[SPEAKER_01]: Today on the Relationship Renovation podcast, we talk with Dr. Maria Safaklis about how to close the bedroom gap.
[SPEAKER_01]: We talk about the three ways you can do it.
[SPEAKER_01]: Know that self, communicate, and redefine sex.
[SPEAKER_01]: So stick with this episode.
[SPEAKER_01]: It's going to be awesome.
[SPEAKER_02]: Hello, all and welcome to the Relationship Innovation Podcast.
[SPEAKER_02]: I am Tara Kerwin.
[SPEAKER_01]: And my name is E.J.
[SPEAKER_01]: Kerwin and about a month ago, we had an amazing episode where we interviewed Dr. Maria Sofficklys.
[SPEAKER_01]: And it was a long episode.
[SPEAKER_01]: It was one of our longers.
[SPEAKER_01]: It was like 50 minutes and it had as high if not a higher listen through rate than any of our other podcasts, which are shorter, which means,
[SPEAKER_01]: It was engaging information.
[SPEAKER_01]: So I want to welcome back Dr. Maria Safakli.
[SPEAKER_01]: She's a board-certified gynecologist.
[SPEAKER_01]: She's a national menopause expert medical director of women's health care of Princeton.
[SPEAKER_01]: This is a big thing.
[SPEAKER_01]: She is like on the forefront.
[SPEAKER_01]: If you don't know about this, there's a lot going on.
[SPEAKER_01]: The FDA around women's hormones and
[SPEAKER_01]: just correcting some BS that's been going on for a long time and she is a part of some major positive changes in women's health.
[SPEAKER_01]: And so we want to welcome back Dr. Sophocles.
[SPEAKER_04]: Thank you both.
[SPEAKER_04]: It is so great to see you again.
[SPEAKER_04]: I'm I'm looking forward to round two.
[SPEAKER_02]: Well, we know that you're a buck closing the bedroom gap.
[SPEAKER_02]: is we're so excited, we can't wait to get a copy of it.
[SPEAKER_02]: But we really wanted to, because we did hear about a lot of our listeners, like how does hormones and everything you're going through in period when a pause and menopause really impact intimacy and I know your book is about that.
[SPEAKER_02]: Yeah, maybe we start with what is the bedroom gap in case people know I love that and I love that book title too.
[SPEAKER_04]: Thank you.
[SPEAKER_04]: The bedroom gap is the title, and it's a concept that I,
[SPEAKER_04]: came up with because I kept having patients come in to see me and they were feeling broken and feeling like something was wrong with them and that was causing problems in the relationship and which is a whole other topic we can get into is you know the whole idea of blaming yourself
[SPEAKER_04]: a problem with your relationship or a problem with your sex life, as opposed to let me work with my partner and sort this out.
[SPEAKER_04]: So the better and get refers to the difference in expectations and sometimes abilities between couples, they can be same sex, but most of my patients are heterosexual couples.
[SPEAKER_04]: So it's men and women.
[SPEAKER_04]: feeling disjointed, feeling like their relationship isn't the same and their sex life is falling apart.
[SPEAKER_04]: And it's looking at all the forces that create that gap, namely history, socio-cultural forces,
[SPEAKER_04]: the patriarchy, biopharma, like big pharma, big porn, sex ed, so many big huge things shape who we are as we become an adult and that fails us when we become a midlife sexually active adult.
[SPEAKER_04]: especially for women who really don't talk about the menopause related changes that happen generally that can make sex really uncomfortable who don't talk about the loss of libido that can happen in menopause and by the way men have their own set of changes too so when you combine the two changing
[SPEAKER_04]: humans and the naivete if you will you get this gap and my books about what that is what are the forces of shape it and how do we close it.
[SPEAKER_04]: So I think we'll talk today a little about how we can we can make things better in midlife sexually for couples.
[SPEAKER_02]: I do want to say thank you, thank you for writing this book, thank you for giving attention to this because I think a lot of people, including me, do feel powerless and don't have understanding knowledge or the skills.
[SPEAKER_02]: So I think a lot of people just give up and they think, right, remember that movie business is good as it gets?
[SPEAKER_02]: Yeah.
[SPEAKER_02]: So like my heart thinks you a lot that you've done all this research.
[SPEAKER_01]: Yeah, and I think, and I think it also, it contributes to the amount of people breaking up getting divorced in that age range because there's a certain point where the most natural thing to do is it's like it's us.
[SPEAKER_01]: Like you're just not attracted to me.
[SPEAKER_01]: We just, this is really frustrating.
[SPEAKER_01]: So we have this pain point that we're constantly in conflict about.
[SPEAKER_01]: And it must just be us.
[SPEAKER_01]: So it'll be better off if I just we just break up and find somebody new.
[SPEAKER_04]: or sometimes it leads to infidelity, the couple doesn't, they're not ready to have the break-up talk or they love their three kids and their life otherwise together and the sex is this big, shameful elephant in the room that they just slide into bed separately and the woman turns away and tries to get to sleep and the man's frustrated or vice versa.
[SPEAKER_04]: and it's amazing how hard it is to talk about sex for many couples.
[SPEAKER_04]: Even though there are people who've talked about the most difficult challenges, whether it's aging parents or kids, or you know, putting your dog down, but they don't talk about sex.
[SPEAKER_04]: So I think that's a big issue.
[SPEAKER_04]: And once you've had infidelity, you guys know this, there's a whole other thing.
[SPEAKER_01]: It's a whole other thing.
[SPEAKER_02]: Building trust back up as even here.
[SPEAKER_01]: And I think it really feeds into your first way to close the bedroom gap, which is no thyself.
[SPEAKER_01]: The second is like, well, it kind of leads right into is then you got to be able to communicate about what's going on within yourself within your relationship.
[SPEAKER_01]: And then the third is I think a huge thing and that is redefining what sex is at this point in your relationship.
[SPEAKER_04]: yeah i think that i hope people will stay tuned for the whole thing because i think that's a really comprehensive way i don't want to give the whole book away because we want people to buy it is on amazon now if people go or my website and they can pre-order it and it comes out in February but i i think it's a fun read i think it's well researched so i hope people will take this as a teaser and will will dig into the book for
[SPEAKER_04]: themselves or give it to someone they know.
[SPEAKER_01]: Yeah, and you know what also we'll do.
[SPEAKER_01]: We'll do a giveaway.
[SPEAKER_01]: Yeah.
[SPEAKER_01]: So like when this episode comes out, everybody will have some notes in the show notes about giving it away through our Instagram.
[SPEAKER_01]: So we'll make sure we get the word out there.
[SPEAKER_01]: So let's talk about know that myself, right?
[SPEAKER_01]: Why is that the first step?
[SPEAKER_04]: Well, you know, any real, you know, if you're the experts in relationships, so you understand that if there's a couple and they're having issues and they're just pointing the finger at the other person, that's you're always want to ask like, what role am I playing in this tension, right, so if you and your partner are not having sex, I think it makes sense to say what role am I playing.
[SPEAKER_04]: Am I not initiating?
[SPEAKER_04]: Am I not interested?
[SPEAKER_04]: Is sex painful?
[SPEAKER_04]: Anything that I can do and this is where so many women think there's nothing they can do they're just broken and this is just that and this is where a trip to a gynecologist or a sexual medicine expert can really help someone who can say, hey, you know you're you're 57 there's there's not as much estrogen in your body and
[SPEAKER_04]: We can help you make more collagen and more blood vessels and have more moisture with sex.
[SPEAKER_04]: Or, hey, your libido is really down.
[SPEAKER_04]: I hear that.
[SPEAKER_04]: Here are some ways behaviorally that you could inspire a rise in libido.
[SPEAKER_04]: You know, hear some ways.
[SPEAKER_04]: medically.
[SPEAKER_04]: Here's just a classroom prescription.
[SPEAKER_04]: I can give you know there's things we can do.
[SPEAKER_04]: So going to to get help.
[SPEAKER_04]: Number one.
[SPEAKER_04]: And number two, know your body.
[SPEAKER_04]: There's this big dark shame around women's bodies.
[SPEAKER_04]: Like men know their own bodies really well.
[SPEAKER_04]: I mean, all you have to do is go to a museum and you can see what male anatomy looks like.
[SPEAKER_04]: It's been sculpted for thousands of years.
[SPEAKER_04]: But
[SPEAKER_04]: Women's bodies are always just like shameful little wedge like you know the legs are crossed and it's like if you don't know your body as a woman How are you supposed to tell a partner?
[SPEAKER_04]: You know what feels really good when you touch me there or when I use a toy like this or like that or this position or that position I also think women are taught that the sex is sort of shameful You know masturbation is shameful.
[SPEAKER_04]: They're all these implicit messages in our society whether they come from
[SPEAKER_04]: movies or Sunday school or your mom or your aunt or whoever told you don't touch yourself, don't masturbate, that's dirty, that's bad.
[SPEAKER_04]: I can't tell you how pervasive that message is.
[SPEAKER_04]: And so until you can be comfortable understanding how you feel pleasure, it doesn't have to be only genital, right?
[SPEAKER_04]: It can be arms, legs, back grubs, whatever.
[SPEAKER_04]: It hinders your ability to communicate with your partner.
[SPEAKER_04]: So that's what I mean by know that I self.
[SPEAKER_04]: Know your body and know what feels good and how it feels good to you.
[SPEAKER_02]: And it feels very like hearing that.
[SPEAKER_02]: It's like, like, I'm so curious, right?
[SPEAKER_02]: And I get to have some empowerment and choices and see what feels good and what doesn't feel good.
[SPEAKER_02]: Instead of being in this right closed off shame place, it's like being open to that.
[SPEAKER_04]: And I think women in mid-life are mostly at an era where they're looking back and they're looking forward and they're saying, look, I'm not ancient yet.
[SPEAKER_04]: I've still got a lovely chapter ahead of me and either they have a loving support of curious partner like you do to her or their widowed or divorced her single and either way.
[SPEAKER_04]: they often want a reset.
[SPEAKER_04]: They want a midlife reset.
[SPEAKER_04]: So I would say a sexual reset can be part of it.
[SPEAKER_04]: It's not just losing some weight or getting Botox or whatever.
[SPEAKER_04]: It is you need a no judgment by the way.
[SPEAKER_04]: Everybody should do what's right for them.
[SPEAKER_04]: But I think a sexual reset for yourself is great.
[SPEAKER_04]: A refreshed look at that.
[SPEAKER_04]: And then hopefully that gives you the power to do the second part,
[SPEAKER_04]: Which is, you want to say any day, drunken?
[SPEAKER_01]: Yeah, which is, which is fine to wait a communicator out of with each other.
[SPEAKER_01]: I mean, that's the big thing that there's so many times when we talk to a couple, and we get to intimacy, and one of the first questions is like, how much of you guys talked about this?
[SPEAKER_01]: And it's just like,
[SPEAKER_01]: Never.
[SPEAKER_01]: Yeah.
[SPEAKER_01]: No, not at all.
[SPEAKER_01]: And if it is, it's a real, it's kind of a negative interaction.
[SPEAKER_01]: It's about like, what's going on?
[SPEAKER_04]: Like, you know, so that's a good lesson, right?
[SPEAKER_04]: Like the fact that it's negative or finger pointing or, well, I hate the way this happens, or I don't like it when we do that.
[SPEAKER_04]: I think just like talking to a boss when you know a boss giving someone constructive criticism you want to paint it in a positive light you want to say I really loved it when we did that or even if you have the courage just to say a lot of women who use sex toys are afraid that their male partners will be pissed off if they know that or feel threatened and I would say I call bullshit on that I think
[SPEAKER_04]: men would like to know that you know how to have pleasure and that you do that in fact it could even be a turn on so i would say don't hide the toy in your bottom drawer put it right out on your nightstand and say yeah how y'all i use this i love it and you know i love it it reminds me of sex more it gets me excited of sex with you more you know what i do a lot is we almost rehearse lines you know i get
[SPEAKER_04]: I get my clients to kind of tell me how they're going to say it or we come up with them together in a way that isn't shameful and doesn't harm the ego of the partner.
[SPEAKER_04]: And in the partner's defense, they're usually thrilled about it.
[SPEAKER_04]: So I think that can be part of communication.
[SPEAKER_04]: But like you said, E.J., they don't talk about it.
[SPEAKER_01]: And I think like the, you know, kind of jumping back and forth between one and two of know that I self and communicate, I think your part as a health care professional off time is like so important to help the person, because a lot of
[SPEAKER_01]: a lot of men, a lot of women don't know what the hell is going on with them, you know, they don't understand.
[SPEAKER_01]: And it's, you know, you know, on the, the male sort of stuff is a little more simple, but at the same time, it's like, when it's not working, when there's erectile dysfunction, it's like, what the hell is going on?
[SPEAKER_01]: Like, what is it, is it stress, is it low testosterone, is it like you mentioned before we started it?
[SPEAKER_01]: Is this like diabetes related?
[SPEAKER_01]: It's like if you don't sometimes have a healthcare professional or even a therapist if it's more than the psychological realm, like if you don't have somebody helping you make sense of yourself, again, huge barrier to you communicating to you with your partner about what's going on.
[SPEAKER_04]: Right, whereas if you can say, hey, I'm having a reptile issues, I'm going to start with my primary care.
[SPEAKER_04]: Make sure it's not a cardiovascular thing or a side effect of a medication or diabetes.
[SPEAKER_04]: That shouldn't be shameful.
[SPEAKER_04]: We have to take the shame away from this.
[SPEAKER_04]: And it can be literally a result of a medication.
[SPEAKER_04]: And then let's say you get checked out.
[SPEAKER_04]: There's nothing there.
[SPEAKER_04]: Then you look into gush.
[SPEAKER_04]: shame, and you don't have that insecurity, and then you can kind of get to redefining sex as a couple for yourselves, you know, however, and that's number three, so I'm getting ahead of myself.
[SPEAKER_02]: Well, but I think like knowing one in two, because it's like you're giving yourselves any other permission to talk about more vulnerable things, because you're feeling more powered, you have more knowledge, you understand that most, if not all people go through this, and it's
[SPEAKER_02]: Oh, what was I going to say?
[SPEAKER_02]: Hang on, see, that's a, that's a menopause thing right there, Dr. Suffolk.
[SPEAKER_02]: I knew.
[SPEAKER_02]: There it is, but I was going to say, hang on, wait for it.
[SPEAKER_02]: Oh, thank you.
[SPEAKER_02]: But then it becomes more normal, like the first time
[SPEAKER_02]: time, you're going to communicate around it.
[SPEAKER_02]: It's going to feel we call it clunky.
[SPEAKER_02]: But the more and more, I mean, and you'll trip up and it will be clunky, but it starts to become more normal.
[SPEAKER_02]: Like, Eugen, I talk about sex all of the time now.
[SPEAKER_02]: But in that beginning, it was like, oh, I'm so scared.
[SPEAKER_01]: Well, before early on, when we tried to talk about it, it was a lot about just closing the door, and I think protecting ourselves.
[SPEAKER_01]: I think you would use these, and I think you said this in our last episode, Dr. Suffolkazee, you said women say, like, you know, my vagina's just broken.
[SPEAKER_01]: And that was like, to terror that there was a point where that was like, would you just like just pretend it's broken and stay away?
[SPEAKER_01]: And so it was
[SPEAKER_04]: which doesn't give you the opportunity to help, to say, I'll go with you to the doctor or what is the doctor's today?
[SPEAKER_01]: No, the message was the opposite.
[SPEAKER_01]: It was just like stay away.
[SPEAKER_01]: Stay away.
[SPEAKER_04]: Yeah, and I'm saying, since she's saying stay away, it's like you, you as her partner that limits your ability to be supportive because she's just, she's sort of telling you the rules.
[SPEAKER_04]: The rules are this isn't happening.
[SPEAKER_04]: So it wears once Tara knows herself, I'm sorry, Tara keep using you as the no, no, it's a couple of times.
[SPEAKER_04]: Yeah, once she knows herself and maybe even gets information from a clinician and maybe even gets help from all that, you know, then it's something you're doing almost together.
[SPEAKER_04]: it's all.
[SPEAKER_04]: Yeah, she can feel there's more moisture.
[SPEAKER_04]: She can feel things are getting better.
[SPEAKER_02]: And like you said, Dr. South, please just to like before we go to the third one for me, the biggest piece was taking the shame out of it and giving myself permission that it's okay from whether it was cultural, early trauma, everything, right?
[SPEAKER_02]: There are a lot of different
[SPEAKER_02]: conditions that contributed to the shame around it.
[SPEAKER_02]: But once I was like, you know what, like, that's old story.
[SPEAKER_02]: You know, I really want to have like a sex positive feeling about my body about our relationship.
[SPEAKER_02]: And so just giving myself that permission.
[SPEAKER_02]: And of course, like, you know, using my own therapist, as I go away to process the shame because shame is big.
[SPEAKER_02]: But I just remember like it starts to shift and so listeners here that's like it does it feels clunky and uncomfortable at first.
[SPEAKER_02]: But when you start kind of using those skills and getting better at them and you guys can work through it.
[SPEAKER_02]: It's it's awesome.
[SPEAKER_02]: It's just freedom.
[SPEAKER_02]: It's like the shame stops and and that's what contributes to disconnection with couples in the first place before intimacy issues even happen.
[SPEAKER_04]: So can I go back to the shame a minute, and I'm going to ask you a question, Tara, and you Jay, because I'm thinking of a patient I had today who really struggles to have sex and really struggles to communicate with a partner.
[SPEAKER_04]: But she is a pretty impressive and early history of sexual trauma and abuse.
[SPEAKER_04]: And
[SPEAKER_04]: getting the shame away is so hard that she really even struggles to get to therapists.
[SPEAKER_04]: She has a trauma therapist, she has a sex therapist, but she's almost not really going because it's so hard and painful.
[SPEAKER_04]: So how do you get, I mean, that's like maybe an hour question, but how do you, you know, for people who don't have the tools you have, maybe some of the people listening, who maybe even have a small amount of trauma in their past,
[SPEAKER_04]: maybe just a bad first marriage or a boring former partner sexually or something.
[SPEAKER_04]: How do you get past that shame of it?
[SPEAKER_04]: It's my fault.
[SPEAKER_04]: I'm guess I'm broken.
[SPEAKER_04]: Like, I mean, E.J.
[SPEAKER_02]: was like, you always make me cry, Dr. Sophocles.
[SPEAKER_02]: And I wasn't even expecting it.
[SPEAKER_02]: I don't think I don't know.
[SPEAKER_02]: like I could not have done it without him because he was really patient and I think his patience allowed me to do the trauma work and shame work.
[SPEAKER_02]: I think because I used to feel EJ's impatience with that and so I would be like, oh god it's even like I'd have even more shame.
[SPEAKER_02]: So once we really started to talk about how much shame was impacting us,
[SPEAKER_02]: He was like, oh my gosh, that's what this is.
[SPEAKER_02]: It's not that you're rejecting me.
[SPEAKER_02]: It's that you're full of shame.
[SPEAKER_02]: And so, EJ's patients and my constant working on myself feeling safe in my body, like if I would be really anxious before making LMP to EJ,
[SPEAKER_02]: I would say E.J.
[SPEAKER_02]: would it be okay if like you massage me for so I can like feel more relaxed in my body?
[SPEAKER_02]: Like I wouldn't just have sex to have sex or you know it was a chore.
[SPEAKER_02]: It always have to be because I feel safe now or E.J.
[SPEAKER_02]: is making me feel safe and we just got really good at him being a support for me and me recognizing what my needs were like there were times where we were physically intimate and something felt really bad and I would stop us like mid
[SPEAKER_02]: Midway, I'd be like, EJ that doesn't feel good.
[SPEAKER_02]: I wouldn't allow my body to have any more fear, but I had to communicate it with EJ.
[SPEAKER_02]: That's the easiest way I could explain it patience and me giving myself permission that it's okay, but EJ holding that space for me while I was doing my work.
[SPEAKER_01]: For me, I can answer, like, as a partner and then as a clinician.
[SPEAKER_01]: So, obviously, for a different, you know, I mean, as a partner, a huge breakthrough for me was, if this is what I'm lucky enough to have with Tara, if it's, you know, holding her hand in the kitchen and sleeping next to her, if that's what it is, then I'm okay with that, because I'd rather have that than nothing.
[SPEAKER_01]: That was like a big thing for me and then because then it took all the pressure off of it was like, yeah, okay, maybe I still have a craving maybe I would still love to have that with her, but I would rather have this than lose her completely like that was the huge like I can remember having that.
[SPEAKER_04]: And a way to say that for everyone listening is also to take the, or to broaden that message, I think, is to take the focus off the penis and vagina part of sex, which is, is what we all universally call sex.
[SPEAKER_04]: Remember when Bill Clinton, I did not have sex with that woman, he was telling the quote, true, right?
[SPEAKER_04]: Because there was no penis in the vagina, even though there was a cigar or whatever.
[SPEAKER_04]: But so since that's what we call,
[SPEAKER_04]: sex I think this has done us a disservice because it's saying unless you do that you're not having sex and I think that takes away the beauty of a relationship that can still be
[SPEAKER_04]: plenty, intimate plenty of arousal in your gums and loving.
[SPEAKER_01]: Yes, I mean, as a clinician, like, and really drilling into shame, like what I've found most affected, because I would not say I'm trauma informed, but there's a point where I have to hand off trauma because it's not, but what I've sent, how to a lot of success with, is helping them.
[SPEAKER_01]: see the child who was abused and having empathy for that because we have this weird thing we do that we longitudinally bring our adult self into that child and whether it's sexual abuse or just like severe physical abuse of just having them look at a picture of themselves as a seven-year-old or some seven-year-old they know.
[SPEAKER_01]: And really, really having that experience of empathy for that, that little person, like how in the world could that have been that little person's fault.
[SPEAKER_01]: We know what a seven year old is.
[SPEAKER_01]: We know it in eight year olds.
[SPEAKER_01]: We even know at this point as 50 year olds, what a 15 year old is, a 15 year old is a child, you know?
[SPEAKER_00]: Yes.
[SPEAKER_01]: And that I find, like, opens the gateway to them, maybe eventually going and doing deeper trauma work
[SPEAKER_01]: How can I take that that little person take responsibility for this?
[SPEAKER_01]: Yeah.
[SPEAKER_01]: How could they take on that shame when when they were clearly powerless?
[SPEAKER_01]: Yeah.
[SPEAKER_02]: This could be a whole episode.
[SPEAKER_02]: But I think that goes directly into the three.
[SPEAKER_02]: But I think that goes directly into the third, right?
[SPEAKER_02]: Is like redefining what sex?
[SPEAKER_01]: Yes.
[SPEAKER_01]: Oh, yeah.
[SPEAKER_01]: I like this one.
[SPEAKER_02]: It goes right into it.
[SPEAKER_01]: I've been thinking a lot about this and it tailors into the trauma as well, is that I think men especially have to especially when they're older, really redefine what sex is because so much of what men are a cultured to comes out of pornography.
[SPEAKER_01]: You know, comes out of like the sort of doing something to somebody versus it being a connecting experience and that old model can kind of work.
[SPEAKER_01]: when you're young.
[SPEAKER_04]: Yeah, especially in hookup commentary.
[SPEAKER_01]: Even then, it's problematic.
[SPEAKER_01]: But it really is dysfunctional in adult sexual intimacy.
[SPEAKER_01]: I mean, there's like, it just doesn't work.
[SPEAKER_01]: And I think men have a big lift here of changing how they even conceptualize what sex is.
[SPEAKER_01]: Somebody was just talking to us about this last week.
[SPEAKER_02]: We just had a sex expert on our podcast
[SPEAKER_01]: about, yeah, about connection about intergenerations.
[SPEAKER_02]: That's what it says.
[SPEAKER_02]: Obligation.
[SPEAKER_03]: Yeah.
[SPEAKER_02]: And he'll say, like, he'll come into the bedroom at night.
[SPEAKER_02]: And instead of like, ooh, I wonder if we're going to have sex tonight.
[SPEAKER_02]: He's like, hey, to his partners or anything that would feel pleasurable for you tonight.
[SPEAKER_01]: Yeah.
[SPEAKER_02]: And then that puts it in her court.
[SPEAKER_02]: Like, oh.
[SPEAKER_02]: Yeah, I have a choice, yeah, I have a choice, right?
[SPEAKER_02]: Yeah, I have a massage, maybe a cuddle, but I'm not in the mood tonight.
[SPEAKER_02]: Okay, great.
[SPEAKER_02]: Well, like again, it's language.
[SPEAKER_01]: And it's just the way you imagine it.
[SPEAKER_04]: It is an expectation.
[SPEAKER_04]: I have many patients who tell me they're afraid to cuddle and put their toes together or rub his leg because he'll just take that as zero to 60.
[SPEAKER_04]: I guess I got permission to have sex.
[SPEAKER_04]: And he will.
[SPEAKER_01]: Well, and that was the big thing with you and I too.
[SPEAKER_01]: I had to be like, okay, I'm going to touch you Tara, but that doesn't mean anything.
[SPEAKER_01]: All I'm doing is touching your shoulder like we had to like be explicit.
[SPEAKER_04]: Well, early on, which is why that therapist has a nice way of doing it to let it be on the woman, to say, what would you, like, what would feel great to you know, or even a code word, like no expectation, you know, kind of thing.
[SPEAKER_02]: I think that's great.
[SPEAKER_02]: We do that a lot of that, like, especially with a couple of where one does have shame or early sexual trauma.
[SPEAKER_02]: We do a lot of
[SPEAKER_02]: You know, the expectation is like, there's no physical contact today.
[SPEAKER_02]: You're just going to like lay next to each other without a pillow between you.
[SPEAKER_02]: I mean, we've seen the whole gamut.
[SPEAKER_01]: Yeah.
[SPEAKER_01]: So let me ask you a real direct question here, Dr. Softly.
[SPEAKER_01]: So like,
[SPEAKER_01]: When you have an individual who you've gotten their hormones back online and atomically things are possible again.
[SPEAKER_01]: There's not dryness.
[SPEAKER_01]: It might not be painful.
[SPEAKER_01]: What's the advice that you give them as far as like closing that gap?
[SPEAKER_01]: I love that question.
[SPEAKER_01]: Then because you're not dealing with their partner, you're dealing with a person who's going back being like, okay, what do I do now?
[SPEAKER_04]: Well, there's always a lot of, not always.
[SPEAKER_04]: I'd say 80, something percent of the time, they're still fear.
[SPEAKER_04]: They remember the pain, right?
[SPEAKER_04]: So when they remember having bleeding or tearing or pain from penetrative sex, and I spent three months and get everything all rehabilitated with estrogen and a laser,
[SPEAKER_04]: and we talk about lobes and we talk about vaginal moisturizers and they're all an I feel like okay you're ready you know get back on the playing field the truth is I do them a disservice if I just assume everything would be all right so we have to talk about
[SPEAKER_04]: Relaxing the muscles not just the tissue and we call this vaginismists and it's not that rare It's like 13 to 17% of all women and it's that reflexive tightening and clenching in the pelvis that Because someone used to feel pain so I'm long-winded way of saying it's not as simple as getting the tissue better
[SPEAKER_04]: but we use dilators and toys and things to practice with to so that they're brain can relax.
[SPEAKER_04]: We actually use vaginal valium.
[SPEAKER_04]: We can put valium suppositories in the vagina and hour before sex.
[SPEAKER_01]: I'm waiting for tear to say, sign a sister out.
[SPEAKER_04]: But after an hour before sex, they do a little suppository valium, a teeny bit goes in the bloodstream, so your brain gets a bit relaxed, but those pelvic muscles gently relax.
[SPEAKER_04]: So these are just ways to cheat a little bit.
[SPEAKER_04]: And then of course the communication and how do we talk to our partner so that the partner's patient the last thing you want is a partner that goes all right you've been with doctor's office for three months Yes, you're ready to go let's do it.
[SPEAKER_04]: You know, I mean that's intimidating right
[SPEAKER_01]: So we got to, it's kind of jumps back to our first episode a little bit, like, because there's been interventions, you know, pharmaceutical interventions that you've, you've told us about the both of us have never heard of.
[SPEAKER_01]: Tara went back to her doctor, and like basically is sort of managing her own health care a little bit now by making suggestions, like what percentage?
[SPEAKER_02]: Thank you, Dr. Savov.
[SPEAKER_01]: Dr. Savov.
[SPEAKER_01]: In your field, our actually
[SPEAKER_01]: You know, something like we said, like a repository of value and like come on, like who was?
[SPEAKER_04]: Probably two percent, probably two to five percent, I mean, all of a sudden, yeah, it's just the training.
[SPEAKER_04]: We were trained to deliver babies and do surgery and do patchmares.
[SPEAKER_04]: And it's a grueling for your residency and nobody says, gee, I'm working 125 hours a week.
[SPEAKER_04]: I'd like to work more and learn about sexual health.
[SPEAKER_04]: And so this is a big thing.
[SPEAKER_04]: I want, you know, is to rehab and renovate clinical education and actually a number of states are now mandating menopause continuing medical education for clinicians to get re-relicensed.
[SPEAKER_04]: So, I mean, it's not going to happen fast, but we'll try.
[SPEAKER_02]: The visual I'm having around kind of vaginal relaxation is like, you know, because you used to be an OBGYN or still no OBGYN, but it's like when I go for my pap smears and that freaking thing would enter me and my entire body lower half would just tense up in the doctor, be like, okay, you've got to relax your muscles, but imagine if you have, because I had that every two years, imagine if you have that almost every time you're about to have sex.
[SPEAKER_04]: Yeah.
[SPEAKER_04]: and you don't know how to live up here, and then when it hurts every time, of course, you're going to do that before.
[SPEAKER_04]: So we work with something called dilators or trainers.
[SPEAKER_04]: They're like little silicone penises of different sizes and it's just start little and when that's comfortable, go to bigger and bigger and it's honestly works.
[SPEAKER_04]: You know, and if not that, then pelvic floor physical therapy and if not that, then
[SPEAKER_04]: you know, you can use the vaginal volume.
[SPEAKER_04]: So there's lots of ways to get get through that.
[SPEAKER_02]: What is like, what do you notice when people have like taken those risks, right?
[SPEAKER_02]: And they're feeling better and more empowered.
[SPEAKER_02]: Like, what's their story?
[SPEAKER_02]: They're before we we've talked a lot about it, right?
[SPEAKER_02]: Scared fear of falling.
[SPEAKER_02]: But what do you see after?
[SPEAKER_04]: After I see people feeling like literally like they've had a rebirth or a new relationship, and just like someone who might be divorced or widowed and then finds the love of their life, and they're like, oh my God, I never thought this could happen.
[SPEAKER_04]: I have an 85-year-old patient, and she and her husband were married since high school, after high school, only partner for each of them.
[SPEAKER_04]: and she came to me recently and said, I don't know how many more years I have, but we have terrible sex.
[SPEAKER_04]: He's a terrible lover and I want pleasure for myself and I want it before I die and I want you to help me.
[SPEAKER_04]: So we're working with toys and dilators and helping her orgasms on her own.
[SPEAKER_04]: now we're trying to figure out how we can help him be a better lover and her big bond recently was I'm actually considering having it a fair because I'm so happy now that I've discovered pleasure that I want it with a man and part of me my heart is breaking that she's 85 because I've known her 17 years and I'm I'm crushed that she didn't come to me 17 years ago with this but she felt it was a betrayal of her marriage.
[SPEAKER_02]: Yeah.
[SPEAKER_04]: But she wants it.
[SPEAKER_04]: So yeah, there's a lot of, and look, we have internet dating now, right?
[SPEAKER_04]: So if you're single or widow divorced, it's a lot faster and easier to have different partners to learn different styles and techniques.
[SPEAKER_04]: I mean, it's scary, too, right?
[SPEAKER_04]: But it's also enabled midlife couples or singles, let's say, to be able to explore or experience sex that they may not
[SPEAKER_04]: had before.
[SPEAKER_04]: I mean, that can also be bad, right?
[SPEAKER_04]: You can have people demanding things of you, and obviously don't ever do anything.
[SPEAKER_04]: You're not comfortable with, right?
[SPEAKER_01]: I mean, I think this, like, really, you know, kind of circling back to those first two points.
[SPEAKER_01]: Yeah.
[SPEAKER_01]: The know thyself.
[SPEAKER_01]: And then communicate is couples just need to realize that this is a this is a we problem if things aren't happening in that aspect of your relationship it's something that both of you can be empowered and it's something you might need some help with and that's that's great, but it's like if you can take that on with your partner and be like we want to
[SPEAKER_01]: And I like pleasure, you know, I think if we can get them out of like we want to have good sex and but we want to have pleasure with one another because I'll tell you what, like as Terran, I have worked through this stuff together.
[SPEAKER_01]: we have more like broad pleasure.
[SPEAKER_01]: We have more pleasure in the kitchen.
[SPEAKER_01]: You know, things are more like, are easing up and it was so heavy for a long time.
[SPEAKER_01]: And we're still working through it for sure.
[SPEAKER_01]: But I feel like we have more pleasure now and it wasn't a one of us problem, you know?
[SPEAKER_01]: Yeah, yeah, yeah, yeah, it was a week before.
[SPEAKER_04]: Realize that.
[SPEAKER_04]: Yeah.
[SPEAKER_04]: And my book talks a lot about pleasure and the right to pleasure and why culturally do women not feel they have a right to pleasure?
[SPEAKER_04]: I mean we allow men we encourage men to masturbate as teenagers we accept it but for women it's like you know we even use the phrase guilty pleasure.
[SPEAKER_04]: Right?
[SPEAKER_04]: Oh, I'm watching that TV show's my guilty pleasure.
[SPEAKER_04]: Why that?
[SPEAKER_04]: F should you feel guilty for watching a TV show or getting a massage or whatever?
[SPEAKER_04]: So I think women as a species, as a gender, I guess, have to reconcile this whole socio-cultural pleasure is bad for women that.
[SPEAKER_04]: Like, throw that away.
[SPEAKER_04]: I don't know where they came from.
[SPEAKER_04]: And I think once they do that, they might feel a little more empowered to ask
[SPEAKER_04]: they want or get it themselves by knowing their body and then find the courage or the practice to say to their partner, you know what, I'd love, I'd love you to give me a massage before we do anything because I may not want to do anything else, I think it's very much about pleasure, very much.
[SPEAKER_01]: Well, we want to get the word out.
[SPEAKER_01]: The bedroom gap is out there.
[SPEAKER_01]: It's available on Amazon.
[SPEAKER_02]: Can we order it?
[SPEAKER_01]: Yeah.
[SPEAKER_01]: You can order it.
[SPEAKER_01]: We'll make sure it is in our show notes.
[SPEAKER_01]: We'll get all the information as we did in the last episode about you.
[SPEAKER_01]: Dr. Safakiz, where people can reach out and connect with you, we think, you know, you're obviously, like, a really cool, fun person to talk with.
[SPEAKER_01]: It's so fun, but you have, like, it's mutual.
[SPEAKER_01]: You have tools that people don't, like, don't have a clue about.
[SPEAKER_02]: Vatch no value.
[SPEAKER_01]: Yeah.
[SPEAKER_02]: Just saying.
[SPEAKER_02]: Okay.
[SPEAKER_02]: Just saying.
[SPEAKER_02]: Yeah.
[SPEAKER_04]: Now we'll, we'll be able to trace where Tara's vaginal valium habits started.
[SPEAKER_04]: Yeah.
[SPEAKER_04]: I'm so glad to be able to share some of these things.
[SPEAKER_04]: There's lots more, and I think the goal was that people feel comfortable listening to this podcast and sending you questions and finding me what reading the book, whatever they need to do to understand that sexual health is human health.
[SPEAKER_04]: We know that staying sexually active
[SPEAKER_04]: and sing connected to your partner in the long term leads to longevity and a healthier you, you know.
[SPEAKER_01]: I was just telling Tara this the other day, I did research around like paid me to close with that.
[SPEAKER_01]: Yeah.
[SPEAKER_01]: Lengthen your life, heart disease, Tara has big existential issues.
[SPEAKER_02]: Make your leg long, Tara.
[UNKNOWN]: Yeah.
[SPEAKER_02]: Oh my goodness, well, thank you so much, Dr. Suffolk.
[SPEAKER_02]: Please, well, always be in touch just to keep all the research you're doing and FDA stuff like this is not our last rodeo with you just FYI.
[SPEAKER_02]: Again, listeners, thank you.
[SPEAKER_02]: We chat with questions.
[SPEAKER_02]: You know, we always get back to you.
[SPEAKER_02]: As always, take care of yourselves.
[SPEAKER_02]: Take care of each other.
[SPEAKER_02]: Bye bye.
[SPEAKER_00]: And you just sing and I'm a train, me and you listening to the rain Me and you are the same, me and you have