Just As Well, The Women's Health Podcast - Your Libido Isn’t Broken: Kate Moyle on Sex, Desire and Feeling Like Yourself Again

Episode Date: August 11, 2026

Sex psychotherapist Kate Moyle returns to Just As Well to answer the questions women are often too embarrassed to ask. From a disappearing libido, stress and motherhood to menopause, orgasms, body confidence, infidelity and erectile dysfunction, Kate explains why desire changes — and why that does not mean there is anything wrong with you. With Claire Sanderson and Gemma Atkinson, this is a frank, reassuring conversation about rebuilding intimacy, communicating with your partner and having sex that feels good for you now. Want more from Women’s Health? Join the Women’s Health COLLECTIVE for workouts, exclusive events and expert advice to unlock your fittest self - Train smarter. Live better. Visit www.womenshealthmag.com/uk/wh-podcast Learn more about your ad choices. Visit megaphone.fm/adchoices

Hi, I'm Gemma Eikinson. I'm Claire Sanderson. And we have just had on for the second time, I'm just as well, the sex psychotherapist Kate Moyle. One of my favourites again. I love these chats with her. So she came on, it's almost a year ago. And I remember when we first launched this podcast

and she was one of the experts that you pointedly wanted us to book to come on. And the episode went down so well and we had such an amazing response to it. We thought, let's get her on again. So we did. And the thing that we love about interviewing Kate is that the questions come from you. Nothing is off limits. We've had relationship advice.

We have erectile dysfunction. We had women's libido's changing. We had squirting, which makes Claire squeam. I reckon I dealt with it quite well today, though. I did. Because I am a prude and Gemma isn't. So Kate has such a calm demeanour. that she...

Nothing phases her. And therefore, I think I dealt with the questions quite well today. Yeah. So if you're thinking about asking your friends or your GP or your partner about sex, but you're a little bit nervous and unsure this episode is for you. Well, it's for anybody really. She answers so many questions that you sent in, which we really appreciate. So enjoy this episode.

Please like and share and subscribe. Send this to everyone because everyone needs to know about sex. Enjoy this episode. Kate, welcome back. It was only, not only fair for the listeners, but fun for me and Claire as well to get you back because since your episode, the amount of messages we've had from people just expressing their gratitude

because you answered so many questions that people were afraid to ask their GP, were afraid to speak to the partners about, and a lot of people thought they weren't normal in thinking or asking those questions. So you put a lot of people's minds at rest. So with that in mind, That's why we've got you back because we are still asked, aren't we?

Yeah. So many questions about sex and female health and relationships. So should we just dive straight in with the questions? Because there's a few, isn't there? So thank you if you did get in touch. The main theme of questions, we had a lot. But it was an overwhelming response from women asking is the sexual desire and sexual changes toward middle age normal, like so.

many women feel ashamed that despite still being in love with the partner, still being attracted to them, the sex drive has gone. One listener said, I'm 37, I have zero sex drive. I'd be happy never having sex again. Is this common? Is it normal? Yeah, so, so common. And I think where we have to start with this is that sex changing across the lifespan,

across our lifetimes, across our sexual lives is the most expected thing. and one of, I believe, the biggest and most persistent myths about sex is that sex doesn't change. And that has to be the kind of headline for all of the conversations around desire, around arousal, around changes, is that we need to adapt sex like we adapt everything else in life and it will change. It's affected by everything else we have going on in our lives. And the biggest, you know, one of the biggest hindrances I think actually is that people worry so much about what's it means about them that it's changing, that that has an added effect. It has an added negative load.

It has an added dampening effect on the fact that we're struggling because we think about the fact we're struggling and then we assume the problem is us. And I think that's one of the biggest problems that we have with this. You know, it's not just the changing. It's what we think and feel about it and then what we can do about it. Another audience member here said she's in her early 30s, but she's never had much interest in sex, even in her 20s. so she's asking, is libido something we're born with

or is it something we can change over time? Can you increase your natural libido level? Yeah, absolutely, because it's about, you know, there's our wanting and our motivation for sex and then there's our body's process of physical and physiological arousal. So while some people may be, you know, less sexual in the way that some people are less interested in many things

in sport, the way that we have natural variation in everything, but it's also about the experiences we've had with sex, the messages we grew up with about sex, how it was talked about, how we feel about it, our relationship to it, and all of those things are going to have an impact. And lots of people describe this feeling of, I never want it,

I never feel like I have this kind of version of desire, which is the version that I think that it looks like, which is often the kind of Hollywood version, which is that it hits me out of the blue, and then I act on it. But actually when we start to unpick it with people, and this is a lot of what we do in psychosexual therapy, we start to explore that actually people do have those moments,

but maybe just not in the way that they think that they were meant to look like or the way they think they should look like. So there's often a difference for people between what they want and then what they think they should want or what they think it should be. I think as well, it's funny like I've got a girl's WhatsApp group and on the group we're all happily in relationships, kids and marriages and stuff. But we're all at that stage where we'll happily say between us,

we've got no sexual desire, but then we'll watch an episode of like The Punisher or see a Tom Hardy film. And we'll be sending each other messages going, but I've got desire for him, that action superhero. But then your poor fella who's downstairs in the kitchen, you're like, nah. And like one of my best friends, she said to me, the thought of having sex with my husband right now,

just no interest, but they've been together a long. a long time. She said, but I'll see other people out, like these celebs or whatever, on social media. And I think, oh, they're all right. And is that a case of you've just been with someone for so long? And your desire's still there, but it's just right in front of your face. You're almost too blind to see it. Or is that just the illusion of what, like you say, the illusion of that person? Well, it's loads of different things, because there's the novelty factor, which is huge. Novelty is such a benefit for our sex lives, for our desire, for our wanting, for our excitement, all the things that are typically there, a lot of the start of relationships. There's also the fantasy and the projection of the fantasy.

Bridgeton is the perfect example. The amount of people, have you seen Bridgeton? Nothing's required of you when you're watching a film and there's someone really hot or you're seeing a sex scene. But it's also your brain responding to something that is coded as sexual in your environment. in our domestic lives, and particularly when we're with someone for a long time and we are doing life with them, we kind of forget that side. And actually what typically happens is that sex becomes something that is more responsive. So we respond to when we start something rather than we suddenly kind of get hit by this wanting out of the blue. Now actually what the research kind of shows is that when you ask people when they're most sexually attracted to their partners or they most kind of want their partners,

it's when they see their partner in their element. So delivering a speech or kind of doing a presentation or like a best man speech or that they are doing something that they're really good at and other people are kind of witnessing that. And it's that seeing them through those kind of non-domestic lens sometimes is really helpful for that. But also we just sometimes get turned on by things

or excited by things that are meant to. So the reason that these beautiful people are cast in the Netflix series and things and the sex is really hot is because it's a separation. I've not seen my fellow for six weeks now. He's been away. I'm going to see him on next Tuesday for the first time. And I'm genuinely so excited to see him. And it is that thing. When I do see him, he'll be on stage in Manchester performing.

So I'll probably be sat there going, ooh, do you know what I? I'll need the wet floor sign, won't I? From the caution, wet floor. But it's that thing because I've not seen him for so long. It's a bit of distance. Yeah, I'm actually, whereas if it had been under my feet for the last six weeks, I'd be sitting there thinking, I've got a break from him.

But it's, I don't know how to explain it. It's when I've not seen him for a while. You've had a chance to miss him? Yeah. Do we think modern women simply have too much on their plate and are too stressed to factor sex into their diary So we had a guest on this podcast recently and we established very quickly that I'm suffering from chronic stress.

No surprise whatsoever. It was a tick list of all the symptoms. She ticked to everyone. I ticked every single one. I'm constantly feeling run down. I have so much on my plate. To then factor sex into all of that just feels another thing to add to my to-do list

as opposed to something to enjoy. And I know I'm not alone in that. So has modern society almost set us? sex lives up to fall. Almost what you just said there, word for word, we hear all the time in psychosexual therapy because it's also the gap between how we think we should be feeling and how we are feeling. Now, the to-do list is the perfect example of a complete desire dampener. So it's never done.

You're always thinking about what you've got to do next. Your head's always somewhere else. You're thinking about the things that you forgot. What have I kind of, what I feel I'm failing at? You know, this is also a thing we see, particularly around like modern motherhood, particularly, because there's this idea that we're kind of working and mothering and we're meant to kind of be at the gym and looking after ourselves and protecting our relationships and being a good daughter and being a good friend. And, and, and, and, and, and, and, and, and, and, and, and, and sex can get put onto the priority list,

and it feels like it takes quite a lot from us and that we have to kind of really focus on it and create the energy for it. And also, when you think about just the logistics of it, most people are having sex in bed and most people having sex in bed in the evening. and that's when most people are thinking about sleep. They're already in that winding down headspace. They're already thinking, okay, like that's going to be like six hours. I've got to get my head down. I've got an early meeting tomorrow. And we need headspace for good sex.

And we need to be able to kind of what I talk about is switching off to turn on. That's pretty hard when your head is full of everything. And it's actually the switch is about all of the things we kind of have to get rid of And I think that thinking about how many things we have to get rid of, there's a lot more than there was before. Because you mentioned sleep there. That's another pressure we put on ourselves. Like the importance of good sleep, get your eight hours. So, yeah, when I'm in bed at 930, that's what I want to do. You know, I feel that's really important to try and get rid of this virus that I feel are constantly have.

One of the things we hear all the time from people, and again, this is a line that I've heard so many times, is when we have. sex, I really enjoy it, and I think, oh, we should do this more often, but I never think, oh, I'm in the mood for sex. I'm never thinking about that before. But once I start doing it, I have a great time, but I'm never thinking about it before. I'm never thinking, I feel like sex kind of out of the blue. That is responsive desire 101. That is how it works. And I think the reason that, you know, I'm saying that so clearly is because so many people are saying the same thing, isn't a one-off experience that someone's having. This is very, very common.

And is that just mainly in women? Because I'm thinking, there's never a time when I would say to Gorka, should we have sex? And he'd go, nah, I'm too tired, or I'm this or that. But it's like he'd be grateful. I could have not showered for five days and he'd still go there. Do you know what I mean? We could have come off a long haul flight jet lag exhaustion.

He would still, if I said, let's have. sex, he would. But I know myself and so many other women, sometimes we say, I'm not in the mood, or I am too tired, or I've got. So is that just a female thing due to hormones? Or does some men experience that as well? We see that male desire can be typically kind of more spontaneous. The kind of underlying assumption is that obviously that's quite testosterone related. But also, men do say no to sex. They do struggle with sex. They do have the same anxieties. sex but there's a lot that socially goes into that as well but I think that it is a more common female experience to feel less spontaneous desire particularly in

long-term relationships so at the start of relationships we don't see the same trend we see people reporting having more sex kind of being more adventurous that they feel more charged as often a phrase that people might use but also if you think about all the things that really lend themselves to desire being triggered and it emerging from that we're touching more, we're kissing more, we have our partners attention more, there's a lot more eye

contact, we're building up a sense of anticipation about seeing them if we're dating and all of those things are really helpful plus the novelty, you're getting to know each other, you're exploring, it's all new those things are kind of neurochemically also on your side

when it comes to that. So there's a lot of things meeting and in order for those relationships or so to continue to a more longer term kind of set up. Some of that has to change. We can't stay in that really heightened state because, well, life. Is there an element that women struggle to compartmentalise? So again, another expert that we had on explained how a woman's psyche,

for instance, when she's working from home, a message will come in about she needs to order something from the school. Then, ooh, the washing machine's just finished. I'll go and empty the washing machine. And then she will struggle so many incoming demands and struggle to prioritise which ones are the most important. She said, but as a man, if he's working from home and he gets a message from the school, he'll go, right, I'll sort that out later.

Or he wouldn't think I have to go and do the washing now. He's able to focus on one thing at a time. Is that, can you relate that to sex then, that men can focus on sex and just want to have that, whereas a woman struggles with all the other competing things going on, in her mind that she is unable to then bring sex into the equation and give it the attention it deserves? Yeah, I guess I've never thought about it in that way, but it makes a lot of sense. And I think one of the things that we see is that even with two working parents, still the overwhelming kind of level of domestic organisations still typically in heterosexual couples, falls to the female partner.

Now, obviously that is not completely, you know, perfect rule across the board, but that's what the data tells us. I think that the switching off thing is probably harder. Also, the more practiced you are at switching all the time. Because when we say multitasking, we're not, we're just kind of actually switching between tasks really fast all the time. And so if being in the moment for sex and focusing on what's happening in our body and being present requires almost the switching. off of more things. Also the practice of switching off all of those kind of breaks, if you want to think, the more there are, the harder work it becomes. We had a message in from a man, actually, and most messages are from women. So when I read this one, I was quite shocked. But he was struggling.

His wife had an affair, and they chose to work through it and forgive her because they had kids and he didn't want to split the family up. But he said he was really struggling at getting an erection whenever she initiated sex. And he said, I can't bring myself to do it knowing someone else has. And I felt really bad for him because obviously he's staying, he's trying to make it work. But it's a big thing. And like you say, for a man, for most men, it's an instinctive. The testosterone's there.

You know, they're more up for it than we are type of thing. But he's really struggling. Is that a common thing after an affair? Yeah, it's really common. And an interruption to sex as it was can be from an affair, from a trust rupture, from any kind of challenge in the relationship through emotional difficulties, infertility, a miscarriage. I mean, you name it, body confidence and it can interrupt sex. Basically, because we are so in our heads, we can't be in our bodies. And for example, What's happening here is he's so distracted, or what I would guess is happening here, is he's so distracted by the thoughts, by how he's feeling, by all of that, that actually he's unable to be in his body physically enough to maintain arousal. And that's why sexual dysfunctions, a lot of the time where there's no organic cause,

are to do with psychology. We call them psychological in nature. because the mind has the ability to change how the body's working when it comes to sex, whether that's distraction, so taking away from pleasure or down to the point of not being able to sexually function in a typical way for that person. Motherhood came up constantly in our audience questions and sex after giving birth and then sex when there's children in the home. why does having children change a woman's relationship with sex so dramatically? I think it changes your relationship with everything so dramatically and sex isn't protected from that unfortunately. But also I think if we think about the things that resource our sex lives.

So sleep, attention, feeling close to our partners, sometimes kind of feeling what we have some independence and freedom, like we're in charge of ourselves. All of those things are hugely impeded on. when we become parents are we're under-resourced by all of the things that help us to be sexual that help us to kind of feel good and desiring and to again have the headspace for it but I think also if someone has gone through the process of being pregnant gone through the process of giving birth gone through the process of the physical recovery of that

also breastfeeding we know interrupts the body's kind of hormonal levels so we see that vaginal dryness is can be a result of breastfeeding because it changes the estrogen levels in the body. But again, we're not taught that. And then we have to kind of try and get back to, this phrase like bounce back, which I have a real problem with. And we assume our sex lives will just bounce back as well. And actually we've been through so many changes.

And then the landscape of our relationship and our sex life has completely changed. And so again, we have to adapt sex within that and not expect it to look the same as it did before. And that's not, including in that conversation, someone who might have had miscarriages, struggled to get pregnant, had to have IVF, or had a traumatic birth or a difficult labour, or pelvic pain, pelvic girdle pain,

all of those things really can kind of turn us off from feeling really connected to that part of our body or being a part of our body which gives us pleasure. And I think one of the other things that doesn't get talked about very much is when we have young children, we can get quite touched out and sex can feel like another form of demand on our bodies and actually a lot of people will say that

particularly if they're breastfeeding say like it's just lots of kind of hands and things on me and my body doesn't feel quite like my own but also that switch into it being in a more sexual mode or me experiencing a different type of pleasure from it can feel a bit confusing one woman said that after children her body feels just more functional than sensual

and she's nervous about intimacy with a new sexual partner because she's had children and been with her ex-partner for so long and her body's changed physically. And she's saying, how can you rebuild confidence after becoming a single mum? I mean, that's tough as well, isn't it? Because if you've been with the same partner for so long, you're used to what they do, how they look,

how they touch you and what you. you know, and then to be then thrust to someone new when you're probably not feeling your best because you've had children, you probably don't look the same, you're still, you know, you just, people don't like change, do they? And it's, I mean, when I was dating in my 20s, it was daunting. I can't imagine ever now having to do that whole first date again and that first kiss again and then see me naked for the first time again.

I would hate that. I would be so panicked about it. And there's no reason to be, I don't think. We also see this with people. who are divorced or people who are widowed is putting yourself out there again can feel really, really scary and the building up confidence thing,

the first thing I would say is to build up confidence yourself with your body, so to kind of start to rebuild a relationship with your body centrally first rather than just kind of jumping into sexually, which is just getting used to like the feeling of touch on your body again in terms of your own. As small as it sounds,

something like getting a really nice moisturiser you like and actually like taking time to kind of rub it into your body and get used to the sensation. And then you can start to build back up again. But the confidence thing is about how you feel. And there are lots of messages that we're given about how bodies should look. And the other thing I would say is think about what kind of bodies

you're looking at all of the time or the messages that you're getting about like what normal bodies look like. Because we're given there's so much noise about all of the time. all of that and that makes a lot of people kind of question themselves. One woman here, this is an interesting one, she said her husband is a bigger man and she struggles to convince him that she still finds him attractive. How important is reassurance and body confidence within long-term relationships. But that's an interesting take is the body confidence of the male partner, not herself.

Yeah, again, I mean, it's kind of similar advice, but there's, you know, attractiveness isn't based on a size and attraction between people. isn't based on body shape or body size. And they've been through a change, obviously. And I think, again, it's the idea that we're so focused on that before must have always been better. Like when people use the phrase, I want to get back to that, actually, it's where are we at now?

And reassurance is a huge part of that, because, again, we're all fed the messages that if we change, it's a bad thing. Whereas actually, people, they could be having the best sex. The confidence thing is an internal point. It's how someone sees themselves. Can some relationships survive completely sexless? Or would you assume sex is happening just not with each other?

I mean, I'm trying to think. I don't know anyone who's in a relationship where the intimacy's gone completely. I do. Really? Yeah. And they're still together. Whether they're completely happy is up for debates. But in fact, I know several couples who are completely in sexless relationships.

I'm a bit older than you. But would they be having sex with other people? Not to the best of my knowledge, but I don't know for sure. Because for me, I mean, everyone's different, but you might as well just live with a mate then, if that's okay. Because I think that's what my relationship is different from a friendship because of the intimacy. But then I guess if you've been with someone so long,

you're completely happy and comfortable anyway. I think it depends on if all parties in that relationship are happy with it or if it's a conflict. between. So one of the biggest, one of the most common things we see in couples is a discrepancy and desire, so or a mismatch. How couples deal with that is the more important part rather than the fact that there's a mismatch themselves. Actually, very, very few, little to know partners, couples are perfectly sexually aligned and we shouldn't expect to be. If it is a sexless relationship, but everyone is happy with that, that's going to be different to particularly

if one partner is dissatisfied. But the other thing is do we have a reason for it? So for example, many, many couples will go through a period of little to no sex. But if they have an explanation, for example, one partner is having chemotherapy, or they're going through health treatment, or someone's had surgery,

they have, they are working in separate countries, they've got a child who's, if there's a reason for it, and we can explain it, we can often work through a period of, let's, if we're using this term, sexlessness, with an understanding that at some point we will get back to something, or, and particularly if there's what we call sexual currency, which is anything you do with a partner,

which kind of contributes to your sexual relationship but isn't having sex, if that stays alive, that tends to be the thing that can kind of carry people through. But the change, the problem tends to be when people lose the faith that when something changes, that the situation will change. And that tends to be more of a trigger point for people. So I remember you said last time, intimacy just doesn't mean penitative sex. There's lots, it could be holding hands, it could be a quick snog in the kitchen, it could be just walking past them and a little touch on their hip.

There's lots of ways to be intimate with a partner. People just assume it means intercourse. A listener said she's struggling to reach climax. She's never climax during sex. she has to have just clitorial stimulation but she can't climax during intercourse is that normal? That is more common than the other way around.

So more common. It is more common for people to orgasm through direct clitorial stimulation than through penetrative sex. And what a lot of people do is they combine the two. And so again this will be about, and when we think about orgasm, it's a learned response. We work out how to do it,

we learn what feels good for us, and then we repeat. And so I would say it's about learning what works for you. But the more we kind of hunt an orgasm or we chase an orgasm because we think we should be having one, the more focus on it we become, the more distracted we become and actually the less likely we are to have it. It becomes a pressure point, an expectation, a goal.

And the thing I would say is take the pressure off it and focus on what feels good and then keep doing that. But yeah, absolutely it's, You know, we have to also explore sometimes the language, common and normal. We often use one when we mean the other. And actually the only thing normal is difference. But it's about working out for us where we want to get to or what's feeling good for us or what we're worried about.

But that concern about it will absolutely kind of hinder our ability to enjoy the moment too. Does your ability to climax lesson as you age? Because another listener here has said, I'm menopausal. and I find it harder to get turned on or reach climax. Is that a normal hormonal shift? Yeah, it is something that we see people reporting particularly menopausal, when they're menopausal and postmenopausal, likely to do with also a decline in estrogen,

but we see that there is kind of a lack of lubrication in the vagina. We see that increase in vaginal atrophy, a reduction in sensation. And so that is really normal. and what it might mean is that that person needs to use a lubricant or to increase the intensity of the sensations that might have previously worked. So it's a really common thing that we see in menopause particularly. A lady, a 56-year-old lady's been in touch. She said, my husband has erectile dysfunction,

and we want to know how we can navigate it together. A erectile dysfunction, whilst kind of common in men under 50, we see that it's typically more common psychologically. And is it, sorry, is that when they can't get an erection? So some people struggle to maintain, so they can get an erection, but they can't maintain an erection. And for some people, they struggle to get an erection in the first place. So also if someone doesn't fit the kind of clinical guidelines

for what we'd call erectile disfunction, we might use a term like unreliable erections, where people are struggling with their erections. And we see that it is more typical in men over 50, and that there is an increased probability of it happening with ageing. So that is an expected thing. So the first thing to do is go to your GP, just have a check. If there is a sudden change of erections,

so morning erections, erections you wake up with, which are basically nocturnal erections that happen during the night, if there is a sudden change of those, so suddenly they're not happening or you notice a really apparent change, that is always, always cause for going to your doctor because it can be an early indicator of other health issues, cardiovascular disease, etc.

But going to your GP in your 50s, getting that checked out, is really standard. Also, the more we worry about it happening, the more likely it is to happen. And learning how to manage that. So particularly for older men and men in their kind of 50s plus, a GP might recommend something like a Viagra or a Cialis, which is a group of medications called PDE5 inhibitors.

which can help with that. But we're also seeing gradual testosterone decline with ageing. But erectile dysfunction does get more prominent with age. So that morning boner, as we call it. Morning glory. That's a health, healthy. I don't know one man who's ever woke up without one. I always think, oh, God.

But it's a normal thing. It's completely normal. And basically erections during the night are it's about blood flow to tissue, to keep it oxygenated. It's about functionality. it's not that all men are having sexy dreams every single night. So there are numerous erections that will happen kind of go up and down throughout the night. It's that you're in a period of REM sleep typically just before you wake up.

And so that's why a lot of people wake up with morning erections. And again, those might be stronger and more regular when you're younger and you might notice that they start to change slightly. They're also impacted by things like sleep. So if someone's doing shift work or not sleeping very much, they might notice changes in that. But sudden changes are a really, you know, it's a really basic thing that actually we should be telling all men that it's important to know about. So you mentioned testosterone decreasing for men.

It also decreases for women as we age and especially as we navigate the perimenopausal years. And testosterone is now fairly widely prescribed to women. And one of the reasons is reduced libido. But we have a woman here saying it didn't work. So it's not the easy fix that maybe we're being led to believe that can save and revolutionise olibidos as we head through these battleground years. Yeah, it's not shown to work for everyone exclusively,

but it might help for some people who are struggling, particularly in the kind of menopausal period and some people might be using HRT to kind of manage menopause and testosterone maybe use like in addition to that. but it's not a kind of magic solution to all of it. And particularly the thing is, as if we're struggling with sex already, we have to look at it as a biopsychosocial issue,

which is there might be something physically going on, but also how we feel about it, emotionally, psychologically, if we're feeling like sex, it's a real struggle for us. We're kind of not feeling any positive anticipation, but we might be kind of dreading, like, the idea of having sex.

That's not going to positively motivate us and encourage us to want to have sex. Maybe we're not having sex, which is feeling good for us. And so all of these things have to kind of be looked at if we're looking at what do we want to change to make sex a more desirable thing for us. We've just done a featuring woman's health about the use of antidepressants

and that's the impact they can have on desire and libido. We have a question here from a listener who's saying she takes 150 milligrams of serteroline and says her libido is disobeyser. appeared. I've also read something similar about people who take GLP1s, that that can have an impact on general mood and feeling flat and therefore that can impact libido. So how common is it that various medications like antidepressants and GLP1s can have a direct impact on desire? Antidepressants can definitely have an impact. I'm not so sure about the kind of GLP1's thing. But also, I have an understanding of these things. I'm not a medical doctor. But what we know about SSRIs, for example, so that group of antidepressants is that they change serotonin in the brain.

But they can have a dampening effect for some people, but also what we typically see is that the higher the dosage is that people can kind of feel more intense dampening based on that. But some people might report that they feel like their orgasms are a bit hindered, that they don't kind of feel like such a sense of design. or arousal that they're struggling to kind of get to where they got to, but also a lot of people who are experiencing symptoms of depression are really feeling not good about themselves, not good mood-wise, not motivated for sex.

And so there's a big thing around that going on. But also what we see is that sometimes SSRIs are used to manage rapid ejaculation in men. And so we know that that effect is sometimes kind of used in a different way, for people who are really struggling with that. So I think it's a clear evidence of that relationship. Some of the most emotional questions we received were from women dealing with either betrayal, abuse, or anxiety around intimacy.

We had these two, and so one listener left an abusive marriage two years ago. She hasn't wanted sex since, and she says, is this a normal response to trauma? And a similar one came in from a lady asking how to manage intrusive thoughts during intimacy after discovering her partner had had a one-night stand. So two traumas, both very different. Neither of the women now wanting sex because of it.

Well, trauma changes how we experience the world around us. And once something has happened, we can't unknow that it's happened. And that can, a lot of people might describe it as kind of haunting them, that they're having flashbacks, but ultimately it's about a sense of safety that they feel. And so if sex has become unsafe, and if it has become associated with feeling unsafe,

we're unlikely to want to kind of rush back to it. And that, I would say, is work for that person to kind of do on their own terms, in their own time, perhaps with a professional, someone like a psychosexual therapist or a trauma-informed therapist who could help them to reconnect with themselves. But they have to get themselves to put back to a sense of safety first. And it's going to be really, really important for that person. And again, the person who's having the intrusive thoughts,

it's because something to do with sex has changed based on their knowledge of what has happened. Sex has become the vehicle for something being unsafe for them. And ultimately, when people are having really great sex and people say they're having really great sex, they feel safe, they feel comfortable, they feel happy, they're in the moment, they're able to let go because of all of those things.

And those experiences can take that away from someone. Can trust and desire genuinely be rebuilt after infidelity? With work, yeah. And I think that the thing that lots of couples therapists might be saying when they're working with couples who have been through this is I think if you decide that you want to make this work, if you want to rebuild trust, there has to be a commitment to kind of doing that,

but also the kind of Trump card at the end of every argument can't be, well, you had an affair. Yeah, can't throw it in the face. You have to kind of both be able to move on from that and rebuild because it has ruptured the agreement that you made in your relationship in some way. And that's the change because the trust is kind of lots of little moments over time and it's maintained and it's about the kind of solidity of the relationship.

And if that feels shaky and that's the foundation for your relationship, then it's unlikely to be able to operate in the same way if you're not able to rebuild that. Because I know for a fact I couldn't because I don't know if it's a stubborn thing and insecurity thing, but I know that would be it for me because I just wouldn't want to touch them again.

But like you say, if we put in the work, but I'd just be like, no, it's done, everything's ruined, completely go. But years and years and years ago, a male friend of mine, he found out his wife had had an affair and he actually said to me if it was just a one-night stand a drunken stupid one-night stand I'd probably have got work through it loved her to death we weren't connected at the time but he said it was knowing it was the emotion involved

they were meeting they were missing each other and he said that's what I couldn't move past so that's why they broke up so there is a big difference than I think think that knowing your partner's just done this one stupid silly thing that meant nothing, then your partner spending time with someone, longing for someone. That's the sneaky side of it for me. The emotional affair is almost more damaging than the physical act. Yeah. Do you get couples experiencing one or the other and dealing with them differently?

Well, sometimes multiple, you know, multiple affairs or sometimes it's about a particular person. I mean, there is no one size fits all. for any of this. And it's really about what it means to us. Now, some people have more open arrangements in their long-term relationships or in their marriages, and they have agreements.

And they're like, oh, we know what we're doing. But again, it's about the rules or the invisible contract that you've made for your relationship now. For some people, you know, like you're saying, you're like, I just know, I couldn't do it. You have to have everyone on side in an agreement about what they were.

want to do. Is that ever really possible, though? So you read, in fact, we're interviewing a woman for woman's health. So it's probably be out by the time this episode comes out. And she'd met her partner in uni, was becoming unfulfilled by the relationship because he was married to his job. He was a medic. And, you know, we all know, like top medics are extremely busy, work long hours.

And she suggested to him that they open up them. marriage. He was mortified initially, but more or less accepted this is what he needed to do to keep their marriage. So now she has boyfriends but says that her and her husband are closer than ever. But when you read between the lines, I find that hard to believe because he is not seeing other people. He is allowing her to see other people. And I read my outside observation of that marriage is that he's putting up with it rather than being completely engaged in that setup and surely that's going to breed resultment. It must be really rare to find two people who are completely chilled with partners happening outside of the core relationship.

But I think it's also not about necessarily being completely chill because if you talk to people who are a non-monogamous relationships, there's a lot of work that's involved. There's a lot of negotiations, a lot of conversations, a lot of logistics, a lot of, and it's, you know, and they still, like all other relationships and couples, have arguments and disagreements and it goes right and it doesn't go right. And I think that, but I think that if we're working on what we want to get from our relationships, I think there's a really interesting, there's a great quote from Esther Perel when she's talking, and this is about affairs, not non-monogamy. And she says, when people are often having affairs,

they're looking for a new version of themselves rather than a new version of their partners. and I think that I love it because I think it shows how so many people, if they're having a face, they're getting something that they feel like they've lost, which is someone seeing that kind of new, shiny version of them, that someone sees them as exciting again, that they're kind of feeding off that in some way. And that might be what was lost in their relationship. And I think it's a really interesting kind of reframe when we're having these conversations.

But for some people, you know, trust is the. most important thing in their relationship and if that's gone then that is something that can't be repaired once that doors open like i mean if gocker initiated that conversation with me i'd be mortified i'd think what you're on about like well if you wanted to open up your own my gosh or your relationship i'd say open it far and wide and don't come back because i'd feel like i wasn't fulfilling them or wasn't enough and again if i asked him to can we bring anyone else in he'd be like why? But I think once that conversation started, that door's open

and you're either going to have a partner who says, yeah, or a partner who says yes but feels like crap because they feel they're not enough. I mean, how would you react? Oh, absolutely no way. I couldn't cope with it at all. It's about the agreements of the people in that relationship. And there are lots of other things.

You know, we have to sometimes address what we might want to change in our relationship. Be like, this bit isn't working. what can we do about it? How are we going to change this? How are we going to address this? Those are the conversations we're not taught to have. And I think a lot of people we fear approaching that in our relationships.

And we're told that if we have to talk about it, that that must be a problem. Whereas actually I'd argue that learning how to have these conversations and approaching uncomfortable conversations and relationships is preventative for relationship difficulties, for relationship problems, but we are not taught how to approach the difficult subjects of sex and intimacy changing.

You know, money is another perfect example. Money is such a taboo topic for couples to talk about. And I think that that is where many of us have really struggle because we also don't see any examples of it happening. We just see the kind of very polarised, particularly, you know, think about, where we get a lot of more information from Netflix and films and things like that

it's either going really well and it's super romantic and it's perfect or it's going super badly and they're arguing and it's this what about the mundane day-to-dayness of relationships the how we all kind of juggle it or the did you do this did you do the dishwasher to do the wins have you got a sports bag what about that did you have we booked parents evening

like there's no I think there's very little that we see for that the appreciation of the normality of lots of relationships and actually how sex and intimacy gets negotiated within that. How would parents navigate talking to their teenagers about sex? How do you have a chat without making them think it's wrong

and it's dirty and they shouldn't be doing it because it's obviously not. It couldn't be beautiful and loving and the best thing for them ever. But on the other side, there's so many things they can watch and you wouldn't want them for any minute to think that's what every partner will want.

or accept or even look like, you know, they're going to be curious and do things themselves. How do you even broach that? There are so many organisations, so there's one, for example, called it Outspoken, there are really great sex education charities like Brooke that are trying to help to close the gap

around the education piece. But ultimately, I think if parents feel that they are more educated than they feel better to have the conversations, and it's knowing also how to allow the conversations to happen. It's a part of health, it's a part of well-being. Also, things like being able to say to your young people, okay, well, you know, this is, the law is 16. Like, that's a really important thing that you know.

If everyone has a sexual experience, that everyone has to say yes. You know, these are really, like, basic things that we should be saying as a part of the conversation. And one of the things that we know is that young people do get access to online things that, the internet is huge that things are very easy to find. So how do we want to buffer that as parents?

How do we want to counteract that? But being the person that they can come to with questions is doesn't require you to know everything and to be an expert in that moment. It requires you to be able to be like, that's super interesting. Like how can I answer that for you? Or could we, can I go away and research that?

Or do you know what? I'm going to look into that a bit more. Like I'd like to know a bit more about that. Like that makes it a more important conversation or an easier one. Just like you say parents aren't taught. I remember one of my friend's sister, older sister, showing us how to put a condom on a banana because none of us are, we didn't know how to put it on.

You know, the whole pinch in the end that we had no idea. And she was explaining to us, she was like, you're both sexually active, this is what you need to do. None of us were on the pill at that time. And she showed us. a mum's kitchen with some she had in her room. But had she not showed us that,

I wouldn't have known how to put on a condom for one of my partners, whatever. I wouldn't have had a clue. My son has done that in school, though. They have to be put in now. That's good. In PHSE class, which he come home and told me.

And you have to sort of keep a straight face and go, oh, it's good that they know that, though. But yeah, so, and I don't know whether that's common in all schools. And even period talk in schools, they separate, they used to separate the boys and girls. So the girls are going to have a talk about the periods, the lads are DPE. And the reality is the men, the lads should know because their mom, sister, partner, cousin, friend,

will have a period if they're female. We've got some lighter questions in, didn't we? Yeah, I can't ask the first one. I'm not asking that. One listener, back to good old squirting, she said, why does squirting feel like a waterfall? What actually causes it?

It happens to me, I don't know why. Yeah, so... Not me personally. The question, before that gets out anywhere, it doesn't happen to me. So, Squetting is basically like a release of fluid. So we've got the Skeens glands and a lot of it is also, we think, kind of diluted urine. But it's the most commonly happens when people are experiencing pleasure through G-spot stimulation, which is on the kind of frontal wall of the vagina.

And not everyone can do it. and not everyone will experience it. But for most people it's kind of like a sign that they're having a great time. It often happens at the point of orgasm. It's going to be dependent on so many things. And also things like pelvic floor strength, how much someone is tensing.

You know, a part of an orgasm is a wave of pleasurable contractions and the pelvic floor muscles. And so we don't really have any kind of exact knowledge on why it happens some ways for some people and some ways differently. This next one, she's a lucky lady. She's in her 40s, but she has a much younger partner. But she wants to know how she navigates the huge difference in their libido.

The difference again, like we said earlier, is the most common thing that we expect in couples. And really it's about like how to navigate the gap between you both. Like what makes sex kind of comfortable, enjoyable. And it's really, one bit is, you know, the very kind of what's going to sound very therapy part of it, which is communicating about what you both want, how you both want. But the other thing is how do we make sure that we're having sex that we both enjoy? And I think that's going to be the important part of this conversation. Another one from a man, he wants to enjoy sex,

but he's not as well endowed as men he's seen online and his friendship group. So he's lost his confidence. What does he do? The confidence thing is, again, because he's comparing himself to what he thinks he should be like rather than what he's feeling. The thing that I would say is that

sexual pleasure isn't necessarily determined exactly by penis size and for him kind of building up that sense of confidence in himself as a sexual partner is going to be an important part of that. Is that something I guess men would not worry about but you know how like so many women when we were single back in the day

we'd be like, oh I wonder what he thought of how I looked and this and that but it must be the same for me. men, they must think, is she used to bigger than me? Is she used to smaller? Is she used to, you know, this position or that position? Men must have the same, not insecurities, but concerns when they have a new partner. Yeah, and I think the thing is there's huge levels of masculinity messaging that goes with that and that people can feel really self-conscious about it, really worried, it can feel really exposing. And the thing that's different, obviously, with

Penises is they're external to the body. So for people who are really worried about their penis or really worried about penis size, they feel like there's no hiding from that. But sexual experiences being pleasurable and satisfactory are way kind of better predictor for sexual enjoyment and kind of increased sexual well-being than other factors. Finally, what would you say to the women listening today right now

who genuinely believes she's broken? because her libido has changed? The first thing I would say is that you're not broken. And I think that if we're feeling broken, we have to think about what we think fixed looks like as an idea or what we think the kind of version of not broken is that, for so many people when you get into it, there are all these perfect myths, perfect ideas.

And if we feel like we're sitting outside of that, then we really struggle, whereas actually, when you start to break these ideas down, they're not realistic, they're not healthy, they're not helpful, they're the thing that are holding us back. And I think that one of the things is work out what it is that you want to feel, what you want to be different. We talk about the kind of physical process of getting touch in our bodies,

of sensuality, of working at where we are at now, kind of thinking about psychologically, like what's holding us back, what is it that we think and feel about sex? are those good things? Are those things that are helping us? Are they hindering us? And then trying to kind of change and adapt to that. Now, for me, there's such a big piece here,

which is about kind of opening up our tunnel vision of what we, you know, our kind of window definition of what we think sex is or what we've been told sex is. And do we need to address that ourselves? You know, Emily Nogoski talks about this as a garden. Kind of when we're young, we have seeds and, plants and things kind of put in there by other people, we're not kind of in charge of it.

And actually, as we become an adult, we become kind of head gardener. We can choose the things that we want to weed out, the things that we want to plant, the things we want to water. What do we want this to look like? And sexual messages are very like that. It's a big part of our lives. And sometimes some of us grow up with unhealthy or unhelpful messages about sex, messages that are really kind of grounded in shame.

And they play a very dominant role in a lot of. people's sex lives and I think that addressing that for people is a really important thing now if we're thinking I'm not normal I would really encourage people to kind of go and have a look at like what we think that idea of normal is and actually I think you'll find that a lot of people are feeling the same way as you and the other thing then is okay well instead of me thinking about the me that I was then and that that's what I need to get back to given that nothing else in my life is the same. Why can't I bring that same attitude of kind of adjusting and adapting into sex as well? And if sex is painful, please go and see your GP, please go and take advice

on that. If something's changed and you, for example, need something like lubricant, like that's fine, that's what it's been made for. That's why there are millions of pounds worth of lubricant sales happening every year. If pleasure feels like it's changed, what do I need to change in order to help myself feel pleasure again and also how do I talk to my partner about that? I think those are, you know, some of the kind of headline points. Right, before we let you go, we have our quickfire questions. Now, you have done these before, so I'm sure you can't remember your answers.

I mean, you maybe have different ones because it's coming on to a year now since the last time we had you on. So we're coming for dinner at yours. What are you making us? It's normally my husband who does the cooking, but if I was doing it, I would make, I really, really like at the moment this orzo with prawns and feta

from Otolengi, it's delicious. That's like a rice pasta thing yeah, it's like rice shaped pasta. So your husband's cooking you Otolengi recipes? Oh, he's, yeah, doing the cooking. Much better for everyone. God, nice. Keeps her happy, you see, so they have good sex then.

Happy wife, happy life. What's the one thing you would take to a desert island? Music, can I say music? Yeah. Yeah. Coffee or wine for the rest of your life. You can only pick one. Oh, this is an impossible choice. This isn't going to be good for anyone who lives with me or is around me. I'm going to have to say coffee because I don't think I could get through the day without it.

But a glass of wine is how I like to end the day. What's the last thing that made you belly laugh? I just had a weekend away with three of my best girlfriends. And we were just so stupid all weekend. Fun, fun, fun. acted like we were at university and it was fantastic. The best times. And lastly, what's the one thing someone can do today to make themselves feel a bit better?

Be kind to yourself. Like if you hear, so many of us are so self-critical, you know, automatically. And I think the thing I would say is if you hear yourself do that, push back. And we have to really consciously address it because it becomes so automatic. and just be like, I don't think that's true. And that would be a really, really simple thing I would love people to do because it's what a colleague of mine called the shitty committee, the voices in our head.

They're just kind of constantly going at us. And so many of us forget to challenge them. And I think actually it becomes our default that we pull ourselves down a lot. And actually, we need the voice in our head, the way we speak to ourselves is the one we hear the most in our lives and actually kind of being a bit nicer to ourselves. It's a really good place to start.

There's a woman I follow online and she's suffered with body image all her life. She's had food issues and she's overcome it now and she's happy and healthy. And she stuck a picture of herself when she was six on her full length mirror. And she said every time I looked in the mirror and I'd go to say like, oh, saw you're like, oh. She said I'd see six-year-old me and be like, no. She's not hearing that. And that's what she did for a full year to get through feeling, feeling bad about herself

because she envisioned the little girl version of her hearing that and how sad she'd be. So I think I'm going to do that but I'm also going to argue with the shitty committee. I love that. I've never heard that phrase before. Well Kate, thank you so much for coming on

just as well again. It's been an absolute joy. And thank you for all your questions for everyone who sent them in. We appreciate it.