Sexual Health During and After Menopause – How to Boost Your Desire

December 27, 2021



Rebekah Kelley: Welcome to the Humanized podcast, all about personalizing your health. I am your host, Rebekah Kelley, and today we’ll be discussing Sexual Health During and After Menopause, How to Boost Your Desire, with Dr. Anna Cabeca. Before I introduce Dr. Cabeca, I want to remind everyone to subscribe and get all of the variety of casts in audio, video and transcription at I’d also like to thank our lead sponsor, Village Green Apothecary, at

A little bit about Dr. Anna Cabeca. She is a triple board certified and a fellow of gynecology and obstetrics, integrative medicine and anti-aging and regenerative medicine. Nationally known as “the girlfriend doctor,” Dr. Anna is a passionate health advocate for women helping them to truly thrive in body, mind and spirit. She is the author of two highly acclaimed books, creator of several popular virtual transformation programs, creator of several top-selling health products and is a sought-after lecturer throughout the world. We’re so lucky to have her.

Thank you so much, Dr. Anna, for being here.

Anna Cabeca: Thank you for having me. It’s a privilege.

Rebekah Kelley: So very excited to talk about this subject. And I want to bring up the fact that hormones are very sensitive to stress and certainly the ages between 35 and 60 can be very stressful for most women. Right? We’re juggling a lot of things. We’re raising kids. We have careers, we’re taking care of aging parents. Can you talk about how that could influence and put stress on our adrenals, our hormones, and create inflammation in our body, and create kind of a perfect storm, right?

Anna Cabeca: Yeah, I think the perfect storm is us going through perimenopause and menopause and having teenage daughters at home, going through puberty. [Laughs]That’s the perfect storm. It’s a cruel joke. It really shouldn’t occur that way, but it has, and it is for me. So… it’s all good. It’s all good.

And that’s the thing. We have our beautiful reproductive hormones. We’ve got progesterone as this mother hormone – pro-gestational, pro-life hormone. It’s so important for so many things, right? It’s important for our mind. We know progesterone is a neuropeptide. It really works on the brain, on memory, and it’s an anti-inflammatory and a diuretic. That’s why it’s been studied in traumatic brain injury in both men and women. And so it’s a beautiful hormone.

As our hormones are changing, that one thing we need to understand, that progesterone is the precursor hormone to make cortisol. So now, add some stress in there and we are just, we have to make this life-saving hormone cortisol in sacrifice to every other downstream hormone, which way down there is DHEA, estrogen and testosterone.

So, we’re using up our progesterone to make cortisol, to a great degree, then our DHEA and our estrogen and testosterone plummet and this creates fatigue, muscle wasting, rapid aging – I mean, look at every president in the White House over, whenever, and from beginning to end, they really age very rapidly. And so that is cortisol. That is stress. And we know that, now during this time of pandemic, the amount of stress we’re under. And also the increase in hormone problems that we’re seeing now, as well as the feelings of disconnect. Because when cortisol is high, the hormone of love, bonding and connection is low and creates this disconnect, creates this imbalance, this feeling of, I call it the physiology of divorce, if we’re not careful.

Rebekah Kelley: So, if we look at that perfect storm then, what’s happening with our hormones, obviously we’re talking about weight gain. So it’s very easy to not feel very sexy as a woman, right? We’re not used to carrying this extra weight. We can talk about fatigue, discomfort, even lack of sexual desire, right? Because our hormones are shifting down. Are we looking at a sexless future, a sexless marriage moving forward? I mean, that’s just too horrible to contemplate. And if so, what do we do about it, if that’s how we feel?

Anna Cabeca: Yeah. Well, and I think that it speaks to the unspoken-ness of this issue because I think the most read article in the New York Times was the article on the sexless marriage. And it just means a lot of people are suffering in silence. And I think, from working with tens of thousands of women now in my career as a gynecologist and obstetrician and expert in sexual health, one of the things that I’ve realized is that – there’s so many things, oh my God, I know we don’t have a lot of time, but… One thing is that a primary sexual response is masculine, a secondary sexual response is feminine. Because as so many patients would say, you know, Dr. Anna, I just have no sex drive. I don’t initiate sex anymore. What’s wrong with me? And, you know, to be honest, nothing, as long as she says, but once we get started – and I’ve heard this enough times to be like, look, I got to investigate this – but once we get started I’m okay, then I’m turned on. That’s secondary response and that’s normal. That’s physiologic. What we want to build in is some natural primary libido, some primary drive too, on demand.

I had patients that came into my office, a couple, a man and woman, she’d been my patient for a while, and they had come in to me and he said, you know, Dr. Anna, we have a great sex life, but she never wants to initiate sex, and I don’t know what’s going on. And I asked her, she says yeah, I have great orgasms, I just never feel like initiating. So I turned to him and I say, well, what do you do after sex? And he goes, I roll over and go to sleep. I’m like, well, that’s a natural response, but it’s not going to get her wanting more sex. Because while the climax is good, the intimacy and connection, while our oxytocin level – that anti-aging hormone oxytocin, my favorite hormone oxytocin – while that’s high, we need that bonding, that connection, that validation, that feeling valued. We need that time. So give us 2 minutes and it’s good. So I sent him homework. I said, don’t fall asleep for 2 minutes, at least, and just connect, just love on each other. Outside of physical intimacy, this is the time to connect. And by the time they came back in, 2 months later, she goes, I’ve already introduced sex a handful of times, and it’s just so much better. And the other part she said – and we’ve talked about things we haven’t discussed in our 15-year marriage. And so I think that’s the value of intimacy and connection, and some of the things that come in with disconnection.

The second biggest thing that comes into disconnect is vaginal dryness and discomfort. As we age, just like we’re going to get wrinkles here and we’re Botoxing them out and filling them out and whatever, lasering them off, I don’t know – but what’s happening down there is even more important. That’s going to affect your quality of life. And so clitoris-anus, that’s primary real estate. And we have to take care of that. There are 8,000 nerve endings in the clitoris and that’s going to atrophy and shrivel up if we let it. But we don’t have to. And the same thing with vaginal dryness, if you hurt every time you have sex, why would you want to? And because mirror neurons, we have mirror neurons with our partner and he will feel what we’re feeling. He will know what we’re experiencing, whether we voice it or not, it’s subconscious, but it happens.

So the point I want to make is that women are responsible for their own pleasure. We’re designed for pleasure. So allow it be present, achieve your benefit from it. Because I’ve heard so many women say, it hurts, I have discomfort, I don’t climax, I’m powering through for the sake of my marriage. Well, that’s not going to last you.

Rebekah Kelley: So for recognizing that part of life and owning our connection, owning our wellness, owning our sexual intimate relationship, what are some of the steps that we can take to do that? I know that you offer some of that in your book, and I am going to show your cream, for those who can see it [holds up tube of cream]. Maybe you can talk about it. Cause I know sometimes you do need some additional support. Right? And sometimes the things that are out on the market, they actually create more problems, right? Because they don’t actually work well with, downstairs, so to speak, and can actually create urinary issues and other incontinent issues. And so I know you created something that’s really helpful. I’m sure you’ve got some other tips that maybe we might be able to use.

Anna Cabeca: Yeah, so I created Julva for myself and my patients because it is a natural topical cosmetic cream for the vulva. Use it clitoris to anus. You can put some on toilet paper and wipe with it, do it every day. You can put it on, massage, massage it in and massage it in yourself, clitoris to anus, around the vulva, the vagina. And use it as part of sexual play, as well. So the reason I created it with the ingredients I created it with, including DHEA and plant stem cells from the Alpine rose and some emollient oils, that it is designed to help be reparative and help reduce the changes that are happening as we age. And it works amazing. And it feels so good to use it because there’s no chemicals in there. It’s clean and it works. We have thousands of testimonials on our website now. It’s been around since 2016, brought it to market, but I’d been compounding formulas since ’99 with my patients.

So that’s one thing. The second thing is definitely my book, The Hormone Fix. It’s a great resource for our listeners because I have a vaginal health chapter in there. And again, it takes more than hormones to fix our hormones. So, understanding all the things that can disrupt our hormones. And when it comes to vaginal health, gut health is crucially important. And we need those healthy fats. We need to get rid of sugar, too, so we want to have sex more often. Believe me, there’s a whole nother discussion there. But that’s a really big thing.

And the third thing that I offer is I have a program called sexual CPR, a fun, holistic integrative approach to address the many reasons why we have “lost our sexy.” And it’s great for men and women to take that course together.

Rebekah Kelley: Thanks Dr. Anna Cabeca. These are really valuable insights. Dr. Anna Cabeca can be found at That’s Let me remind you to subscribe, to get access to all Humanized videos, podcasts and transcriptions from all of our thought leaders on personalized health at

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