We were joined recently by Kate Moyle, renowned expert and trusted resource in the field of psychosexual therapy, who has written extensively on the topic of sex in midlife. Her work focuses on providing guidance and support to individuals experiencing changes in their sexual lives during this stage of life. She's also the host of the Sexual Wellness Sessions podcast.
With plenty of giggles and in true ‘girly’, blush-worthy style we asked her questions received anonymously from friends. She had some excellent responses and advice to help navigate this new chapter of our lives, when rekindling intimacy, finding connection and making the best of our new empty nest ‘freedoms’ which can be an exciting adventure - or, you might decide it’s time to take action, make your desires clearer (maybe for the first time in your life - gotta love those fifty year old zero-filters!) and rediscover romance.
Here’s the transcript from our chat - you can also watch it on YouTube here or enjoy the full podcast episode here.
Liz:
What is the definition of sex?
Kate:
Well, really the definition that most of us kind of work on is sex is intercourse or penis and vagina penetration. And one of the biggest problems that we have with this is that obviously that is a part of sex, but it's not the sex that a lot of people are having. It's not the sex that is applicable to all couples or all people or all individuals based on genders, based on sexuality, based on physical abilities, bodies, there's so much going on based on preference. And so what we tend to now try and think about is the circular model of sex, which is that it's a sexual experience, which we can do for a number of reasons. And again, that it's not just something that is for procreation. And so much of sex has become focused and particular sex education has been focused around reproduction. But we know that the reasons that most people are having sex isn’t to conceive a lot of the time and one of my favourite pieces of research identified 237 reasons for why people said they were having sex and you know the meaning of sex is such a big part of that and a lot of the time is the reason why people are having it.
Michelle:
So, okay, in midlife, we may have been with our partners for quite some time. We may be into decades of marriage, perhaps. And as you mentioned, early days, you're kind of looking at the reproductive side of it, the fun side of it. How do we reintroduce more fun when perhaps it's got a bit dull and boring? How do we even open up those communications when you've just been in this routine, perhaps for a long, long time, without it becoming...how can I say, maybe confrontational or critical even?
Kate:
Mm, yeah, I think it's a huge question. And it's one of the things that is really important to say here is that people can have been having sex for 20 years and never talked about it. And often one of the things that happens is people don't really talk about sex until they have a problem. And if they haven't started their sex life or their relationship by being one of those couples that talk about it, it feels like it's something very hard to start and almost arguably harder, the longer you've been together, the longer you haven't talked about it.
Often people kind of work around it without ever having to confront it. And I think that a really good way of starting the conversation is around. What's changed, and we know that midlife is a time that changes things for lots of people, and it's not necessarily that people have been in relationships for a really long time. We know that there's a huge, huge group of people who are starting new relationships at this point in their life, and that actually can come with a kind of separate group of anxieties or a very different group of anxieties. The familiarity, the routine bit is something that happens a lot of the time. We call it habituation for us as humans, but particularly a lot of the time in relationships and that becomes paired with the, we don't know how to talk about changing it factor. And in terms of starting a conversation, even if it's something we've never talked about, I often say to people kind of say, I listened to a podcast today (like Two Women Chatting!) or read a book today or I read an article today or I try and kind of L-shape the conversation so it feels like it's come from another source and that can be a good way of starting it because often I think when we feel that we have to start it, the pressure means that we'd rather just avoid it at all costs.
Liz:
But when you're on holiday, or you're in a hotel room or something, you know, your inhibitions seem to disappear. Why can't you bring that back home? What is it that's stopping it?
Kate:
Because context is so key to sex. Sex is always in context. And the reality is most of us in our homes, there's always something else to do. Sex very easily becomes deprioritized. And we talk about sex, not like a kind of drive, like the drive that we have for everything else, you know, to sleep, eat, breathe, but a kind of secondary drive that very easily gets deprioritized. And we particularly know that desire changes across the lifetime, is really context-based, that it changes whatever we have going on, whether that's our physical environment, whether that's how we're feeling, whether it's our mental health, our medication, physical symptoms that we're experiencing. And on holiday, we are typically kind of escaping routines, we're typically escaping our to-do list, we might switch off. Something I talk about a lot is this idea of switching off to turn on, and it's much easier to do it in a context which is separate from everything else that we have usually, but also it gives us a chance to see ourselves and our partners in a new light and that can be a great thing for desire.
Michelle:
And I think what you almost touched on there, Liz, was also, you know, if our kids have left and we now have an empty nest, that can be kind of liberating, can't it? Because you don't have people coming, you know, into the room potentially. You don't have like, can they hear us? You know, do we have to be really, really quiet? Do we have to be, you know, just only do it in the bedroom? All that sort of thing.
Kate :
Yeah, and I think, again, that's a distraction. People in the house, and particularly when children are either really small or really young, really small and really young, or kind of older and near adults, we know that kind of rules of coming in and coming out change. Whereas when children are kind of that slightly like middle-aged, they might just like potter around, go downstairs. Whereas teenagers, and particularly kind of closer to younger adults kind of coming in and out more as they wish and kind of roam around the house and young children have no concept of kind of private spaces, you know, very young children. So we can fear that anxiety sometimes about being overheard or being interrupted. And that in itself becomes a distraction. And when we are distracted, we're not really physically in our bodies and in our pleasure. And that in itself can inhibit both our kind of psychological motivation, wanting of sex, so the desire bit, but also our physical pleasure.
Michelle:
I think especially with women, would you agree that I think we're sort of on high alert all the time listening for, oh, do the kids need us? Is that the doorbell or whatever it is? I think women find it really hard to completely switch off from the multiple responsibilities that they have. But hopefully that becomes a little bit easier if you know there's nobody in the house or whatever that could be for you.
Kate:
I think absolutely when we are preoccupied, and this is something that we hear a lot from mothers and a lot from people kind of in that stage where we're also not focusing on ourselves, we're so prioritizing everyone else's needs and what can happen is sex can feel like another thing which is about someone else's needs at points and that distraction that can come about from all of those things and knowing that kind of to-do list is never done and that list of things is never fulfilled is really, is really interrupting when it comes to desire. And I think that that's when we talk about that ability from switching off to turn on. And we've seen that mindfulness studies have proven to be really good for sex lives. And actually where studies have been done by people like Dr. Laurie Brotto, who is based in Canada. She has done it with people who have gone through cancer. And what she's found is not only do the mindfulness exercises help with the psychological side of feeling increased desire, but also that there was a physical impact. So the body is actually creating more arousal in response to those kinds of techniques as well.
So Dr. Laurie Brotto, she's been a guest on my podcast, which is the Sexual Wellness Sessions. She has a brilliant book and there will be numerous kind of podcasts with her around and videos. But really simply mindfulness is directing your attention in a particular direction without judgment. So it's kind of basically directing your attention back into the body is what we talk about when it comes to sex, because so many of us, we’ll be having sex and suddenly like a thought will pop into our heads and we'll be thinking about that and then that will take us off somewhere else and then we kind of almost forget that we're in the moment of having sex and like you were saying earlier, that sense of kind of being feeling like we're permanently distracted. And so it's about directing attention back towards the sensations that are happening in the body and a really good exercise to do if you're trying to practice that is running through the five senses at any point. So whether that's in the shower or kind of going about your daily day and because it is a practice, it's about kind of learning how to do that.
Liz:
A friend of mine used to put it in the diary. Is that healthy or is that sensible? At least it's logged that she's got to have sex with her husband. Or is that negative towards the marriage?
Kate:
I don't think it's necessarily a negative. Well, what we recommend as psychosexual therapists is that we don't schedule sex, but we say do schedule time to be together. Do put things in the, do mark that time. And there's an intentionality which is really good for relationships, which is this is important for us to spend time together and to be together. And we're gonna prioritize that above anything else. So, and you know, I always liken it to the fact that we book our meetings at work, we call our friends, we schedule to catch up with our families, to put in our doctor's appointments, our gym classes, we do it with everything else. But we have this very romantic view of sex and relationships, which is that they just happen, and actually scheduling means that you're making sure that it happens, and that prioritising and that intentionality is a really important part of relationships, and actually is one of the things that we see is a really important factor for people who report maintaining and having good sex lives is that they make it, they make sure it's a part of their lives and it's not about the act of having sex in that moment, but it is about kind of connecting in that physical way.
Kate:
The thing is we use the term sex and intimacy synonymously, and actually they're two different things. And obviously there can be a relationship between the two and they can contribute to each other. But you can have an intimate relationship without sex and you can have a sexual relationship without intimacy. But what the Gottmans, who are some of the biggest sex and relationship researchers in the world...describe as exercises like a six second kiss and a 10 second hug. And what they call the six second kiss is a kiss with potential. And I love that phrase because so often, you know, we all do it, we're all kind of busy and hectic and modern life is full on and we never switch off because our technology never switches off. So we're always contactable. But as we have those kind of, you know, peck on the cheek, run out the door moments. And what those potential moments allow, when we lean into them, A is a potential for responsive desire to be triggered, which might mean that we start to lean into feeling sensual and then sexual. And what we talk about responsive desire is, is the type of desire that happens once we have, we start something and then the desire to kind of continue emerges. So rather than we feel really turned on in the kind of flash of lightning feeling, and then we do something about it.
So we can start that. And that's where the scheduling kind of time together, we talked about a minute ago, also kind of comes into effect. But it's those little moments of connection, often what I describe as bridges, are really important in relationships because even if we're not having sex, what they can do is allow us to feel connected or there is a level of sexual connection there. And we often describe those as sexual currency. So it's about kind of keeping currency rolling or higher within a couple so that we feel that those moments are still there or that kind of type of connection is still there, is still present.
Liz:
Is it good for a relationship to have, you know, a couple sleeping in separate bedrooms as they get older?
Kate:
I think it's dependent on the couple. I mean, lots of couples do, and it depends on, then I think their routines of coming back together if they want to be intimate and to have sex. For some couples, it means that they can sleep better, you know, particularly, we see that certain times it might happen, so if people are having cancer treatments and they're not feeling like they want to be close to their partner or they're having to, you know, go to the bathroom loads of times a night or they're having hormonal reactions, you know, lots of women who are menopausal, for example, or peri-menopausal say, they get so hot, they have such disturbed sleep, they're having night sweats that they just actually don't wanna be touched by anyone. If we have people going through induced menopause where it's very sudden, they can have those reactions really strongly and really intensely. And it can feel easier sometimes to manage those things on your own. But really it's about how that works for that particular couple. And also what it can do is people can do it without then having those bridging moments or those connection moments in another way.
And I think if you're doing it, but you want to maintain a kind of sensual sexual relationship, it's about working out how you do that. It might be that, you know, actually that you, if you can, and if your schedules allow it, then kind of come back together in the morning and start your mornings by being together, rather than kind of closing together at night.
Michelle:
So shifting the time, it doesn't have to be at night, does it? It can be during the morning, Sunday morning, Sunday afternoon. And I think you meant you just touched upon the menopause. Gosh, that comes with so many hangups, confidence things. You know, sometimes your sleep is disturbed so you're not feeling frisky. You're just exhausted all the time. I had a question from somebody that says, that was when you've put on weight, as so often is the case in midlife, and you're not feeling body confident, you're worried about your body image, and it becomes very much a under the covers, never see me naked, don't even shower in front of your partner anymore because you just don't feel confident. Is that something that, how can you work on that? Because I do really think that if you have more inner confidence and you're more confident in your body, you're more likely to be a bit more adventurous perhaps and a bit more, just carry yourself in a different way. Would you have any advice on how to try and claw back on that? And then as a supplementary question, there's the more painful aspects of sex in menopause, the vaginal dryness and so on.
First of all, the body confidence. I think that's a big one for lots of women.
Kate:
Hmm. I think the body confidence thing is across the lifetime. And, you know, we see it particularly with people who are postnatal or, you know, also things people going through things like infertility or miscarriages who were struggling with a relationship with their body again, through cancer, you know, whether it's diagnosis, treatment, um, through menopause and body confidence really is about not how we look, but how we feel. And a lot of people's anxieties come from how they feel they've changed.
I think a lot of the time conversations with our partners can be really helpful, but doing things that make you feel good in your body. So whether it's wearing something like a texture of a material that feels really nice on your skin, it might sound really small, but it might be something that just makes you feel a bit better. And again, it can help you to kind of root in your sensations and we want you to be feeling good and feeling pleasure. The body confidence bit.
Again, what it does is it takes us into our thoughts and keeps us preoccupied by what's going on in our head rather than what's going on in our body. And really the kind of simple answer, which is not wildly helpful, is do what helps you to kind of feel good in yourself. And once we know that people feel more comfortable then they feel more confident. But we also live in a society where women get a lot of messages about how they look, how they appear, what their bodies should be like all the time.
And so there is a much, you know, a much bigger, wider conversation going on here. And then in terms of kind of the vaginal atrophy that we can experience in menopause. So menopause has 34 common symptoms, very few of which make us feel good or make us feel sexy from, you know, kind of, kind of cloudy brain, muddled brain to night sweats, to vaginal dryness, to hot flashes to feeling kind of really up and down in our feelings, to not feeling listened to, to changes in identity. So we talk about these things from what we call a biopsychosocial approach. So the biological, the social elements and the psychological elements. And, you know, often women are saying, I just don't feel like myself. And that's not something that makes me feel good. Or I felt kind of top of my game and top of my career. And I'm struggling to remember like where I put my keys. And that stuff can have such a negative impact on how we feel about ourselves.
And the vaginal dryness is to do with the drop in oestrogen where the tissue of the vagina becomes less lubricated, less elastic. A great water-based lubricant is a really, really good thing here, as well as vaginal moisturisers. And I recommend, yes, organics all the time. They're brilliant, all natural, all organic. But having sex when it hurts you and it's causing you pain is going to only be a negative thing. It's not going to make you want to do it again. It's going to have an impact on your desire, but also it's negatively reinforcing. And there are lots of simple solutions, but so many of us feel shame or embarrassment about having to use those solutions. And that in itself is one of the biggest barriers.
Michelle:
So talking to your GP as well about these things, I think it's really important because there are things that you can take like the vagifem and the pessaries that are oestrogen based and the lubricants as you mentioned. You know, we're not in our 20s anymore and I think we have to consider sex in a different way that makes it more pleasant, pleasurable.
And the pleasure index, I think, is very important, isn't it? To do it because you want to do it and because it's fun. And do we focus perhaps too much? I would say that most women, as they get older, no, I don't know, I don't know my stats, to be honest. But from the general conversations that I've had with people, it is harder and takes longer to orgasm. Do we focus too much on that being, that's what we're going for, and if we don't get that, then that was kind of rubbish.
Kate:
We do have a really goal-orientated model when it comes to sex. It is, as you're describing, a lot of women say that they are struggling. And, you know, men as well, but a lot of people are saying they're struggling to reach that point of orgasm in the way that they used to. Part of it is, you know, the physical and the changes that we're going through. Part of it is also the more we worry about it not happening or the longer we worry about it, the more we worry about that it's taking longer, the more distracted we are and the more that's interrupting our pleasure.
Kate:
Our sex lives go in all these different phases and stages. And again, how we're taught about sex is that it's a static thing that never changes. We're never kind of taught about it as, you know, there's gonna be changes, there are gonna be things that happen to you, that this is something that might be more fluid, and that, you know, adapting our sex lives throughout these different stages is a really important thing to acknowledge that we might have to do or that might make it work better for us. And I think making it work for us in whatever way it works is a big part of that.
Liz:
I guess that sort of brings in Viagra, which I always thought it was for men, but I've heard there is Viagra for women as well, is that correct?
Kate:
it's not licensed, it's a different product. And there's nothing like that kind of in the UK at the moment, but Viagra has just had its 30 year, it's 30 years this year. That's why there's lots of documentaries and stuff going on around it at the moment. But also the way that it works is it's not an aphrodisiac. What it does is it inhibits the reaction. So it basically stops erections kind of draining or going away as quickly. But I think that often people take it and they think that it's an aphrodisiac and it's gonna make them feel really turned on. Now, obviously there can be psychological effects, which there can be a relief with taking something like that or a feel, you know, a feeling of, okay, I've got some assistance or I can relax more or I can feel more confident. And those things of course can have an impact, but really it's about changing blood flow.
Michelle:
How would, I'm trying to think, if you feel that your partner has got an erectile dysfunction, how can you gently go about suggesting that perhaps he looks into Viagra or something similar without being offensive?
Kate:
That again a conversation around it we know that the statistics for men struggling with erections increases with age and we know that that's for decrease in muscle tone but also decreases in testosterone and so that it's not something that's unexpected and we see those statistics increasing in line with age it's really normal to go and discuss that with your doctor if you're
loss of morning erections. So morning erections basically are nocturnal erections which happen throughout the night and typically when you're in the period of REM sleep just before you wake up is when you'll be having an erection. So which is why lots of people wake up with morning erections. Again, exactly. But again, there's decline, there's decline naturally with aging but if they change suddenly it's absolutely something to seek medical advice on because it can be an indicator of something else going on in the body, for example, things like cardiovascular disease because of changes to blood flow. And really, if it's interrupting your sex life, that your partner is struggling or that you're noticing that they're struggling, being able to talk about it and then seek some advice about it is a really, really good thing. And there's nothing to be ashamed of. I think the shame of feeling like we're the only ones that have a problem is...
one of the biggest barriers to people seeking help and advice, which could really change things for them in a really positive way.
Michelle:
Well, there's a lot of health benefits, isn't there, to having a sex life at any adult age? But in midlife, I'm thinking more like strengthening your pelvic floor. And does it help with incontinence too, if you can do more exercise down there?
Kate:
Well, strengthening the pelvic floor, having a toned pelvic floor is great for everything pelvic related. There's a brilliant book by a friend of mine called Strong Foundations. She's a pelvic floor therapist called Claire Bourne and she talks about pelvic health across the lifetime. But we know that a more toned pelvic floor helps with incontinence, helps improve orgasm because part of orgasm is a wave of muscular contractions. And so a more toned pelvic floor can mean that you can feel those contractions more, that they can be stronger.
But also it's important to say an over tight pelvic floor can make sex uncomfortable. And so, because the vagina basically runs through the pelvic floor and so if you're really tense, then it can make penetrative sex painful or sore. And, but definitely like a pelvic floor has range of benefits, but making sure that we're, if we're doing those exercises, that we're doing them properly, the relaxing is as important as the tensing.
Liz:
Do you know, I was always told to do these pelvic floor exercises when I was pregnant. Of course I didn't. And I'm just wondering, you know, that's the little children that say, is it too late? Because I'm sure there's lots of women out there who are the same as me. It's never too late.
Kate:
No, it's never too late. And I think one of the things that is you've just hit the nail on the head is we only tend to hear about them for the first time when we're pregnant. And then you have it drilled into you because obviously the pelvic floor is under such huge amounts of pressure during pregnancy and then childbirth. Um, but then we kind of forget to mention that it's important all of the time. And we know that incontinence statistics and women, particularly kind of midlife onwards, a huge.
Michelle:
I have one almost final question because quite honestly I could sit here and talk to you all day. But how about a helping hand sex toys? Here you go. I don't even know how to ask it. But would you recommend it? Is it? I mean, I think a lot of people take different times to get to where they want to be particularly in midlife, I think with distractions and it's maybe a little harder to get to orgasm. Would you recommend using something like a sex toy or a vibrator to spice things up, help you get there? And how do you kind of get over the embarrassment of, so should we try this then? It's a bravery move in some ways, but it's also kind of selfish and necessarily so.
Liz:
It can be funny. You know, you make it funny, make the entertainment value out of it. But you know, it's entertainment, you can make it funny and then it can work.
Kate:
Yeah, I mean, I think sex toys are a great addition at any stage. I work with a sex toy brand called LELO, but, and what I love about them is that they do have a whole range of products and they don't look, I think sometimes when we think about sex toys, we think they have to look really phallic or really realistic or really body-like and actually sex toys nowadays. I mean, there is the most enormous range and they can be completely beautiful and fit for purpose, some that fit in the palm of your hand, some that are designed for men to wear, some that are designed for couples, individuals. What they are great at is increasing intensity of sensation. So if you are struggling to reach an orgasm or it feel like it's taking longer or you feel that you need more, then they can be great for that. They are great for both kind of solo or couples, I think introducing them with a partner. If you don't know where to start.
It's kind of having that conversation, which is shall we try something together? How would you feel about trying something new? Remembering you're always a step ahead of them if you're the one introducing the conversation. So if they need a bit of time to catch up with you, kind of give them that chance. But I often say to people, look at a website together and choose one together so that you're then at least in the same boat, or you can both say that looks terrifying. No, never will I ever try that. But that one I'm kind of okay with. And I think there's something in that,
There are some great ones that are, you know, literally like little vibrators that kind of sit in the palm of your hand or some that are kind of more like wand shaped and or kind of bullet shaped. And I often say to people incorporate them into non genital play or like massage. So kind of rub them all over each other's bodies or try them on your own first, see how you feel and just work out what feels good. If the goal is what Emily Nagoski, who's a kind of icon in my world, describes as pleasure is the measure, then doing something together which feels good for you both can be a great thing.
Michelle:
I think that's a great place to end on as they say. A happy ending. Sorry! Okay you are obviously just full of great tips and advice. If people want to know more where do they find your website and your contact details?
Website: www.katemoyle.co.uk
Book: The Science of Sex
Podcast: The Sexual Wellness Sessions
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