Cathy Saputo on Menopause/Perimenopause and How it Affects Relationships & Sexual Health – Smart Sex, Smart Love

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This week, Joe is joined by Certified Sex Therapist, Cathy Saputo, from Saputo Counseling Services, and they’re chatting about perimenopause, menopause, relationships and sexual intimacy.

Cathy wants people to know that perimenopause and menopause, does not have to be a negative experience. Sure, it can be challenging, especially when we are not informed, but it can be managed! We need to make it less of a taboo subject and more of a health conversation.

Cathy aims to normalize this change of life and talk openly about it! She says this part of a woman’s growth can be sexually satisfying and does not need to be feared. Joe and Cathy talk about what ‘midlife crisis’ can mean to both women, and their partners, how to still be sexually active with the best lubes out there, and everything in-between!

 

This episode is sponsored by LetsGetChecked –  a fast, affordable, and always confidential, at-home male hormone test kit. New LetsGetChecked customers get 20% off by using our special discount code JOE20 at checkout. Go to: www.trylgc.com/joe

 

 

 

 

Find Cathy Saputo at:
Website | Facebook

Speaker 1:

Welcome to smart sex, smart love. We’re talking about sex. It goes beyond the taboos and talking about love goes beyond the honeymoon. I’m Dr Joe Kort. Thanks for tuning in.

Speaker 2:

Hello and welcome back to my listeners. Thank you for joining me again and if this is your first time listening to my show, welcome. Before we start today, I’d like to take a minute to talk to you about a few stats. Did you know that across the globe, men’s healthy sperm counts have dropped by 50% in the last 40 years? Hormonal imbalances and reduce testosterone levels are becoming commonplace in modern male health. One in four men over 30 are low in testosterone and have a hormonal imbalance. Symptoms of hormonal imbalances may include low energy or fatigue, erectile dysfunction, low sex drive, anxiety and brain fog. But there’s a solution. Let me introduce you to our sponsors of this episode. Let’s get checked. A company with a mission to make professional healthy testing easily available. They’re fast, affordable, and always confidential. At-home male hormone test kits help you to take a measured approach to your health from the comfort of your own home.

Speaker 2:

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Speaker 2:

Women do too. This week, I’m joined by licensed professional counselor and Assect certified sex therapist, Cathy Saputo. And we’ll be talking about the menopause and perimenopause and how it affects women’s sexual health and relationships. Kathy wants people with ovaries to know that perimenopause and menopause does not have to be a negative experience. Sure. It can be challenging, especially when we’re not informed, but it can be managed. She says we need to make it less of a taboo subject and more of a health conversation. Two thirds of women’s life is spent post-menopause, half the population that the other half is impacted by it and it remains a taboo subject. Let’s make menopause more of an everyday conversation and we’re stunning with you. Kathy, welcome to the show.

Speaker 3:

Thank you for having me. It was, Oh, you did. You’d set it right. And um, there’s, uh, the only other Saputo do I really know is Saputo cheese, I think out of Canada. So it’s not really popular here, but it’s, um, my husband calls it the Smith of Italy.

Speaker 2:

Well, I can’t believe I’ve known you all these years and I’ve seen it written. I’ve written it out and everything, but I’ve never said your name full name out loud, but I’m glad I did.

Speaker 3:

Yeah, you did it well it was interesting to hear that, um, you were talking about male hormones as you transitioned into this conversation today because it was serendipitous I think because we are going to be talking about um, the female hormones.

Speaker 2:

Yes. And I’m so glad and I know that men are going to be listening to this too. I actually hope they do or their female partners will have them. Could you describe the difference before we get started with menopause and perimenopause?

Speaker 3:

Sure. And that’s actually something I really did want to make sure I talked about. So we often hear, I’m going through menopause, but actually we’re going through perimenopause. Perimenopause is actually the stage leading up to menopause. Menopause is actually only one day in your life. It is the day that follows 12 months of no menstruation. So once we know we’re in menopause or post-menopause, we’ve not had a period for 12 months leading up to that. All the hormonal fluctuations that are occurring are actually the perimenopause stage, and that stage can start as early as in our thirties and it can also be induced by medications or surgical procedures that might affect our ovaries. But today, you know, we’re primarily going to be talking about natural, the natural progression as we grow older.

Speaker 2:

Great. No, that’s really helpful because maybe even some women don’t know the difference. Have you, have you noticed that in your own practice?

Speaker 3:

I’ve definitely noticed that we talk a lot about being in menopause or going through it. We don’t really talk about perimenopause, so that’s part of what I want to talk about is, is just that this is kind of cloaked in some mystery. Sometimes people don’t realize that this can start earlier than they’re thinking and they don’t associate then all the changes that are happening in their lives. With this actually being this transitional period?

Speaker 2:

No, this is going to sound so strange, but I’m 57 and my first exposure to menopause was watching this show called mod, which was beach features at be Arthur’s first show, and I remember her going through it. I didn’t really know what it was. I was like 13 years old, but I remember taking a comb and putting it under her nose for a mustache and crying in front of Walter saying, we’re going to have matching mustaches.

Speaker 3:

Oh my goodness.

Speaker 2:

Is that still a common worry that women day have? But it’s going to,

Speaker 3:

well, right. Part of what’s going on in this phase of the hormone fluctuation is that our testosterone is fluctuating as well as the progesterone and the estrogen. The estrogen is the big thing that’s happening. It’s, it’s lowering during this phase and so testosterone might fluctuate up and down, but a lot of changes happen. So one of the changes that could happen for some people is the hair loss or hair in places that we weren’t expecting to see it before. So when she maybe held that comb up and said, Oh my gosh, here’s what’s going on, I’m growing hair in places I wasn’t expecting. That’s, that’s maybe what she was talking about. I love mod.

Speaker 2:

I do too. That one’s in the beginning, wasn’t it before a golden girls. So, um, can you say, what age does perimenopause usually start for women?

Speaker 3:

So it can start as early as our mid thirties. Lots of times it follows pregnancy. Um, but it can also, like I say, be induced by some medical procedures, um, if that’s the case or even cancer treatments or other kinds of medication. But generally if it’s just a, a natural occurrence, it can be as early as our thirties. So it’s, it’s probably not the timeframe most of us are thinking about. We’re thinking this only kind of happens for older women and I don’t know about you, but I definitely don’t want to say somebody in their thirties or forties or even fifties is really an older person at this point. Um, so I think there’s a misnomer that it’s happening to the older people and so I don’t have to worry about it.

Speaker 2:

Yeah. And, and I also know, and I’ve, I’ve seen women in my family this way, they can be into their fifties still having menstruation.

Speaker 3:

Right? I mean, it’s absolutely right. The average age, that menopause that, that, that final day and then into post-menopause occurs is 51 in the U S um, so it is, um, you know, a lot of leading up to that can be like eight to 10 years.

Speaker 2:

Yeah. And I know a lot of people are listening to my show and want to hear how it affects, you know, not their relationship, but also their sexual relationship. So maybe you could start with how does it affect relationships?

Speaker 3:

Sure. Well, relationships are affected because what I hear a lot of people say, um, is that they weren’t expecting these changes to be happening. They didn’t know what was going on. They didn’t know what was going to happen. So early there were a lot of changes. They weren’t associating to this part of their life. So for example, um, like we just talked about the hair changes. Um, it might be just feeling like not themselves is really what I get the most is I don’t know what’s happened. I don’t feel like myself. I don’t feel safe in my own skin. I don’t feel the same type of sexual ways I felt in the past. My body’s not responding in the ways I want it to. Um, and then that insecurity, that lack of confidence impairs the relationship because a once confident person in their body who could express to their partner, you know, what wanted, what was working, what felt good, that’s all changed. And they don’t even know what’s feeling good for them. They don’t even know what’s happening, let alone being able to convey that to their partner. So it’s that real feeling of something’s gone on, something’s changed. I don’t know how to kind of put my finger on it.

Speaker 2:

It’s gotta be so hard for people, you know, to be able to recognize that or even a partner to be able to recognize that.

Speaker 3:

Absolutely. So I definitely want to acknowledge that the partners could be a male partner, a female partner, you know, whoever their partner is. Um, they just might not be expecting it and they might not know really what to do in response. Um, you know, the first thing I always say is don’t try to solve the problem. Just try to hear about the problem. Be a really good listener at this point and get educated because again, that person is going through this phase, doesn’t really understand what’s going on. Either they’re not going to be able to necessarily tell you. And that can be frustrating on both sides.

Speaker 2:

So how can a partner even ask? Because I know a lot of male partners in the couples I work with, mixed sex couples or men I work with say I don’t know how to ask or even, uh, alluded to the fact that might be this because it makes her upset, you know, like, um, she’d been reduced to just that in the Kansas city. Her mood. Do you have any advice for the men?

Speaker 3:

Right. So that’s, that’s something that, you know, even the word menopause, right? It’s still kind of this taboo word. Um, it’s kind of like sex therapist when I introduce myself and I say I’m a sex therapist, either you walk towards me and want to know more or more often than not, people lean back from me and kind of walk away. Um, so I kinda, you know, it’s kinda the same way with the menopause. If you say menopause, you get a little bit of the people that are kind of like, Ooh, curious. I want to know more. But more often than not, it’s kind of like the conversation ends. People move away. They don’t really know what to say or what to talk about. Or, you know, it’s, it’s a very uncomfortable word still. And that’s why I want to talk about it more. Um, so first off, like I said, um, for the partner, try to listen more than to fix, fix the other person, try to hear from them what are they going through and then approach it in a way of curiosity. Could this be what’s going on for you? You know, tell me more about how this experience is, this seems familiar. Maybe we can do some research together. Could it be that this is what’s affecting you, your hormones? Join up with them, maybe in an office visit to a physician to, you know, understand better what’s happening and be their ally versus their adversary that, you know, again, wants to maybe pull away and not have the conversation.

Speaker 2:

I really liked that and I think that’s true for anything in couples, right? Just sitting with curiosity and empathy because this is something confusing, a woman that’s going through. But also I would, would you also add, you know, say it in the middle of a reactive fight. You know, that’s what people end up doing. That the problem or part of the problem?

Speaker 3:

Well, absolutely. So I always say try to respond rather than to react. Go from a place of, you know, pausing, um, no pun intended. Um, pausing to think about what’s really going on here and how do I want to come across to support my partner and check your own attitude as a partner. Check your attitude about what does this phase mean to you, what have you heard about it? Why is the reaction maybe coming up for you rather than a response? Look to find ways that you can be more satisfied in the relationship and not so much make the partner responsible for that. Because again, this is a difficult time to navigate for both of you. Um, but, but you know, again, partner up in that and not work against each other.

Speaker 2:

It’s really, really good advice. I really like what you’re saying. You said earlier that it robs you of your libido. Could you say more about like why?

Speaker 3:

Yeah, so sure. So, so estrogen during this time is, is decreasing or fluctuating. So again, remember this can happen over a period of like eight to 10 years that these hormones are shifting. Um, so it’s not necessarily like one day where my, my libido’s low and it’s never going to come back. It’s just that it’s kind of up and down with a lot of other things that are happening. Um, so that lower estrogen level, um, mixed in with that testosterone going up and down can really affect the libido. Um, additionally, what can end up happening is that with the low estrogen, it really affects lubrication and moisture within the vaginal canal and the vulva area. So pain can sometimes come up and then the cycle of kind of fearing the pain that can occur during sexual interactions can then lead to anxiety, fear pulling back, um, and then a decrease desire for engaging in those sexual interactions. So it’s not just that the libido hormonally is, is going lower, but it’s that fear of maybe this is going to hurt, it’s going to be uncomfortable. I might be in pain. And who wants to go towards something that’s painful,

Speaker 2:

right? In the men have talked about how it makes them afraid they don’t want to hurt her and then they begin to have erectile dysfunction because you know, they’re not aroused anymore. They don’t want it. They’re more concerned about her pain than, than the arousal state. So it works both ways.

Speaker 3:

Absolutely. So I do hear that. So it’s, it’s hard to have those conversations and know how to navigate around the pain. And then like you said, the partner is kind of on standby going like, does this hurt? Is this okay? Maybe I don’t want to see you in pain. They pull back. Um, so again, it goes back to that, you know, really important piece of it, which is communication, which is the, which is seeking to understand and, and have some education.

Speaker 2:

You know, a lot of this reminds me of the show we did with Joan Price. You know, she does those sets after 50 and she just so totally normalizes and we just don’t do that in our culture because we don’t talk about a little bit people. Just that our bodies are going to change. Even, you know, men’s erections don’t go, don’t happen as quickly or or at all as they used to. And women going through what we’re talking about today in terms of menopause. It’s just how do you adapt to the new normal without pathologizing either partner.

Speaker 3:

Absolutely. And I did listen to that podcast with Joan and I loved that. I loved her approach to it. Um, so you know, another thing, um, related to that is thinking again about that responsive desire model that is, is more familiar with women is that we’re not necessarily the spontaneous desire, um, group. Um, oftentimes we respond sexually after we sort of get started. So it may take a little bit longer foreplay. It may take discussing, um, you know, what other turn-ons could be there throughout the week. Um, to kind of start the conversation around intimacy, to let each other know I’m here for you and I’m excited about you and I want to be with you. That can start all week long. And then in addition, the physical touch, the caressing, the, um, you know, nurturing that foreplay before to then have more of a responsive desire for the sexual interactions rather than this spontaneous thing that’s going to happen out of nowhere because less, if that’s way less likely to occur.

Speaker 2:

Yeah, no, that makes total sense. Um, what, what are the common things like in your office? But I think the most common thing I hear from the women is that the dryness and, um, they want to know what do I, what can I do? The men don’t know how to make, you know, help them with lubrication. What do you recommend?

Speaker 3:

Sure. So again, that’s a conversation that, you know, it was really important and it’s not talked about because there’s this kind of myth that all of us should be served as ready for sex at any given time. If we start to talk about it or we see a picture or we’re watching pornography or you know, we’re flirting with each other that, okay, then now we’re ready to go. And it’s just not the case. And that’s not even the case amongst really any of us at any time, but it’s even more important to think about this. As you know, we’re in this perimenopause place where the, again, estrogen level affects moisture, it affects lubrication and it’s not a bad thing to add lube add moisturizer to the equation. Moisturizer is something that the woman would use daily herself. Um, just moisture. It’s just like my stretching your face.

Speaker 3:

You know, your face is going to get dry during this period. Your skin is going to be dry all along your whole body and you’re going to put on moisturizer and in the vulva area you need moisturizer too. And then with lubrication, try all sorts of different lubrications out. Um, you know, there’s so many different ones on the market, so look for one that works for you. If you’re going to be using condoms, then you do want to make sure that, um, you’re not using something that’s going to degrade a condom. But otherwise, you know, experiment with the lubes. There’s ones that have flavors, there’s ones that smell different ways, there’s, you know, really slippery ones. And then there’s ones that, you know, aren’t a slick, so it just depends on the two of you, but, or three of you or whoever’s involved, um, you know, test it out, give it a try and don’t be ashamed of it because it’s perfectly normal that we might need to moisturize on boob at this time.

Speaker 2:

I’m so glad you brought up the, uh, not to degrade the, um, the condom because a lot of people don’t know that even today. You know, I, I remember learning that even before I was a sex therapist, maybe because I’m male, you know. Um, but, uh, so how would they know that? Like what would you tell people to do to know that whether it’s going to degrade the condom or not?

Speaker 3:

Um, so you want to look for like more of a water based lubrication is always probably your best bet. And it’s also usually much less irritating for most of us since, you know, most of us are, um, uh, what we are all humans made out of waters ourselves. So, um, the water based lubricants probably are your best bet.

Speaker 2:

Oh, that’s a really good way to say it so that people can remember that because, uh, I just know a lot of people get confused about it and then they get online and they’re like, you know, is this a good product? Is that a good product? How do I trust it? How do they know? Do you have ideas of where people can go that are, that are legitimate places?

Speaker 3:

I’m sure. So you might go online. Um, there’s menopause.org is, is a site just from the national menopause association and they talk a lot about, um, different ways to manage perimenopausal symptoms. So that might be a good resource to look at. Um, you want to also stay away from, like, a lot of people might try like natural lubricants that they have at their home. I mean, I’ve heard from like coconut oil, olive oil, you know, different things at home. I don’t necessarily recommend those. Um, just because, you know, I don’t know how much you’re using, I don’t really know what you’re using and, and I’d rather say, you know, go to something that, um, we can really count on. That’s, that’s been tested and you know, kind of FDA approved. And again, those water based ones. And I would stay away from any that have glycerin in it. Glycerin is really like a sugary, you know, stickier substance and sometimes those are really kind of, they dry out and then um, they can be really irritating and then cause other, other problems in the vulva area.

Speaker 2:

I’m th this has to be so informational for people because this is not easily accessed information, especially like you say, it’s a taboo topic to be talking about. Um, w w when you, when women are going through this, how do they know, like what are some of the signs or symptoms that it’s actually happening to them?

Speaker 3:

Yeah, so like I said, um, you know, one of the things, first and foremost, it’s just kind of the complaint of I just don’t feel like myself, you know, I know my body is not reacting as it usually does kind of what’s going on. So that’s kind of maybe the first kind of feeling or presentation I get from clients. Um, but again, like we talked about, it might be that our arousal or desire for sexual intimacy is fluctuating. You know, it just doesn’t feel like it’s showing up in the same ways as before. So that could be a sign. Um, a lot of changes happen and, or potentially that can happen. So, you know, not all of these will happen for everyone, but things like breast fullness will decrease the skin changes happen all over our body. So it’s more dry feeling. We have a less elastic city and this is, you know, everywhere on our body.

Speaker 3:

Um, so we start to hear about like saggy skin sensitive skin, um, more breakouts. You know, it’s kind of like we’re back to that puberty stage cause again, those hormones are fluctuating and changing. So we’re, we’re re-experiencing some of those things that we thought we left behind. Um, we’ve got that hair change possibility, you know, on all over, like the hair on top of her head might be thinning. So we might notice more hairs coming out in the shower. We might have facial hair showing up in, you know, more than it ever has. We can have weight fluctuations, heart issues can come up during this time. Our joints and our bones can be affected. I mean the list goes on and on. There’s so many different things that can be happening and they can all be part of this paramedic pause phase. You know, they don’t have to be, they aren’t necessarily like a heart issue might be something separate that we want to rule out but, but it definitely can be affected because I’m listening to this, I’m imagining as a therapist you’re having to help navigate the fear. This sounds scary to me. Make me afraid.

Speaker 3:

It is scary. And you know, one of the other things I hear about is a lot of people are presenting with what they call kind of like a brain fog. So that cognitive impairment that that can happen where they, you know, it’s not just about like lose track of somebodies name. Right. We all kind of experienced that. Or we walk into a room and we go, what did I come in here for? Um, but you know, absolutely. But you know, it goes beyond that though. It’s like they’re having impairments at work, like they can’t concentrate as much. Um, they’re having difficulty, um, just kind of with their thoughts, you know, not necessarily wandering or just difficulty in conveying what they really want to say and how they can express themselves. Um, so that’s scary and, and that, you know, maybe things we might think that, Oh, I mean I’m going through, um, maybe is this early dementia, am I having some kind of bigger, you know, neurological issues. Um, so I definitely recommend if people are concerned and they’re starting to worry about those things, rule out some of these things with, with competent physicians. You know, don’t be afraid to go to a doctor and say, look, I know this is probably this perimenopause thing, but I want to rule out a heart condition. I want to rule out a neurological condition that will alleviate some of the fear.

Speaker 2:

Yeah, that’s good advice. What would you say are the top three things that women can do to feel better about themselves during menopause?

Speaker 3:

Yeah, so I think definitely get support and that support can come in a manner of many different ways. Get an ally physician that you really can trust and who’s competent in this area and the education, um, with regular practitioners, you know, may not be there as much as, and it’s not really something a lot of practitioners focus on. So make sure you do your research. Again, you can do some research@thatmenopause.org site to find out who’s been really specialized in menopause, but, but get educated, get an ally. Um, the other allies might be coming from friends, you know, friends that might have gone through this a support group. Um, it might be talking with, you know, the people that have come before you and your family that have gone through this transitional period and hearing what their experience was kind of just again, to normalize it and know that, you know, you’re not alone in this. Um, also just to find some acceptance, this part of your life does not need to be a negative experience. So find some acceptance that this is just something you’re going to transition through it. Much like puberty. Again, it’s a phase. It’s, it’s supposed to happen, you know, it’s a natural occurrence. Um, find some acceptance and some compassion for yourself through it. I think that’s really important is to cultivate up compassion.

Speaker 2:

You know what, I wish, um, it’s kinda not, it’s a part of what you’re saying, but it’s, it’s not so, um, a lot of younger men are really attracted to older women. Right. Even throughout menopause and there they find, you know, they call the MILFs whatever they call them, right? They’re, they’re, they’re very attracted to them. But most of the women I talked to say, but I don’t, that doesn’t make me feel sexy because I’m not attracted back to them. And sometimes I feel sad about that because in the gay male community, the younger guys, like the older guys like me, they would call me like a daddy. And it makes me feel sexy. It makes me feel like I’m still vibrant at my age. Why do you think women can’t feel that way? I mean, I guess it doesn’t have to just be from a younger guy, but what happens that they start to, I mean, you’ve already explained so many things that their bodies go through, but it just, it’s, it makes me sad. They can still feel sexy even when a younger guy is looking at them going, you are a sexist.

Speaker 3:

Yeah. I think that’s again, kind of about like attitude about this part of our lives. I mean, you know, still in our society like it or not age is a factor of kind of how we view beauty and, and you know, sexual, um, longevity and, um, sex appeal, you know? So I think there’s still kind of is driven by that, that the message is that once you kind of age out, you’re, you’re not that sexy. You’re not that interesting. You know, you’re not that appealing. And so we still buy into that even though it’s absolutely not the case. Um, so, you know, how would you kind of beat that on our own and, and really embrace this part of ourselves is, you know, we could do some more self exploration with our own bodies, really get to know our bodies. You know, it has, it has maybe changed and it’s not acting in the ways that it used to, but what are some of the other really wonderful things about this phase? I mean, one thing some people cite is that it’s much less risk of pregnancy and that’s really freeing for a lot of us. It’s like, okay, great. I’m not, don’t have to approach sex with a fear of pregnancy. I can approach it now from a place of pleasure and just sheer enjoyment. So it’s really about kind of how we’re looking at it and look at it through that positive lens rather than that negative lens.

Speaker 2:

I love it. Um, how can people find you, Kathy, if they want to know more, learn more, or maybe even work with you?

Speaker 3:

Sure. So, um, I have my, uh, website, which is the poodle, counseling.com and then Michigan sex therapy is my Instagram. And I’m on Facebook at the poodle counseling.

Speaker 2:

This has been a great conversation. I really appreciate it. It’s, it feels to me like a continuation of changing it from like what you say, a taboo subject to more of a health conversation. Thanks so much, Kathy, for being my guest and to everyone listening, and I’d like to also think our sponsors of this episode. Let’s get checked for 20% off your male hormone and home test tickets. Go to T, R Y L G c.com, forward slash Joe, that’s T R Y L G c.com, forward slash Joe and use the code in the shopping cart, Joe 20 at checkout. Remember, this isn’t just for men who think they’re in a funk, all mentioned be tested, um, testing their levels on a regular basis. I’m testing mine tonight and don’t forget to follow me on Instagram and Twitter at dr Joe court and please rate, review and subscribe to my podcast until next week. I’ll see you next time.

Speaker 1:

Thanks for listening to this episode of smart sex smart love. I’m dr Joe court and you can find me on Joe kort.com that’s J O E K O R t.com. See you next time.

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