Treating weakness: Kegels and physical therapy

Dr. Rena Malik, board-certified urologist and sexual medicine expert, has the most frank conversation about female sexual health you'll hear anywhere. She covers pelvic floor dysfunction (incontinence affects 1 in 3 women), the genital urinary syndrome of menopause (80% of women will experience changes), and the orgasm gap—plus why same-sex couples don't have this problem. Dr. Malik breaks down low desire in midlife with actual treatment options, explains responsive vs. spontaneous desire, and tackles the hard conversations about pornography's impact on our kids. Whether you're dealing with changes yourself or supporting someone who is, this episode removes the shame and gives you actionable solutions for better sexual and pelvic health.

Episode Overview (timestamps are approximate):
(0:00) Intro/Teaser
(4:00) Pelvic Floor 101: Anatomy and Function
(8:00) Urinary Incontinence
(14:00) Tight Pelvic Floor & Pelvic Floor Dysfunction
(18:00) Strengthening Weak Pelvic Floor
(21:00) Pelvic Organ Prolapse (POP)
(29:00) Menopause & Genito-Urinary Changes
(33:00) Female Arousal & Clitoral Anatomy
(37:00) Responsive Desire & Maintaining Sexual Connection
(44:00) The Orgasm Gap
(49:00) Pornography & Realistic Expectations
(55:00) Pornography Use & Sexual Function
(1:00:00) Types of Orgasms
(1:03:00) Semen Retention & Orgasm Frequency
(1:08:00) Low Desire in Women
(1:16:00) Arousal vs. Desire
(1:19:00) UTIs & Bladder Health
(1:23:00) BONUS: After-Party with Dr. Stephanie

Resources mentioned in this episode can be found at https://drstephanieestima.com/podcasts/ep447

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P.S. When you're ready, here are two ways Dr. Stephanie can help you:

Subscribe: The Mini Pause — My weekly newsletter packed with the most actionable, evidence-based tools for women 40+ to thrive in midlife.

Build Muscle: LIFT — My progressive strength training program designed for women in midlife. Form-focused, joint-friendly, and built for real results.

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