In short
Sex life after having kids—how desire, intimacy, and sexual identity can change, and why many parents report equal or improved sex.
Guests
Dr. Jessica Shepard, board-certified OB-GYN, women’s health and sexual wellness expert, menopause specialist, chief medical officer at HERS; interviewed by Dr. Becky (Good Inside host).
Key claims
The “kids kill passion” myth is overstated; married parents report more sex than singles and often describe it as “wild” or “best ever.” Passion can persist but looks different. Great sex is linked to comfort, vulnerability, emotional connection, reduced blame, and “locating yourself” amid parenting stress/mental load. Hormonal shifts (especially perimenopause/menopause) affect desire and pleasure; hormone therapy can help.
Notable examples
“Banana in hair”/vomit-on-shirt moments still enabling closeness; discussing birth/vulnerability to enable honest intimacy; reducing mental load by stopping over-functioning (e.g., letting partner handle water bottle/snacks); scheduling sex as a “container.”
Written by AI. May contain mistakes. Listen to the episode to check what was said.
Chapters
Tap a time to open that second in VOExploring Sexuality After Parenthood
1:19 to 2:34
Discussion on how parenthood affects desire and intimacy in relationships.
“Today we're talking about sex life after having kids.”
Debunking Myths About Passion
2:34 to 4:21
Dr. Becky and Dr. Shepard delve into myths surrounding sexual passion in lasting relationships.
“They were having sex nine times a month versus five times a month.”
The Role of Vulnerability in Intimacy
4:21 to 6:15
Exploring how vulnerability and comfort with partners enhance intimacy after having children.
“And so that can somewhat shift what that view is on passion, but it doesn't necessarily mean that the passion is gone.”
Humor and Connection in Parenthood
6:15 to 7:54
Discussion on how shared experiences in parenthood can strengthen intimacy.
“I think that struck me as, you know, as an individual married as something that was, Oh, well, wow.”
Understanding Mental Load in Relationships
7:54 to 11:51
Conversation about the mental load carried by partners and its effect on desire and intimacy.
“Is that you still have that connection and the connection that can be strong even though it's not sensed in that way as you're maybe peddling kids off to school.”
Managing Mental Load in Relationships
14:01 to 15:10
Learn how to communicate mental load issues to your partner effectively.
“You know, I just like I gave you the address, right?”
Navigating Desire and Intimacy
15:11 to 19:01
Explore the connection between handling mental load and sexual desire.
“That is exactly what I mean when we have to release some of that mental load.”
The Importance of Feeling Seen
19:02 to 19:47
Understand how feeling seen impacts both mental load and sexual connection in couples.
“In some ways, I think this dynamic can get enacted where sometimes one partner saying, hey, I want to feel seen and important to you.”
Parenthood and Sexual Identity
22:34 to 25:01
Discuss the correlation between parenthood and sexual identity and confidence.
“If your brain feels like it's holding everyone's schedule except your own, you're not doing it wrong.”
Hormones and Sexual Desire
25:02 to 28:05
Gain insights into how hormone levels affect sexual desire and intimacy.
“someone else, it puts an impetus on you as well to show up as that person in addition.”
Show all 16 chapters
Understanding Hormonal Changes and Intimacy
28:05 to 29:56
Learn how hormonal changes impact sexual desire and intimacy after pregnancy.
“But they do start to increase in da-da-da adolescence, which is why with puberty and then, you know, they're sky high at that point.”
The Role of Communication in Relationships
29:56 to 31:53
Explore how communication about hormonal changes can improve intimacy in relationships.
“it is very hard for me to get women to say the thing of what they need.”
Defining Sexual Performance and Pleasure
31:53 to 33:46
Discover what sexual performance means and how it evolves with age.
“Like move to the next step and be like, what can I do to help myself, especially now that we have ways to do that?”
Exploring Orgasms and Sexual Intimacy
33:46 to 36:08
Examine how orgasms and other forms of sexual intimacy change over time.
“Now you're getting to the stuff everyone's like, I'm sorry, Becky, do not let her move away from the subject.”
The Importance of a Holistic View on Sexual Health
36:08 to 37:51
Understand why a holistic view of sexual health is essential for well-being.
“So in both male and females, you do start to see that with biological aging and hormone decline.”
Changing the Narrative on Intimacy Post-Children
37:51 to 39:52
Learn how to approach intimacy discussions in a healthier way after having kids.
“There were so many things about that conversation that are sticking in my mind.”
Transcript
Automatic transcript. May contain errors.0:00So it's summer and your kid's out of school and you hear them say, I'm so bored. That's a stressful moment, right? I mean, it is for me. But here's a reframe. Boredom is a doorway to creativity. And Play-Doh can actually help you and your kid walk through it. What I love about Play-Doh is there's no one right way to play. Kids can make up the rules as they go. If you have a kid who loves animals, your kid can make a dog or a dolphin. The kid who plays with their food can make a donut or pizza. Your kid can make anything. And your kid isn't just having fun. They're using their imagination and expressing themselves.
0:42And if it all gets smushed into one big blob, you have a kid who felt free enough to play. And that matters. And here's my favorite thing. You can sit down next to your kid with a can of Play-Doh and no agenda. You can play together, play side by side. There doesn't have to be any teaching or fixing. In fact, I recommend leaving those things out. It's an opportunity to give your kid what they want the most, presence and connection. This summer, give your kid, and honestly yourself, permission to play. Shop Play-Doh at walmart.com slash Play-Doh. Today we're talking about sex life after having kids.
1:23We're going to be talking about what happens to desire, connection, and sexuality once people become parents. Now I know what you might be thinking. In TV, books, media, it tends to always be the same caricature. Kids arrive and the fire goes out. Sex life is non-existent. And that can happen sometimes. But new data from HIMS and HERS suggests the story might need an amendment, or at least it's more complicated. And in some ways, it's a lot more hopeful than we've assumed. Joining me today is Dr. Jessica Shepard. She's a board-certified OB-GYN, women's health and sexual wellness expert, menopause specialist, and the chief medical officer at HERS.
2:08We're going to look at what their new survey reveals about the evolving landscape of American intimacy, but also through a Good Inside lens, how emotional connection, identity, vulnerability, stress, self-knowledge, the ability to locate yourself, and even mental load around parenting shape our relationships to desire, to intimacy, to sex, and to ourselves. I'm Dr. Becky, and this is Good Inside. I'm so glad you're here.
2:41you just released a study and i'm hearing that some results were surprising even surprising to me you know being a parent married is that what we found through the survey was how many times couples were having sex a week the stat itself because we're going to go over a few numbers i want because i love digging behind the numbers but let's start with what the numbers are so So you're saying married respondents in your survey were having almost twice as much sex per month as singles. They were having sex nine times a month versus five times a month. And for anyone listening, and I know we agree on this, there's no magic number.
3:19There's no magic number. If you're like, I'm under nine, I'm over nine, I'm under five. No, no, no. Intimacy is so many things. It's really about what works in your home. But I think the point of this conversation is to maybe, I don't know, untangle some myths. So this idea that passion kind of fades in long-term relationships, right? I mean, I think this is something people have been saying. Oh. So yeah, that's not what you guys found. No, we did not find that. And I think passion is underestimated or undervalued to the sense of what we think. I think we think it would have been in polarity, right?
3:54Passion has to be what we see when we're maybe first dating someone or when we're first married. And that is like where passion needs to be at all times. And what we do find is that passion actually can stay consistent, but might have different forms in how it appears. And because we have this idea of what passion is, we sense that if it's not at that level, then it's lost. Now, parenthood obviously does throw in some other obstacles to how we view our partner, how we interact, the time that we have together and how that time is spent. And so that can somewhat shift what that view is on passion, but it doesn't necessarily mean that the passion is gone.
4:38Yeah. And I think, look, you know, passion and familiarity, spontaneity and predictability, like these are all the things we're all wrestling with in our relationships. Right. To some degree, those of us who have decided to get married or commit to one partner and have kids, we're saying that part of me that's looking for predictability and stability and a foundation. that part of me is strong, right? That's like a big part of our lives. And that's why we talk about logistics all the time with our partners, right? When we have kids, okay, well, who's doing soccer and what time are you home? And, you know, who's gonna pick up our kid at childcare, whatever it is, right?
5:10But what I think is so interesting is that doesn't have to be at odds with our desire to be spontaneous or to also have passion. And maybe there's something about the comfort of the structure and the familiarity that allows us to maybe say for the first time, different things to our partner around, I don't know, our intimacy or sexual desires? I think it gets really real and raw when parenthood is thrown into the equation. And when that happens, it really takes on a different role in how we play as partners, how we interact as partners. And you said that before, the spontaneity is sometimes lost.
5:47And so maybe it needs to be focused on again. But that spontaneity is lost because you do have a human that requires full attention and all hands on deck. at any time of the day or night, multiple times a night, I might add. Yeah, exactly. Well, related to that nine times a month versus five times a month, something else you found, I just have to read this because I want to make sure I got it right. Married respondents in your survey were almost twice as likely to describe their sex life as wild, the best it's ever been. Yeah. Did that strike you as surprising? I think that struck me as, you know, as an individual married as something that was, Oh, well, wow.
6:26But when you actually think of the time that you have to devote to sexual intimacy and the unsexiness, I guess you could put it as, you know, parenthood and child rearing, those moments do become more passionate because many times in your day or the time that you spend in the day raising children is not maybe, you know, as you're walking around with maybe a banana in your hair or, you know, with throw up. on your shirt is those moments do become more vivacious and it creates that spontaneity of a moment where the passion is high. But tell me more about that. So I'm walking around, I've been added my hair.
7:07I have like spit up on my shirt, right? I maybe say to myself, honestly, like I actually forgot to shower today and maybe yesterday too. And then I actually helped me connect the dots from there to best sex I've ever had. Like I'm even struggling to connect the dots. Well, many times before parenthood was thrown into the equation, we had time to prep. We had time to look our best and maybe, you know, spend two hours in the mirror before. And now we don't. But the fact that we have someone who's still there available, who still can see us in our worst with banana in our hair, throw up on our shirt, but still is available for you emotionally and in a way that there is desire still there and intimacy, right?
7:51So the closeness of you spending with that person, albeit you don't necessarily look the same and maybe your hair is not perfectly curled and you're not wearing stilettos. Right. Is that you still have that connection and the connection that can be strong even though it's not sensed in that way as you're maybe peddling kids off to school. Yeah. It can be there. So question. Is part of maybe an explanation for the data – I'm just playing around with this so tell me maybe I got it wrong. is, okay, if I can have banana in my hair and spit up on me and, you know, maybe even my partner, like, saw me gave birth, saw me bleed through many pads, you know, all the things, you know, that happen after we have a baby.
8:32Maybe I'm also more comfortable saying to my partner, hey, I've never actually liked, I don't know, I've never actually liked missionary. That's not like a thing for me. I want to tell you, like, never actually had an orgasm that way. Or is that, I'm trying to connect this comfort is what we've been through to best sex of my life where I think some, you know, having the best sex is about your comfort, knowing what you like, knowing what you want, then feeling like I have someone I can say that to who might receive it, right? Like none of this is magical. A lot of it comes from knowing yourself in communication and being with someone who you're comfortable enough to say it to.
9:08So is that part of the connecting of the dots? There's comfort, but you know what also comes from this is vulnerability. The vulnerability that now that you have had a child and, you know, as an OBGYN, I know how that goes. All of a sudden, you know, in labor, you know, it may be nice and quiet with maybe you brought some background music. And then when it's time to deliver, now there's 28 people in the room. You are now being seen, you know, in a different way. Now your partner is possibly, you know, how much they saw of the delivery or, you know, whether it was C-section or not. There is a veil that has been removed and vulnerability now becomes a different part of the language in how you communicate.
9:50Yeah. So, yeah. And just for anyone listening, I think there's a way you can make that link if you haven't yet where, you know, there's this narrative. I'm noticing it in my brain as we're talking where, okay, how can you still have great sex with someone after they've seen you give birth, after they've seen you had diarrhea, like whatever the things that happen when, you know, you've been married for a while or you're cleaning up your kids' vomit together. You're like, how does that relate? Right. But I think there's this alternative narrative, which is I can start a conversation with my partner, very honestly saying, look, we've been through some real stuff together.
10:25Birth, you watched it all. Cleaning up, you know, Sally's vomit the other day. We've been through some real stuff. And that makes me think we're ready for a conversation maybe we've avoided, right about hey what is our intimacy and sex life like for you what do you want to be different what are the things you think I think you enjoy and you're actually like no I don't and vice versa and given how much we've been through I feel like we have a foundation to say let's jump into that conversation and we also have less time in the sense that before when kids weren't really necessarily on the scene.
11:06And we had more time to, you know, primp and, you know, kind of play the, you know, maybe things that we weren't, or say the things that we didn't want to say, is now there's a time crunch. And also vulnerability kind of stirred into the pot is with lack of time to do whatever we want to do, we really have a finite amount of time to devote to each other. So let's make the best of it. But also there's vulnerability as well, because you've seen me in my worst. Let's get to the real stuff. Let's just cut to the chase and get to the real stuff. And that's where you start to see a heightening of let's make this time the best.
11:46And also I'm going to give more to it because I want more out of it as well. Let's do the stuff that really, really matters. The pressure is less and you don't have to play it necessarily to ideals of what you think the other person might want to see because that ideal has been shot to the ground. Yeah, right, right, right. We're not playing that game anymore, buddy. No, no, no. Let's be honest. Let's talk about mental load and how it relates to, I don't just want to say sex. It's to desire, to connection, to what, and I'm sure it could be men too, but I think about as a woman who's often, not always, but the default mental load carrier if they're in a relationship with a man.
12:25How, I think that's kind of, it's not directly in the study results, but I think you and I know there's something there in terms of at night. Oh, I know it's there. Okay. Yeah, yeah, yeah. So tell us. I mean, mental load, I didn't even really know that I was carrying it because, again, conditioning, right? Yeah. So I think there needs to be a lot more honest conversation without blame. I think once you put blame into the category, then we're not going to get anywhere. Of what mental load really means, and as an emotional being for women who usually tend to tie that mental load to their desire for their partner in a heterosexual relationship is very profound.
13:04And I think the more that we enlighten without blame, I will always say that, is that we can have a better understanding of what mental load means. But even for women who are listening, I had to learn this myself, over-functioning and not setting boundaries makes the mental load harder. And so I've had to learn to set boundaries. Yeah, is when we realize that sometimes things may have to fall apart and we can't fix everything will actually decrease our mental load. So example, I'm just thinking because this seems, you know, like something that can happen. You're thinking, let's say I'm married to my husband and he's like, yeah, I'm taking the kids to soccer.
13:42I'm taking our son to soccer. And I'm thinking, yeah, but I found out that he needed new shingards. I went to get them. I packed them. I got the water bottle ready with ice because if Bobby doesn't have ice in his water, it's a total conniption. And I have the water bottle ready over here. And I also old school printed out MapQuest directions. That probably didn't happen, but shout out to MapQuest days. You know, I just like I gave you the address, right? By the way, I might have even packed you a snack because you get cranky, my lovely husband, when you're out for too long. Okay. And my husband's like, but I took him to soccer.
14:16Okay. So I'm thinking about that situation. as what I might need to say to myself if I'm over-functioning, right? Is I might say to my husband, before I'm too resentful, you know, I know soccer is your thing. It feels like it's both of our things. Like I get it. You take Bobby, I'm not there, but I get the water bottle ready. I do this. I know those things seem like tiny things, but it ends up where we're splitting the task and I'm holding a lot. I want to let you know, by the way, for the sake of our relationship, I don't want to keep doing things that lead me to feel resentful of you. You might not even know them, so I should stop doing it.
14:55I'm not going to do that anymore. And so a couple of things might happen. Either you could transition to taking over the water bottle and the snacks, or you're going to have Bobby on the sports field and he's going to be like, I don't have a water bottle. And like, I just actually believe you can handle that. So I want to talk about that with you. Is that? That is exactly what I mean when we have to release some of that mental load. Or in my instance, when it, I don't know what my issue is, but stacking dishes in the sink, like they have to be stacked properly. And so when they're not stacked properly, then I found myself having to go rearrange the dishes in the sink to be stacked properly.
15:31So I was creating mental load. And so in order for me to stop that, I had to step away, push away from the table of having the dishes perfectly stacked in the sink. Yeah. I think that's really, really important. And I always like to make it one more level concrete because, look, I think I do hear this one dynamic. And I don't think this explains all of the he wants to have sex and I don't dynamic. It's way too complicated, right? Sometimes it's the opposite. But what I do hear come up a lot in that dynamic anecdotally, both from Instagram, from my friends, is some version of I'm handling the mental load all day.
16:06Like I'm thinking about, oh, we have to sign up for camp or else my kid's never going to be in camp. and I'm thinking about the next set of bathing suits and clothes that need to be ordered now because if we get to a hot day, everything's too small from last year. And I'm thinking about the teacher's gifts and I'm thinking about all the things. And my husband's like, why don't you wanna have sex? And I'm like, are you kidding me? But I think the almost playful and same team approach could be like, hey, we've been in this dance a lot. Guess the end of the night, you wanna have sex. And I think it's one of your ways of saying, I wanna be close to you.
16:39Yeah. I say, are you kidding me? which probably feels like I'm saying to you, I don't want to be close to you. And I just, I think there's a way we can work through this where I think for me, one of the dynamics beyond what I'm learning about my hormones is there's so many little things that if I say any of them, they almost seem absurd, but it's the accumulation of managing them all, mostly in my mind, not even in the execution that leads me to feel so depleted. I don't even have any energy to connect you in that way. And I actually would like fewer of those to be on my list, but I'm also kind of, I'll put this on a tray for you.
17:14Okay. I'm going to put this on a tray. Lovely husband. If you would think about the camp signups or the doctor's appointments or food on the weekends for our children who seem to eat every 90 seconds, if you want to pick up one of those, I feel like we're both going to win. Yeah. Like giving options too. And I do feel like that. Like, I want to say to the person who has more desire at night, if you proactively say to your partner, hey, this is a crazy idea. Do you want me to help more? Not with the execution of logistics of things, but in thinking about things. Do you want to give me a couple of categories?
17:53Can you imagine if your partner said that to you? I'd be like, right here, right now, This is going to happen. Exactly. Right here, wherever we are. I don't care. A hundred percent. And change never happens overnight. So I think the expectation that I told you to do it this way and it didn't get done is you're actually setting yourself up for failure. And so those small conversations have to happen over time. Yes. And not getting frustrated. The other thing that I've heard from a sex therapist was that sometimes to get us back into the rhythm of what we would like to do sexually, schedule it. 100%.
18:32Put it on the calendar. It sounds so weird, but really when you prioritize and you are like, this is how I have to make time for it. That's right. Eventually it won't be that you're scheduling it, but you may have to schedule it to get it back into the schedule. Esther Perel always says that. And I think about, you know, scheduling sex, scheduling anything. It's just saying this is a container. Yeah. What happens in that container can be whatever you want it to be. So people think, oh, that means we're so boring. We're so lame. No, you've just set up a container. You can do whatever you want to do inside the container.
19:01Right. And I think going back to this mental load, sex, who has desire, who doesn't, what will it take for both people to be on the same page? In some ways, I think this dynamic can get enacted where sometimes one partner saying, hey, I want to feel seen and important to you. And one way I experience that is through sex. And actually the other person saying, I want to feel seen and important to you in a way that would actually be true for me is if you take on some of the things in the family. So in some ways, it's very, very different on the surface, mental load and sex. How does that relate? But underneath, it's probably about feeling seen, feeling important, feeling real in the moment, feeling close.
19:36And so in that way, I find it's really, really possible as a couple to work through these things because you're actually kind of speaking the same language underneath. It's just wanting to be seen and heard and validating your partner. 100%. Yeah.
19:57Okay, parents, quick check-in. If your brain feels like it's holding everyone's schedule except your own, you're not doing it wrong. You're carrying a lot. I see this all the time. School emails, activities, chores, dinner plans, and somehow it all lives in one person's head. Usually, moms. And that gets exhausting. That's why I love Skylight Calendar. It's a smart touchscreen calendar that takes everything swirling around in your brain, schedules, chores, meals, grocery lists, and puts it in one place. Where the whole family can actually see it and participate. It syncs with Google, Apple, Outlook, all of it, and you can color code each family member.
20:38So there's a lot less, wait, I didn't know, in your house. Plus, with the free Skylight Companion app, you can add or update events, lists, and more on the go. And I appreciate this. If after 120 days, you're not 100 % happy, you can return it for a full refund. No questions asked. Right now, you can get$30 off a 15-inch Skylight calendar at myskylight.com slash Becky. That's M-Y-S-K-Y-L-I-G-H-T dot com slash Becky. There's a very specific moment in the day a lot of parents hit, usually in the afternoon where you're still going, but everything feels harder than it should. You're answering questions, making decisions, trying to stay patient, and suddenly simple things feel complicated.
21:28Like, why does choosing a snack suddenly feel like a high-stakes decision? And most of us, me included, have the tendency to just push through it, power through. But I've started to pay more attention to those in-between moments and how something as basic as hydration can actually help. And that's what I like about Elements' sparkling electrolyte drinks. They're designed for those exact moments, not just workouts, but real life. School drop-off, the transition between soccer and coming home, that mid-afternoon dip around 4.07 p.m. And it's a simple grab-and-go can. No mixing, no prep, something I can just reach for when I need a small reset for me.
22:12No sugar, no artificial ingredients, just a way to support yourself a little better in the middle of a long day. If you want to try it, Element is offering a free gift with any purchase. Just go to drinkelement.com slash goodinside. That's drinkelement.com slash goodinside. Okay, parents, quick check-in. If your brain feels like it's holding everyone's schedule except your own, you're not doing it wrong. You're carrying a lot. I see this all the time. School emails, activities, chores, dinner plans, and somehow it all lives in one person's head. Usually mom's. And that gets exhausting. That's why I love Skylight Calendar.
22:55It's a smart touchscreen calendar that takes everything swirling around in your brain, schedules, chores, meals, grocery lists, and puts it in one place where the whole family can actually see it and participate. It syncs with Google, Apple, Outlook, all of it. And you can color code each family member. So there's a lot less, wait, I didn't know in your house. Plus, with the free Skylight Companion app, you can add or update events, lists, and more on the go. And I appreciate this. If after 120 days, you're not 100 % happy, you can return it for a full refund. No questions asked. Right now, you can get$30 off a 15-inch Skylight calendar at myskylight.com slash becky.
23:43That's M-Y-S-K-Y-L-I-G-H-T dot com slash becky.
24:01Okay, something else you find is parents are significantly more likely than non-parents to identify as sexual. Do you identify as a sexual person? Parents say yes at 41.5 % and non-parents say yes at 29%. That is a big jump. Yeah. That is actually those that I was more surprised at that than maybe the first statistic that we went over. And there are so many things that we encounter as parents that we have to be sure of what we're saying. And we have to have more ability to make a stance and have the substance behind it than when we didn't have to necessarily be as sure. There is a certainty that comes with being a parent that you have to show up a little bit more for yourself because there are other people involved that also require your time and your effort.
25:00And that actually, so it's kind of like, as you have to do that for someone else, it puts an impetus on you as well to show up as that person in addition. It's kind of like the domino effect. Yeah. When one domino is kind of pushed down, it kind of creates this momentum and shift to you as an individual as well. And that comes with certainty and actually being more stable in who you are. You know, I have this term I've always used. And you might be like, that's so weird. I've never heard someone describe it, but I think you'll feel it. Okay. Where I I always talk about how I'm drawn to people I can locate.
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25:39That's the word. And I just, like, I can locate them. They have a POV. They kind of know who they are. I'm always drawn to people I can locate even when I disagree with their opinions versus someone you're talking to. And I don't know, you're kind of like, where are you? Like, yeah, you're always trying to find them. I'm trying to find them. Like, they could be sitting with me at a table and I'm still trying to find them, you know? And I think what you're saying maybe in parenthood is there is this process. And I think especially if we take on parenthood as a journey of, you know, some, I always think the best compliment I ever got from a good inside member said, you know, I've been here about a year or so.
26:12And I actually think you helped my kid grow, but you helped me return. And I feel like parenthood could be a process of relocating yourself, right? Here I am, and I'm learning about myself and I'm able to set boundaries and I can tolerate my kid being upset with me. And there's real power in that. And there's real kind of locating of your own needs and desire in general, which probably then relates to sexuality. There's an unveiling of yourself. Yeah, exactly. Your kids really don't care about what they say. They're going to tell you the honest truth. And that is very revealing and very humbling, I might add.
26:47I've heard many things that my kids have said to me where I'm like, tell me more, but maybe not. Yeah, like in a minute. Damn. They will strip you down to a nub and they'll be like, now let's go play. And you're like, sure. Yeah. You're like, hold on. And that was like two years of therapy from what you just said to me. Exactly. Let me appreciate that insight, you know? Okay. 95 % of parents reported that hormone treatment positively impacted their sex life. This is all me and my girlfriends are talking about, okay? Obviously. Mine too. I'm in that age range. Yeah. Okay. The perimenopause range.
27:22And everyone is like, hormones, no, HRT. And so maybe just give me and anyone listening a little bit of a foundation of what that is. and then how you know, maybe even in a biological sense, a medical sense, how that relates to desire and sexuality and intimacy. Yeah, desire and sexual intimacy are two different things in a sense when we think of the mind and the body, right? So the body can be pleasured and it has the ability to do that through our sexual organs. But the mind really plays a big part in that as well when we think of desire. We usually like to separate them, which we should not.
27:57And we really should interact with them as one holistic kind of interaction and experience. So we're born with all the hormones that we'll ever have, right? But they do start to increase in da-da-da adolescence, which is why with puberty and then, you know, they're sky high at that point. Oh, yes, they are. But the body is this beautiful machine where it already is going to do what it's going to do hormonally. So when we think of our, and I hate terming them this, but our sex hormones for both male and female will heighten at puberty. But then they will start to decrease from a reproductive standpoint when we're in our latter 30s.
28:35For women, you know, typically men have a different curve and into our 40s. So if our desire. Is men sort of later? Yeah, they actually, their testosterone starts to, it does decrease, but not at the rate that we see for women. But typically because of pregnancy, it really has to do about reproduction. So as we get further out of our reproductive years, our hormones are going to start to decrease, which makes sense biologically. But where that somewhat impacts our ability to be intimate sexually with desire, right, but also pleasure with the body, is that's what you see through perimenopause. So it makes sense when we talk about hormone therapy and hormone replacement therapy that if we have the ability to somewhat give back those hormones that play a part in desire and pleasure and intimacy, then you will start to see an increase in what happens in sexual interactions.
29:36Why do so many people – I was going to say women. I think it was more women, but maybe you can correct me – kind of suffer through hormonal changes kind of silently. Yeah, because we've been pretty much taught that. You know, for me as an OBGYN and chief medical officer at HERS, we can do something really powerful for you as far as hormones. I've noticed that even as an OBGYN, it is very hard for me to get women to say the thing of what they need. And so what we're able to offer for both men when we think of ED, that was very, very like, I'm not going to talk about that with my doctor. We were able to fill that gap with providing that.
30:10And then for women going through perimenopause and menopause, having the ability to have a platform that offers estrogen and progesterone. But we also want to help you understand how important it is for you to take part in this message for yourself, which also will help your relationship. Yeah. And so for, for let's say there's a woman listening to this, because I do think what I hear a lot in relationships where a woman is married to a man, it's like, I don't know, people are in like their forties, let's say. I'm just piecing this down in my head. My husband wants to have sex all the time. Like, I love my husband.
30:51I want to be close in other ways, cuddle on the couch. I just don't want it. There's such a mismatch. Is part of that maybe related to the differing hormonal curves? Completely. Changing the narrative really has helped when we look at the hormonal shift of like what happens biologically. Like you have no control over that. Your ovaries are your ovaries and how your brain tells your body to release hormones changes. But also going back to the brain, which I love always making the connection between mind and body, is that the brain also has neurotransmitters like our serotonin and our dopamine and our feel-good hormones that are impacted by estrogen and testosterone and progesterone.
31:28So if we're already in a biological decline of those, of course the interaction and communication between our feel-good hormones of serotonin and norepinephrine and dopamine are also going to be impacted. Yeah. So when you make that connection and you take away the blame from yourself, I do find that women can sit more in, I'm going to be okay, it's not my fault, I didn't do anything bad, now what can I do? Like move to the next step and be like, what can I do to help myself, especially now that we have ways to do that? And we're talking about it more. Yeah. And I think also it's really helpful, you know, if there's a partner who has a different hormonal curve, let's say it's the man, to know, oh, this isn't rejection necessarily.
32:11Like this doesn't – I keep thinking about this one line that I repeated the other day, which is – can be used in so many contexts. Like sometimes hard things happen and it's nobody's fault. It doesn't have to be her fault. It doesn't have to be his fault. Yeah. There could be a biology to this. And for anyone listening, I also know sometimes it's not just biology. Sometimes, you know, yeah. Or the woman's like, I feel like I am managing everything for our family all day. And I've made a million decisions and cared for everyone. And, you know, if my husband was more involved in the mental load, ordering the kids' bathing suits, all these things, I'd be more ready, you know.
32:43So there's never one answer. But I think the biological perspective. And I try to learn a lot about as many aspects of human development as I can. And I have to be honest, it makes sense to me as soon as you say it, but I wasn't aware that the actual hormonal curves are different. And it's a really helpful additional framework. So thank you. And I feel that if we had more of these conversations involving men, I'm so glad that you said that, that's where we would start to see, oh, it's actually no one's fault. There's just a common understanding. Exactly. Exactly. Moving away from fault to understanding.
33:15100%. Okay, something else you found is that 51 % of married respondents to your survey said their sexual performance improved with age. Now, I just, first off, what does that mean, sexual performance? Like, I didn't know I was getting graded, so I need some information about what the grade is based on. Tell me what this meant. Sexual performance really has to do with ease and comfort. Does performance mean likelihood to have an orgasm? Does performance mean maintain an erection? No, because I will tell you with those two things, those actually decrease when we think of hormones, both erection and I guess you could say climaxing or having an orgasm.
33:54Now you're getting to the stuff everyone's like, I'm sorry, Becky, do not let her move away from the subject. I hear it. So tell me. That to me is a physicality or an outcome. But that changes us. That absolutely changes for both men and women, which is why hormones are actually important. Because as we age and as we start to decline in hormones, both men and women, our organs don't necessarily do the same thing that they did when we were 20. Performance really is from a holistic standpoint of outcome of did I actually get the pleasure that I was looking for? Was I able to have connection with my partner?
34:29Was I able to have a better holistic experience than when you're younger and you actually don't even know what you're doing? Yeah, but you may have a great erect penis and lots of orgasms, but did you really truly have a great performance? And I think that's different. And how we look at sex again, typically in the westernized world, is not connection. It's actual, for lack of a better term for when we think of heterosexual relationships, is penis and vagina. That's really all we relate it to, but we don't relate it to connection. Got it. Yeah. Okay, so that's performance. But tell me more about orgasms as you get older.
35:10I love this topic. I think if we were able to, again, not always look at penile vaginal sex and clitoral sex, there are ways to actually have good outcomes of sexual intimacy without looking at it that way. But that does happen. But there are ways to kind of redirect in how that happens, the duration of what happens using vaginal estrogen. There are ways to actually enhance with actual medications that are focused on enhancing the sexual response. There are medications on the market that do that. For women. For women and also men. I mean they've had them for years but hello, we're going to actually include women now.
35:52Yeah. But for men, same thing. That's the reason why, you know, medications for ED are available because it was a change in vasculature and blood flow that actually contributes to erection that was starting to decrease with age. So in both male and females, you do start to see that with biological aging and hormone decline. Yeah, so helpful. All right. If there's a kind of to sum it up, like a TLDR on kind of what you were left with around this study, like what's the thing that kind of keeps ringing in your brain? I think that there are two things that I want to, you know, kind of for me personally, like for me as an individual who deals with patients who come to me and see this all the time.
36:36And then even in my own personal life going through perimenopause is that there is so much that happens to women. And I'm going to single out women for this particular statement that we inherently are not privy to or we're not told. And I say that as a physician. And I think that how we're taught to actually treat women in midlife for so long was not encompassing, one, sex as part of that transition. And two, looking at the mind body of women going through perimenopause and menopause in that the brain and the body play a big part in that. So I think we need to change that messaging and looking at it just as, oh, your ovaries just start, you know, stop giving off estrogen and here we are, is that it's a whole body type of transition that we need to account for.
37:23Specific to the study, I would say if I were to leave a message for anyone listening is to actually take a step back and look at your sexual health and sexual life as part of your entire life. Because clearly from this, we have seen from the statistics that maybe the connection part of sexual intimacy is much more of a whole body and a mind-body connection than we ever thought. And that comes with what we were talking about earlier when we started is the connection and the vulnerability of having a safe person there or a person who's seen you in your best and your worst can actually enhance the performance and actual sexual intimacy.
38:15There were so many things about that conversation that are sticking in my mind. I think the biggest thing I'm thinking about is the multitude of reasons why intimacy might be better or might feel a little off after kids. And if you're listening to this thinking, great, all the data is that all these people feel better. I am not in that percentage. nothing's wrong with you. And my hope is that there's something from this episode that makes you feel a little less ashamed, a little more empowered, maybe moves from fault mindset, whose fault is this, to understanding mindset. Huh, what's really going on?
38:54And what is this all really telling me? Right? If intimacy feels off, maybe there's something going on on the hormonal level. Maybe there's something going on around the mental load level. Maybe there's something going on around communication. There's so many factors, which actually means there's so many roads in. You know, I wanted to put something together to make this even more usable for anyone who listened to this and is thinking, okay, this makes me want to have a different kind of conversation with my partner. Maybe we can actually talk about this stuff from same team perspective instead of enemies.
39:26And so I'm putting together my kind of top three tips around how to talk about intimacy and sex life with your partner. I'm going to link to it in the show notes, so it's easy for you to just go click. Get it. Maybe you and your partner can even just look at it together. After all, when you say someone else made it, hey, this Dr. Becky woman put this together. What do you think? Now all of a sudden it's the two of you on the same team a little bit against me. That's fine. Instead of you guys just kind of being apart from each other. All right, let's end the way we always do. Place your feet on the ground.
39:56Place your hand on your heart. Let's remind ourselves even as I struggle on the outside, I remain good inside. I'll see you soon.
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From the publisher
After kids, a lot of couples assume intimacy is supposed to disappear. You’re exhausted, touched-out, overwhelmed by logistics, carrying invisible mental load — and somewhere along the way, sex can start to feel complicated, distant, or impossible to even talk about.
But what if the story is more nuanced than that?
In this episode, Dr. Becky talks with board-certified OB/GYN, sexual wellness expert, and Chief Medical Officer at Hers, Dr. Jessica Shepherd, about new survey data exploring what actually happens to intimacy in long-term relationships and parenthood.
They discuss:
- why some married couples report better sex after kids
- how vulnerability changes intimacy
- the connection between mental load and desire
- hormones, perimenopause, and libido
- why “whose fault is this?” is often the wrong question
- what it means to approach intimacy from a same-team perspective
This conversation is honest, practical, funny at times — and ultimately hopeful. Because intimacy is about feeling seen, understood, connected, and able to locate yourself inside your relationship again.
Dr. Becky wrote up a few tips for talking to your partner about intimacy after kids. You can read those here.
Thank you to our partners for making this episode possible:
- Play-Doh: Shop Play-Doh at Walmart for a summer of imaginative play
- Skylight: Get $30 off a 15-inch Skylight Calendar at myskylight.com/becky
- LMNT: Get a free 8-count sample pack with your purchase at LMNT.com/goodinside
- Oso & Me: Use the code OSOGOOD15 for 15% off clothes newborn through age ten
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