EXPLICIT. Let’s talk about sex, baby! Co-hosts Erin Stein and Dr. Gillian Goddard welcome Dr. Jenn Kennedy, a board-certified sex therapist, for a frank and funny conversation about desire, intimacy, and what changes in midlife. We’ve got you covered at every age with this fabulous episode.
Jenn explains why sex can feel complicated in midlife from the exhaustion of raising kids and building a career to the changes of perimenopause and beyond as our bodies change. She talks about desire discrepancy between partners, what’s actually “normal,” and why widening the definition of sex can take the pressure off. Gillian shares why vaginal estrogen is worth knowing about at any age, and why lubricants alone often aren’t enough.
Then Jenn walks us through how masturbation and self-knowledge can help you understand your own pleasure. We also get practical with tools that can help, tips to start the conversation with your partner, how to bring up concerns with your doctor, and what to look for if you seek out a sex therapist.
References:
Find out more about Jenn Kennedy, PhD and LMFT, on her Instagram @drjennkennedy; on her website at drjennkennedy.com or pleasureproject.us and listen to her podcast here: pleasureproject.us/podcast
To find a local sex therapist search www.psychologytoday.com for licensed providers.
Some of the products Dr. Kennedy mentioned can be found at www.womanizer.com; www.heytabu.com; and www.estherperel.com.
For the prudish among us, Erin also recommends a book she published, Ready For It by Chusita Fashion Fever. (Yes, really.)
We take a moment to remind you that while this is a medical discussion, it is not providing a diagnosis or treatment or any medical advice. The only way to get a diagnosis, treatment or medical advice for your particular condition is through a discussion with your doctor.
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Visit www.thesavvypatient.com/podcast for episode transcripts.
Watch full podcast episodes @TheSavvyPatient on Youtube.com.
Get your copy of The Hormone Loop by Dr. Gillian Goddard wherever books are sold.
This episode was produced and edited by Erin Stein. Music: “All We Live For (instrumental)” by Wolfclub licensed through Audiio.com. Intro and outro edited, and video created, by Ian Mayer. The Savvy Patient logo by Amanda Spielman.
TRANSCRIPT
Erin Stein: Hello and welcome to The Savvy Patient. We have a very special episode for you today with a special guest.
Gillian Goddard: I know I'm so excited. I'm so excited to welcome Dr. Jenn Kennedy. Jenn is a sex therapist. And so today we're going to talk about sex.
Erin Stein: We all need Doctor Jenn.
Gillian Goddard: Jenn, can you introduce yourself to our audience?
Dr. Jenn Kennedy: Sure. Yeah. So, I am an LMFT and I'm a sexologist. So, I see couples and individuals coming in for therapy with issues around dysfunction, meaning things aren't working, or dissatisfaction, meaning they don't like the sex they're having. So, it's around sexuality, intimacy, kind of that whole spectrum of issues relating to sex and sexuality.
Gillian Goddard: Amazing.
Erin Stein: Sexologist is an amazing title.
Dr. Jenn Kennedy: Yeah. I know, isn't it fun?
Erin Stein: It is fun. I love it.
Dr. Jenn Kennedy: Yeah. My business card said chief sexologist. I was like, yeah, that's what I am. I'm the CSO.
Erin Stein: Yeah, that's right. Sexologist in charge. I love it.
Gillian Goddard: That's right. That's right. Well, we wanted to have you come and join us because, you know, much of our audience is women in their 30s, 40s, and 50s. And we know that the perimenopausal transition can be a time when women struggle with sex or maybe they encounter problems with sex or issues related to sex or intimacy with their partners for the first time. It's such an important topic. And so, we really wanted to have an expert come and talk with us about it.
Erin Stein: And also, we were both raised Catholic, so we are not the people to talk in depth about it. And I've shared a lot on this podcast so far.
Gillian Goddard: Ha ha ha ha!
Erin Stein: I spent two episodes just talking about my boobs.
Dr. Jenn Kennedy: Ha ha!
Erin Stein: But I have a husband and he might not want all of our details shared. So, I can't just use my personal experience on this episode.
Gillian Goddard: Yeah.
Dr. Jenn Kennedy: No, there's so much going on between 30 and 50. My goodness, right? Like there's just so much going on. And I feel like, yes, the twenties are easy. Sexuality should be just like turnkey; it's just like the turn on seems very accessible. And then 30s. I mean, you talk about this in your book, which I loved, by the way, Gillian.
Gillian Goddard: Yeah. Thank you.
Dr. Jenn Kennedy: I like how you broke it down, sort of what happens throughout the life cycle, because it's so true. And the women that are typically, I mean, not always, but starting to raise kids and going into careers and doing things in their 30s are sort of I think shocked at how little sex they want when all those things are happening because we're competing for resources, right? It's like you've only got so much attention; you've only got so much energy. And also, your body has changed if you've given birth and you're going in a million directions. But that's before you, typically, before you even reach the perimenopause.
Gillian Goddard: Right?
Dr. Jenn Kennedy: That's a whole different kettle of fish that's coming for you that nobody talked about. I mean, I was like, is this like a secret that everyone kept under the covers? And now I'm 53 and I'm in the thick of it and all my friends are like so chattering about, it. But yeah, forties are a different animal and fifties for sure.
Gillian Goddard: Absolutely. Can you talk a little bit about sort of why these times are so challenging and what kinds of things do you see coming up for women during this time?
Dr. Jenn Kennedy: Yeah, so I kind of mentioned in the thirties, typically family is starting, career is starting, it's early career, so they're jockeying for like position and you know, I find that I don't see a lot of people coming for sex therapy at that age, but that is changing a bit. We definitely are starting to see more conversations around polyamory. So, they're looking to help have some support around contracting that. The new generation is very different. They don't commit in the same way; they don't marry and settle down and start a family as much as people used to. So, trying to understand that for those people that went through COVID even more so have had some struggles in their twenties now with commitment. You know, we've seen a delay in terms of dating, wanting kids, wanting family. Do we even have that traditional structure? It is all sort of like up for grabs now. And so, we're finding that it's more challenging to be relational. And so, sex is part of that. They might have hookup sex, but they're having challenges with like, how do we relationship build? How do we articulate needs? Also, if you've been raised with a lot of porn, you're having some sexual dysfunction show up. And so, we're seeing that in 20s and early 30s is like my erotic template looks different because I've had so much influence. I also don't know how to show up interpersonally in the same way. So that's sort of a 20s, early 30s thing going on with 40s. You're starting to see, you know, they have kids that are maybe, middle schoolers or something like that. So, they're in it, they're running to sports, they're doing lots of activities, they're more mid-career. I've got a bunch of those parents in my room going, I am exhausted. I cannot give anything more. And where do we find time for a date night?
Gillian Goddard: Yeah.
Dr. Jenn Kennedy: Desire doesn't exist when you are constantly under pressure to try to do all these other things. It's really hard, right?
Gillian Goddard: Yeah.
Dr. Jenn Kennedy: Desire exists when you want to play, when you want to explore, when you want to be goofy and curious and you can't when you're just like trying to get all the parts organized. And so that's hard.
Gillian Goddard: Yeah, I also had a friend say, you know, it gets hard when your kids get older, they're not going to bed early anymore. And if you go in your bedroom and you lock the door, they may know exactly what is going on in there.
Dr. Jenn Kennedy: They're like [knocking sound].
Gillian Goddard: That can make everybody feel a little uncomfortable.
Erin Stein: There's no escape.
Gillian Goddard: Finding the space. Yeah.
Dr. Jenn Kennedy: A lot of people don't want to lock the door, or if they don't lock the door, then still like they hear the kid's bedroom is adjacent. And also, it's just hard to shift from parent mode to erotic partner mode. Right?
Gillian Goddard: Yes.
Dr. Jenn Kennedy: Those parts of your brain are like kind of different.
Gillian Goddard: Not all that closely connected.
Erin Stein: We recorded a whole episode about being the sandwich generation. Like, your kids but also your parents, other adults you're caring for, plus your life, your job, your house, your flat tire. I mean on the car, not on your body. [Laughter.] I had a flat tire this week, but it it's just there's so much.
Dr. Jenn Kennedy: Well and we're talking about men versus women because I find that men are raring’ to go for quite some time. And a lot of who's coming into my office is, in the heterosexual construct, the men are bringing in their wives 'cause the wives especially are around 45 to 55 saying I'm kind of done. Right? I don't really care or I could take it or leave it. Especially if they're starting to have vaginal dryness and they're having all the perimenopausal stuff. They're just like, I've raised kids, I've done my duty, I'm like kind of done.
Gillian Goddard: Ha ha.
Dr. Jenn Kennedy: They don't realize they can get vaginal estrogen and stuff. But also, they haven't really been having a good sex life for quite a while anyway. So, the men are still quite high interest and so we're calling that a mismatched interest or, desire discrepancy. The women could take it or leave it. What I have seen though is that a lot of times she just has never had really great sex.
Gillian Goddard: Yeah.
Dr. Jenn Kennedy: I'm also seeing a cutoff in terms of women right now they're about 50. Plus, maybe even a little bit older, have never really known how to ask for that, didn't feel entitled to it. And so, I'm seeing a cultural shift where the younger generation is like, no, no, like I deserve this as much as he does. And so, I'm going to ask for it from the outset. Our pleasure matters equally. And so, if you can get what you want and if the sex is really rewarding, you're probably more incentivized to do it. But if you're just like this is another chore, no thanks, you know?
Erin Stein: Yeah. That makes frankly a ton of sense. Um, I think that it's heartening to hear you say that it is changing, because it should be. There's been such a deficit and inequality in these you know, societal constructs that so many people feel like they have to conform to. So, it's nice.
Dr. Jenn Kennedy: Yeah.
Gillian Goddard: Yes.
Dr. Jenn Kennedy: I think it's been a changing messaging overall. I think women now have jobs and money and more opportunity. And I just think with that has come more of a sense of pleasure and entitlement or interest and having access to healthcare that matters, like so many women. Again, you see the cutoff of all those women that didn't do hormone replacement.
Gillian Goddard: Right.
Dr. Jenn Kennedy: And they just suffered through it. This new generation of women who are actually using HRT makes such a difference. And the vaginal estrogen makes all the difference with comfort.
Gillian Goddard: All the difference. And I think that one of the things that is so important to tell women because that generation of women who didn't get hormone therapy around menopause, you can still get vaginal estrogen. There is no time cutoff for vaginal estrogen if you are 65, 75, it is safe to start vaginal estrogen. Any time even if you are many years past menopause and so I would like broadcast that shout it from the rooftops.
Dr. Jenn Kennedy: Mm-hmm.
Gillian Goddard: Because it's so important for, I mean comfort…
Dr. Jenn Kennedy: They're like, do I want to open that up for business again? Right.
Gillian Goddard: Well, it's also Important for other things like preventing urinary tract infections.
Erin Stein: I think that some women may not know they could be back open for business.
Gillian Goddard: Right?
Erin Stein: You've been told, and this is where media and society come in, like you're told you're done. You know, listen, Madonna is 70 and everyone's like, go away. Get out of here. I don't want to see you. Put your boobs away. She can have her boobs out! She's probably having a better sex life than most of us.
Gillian Goddard: I know.
Erin Stein: Bless her for it, you know? Like you don't have to shut down and be done for the rest of your life just because you're older. But you said something else, Jenn. I mean, I think there's sex for pleasure and there's sex for procreation. And we tie those two together so much when we don't have to anymore at a certain point.
Dr. Jenn Kennedy: Yeah.
Gillian Goddard: I always joke with my patients who are talking about trying to get pregnant that there is nothing less sexy than the sex you have to try to conceive.
Dr. Jenn Kennedy: Yeah, right. It's like so focused and you know, it just pushes all the air out of the room when you're like staring too hard at the thing and wanting it too badly, you know?
Gillian Goddard: Exactly. Let's talk a little bit about examining this idea that there's like a right level of activity in your intimate relationship and in your intimate activities with your partner. I think people feel like there's like a right amount of time, like…
Erin Stein: Number of times you're having sex every week or every month. I mean, people have like these stats, you know?
Gillian Goddard: Yes, yes. They do.
Dr. Jenn Kennedy: Yeah. This comes up a lot where people are, are we normal, right? They want to know like what's the frequency.
Gillian Goddard: Yes, exactly.
Erin Stein: Right.
Dr. Jenn Kennedy: And I would say it depends—well everything depends—but it depends on how long you've been together. And if you've been together under, I'd say a year and a half, typically there's a fall off after kind of that point. Hate to announce that, but you know, the limerence period is usually six to eighteen months. And then after that we start to see a fall off. Younger couples might be having it twice a week, couples that are I would say over 45. I see a lot of older couples, older being 50 to 70 is kind of more my population. Maybe once a week, maybe once a month, you know, more
Gillian Goddard: Yeah.
Dr. Jenn Kennedy: Frequently than once a week is more unusual, I would say. Once a week is you're doing great.
Gillian Goddard: It's also—correct me if I'm wrong—I think if everybody's on the same page and everybody's happy with the frequency, then you don't have a problem.
Dr. Jenn Kennedy: No, absolutely not. I just want to do a caveat too, is that how are we defining sex? Because I want to be careful and not go back to the, you know, the heterosexual construct of like, is it penetration? Does it have to end in orgasm?
Gillian Goddard: Mm-hmm. Right.
Dr. Jenn Kennedy: Because I feel like that's a little bit of a setup. And that's the setup that especially is a quagmire for older couples. Because if it can be erotic play, if it can be maybe mutual masturbation, if it can be I'm like bumping up against all your guys' Catholic stuff right now. [laughs]
Gillian Goddard: Yeah, that's okay. That's all right. We're both we're both lapsed, so…
Erin Stein: I rejected it long ago, but it's there.
Dr. Jenn Kennedy: Okay. Because it's like sex can be, if we really widen the definition, right? And it's like I'm trying to get my couples to just bring a toy in or do something. Just do something that feels playful, that feels good and erotic to you. And it does not have to end in one or both of your orgasming. It doesn't, right? Take the pressure off. Then people are a lot more willing to engage and it feels more successful, especially if someone's having dysfunction. Because if someone's having dysfunction, then a lot of times shame rolls in and it leads to a whole bunch of other stuff. And then both people feel so much trepidation. So, if you can have some sort of erotic exchange, that to me feels like the qualification we're going for here. And have it be, you know, ideally what, maybe every seven to ten days, something like that, that would be great, you know?
Erin Stein: Love ‘erotic exchange.’ What a wonderful phrase to use. Cause I do think there's so much pressure. I think so much of this comes from pressure on yourself maybe from your partner, maybe just from society at large. Like we said, people want to know what's normal, is something wrong with me, but there's also just time periods where there's a lot going on and you're just not going to be having much sex until you get through it, right? It is normal to have it and it's normal to not have it. And it's normal for it to take multiple forms, different forms, like you were just describing. And I think the whole thing needs to just be opened up. Um, but it's hard and you know, the Catholic childhood made it difficult to talk about these things, right?
Gillian Goddard: Yeah. I'd love to talk about that. I'd love to talk about if you're someone who for whatever reason has concerns about your intimate life with your partner, how do you recommend people kind of broach those conversations?
Dr. Jenn Kennedy: In terms of like it's not happening or you don't like the quality or
Erin Stein: Yeah, like I guess we're thinking if you're talking to your partner, like how do you even bring it up to start? How do you say, hey, let's talk about our sex life? Is it good for you or not? And maybe I would like something else? You know, how do you even start that?
Dr. Jenn Kennedy: Well yeah. Well, if you want an assist, I would say listen to a podcast. That's a way or like Esther Perel has this really great card game that asks and prompts a lot of questioning, right? You can bring in a third thing that can sort of give you guys something to respond to, then it doesn't feel like you're carrying the whole conversation. Of course you can see a sex therapist too, but that might feel like varsity level, like you're like, ah, we're not broken, you know.
Erin Stein: Yeah.
Gillian Goddard: Hahaha
Dr. Jenn Kennedy: But you know, depending on the comfort and how informed your regular couples therapist [is], they might be able to navigate the conversation. A lot of times they're not actually that skilled at it. They get a little nervous too. I find that a lot of therapists are kind of queasy when talking about sex.
Erin Stein: Ha!
Dr. Jenn Kennedy: It's remarkable. And I don't know, primary care people too.
Gillian Goddard: Oh, my goodness.
Dr. Jenn Kennedy: I made my primary care person very nervous when I, you know, asked her some questions. She was like, ugh, her eyes got all like…
Erin Stein: Yeah.
Dr. Jenn Kennedy: I was like, I think I bruised my cervix with a, you know, I was testing this, it was like a glass dildo basically, and she was like, “What?” She was like, “I don't I don't know. I don't know.” I was like, okay, I've made you uncomfortable, it's okay.
Erin Stein: Some people are very private about it, and they, you know, feel like this is not something you discuss with people, but it is part of your health care. You do need to sometimes talk to your doctor about it. And it should be something you can talk to your doctor about.
Gillian Goddard: Yes.
Dr. Jenn Kennedy: Yeah. And it's like if you don't know how to bring it up with your healthcare provider, it might feel really foreign bringing it up. I mean, they are your intimate partner and yet there's lots of people having sex that don't know how to talk about it.
Gillian Goddard: Yeah.
Dr. Jenn Kennedy: Sometimes an avenue in, I think it's a great question, is hey, I heard this podcast. Um, would you listen to it and then can we talk about it? Like how do you think about that? You know, and so it's somebody else is saying it, this is a great launch point, you know?
Gillian Goddard: Yeah, I love that. If you want to talk about it with your doctor, I would say, I mean, in my experience, people have definitely different levels of comfort. The thing you don't want to do if you want to talk about it with your doctor is kind of bury the lead. One of the things that I see a lot when people come in and have sexual concerns is that they spend the whole visit talking about other things and then you literally have your hand on the doorknob and they're like, “And I'm having this problem with sex” and you're like, That's why you're really here it.
Dr. Jenn Kennedy: Yeah, yes, yeah.
Erin Stein: It took a lot for them to say. I would write it on a note and fold it on a piece of paper and slide it over to you. You can read it to yourself. I'm not going to say it out loud.
Gillian Goddard: Ha ha!
Dr. Jenn Kennedy: Right.
Gillian Goddard: I had the most evolved conversation with a couple the other day where the couple are both patients and they often come together and one of the things that they wanted to do with this visit was talk about some issues in their sex life that were related to a mismatch in desire that was very clearly perimenopausal and it ended up being a really great and I think very useful conversation and we put a plan in place. It in may have involved trying out a little testosterone for hypoactive sexual desire disorder, which is the technical term for struggling with desire and arousal. In this case it was bothering her and it was creating tension in their relationship. The key is knowing what you want to talk about and not waiting to the last minute to bring it up.
Dr. Jenn Kennedy: I'm a sex therapist, so most people come to me with that knowledge,
Gillian Goddard: Sure.
Dr. Jenn Kennedy: But also on my intake paperwork, I signal it, right? I ask specific questions and I think it's helpful if providers do that because then it gives permission, it signals this is a place to bring that up.
Gillian Goddard: That's great idea.
Dr. Jenn Kennedy: You know, I do training sometimes for providers. Medical providers and um healthcare of different kind providers. And so, I give like sample statements of how you might in the natural, you know, course of questioning that you would do bring up so you don't just sound like, you know, creepy. You know, like, how's your sex life?
Erin Stein: Ha ha ha.
Dr. Jenn Kennedy: It's an extension of your normal line of questioning of like, how is your health? How is your sex life? So, like if you're having trouble with sleep, if you're having trouble with blood pressure, if you're having trouble, this would be a natural thing to ask about as well. You know? So hopefully you can do that and not have your tummy going inside and like freaking out as the provider.
Gillian Goddard: I will tell you, it is definitely not something that we got a lot of training on. I mean, when I was in med school, and this is going back many, many, many, many moons. I mean, the big thing that we were trained on was just to ask in a nonjudgmental way whether someone was having sex with men, women, or both. For health reasons and to be assessing risk.
Dr. Jenn Kennedy: Mm-hmm.
Gillian Goddard: And that was it. That was all the education we got about talking about sex I think everybody was like patting themselves on the back like ‘we're so accepting.’
Dr. Jenn Kennedy: What if the answer is all three, you know? It's like or what I guess that'd be the both, right? And then you're like right What if the answer is all. Okay, so then that leads down a road of questioning, you know? So yeah.
Erin Stein: Yeah.
Gillian Goddard: Yeah. Yep.
Erin Stein: I like how you started talking about how we define sex, how that might shift and how that might look different. Is it the same with desire? I feel like desire in your twenties is very hormonally driven, perhaps. Does that shift and change? I'm kind of trying to get at like when we get to midlife, things are not the same as they were when we were teenagers or in college. We have more life experience, probably more sexual experience, and we may have been with a—
Gillian Goddard: Some of us may have been with our partners for a long time.
Erin Stein: Or a couple of decades. So how does desire change?
Dr. Jenn Kennedy: Well desire is like so much up here. It is different when you've been with the same partner for many years, ten, twenty, thirty years. It definitely is a question that arises a lot in the people I see because you're returning to the same thing, the same approach.
Gillian Goddard: There's no novelty.
Dr. Jenn Kennedy: Yeah, well there typically isn't, but…
Gillian Goddard: Or there may not be novelty, right.
Dr. Jenn Kennedy: You can introduce that; you can introduce any sort of; anything new is oftentimes welcome and interesting to the brain. It's like, what? Like if your spouse comes out or your partner comes out dressed in a particular way that you really like, it's like, ooh, you know, or you go on vacation, this I'm talking about me now. I love being in a nice hotel with good thread count, like sheets. I'm like everything's clean, you know, nice sheets.
Erin Stein: Yeah.
Dr. Jenn Kennedy: You know, just any sort of element, yeah, desire is interesting. And you have to understand, I've got, you know, some exercises that I do with couples that help them sort of cultivate like what creates desire for you. And part of that isn't just what positions do you like? It includes that, but it's also how do you turn yourself on? Like what do you what delights you from a sensory standpoint in a broader view? What time of day? Yes, what positions, but also what type of energy coming at you.
Erin Stein: I need to get into it before I'm in a position. Right.
Gillian Goddard: Ha ha!
Dr. Jenn Kennedy: Yeah, yeah, right. It's so many things. It's like, do you need intensity? Do you like it when your partner is very confident and also desire typically isn't just a flip of the switch. I mean, I guess it can be if they were really good at it, but like most of the time it's these little things that have been dropped along the way over the last ten hours or two days or whatever. It's the dance that you're doing in coordination, right? We can't see sex therapy outside of the relationship. It's a microcosm of the relationship. And so, I'm always looking at the health of the relationship. Like, how are you guys talking to each other? Is there respect? Is there mutuality? Is there common interest? Like how is the general relationship doing? And then also 'cause sometimes they're just really good friends and they they're good like business partners sort of in running the family. But then is there any real effort aimed also at like switching into this erotic space that feels particular? Like do you know how to also delight me and turn me on in the ways that get me here? And then also the physical ways too. Right. And so sometimes it's having very pointed conversations to cultivate those things.
Erin Stein: All of that is amazing. And for women, and I think this is a cultural, societal thing, but I think for women it is more in your head than physical. A lot of the times we call it foreplay; we call it getting in the mood. The leading up to the act is getting ready for it both mentally and physically and I think the two are totally tied together for many, many women. For a lot of reasons that I won't spend the next hour talking about.
Gillian Goddard: Ha ha.
Erin Stein: It's important to recognize that you have to be engaged mentally, not just physically. We think about sex a lot of the time as a purely physical thing. I see this attractive person and I'm physically attracted to them. I watch porn and I'm physically turned on. You know, we think about it as our body responding to something, but it really is also our brain, our head, our cognition, our feelings, you know, it is as you say, it's a whole scenario. It's not just the one moment.
Dr. Jenn Kennedy: Yeah. Well, you know what I find interesting though, like as I'm thinking about this, is the on ramp for partnered arousal it can be so long.
Erin Stein: Yeah.
Dr. Jenn Kennedy: And yet if you think about masturbation, I mean, that can be so short. Right.
Erin Stein: Yep. Yep.
Gillian Goddard: We tend to be very efficient when we are on our own.
Erin Stein: Mm-hmm.
Dr. Jenn Kennedy: It's like you can just pop in that soundtrack, you're like, I know how exactly how to get myself there, right? And yet when there's the relational element, there's just there's a lot of compounding factors that also can, you know. So, if you can extrapolate what really takes you there individually and bring that to your partner, what a gift. What a roadmap. But that's also super vulnerable and sometimes hard to do.
Gillian Goddard: Yeah. So, let's talk about masturbation a little bit.
Erin Stein: Yeah, let's do it.
Dr. Jenn Kennedy: Yeah, let's do it.
Gillian Goddard: Ha ha!
Dr. Jenn Kennedy: But by the way, I thought I invented it. No one admitted it to me until I was like in college. I started doing it when I was like four. And you know, I was like on the stairs and my mom was like, you need to go to your room, you know, that's for you privately.
Gillian Goddard: So normal.
Erin Stein: I know, bless your mother. I mean bless the parents who don't freak out because…
Gillian Goddard: Yes, who are like that's something we do when we're by ourselves.
Dr. Jenn Kennedy: Yeah, yeah.
Erin Stein: But it's fine, just go do it in your room.
Gillian Goddard: Yeah.
Dr. Jenn Kennedy: Yeah. I was like, this is amazing. And I literally never had a single person ever admit it. And then I got to college and I was like, okay, other people actually do this too. But yes, I'm shocked at how oftentimes religiosity gets in the way of like, don't do it, which again, I don't know if God could stop me from touching myself. I don't think it's—I don't think it would work.
Erin Stein: I really don't think it's his priority. I don't know.
Gillian Goddard: It just seems like he's got bigger fish to fry.
Dr. Jenn Kennedy: Yes, yes.
[laughter]
Gillian Goddard: Oh, my goodness. I do think that you get at something that is pervasive, which is this idea that somehow we're the only ones doing it and no one else is doing it. And I guess that's because it's personal and so then you don't talk about it with other people. It's really interesting to me how everybody seems to figure it out. And we all think we kind of invented it.
Dr. Jenn Kennedy: More or less. Yeah. I taught this online course for a while. I did it for a couple years and it was like that was one of the chapters was we talk about female masturbation, and it was live and I could just see it was on Zoom and the women would be so sheepish. But I was like, okay, let's get into some specifics. Like, who does it? How is it you know, and everybody would just be like, um, but eventually they'd start talking about it, again there was a delineation by age because the younger women are very much owning their pleasure, a lot of times using toys, various toys, and there's a range of toys. But part of what I was trying to get at is that different things please different bodies, you know, and vulvas are different in terms of pleasure center.
Gillian Goddard: Mm-hmm.
Dr. Jenn Kennedy: And I I've always asked who masturbates on their stomach. And women are like, that never occurred to me as an option. And I'm like, try it. Try it this week. And so, they come back to next week and report back. Have you tried it? You know? Like, try different things. Because you access different pressure points that way. Some women like internal, some women prefer to stay external without direct clitoral pressure. So, I think really understanding what your pleasure profile looks like is important and toys may assist in that. They don't necessarily need to, but just understanding what actually builds pleasure for you, I think is useful.
Erin Stein: And here we are at our message in every episode. Everybody is different.
Gillian Goddard: Yes, we do. We say this every week.
Erin Stein: Everybody's body will react differently. How your parts react to stimulation, different parts reacting to different kinds of stimulation, it's all going to be unique to you. And again, we treat sex like this monolith, like this is how it happens, this is how it works, this is how you're supposed to react and that's not true and I would imagine for many women in midlife at this point require some self contemplation.
Dr. Jenn Kennedy: Yes. Oh yeah.
Erin Stein: We get stagnant in our relationships, but you get stagnant in your relationship to yourself, right? You figure out how to masturbate at a very young age, usually, and you probably haven't varied your technique much.
Gillian Goddard: It's true.
Dr. Jenn Kennedy: Yeah. Yeah. It's like you got your go to and you just continue. Well, and sex in general. People kind of just have their greatest hits and they go back and it's like that's why I'm challenging you. And that's also why I'm getting specific is like I want you to try different things. I want you to see maybe something else works better for you. I have had women that have are like, “it doesn't work for me. I don't respond to it,” and I'm like, okay, let's understand why what what's happening because it might be something logistical. Like you might be actually touching yourself in the wrong place, or uh you might not like the direct pressure, or you might not like insertion. Like all of those things are fine. You might take a little bit more time, you know. The vibration usually will get you there eventually because it's really just a muscle spasm. So, it's going to work eventually.
Gillian Goddard: Mm-hmm.
Dr. Jenn Kennedy: Sometimes it's the vibration, sometimes… Womanizer makes this really amazing clit sucker that tends to be a crowd pleaser. And I've given that as a suggestion and several women that weren't able to orgasm with a traditional vibrator found that to be, like that worked. So, it just kind of depends. And women that didn't like oral sex actually did respond to that. So, it's kind of interesting. It depends, I think sometimes in having power over your pleasure. Can transform what you thought you liked and then what you actually liked.
Gillian Goddard: As with so many things, it's about taking some control, taking some agency goes a long way. So, let's talk about when someone or when might a couple think about seeking help from a sex therapist.
Erin Stein: How do they end up at your door?
Gillian Goddard: How, yes, how do they end up in your office?
Dr. Jenn Kennedy: Oftentimes they are referred by their therapist when I think they're out of their depth. But they would self refer when their issues are specifically about sex or they want to go more directly for that topic when it's around, like I said, dysfunction, meaning erectile dysfunction. A lot of times I get referrals from gynecologists for women that are having pain with sex, but there's really no gynecological explanation for it. So, it's a situation where they're having avoidance or guarding like with sex.
Gillian Goddard: Mm-hmm.
Dr. Jenn Kennedy: And so, we need to address that. And I see individuals too. So sometimes it's women that have just been really avoiding sex for quite some time and they want to be able to have a healthy sex life. So that's a good candidate. Also, sometimes certain medication regimens will cause some dysfunction. They might have reduced blood flow. So, they're going to have issues with erect erectile functioning, antidepressants, that type of thing. I can't necessarily fix those dysfunctions. It's going to be about, you know, working with what we've got and having a sex life that feels satisfying enough sometimes recalibrating your expectations, right? You've still got hands that work, you've still got a mouth that works.
Gillian Goddard: Right.
Dr. Jenn Kennedy: You might even still have a penis that sometimes works or partially works, works, meaning partially erect. So, it's having direct conversations to yeah, to just address these things because a lot of times, they're collapsing into shame and so they're just backing away from sex altogether. So that's the dysfunction. The dissatisfaction is a different conversation. That's when one or both people are not satisfied with the way things are playing out in their sex life. And so, it could be frequency. That's often how it comes in, but behind frequency is typically the mechanics. Right?
Gillian Goddard: Mm-hmm.
Dr. Jenn Kennedy: I usually separate those couples after seeing them once or twice. And so, then I can really get the download from each of them. And a lot of times from the women I'm hearing: “He's got no game. He doesn't touch me well. He just gets on me just like I got, you know, whatever, a minute and a half of like that and then it's done.” And so, they want a different type of approach. And so, I'm trying to understand what do they want, what would get them engaged, what might feel better, what might feel pleasurable. And then I'm negotiating that between, I'm bringing everybody back in. I'm trying to soften the delivery of the information, so it doesn't just sound like again, shaming or complaining or whatever. And we're trying to cultivate what's possible. Because otherwise sometimes couples don't want to hurt each other's feelings, so they're just not saying anything, or they're saying something that sounds so mean. It's just like ouch.
Erin Stein: That's I think part of why it's hard to talk to your partner sometimes is if you're unsatisfied, it's not necessarily a judgment on them because you haven't yet explained what you need, but by explaining what you need, you're sort of de facto saying you're not doing it, so you suck, right? Like so many people hear it as criticism as opposed to just, I'm trying to let you know what would work best for me so you can do it. And it's not always a bad thing that you're not doing it because you just didn't know. But we hear it as, oh, well, she's complaining about me.
Dr. Jenn Kennedy: But it's tricky 'cause if you're like ten, twenty years in and you haven't given them the memo all this time and then they're like, what? What are you doing? You know, and then it's mm hmm.
Erin Stein: Yeah. Where was the memo?
Gillian Goddard: Yeah, yeah. Yeah, yeah, where was the memo?
Erin Stein: Where was the memo?
Gillian Goddard: And I think on top of all of this, when we think about this, we are talking about our intimate partners. So, I would suspect in at least in most cases, this is someone you care a great deal about, and you don't—
Erin Stein: Hopefully.
Gillian Goddard: Hopefully, right? Like especially if you're to the point where you want to fix it. Presumably it's because it's someone that you really care very deeply about.
Erin Stein: Right.
Dr. Jenn Kennedy: Yeah, yeah.
Erin Stein: Even if they don't have game.
Gillian Goddard: Even if they don't have game.
Dr. Jenn Kennedy: That's a little tricky 'cause, you know, they will, they'll level with me and just say, my gosh, they just don't have rhythm.
Erin Stein: Yeah.
Gillian Goddard: Hehehehe.
Dr. Jenn Kennedy: I’m okay, right, we're going to try to teach some basic things about touch and you know, response and yeah, we're going to try to figure this out, you know. I sometimes give couples dance lessons as an intervention because it's like part of this is we need to learn some rhythm.
Gillian Goddard: Yeah.
Dr. Jenn Kennedy: We need to learn some, you know, paying attention and also sometimes it's like giving up control or, you know, letting someone take charge or letting someone, you know, surrender. It's like there's lots of lessons in this.
Erin Stein: I love the dance lesson idea because you're just setting up a scenario where you are touching each other and you are having to work together in some way to do the dance, right? I think that's a great segue into it, yeah. Hmm.
Dr. Jenn Kennedy: Mm-hmm. I feel like it's such a parallel. Mm-hmm.
Erin Stein: I might have to sign up for some dance lessons.
Dr. Jenn Kennedy: It's like the ego is involved, but like you do have to, you know, pick your role and then stay with it and let the other person, you know, you're going to step on each other's toes. And but anxiety is like the biggest challenge with sex. It really is. It's amazing how much that makes sex difficult.
Erin Stein: It's fair that we're all anxious about it because look how much of it is represented in the media, online, you know, body shaming, body image. We had a whole episode about body image.
Gillian Goddard: Yes.
Erin Stein: You know, everyone is self-conscious and not only about your own body and your sexual attractiveness to other people, your partner and you're well aware that it's been a long time. Who knows if they're interested anymore? Like you're all wrapped up in your head about that, but then we're watching people have sex on TV all the time. The internet, movies, porn, you know, as you've mentioned…
Dr. Jenn Kennedy: Mm-hmm.
Erin Stein: I mean some great people have been trying to sort of stage interventions with younger people. Of course, no one wants them to come to school and talk about porn, but if kids are already watching it, they need to be told this is not real life. This is not how people have sex. This is a manufactured entertainment. That is not how this actually works.
Dr. Jenn Kennedy: Yeah, yes. And yet it's like in our psyche and the comparison.
Erin Stein: Exactly.
Dr. Jenn Kennedy: That it should be so easy. It's not just kids, it's adults too. There's just this expectation from watching movies and reading media that it should be so easy and it's not. It's messy, it's awkward, the timing's bad, whatever you have a bad back, like you need props, like there's just like…
Gillian Goddard: Yeah.
Dr. Jenn Kennedy: Old person sex is different, you know? Gotta get in there. But there's got to be enough relational trust.
Gillian Goddard: That doesn't mean that it can’t be great. Yes.
Dr. Jenn Kennedy: I was just talking about this with a couple. And I don't mean like I don't trust you because I think you're a cheater. I mean more like I trust you enough to let my guard down and maybe seem a little awkward and imperfect and maybe let my stomach out or maybe um reconfigure if I'm getting a cramp or um tell you that I that's too much pressure, actually, that hurts. Or, you know, and it doesn't have to kill the mood. It's like I'm trying to engage here to have this work better for us. Right. But a lot of people don't say anything, and they just go through it. And then it's just like, that wasn't fun. So relational trust happens in the everyday, but then it carries into the bedroom. You know?
Erin Stein: Yeah. And, you know, it's Breast Cancer Awareness Month. I had breast cancer, so I have scars. So, you know, you go through a lot of medical procedures in midlife also. And then your body is changing.
Gillian Goddard: Yeah.
Dr. Jenn Kennedy: Mm-hmm.
Erin Stein: You have scars, things are different. I would love to, if there are other things about sex as you get older or in your older ages, you know, are there things we can tell listeners like this is how it might shift, this is how it might look later, it's okay. Some guideposts to what is in your future. 'Cause we never talk about it. Old people aren't allowed to have sex, right?
Dr. Jenn Kennedy: Well, okay, I hate this phrase. I mean, I hate the phrase uh vaginal atrophy. It's so …
Gillian Goddard: I do too.
Erin Stein: We all hate it.
Dr. Jenn Kennedy: Cringe, right?
Gillian Goddard: It is terrible.
Dr. Jenn Kennedy: It sounds so like decrepit, but it's a thing. And if you don't have sex for long periods of time and that tissue tends to get thinner and it does get really painful. And so, if your sex feels like sandpaper, is happening there is solution, there is help for you. Get some vaginal estrogen stat.
Gillian Goddard: Yes, yes. And don't let your doctor tell you to try lubricants first. Like get the vaginal estrogen. You can use lube too, but like vaginal moisturizer and lube is not like… that's in addition to vaginal estrogen, not instead of.
Dr. Jenn Kennedy: Yes, yes. So that's definitely one that occurs to me as we get older. Also, there's like these wedges. Tabu has one that's really great, T-A-B-U. There are other companies that make them too, but there's wedges that can help with body angles for tilting the pelvis, for lots of different sexual positions. But just if you've got a bad back, if you're having trouble angling, um as we get older, sometimes you don't have you can't thrust in with as much ease. You know, whatever. Don't be ashamed to do that. I've had couples with where one person had incontinence and there's also companies that make these blankets that you can throw down that act as a barrier. I'm like, let's get real practical guys. Like you can have wet wipes, there's a blanket you can throw down, and then after sex, you know, or if you have any sort of concern about that, you can take that off and throw that in the wash. Like, understand what your barriers are and just hopefully, again, you have enough relational trust to manage them. You know, like what's coming up for you? I know after childbirth, sometimes there's some of those issues. And so, communicate about them and communicate with your healthcare provider, hopefully, communicate also with your partner. So that it doesn't feel like you're trying to like to hide the ball, so you can't see the scar, or you can't see the thing, or you don't acknowledge the pain or like you can't stop to run and pee or whatever. Like do what you got to do and just get back in.
Gillian Goddard: Yeah. Yeah. That's great. So, let's get really practical here. If someone thinks that they would like to see a sex therapist, how can people find a qualified practitioner? How do you find a sexologist?
Erin Stein: I was just going to say, how do you find a sexologist?
Dr. Jenn Kennedy: So, if you go on Psychology Today, that's probably the best general resource for therapists, but look for somebody who is a certified sex therapist. That's sort of the entry level. Sexologist means PhD, so that's education if that's sort of like what you're looking for. But certified sex therapist is good. That's a good thing. That means they've had specific training in that area.
Erin Stein: I think there's people who do different things for people in this area. And so, like there's sex therapy, there's…
Dr. Jenn Kennedy: Sexological. Yeah, there's sexological body workers. That's different. That is not academically focused. I actually just had one of those folks on my podcast. They do important work that is quite different. They're doing like internal work, they're doing um, you know, sex coaching that is hands-on. We do not touch, we're not allowed, our licensure does not cover touching in any way ever. A sexological bodyworker might be somebody who's going to show you how to touch yourself or show a partner how to touch you. They are in the coaching realm. Would have to look for sexological bodyworker, I guess is what you would search for. They'd probably be in most major cities. Dominatrix would be a sort of different category if you were looking for kink. Or maybe wanting to explore some of that sort of direction. Um, you know, they're kind of a different category, I again, not academic.
Erin Stein: Right. I just wanted at least to make it clear what you're doing is not that; that is something available to you, but that's a different profession.
Dr. Jenn Kennedy: Yeah. Yeah. Yeah. I give advice about like the technical part of it and I do the psychological part, but I don't do any hands-on work.
Erin Stein: I think it's interesting to ask this question, what are the health benefits of having sex? We know that you can make babies by doing it, and we know that you can have a nice time and enjoy yourself by doing it, but is there a benefit to doing it? Is it better to be having sex at least occasionally than to not?
Dr. Jenn Kennedy: I remember this graphic that I came across during my dissertation, which was reasons for having sex.
Erin Stein: Mm.
Dr. Jenn Kennedy: And you know, there's relational reasons, there's physical reasons, there's emotional reasons. Um and it makes sense. I think we've all experienced those at different times, right? Sometimes we do this to build a stronger relationship. We know it pleases our partner. We know that's going to make them happy. We know that there's benefits in the subsequent days because we feel closer. Sometimes it just feels really good and it helps us go to sleep. It helps us get rid of cramps.
Gillian Goddard: Yeah.
Dr. Jenn Kennedy: I know when I was having really gnarly cramps, like that was sometimes the only option. It is a stress reducer. Yeah.
Gillian Goddard: There was actually a study. Yeah, there was a study that showed that it reduced menopause symptoms. And the menopause symptoms that it reduced was it helped people sleep. I was like, well, okay,
Erin Stein: Yeah. Yeah, we've discussed this. Duh.
Dr. Jenn Kennedy: Oh yeah.
Gillian Goddard: Right.
Dr. Jenn Kennedy: I mean, it's like, yeah, some of those physical symptoms of just like kind of calming the whole system down, which we also know like right after having an orgasm with partner or without partner, you just kind of feel like dreamy and sleepy and like more relaxed. So, the overall system just feels kind of calmer with that, you know, flood of hormones. But you know, you don't have to have sex. It's not mandatory for the wellness of a human. I think it's a benefit. If you are having good sex and if you're having consensual you know sex that you want, yeah, I think it's kind of like one of the bonuses out there. Overall, there's been some studies around like heart health, but I can't really speak to those in depth. You know, I think overall it's just kind of a nice bonus if you can do it and have access to it in a good way.
Erin Stein: Yeah, consensual and pleasurable are pretty important qualifiers.
Gillian Goddard: Jenn, thank you so much for joining us. It's been so great talking with you. Please tell us where people can find you if they want to know more.
Dr. Jenn Kennedy: Yeah, definitely. So, you can go to drjennkennedy.com and that is my site that has my podcast link and articles and also courses. I have two courses. One is for clinicians and one is for just everyday people that want kind of a deeper dive and that course specifically is for women with low desire who want to understand and sort of address that. Both of those are available on that website.
Erin Stein: Awesome. We'll put the link in our show notes and definitely check out Jenn's podcast because if you need a little something to say to your partner, hey, why don't you listen to this? Then let's talk about it.
Dr. Jenn Kennedy: Exactly.
Erin Stein: I think that might be a good place to start. So, thank you so much for doing this, Jenn, and saying all the things out loud.
Dr. Jenn Kennedy: Yeah. It was fun. Thank you.