In this honest conversation, pelvic and sexual health physiotherapist Lisa Fitzpatrick draws on 30+ years of clinical experience and her own heartbreak to explain menopause and sex, vaginal dryness, painful intercourse and reclaiming pleasure in midlife.We call out myths and bring truth to misconceptions; the silences surrounding women’s sexual health as we age. Silence that breeds shame and holds women captive in their own minds and bodies.Clinically, we explore the genitourinary syndrome of menopause (GSM), why pelvic floor relaxation matters as much as strengthening, vaginal moisturisers and lubricants, local oestrogen, and why ‘use it or lose it’ applies to pelvic health.Emotionally, we talk about shame, nervous system safety, identity, desire, relationships and the role of connection and self-trust in thriving after menopause.Whether you are navigating menopause yourself, supporting a partner, or simply want to understand women’s sexual health in midlife, this episode offers compassionate, practical insight.In this episode we talk about…Why Lisa wrote Sexy Menopause - The New Science and Soul of Midlife Desire:* Why Lisa felt this book needed to be written now and how her own experience of menopause and heartbreak shaped it.* Navigating body changes, disrupted sleep, joint pain, weight gain and a changing sense of identity in midlife.* Why Lisa believes women need honest, compassionate conversations about desire, intimacy and pelvic health, without the secrecy and shame.“I’m either going to get bitter or better… I’m going to write my way through this. I’m going to heal out loud.”What happens to the body in menopause:* How changing oestrogen levels can affect the vulva, vagina, bladder and urinary tract.* The Genitourinary Syndrome of menopause, including vaginal dryness, discomfort, urinary changes and recurrent urinary tract infections.* Why the vaginal canal can shorten and narrow, and how this may affect comfort with penetrative sex.* Why changes can occur after a period of abstinence—and why it is never too late to seek support.“If we don’t use it, we lose it.”Rethinking pelvic floor health:* Why pelvic floor health is about much more than doing Kegels.* The importance of relaxation, lengthening, softening and creating spaciousness in the pelvic floor.* How breath, nervous-system regulation and tension patterns can influence pelvic health.* Why moisturisers, lubricants and local oestrogen may each play different roles in supporting tissue comfort.“The pelvis keeps the score as much as the body keeps the score.”Pleasure, desire and the clitoris:* Why the clitoris remains an important source of pleasure throughout life - it’s always available to us.* Why pleasure does not have to depend on penetrative intercourse.* How vibrators and other tools may support comfort, circulation, familiarity and pelvic floor relaxation.* Why desire and sexual response can change in midlife and why that does not mean the end of desire. It will re-define it.“It doesn’t mean the end of pleasure.”Relationships, intimacy and emotional safety:* How couples can navigate changes in sexual function and intimacy together.* Why emotional safety, nervous-system regulation and communication can be just as important as physical treatment.* Why sex after menopause does not have to be (and is often not) the same as it was earlier in life. It may become more connected, creative and fulfilling.* The impact of shame, cultural expectations, religious messaging and unrealistic portrayals of sex on women’s relationship with their bodies.“It won’t ever be the same as it used to be, but it can be even better.”Identity, self-trust and authenticity:* Why midlife can be a powerful time to reconnect with who you are and what you want.* The importance of self-trust, intuition and listening to your body’s messages.* Why authenticity, boundaries and self-compassion are central to a ‘sexy menopause’.* Lisa’s reminder that this conversation is inclusive of all women, regardless of relationship status, sexuality or gender identity.“We do not need to prove anything to anyone.”Lisa’s Pelvic Health Toolkit:* The pillars of Lisa’s practical approach to pelvic and sexual health.* How diaphragmatic breathing and nervous-system regulation can support pelvic floor relaxation.* Gentle hip mobility and pelvic stretching to help release tension.* Every woman’s toolkit needs to be individual, depending on her symptoms, history and circumstances.* Why a pelvic health assessment with a trusted women’s health physiotherapist can be an important step.“You’re going to get your mojo back.”Thank You Lisa…for sharing your wisdom, clinical experience and personal story so generously. I know this conversation will help women feel more informed, less alone and more confident about seeking the support they deserve and need.Pre-Order Sexy Menopause - The New Science and Soul of Midlife DesireIf ...
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