Welcome back to We Can Do Hard Things. We are going to jump right in today because we are lucky enough to have Dr. Jen Gunter back to answer all of our burning for many of us menopausal women literal burning questions about menopause.

We are committing the feminist act of demanding to understand our own bodies and we are also going to talk about all of even the embarrassing things about menopause in our bodies today because we refuse to allow the entire world to talk about women's bodies and sit it out.

Everything on earth is sold with a woman's body. Everybody from companies to movies to everyone earth religions to congresses gets to talk it incessently about women's bodies and then for some reason we are ashamed to take the conversation back.

We are not going to let the whole world talk about the way our bodies look today. We are going to talk about the way our bodies function and feel.

The menopause menopesto can't recommend enough also the vagina Bible and the preemie primer and Dr. Jen I want you to understand that I have the menopause menopesto and the vagina Bible on my coffee table so that everyone who sits down can feel more comfortable with the words menopause and vagina right up in their face.

She is the host of the podcast body stuff Ted audio collective and of the streaming docu series Jen explaining she blogs at the vajenda.com and her writing can also be found in the New York Times clamor dame and other publications her mission is to build a better medical internet.

She has been called Twitter's gynecologist the internet's OBGYN and a fierce advocate for women's health Dr. Jen Gunter thank you for returning to we can do hard things.

Thank you.

We're going to talk today about the biggest most important most common questions that folks have about menopause and our first one is from Lynn.

This is when I'm facing menopause and if I hear one more goddamn thing about a hot flash or about all the sort of surrounding things for midlife.

No one is talking about orgasm I can't have an orgasm anymore and I'm shouting it from the rooftop because I'm so tired of this being dismissed.

I listen to so many midlife podcasts. Oh just rub a little essential oil. I don't need essential oil. I need an orgasm to understand and I know you feel me.

So just please help me find a really good person that can come on your show. Talk about orgasm. Talk about the brain event.

I just need a bunch of professionals to figure out why I can't have an orgasm at 50. It's not okay. Okay. I love you. I love sister. I love Abby. I love the whole thing. I guess that's it. I think that's enough. I'm not angry. I'm just ready to get some answers. Love you guys.

I love her. I love her. I don't need essential oils. I need to go to more gas. Can we call this episode that I was taken only speak in generalizations because there are so many questions to ask an individual person. And especially when you're talking about sex, you actually have to know what their sex life is beforehand leading up to it.

So if we're sort of thinking about somebody who said, you know, I'm really having difficulty achieving orgasm or I can't achieve orgasm now. There are kind of a list of things to run through. So the first is probably to start treatment with vaginal estrogen to make sure that you have enough blood flow to the tissues.

So when we go through menopause, there's a decrease of flow of estrogen to our vaginal tissues. And that affects how well things function. And if you think about Viagra and those drugs, phosphodiesterase inhibitors for men, what they do is they increase blood flow to the penis. Well, vaginal estrogen increases blood flow to the clitoris to the vaginal tissues.

So the number one thing for someone who's having a sexual difficulty would first of all be to make sure that they're using vaginal estrogen and using enough so that the tissues are kind of at the baseline.

Now, what can also happen sometimes with each and sometimes even with menopause as well as the pelvic floor muscles get a little bit weaker. And those are the muscles that wrap around the vagina and when you cough or sneeze, those are the muscles that that hold your urine in or if they're a little bit weak, they let the urine out.

Yeah, sure do.

Yeah, sure do.

And so that's exactly so those muscles can actually weaken a little bit.

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