Episode 61: Why Libido Changes During Menopause

Sex and desire can change in midlife in ways that feel sudden, personal, and isolating. We wanted to pull this topic out of the shadows and put real language around what is actually happening in your body, your brain, and your life. Our guest, Dr. Sarah Berg, is a board-certified OBGYN and certified menopause practitioner known for a direct, honest approach, and she helps us replace shame with clarity.

We dig into why menopause libido changes are rarely “just hormones.” Dr. Berg breaks down the biology that can make sex uncomfortable including vaginal dryness, tissue changes, pH shifts, and urinary symptoms that raise UTI risk or create fear of leakage. We define genitourinary syndrome of menopause (GSM) in plain terms, explain why it affects the vulva, vagina, urethra, and bladder, and talk through how painful sex can create a lasting pain-tension cycle that takes time to unwind. You will also hear why pelvic floor physical therapy can be a game changer for both function and pleasure, and what to expect if you book an evaluation.

We also get practical about treatment options and expectations. Dr. Berg explains where vaginal estrogen fits, why it is different from systemic hormone therapy, and why it matters for comfort and UTI prevention. We cover testosterone as a possible tool for carefully selected cases, plus the real first step many women skip: bringing it up with your clinician and asking for time to address sexual health properly. If you are carrying the mental load, running on no sleep, or caring for everyone but yourself, we talk about that too because desire does not thrive in survival mode.

Dr. Sarah Berg is a board-certified OB-GYN and Certified Menopause Practitioner who spent over a decade caring for women across all life stages. After seeing too many women feel dismissed or confused in midlife, she made it her mission to change that through education.

She is the founder of Selfority, a science-based women’s health education platform designed to make menopause information accessible, engaging, and empowering. Dr. Berg writes for Katie Couric Media, Parents.com, and Unbiased Science, and is a national speaker known for her honest, direct, and slightly “spicy” approach to women’s health.

Her work helps women better understand their bodies, advocate for their care, and feel confident navigating the menopause transition.

Website: https://www.selfority.com/

Let’s Talk Menopause Menoposium/ Boston: https://www.eventbrite.com/e/lets-talk-menopause-live-boston-ma-tickets

www.letstalkmenopause.org

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MiDOViA is dedicated to changing the narrative about menopause by educating, raising awareness & supporting women in this stage of life, both at home and in the workplace. Visit midovia.com to learn more.

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