re giving you a lot at a certain time, and then they go down, whether you do it once a week or once every other week.
it doesn’t keep a steady state. So that’s my concern with the shots. And it’s a shot and people don’t love shots. So that’s the two concerns, right? I am a huge fan of the pellet. and the truth, I’m a huge fan of the pellets. My experience with the pellets is you put a pellet in, it’s you, they make this little tiny incision in your butt.
It’s like the size of a tic-tac, and they pop it in, and then it’s, you’re done for three months. Now I’m a fan of the pellets because A, it gives you a steady dose. B, you don’t have to do anything. It’s like the Mona Lisa, like as somebody who personally hates putting on creams and you know, I just don’t like having to do stuff every day.
I love these one and done solutions, right? So I’m a big fan of the pellets. I will tell you that there’s some hesitation from the American Gynecological Society about the pellets. And, and I’m sure that they’re may be right, but I will also say that they have a lot of questions about testosterone cream 20 years ago.
Like it just takes a long time for the science to catch up to the reality. But in my experience, of those 25 years working at the center, We used pellets and it worked great. It worked more efficiently. It worked quickly. We didn’t have to worry about women forgetting their dosages or remembering to do it.
Mm-hmm. I’m a big, so I personally am a big fan of pellets. Do you have any thoughts on them? So I have a friend who does them and loves ’em, loves ’em. and, and I’ve known a lot of people who love ’em, but I have a story to, to share. One of my clients, , she got it. And, and I’ve heard this happening before and I didn’t understand that because I, I, I don’t know.
I’m not a scientific first. I’m not a doctor. I don’t know that part of it. So it just seemed to me that if you put it in, it would be stronger at first and then it would wear down by the third month. But I don’t know, maybe it. But she said that her, the dosage they gave her was so intense that all she did was
She felt like a teenage boy. She just thought about sex and she was calling her husband home every 15 minutes. Like, you have to come home. You have to get home getting, so can I just tell you, so that has to do with the dosage, and you may wanna start with the cream before you but it, but I had almost an exactly the same story with with a client who came in.
Who had been gone to another doctor who didn’t give her, who gave her way too high dosage and she was putting it on she was putting it on her vulva, so it was absorbing really quickly and really deeply. And she, when we tested her blood levels, they were like literally 10 times what they should have been.
And so she, she was laughing. She said, oh, no wonder I was fantasizing about this little old man neighbor I have. She, I was like, fantasizing about everybody. And so, so the good news and the bad news. Even if the pellet’s too high within three months, it’s gone. Right? Like it, it goes away. So it’s not like you’re stock, number one.
Number two, if anything proves to you how significant the testosterone is, that story does Right. Exactly. Like ex, right? Mm-hmm. like we, we don’t like to believe how much our brains are affected by biology, but they are. Mm-hmm. and, and the D H E A that you’re talking about is really interesting because, . It is a precursor hormone, right?
D h a, you can walk into CV s and buy tomorrow. That’s what’s interesting that d d a, mm-hmm. , you could just walk it, but what you need, and it’s not controlled at all by the F D A, it’s considered completely, you know, over the counter. D H E A is a precursor hormone. It’s a hormone that turns into estrogen, progesterone, or testosterone, right?
It turns into one of those three. Theoretically, it should turn into whatever your body needs the most. Really? I didn’t know that. Yes, exactly. Very interesting. Yes. So so like for example, also if you’re a baseball player, if you use you, you maybe use D H E A and you’d be ex disqualified for, for using like testosterone.
But you’d be using thousands of milligrams, not 50 milligrams. Okay. It’s, it’s, it’s very gentle, it’s very light and it’s very gentle and you are using this kind of a backup to your other hormones. Mm-hmm. sort of to help push them along. And it can be incredibly helpful as well, especially cuz it’s over the counter, so it’s just easier to manage.
Right, right. Well I love that. I love that explanation. we know that hormones can help us, but let’s talk about. . Okay. So there are these four areas that, that, and then when I read these four areas, pain, arousal, orgasm, and desire. . I think all four of these areas can be menopausal women for sure. Right?
I mean, absolutely pain. Cause they’re dry, right? But it’s not just the dry. Can we talk about paint for one minute? Yeah, let’s, let’s not do that because I wanna tell you the story about a client that I had years ago that like completely for me just changed everything. This had to be. 15 or 20 years ago, and I get a call from this woman in New York City where I live and where the, our center was one of our, we had a couple centers, but, and and she said, you know, I, I, I’ve been married for 30 years, I always had a good sex life.
All of a sudden it’s so painful and I wanna know what you’re gonna do for me before I come in because I’ve been to three of the top gynecologists in New York City and they just keep throwing estrogen at me. And I said to her, I’m really good at what I do, but I have yet hit profit status and I cannot do this over the phone.
Like we need to figure out what’s going on. It was like a medical center when they came in. So what became really clear and what people don’t get is that what happens for reasons we don’t totally understand is your muscles tighten up. In addition to the fact that your MU is a mess, your skin is a master.
You need the estrogen. Your muscles tighten up. Now that could be because there’s pain and so you, your body reacts by tightening, or it could be just as we get older, our muscles get tighter in other places, so you need to kind of re-stretch those muscles now. To do that. It’s not complicated. You use these like sticks sticky kind of things called dilators.
They’re like vaginal dilators. They’re white. They tend to be white or colored, but this is a pen. But they started this size and they start getting wider and wider and wider, and you just, you basically insert them. You move them around you. You basically are teaching your vagina to do a split again, right?
Like there you go, , right? Like, People do not, people don’t understand. The vagina is not a hole, right? It’s not a space, it’s a potential space. Think of a turtle, next sweater, right? You want your vagina to be able to open to let that penis in, or a finger in, or a dildo in or whatever. Vibrator in and close again, when it’s done right, it has to be able to stretch, right?
And for any number of reasons, our muscles get less stretchy as we get older. Nobody thinks to give women in their forties or 50 dilators. They think of giving ’em to women who are 20, who are having pain, cuz they’re just starting out. But people think, oh, well they’ve been married 20 years, they’ve been having intercourse for 20 years or whatever.
Why would they need a dilator? So doctors don’t think about that. So the estrogen alone doesn’t help. Like you need a combination. But if you use that combination, usually the problem. , I don’t know, three weeks. That client, that the woman who came in who was like, she came in, we gave her estrogen. I said, you do need to use estrogen.
They’re not crazy, the doctors, but I also wanna give you these dilators to use, and I want you to use one every day for like four days and go up to the next size. Literally two weeks later, she came back. She said, I am a hundred percent pain free and I don’t know if I should laugh or I should cry, because on the one hand, it was so easy.
On the other hand, I’m so mad that I wasted two years on something that was. Freaking easy to fix. So so for any woman who’s listening out there right now, now there are a couple other conditions that can be more complicated, like it’s sclerosis, but you’re. OB gyn will pick those up. But if you’re having just pain with intercourse in a way you weren’t having before, find out, get local estrogen that you can use in vagina and get yourself online.
You can buy vaginal dilators, and I go all through all this in the book. It’s so easy. You could do it yourself or you can find a pelvic floor physical therapist or your doctor. There’s ways to do that if you, if you, if you’re like somebody who likes to work with somebody else, but I, I, there’s no reason to have.
There’s no reason to have pain when you’re 20. There’s no reason to have pain when you’re 30. There’s no reason to have pain after you have babies, and there certainly is no reason to have pain in your forties and your fifties and your sixties and your eighties. Right. Oh, and I love that because, you know, and, and here’s the other thing, I think I see a lot of women that get divorced and they’re in their forties, fifties, maybe sixties, and they’re not using it as much.
And maybe, maybe they’ve even lost desire and they’re just like, but if they wanna find a new partner, I mean, like, come on, you’re gonna have to, I mean, yep. I mean, so I mean that’s part of having a partner, let’s be honest. And one of the good parts of having that. That partner. So, and you’re totally right, by the way, if you don’t, if you, you know that thing about you lose it or use it or lose it.
It is so true about your vagina. People just laugh about that. But it is so true that vagina’s gonna tighten up girl if you don’t use it. Mm-hmm. . And if you don’t have a partner, get yourself a internal vibrator or a get yourself a dildo or there’s a lot of other ways, but you should have something in that vagina and you should make sure that you’re comfortable and you still can get wet.
and then you’re good to go when the time comes and you feel and you don’t feel nervous, and you don’t feel scared and you feel excited. Exactly. Exactly. Love, I love that you said that about the divorce women. Yeah. Well I’m, I’m on my third marriage, so appreciate, I try, I try to divorce women, so I’m like, , you, you, you, like, you really wanna take care of that population.
Yes, exactly. Okay then let’s go to arousal. So let’s talk about arousal. What is arousal first? Because I think, I think it. Confused with arousal, desire and desire. Yeah. Yes. Yes. I think like, if there’s any, there’s a few aha moments I like to point out in my book, and one of them is that there is a difference between desire and arousal.
So women will come in and they’ll say, ah, I have no desire to have sex. And then when I’m talking to them more, what comes out is. They do wanna have sex. It’s just that when they start having sex, it sucks, right? Like they don’t get wet, they don’t get turned on their brain. They cannot turn off their brain with the, like, making lunches for their kids.
You know, they wear the carpools, they just cannot get past that. And and they just, they, nothing is happening in their body. That’s arousal. Now, believe it or not, there are some women, n not few, a lot who say, I get started having sex. I get really turned on, my body gets wet. I’m like into it. My brains gets into it.
I have an orgasm and I still don’t wanna have sex. And I really love my partner. So it’s not that I don’t, every time we have sex, I’m like, he’s confused. I’m confused because. I’m like, this was great. Why the hell don’t I wanna do it again? That is desire, and that seems to be a different neurological pathway.
We don’t quite understand why, but those are two things, and the moment you understand, they’re two things. . It really is helpful because then you kind of know what to work on, so mm-hmm. , if the reason you don’t wanna have sex is cuz your sex sucks, then let’s fix the sex. Right? Right. If your sex is good, but you still don’t have good desire, then we gotta figure out what we can do to sort of get that little motor going again.
Does that make sense or does it, does that, does that resonate? Yeah, no, I understand. So the desire part is like, I wanna have sex, you. You do wanna have sex. You wanna have sex? Well, yeah. If you have desire, then, then you want to have sex. Correct. Okay. And arousal is that you wanna have sex, but you just can’t get going.
Right? Okay, so let me, let me say this again. Okay. If you’re having a problem with the desire, then you don’t wanna have sex. No matter how good the sex is, your just desire is gone. Right? And if your arousals a problem, it. You wanna have sex, but nothing happens once you get started. Right. Okay. Yeah. So desire, and people sometimes think one is physical, one is that’s not true.
They’re both physical and they’re both psychological. Right. So arousal is getting turned on. Turned on. In your mind, in your body, I’m having sex. Is that, that tingly feeling? Is that that tingly feeling, that tingly feeling and the ability to get your brain in the game. Okay. Those, exactly. The tingly, exactly.
Those little butterfly, tingly, giggly things that are going on in your vuln, your vagina. Yes. You’re like, oh yeah, I’m feeling. Yeah, exactly. And to do that you really gotta gee there in your head and your body. That’s arousal, right? Okay. Yeah. Desire. That’s what left me for a while. I mean, it left me, yes. I was like, where did you go?
Okay. Yes, yes, yes. And the C Oster I’m sure helped and we can talk about other things and then sometimes because of that, you don’t want to have sex and your desire goes. But technically, like if I say to you, Gianna, I’ll wave a magic wand and the sex will be great. Do you wanna have sex? and you look at me like I’m crazy, like of course I’d wanna have sex as the sex is great, then you’re not having a desire problem, you’re having an arousal problem.
Mm-hmm. , does that make sense? Right. Yeah, yeah, exactly. Okay. Exactly. Yeah. So so now sometimes solving those things can be very overlapped. Right? The same kinds of things can help because I’m, I’m telling you, the hormones can be super duper helpful. Also, looking at the arousal specifically, the other medications you’re on can have a deep impact on that.
So like, SSRIs, the anti-anxiety medications can be, you know, can. make that more problematic, right? Mm-hmm. , for sure. Mm-hmm. , that could be a piece. And yeah. If people are still on birth control pills, sometimes people stay on birth control pills through perimenopause and menopause, and that can have a consistently higher and higher problem in terms of like arousal also.
Mm-hmm. , so you might wanna look at those. Mm-hmm. . But one of the things that I have found to be really critical to women is their erotic brain and how such a good job we do turning it. Right? Mm-hmm. . Yeah. I think partly, to be honest with you, I think I did that a little bit when I became a grandmother. I thought it, it wasn’t like conscious, but it was like, you know, it’s almost like when I became a mother.
You’re supposed to be like Mother Teresa. You know? I mean, and so I think that was part of what happened to. I love that. You know what, that could be a topic for another book like Grandmas and Sex. Cause I think that that’s so true. Mm-hmm. and we women do such a number of turning off our erotic brains unintentionally.
Really unintentionally. We turn it off because we’re busy. We’re doing a million other things. We think that we shouldn’t have to work on it. Right? Fantasies are something that should just drop by pixie dust, but that is not the reality. Like you have to actually work on it, you know? . A really good analogy to this is like if you speak another language, let’s say you speak French.
If you speak French all the time, you’re gonna be really good in the, those words will just come to you like that, right? Right. . If you stop speaking French for 10 years and then you wanna speak it again, it’s gonna be really hard cuz that part of your brain has kind of shut down, right? Mm-hmm. , the synapses aren’t running, the blood isn’t flowing.
There’s just less neurotransmitters and you’re gonna have to work on getting it back again. But once you do, you find it gets easier and easier. That whole part of your brain starts to light up and function, and all of a sudden that French comes back and. , you can learn Spanish easier at that point too, cuz that’s the same part of the brain, right?
Right. So, so what, what I say to women is you need to really start focusing on learning, going back to your fantasy life. That may be reading Eroica, watching erotica, listening to Eroica. Fantasizing in your brain, but you need to start lighting up that erotic part of your brain. And I know, I know it feels so weird in the beginning to be working on fantasies.
Like we think, oh, fantasies should just happen. But they don’t just happen. They don’t just happen unless you’ve sort of used that part of your brain and once you’ve used that part of your brain, it’s more likely to pop back in and. Wait, so before I say anything else, what do you think about that? Oh, I like that.
I think that’s really true too. I mean, let’s face it, who didn’t, doesn’t remember when we were all reading the book of, what is it now? 50 Shades of Grain. Yes. I mean, like you would be squirming the whole time when you’re reading it. If you read it, I can remember reading it on a, a airplane and I’m like, oh my heavens.
And like, where, where’s my. That’s great. That’s what you want. I mean, that is what you want. And I love that book. I mean, I love that book because what it did to so many women, it freed them up to be thinking about sex in a really hot and sexy way, and. Women do this whole number of like, I shouldn’t be thinking about this cuz it’s in a, like, like you, like you said, I’m a grandmother, so I shouldn’t be, I shouldn’t be imagining sex with three people.
That’s not okay. , you know, like, what kind of grandmother am I? Or, or women will come in, they’ll say like, I’m, I’m, I’m, I, I’ve been fantasizing about women, or I’m watching, I’d like to watch erotica about women or read ERO about. , does that mean I’m a lesbian? I’m like, no, it does not mean you’re a lesbian. It just means you like reading erotica about women.
That’s all it means. You know, women are so quick to, like, I’m thinking I’m, I’m fantasizing about this actor or this baseball player or whatever, and like, oh my God, is that being am I being disloyal to my husband? Right? Like, that’s, that’s, you know, and I’m like, no. Where did we, where did we come up with this idea that.
Fantasy and reality are the same. They’re not. What’s going on in your head is just going on in your head and you are doing it so that you can make your erotic green, wild, and free, which is how it likes to be, and so that you can go back and have great sex with your partner. Your partner is gonna be so much.
The beneficiary of your learning to fantasize and not judging that the fantasies are appropriate or wrong, or you’re the wrong age for them, or they’re out of, you know, they’re too wild and crazy, like just let it go. It’s just a fantasy and it’s so important for women to kind of learn to let that go. I think it’s like critical.
I, I do, I think it’s really hard because especially if you’re brought up you know, was brought up in a Christian home and it was just like, you know like, I don’t know, sex, we really didn’t even talk about sex, but I just, yesterday at church the, our preacher talked about sex and he. Sex is meant to be enjoyed.
And then there’s a whole chapter. Yes, there’s lots of it in the in the Bible talking about it and how amazing it can be. So it’s not that we, we are, we can enjoy it and we can but for some reason it is. I, I really do think in this Bible belt we were really taught wrong, and so it’s really a struggle.
It has been a real big struggle for me. Like, I’m a bad girl if I think this or if I’m a bad girl. You know, like that kind of, that you have to really work on. Because your, you’re right. And your erotic brain does not like being held hostage. It just doesn’t, and you have to just keep reminding yourself.
Just because I’m thinking about something does not mean that I want it to happen. You know, it’s so funny, we in English do not have good words for fan. We have one word for fantasy and that’s fantasy. Like, I laugh cuz like in New Zealand they say there’s like, I. 17 different words for sheep because they have lots of different sheep.
And in Hebrew, which I actually speak, there’s like seven different words for God. Right, right. That mean different elements of God. Right. I’m, I feel like we need new, new words for fantasy, because when you say fantasy, like I’d like to have sex on the beach. That might be a fantasy that you might wanna actually try or in the ocean.
Right, right. That is really different than if you say, oh, Bach, I’m having a fantasy about, Having sex on a rocket ship to Mars with three martians like that, you’re not expect, you know, I mean, that’s a different experience, right. , you know what I mean? Or, or, or being watched by people on a stage while I do a strip tease.
Right? Right. You don’t actually want that to happen. That’s just a fantasy that you just, it’s fun to revel in and the more we can kind of figure out what turns us on, we each have our own erotic maps where they come. I don’t even really care. We just need to figure out that it’s okay and not to worry about it, and so many of us.
You know, transgressive sex, sex that somehow feels wrong is big turn on. And you know what? You can go there in your head. It doesn’t mean you’re gonna walk down that path of actually doing it. It just means it’s fun to think about and mm-hmm. , the more you can allow yourself to think about it and the more sort of free you can let your ERO brain roam, I’m telling you it’s gonna back in dividends.
And we menopausal women have done such a number shutting down our erotic brains. It’s time to like reclaim them and turn them around. Yeah. You know, it goes back to this thing of like, I feel like when I hit my 50, I’m like, I, this is who I am. I don’t care as much about what people think of me. Like when I was in my forties, I’d probably never have a podcast where we talked about sex.
I mean, you know, and in my fifties, I’m, I’m passionate about this because I’m passionate about letting women know that, hey, We need to be doing this, and we need, you are not alone. If you, if you, if that libido, you feel like it’s just gone down, down, down, and you just don’t even have that desire anymore, you, you’re not alone.
And there are things that you can do. And I think that’s so important because like we said at the very. A good, healthy person has sex. I mean, we need it to release all these other things, oxytocin, and to live the, a healthy, vibrant, confident life. Yes. Yes. Yes. Can I a, can I say one thing about vibrators also?
Yes. I know we probably are. I have, don’t have that much more time, but I do. I wanna say like, I feel like my PhD thesis was on vibrator use with women. Oh. And I know, right? And one of the most, I think one of the most underused tools in women’s sexual arsenal is a vibrator. And that’s because women think of vibrator is something they should only use by themselves and not something that they should use with their partner.
Mm-hmm. . And as we hit menopause and perimenopause and menopause, sometimes it gets harder to have orgasm. And that vibrator can take a job, which feels like it could take forever or it’s not happening, and it makes it so easy and so fun. And one of the things I’m always preaching to women is that vibrator is a tool just like lubricant.
If it makes it easier for you to have an orgasm, take it into the bedroom with your partner and you know, Nine out of 10 partners, I would say nine and three quarters out of 10. Partners love that vibrator. It makes their job easier. Their hand and their mouth and their penis get really tired. , you know?
Exactly. So that vibrator can be life-changing. Life-changing. I had an 80 year old patient who. I loved her so much. She was like a bird watcher. And, and she was just, she was full of life and she was having a hard time having orgasms. And so I gave her her first vibrator. It worked great. Aw. And she used it with her husband.
And one day she comes in and she says to me, you know, we were on this trip, we came out from this trip to Greece, and my husband was like totally down the rabbit hole of making a an album. And he was ignoring me and it really got me very upset. So I took the vibrator and I left it on his pillow. Isn’t that great story?
Love that. So he got the hint when he came in and there’s no reason if it’s a little, if having orgasms is different in your sixties than it was in your forties or your eighties, that’s fine. Just realize that there are so many tools to get the sex right back on track and to have fabulous sex all your whole life.
I just feel like the more you know about the options, the more empowered you feel. Yeah. I, I, I totally agree. And I note do in the book, do you have a chapter on the vibrator and where, what, which ones you recommend and all that stuff? Absolutely, absolutely, absolutely. I have a chapter on fantasies. I have a chapter on vibrators.
I have a chapter on the, all those hormones we talked about. I have a chapters about like, just some very practical suggestions about things to do that may be helpful. I have a chapter on like the biggest problems that come up and how to avoid them. Like, here’s my feeling Tiana. If we can make women feel empowered to get the help that they need, you can have a great sex life your whole life, and there’s no reason not to.
Right. There’s no, for all the reasons you said, like sex is just such an important part of who we are and for all the women who are listening who are feeling like hopeless. Cause I know it could get like that. You feel like it’s never gonna get better about Chava. Like that’s just not the case like it is so.
I think that’s probably part of why I love working in the sexual health field, like I’m a therapist, but I love working in sexual health because I feel like you can make really good strides really quickly with sexual health in a way that you can’t with, you know, you know, anger or, you know, depression.
Right? You can change those things, but this is something that’s so concrete and you know, I’ll say to people. I didn’t go into this field cause I’m so fascinated by body part A and how it fits into body Part B. Do you know what I mean? Like that’s good and that’s interesting and I will talk about that a lot.
But I’m much more interested in how sex affects us as people and affects our relationship because it has, just for all the reasons you said, it has such a deep, deep impact on how we feel about ourselves and how we feel about our relationship and, and you can be empowered to make it. Oh, I love this. I love it.
Okay, so. Chava, Chava p Chava. I’m gonna get this Dr. Va Chava. So tell everybody where they can find you and how to get your book and all of that. We’ll have all this in the show notes too, you guys. So if you don’t have to write it down, you can click on the show notes, but go ahead and tell us every Yeah, so I’m very active on Instagram and TikTok.
I just, I feel like they’re great platforms for education, so I’m Dr. Bache. Dr. Cheva, B A T S A G V A on Instagram. I’m the Doctor Cheva on TikTok cuz they threw me off the first time. . Oh wow. Can you believe it? I’m so conservative. I cannot believe they threw me off. Anyway, anyhow, but I’m there as the Dr.
Cheva and my website is dr cheva.com and my book is available at any major book sellers like Amazon. Barnes Nobles, if you go to my website, there’s a click so you can, you know, there’s, and I love, you know, especially on social media, I love hearing from people, getting feedback from people. So you know, I, I hope you can tell I do this cuz I feel so passionate about it and I just, I, I want people to feel like they can own their sex life.
And I’m always sort of here and available because I wanna talk. Thank you so much. Thank you. I mean, I, I really appreciate what you are doing for all of us women out there because I think that yeah, we need to know that there are different things that we can do that we don’t have to accept pain. Not having the arousal, not having the desire.
And we certainly. We want that orgasm. At least I do. I know. I think most women do want that orgasm too. Right? Yeah. Well, thank you for everything you’re doing, bringing this to people, because you’re right. It’s a conversation that’s hard for people to have, and we live in a world that just seems saturated with sex, but then nobody’s actually having real conversations about it.
Right. So, right. Good for you. And thank you for doing this so much. Well, Well, thank you again for coming on to Well and Worthy Life and I appreciate it and I can’t wait to get the book and really dive into it myself cause I’m sure there’s lots of improvement I can still make and I I want to have a long, long sexual life with my partner.
So thank you again. I appreciate it.
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