What’s Your Pleasure? Bridging the Midlife Bedroom Gap with Dr. Maria Sophocles
Show Snapshot:
Want a better sex life? Sexual health expert Dr. Maria Sophocles helps us amp up our orgasms and sex life with ideas for closing the “midlife bedroom gap” and managing what can get in the way of pleasure—think painful sex, low and mismatched libido, and vaginas that have morphed from “Nordstrom to Ikea” in midlife. We cover actionable ideas to boost lubrication, the role of HRT, sex toys, and steamy audio erotica. Plus, ideas for rewiring your brain to become a “sexual savings account” ready for spontaneous withdrawals. Hot tamale alert! This extra spicy show is the adult sex ed no one teaches you!
About Dr. Maria Sophocles: Dr. Maria Sophocles is an OB-GYN and author of “The Bedroom Gap,” drawing on 30 years and tens of thousands of patients treated. She's a leading voice on midlife sexual health, offering practical, judgment-free solutions — from mindfulness to sex tech — for reigniting desire and preventing painful sex.
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Quotable:
When we lose estrogen, we can't make as many blood vessels, and we can't make as much collagen and the quality of the collagen we do make gets kind of crappy. So we go from having a Nordstrom-level vagina to an Ikea- level vagina, because we're just making really low quality, it’s-gonna-break-down-in five-minutes-collagen.
Transcript:
Dr. Maria Sophocles (0:00)
I mean, I think you can just improve your overall sex life as you age, and I think it's a big myth that your best sex is in your 20s and 30s, and that's it — it's all downhill from there.
Katie Fogarty (0:14)
Welcome to A Certain Age, a show for women who are unafraid to age out loud. Beauties, we have a fab show today. We are getting into sex and sexual pleasure and what can get in the way, and we're doing it with an absolute pro. Dr. Maria Sophocles is a gynecologist and sexual medicine specialist who's been at the vanguard of women's health and sexual wellness for over 30 years, and she is now out with a popular TED Talk on the midlife bedroom gap. Yes, you heard that right. Changes in our midlife bodies that impact pleasure and libido, coupled with a difference in sexual expectations of men and women, can add up to a bedroom gap — or even a giant gulf — which impacts relationships, sex lives, and even our sense of self. Dr. Sophocles joins me today to share ideas and tools to close that bedroom gap, because sex should be pleasurable and comfortable for everyone. Please welcome Dr. Sophocles.
Dr. Maria Sophocles (1:15)
Thank you, Katie. So happy to be here today on this beautiful summer day.
Katie Fogarty (1:19)
Yeah, I'm so excited! This is such an important topic. I've done a few shows on this in the past. I've had so many listeners reach out to me to talk about their changing sex lives, and how it really can do a number on your confidence and your relationships. And you've done an incredible TED Talk on closing the midlife bedroom gap. But let's start by defining it — what do you mean by "bedroom gap"?
Dr. Maria Sophocles (1:45)
Sure. The bedroom gap could honestly happen at any age, but it's particularly pronounced in midlife. A bedroom gap involves a difference in understanding and expectations about sex between the two people in the bedroom. What I've found is that many of my perimenopausal and menopausal patients were coming in saying, "I'm broken. Something is wrong with me. I can't get wet anymore. I can't have an orgasm anymore" — or, "I actually never had an orgasm, and now I have a new sex partner, and for the first time ever I'd really like to care about the sexual outcome."
So it's this gap, and the gap is really many gaps. It's our own knowledge of our own bodies. It's our partner's knowledge of female bodies and how they change with age. If you ask most people, "Give me a one-word answer — what is menopause to you?" eight out of 10 will say hot flashes. A couple will say moods, grouchy moods. But almost nobody says bladder issues, genital issues, vaginal dryness, or painful sex — because their doctors don't talk to them about it, their mothers don't really talk to them about it, and it's not really portrayed in Hollywood either. Hollywood portrays menopausal women as grouchy, crying, and screaming, but no Hollywood starlet is going to risk her career by coming out publicly and saying, "Well, I actually have sexual issues." So it's stayed in the closet. I'd love the bedroom gap to come out of the closet, so we can all start talking about it and get the sex we want as we age.
Katie Fogarty (3:37)
Yeah, it's so incredibly important. Your TED Talk — which I'm going to link in the show notes — is really a must-view. It's appointment viewing for anyone listening to this. You open it by quoting a patient who walked into your office and said, "My vagina has betrayed me." It's a funny line, but—
Dr. Maria Sophocles (3:54)
It's a funny line, but—
Katie Fogarty (3:56)
There's absolutely nothing funny about having our bodies and our sexual wellness impacted in this negative way. So — what happens to our vaginas in menopause? I've done some shows on this, but for listeners who need to get caught up, walk us through how these physical changes impact the way our vaginas and sexual organs work.
Dr. Maria Sophocles (4:17)
Sure. As we become perimenopausal — mid-30s to say early 50s, right, because it's a much broader time frame than we previously realized — we begin to have less consistent estrogen produced in the ovaries, and eventually less quantity of estrogen overall. Once we're menopausal, there's almost no estrogen being produced by the ovaries. This lack of estrogen has direct effects on the cells in the vagina, the clitoris, the vulva, the bladder — the whole genitourinary system. Specifically, what happens is we lose blood vessels. And when we lose blood vessels, we lose health. We lose the color of the vagina. We lose the ability to make moisture.
So, as I said in the TED Talk: no matter how turned on you might be in your head, if you don't have enough blood vessels in your vagina, you literally can't get wet. That's the betrayal women feel, because they count on the fact that getting wet when you're aroused is a sign to your partner that you're aroused — and you can't fake that. You either have moisture or you don't.
Katie, you and I could do a whole other episode just on faking orgasms — why women fake them, and what that says about society. Why do we feel we have to fake it? Why do we even lie as women about sex? I'm dying to do an episode on that. But for now, know that when we lose estrogen, we can't make as many blood vessels, and we can't make as much collagen — and the quality of the collagen we do make in the vagina gets kind of crappy. So we go from having a Nordstrom-level vagina to an IKEA-level vagina, because we're just making really low-quality — going to break down in five minutes but looks okay — collagen. So, all due respect to IKEA. Oh my gosh, I have an IKEA sofa, but—
Katie Fogarty (6:23)
Yes! I think we all get it — we've all had IKEA furniture in our lives, but we want Nordstrom vaginas.
Dr. Maria Sophocles (6:30)
We do, and we deserve that, and we can have them — effectively, safely, and easily. But we don't take care of ourselves. We could do a whole other episode on why women don't take care of themselves, but part of the problem is that women don't know this is going to happen to them. Think about sex ed. Sex ed tells you how to put a condom on a banana. It tells you not to have sex ever, or you'll get chlamydia. It tells you don't get pregnant. But sex ed as a teen never talks about female pleasure — not in the U.S. anyway — so female pleasure itself becomes this mysterious topic. And then we don't have "sex ed" for menopause. There's no such thing. There's no moment when, say, at 48, the government sends you a free app to learn from or courses to take. So women stunningly do not know that their bodies are going to change down there, and they feel super frustrated. And their partners don't know either — the partner thinks, "Why isn't she turned on?" And then you're aware that you're dry, and he's aware that you're dry, and it becomes this awkward bedroom gap.
Katie Fogarty (7:41)
It's sort of astonishing — when I was researching for this episode, I learned that about 23 million men take Viagra. It may even be more, but that's the number I found — an enormous number of people getting assistance with their sexual needs as they mature, which is great, they should have that help, there's no shame in that. But if they're partnered with a long-time partner — a wife, a romantic partner, a new romantic partner — who's the same age and isn't getting that same assistance, you can see how that enormous—
Dr. Maria Sophocles (8:20)
That's right.
Katie Fogarty (8:20)
—gulf is happening. So I have a—
Dr. Maria Sophocles (8:22)
Right.
Katie Fogarty (8:23)
Tell me.
Dr. Maria Sophocles (8:24)
And then, as the new partner, you're going to bring a tube of lube to your new online sex date — it's shame. It's like, "Oh, by the way, I'm older." It just makes it so awkward for women. Whereas men, I think, can comfortably say, "Yeah, I'm going to use Viagra so I can have a four-hour erection." It's almost become a party drug! I have friends who buy it for when they travel, so that if they meet people to hook up with, they're ready. I have gay friends who keep it at their parties. But you don't see women having that same sense of empowerment — "I'm going to bring a vibrator and some lube." It's just still this double standard: we're supposed to stay sexually vibrant and multi-orgasmic at the drop of a hat. It's really crazy.
Katie Fogarty (9:22)
It is, yeah. And I think this is true even for long-term partners. You put your finger on it earlier when you said that women don't understand that menopause is necessarily going to change their sex lives. So as we're trying to close the education gap about how menopause impacts our bodies — which is so important — I think as women begin to learn that they don't have to suffer, and that there are options out there, they're going to take advantage of them. We're heading into a quick break. When we come back, I want to ask you about reframing sexual health as a lifelong maintenance project, because I want to know: is it possible to improve lubrication and orgasm as we age? We'll pick this back up.
Dr. Maria Sophocles (10:06)
All right.
Katie Fogarty (10:07)
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Okay, Dr. Sophocles, we're back from the break. Before we went into it, I mentioned something I'd read on your website while researching the show: you believe sexual health is a lifelong maintenance project. I want to know — what's possible? Can you improve lubrication? Can you improve orgasm as you age?
Dr. Maria Sophocles (11:43)
Absolutely. I think you can just improve your overall sex life as you age, and I think it's a big myth that your best sex is in your 20s and 30s and that's it — it's all downhill from there. That's based on an androcentric sex model, meaning sex is all about men and how much pleasure they get. Male sex drive and female sex drive come at different times in our lives, for sure. But the way we can improve it is, first, education. Know what happens to your body. Understand that when you become menopausal, your ovaries aren't making as much estrogen, so your genitals aren't getting the health benefits of estrogen. How can you help that? Well, the obvious answer is to put estrogen right back in the vagina — and I don't mean systemic HRT, although that will do it in a partial-credit way. I mean topical, localized vaginal estrogen. The bioidentical form is called estradiol, and almost every estrogen formula for the vagina is estradiol. You don't have to go to some special compounding pharmacy or a functional medicine doctor — your primary care doctor or your OB-GYN can prescribe generic estradiol vaginal cream.
It comes with a messy plunger applicator — throw the plunger out, I don't know who invented that — just use your finger. Put a little blob, about the size of the first joint of your finger, in the vagina twice a week, for life, forever, and you will inspire new blood vessels and new collagen. There's also estrogen rings, tablets, and suppositories — it comes in lots of different flavors and colors.
Vaginal estrogen comes in lots of forms and from lots of companies. Estradiol is the bioidentical form — we think it's safer. It comes in tablets, creams, and a ring. There's also vaginal prasterone, which you can think of as a hormone that's a cousin of estrogen. That's an every-night suppository — it works very well, but it's a little more labor-intensive; vaginal estrogen is usually just twice a week. There's also an oral medication called ospemifene, which was originally invented for osteoporosis, but it turns out it also activates estrogen receptors in the bladder and vagina, as well as the bone. For people who don't want to put something into the vagina, this is a once-a-day pill you can take with food any time of day. And then there are radiofrequency and laser devices that can also regenerate tissue — making new blood vessels and new collagen — without the use of any medications.
Katie Fogarty (14:38)
Do you ever recommend doing those in tandem — vaginal estrogen and lasers?
Dr. Maria Sophocles (14:45)
Yeah, I do, because I pioneered the use of laser in the United States — I brought the first one here in 2015. I took that laser to five different continents and taught doctors how to use it. When I was in South America, a Brazilian research group studied laser versus estrogen versus the combination, and — no shocker — they found that patients who combined laser and vaginal estrogen had more satisfying sex, better moisture, and more comfort. So I like to be synergistic. But the laser isn't covered by insurance, it can be expensive, and it's not widely available — there are so few practitioners who even own one that it's not something we can broadly recommend, because most women don't have access to it. Do I use it every day with patients? They love it, I get tremendous results, and I always try to pair it with estrogen. Except for women who have estrogen-receptor-positive breast cancer or are actively managing their breast cancer — we try to avoid vaginal estrogen in those women. Even though some studies show it could be safe, it's really an individualized decision.
Katie Fogarty (16:02)
That makes a lot of sense. We've talked a lot about HRT — who's a candidate and who isn't — on the show. I recently had Dr. Jessica Shepherd on, who walked us through some of that. And there's also a wonderful book called Estrogen Matters, written by a breast cancer oncologist, that makes the case that breast cancer survivors might be more eligible for hormone use than they think. It's definitely something to talk through with your own practitioner, but Estrogen Matters is a wonderful resource for any woman who's had breast cancer or has a history in her family — you can really do a deep dive into what might be possible.
Dr. Maria Sophocles (16:41)
Yeah, there are 4 million breast cancer survivors in America right now, and they're living many, many years after their diagnosis. They want to be sexually active. They want to be vibrant. So we owe them, as clinicians and researchers, options. And lube is just lube — I'm a big fan of lube, a huge fan — but it's never going to make new cells and new collagen the way a laser or vaginal estrogen can. When I brought the laser to the United States, I was really thinking of breast cancer survivors and what we could offer them that they didn't currently have.
Katie Fogarty (17:23)
That's such a great point — that they have an option that isn't estrogen-based at all. It's so wonderful to hear that those options exist. I had a great expert on the show, a woman named Tracey Cox, who's written 17 books on sex, including one called Great Sex After 50: How to Age-Proof Your Libido. She said no woman over the age of 40 should be having sex without lube. Lube helps with lubrication, obviously, but as you pointed out, it's not rebuilding your tissues. And taking care of your vaginal health goes beyond even your sexual health, because infections can take root — you can get UTIs, which are one of the biggest reasons women wind up hospitalized in their older years.
Dr. Maria Sophocles (18:07)
That's why we say your sexual health and your vaginal health should be part of your overall health. You shouldn't think, "Well, I'm not having sex right now, or I don't have a partner right now, so it doesn't matter." People forget that the opening to the bladder is in the vagina. So when you make the vagina healthier, you're keeping protective bacteria in the vagina that keep bad bacteria out of the bladder. I tell people it's like sentinels at a guard gate — the healthier you keep the vagina, the less likely pathogenic or bad bacteria are to get up into the bladder.
Katie Fogarty (18:47)
Well, I'm sold — I'm a user of vaginal estrogen, and I've seen it make a difference in my own life. I'm so glad we're having this conversation. Let's move on and ask a bit about orgasm, because obviously you need healthy tissue, but you also need libido — a sex drive that goes beyond the physical tissue. How is libido impacted by menopause, and what can we do if we feel like we've got a low flicker instead of the roaring flame we want?
Dr. Maria Sophocles (19:17)
Right. Unlike physiologically changing the vaginal tissue — which is really straightforward and effective, which is what we just talked about — libido is a more nuanced and complex topic. We know libido is actually a problem for women in every age group. There's a bit of a myth that only menopausal or older women have low sexual desire or anxiety about it. It turns out women in their 20s and 30s also have a lot of anxiety — maybe more — about low libido, because they feel a lot of performance pressure, whereas older women feel less performance pressure. But still, low libido is the single most common sexual complaint of women in midlife. "My libido left the building" — I hear versions of that all day long. And sadly, we don't have a magic wand or a pill. We don't have a "Viagra" that zooms up your libido.
We do have two FDA-approved medications, and both are wonderful steps forward, but imperfect. One is called Addyi — it works in the brain. The full mechanism of how Addyi works isn't fully understood. This was the "little pink pill," our answer to the "little blue pill," Viagra. But Viagra creates penile erection; Addyi doesn't do anything to create a clitoral erection or anything like that — it works in the brain to improve interest in sex. It hasn't had the popularity Viagra has had, partly because women don't want to take a pill every day just to have sex one or two more times a month — the return on investment is hard to sell. Whereas men can take Viagra before sex, on demand, and see clear results.
Katie Fogarty (21:21)
Which motivates them.
Dr. Maria Sophocles (21:24)
Exactly. The other medication is an injection, which turns a lot of people off right then and there. That medication is called Vyleesi, and it releases a huge amount of dopamine from the brain. It lasts about 15 hours. Many of my patients order it before they go on a cruise with their partner, or a weekend getaway. It really does make you want to have sex — you wake up the next morning and you really want to have sex — and then it wears off.
The problem is that this is really just a band-aid, and I think the better bang for your buck is working on how you can increase libido yourself, in your mind and in your life. Start with optimizing the health of your organs — the vagina, the clitoris, the vulva. Make sure everything is well-estrogenized. Use lube if you need it. Get to know your own body. Get comfortable — maybe even comfortable masturbating; not everyone feels they've had permission for that. Then, once you and your invested clinician have made the vagina really healthy, and you can see that you get wet when you're aroused, you have to give yourself permission. This is really important, Katie — I might say it twice.
Katie Fogarty (22:40)
Say it twice.
Dr. Maria Sophocles (22:42)
You don't have to feel desire while you're doing the dishes, or even by the end of your dinner date. Many women don't just come home and think, "God, I'm really dying to have sex." What we know — from a doctor named Dr. Rosemary Basson, who did the research — is that desire can be kindled, or receptive. In other words: let's say your bedroom smells nice, from a candle you associate with sex, and you're wearing a negligee that makes you feel sexy, and your partner looks great because you just went out to dinner and he's wearing a shirt you love. Whatever it is — that makes a tiny spark. You begin kissing, stroking, being mindful of touch, taste, smell — multisensory stuff — and desire can kick in after that. I think this is important because I think women beat themselves up for not having that spontaneous, beginning-of-the-relationship desire, like they're just waiting to rip someone's clothes off. That's okay. That's been waiting a long time.
Katie Fogarty (24:03)
That's hysterical. Yes.
Dr. Maria Sophocles (24:04)
They've been waiting a long time, and they come into my office distressed about it, Katie. Hollywood especially has sold—
Katie Fogarty (24:12)
—people a big old lie, because it looks that way in the movies. People are ripping shirts off, like those bodice-ripper books you used to see on bookstore shelves.
Dr. Maria Sophocles (24:22)
Right. And the truth is men do have more of a zero-to-60 thing — they see a partner take half their clothes off and think, "Correction, I'm ready to go." Whereas we're thinking, "Okay, I've got to fold that shirt nicely, I have to wear it tomorrow." It's hysterical.
Katie Fogarty (24:43)
Right?
Dr. Maria Sophocles (24:43)
Women hate how different the sexes are — they feel like they're wrong, or broken. But you're here to tell them they're not, which is—
Katie Fogarty (24:50)
—why we're having this conversation. I love this. I actually had Dr. Kelly Casperson on the show, and she talked about spontaneous versus receptive desire — I'll link to that episode in the show notes too, because it's another good dive into this idea. It's the same thing: we're not always in a big roaring inferno of lust, but when you have that flicker and, as you said, you engage with it — you stroke, or you feel sexy yourself — then the desire comes. I think that's really important.
Dr. Maria Sophocles (25:20) [Editor's note: mislabeled "Speaker 1" in original transcript]
That's—
Dr. Maria Sophocles (25:21)
—okay. But I'm telling you, maybe 0.001% of women know that or feel that way, and of course that's not in your ninth-grade sex ed class. And frankly, I don't even think it's being talked about at girls' nights and book clubs.
Katie Fogarty (25:40)
Well, we're going to change that.
Dr. Maria Sophocles (25:41)
We're changing that. You and I have to go on a multi-city tour — we'll get Kelly Casperson too.
Katie Fogarty (25:45)
Let's do it. So how do we improve our odds that receptive desire will kick in?
Dr. Maria Sophocles (25:52)
There are two ways. This is going to sound obvious, but I'll say it anyway — one is the appropriate setting: a bedroom free of your cell phone, free of anger, free of resentment. If you had a fight last night, maybe you need to clear the air first. Or if you're annoyed that someone didn't put away the dishes, maybe you need to not have sex tonight — have a talk about that instead, and free yourself up so the bedroom can be for sex and sleep. I used to study under Dr. Ruth, and that was one of the very first things she taught me: the bedroom is for sleep and sex. Maria, she'd say, the bedroom is for sleep and sex — no televisions.
Katie Fogarty (26:38)
Or big piles of unfolded laundry. I may need to clean out my own bedroom — doesn't feel very sexy right now.
Dr. Maria Sophocles (26:44)
I know — mine isn't either. And even the temperature matters — we know that above 70 degrees, most women of a certain age don't sleep as well. So put it around 69 degrees. I'm sure there's a pun in there somewhere, but 67 to 69 degrees can be very conducive.
Katie Fogarty (27:06)
Oh my god, 69 — that's so on the nose.
Dr. Maria Sophocles (27:09)
No distractions — we live in a world with so many distractions. So, appropriate setting is number one. Number two is sexual stimuli — teasing, laughing, hugging, touching, petting, kissing, watching. There's audio erotica — women hate the word "porn," but it's just a term for audio or video content that's arousing to women. I keep an app on my phone called Quinn, and if I have some extra time, I put headphones on, lie in bed, and let someone read me an erotic story. I show it to my patients, because it's right there on my phone, and I tell them, "You have to get an app like this," because we're so busy taking out the trash, walking the dog, prepping for our podcast — we push sex and sexual needs way down the list, somewhere between feeding the goldfish and watering the ficus tree. You have to give it some time.
Katie Fogarty (28:17)
Prime the pump a little.
Dr. Maria Sophocles (28:19)
Right — I don't care whether that works for—
Katie Fogarty (28:22)
—everyone.
Dr. Maria Sophocles (28:22)
Oh my god, yeah, we know this — these are studies, this isn't just me. We know women's brains have a kind of sexual savings account. Why do you think women read beachy trash novels? Whether it's a guy on horseback riding down the beach, or—
Katie Fogarty (28:43)
The hot gardener.
Dr. Maria Sophocles (28:44)
The hot gardener, the billionaire who falls in love with the quiet bookworm librarian — my mom's a librarian.
Katie Fogarty (28:52)
I'm deleting that comment, because librarians rock and they're very sexy. But—
Dr. Maria Sophocles (28:57)
Totally, totally. But whatever your jam is — and first of all, we should talk about the importance of fantasy. Fantasy isn't just for Disney World; it should be in your life. You should have something, or someone, that makes your palms sweat, or gives you that funny feeling where you look around the room to see if anyone can tell what you're thinking about. You need to find that for yourself. Other couples do it together — they watch a movie with erotic content.
Katie Fogarty (29:27)
And it can be steamy — it doesn't have to be porn, it can just be tinged with—
Dr. Maria Sophocles (29:33)
—erotic scenes. Right.
Katie Fogarty (29:35)
That's what I'm picking up from you.
Dr. Maria Sophocles (29:36)
Yeah — or vibrators. If you use one, great, use it by yourself, or use it with your partner as foreplay. If you don't use a vibrator — I mean, come to my office, they're in every exam room, they're everywhere. We're living in interesting times, with the sexual wellness industry exploding. You can look up LELO, L-E-L-O, or Dame, D-A-M-E. There's a lot out there, and it doesn't have to be threatening — it doesn't have to be something that goes in the vagina.
Katie Fogarty (30:06)
I love that. I want to come back to this in a minute — but I love this idea that women have a sexual savings account in their brain, and that if you're loading it up with spicy stories or things that make you feel, as you said, a little sweaty—
Dr. Maria Sophocles (30:21)
Yeah—
Katie Fogarty (30:22)
—you're able to draw on that when you're having your own—
Dr. Maria Sophocles (30:26)
—private or partnered experience. Right — the phenomenon is, if you put your head on your partner's shoulder, male or female, and you're cuddling and being appreciative — "I love you, thank you for walking the dog," whatever it is — that's wonderful, and it's a wonderful part of intimacy. But if you've been reading these sexy stories or watching steamy scenes, it's more likely you'll feel that shoulder — or the chest, or the neck, whatever part is a turn-on for you — as something a little more erotic. I think that's part of it.
Katie Fogarty (31:04)
So these are deposits into the savings account we need to be making. I love that. You mentioned Quinn as one, and I'll put some others in the show notes. Let's segue into sex toys, since you've mentioned a few. I've had other experts on the show talk about the importance of sex toys, for newbies especially. Is there one you recommend? Is there a good way to get started? Tell us about why these matter and how they work — because I know some of them can actually help with blood flow, right? Isn't that part of the idea?
Dr. Maria Sophocles (31:36)
Yeah, that's true. The whole idea is really to normalize sexual pleasure — that pleasure is for you, as a woman. The sex toy industry has exploded. There are toys that look like a penis and can be inserted into the vagina, but I don't think that's a great place to start, because it implies you have to get pleasure from something inserted into your vagina, and you absolutely do not. You can get pleasure from something vibrating on your inner thigh, or the side of your breast, or your arms. Some of the earliest sex toys I helped design, with a Swedish company many years ago, just looked like a little mouse — if it were sitting on your desk, Katie, you wouldn't even know what it was. We designed it that way to take the threatening "penis image" away, so women could just use them. I call it "G-rated stimulation on G-rated parts of the body" — to feel good, and to feel what that feels like. Then you can move that same device to your breasts, which have erectile tissue, or your inner thighs, or your vulva. You don't have to jam something in the vagina and think, "Well, I guess I'd better have an orgasm now." This will be a surprise to no one: most women don't orgasm from penile penetration, they orgasm from clitoral stimulation. And you don't even have to start with a sex toy directly on the clitoris — you can warm up to it.
Katie Fogarty (33:15)
I love this idea of warming up, for people who are new and just want to give it a—
Dr. Maria Sophocles (33:20)
—kind of PG-rated—
Katie Fogarty (33:21)
—whirl, you know.
Dr. Maria Sophocles (33:23)
It's like beginning — maybe while you're listening—
Katie Fogarty (33:25)
—to one of your sexy audio stories.
Dr. Maria Sophocles (33:28)
This is actually why not, right?
Katie Fogarty (33:30)
Why not?
Dr. Maria Sophocles (33:31)
So, look — make some very—
Katie Fogarty (33:33)
—big deposits into your sexual savings account.
Dr. Maria Sophocles (33:37)
Or at least regular ones — literally five minutes as you're falling asleep, listen to a story. Or if you're waiting at the doctor's office and it's totally boring and you're thinking, "I'm so annoyed that I'm waiting," listen to a story then too.
Katie Fogarty (33:52)
That's hysterical — I'm picturing women all over America now, in doctor's offices, giggling, slightly sweaty, looking around. Oh my god, I love it.
Dr. Maria Sophocles (34:07) [Editor's note: preceding word "them" was mislabeled "Speaker 2" in original transcript, restored here as part of Katie's line above]
Some are clitoral massagers, where you're aiming something at the clitoris and sound waves or vibration are stimulating it. There are sex toys that are literally oral sex toys — they mimic oral sex. So if oral sex is your thing, you can buy a toy like the LELO ORA. It's an oral pleasure stimulator — this little tip that slowly goes around and around, and you hold it with a couple of fingers. A very patient—
Katie Fogarty (34:36)
Patient device. How are we spelling LELO?
Dr. Maria Sophocles (34:40)
L-E-L-O — that's the Swedish company I mentioned earlier. And ORA, O-R-A, is the model that simulates oral sex. I mean, who doesn't like that?
Katie Fogarty (34:55)
I'm putting all of these in the show notes. And by the way — DM me if you've given one a whirl. I had someone on years ago, when I first launched the podcast — almost four years ago now — I think it was Tracey Cox, who also talked about sex toys. I was invited to speak at an event, and afterward one of the women in the room came up to me — it was so adorable — and said, "I took your advice and I bought a vibrator." And I was like—
Dr. Maria Sophocles (35:19)
Yay!
Katie Fogarty (35:20)
Get it! I loved that she did it, and I loved that she came up to tell me she was inspired to. So if anyone listening feels inspired, let us know — it's important to spread the word to your girlfriends.
Dr. Maria Sophocles (35:34)
For sure, for sure. And forward the TED Talk, so other people can be like, "Wait a minute—"
Katie Fogarty (35:40)
Now the TED Talk is appointment viewing. Actually, I think this is a great idea — you need to book a ladies' night. It's summer, it's a gorgeous time to hang out with your friends, be outside, have a glass of wine — or whatever you drink, it doesn't have to be wine — and watch the TED Talk with your girlfriends, because you'll leave smarter, more inspired, and feeling—
Dr. Maria Sophocles (35:59)
Some good conversation, for sure. Yeah.
Katie Fogarty (36:01)
—just a sense of agency, too. I think that's a big part of it — recognizing that we have control over keeping our bodies healthy and vibrant, and that vaginal estrogen is one tool among others.
Dr. Maria Sophocles (36:18)
Sure — and fun ones. I have a friend in Australia who hosted a dinner party. She invited 30 women, and they all watched the TED Talk together — they Googled it, watched it at the dinner party, and then discussed it with a lot of wine. They loved it so much they repeated the dinner party with their partners — made all the men watch the TED Talk too. She said the men were actually great about it — "We need to see more of this." It was neat to see. And I was just in Morocco, and a woman there told me she's using my TED Talk as part of her own podcast, to help educate Moroccan women about sex, since they're told never to talk about it. It's interesting — the universality of the desire for sexual agency — but in some countries and societies, it's still deeply repressed.
Katie Fogarty (37:21)
The TED Talk is a great start. Maria, I'm hearing some beautiful wind chimes behind you — are those yours?
Dr. Maria Sophocles (37:27)
I am.
Katie Fogarty (37:28)
I love it, listeners — you're getting the summer vibe.
Dr. Maria Sophocles (37:31)
I am, but I probably should have picked a different room — sorry about that.
Katie Fogarty (37:35)
No, it's super cool, it's fun — nice ambient noise. All right, we're heading into the wrap-up of our show, which I always end with a speed round. For listeners feeling inspired and educated by this conversation — Dr. Sophocles is coming back in a month or so to talk about testosterone therapy and its role in your sexual wellness toolkit. So we're going to do a deeper dive into testosterone in the coming weeks.
Dr. Maria Sophocles (38:06)
Yeah, I left that out on purpose, but it has to be covered.
Katie Fogarty (38:09)
Absolutely — people have been asking me for it. So we're going to do a "testosterone 101" — everything you need to know, the role it plays, and how you can bring it into your sexual wellness toolkit. Stay tuned for part two, but we're wrapping up part one with a speed round — one- to two-word answers, to end on a high-energy note. Let's do this.
Dr. Maria Sophocles (38:35)
Yeah.
Katie Fogarty (38:36)
This is a topic I could talk about again and again.
Dr. Maria Sophocles (38:40)
Sorry — there's so many. Wait, you mean I only get — okay. Non-penis-and-vagina orgasm.
Katie Fogarty (38:52)
Okay, right — non-penetrative orgasms. There are other ways to do it.
Dr. Maria Sophocles (38:56)
Yeah, other ways to do it.
Katie Fogarty (38:57)
I love it. Okay — we talked about sex toys a little bit, and you helped develop some as part of your career. Is there a sex toy or sexual wellness tool you think every woman should have in her toolkit?
Dr. Maria Sophocles (39:10)
I mean, lube for sure. And also the LELO NEA, N-E-A — it looks like a little mouse. It's a personal massager, you can use it anywhere on your body, and it's great for sex, but also just for well-being. Nice, simple little tool.
Katie Fogarty (39:28)
That's going in the show notes as well. You have a phenomenal TED Talk that I'll link to — for people looking for a book, more reading, or even just a website to build out their sexual education toolkit, where would you send them?
Dr. Maria Sophocles (39:43)
There's a book called Faking It — I think it's interesting, because it goes beyond just faking orgasms. It talks about the lies women tell related to sex and reproduction, and what that reveals about how we feel we're supposed to exist in society. It's by Lux Alptraum — L-U-X is her first name, A-L-P-T-R-A-U-M is her last name. I can send you the exact title — it's Faking It: The Lies Women Tell About Sex, and the Truths They Reveal. That came out in 2008. I think that's a good one too.
Katie Fogarty (40:30)
Fascinating.
Dr. Maria Sophocles (40:31)
Yeah, I think that's a good one.
Katie Fogarty (40:36)
All right, perfect — that's going in the show notes. Okay, serious question, I'm dying to hear your answer. You're a practicing doctor, you're CMO of a medical care company — we didn't even get into that — you just did a TED Talk, you're working on a book. You have a lot of plates spinning in the air. What's a lifestyle hack that keeps you sane?
Dr. Maria Sophocles (40:57)
I try to exercise six times a week, and I do that for myself — not just for vanity, but to carve out the time and prove to myself that something for myself matters, before I dig into a day full of meetings, Zoom calls, surgeries, and the crazy mix of my life. I try to do that from seven to eight every morning. I started it — well, I've exercised my whole life, but I really started this routine during COVID, doing a four-mile walk in this beautiful park. I still do that sometimes for fun, but I make sure my exercise routine is set into my calendar, not just something I get to when I get around to it.
Katie Fogarty (41:40)
Yep, such smart advice. I've been doing that over the last several years too — putting the Bikram yoga classes on the calendar, treating them like an appointment, because then it actually gets done. I love that. And listeners will have their own thing, but I think if you start your day giving yourself some time, everything else feels manageable. Okay, finally — your one-word answer to complete this sentence: As I age, I feel—
Dr. Maria Sophocles (42:06)
As I age, I feel free and—
Dr. Maria Sophocles (42:10)
—liberated. And I think that comes, honestly, from being a mother of four kids, and a working mom who had a really high-powered career while raising those kids. I never felt I was worth giving any time or effort to, because I felt so much guilt about trying to have a career and raise my kids. So I feel really free and liberated now. Not that I don't love my kids to death, but it's a great time in our lives, if we can learn to enjoy it. There are scary things too, right — sandwich generation, aging parents, financial things, older-kid problems. But I have a sizzle reel for an upcoming documentary I'm working on, and it includes a great clip from Fleabag, where a middle-aged character is asked, "Well, what's sex like when you get to menopause?" And she says, "Oh, menopause — it's horrendous, and then it's phenomenal." I think we have to embrace the horrendous and the phenomenal — just like life.
Katie Fogarty (43:17)
Yes, absolutely, I love it, I love it. What's horrendous becomes less daunting — I think perimenopause has that rollercoaster quality that's challenging, but when you get through to the other side, working with doctors who get it and taking advantage of the science and tools available to help with what's challenging, you can work on the body stuff, and then, like you said, feel free to explore the interests, the creativity, the time — to make this such a rich phase of life. I love that philosophy. What a perfect note to end on. I've so enjoyed this conversation, and I can't wait for round two. But before we say goodbye, I want to make sure listeners know how to keep track of you, find your TED Talk, and follow your work before you come back for round two.
Dr. Maria Sophocles (44:04)
mariasophoclesmd.com is a website they can go to — they'll also be able to see the book when it comes out, which is called The Bedroom Gap. That'll be next year. I love hearing from women, and I'm so blessed to have connections to women literally all over the world. What's really neat for me, Katie, whether I'm on a podcast or doing radio work, is hearing people say, "I'm calling from the Philippines," or "I'm calling from Morocco," and hearing their experience. The universality of it is stunning.
Katie Fogarty (44:42)
That's such an important point too, because sometimes when we're going through these things, we can feel alone. You mentioned that women don't even share with their closest girlfriends that they're having bladder issues or sex problems — there's a sense of shame around it. But there's so much community out there, so many people in exactly your spot, and when you're willing to share and be vulnerable and open up, you connect yourself to the tools, resources, and support you need to keep thriving. I love that. Thank you so much for coming on — this was a total blast.
Dr. Maria Sophocles (45:18)
I know — you and I need to plan our dinner party.
Katie Fogarty (45:21)
Let's do it — TED Talk-watching dinner party, wine, the whole thing.
Dr. Maria Sophocles (45:26)
That's right, that's right. All right — thank you, Katie, thank you so much.
Katie Fogarty (45:29)
Bye! This wraps A Certain Age, a show for women who are aging without apology. Before I say goodbye — you know my ask: we would love a review over on Apple Podcasts or Spotify. Did you learn something on today's show? Do you feel smarter, more informed, more supported, more seen? If so, please take five minutes to write a short review, and forward this fabulous show to a friend. We need to spread the word, keep our friends in the loop, and help ourselves keep it spicy. I love this episode, and I know your friends will love it too. Special thanks to Michael Mancini, who composed and produced our theme music. See you next time — and until then, age boldly, beauties.
