Language of Love with Dr. Laura Berman - The Body Keeps the Score: How Trauma Can Impact Our Physical Forms and Sexual Pleasure

Episode Date: September 9, 2021

On today’s episode of “The Language of Love,” Dr. Laura Berman talks about the most common challenges that couples report. She reveals that the top complaint that partners have is uneven desire when one partner has a higher libido than the other, and how that can lead to trouble throughout their relationship. She says one issue is that even though many women struggle with some form of sexual dysfunction, whether that is lack of desire, difficulty reaching orgasm, or pain during intercourse, the medical community has only just begun to put attention into addressing female sexual pleasure. Hence, while men can turn to options like Viagra or Cialis, women are left with few, if any options, for improved sexual response, and most are too ashamed to even raise the issue with their doctor. So, what should women with low desire do? First, Dr. Berman says women need to go to their doctor for a hormone panel as well as to investigate whether any medications they are on may cause sexual side effects (popular prescriptions like anti-depressants and hormonal contraceptives can have downsides in the bedroom). After investigating possible physical causes and troubleshooting possible solutions, Dr. Berman says she would also want to delve into a woman’s past and look at issues like body image, past sexual trauma, sexual shame related to religious or cultural upbringing. Our bodies can carry cellular trauma which can be passed on genetically and Dr. Berman explains that unless we get in touch with our physical selves and where we might be carrying tension or dis-ease, we won’t be able to fully release, whether we are in or out of the bedroom. Hear her reveal how she uses somatic therapy to tap into her physical body and how you can start ‘being in body’ right now. Learn more about your ad choices. Visit megaphone.fm/adchoices

Hey, I'm Dr. Laura Berman, a sex and relationship therapist. And for the past three decades, I've been helping people learn how to love and be loved better. That's what we're doing here on The Language of Love, where I get to answer calls and emails from people just like you. My goal with The Language of Love is to help you discover more meaningful emotional and physical intimacy and to help you build more awareness of how precious and sacred your sexuality really is. Be sure to email me or reach out with your very own love-sex relationship questions, and I might just answer them live on the air. It's time we all become fluent in the language of love.

Hi, everyone. Welcome. I actually just came back recently from a shaman's gathering in Sedona, So I feel very grounded. And a lot of it was about the divine feminine, which I thought was really interesting. Shamanism and the divine feminine, although that wasn't the topic of the weekend. It was Don Miguel Ruiz, who's a famous shaman, probably one of the more famous mainstream shaman and his sons. but also a lot about, there was like eight to 10 shaman teachers there, which was really interesting. You know, some stuff about sex came up, sex, love, relationships. And I'd never been to Sedona before, which was absolutely gorgeous. I don't know if you've ever been there. And it was a very special weekend, a lot of drumming and sound bowling and starlight dancing and getting and to our bodies, which, you know, I think is really, I love talking about sex. I've been

talking about it for decades, but what I've really been called to in more recent years is how to take sex to the next level. Yes, sure, spicing it up, but it's also about making sex more soulful and the power of sex for sort of manifesting what we want in love, relationships, but also in our lives. So I'm here to talk about the most basics of sex, sexual challenges that people have, sexual conflicts or struggles they're having in their relationships, dating, mating, ovulating, whatever it is. No question off limits as far as I'm concerned. You talk about challenges. And I think anyone in a relationship recognizes that there's going to be challenges that face us as we're navigating the waters that exist in relationship land. What are some of the most common challenges that you hear when you're working with clients and when you obviously you've had your shows both on TV and radio? If there's a theme or themes that you've noticed in terms of challenges, what would those themes be? I would say probably the most common that I see in relationships is uneven desire. One person, one partner wants it and more than the other or the other doesn't want it at all and isn't really interested. That's probably uneven desire is probably the most common. And but there are a whole range of sexual challenges that people face, whether it's low desire, difficulty getting aroused, difficulty getting, you know, reaching orgasm, pain. the latest statistics, they really need to update these because they're several years old. But just

for the under 59ers, you know, 59 year olds, 43% of American women have some kind of sexual function complaint that they're struggling with. And that increases as women age and start going through menopause and everything else. So what's been really fascinating to me in my career, because I would say it wasn't until about the late 90s, early 2000s that we really were able to start looking more specifically at the physical and medical aspects of women's sexuality. You know, we're about 20 years behind men and there still isn't really an FDA approved intervention to even treat female sexual issues. And there are millions of them for guys. So it's sort of an uneven playing field when it comes to men and women in terms of especially the medical aspects or

physical challenges that women face. But, you know, our main sexual organ for all of us is between our ears. And so what's always been fascinating to me is the intersection between our body image, our self-worth, our relationship, our sense of connection and our sexual function, because there are always those medical, physical factors, relationship factors and personal emotional factors happening simultaneously you talk about the desire piece being one of the main focal points that cause a bit of challenge for people because there's different levels of desire that one may feel in a relationship and because there's that unbalanced reality that some people just have more desire than others at the same time you also talk about that a lot of

this does come down to our mindset and mental. So I'm curious, what advice do you have for somebody that is in a relationship where they feel the desire is not equal, especially as it relates to sex itself? Well, it's really important, I think, to acknowledge the importance of sex for all of us, right? It's a key part of our general health and well-being. It's a fundamental part. It boosts our immune system. It staves off depression and anxiety. It promotes blood flow, healthy heart. I mean, there's so many health benefits, not to mention relationship benefits, if one is in a relationship to a healthy sex life. And I always say that when sex is working in a relationship, it's one small part of the larger working relationship. But when it's not

working, it really can start to fray the fiber of your connection, especially when one of you still wants it or wants more of it, you know, and the other one does not. And so the way that I tend to approach this, you know, is first and foremost, in order for someone to be considered to have an issue with low desire, they have to consider it a problem or the way the experts or the scientists, you know, talk about it, that treat this, they say it has to cause the individual personal distress in order to be considered a diagnosis of, let's say, low libido, which is what we're talking about, low desire. But it gets tricky when you're talking about low libido. In particular, it's one thing you can say, yes, pain causes me, you know, pain during sex causes me

personal distress or difficulty reaching arousal or orgasm when I'm really trying and wanting to causes me personal distress. But if I don't have any thoughts, fantasies, motivation to be sexual, doesn't cause me personal distress to not have that, right? So where the personal distress comes in is kind of indirectly in terms of the impact it has on the relationship. So it's more personal distress in connection with the relationship than personal distress itself. And when someone comes to see me or presents with this, I think it's really important, especially with low libido, because there can be so many with all sexual function issues, there can be medical factors. But I think in particular, with low libido and the role that hormones play, it's important

and medications, it's important to look at like the medical physical factors, as well as emotional ones and relationship ones, even as an outgrowth, you know, so in other words, if a woman, let's say has low desire, there are impacts that it's having on a relationship affecting the emotional connection, the sense of peace and romance in the relationship, all sorts of things that then circle back to negatively affect her desire. So it may not have started out that way. It may be secondary to her low desire or as a result of low desire, but now it's coming back to negatively affect her desire. You know what I'm saying? So it's really important, I think, to understand the full picture of what is causing the low desire,

even the issues in the relationship that have kind of grown out of the low desire but now are negatively affecting it and then I like to sort of address all of them at once so you know when a woman presents with low desire I'm definitely sending her to the physician to get her hormone levels checked and to look at medications she's on and any other medical conditions I'm looking at her body image for any history of sexual trauma or abuse and you know something really simple that I see just almost globally with women of all ages, although less so with younger women, but surprisingly still there in great quantities, is that girls are not really raised in the same way boys are to feel really connected to their sexuality, sex. They're sort

of conditioned to see sex consciously and unconsciously. And you see this on social media. You know, all I have to do is spend five minutes with my 15-year-old girl after girl doing this of sexualizing herself. And what happens is that women kind of come of age with a very disconnected relationship with their sexuality. And this has been going on for time immemorial. It's not just young girls and women today. But we see sex as we're kind of raised and conditioned and condition ourselves to see sex as a means to an end. It's a way to get attention. Now, these days. It's a way to get likes. It's a way to get a partner. It's a way to get a ring on it. It's a way to get pregnant. And then once she's in a stable relationship, and especially after

she has kids and she's got a busy life and she doesn't have the same externalized motivation to be sexual, she can't rely on her internal relationship with her own sexuality because she's never developed that. No one's ever taught her about that. No one's ever encouraged her to cultivate that. So I see just slews of women with this issue where they really never developed a personal relationship with their own sexuality in its own right. And I see that much less frequently than men than I do with women. If you're like the millions of women out there and the people who love them, whose sex lives have been negatively affected by chronic urinary tract infections, I wanted to tell you about a product line I discovered called Eucora because people don't

talk about this enough UTIs can happen due to menopause pregnancy so many other factors and so many women struggle with this and go to the doctor repeatedly and then end up avoiding sex as a result Eucora not only offers UTI relief and proactive urinary tract health supplements but they have a whole learning center on their website with research and information for you so get proactive about urinary tract health with Eucora. Right now, Eucora is offering 20% off when you go to Eucora.com slash love, but hurry because it's a limited time offer. Go to Eucora.com slash love and get 20% off your order. That's E-U-C-O-R-A.com slash love. I have one quick question regarding parenting and preventing future generations from growing up

in a way that you've described, which frankly causes unintended probably consequences as it relates to especially women growing up with not having a healthy perspective on sex. What can we as parents be doing to raise our kids in the right way? Well, it's interesting because I was just, I mean, I think most of us have seen it. The New York Times first broke this story and now I've seen it, you know, on pretty much every newsfeed about this private school teacher in New York. I think it, I don't remember what school it was, but it was some private school in New York, very progressive. And she was their health educator and sex educator. And she was basically forced to resign or, you know, fired, but they let her resign because she had taught second

graders as part of a larger health and sex education program, that it is normal to touch their genitals and that it feels good to touch their genitals. And if they do, they should do it in private, which to me is like completely normal and important to teach children. And it was part of some film she was showing where it said, you know, why doesn't where the little boy said, well, why does my penis get hard sometimes? And it explained, well, that's an erection. And Is it OK to touch it? Yes, it's OK to touch it. But you do that in private. There's nothing wrong with that. Right. But because we put so much shame around it, I think globally this is, you know, the parents flipped out that the second graders, that there was some sort of discussion to them about masturbation. the teacher wasn't talking about, about sexual thoughts or fantasies or masturbation. Even she was just normalizing what kids do naturally. Every kid plays with themselves. They do that to put

that you they've documented this happening in utero babies playing with their genitals or touching them. They do that to soothe themselves. They do it to put themselves to sleep. They do it because it feels good. They're not thinking like we think about touching one's genitals or someone else touching their genitals. It's just normal sexual development. But it sort of gets co-opted by all of this fear and judgment, especially for young girls, but for boys as well. And so I think it really starts early. You know, that really upset me when I saw that this teacher was like roasted for that, where I think she should be taken out to lunch, you know, begins celebrated. But that's the problem. That's a perfect example of the problem that we kind of

marginalize, demonize, and shamefully age our kids in very subtle and overt ways. At the same time, every television they show is, you know, show that they watch from adolescence on is rife with sexual images. Every advertisement they see in any magazine is rife with sexualized images of women. So they're taught from a very early age that it's not okay to touch yourself. It's not okay to be connected to your own sexuality and to cultivate your own relationship with your sexuality, but it is certainly okay to sexualize yourself for visual pleasure of others. And that in and of itself is a really skewed message that I think is one of the core underpinnings of the problem that we're talking about of women sort of growing up to feel really

disconnected from their own bodies as an instrument for their own pleasures. Our sexuality is the most sacred and beautiful gift that we've been given, natural to us. And it's a beautiful, sacred gift every time we share it. Not just the first time when we lose our virginity or whatever you think of with that, but every time. And our bodies are sacred every time we share them. And that doesn't mean that it's wrong or bad to share them on TikTok. You know, that's fine. It's the consciousness with which you're doing it and the intention with which you're doing it. And are you doing it to objectify yourself and to get the feedback, you know, and to get likes? Or are you doing it as a source of empowerment and connection with yourself? And I think there's a big difference

between both of those. Dr. Berman, you know, I just want to really agree with your and support your comments about communicating with students. I think we seriously disadvantage our kids. So my question though, I had clients that came to me, a couple looking for some micro skills in communication, and I thought it was just going to be kind of a straightforward thing. And of course who wasn't and just FYI, did end up referring them for therapy. But the interesting thing that came up was realizing that on their time together, one of them needed to get high and have a drink and, you know, and that became just, you know, part of their routine. And then work comes in in life comes in. And I forget the phrase that you said, but, you know, imbalance in desire and

and and well, you know, I can't really get drunk tonight. I can't really get high tonight. So I don't really want to have sex, you know. Right. And that just started to sound like a lot to unpack. Where do you go with that? Yeah, that's usually related to trauma of some sort. Where some see heroes and others see egos, Bloomberg sees the era of billionaire athletes. While others follow the noise, we follow the money. Learn more at Bloomberg.com. And it doesn't have to be sexual trauma, but some trauma that it also can be body shame, trauma, you know, having been hyper criticized about your body and its appearance, you know,

it can be, but usually it's deeply related to deep seated inhibitions. And the reason that the person, you know, yeah, a lot of people like to get high or drunk and, you know, and it keeps their inhibitions, it makes your inhibitions lower, you know, and a lot of people enjoy smoking a little pop before sex because they say that it enhances their experience and their sensations. And there's not, you know, if you're of legal age and you want to play with some of that and it's consensual, like that's fine. But it's when, as you're describing, you are dependent on that in order to get into a sexual situation, then what you're trying to do is what therapists call disassociate. You're trying, you know, it's not just enjoying the lowered inhibitions or the

enhanced sensations. It's about being able to make yourself unconscious enough to be able to tolerate the discomfort of a sexual exchange. And that to me is a, you know, almost always a red flag for some sort of trauma history. And that's how you would unpack it is to really explore, I mean, and obviously with a trained clinician who deals with trauma, you know, you would explore what the trauma, what those traumas were, what the root of those inhibitions are. And, you know, if the person isn't getting wasted all the time, and doesn't have an addiction issue, which it doesn't sound like they do, because they're, you know, saying, I can't get drunk tonight. So I'm not gonna have sex, you know, that's one thing, then it's an addiction issue.

But that's not what we're talking about here. We're talking about someone who wants to not be conscious so that they can tolerate the emotional discomfort of a sexual exchange so that they don't get triggered, you know, because what's probably happening is when they're not wasted having sex, they're too conscious. And so then flashbacks come, inhibitions, discomfort, anxiety, and depending on how conscious the person is or what memories they have of the trauma, sometimes they don't even know, right? They've repressed it so much. So that's where the unpacking would be around the trauma. So it sounds like the referral was appropriate then. Yes, definitely. I would say definitely. Thank you. And thanks for referring them.

A lot of people would try to barrel through. Yeah, disassociation is interesting. What happens is when we're little or young or even a little bit older and we're being molested or abused, the way that the brain survives it is by, you know, leaving ourselves. We leave our bodies. We go somewhere else in our minds in order to, you know, and thank goodness we can do that. Otherwise, we would go insane with the pain of what we're experiencing. But especially if the trauma went on over an extended period of time, and that was the coping mechanism, which is a very healthy coping mechanism for trauma. it's not a healthy mechanism for intimacy or for life but what ends up happening is that then that becomes one's sexual template they don't even really know how not to disassociate and when they or sometimes they don't even realizing they're just realized they're disassociating and then when they aren't either because they're not taking the substances that help them disassociate or they're making a really conscious concerted effort to stay in their bodies then all of the anxiety and pain starts to surface that they don't want to be with. So, um, you know, a really easy

kind of example of disassociation, which is not a trauma induced disassociation is, is when you're really, you know, when you're driving somewhere that you're used to driving and all of a sudden you've arrived at the location and you're like, Oh my God, I don't even remember driving here. I just did this automatically. You know, you weren't really home. You were thinking of other things and you're disassociating for a very different reason out of habit. It's a different mechanism at work. But a similar thing happens during disassociation with sex. So you can imagine that you're not really going to enjoy it. You're not going to have orgasms because you're not in your body. You're off somewhere else.

Let's say it has been discovered either through a clinician or someone who is skilled at uncovering if disassociation is a result of trauma? And I guess it would probably vary case by case to some degree, but what would be some of the suggestions you would see as common suggestions one would make to prevent that from happening in the future? Well, it usually comes down to healing the trauma. So when there's been sexual trauma, and this is only what's been reported at 30% of women, and probably I think it's significantly more now that all the church cases are coming out. But about five or six years ago, it was 30% of women and 15% of boys. I think that is a huge underreporting, have had some kind of sexual

trauma. And that 80% of women, while not forced, their first sexual experience was not consensual. In other words, they didn't really mean for it to happen. They just sort of didn't know how to say no, you know, they weren't necessarily raped, but they were kind of, you know, the Me Too movement would call it rape. But back then, you know, it was just sort of, I didn't quite know how to say no. He was going to leave me if I didn't do it, you know, the kind of subtle pressures. And those are still sexual traumas. It's not, you know, there's a continuum. It's not like every Sunday when you go to visit your grandfather, you're getting molested, right? It's a one-time thing. but depending on your emotional constitution and how traumatizing these experiences were

for you in particular, you know, everyone experiences trauma differently. So it's first and foremost, understanding what the trauma or traumas were, and then starting to heal them. And when we heal sexual trauma, you know, the first step obviously is, you know, understanding what happened. But the biggest roadblock to healing, I think, is just the heartbreaking shame that trauma victims feel. And so much of my work with trauma victims is spent trying to help them understand that it wasn't their fault, that even if it felt good, what they were experiencing, that is normal. You know, your genitals are being touched in a way that's going to make anyone feel good. The attention you got from the person that was grooming you and abusing

you felt good. You felt special. Even if you went back for more, it's still not your fault because you were a child or you were a person who didn't have the same degree of power. You know, this person had power over you or authority over you, or you were a child or something like that was happening. But so much of what causes the disassociation later and the disconnection from sexuality is not only the habit of disassociation, but the shame that becomes correlated with sexual arousal, right? So if sexual arousal causes you shame, it's really hard to enjoy sex or to want to be sexual. So we work a lot with identifying those things, normalizing them. And then, as I know I've said before here in different contexts,

I'm a huge fan of somatic experiencing, that form of therapy in particular, once you've really identified the trauma and worked through some of the basics of it, to then start moving into somatic experiencing is one of the best treatments of trauma, all kinds of trauma, including sexual trauma, that I have found. Can you speak to that a little bit for those who may be unfamiliar and walk us through exactly what that looks like? Yeah, I'm actually doing it now. I started doing somatic experiencing after my son died tragically and suddenly in February,

you know, and I found him because I had and still do have such tough PTSD and feel, you know, in addition to the grief, such trauma around the loss. So I can speak from personal experience as well as professional. But basically what somatic experiencing is, it's a form of therapy that goes beyond talking. You're not talking as much as going into your physical body and allowing feelings to move. Because what emotions are, anxiety, fear, sadness, anger, happiness, joy, what all emotions are, are energy in motion. And they are experienced through our physical body. Obviously, our brain plays a role.

we're having thoughts that go with these emotions. But the experience of the emotion is physical. And what most of us are taught is to repress those emotions, especially the tough ones that we don't want to look at or feel or that make other people uncomfortable. So we repress them. But the emotions don't go anywhere. They stay stuck in our body. And many holistic doctors and health practitioners will tell you, you know, all the data and all the reasons why they believe disease is really dis-ease. So often it's caused by repressing pain and, and there's, you know, the body starts to react. And now we know there's a cellular memory of trauma, even that gets passed on genetically. There's so much we don't understand, but what, what yet, you know,

we're just starting to understand. But what we do know is that when you and so I'll give you an example, just like what I do once a week, I meet on zoom with my somatic experiencing therapist. And she's wonderful. This one, I mean, there are plenty of them. This woman's name is Kate Hudson. She's out of Chicago. And I, you know, we ground I kind of sit down, I'll just sort of do a body scan. And I, you know, gently kind of scan my body with my consciousness. And you can all do this now and see what I mean. It's very natural and easy for us to do. But if you put your attention there, you'll see that you'll come upon a place, a sensation, a tightness, a density, pain, thickness, you know, whatever word appears to you or occurs to you. And then as you just

rest and settle into that sensation, your body, and you allow it to, your body will just take over. Sometimes you want to cry. Sometimes you're rocking back and forth. Sometimes you're beating the shit out of a pillow. Sometimes you're screaming, you know, but you're moving the energy through your body. And with trauma, especially, that is the hardest part and the most effective way to heal because what most anxiety treatments or trauma treatments historically have been is repressing deep belly breaths, right? That's what my son who struggled with anxiety as a child was taught by their behavioral therapist, deep belly breaths, visualizations, all these ways to repress or distract from what we're really feeling because we're also scared

to feel the hard stuff. But what we now know is when you allow yourself to actually feel the feeling, even the really yucky bad ones. And I can tell you, I'm very intimate with the yucky bad ones these days. They only take 30 seconds to a minute. If you totally surrender to it and let it happen, it takes 30 seconds to a minute to pass through you. And then it's done. And you feel so much lighter and grounded and less stuck. And, you know, depending on how severe the trauma is, you just keep doing that, you know, bit by bit and it releases and the hold of the inhibitions, the fear, the anxiety that comes up around your trigger, whatever those triggers are that triggered those feelings in you, you know, like Rex was talking about with the couple he

was dealing with, sex is a trigger for one of the people in that relationship, right? So then the triggers get less and less powerful because you've released so much of what you're repressing when the trigger comes. If somebody's like self-diagnosed, they say, okay, I realize I've had this trauma and I want to help myself, but for whatever reason, I'm resistant to get professional help.

Is there something that people can do on their own to help move the energy in the way in which you've described without hiring professional? It's really just an allowing. I mean, I do it on my own every day. In fact, I made a video of myself doing it to try to show people exactly what to do, because I think it's so important to normalize experiencing big emotions and letting them pass and not being so scared of them and working so

hard not to feel them. And we spend so much of our lives trying not to feel the stuff we think is hard to feel because we're scared it'll take us over. So if you go to my Instagram, my IGTV videos, there's a whole series of videos on being in body, but there's one I did with being in body with my emotions. And I show you how I do the scan. Every morning I take about 10 minutes and I just take some really deep breaths and I ground myself energetically. So I imagine as I breathe in a beautiful light, it's a different color every time, But flowing in through the top of my head and as I'm breathing in, it's filling every cell of my body. And as I'm breathing out, it's going out my tailbone, kind of rooting into the earth, grounding me because it's hard to let yourself go if you feel ungrounded, right?

So I take several breaths like that. And then I just quietly scan my body from head to toe, just put all my conscious awareness, almost internally, slowly scanning my body, and then I'll come to a hitch. So I think in that video I did, and this is a common one for me, I got to my chest where I felt just a density and a thickness there. So you just breathe into that for a little bit and put all of your conscious awareness and attention on that spot. And that's all you have to do with a softness and an awareness and breathe into it. And then the next thing you know, your body will want to do something. So you get, you kind of let your body take the driver's seat.

You don't, you stop thinking. You give yourself permission for these 10 minutes not to think and to follow your body's lead. And I like to have a lot of pillows around because I don't want to freak my 15 year out. You know, I'll scream into the pillow if I need to scream so I don't scare him. I have tissues nearby because I often cry and it's just energy coming out. I'm not even having a thought. And it's important not to think too much because that's what we do.

We kind of intellectualize our feelings away. And the reason we stay stuck in our feelings is also intellectualization because, oh, no, it's so bad. And you keep going and going. So you don't think. You kind of stop putting meaning to it. And you focus fully on the sensations and letting your body take the lead. And your body will.

It's like waiting for you to let it do that. and it's and it really likes it and so it'll start moving it'll start rocking it'll start you'll start moaning you'll cry you'll scream into a pillow or a bowl of cold water whatever you want and then the energy and then you're done it takes at most a few minutes and then it just comes to a natural conclusion and then you take some more deep breaths and you're done But you can also go to Trauma Healing. I think the website is traumahealing.org. That is where you can find a somatic experiencing therapist near you. I was just I mentioned earlier at this shaman's retreat and I was with two girlfriends. We all went together. We were sharing a room and I woke up as I sometimes do these days. I just woke up feeling so heavy and depressed and, you know, for no good reason. and I knew what it was. I knew I was just feeling some grief. And so I was just kind of trying to

work through it and talk myself out of it and, you know, kind of get through the day. And then after breakfast, we went to meditate somewhere and, you know, these girls know me well, and they're as open to this sort of stuff as I am. And so I just say, don't be alarmed. I'm going to move some emotion now. And so they just, you know, handed me some tissues, carried on meditating and doing whatever they were doing. And I was just rocking back and forth and getting into child's pose and crying and snotting. And I was done after a few minutes. And then I felt fine and moved on with my day. But it's really important to get in the habit of letting your body release, including for your sexuality, because most of us, even without trauma,

if you're not used to being your body's ally and letting your body take the lead and being physically in your body, it's really hard to have a great sex life, much less even want sex. I do have one question going back to routine. And you've given this advice before, which is for those people who are in a relationship or a marriage, that maybe the love life is not what it once was, one of the suggestions you've given is to actually schedule a time to have sex, which is an example of creating a routine. What are some other practical tips that someone listening right now can apply in their own life that would allow them to build a routine around sex? Yeah, I think it's about, I'm a huge fan of scheduling sex. And what I find for most people,

assuming that you don't have really difficult PTSD around sexual trauma, or that you're not in a relationship that is really difficult and conflicted, right? Let's assume those two things are not the case. Then it's really about scheduling for sure that pocket of time that you can count on once a week, where you're going to be sexual together and really embrace it and start to look forward to it and know that that is, you know, that's the time for the two of you to be intimate. Because what I find is that for most people, once they get started, then they really enjoy it and they have a great experience.

It's just getting started that makes it difficult. You know, they're distracted. There are other things they have to do. They're tired. So if you know it's coming and you know when it's coming, then you can rest that day. You can put a little more effort into your appearance. You're prepared. Whatever those things are. So I think that's a really important piece. Also, just cultivating your sensual connection, I think, is something that most of us don't do in our daily lives. And by sensual, Well, sensual is certainly sexual, and it certainly makes sex significantly better.

But what sensuality really is, is an attunement to your senses. And it's a kind of mindfulness. When you go about your day, you know, and none of us can be mindful all the time. I mean, we've got places to go and people to see and things to do. But even if you just take a beat when you're eating a meal, one of the meals, you know, maybe two of them, you're standing up at the kitchen counter, but at least one of them, you're sitting, you're attuning to all of your senses, how it smells, how it tastes, the textures. When you're walking outside, you're taking a moment to smell the air and to feel the breeze

on your skin. You know, you're maybe taking a bath and really nurturing yourself with loofahs and oils, you know, you're really at least putting some time in every day to cultivating, nurturing and feeding your senses. I find that that, you know, that sensual awareness that we can walk around the world with not only makes us more attuned to our environment, but definitely feeds and fuels sexual desire. I think also paying attention to just your health and medications you're on. And as you hit your mid to late 30s, and into your 40s, for men and women, there are hormonal changes that can affect your desire and sexual response. And attending to those with a physician, you know, to make sure that you're doing what you can, you know, if you're

a candidate for hormone therapy, and also exercising, there's a lot of data coming out that shows, in particular, weight-bearing exercises really cultivate and promote testosterone production. So the longer and more you can do that, or more regularly you can do that, the more you're supporting your hormonal structure. And if you're in a, you know, and this is all true, whether you're in a relationship or not, because having sex with yourself, you know, even if you're self-stimulating, that's, as Woody Allen would say, having sex with someone you love, you know, And it's definitely important. It's important to cultivate that sexual relationship with yourself, especially if you're not in a relationship with someone else, but even if you are, and if you are in a relationship with someone else, if you want a really good sex life, it's also super important to cultivate the emotional connection between the two of you with appreciation, looking for things to appreciate and expressing that quality time where you're talking and kissing and cuddling with Without talking about the logistics of your lives, but really enjoying each other off technology, having those technology breaks together, all of those things can really help cultivate the sexual connection.

Hi, I didn't know. I heard you say that, you know, with hormone changes, when you get to be like middle aged, that your sex drive can change, which I know. But how would you know, is there a difference like signs, like symptoms and signs that it is hormonal if your sex drive drops from hormones related? Well, so the way to tell that is in two parts. Like one is if nothing has changed emotionally or relationally significantly in your life and you did have the desire before and now you don't, chances are it's something physical, right? Like if you've never had desire or you're currently in a relationship where there's conflict or disconnect or whatever, then it's harder to parse out. But if all other things are basically equal and you find yourself having lower desire, then that's a big sign that there may be something physical at play.

But like I was saying earlier in the conversation, you definitely want to address all things at once, right? So with low desire, especially within a woman, you know, we definitely have seen lots of evidence and the research has shown this as well, that chronic stress, it doesn't seem to affect men's libido in the same way it affects women's, even hormonally. You know, those cortisol changes really change our free circulating testosterone. So the symptoms of low testosterone, testosterone is the hormone of desire that both men and women have. men have a lot more of it than women do. But also a woman in her 20s has double the testosterone that a woman in her 60s has, and it's slowly declining throughout our lifespan. So symptoms of low testosterone, which a woman may start experiencing in her mid to late 30s sometimes, but certainly by the mid to late 40s, is low desire, low genital sensation and nipple sensation,

difficulty getting aroused, low energy, and, you know, sort of some mild, not really depression, but just kind of blondness, not the same joy in life that you had before. And that's true. Men can get low testosterone as well, especially in their mid to late 40s and on. So those are the typical symptoms of low testosterone. And estrogen tends to show up, you know, a little bit later in the mid to late 40s into the 50s, where the symptoms of low estrogen are typically definitely difficulty getting aroused, but also dryness and symptoms of low progesterone tend to be, which a lot of women get in what's called perimenopause, mid to late 30s until finishing menopause is moodiness, mood swings, sleeplessness, depression.

so hormones changing can definitely create changes in us not only in our desire and enjoyment of sex but also mood sleep energy all of that i'm in my late 30s so i always like to be on more of the preventative side in terms of health than waiting until you know it's for someone your age also I would say you know my advice and I'm not a medical doctor but I certainly have ushered many women through this process we also know that hormonal contraceptives can cause low desire as well especially in a woman in her mid to late 30s and beyond because for that reason I talked about our testosterone is slowly declining and what happens when you take hormonal contraceptives, or when you take estrogen replacement therapy, without also attending

to testosterone, is that it increases a protein in the blood called SHBG, sex hormone binding globulin, or steroid hormone binding globulin that binds to testosterone and makes it unavailable for your body to use. So if you reach your mid to late 30s, you have, let's just say less of a full deck of testosterone and the testosterone you have is being bound up by the hormonal contraceptives. And so when I see low libido in the 30-somethings, often it's related to hormonal contraceptives. So another form of birth control like an IUD or something like that may be helpful as well. In regards to what you just said about the birth control, if you were somebody who took birth control for a long period of time, would that affect anything, um, I guess maybe

permanently in your body? Cause you know, there's a lot of, it really shouldn't, it really shouldn't affect anything permanently unless you're already, unless, you know, you're already going into perimenopause or menopause. Otherwise, um, just because you were on birth control pills for a long time, there's been no evidence to suggest that that doesn't re-equilibrate. It can take, six months to a year to re-equilibrate. Same thing with after multiple pregnancies, there's something called postpartum androgen deficiency syndrome or testosterone deficiency syndrome, or typically after the second child. Sometimes even after the first, a woman experiences a drop in testosterone that doesn't re-equilibrate as easily after that second child

is born. So I would explore the American Academy of Anti-Aging Medicine, their website, and they have lots of practitioners around the country that look at hormone levels in a holistic way, bioidentical hormone levels, medications you're taking, medical conditions. So they can be extremely supportive. Well, we started off with sex 101 and it got deep pretty quick, but that's okay. I, you know, I like to go where we're going. I think it's just really important to recognize that there's big T and little t trauma for all. I mean, there's not one of us who hasn't experienced some kind of trauma. That doesn't mean horrific abuse or sexual trauma, but there are ways in which we've left parts of ourselves behind, which is just sort of natural in our evolution

as from children to adults, places where our boundaries weren't respected, where we were hyper-criticized, where we felt like we couldn't measure up, where we were abandoned emotionally or literally through death or illness or divorce. So we're all trauma victims to one extent or another. And I think that's really important to acknowledge and to normalize, to know that we're all in this together and there is help available and healing is always possible and probable.

You just have to be brave enough to let yourself heal and to let yourself heal. thank you so much for joining me on this episode of language of love i love all these questions from you and you remember that you can keep them coming you just go to drlauraberman.com right there on the home page you can either leave a voicemail question or an email question you can also go to speakpipe.com backslash language of love directly and leave a voicemail question as well. But it's sometimes easier just to click on the link. I will meet you back here. A brand new podcast is coming out next Wednesday. So look for that. Make sure to subscribe if you like it.

And I'll see you next time on the Language of Love. where some see heroes and others see egos bloomberg sees the era of billionaire athletes a fad to some the future of money to others we see crypto's trillion dollar swings the end of jobs or the end of human struggle we see the endless funds fueling the ai hype while others follow the noise we follow the money learn more at bloomberg.com