Things You Learn in Therapy

Ep 142: Hormone Havoc and Honey, We Need to Talk with Brooke Bralove


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The silence around menopause and sexuality in midlife is finally breaking. Sex therapist Brooke Bralove returns to the podcast for a candid, informative conversation about what women really experience during perimenopause and menopause—and why suffering should never be the default option.

Brooke reveals that even as medical understanding evolves, many healthcare providers remain woefully undereducated about treating menopausal symptoms. Most OBGYNs receive just hours of training on menopause management throughout their entire medical education. This knowledge gap leaves countless women struggling with hot flashes, painful sex, mood swings, joint pain, and fatigue without proper support or treatment.

The conversation dives deep into how hormone replacement therapy (HRT) has been misunderstood and unfairly maligned. Contrary to outdated beliefs, many forms of HRT are safe and effective for managing symptoms that significantly impact quality of life. Brooke encourages listeners to seek out menopause-educated providers who understand current research rather than accepting outdated "it's just part of aging" dismissals.

Beyond the physical aspects, we explore how menopause affects relationships and sexual satisfaction. Many couples who've been together for decades have never had honest conversations about their sexual needs. Brooke offers practical strategies for breaking through shame and initiating these difficult discussions, including "walk and talk" conversations and sexual activity lists that help partners express preferences without direct confrontation.

For women experiencing painful intercourse—a common menopausal symptom—the message is clear: stop. Expanding our definition of sex beyond penetration becomes increasingly important as bodies change. As Brooke puts it, "Women in their 40s and 50s are very empowered and want more pleasure. They know they can have it."

Want to learn more about navigating menopause and enhancing intimacy in midlife? Visit About Brooke Bralove | Bethesda, MD or follow @brookebralove_psychotherapy on social media for resources that can help you reclaim pleasure and well-being during this transformative life stage. 

This podcast is meant to be a resource for the general public, as well as fellow therapists/psychologists. It is NOT meant to replace the meaningful work of individual or family therapy. Please seek professional help in your area if you are struggling. #breakthestigma #makewordsmatter #thingsyoulearnintherapy #thingsyoulearnintherapypodcast

If you or someone you know is struggling with mental health concerns, please contact 988 or seek a treatment provider in your area.

If you are a therapist or psychologist and want to be a guest on the show, please complete this form to apply: https://forms.gle/ooy8QirpgL2JSLhP6

Feel free to share your thoughts at www.makewordsmatterforgood.com or email me at [email protected]

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Things You Learn in TherapyBy Beth Trammell PhD, HSPP

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