← Rena Malik, MD Podcast
Rena Malik, MD Podcast
Want Better Sex? Sex After 40 Changes More Than Most Couples Realize
01:06:40
Dr. Maria Sophocles, gynecologist and sexual medicine expert, joins Speaker B to discuss sexual burnout, the bedroom gap, and how cultural messaging shapes intimacy. They cover the health benefits of a lasting sex life, overcoming shame and miscommunication, ways to restart intimacy, and practical interventions like vaginal estrogen. The episode also addresses gender differences, aging, and how communication is key to sustaining healthy relationships and evolving definitions of sex.
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- [00:00]
Dr. Maria Sophocles
You survived the Miami weekend, nailed the speech, and maxed out your credit card in the name of friendship. Now you've got one hangover, four pastel dresses, and zero reasons to wear them again. Sell them on Depop. Just snap a few photos and we'll take care of the rest and you at least get some of your dignity money back. Someone on Depop wants what you've got. Start selling now, Depop. Where taste recognizes taste. Someone will say to me, sex is not really part of our relationship anymore. And I'll say, well, when's the last time? Sometimes it's two, three weeks or two, three months, but sometimes it's eight years. And this can be relationship wrecking. I think a lot of men need to know it's okay to look at porn. It's okay to want to see sex scenes in movies or read them in books or magazines. In fact, it's healthy. It's feeding erotic content into the brain, which helps remind us all that sex is natural and healthy and fun. Go outside the box, men and women, and let yourself redefine sex in some ways. If one of you is sexually averse or burnt out or whatever and and start G rating. Don't be afraid to start G rating.
- [01:13]
Dr. Rena Malik
People who keep sex in their life long term have lower blood pressure, less depression, less anxiety, less loneliness, and ultimately better Health. I'm Dr. Rena Malik, urologist and pelvic surgeon, and welcome back to The Rena Malik, M.D. podcast, your trusted guide for leveling up your relationships and sex life with evidence based tools. Today I'm joined by Dr. Maria Sophocles, a board certified gynecologist, surgeon, sexual medicine specialist and author of the bedroom gap. Dr. Sophocles has spent 30 years and over 85, 000 patient visits studying what she calls the bedroom gap, the difference in sexual expectations and abilities between partners that can quietly wreck even the strongest relationships. In this conversation, we're talking about sexual burnout when it becomes a long term relationship crisis, why both men and women feel shame about their desires, how to restart intimacy from absolute zero, how years of cultural messaging still shape our bedrooms today, and the surprising health benefits of maintaining sexual activity as we age. And of course, we discuss the specific medical interventions that can help and why communication really is lubrication, even when that first conversation feels impossible. Guys, if you are struggling with difficulty with erections and you need help, check out my Erectile Mastery course. This is a course that is designed by me to take you from everything you need to know to improve your erections from lifestyle changes to traditional medications and even newer sort of technologies and therapies that you can look into to help improve erections. This is exactly what I tell each and every single patient and I wanted you to be able to access it as well. So check it out today at learn.renamelicmd.com Erectile Mastery thank you so much for joining us today. I'm so excited to talk about all your work.
- [03:01]
Dr. Maria Sophocles
Thank you. I'm really glad to be here and talk with you.
- [03:05]
Dr. Rena Malik
So tell me, what is sexual burnout?
- [03:08]
Dr. Maria Sophocles
Sexual burnout is a term just to reflect the fact that for many women and men and couples, they reach a point where there's no sex happening. They're either not interested or not able to really be on the same playing field. There's what we call often a sexual desire mismatch where one person still desires sex, but the other has absolutely no interest. And women will come into my office and say, I'll say, how, how is sex? Are you having sex? Are you? Is it comfortable for you? And they'll say, ugh, it's not even in my life. I don't care if I ever have it again. I have zero. Whatever is less than zero. That's my sexual desire. And so I feel like they're so life burnt out that they've deprioritized sex and made sex absolutely like off the table, almost non negotiable. So it's a hard place to start as a clinician and a sexual counselor because they're telling you not interested at all.
- [04:08]
Dr. Rena Malik
Yeah. We had Lori Brotto on the podcast before and she had said, based on the research, it appears that women look at sex as a stress ad, whereas men tend to look at sex as a stress relief.
- [04:22]
Dr. Maria Sophocles
Exactly.
- [04:23]
Dr. Rena Malik
And that is something that's always stuck with in the way that people perceive it. And it's a real problem because, you know, it should be a source of pleasure, a source of joy. And for some reason it's just not seen that way for a lot of people. And so how do you help people really get through that?
- [04:41]
Dr. Maria Sophocles
Well, I think the important thing is to help well, to bring back the concept of sex as fun and joy and play these words that so many adults kind of push away from their lives. We have a culture of productivity over pleasure. We prioritize productivity over pleasure. And I think once you set that as the rules of engagement for how you live as an adult, and it sounds so harsh, but it's really not. If you think about how people wake up and dump the Trash and make breakfast, do the dishes, get on their zoom calls or go to the operating room or go to the boardroom or whatever it is. And they do that throughout their day. Wash, rinse, repeat. And then sex is something like for maybe Friday night, if they're not too tired, they do it, but they're either getting it over with if they're feeling that it's a chore, or they're, oh, thank God, we finally can have sex. Finally, finally. And I think both of those are almost destined to fail as having sex be a part of your life, I mean, something almost all humans do. And we know that people, people who keep sex in their life long term have lower blood pressure, less depression, less anxiety, less loneliness. And they have, you know, that's what we call the longer sex span. That part of your life where you're sexually engaged, where sex is part of who you are. That's where I came up with this concept of the bedroom gap as a difference in expectations and sometimes abilities between partners could be same sex partners, but most commonly between men and women. And I think for the people who have sexual burnout, this is very distinct from people who are just having a low patch because I don't know, their kid is having trouble in college or their aging parent is having a health setback or there's a little financial issue. Some people will have a few months where they just really need to disengage and good partners understand that and say, hey, let's just cuddle a lot, I'm here for you. But sometimes it becomes a long term thing. And I'll say to someone, someone will say to me, yeah, sex is not really part of our relationship anymore. And I'll say, well, when's the last time? You know, and sometimes it's two, three weeks or two, three months, but sometimes it's eight years. You know, if, and, and this can be relationship wrecking and lead to infidelity, divorce or just perpetual non communication relationship issue.
- [07:08]
Dr. Rena Malik
You know, I think part of it is that women were never taught that sex is something that's fun for us.
- [07:13]
Dr. Maria Sophocles
That's right.
- [07:14]
Dr. Rena Malik
And I think that it's really perpetuated in the sense that like, well, sex is for the partner and it's not if you're, if you're in a heterosexual relationship, sex is for the partner. And if I am, I'm giving it to them rather than I'm receiving any
- [07:28]
Dr. Maria Sophocles
pleasure or I'm doing it for them. And I think, by the way, this is not the fault of men. This is not the fault, it's not about fault. It's about how we've gendered our roles sexually sexy. So when you're a little boy, you start hearing about sex and seeing some your uncle's magazines and you eventually get to porn. And now younger and younger and younger men are exposed to porn. And so this becomes a major way that they learn about sex. And frankly, men shouldn't feel ashamed of that. It's not that they've failed, it's that our society has failed to teach sexual roles and mutual pleasure early. In Holland, the Dutch teach sex ed starting at age 4 and they teach about body parts. And by 9 or 10, they're teaching about what sex is. But they very early teach about mutual pleasure. So the men and women both understand that those are roles and sort of appropriate expectations for normal interactions. Whereas in America, we teach sex ed as fear based. Right. Put a condom on a banana, pregnancy STDs, there's no teaching of pleasure for anyone. And so we really get very skewed education. And then you layer on that the 4,000 years of messaging that sex is for men because remember, women were property for most of that 4,000 years. So there's never been room in the conversation for pleasure for women. I applaud men who take the step to listen to this podcast or to read a book or to say, what can I do to evolve sexually beyond that? So if you're out there listening, I'm sending you a big high five saying, good for you. Because guess what? You'll have a better, more fulfilling relationship when there's mutual pleasure and you'll have a partner who's actually eager to embrace sex as a facet of the relationship.
- [09:27]
Dr. Rena Malik
Yeah. And I think men get shamed for wanting to have sex a lot of times, like there's something wrong with them and they why do you want it all the time? Why do you want it? It's actually a marker of good health. Right. It means they're hormonally functioning appropriately Y should want sex and it's a normal thing. And if you don't want sex, well, maybe that's a signal that either there's, you know, stress in your life or there's a hormonal problem. You know, there's, there's something that needs investigation. And so I think it's normal to have desire. But desire does change over a lifetime and in long term relationships. And we've talked about that quite often on this podcast on my channel where, you know, there becomes this sort of responsive desire. It's not like I see my partner. I want to jump on them. I want to, like, it's contextual. I have to feel like, oh, yeah, we're intimate, we're close. And oh, yeah, I used to like this. I enjoy this. This is fun, right?
- [10:22]
Dr. Maria Sophocles
And that's okay. There's nothing wrong with needing to have the desire develop after there's arousal, after someone has given you a back rub or made you feel good in one way or the other. I think so many men do feel shame about it. I've had many men come to me and say, I know you're taking care of my wife and helping her with this vaginal dryness stuff, but I think there's something wrong with, like, I do you think I could be a sex addict or a porn addict? And, you know, I think a lot of men need to know it's okay. It's okay to. To look at porn. It's okay to want to see sex scenes in movies or read them in books or magazines. In fact, it's healthy. It's feeding erotic content into the brain, which helps remind us all that sex is natural and healthy and fun. Obviously, you want to make sure the content isn't giving you or your. Or young people the wrong messages. And there is porn that is, I think, dangerous messaging, usually porn that's extremely violent or with children or, you know, you have to obviously make sure the sexual cues you're getting are healthy. But there's nothing wrong about wanting to have sex, about wanting to look at sexual images. And I think fantasy is healthy. It's wonderful. It helps keep the brain neurons firing, saying, oh, yes, this is another version of sex. And we also don't give ourselves permission as adults to think of fantasy as something that's normal. We think it's something shameful. But we know that when we have sex in a new position or. Or a new partner or in a new way or with a new toy, we actually are releasing lots of dopamine. Endorphins get released, even oxytocin gets released. And not to be a nerdy doctor, but these are all good, healthy things. And a really crazy thing is that oxytocin, which is something that is released, we call it the cuddle hormone, right? When we breastfeed or otherwise are cuddling, when oxytocin's released, it actually has benefits on muscle, on building muscle cells. So I. My dream is that people, as they age and they start having a hard time maintaining muscle and they're getting weak, and we've all Seen older people get very frail. And if those people are sexually active, even if the version of that is just cuddling or is masturbating, they're actually helping maintain muscle mass. I mean, those are dots I never connected before. And so I sort of love that. If you're not going to have sex for your partner, have sex for yourself so you can maintain some good muscle mass and happiness. Really?
- [12:59]
Dr. Rena Malik
Yeah, absolutely. I have a secret. I hate doing my makeup because it takes forever and because there's a lack of regulation in the beauty industry, I can't ever be sure that the ingredients in my makeup won't cause long term harm. I was so excited to try OG beauty because it only took me five minutes to do my whole face and it doesn't have any synthetic fragrances, fillers, or unnecessary additives. This is makeup that feels like skin care. It's breathable, lightweight, and lasts all day. For me, as someone who thinks critically about what goes into and onto my body, this is, is it certified organic standards and high performance. You don't have to compromise. If you're ready to raise your beauty standards, OG's got you covered. Go to og.com rena and use code reena for 20% off. That's oge.com rena code reena so how do you go from zero? Like, I, I don't even want sex. It's off the table. I could live my rest of my life without having sex, which, you know, you and I have been in that situation and heard those patients.
- [14:02]
Dr. Maria Sophocles
I thought you meant you and I. I'll speak for yourself.
- [14:05]
Dr. Rena Malik
Meaning? Meaning we seen, we've heard those patients. We will never be in that situation. But you know, where you're like zero. No. You know, how do you get someone to come back and, and appreciate sex again?
- [14:17]
Dr. Maria Sophocles
Listen, it's not hard because women are givers and pleasers and servers. And again, socioculturally, for centuries, we've been told to think of others first. And that's how most women were raised. And so you have to unhook the shame and the selfish, the concept that it's selfish to think of yourself as a sexual being. So there's a lot of psychology. I spend so much time not being. I am a gynecologist by trade. I'm a surgeon like you. But I spent a lot of time getting sexual counseling training because I felt so inept at being able to help people like this. So a lot of it is, well, meeting them where they are too. Right. As any good clinician knows, you have to Meet the patient where they are. But we talk about things that do give them joy and about putting that back in their life so that they can again, not even sexual. We just try to help them understand how good it feels to have something joyful in your life. I mean, there are plenty of patients out there that do not. They push joy away. And this is really frustrating to their male partners because it's like they won't even give it a chance. We do something called the chocolate bar visit. I buy two very expensive, beautiful chocolate bars, the kind with wrappers with a beautiful font, and we slowly unwrap that wrapper. First I find out are they a dark chocolate, milk chocolate or white chocolate fan. So we give them what they want and we have a lot of. I help them feel the joy and the pleasure of sliding the wrapper off of the kind of bronze covering. And then we just smell the chocolate. We don't taste it yet or anything. And it's to remind them that there are many ways to have pleasure that don't involve a penis and a vagina. Because that's what a lot of them are afraid of, is the pain of that. Or that as soon as they cuddle with their male partner, he's going to say, okay, great, it's going to be penis and vagina. So I would say for men listening out there that know that women often want to cuddle and have sexual relations that doesn't involve penis and vagina, which also involves some learning on the man's part that we can feel gratification and pleasure and even orgasm when there's no penis in the vagina. Remember, most women need clitoral stimulation to orgasm. I'm stating the obvious here, but there are men who will be, at least to us.
- [16:40]
Dr. Rena Malik
But.
- [16:40]
Dr. Maria Sophocles
Yeah, yeah, exactly. And there are men who feel that. Well, unless there's a penis and a vagina, they're inside a vagina, then sex hasn't occurred. And you know, President Clinton definitely felt that way. Remember when he said, I did not have sex with that woman?
- [16:54]
Dr. Rena Malik
Yeah.
- [16:54]
Dr. Maria Sophocles
So I would say go outside the box, men and women, and let yourself redefine sex in some ways. If one of you is sexually averse or burnt out or whatever, and start G rated, don't be afraid to start G rated, where you're sitting in a big oversized chair together, cuddling, reminiscing about some fun vacation you had, talking about anything but politics or taxes or ugly things. Leave your phones outside the room. Start G rated. Remember how nice it feels to have skin touch skin Even if it's just your arms or your legs or your toes, that's the beginning crumbs of sex. And that can bring joy and then you can build from there. But I think if you're at zero, you really don't want to just go to 60. I think you're setting yourself up for failure.
- [17:45]
Dr. Rena Malik
Yeah, it's interesting. I was talking to Barry Kamasarek yesterday. He was a guest on the podcast before, and he is really interested in pleasure and what his research right now is working on pleasure. And he was talking about how pleasure is basically sensations that you haven't had for a while. And so it's sort of like if you were to not hear for a while and then finally you heard something beautiful, it would be pleasurable. If you couldn't see for a while and then you saw something beautiful, it would be pleasurable. And then we also have these templates in our brain about what is pleasurable. So I think it's also like sort of figuring out, okay, what sort of sensations maybe have you not provided with your. Have you not had with your partner? Not provided necessarily, but have you not had with your partner? And how can you have those? And it could be as simple as, you know, a rub on the back or a gentle caress or just something sweet. And I always say foreplay starts in the morning. Right. It's not just like this one moment in time where you're having sex, it's that you are building and cultivating this environment of desire.
- [18:44]
Dr. Maria Sophocles
Yeah. I tell people it's like a savings account. You can put erotic content into your brain and your brain will store it. So if you're reading an article about sex, or if you're watching something on Netflix and there's erotic scenes, that sort of counts, you can. Your brain holds onto those images. And then when you put your arm around someone in bed at night, even if you're just saying goodnight and whatever, there's something a little bit more erotic. You. You feel the contour of the muscle on a man's chest, or you feel the delicacy of a soft shoulder. And those little. Our brain, you know, we're smart, we link those to some of the erotic content that we've had. So we get pleasure through the ey, through the nose, through the ears. There's so many things. And that's why even there are apps now where people will read you erotic stories. So whatever your version is, and for many women, they prefer something private like reading or watching a movie or listening to an app. And that's okay, maybe you can even do it with your partner. You put something on together and you sit on the sofa together and you kind of hold hands or stroke arms again. It can be what we call G rated, but it's all building versions of pleasure that then make you realize, I love this person's smell. I love their touch.
- [20:02]
Dr. Rena Malik
This episode of The Rena Malik, MD podcast is brought to you by Alloy Health. I talk about menopause and perimenopause all the time on this podcast because the symptoms are real, they're disruptive, and for way too long, women have been told to just push through the sleep disruptions, hot flashes, brain fog, changes in sexual desire, and they're treatable. And as a physician who specializes in this space, it genuinely frustrates me that almost half of women go three or more years before getting help. We need women to stop suffering in silence and Alloy is helping women get the care they are struggling to find. Alloy is a digital health platform that connects you with menopause specialized doctors to create a personalized science backed treatment plan for your specific symptoms. It's all done online from the convenience of your home. Your prescription ships directly to your door with automatic refills and you get unlimited messaging with your doctor. Join the 95% of women who tried Alloy and saw relief in the first two weeks. Head to myalloid.com and use code Reena. Tell them about your symptoms, get a fully customized treatment plan, unlimited messaging with your doctor, and $20 off your first order. That's M Y-A L L O Y.com code Reena. So in your book you've gathered stories from women continents. What sort of stories and patterns emerged from these women in terms of the bedroom gap?
- [21:28]
Dr. Maria Sophocles
Well, the universality of it really. And you know, the book is largely the stories are the 85,000 or so patient visits I've had in 30 years, mostly in the United States. So most of the stories end up being American women. But just for you and I to know and the listeners to know, I have done interviews all over the world with people. And I think that's why the TED committee liked this idea for a TED talk, because they said it's universal, the fact that people from any country, race, religion and socioeconomic background can come together. And there can be these problems in that they're largely unspoken, that you can be with someone for 30 years and have never really spoken about the fact that you actually don't like when someone nibbles your ear or you don't like this position or that position. And I found that stunning that people could spend 30 years together and put kids through college together and deal with death and loss and financial crises together, and yet they come together and do this sort of rote, you know, kiss, cuddle, penetrate, ejaculate, go to sleep thing without really communicating about it. So one of the points of the bedroom gap is to. The book is to help people understand how universal the forces are that shape who we are. Society, culture, pharma, gendered healthcare, research, gap porn, and that. That shapes the role of who we are as a man and as a woman in the bedroom. We show up with certain expectations that this is what we're supposed to do. And then the book is also how to overcome that, how to rewrite the rules for yourself so that you can have better sex and you can restart from zero. But the countries were all just. I mean, look, of course there are differences between someone in Argentina and someone in Singapore and someone in Iowa and someone in Valencia, Spain, but. Because every culture is a little bit different. But I found the sexual issues incredibly universal, even in, you know, Muslim countries where they were like, oh, we can't talk about this. You know, a friend of mine from the TED community has a podcast in Morocco about sex and really hard. The government really doesn't want her to say certain things.
- [23:46]
Dr. Rena Malik
Yeah.
- [23:47]
Dr. Maria Sophocles
But she told me off the record, how it's incredibly universal, this whole. Many of the men feel it's sort of something they. They are doing, they have to do for their own pleasure. And the women feel they're sort of a passive receptacle. So it's. It's. You know, we're trying to change things. One woman, one country, I guess, at a time.
- [24:09]
Dr. Rena Malik
Yeah. And you feel like that. That miscommunication or lack of communication is so universal. And how do we. I mean, I think it's. It's really easy to say, talk about it. Right. Like, just talk. But it's very difficult, very difficult to. To sort of say, like, hey, you know, where do you begin? And. And so I'd love to get your take on what you tell your patients. Like, well, how do you begin having these conversations?
- [24:29]
Dr. Maria Sophocles
Yeah, the first one's the hardest. Right. And I think for many people, even people who've been together a long time, we know that looking at each other, you can read each other's faces very well. And it's really important not to begin the conversation with judgment, finger pointing, shame, or anything that makes the other person feel, you're making this my problem. So I often tell People to have the first conversation in the car as they're driving or on a walk, because then they take away the ability to have judgment from facial expressions. Also on a walk, as you're doing, breathing more deeply. So you're activating the parasympathetic nervous system, which tends to relax you. And there are sort of natural pauses, but you want to start. I try to tell people to start honestly, with a compliment and with. To say that, you know, find a time when the sex was there or was good and reflect on it. This sounds very obvious, but, you know, remember when we went on vacation to the mountains, and I just loved how we had free time, and I loved that we could have sex in the morning, which we always seem to be too busy for. It would be really great if we could find a way to do that again, even if we're not on vacation, because that just. I don't know. There was something about that that was really liberating for me, and I really appreciated how thoughtful you were. I'm just making this up. Some scenario where that person feels appreciated, but between the lines is a little request that sex be a little more like that or that. Remember? And we didn't even fully have sex, but I so enjoyed it. You know, someone can read between that, that you want to engage, but you don't really want it to be just every Friday night the way it always is. Something like that.
- [26:18]
Dr. Rena Malik
Yeah. I think the challenge is I've had so many men in my clinic come. Come back and say, look, I've tried. I've tried to talk about it, and I've been shut down. Oh, And. And, you know, rejection. Men learn very early on, at least in my generation. I don't know about this younger generation, but in our generation, men learned, like, you got to take rejection like it's part of the game, right? You go up to 10 women, and, you know, they may all reject you, nine may reject you. Right? Like, it's very, very common, but it is wearing on you when it's the partner that you chose to be with, right? And so. And then they just stop because they're human and they hurt and they feel sad, right? And I think that.
- [26:56]
Dr. Maria Sophocles
Or they go elsewhere, or they go elsewhere, but.
- [26:58]
Dr. Rena Malik
But they ultimately, they stop trying to have that communication with their partner. And I think that's the real challenge is I tell them, look, like any. Any sex that is any relationship and having good sex is worth working for, but it is difficult. And so I always say, like, you know, exactly those things that you've said. But also, like, just. You realize that the first few times you bring it up, it might be met with a lot of negativity. It may be shut down. But realize that that's their. You have to kind of expect that that's also their learned response. Exactly right. Because they've learned that, like, this is a chore for me. This is not fun. This is whatever their preconceived notions are that you're requesting of them. And so they have to relearn those things, too.
- [27:42]
Dr. Maria Sophocles
What if we could suggest to men that they. Because I think if men understood this is also part of the bedroom gap. That's why I want men to read this book or listen to this book. Could learn that in midlife, in menopause, and sometimes even before women can experience vaginal dryness and pain, and that women often just suffer silently, which is honestly our fault. We should be better at saying, hey, this really hurts and I want to get it checked out or I want to do something about it. And that lube wasn't a shameful thing. Oh, it must mean you're old and all dried up. Lube is for everyone at any age. It can be displayed proudly on your bedside table and say, hey, I'm enjoying sex, but not so much anymore. It's painful. So I bought this lube. Let's try it. If this lube isn't helpful and I'm still uncomfortable, I think I better go see a doctor. If we could get women to say that, to not be shamed into feeling that they failed, if they're not this sexually vibrant, always easily orgasming person, I think then that begins a conversation. But maybe men listening could say, huh? There could be that maybe I should preemptively say, hey, I don't know. I don't have a woman's body. But are there things changing in your body that's making it harder for you to orgasm or harder for you to get wet? Because I kind of want to learn about it so we could learn together. Like, how amazing would that be?
- [29:10]
Dr. Rena Malik
Yeah. I always tell them, like, if you don't even want to bring it up, like, hey, I follow Dr. Malik. I found this great video where she talked to an expert about menopause. And, like, you're, you know, I don't know where you are in this thing, but I think every woman should learn about this. So here's a video, right? Or just something where you don't even have to do the conversation. You can just say, and I don't know about you. But I get, like, hundreds of reels every day from my husband about things I should watch and listen to. And, like. So I feel like that's like a language of love these days, right? It's like who you send reels to or videos to to watch is like, oh, I'm thinking of you.
- [29:42]
Dr. Maria Sophocles
You know, that's right. And it's a way. It's kind of bizarre, but it's a way that we can also. If it's too awkward for us to communicate, let's say you and I were a couple, and this is too awkward to sit in a chair and talk about it. If at least I'm sending you some reels. I'm saying, you know, I'm saying subliminally, these are some things we might want to think about as a couple. Oh, look, here's a course called Imago Couples therapy. Or, oh, look, here's a double massage. A place you can get couples massages. You know, whatever you're sending is sending a message, right? And it. And it shouldn't be met with anger or resentment. It should be met thoughtfully with, okay, we should talk about that.
- [30:21]
Dr. Rena Malik
There's a saying. So I don't know if you've been seeing. Also, speaking of reels, there's been this. Lots of reels where men are, like, doing chores and women are getting turned on. Right? Chore play, right? But it's interesting because some people are like, this is it. This is foreplay. Now, I'm of the mind that, like, yes, of course. It's lovely that your partner is supporting you, and that should be normal, right? Like that you sort of, like, support each other in whatever way you can. But I think the message that's going on is, like, doing dishes going to get you laid.
- [30:49]
Dr. Maria Sophocles
Okay, that's sort of silly, but it's not totally crazy because I think we have different love languages. We all know what that is. Love languages. One might be acts of service, like doing the dishes. One might be buying gifts. One might be just spending time together. It is, as corny as it sounds, worth giving 30 seconds to thinking about what's your partner's love language? Because if it's spending time together, put your phone down and go sit next to him or her on the sofa and just say, how are you? Or what's good for you? Or what's really pissing you off these days, man. A simple little question that says, I care about something deeply, not just, what was the score of the Patriots game? Or whatever is really a wonderful thing. If it's Chores. If it's acts of service, then yes, that is a version of foreplay. That doesn't mean I'm getting laid. It means I am building rapport. I'm letting my partner know, I hear you. I know what's important to you, and I'm willing to put the work in to build a relationship, part of which I hope will bring us intimacy. I want people to really think of that word rather than sex or getting laid. Although, you know, when couples are intimate, sex and intercourse is often part of that. So, yeah, I guess indirectly it could be that. But I think that it's about building the relationship you want. And I think chores for some people are that I give a lecture on sex and longevity. And there's a cartoon from the Atlantic magazine and it's a woman in bed and she's like reading a magazine. And the man comes in and he's got a feather duster and a vacuum cleaner and like every possible thing. And he said, is there any fantasy you have that doesn't involve me doing housework? It's the cutest little thing because I do think, think for some women, and that's kind of a shame, but I think that can be an opener for communication. You know, think of that little line and you could say it in a cute, funny way, like, okay, I'm even gonna do the disgusting pots from the chili that I hate washing. I will do that because I love you. And I don't do it with expectations that there's gonna be a trade off for it, but I do wanna make sure we know each other and we know what makes us happy.
- [33:05]
Dr. Rena Malik
I think the other thing is that, you know, people want to be seen. And I think we women do a bad job of saying what we want, Right.
- [33:13]
Dr. Maria Sophocles
We want them to guess it and just know it.
- [33:15]
Dr. Rena Malik
Yeah. And so I think it could be as simple as saying, hey, what can I do that would help you feel less stressed? Or what can I do that makes your day a little easier today just so that you're like, hey, I may not pick up on the, like, read between the lines. Because that's not me. Like, I'm.
- [33:31]
Dr. Maria Sophocles
You know, men don't read. Men read the lines.
- [33:34]
Dr. Rena Malik
They read the lines. Just tell us what you need, right? And so. And they want to fix it. They're. They're like, many men are fixers, right? If you tell them I'm having a problem, they'll want to fix it. Sometimes that's a problem, but because they'll try to tell you what to do and you're like, I just want to tell you what's wrong with me. But that's a whole another discussion, I think, really just saying, like, hey, what can I do to make you feel less stressed, to make you feel loved?
- [33:58]
Dr. Maria Sophocles
You know, I know my own personal thing is we have stairs going up from the kitchen level. And I always put stuff that needs to go upstairs that's not mine on the stairs. And my sons and my husband would walk by them a hundred times. And I think, how can you not understand? This is your stuff, Put it away. But they've said, if you just tell me you want me to put that away, I will. So I think that's a version of that is women want men to intuit this and men just want to help and do the right thing. But just tell me what you want.
- [34:29]
Dr. Rena Malik
Obviously, other thing that we're guilty of is like, can you do it right now? Like, no, I can't do it.
- [34:35]
Dr. Maria Sophocles
Yeah, my husband's made that very clear. And I really have learned to respect those boundaries, that when I want something cleaned or put away, I want it done right away because I'm thinking about it. And that he said, you know, I'm in the middle of this important zoom call and I will get to it when I can. And so it's been good for me to hear him and really say, okay, I'm asking for something that's unreasonable and I shouldn't resent you for the fact that, that you're not doing it on my terms. You are going to do it.
- [35:04]
Dr. Rena Malik
And this is so important for relationships in general. I think a lot of times, at least this is just anecdotal. I can't say I have any research on it, but a lot of times that men who are in long term relationships who find out that their partner's really wanting to think about divorce or separation, they're like, oh, I never knew you were so unhappy. These little things. I've asked you to pick up the socks or whatever crap there is, and you didn't do it. And you're like, but it was just the socks. It wasn't a big deal. And that's not the reason. It's like there's these small little things over many years, years that they have picked up on, but they're like, you never told me.
- [35:35]
Dr. Maria Sophocles
That's right. You know, it just brings us back to the whole communication is lubrication phrase, right? When we're trying to connect the dots between household chores and sex, or between noticing that you're supposed to do things. And now I want a divorce. That sounds crazy.
- [35:51]
Dr. Rena Malik
Yeah.
- [35:52]
Dr. Maria Sophocles
But the connection of the dots is communication.
- [35:55]
Dr. Rena Malik
Yeah.
- [35:55]
Dr. Maria Sophocles
It's. It's saying and. And taking the risk to say, hey, you seem kind of pissed off or even a little snippy. I think if you tell me what's wrong, I can work on it. I'm willing to work on it, but I need you to communicate. And so women, as much as we talk and we know women use more words than men do, they can be poor communicators about that.
- [36:19]
Dr. Rena Malik
Absolutely. We had Charles Duhigg on the super Communicators. He wrote the book Super Communicators. That was so useful because it does really talk about how to. To communicate better.
- [36:28]
Dr. Maria Sophocles
Right.
- [36:28]
Dr. Rena Malik
And we all could use that. Everybody. Absolutely.
- [36:31]
Dr. Maria Sophocles
I don't even think that's gendered. I think that's human.
- [36:33]
Dr. Rena Malik
Everybody, you know, And I've had these conversations about chore play and doing chores on the podcast before, and there's a lot of people who in the comments will say, look, I. We. 50, 50 we. I do half the work, I help with the kids, I do everything. And I'm still not enough. I'm still not getting the sexual connection or the intimate connection with my partner. And I think they feel like I'm doing my part. And oftentimes they are right. And their part may not be doing chores. They may be like, I'm going to work and I'm providing for the family and I'm doing everything I can. And they feel rejected. How do you think that again? I think. What do you think is happening there?
- [37:12]
Dr. Maria Sophocles
I think a couple things are happening. There's a tendency to measure, and I think that's really fatal in a relationship. You never want to think, I gotta make it 50, 50. I think you wanna aim for, I'm gonna do more than 50%. Because I think there's always more that your partner's doing than you realize. Right. I've gone through periods in my marriage where I thought I am doing 80%. You know, big mistake, because the 20% I think he's doing is actually a ton. You know, the taxes, the miserable things I would do badly, I wouldn't wanna do. Yes. I'm throwing out the carrots when they get old and rubbery, and that's annoying. And he will never do that. I mean, you know, I will be in the casket and that man will never throw out those old carrots. And I have to make peace with that. But I think so take away the measuring and also take away that connection Of I'm doing all I can. So there should be more sex happening. I think the sex is going to happen. Let's go back to G rated. Sex isn't going to happen with you doing more and more chores. The sex is going to happen when you both put the chores down and you say, we're gonna actually schedule time for intimacy, not sex for being together. I'm serious. I tell my patients, pick a time like Friday afternoon. No company gets sold on a Friday afternoon. Nobody's stock buys on a Friday afternoon. Kids are all handled on a Friday afternoon. Close the door, leave the phones out of the room, and just remember to get to know each other. Get to know the person you fell in love with, the person you were attracted to and you still are in some way and find that attractiveness. Their humor, their jawline, their wit, their sarcasm, whatever it is, it's still there. Just because they have gray hair and a little bit of a belly doesn't mean it's not there. And you can find that attractiveness again. And that's not a chore. That should be fun. And I literally make my patients schedule it. We just start with 30 minutes once a week. I mean, if you can't give the most important relationship in your life 30 minutes once a week, you need a big priority reset.
- [39:16]
Dr. Rena Malik
Absolutely.
- [39:16]
Dr. Maria Sophocles
And then you build from there.
- [39:18]
Dr. Rena Malik
Yeah. I think that's so valuable. Right. I think what is it worth to you? Right. Like, what is it worth keeping your relationship for? Right. And if sex is a priority for one partner, well, that should to some degree be a priority to figure that out. Right. And it may be that, you know, you need to convince your partner, like, it's a priority, but it's not going to happen the way it used to. Right. It might look different, but it's still like, how do we come together? And just like you talk about any sort of challenging situation or relationship, this is also something that you need to prioritize. I think the biggest mistake is that people think sex is easy and that sex doesn't require work and that sex should just happen and it's not a realistic expectation.
- [39:59]
Dr. Maria Sophocles
Well, again, look where we've gotten these messages from, right? From movies and porn, where people meet in a bar and they're looking at each other and stars are flying out of their eyes and then they're ripping each other's clothes off. And then, like, it literally cuts to the aftershot of they're both lying in bed grinning. And it's like, you know, in real life we have, you know, Dogs that are vomiting from eating something bad and kids that can't find their socks for school and tax bills that we forgot to pay and things that are stressful. And so I think it's not easy to clear your head for sex and to have the time. And some people have their kids sleeping with them at age 5 and some people have a mother in law who moves in and is in the next room. So these are real life things that make it not the Hollywood moment that we see on tv. And then we look in the mirror and we live in an Instagram world where everyone is doctored and airbrushed and everyone looks in a mirror and they see fat on their inner thighs and they see their breasts sagging and they see a paunch and they look at each other and they, they don't necessarily look at their partner in a bad way. They look at themselves. They're so critical. I don't have a six pack, I don't have an eight pack. I don't have a. Whatever. You are enough. Like you are beautiful. Your partner found you beautiful and still finds you beautiful or handsome. And I think there's nothing wrong with saying that. Even if you're just having your 30 minute check in and you just lean over and stroke someone's cheek and tell them you think they're a beautiful human being. I mean little things like that can mean a lot, especially as we age and we know we are all aging.
- [41:36]
Dr. Rena Malik
Yes, yes, there is definitely also that double standard. I was having a conversation yesterday with a colleague. Women are held to a different standard in aging. We become more invisible in many ways because people expect young is beautiful in terms of women, we are taught to
- [41:53]
Dr. Maria Sophocles
be sexually vibrant also for our whole lives, which we know is very hard as we have hormonal changes. But I would argue that men suffer too. Like how many men lose their hair, it goes gray. It's not as acceptable maybe for men to dye their hair. Women in a room of 160 year old women, you better believe 95 of them have dyed their hair.
- [42:14]
Dr. Rena Malik
Right.
- [42:15]
Dr. Maria Sophocles
And yet 160 something year old men, probably not. So men sort of have to go gray. They lose their hair. They have their own, I think, feelings of a little bit of insecurity. And you know, there's always the one guy friend who has a full gorgeous set of hair and barely any gray. And he comes to your dinner party, you know, you as a woman note, wow, he looks great. But as the other men are probably
- [42:40]
Dr. Rena Malik
like, damn, they're just genetically blessed.
- [42:43]
Dr. Maria Sophocles
Yes. So you Know, I think men have their own frustrations with aging and how they look. I, I think it's. They haven't been given, look what we've been given. We get to put makeup on and we get to dye our hair. And in a way, they're told they have to age more naturally, but they're still aging.
- [43:00]
Dr. Rena Malik
Yeah. I think just societally it's more acceptable for men to age.
- [43:03]
Dr. Maria Sophocles
Right. And we know about the double standard. Look at online dating, right. If you're a 55 year old, wealthy, handsome man, you can date a 20 year old, a 30 year old, a 40 year old, a 60 year old. But if you're a 60 year old woman, you're not getting a lot of 40 to 60 year old men interested in you, which is a horrible, unfair double standard. So we do have some tricky ones there.
- [43:30]
Dr. Rena Malik
It is a challenge. Yeah. And I think that, I mean, we've talked about this a little bit, but I think that the thing is, men are not allowed to express their frustrations with aging with changes in their bodies, they keep to themselves. They don't. Like, oftentimes my patients, I'm the first person they've ever talked to about their sexual difficulties. And it took them years to even come and see me. Right. Because they're so nervous about it, they can't tell their friends, like, hey, what are you doing?
- [43:54]
Dr. Maria Sophocles
It's like, cool. It's not manly.
- [43:55]
Dr. Rena Malik
What are you doing for this? How can you help? Like, women do tend to have a little bit of a hive mentality. Like, hey, I'm struggling with this. Let's talk about it, let's vent about it. What are you doing? What am I doing? Oh my God, I found this.
- [44:04]
Dr. Maria Sophocles
We have to talk to each other more. But many of my female patients will say, oh, I can't talk to my husband about that. He would never talk to me about, I think he's having erectile issues, but he would never talk to me.
- [44:14]
Dr. Rena Malik
Exactly.
- [44:14]
Dr. Maria Sophocles
And I'm thinking he'd never talk to you because society has not given him permission to age or have a problem. And this is where actually in the book I talk about Viagra and how it sort of made the playing field uneven for aging because women didn't have and still don't have something like Viagra. We do have vaginal estrogen, thank goodness. And it's safe for absolutely every woman out there. So if you have a partner or if you are a woman who's suffering with vaginal dryness, please know the vaginal estrogen's for you, there's absolutely no one that it's not safe for. People worry, they misunderstand that it's unsafe or linked to cancer. Vaginal estrogen is not cancer causing for anybody. And even if you have a cancer, you can take vaginal estrogen. That's kind of shocking news to a lot of people. And if you're the partner of someone who needs that, I mean, there's no bigger turn on in the world than you going to a woman and saying, I don't want you to be uncomfortable. And I feel like maybe things are a little less comfortable. Let's go together, let's go get you vaginal estrogen. I wish it was over the counter, but it's not. Oh my gosh. I think women would be shocked.
- [45:27]
Dr. Rena Malik
And fortunately we do have a couple medications for low desire. We do now coming on very soon. Topical Viagra basically for women, which we'll see how that works for. It'll help with arousal. So there are some things. But I think we're starting to have these conversations for women too. And that's important. But you're right, I think that the urologists who talk about men's health and women's health, who look at both sides of the coin, like myself, it's like, okay, I always ask my male partners like, well, who are you having sex with? When was the last time you had sex? Because if they're your age, they may be struggling and they should either come see me or see their gynecologist about, or their primary care about vaginal estrogen or, or whatever they need maybe hormonal therapy. If they're struggling with symptoms because they are not going to wanna have sex if it hurts, they're not gonna wanna. And very often 40% of women struggle with low desire. And so it is something that, you know, they may need help with and that's okay too, right?
- [46:28]
Dr. Maria Sophocles
Yes. We have a couple of FDA approved medications for low desire for women. Yay. But not all women have access. Some women don't want to take a pill every day. They just don't want medications or they don't want to have an injection. You know, one medication is called Addi a D D Y. I. It's a pill taken every day. You don't take it just before you want to have sex, you take it every day. And vylease the on demand injection maybe is a little more like Viagra in that it's on demand. You give yourself an injection an hour or so before you want to have this big dopamine Rush to make you want to have sex. And both are great, but they're not without potential side effects. There's cost involved, I would say it's not that we don't want you to use those, but we want you to look at the relationship first. Work on the communication. And if there's pain or dryness, for sure, go to a urologist or a gynecologist or your primary care, if you have one that's progressive, and say, I really need help, because the vagina is very, very responsive. It's one of those amazing parts of our body that we can rehabilitate. We can literally turn the clock back, which is we're so lucky. So I would say avail yourself of that and don't be afraid of using a medication that's vaginal. It doesn't go systemic, really, so you're not increasing risk. A lot of people tell me, well, I don't want to get cancer or have a stroke. And I just can't say it enough. You're not going to. It's safe. And if you're the partner of someone who needs it, know that you're not being selfish to ask her to go get it. You're contributing to her overall health. Because if we keep the vagina healthy, we also help bladder health. We help women who have fewer UTIs as they age. And believe me, urinary tract infections in older women can be a really dangerous thing.
- [48:18]
Dr. Rena Malik
They can kill you.
- [48:19]
Dr. Maria Sophocles
They can kill you. My mom just got out of the hospital. She was in the hospital last week from a UTI because she had stopped using her vaginal estrogen, Unbeknownst to me, of course, wound up with a very dangerous UTI that went right to her kidneys. And it's no joke. She was very, very near death. And so I think, again, it'll help you sexually maintain the ability to have new collagen and new blood vessels, which, if you look at my TED Talk, there's a great little animated video, and it's just like 10 or 15 seconds this woman made for me of what happens when we lose estrogen in menopause. What happens to the vagina? And you see the walls go from thick and dark and ridgy and full of blood vessels to thin, pale, inelastic. The collagen gets replaced by a crappier quality collagen, and the blood vessels go away. So those things are so sad. And they never, ever come back on their own, but they will come back with vaginal estrogen or with a CO2 laser. I mean, There are other ways, but estrogen is inexpensive and safe. So I would say we're crazy not to avail ourselves of that.
- [49:32]
Dr. Rena Malik
Absolutely. I have a colleague, Dr. Rachel Rubin, who was on the podcast as well. She calls it Female Viagra, around since the 60s. She's like, it will completely improve your genital health and increase blood flow and do all the things that Viagra does for men. And it's. It's. It's been around forever. It's been around forever.
- [49:50]
Dr. Maria Sophocles
I know. I always say, I think when women turn 50, the government should actually mail them the vaginal estrogen every year. I think of the money it would save our healthcare system.
- [49:59]
Dr. Rena Malik
Oh, yeah. And there's been studies on. They've looked at, like, how much money we would save on UTIs, right?
- [50:05]
Dr. Maria Sophocles
That's right.
- [50:06]
Dr. Rena Malik
If everyone had hospitalizations. A lot of money.
- [50:08]
Dr. Maria Sophocles
Exactly.
- [50:09]
Dr. Rena Malik
Billions of dollars.
- [50:10]
Dr. Maria Sophocles
But we're also making happier sex last longer. Right.
- [50:14]
Dr. Rena Malik
And people live longer and live healthier when they're having sex.
- [50:16]
Dr. Maria Sophocles
Boy, you and I should be on commission from the original estrogen companies.
- [50:20]
Dr. Rena Malik
The other thing I would say is, you know, I'm going to push back a little bit because you said, you should work on your relationship first. I never tell men they have to work on their relationship first. I say, you can do both at the same time.
- [50:30]
Dr. Maria Sophocles
You can. You're right. And I think that I meant before just getting a prescription for Addie.
- [50:34]
Dr. Rena Malik
No, but you can do both, right? Like, I don't see why not. And I think you're right. It's not. It's not cheap. It's not covered. It's. It's not covered for everyone by insurance. Sometimes you have to pay cash. Depends on your insurance. And so there is accessibility issues, whereas Viagar is super cheap now, or any of those PDE5 inhibitors. But I do think that, like, when a man comes in and he's struggling with his relationship and he's having difficulties with erections, I will say, look, look, I can give you this pill. It may help your confidence, but you still need to work on these things. I think the same can be said to women. And I think we really have to think about how we talk to women about their sex lives. A lot of times women are told, work on your relationship first.
- [51:11]
Dr. Maria Sophocles
No, no, I misspoke. I never say to someone, I'm withholding anything from you until you work. But I would say for people who are reluctant to have prescription medication, and I don't really mean vaginal estrogen, because I think that's literally for everyone. But for people who say, gosh, the injection's really expensive for me is really going to be hard for me to do. And they're thinking this is a magic bullet that will fix everything. I just want them to know, I think in parallel, you have to look at your own relationship to sex, to your own body. Do you know your own body? Do you know how to elicit pleasure? So we go way back to that. We do an anatomy lesson. We always look in my office with a mirror. I have a little vulva puppet. We go through it and we talk about where things feel good to be touched and have you ever masturbated? And a huge number of women have been told masturbation is shameful and dirty and not for me. So I have an 82 year old patient who came to me the other day and we talked about masturbation and she's now masturbated for the first time in her life. And her sex life was so not gratifying to her. She had never orgasmed, she had never had a man please her. So she, in her 80s, is experiencing orgasm for the first time and it's really fantastic.
- [52:28]
Dr. Rena Malik
Absolutely.
- [52:29]
Dr. Maria Sophocles
I see that for her.
- [52:29]
Dr. Rena Malik
I wish she had come earlier, but
- [52:30]
Dr. Maria Sophocles
you know, Me too, me too.
- [52:32]
Dr. Rena Malik
The other thing I would say is that, you know, we're always looking. You said there's no magic bullet. And it's interesting to me that people are always looking for the magic bullet. Like they will take a supplement that's unproven, that's untested, and say, I would rather do that than take an FDA approved medication. And I would say that, look, if you are willing to take a supplement and pay money for that, I would think about that as an investment in something that really works, that's been spent millions of dollars on doing research and investigations and try those things first, right?
- [53:01]
Dr. Maria Sophocles
Yes. They're more studied, they're more vetted. You know, what's in the bottle is what you're getting. And I can't remember the statistic now, but it's something like 65% of all supplements do not actually contain what is on the label because they don't have to. And I think we make a big assumption that if it says creatine or nad or lion's mane, that that's in there. But the truth is over half the time it's not in there. And it's not in there in the quantities that it purports to be. Whereas at least an FDA approved medication, we know that if it says 0.05 milligrams on that estradiol patch. That's what's in there.
- [53:41]
Dr. Rena Malik
Absolutely. And look, I'm not against supplements. I think there is a role for certain supplements in certain situations. But I do think that I will give an example. I had a patient come in with a box of supplements and he was overweight and had high cholesterol and was pre diabetic. And I said, look, these are not gonna fix you. And so please take that money that you've invested in that box of supplements. Get a nutritionist, get a personal trainer, get statin. Right. Talk to your doctors about the medications that can help you, you. And then once you've gotten that down, then you can look at supplements. Right. Because otherwise we're just throwing money into things that don't really help.
- [54:19]
Dr. Maria Sophocles
Exactly. And there's a lot of snake oil out there. Take this. It'll melt the fat away. If I see that word, melt the fat away one more time. There is nothing that melts fat away. I'm pretty sure.
- [54:32]
Dr. Rena Malik
No, there's not.
- [54:34]
Dr. Maria Sophocles
I feel frustrated when patients come in and they say, I, I take 16 supplements because I just really want to get rid of this fat. And there are ways that are much safer and cheaper to do that. And so same with sex. I think that's all I meant is if something's really expensive or you're afraid of taking something by prescription, try things that don't involve medication. Try communication. Try things like.
- [55:00]
Dr. Rena Malik
Absolutely. I mean, you always want to go from, from most conservative to more risky in general. But I think if you want to, if you are like, I'm the person who wants to do four different things.
- [55:11]
Dr. Maria Sophocles
Yeah, do it.
- [55:12]
Dr. Rena Malik
Absolutely.
- [55:13]
Dr. Maria Sophocles
And we have topicals. We can have compounded pharmacies make up testosterone for women. We can have them make up what we call scream cream or oat cream. These are still compounded. But as you alluded to, I think the door is opening for more research and more FDA approved formulations for women's sexual health, which will be, I think, a big help in the bedroom.
- [55:35]
Dr. Rena Malik
Yeah. And, and guys who are listening, if your partner is struggling, you should say, hey, did you ever hear about this medication? Or hear about this thing? It's also like a point where you can bring, oh, look, I saw this news article. Like, this is coming out, or this is, you know, there's this documentary coming out, the pink pill or whatever. Right. So things that you can sort of talk about and, and just open the door to talk about it. Yeah.
- [55:54]
Dr. Maria Sophocles
So I'm actually working on a Documentary called Hot, which isn't out yet. It'll be out next year. But we're interviewing women and men of mostly midlife and some with who are cancer survivors and some who are straight and some who are gay and all different types of couples and individuals to kind of get their perspective on things. And I think I'm hoping, you know, that that'll be great for communities to hear and feel heard, feel like or relate to and say yes, and maybe even inspire some of these conversations. That'll be fun.
- [56:25]
Dr. Rena Malik
Absolutely, Absolutely. So you've been in practice for decades. You've obviously written this book, you've talked about this issue a lot. What is something that you really changed your mind about since when you started?
- [56:38]
Dr. Maria Sophocles
I approached the book as something. As a doctor, I want to teach women about what happens to them anatomically and physiologically. And so they and their partners could read this book and say, ah, okay, no estrogen, this is what happens. No testosterone, this is what happens. This is why libido drops. But along the way, I really realized that we as humans, men and women, are so much a product of our current culture of everything from Internet dating to ubiquity of porn to the gendered healthcare gap in research that we don't have as much for women as we do for men. And the pink tax, they call it, the fact that for women many things are more expensive than for men. Men, but also from history, thousands of years of being told that sex is for men and men are entitled to it and that. And again, not to crap on men, but just these roles and these expectations that provide problems, they're relationship wrecking both for men and for women, that women feel they owe the man something because he has needs. And men feel sort of ashamed that they're supposed to be wanting all this. So it became much more of a psychological exploration. And I think that's why the book will be great for people to read, to really understand why they might feel the shame they feel or why they might feel they don't understand why their partner isn't interested. I mean, I think people need permission to learn and to feel that they're not alone or strange or deviant or prudish or cold.
- [58:12]
Dr. Rena Malik
Absolutely. If you could take one thing that you think everyone should take home from this episode, what would that be?
- [58:21]
Dr. Maria Sophocles
I think it's just to find the way in your relationship to begin the communication. Because I think that there's more attention now. Women can get vaginal estrogen, Men know how to get Viagra. We can do those Kind of things. But until you can begin to have the communication in the relationship that leads to long term intimacy. Because when we say long term sex, that's fine. But I think as people age into their 60s, their 70s, their 80s, their 90s, and I have couples who come to me in their 90s and they're still sexually active. So make no mistake, we're living longer, we're staying sexually active longer if we can. But A, remember that you can redefine what sex is for yourself at any age. B, take the pressure off yourself and your partner that the goal of sex is an orgasm and that the real goal should be fostering intimacy in whatever way that makes your relationship flourish. And I guess the very last point is just to never stop the understanding the importance of the communication. If you get that first talk in and as you said, people are shut down or shameful or you, you think to yourself, well, that didn't go so well. Try again. Try again differently if you have to. And once you find the right cadence or the right rhythm or the right tone, the where, when, how, repeat it. Have a quarterly check in. Even if you don't say to your partner, okay, we're have a quarterly check in. It sounds like you're an accountant or something. Make sure that there's regular communication about it. Because our bodies change, our relationships change, the external forces change, and I think people give them grace and say, hey, I know you are really struggling with this issue with your sister right now and it's taking a lot out of you. And I just want you to know I'm here for you and I would just love to put a movie on and just hold you. Oh, my gosh. People would feel so much relief at knowing that you're not expecting that it's Friday night and they have to have sex. So I think just giving people grace is good.
- [60:24]
Dr. Rena Malik
Yeah, absolutely. So where can people find more about you, your work, your book?
- [60:30]
Dr. Maria Sophocles
Mariasophoclesmd.com is my website or Aria SophoclesMD on Instagram. The book is available wherever books are sold online and in bookstores and in other countries too. So that'll be fun. But for us listeners, they can get the bedroom gap. They can just Google the bedroom gap. Maria Sophocles. And it'll take them. 70% of books are sold on Amazon, so Jeff Bezos will happily deliver it to you in a day. But I would say support your local little bookstores too, because they need you to go buy a book there. Oh, and audible, right? It's on Audible. And the reason I think that's important is that a lot of us are just too darn busy to pick a book up and read the whole thing. But I listened to it on the plane ride over here to meet with you. It was a six hour plane ride and I got through most of the book. And honestly, it was a very easy listen because it's very conversational. And so I would say if you don't want to read a book, listen to it. It, it's really absolutely, you know, the way. It's. It's a lovely luxury we have now.
- [61:33]
Dr. Rena Malik
Oh, I know. I love listening to books. It's. It's great. And then we end our podcast with four questions. We ask everyone. They can be about your life, they can be about your work, whatever you want. What is something you know now that you wish you knew earlier?
- [61:43]
Dr. Maria Sophocles
Oh, I think just the sort of bi directionality of the sexual experience and that, you know, as someone who has almost exclusively only treated women for 30 years, I was a little ashamed at my own ignorance as far as what are men going through? What's happening on the other side of the mattress that as a gynecologist I hadn't considered. And I've learned so much about the fact that men by and large want, you know, they want their partners to be happy and be pleased. They're not selfish. They don't just want to have penetration. But it can seem like that. And that I think we have to remember that that other person has a second story to. And to try to ask about that. That was something I learned along the journey of writing this good.
- [62:29]
Dr. Rena Malik
What's a non negotiable something you have to do every day?
- [62:33]
Dr. Maria Sophocles
I have to do every day. I have to get outside every day. I just, I can't do that. Zoom call back to back podcast. Every day I need to walk. I live in a beautiful place and I love to walk in nature if I can. Every day. If I had a fantasy, I would be in the Aegean Sea every day in Greece. That's my fantasy. Non negotiable. But often it's just in my mind or looking at a picture.
- [62:54]
Dr. Rena Malik
Swimming or just swimming.
- [62:56]
Dr. Maria Sophocles
Paddle boarding in a boat. I have a little captain's license, so I go to Greece every summer and that's where I get my fix of Greek water and a lot of feta cheese and tomatoes.
- [63:06]
Dr. Rena Malik
So yeah, lovely. What's a life hack or health hack you'd share sleep.
- [63:11]
Dr. Maria Sophocles
That I think sleep is the key. I think if you can get your sleep to happen deeply and reliably and consistently. You have the energy to face the day. You have the energy to wake up and feel so good that sex feels like a lovely luxury when you and I know it shouldn't be a luxury, but you feel empowered to give of yourself. And maybe that means giving of yourself in a sexual way, or it means getting up and giving to your community or others. I think sleep is one of the best biohacks for good sex and good life.
- [63:44]
Dr. Rena Malik
Yeah, absolutely. If you couldn't be a physician, you couldn't be an author, what would you be?
- [63:51]
Dr. Maria Sophocles
I would either be a boat captain on a little island in Greece where my life was really simple and I could just help people get in that water, or I would be a conductor. And since I have really no musical skill, that's a total fantasy. But I've always thought it was phenomenal to stand and coordinate all kinds of incredible musicians, each one making something beautiful into something even more beautiful.
- [64:15]
Dr. Rena Malik
Yeah, that's lovely. Well, thank you so much.
- [64:17]
Dr. Maria Sophocles
You're welcome. Thank you for the questions. That's really neat.
- [64:20]
Dr. Rena Malik
I hope you guys like that conversation as much as I did. And if you did, there's one way you can show your appreciation that is completely free. Hit, subscribe or follow wherever you're watching or listening to this episode. And this is a great way to tell other people that this is a podcast that's worth listening to and helps us get our message around to more and more people. And as always, remember, take care of yourself, because you are worth it.