Ep 85 | Breaking the Silence: Reclaiming Sexual Desire and Pleasure During Menopause

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Are you experiencing low libido, loss of sexual desire, or intimacy challenges during perimenopause or menopause? In this episode of Pleasure in the Pause, host Gabriella Espinosa joins Dr. Anna Cabeca on The Girlfriend Doctor Show to share her deeply personal story of sexual awakening during midlife. 

Together, they address one of the most common yet rarely discussed symptoms of perimenopause: the complete loss of sexual desire. Gabriela opens up about how her libido plummeted overnight, leaving her without the language to describe what was happening — and the transformative journey that led her to become a sexual wellness coach. 

You'll learn about pleasure anatomy most women were never taught, practical techniques for rebuilding arousal and desire, and how to communicate your needs to your partner. If you've ever felt alone in your struggle with menopause-related sexual dysfunction, this conversation will show you that solutions exist and your pleasure matters at every age.

Dr. Anna Cabeca is a board-certified gynecologist, women's health expert, and hormone specialist known as "The Girlfriend Doctor." She is passionate about empowering women to reclaim their health, hormones, and vitality during midlife and beyond. Dr. Anna specializes in sexual health, intimacy, and menopause care, helping women address the "three Ds" that affect intimacy: desire, disconnect, and discomfort. She is the creator of innovative vulvar health products designed to support women's sexual wellness during hormonal transitions. Through her podcast, online communities, and clinical work, Dr. Anna provides practical, compassionate guidance for women navigating perimenopause and menopause.

Key Takeaways

• Loss of libido during perimenopause is biological, not personal failure. When Gabriella's desire plummeted during perimenopause, her doctor prescribed beta blockers and antidepressants without addressing the root cause. Understanding that hormonal changes can switch off desire overnight—and that this doesn't mean your sexual story is over—is the first step toward reclaiming intimacy.

• Most women don't know their own pleasure anatomy. Gabriella didn't learn the names and functions of her sexual anatomy until her forties. The clitoris isn't just the visible bulb — it has an extensive internal structure with legs that extend down to the perineum. All pleasure anatomy exists externally on the vulva, which is why vulvar health and proper stimulation of the entire area (not just penetration) is essential for arousal and satisfaction.

• Arousal in midlife requires time, presence, and communication. Women typically need 25-45 minutes to build full arousal, and this becomes even more important during menopause. Start stimulation at the outer labia and perineum before moving to more sensitive areas. Communicate your needs to your partner without expecting them to be a mind reader — your pleasure is their biggest turn-on.

• The three Ds affect intimacy (desire, disconnect, discomfort), but the three Ps restore it. Focus on pleasure (what feels good inside and outside the bedroom), presence (staying connected to sensation and your body during intimacy), and play (approaching sex with curiosity and exploration) to rebuild sexual connection.

• Unpacking shame and inherited narratives is essential work. Gabriella shares how writing her essay for "Midlife Private Parts" brought up her mother's voice asking "What will people say?" Journaling, therapy, and connecting with other women help release the shame that blocks us from experiencing pleasure and advocating for our desires.

Your body isn't broken, and menopause isn't the end of pleasure — it's an invitation to discover yourself in new ways. 

Subscribe to Pleasure in the Pause for more honest conversations about female sexuality, menopause, and reclaiming your power in midlife.

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