
unPAUSED with Dr. Mary Claire Haver The Sex Life Nobody Warned You About: What a Top Sexual Medicine Expert Wants You To Know
Feb 24, 2026
James Simon, a board-certified OB-GYN, reproductive endocrinologist and sexual counselor, unpacks how sex, desire, pain and intimacy evolve with age. He talks about sexual aging, practical tools to rewrite routines, testosterone and vaginal therapies, pelvic floor issues, male sexual aging and non-intercourse intimacy. Short, clinical wisdom on topics most clinicians never address.
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Treat Male ED Rather Than Blame Partners
- Address male erectile dysfunction proactively and realistically; use PDE5 inhibitors and check testosterone when appropriate.
- Dr. James Simon notes up to ~50% of 50-year-old men and higher percentages with age have ED and medications can restore intercourse feasibility.
Treat Vaginal Pain Before Boosting Desire
- Fix vaginal pain or tissue problems before considering desire-boosting therapies like testosterone.
- Dr. James Simon compares sexual pain to a hot stove — pain suppresses desire and must be treated first.
Testosterone Improves Female Desire And Sexual Self Image
- Testosterone has the strongest, most consistent evidence for improving female sexual desire and related sexual function.
- Dr. James Simon cites ovary-removed women studies and notes improvements in desire, arousal, orgasm, and sexual self-image.


