Menopause does not wait until you feel “old,” and it does not only live in your hot flashes. In this episode, I sit down with Dr. Lauren Streicher, one of the leading experts in menopause and sexual medicine, to talk about sexless relationships, painful penetration, and why so many women suffer in silence when solutions exist.

We break down what really happens to your hormones, blood flow, muscles, nerves, and brain during perimenopause and postmenopause and how all of that shows up in your sex life. Dr. Streicher explains why painful sex is never something you should push through, why lubricants on their own rarely fix the problem, and why local vaginal estrogen is one of the safest and most misunderstood treatments in midlife.

We also talk about access to care. Who helps you when your doctor shrugs, you live outside a big city, you are on Medicare, or you survived cancer and nobody ever mentioned sex in your follow up. Dr. Streicher shares what a real sexual medicine consult looks like, why pelvic floor physical therapy often changes both back pain and bedroom pain, and why there is no expiration date on your vagina, even after years of a dry spell.

If you are in a sexless relationship, scared of hormones, or confused about where to start, this episode will give you language, options, and hope, plus a roadmap to Dr. Streicher’s new deep dive audio course, “Come Again,” for women and professionals who want real data, not fear.

In This Episode:

00:00 – Welcome and show intro.

00:32 – Why sexless relationships link to menopause.

02:10 – Menopause is not an “old woman’s” issue.

04:20 – Sexual problems that start before menopause.

06:30 – What a normal sexual response needs.

09:25 – How estrogen loss affects sex and desire.

12:40 – What happens in a sexual medicine consult.

15:20 – Why doctors rarely refer to sexual medicine clinics.

18:05 – Telehealth for menopause and its limits.

21:30 – Why menopause never fully “ends.”

25:05 – Painful sex and the need for accurate diagnosis.

29:10 – Vaginal estrogen use, placement, and safety.

33:15 – Partners, pain, and the “use it or lose it” myth.

36:40 – Pelvic floor pain, SSRIs, and low libido.

38:40 – Wrap up and closing message.

Want a deeper look? Watch the full episode on YouTube for a more visual experience of today’s discussion. This episode is best enjoyed on video—don’t miss out!

Karen Bigman, a Sexual Health Alliance Certified Sex Educator, Life, and Menopause Coach, tackles the often-taboo subject of sexuality with a straightforward and candid approach. We explore the intricacies of sex during perimenopause, post-menopause, and andropause, offering insights and support for all those experiencing these transformative phases.

This podcast is not intended to give medical advice. Karen Bigman is not a medical professional. For any medical questions or issues, please visit your licensed medical provider.

Looking for some fresh perspective on sex in midlife? You can find me here:

Email: karen@taboototruth.com

Website: https://www.taboototruth.com/

Instagram: https://www.instagram.com/taboototruth

YouTube: https://www.youtube.com/@taboototruthpodcast

About the Guest:

Lauren Streicher, MD is a clinical professor of obstetrics and gynecology at Northwestern University’s Feinberg School of Medicine, a certified menopause practitioner of The Menopause Society, and the founding Medical Director of the Northwestern Medicine Center for  Sexual Medicine and Menopause. She is  a Senior Research Fellow  of the Kinsey Institute of Indiana University.  

In addition to her academic appointment at the Feinberg School of Medicine, Dr. Streicher is on the faculty of Northwestern University’s Graduate Program in Reproductive Science and Medicine for students pursuing a Master of Science degree in medical research.She is also the Faculty Advisor for The Medical Student Forum on Female Sexual Dysfunction, an organization to facilitate Chicago area medical students to collaborate, learn, and educate their academic peers about female sexual medicine. Dr. Streicher serves on many advisory boards including The Kinsey Institute, Let’s Talk Menopause, Let’s All Talk Menopause, Tell, LUWI, and Midi Health. Read more: https://www.drstreicher.com/about

Connect with Dr. Streicher:

Website: https://www.drstreicher.com

Instagram: https://www.instagram.com/drstreich

Substack: https://drstreicher.substack.com/

Podcast:: https://www.drstreicher.com/podcast

Limited Podcast ‘Come Again’: https://www.drstreicher.com/comeagain

About the host:

Karen Bigman, a Sexual Health Alliance Certified Sex Educator, Life, and Menopause Coach, tackles the often-taboo subject of sexuality with a straightforward and candid approach. We explore the intricacies of sex during perimenopause, post-menopause, and andropause, offering insights and support for all those experiencing these transformative phases.

This podcast is not intended to give medical advice. Karen Bigman is not a medical professional. For any medical questions or issues, please visit your licensed medical provider.

Looking for some fresh perspective on sex in midlife? You can find me here:

Email: karen@taboototruth.com

Website: https://www.taboototruth.com/

Instagram: https://www.instagram.com/taboototruth

YouTube: https://www.youtube.com/@taboototruthpodcast

Substack: https://karenbigman.substack.com

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