343. Sex Therapy in Midlife

22 snips

Nov 9, 2025

In a vibrant discussion, Dr. Rachel Boyle, a marriage and family therapist and certified sex therapist, dives into women's sexual health, focusing on perimenopause and menopause. She shares how hormonal changes affect desire and the importance of communication in relationships. Dr. Boyle discusses the transformative power of EMDR for trauma and debunks myths about women's sexual interest. The conversation emphasizes the need for qualified therapists, as well as the significance of creating safe spaces for women to explore their desires.

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INSIGHT

Midlife Can Be An Opportunity, Not Decline

Reframing midlife as an opportunity rather than a decline shifts outcomes and motivation.
Normalizing perimenopause like puberty or childbirth reduces shame and opens treatment.

ADVICE

Consider Hormones As Part Of Treatment

Consider hormones (including testosterone) for perimenopause-related anxiety, depression, pain, and libido issues after informed evaluation.
Hormone treatment can restore sleep, reduce aches, and improve sexual receptivity for many women.

INSIGHT

Sleep Is Crucial For Trauma Work

Sleep and REM are essential to memory processing and trauma recovery; insomnia undermines therapy effectiveness.
Improving sleep is a prerequisite for successful EMDR and mental-health treatment.

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In this episode of the You Are Not Broken podcast, Dr. Kelly Casperson speaks with Dr. Rachel Boyle, a sex therapist specializing in perimenopause and menopause.

They explore the complexities of women's sexual health, the impact of hormonal changes, and the importance of communication in relationships. Dr. Boyle shares her journey into understanding perimenopause, the effectiveness of EMDR therapy for trauma, and the cultural pressures women face regarding their bodies and sexuality.

The conversation emphasizes the need for qualified therapists and the significance of creating safe spaces for women to explore their desires and experiences.

Takeaways

Low libido can be a message rather than a problem.
Healing trauma doesn't require reliving it, but releasing it.
Perimenopause can last for many years, affecting women's health.
EMDR therapy helps process traumatic memories effectively.
Women often bear the emotional labor in relationships, leading to stress.
Communication about sex is crucial for healthy relationships.
Desire for sex can be influenced by hormonal changes and emotional safety.
Cultural attitudes towards women's bodies impact their sexual health.
Consensual non-monogamy requires clear communication and boundaries.
Therapists should be trained in women's sexual health issues.

https://www.rachelboyle.com/

To my fellow clinicians: listen to this podcast on ⁠⁠⁠Pinnacle for FREE to earn CME credit⁠⁠⁠

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Thanks to our sponsor ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Midi Women's Health⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠. Designed by midlife experts, delivered by experienced clinicians, covered by insurance.Midi is the first virtual care clinic made exclusively for women 40+. Evidence-based treatments. Personalized midlife care.⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.joinmidi.com

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