Where Did My Orgasm Go? Menopause, SSRIs, and the Science of Pleasure with Dr. Lauren Streicher

What happens to your orgasm after menopause? It's something that nearly half of women experience during midlife, but so few are talking about it. In this episode of unPAUSED, Dr. Mary Claire Haver sits down with Dr. Lauren Streicher to discuss exactly what changes to orgasm, libido, and sex, why it happens, and what you need to know if you're struggling.

Dr. Streicher is a professor of Obstetrics and Gynecology at Northwestern University Feinberg School of Medicine, the host of Dr. Streicher's Inside Information Podcast, and the creator of Come Again, a 30-episode audio series on sexuality and sexual function. She's a senior researcher at the Kinsey Institute and one of the true pioneers of sexual medicine, helping to define and legitimize a specialty that for decades simply didn't exist.

Dr. Haver and Dr. Streicher start with the basics: what an orgasm actually is, the anatomy of the clitoris, and why most women cannot have an orgasm from penetrative sex alone. Dr. Streicher explains vaginal orgasms, cervical orgasms, the G spot, and the historical research of Princess Marie Bonaparte, who measured the distance between the clitoris and vaginal opening in 240 women in an effort to understand why she couldn't orgasm during intercourse. They discuss what happens to orgasm and sex post menopause, including the role of blood flow, nerve health, clitoral atrophy, cardiovascular disease, diabetes, and medications, especially SSRIs that can affect both libido and orgasm. Dr. Streicher walks through how genitourinary syndrome of menopause affects the clitoris, why the pelvic floor matters for orgasm, and why so many women have never even seen their own anatomy. They also talk about anorgasmia, the inability to have an orgasm, both primary and acquired, and why this is almost never discussed in medical training.

Guest links:

• Dr. Streicher
  
• Dr. Streicher (Instagram)
  
• COME AGAIN: Sexuality and Orgasm
• Dr. Streicher: Menopause: The Inside Info (Subtack)
  
• Dr. Streicher’s Inside Information: Menopause, Midlife, and More (Apple Podcasts)
• Lauren Streicher - Faculty Profile (Northwestern Medicine)
  
• Dr. Streicher (YouTube)

Books:

• “Slip Sliding Away: Turning Back the Clock on Your Vagina,” by Dr. Lauren Streicher
  
• “Hot Flash Hell-A Gynecologist's Guide to Turning Down the Heat (Dr. Streicher's Inside Information),” by Dr. Lauren Streicher
  
• “The Essential Guide to Hysterectomy: Advice from a Gynecologist on Your Choices Before, During, and After Surgery,” by Dr. Lauren Streicher
  
• “Sex Rx: Hormones, Health, and Your Best Sex Ever,” by Dr. Lauren Streicher
  
• “She Comes First: The Thinking Man's Guide to Pleasuring a Woman,” by Dr. Ian Kerner
  
• “The New Perimenopause,” by Dr. Mary Claire Haver

Subscribe to COME AGAIN: Sexuality and Orgasm DrStreicher.com/comeagain         
Use code UNPAUSED20 for 20% off (This code expires Dec 23)

Gyne Hacks! (Including how to How to Get a Hands-free Free Vulvar View)

Other Resources:

• Kinsey Institute
• International Society for the Study of Women’s Sexual Health 

Articles:

• Sexuality and Reproduction after SCI (American Academy of Physical Medicine and Rehabilitation)
  
• The Elusive Orgasm: Princess Marie Bonaparte, The Halban-Narjani Procedure, And 20th Century Modern Art (The Journal of Urology)
  
• A Natural History of Erectile Dysfunction in Elderly Men: A Population-Based, Twelve-Year Prospective Study (Journal of Clinical Medicine)
  
• “I want to feel like I used to feel”: A qualitative study of causes of low libido in postmenopausal women (Menopause)
  
• Genital vibration for sexual function and enhancement: best practice recommendations for choosing and safely using a vibrator (Sexual and Relationship Therapy)
  
• Prevalence and correlates of female sexual dysfunction and sexual distress in reproductive-aged women: a systematic review and meta-analysis (BMC Women’s Health)