In this episode of Our Better Half, hosts Dr. Jane Fleishman, Dr. Sabitha Pillai-Friedman, and Dr. Rosara Torrisi welcome Jenifer "JJ" Firestone, a seasoned geriatric social worker and community organizer with a rich history of LGBTQ+ advocacy. JJ shares her journey from coordinating artificial insemination programs in Boston to pioneering a unique family structure where she co-parented her daughter through a landmark 35-page co-parenting legal decision with two fathers. Her extensive career in hospice and her personal experience caring for her own aging parents for six years have culminated in her latest and most ambitious mission: redefining the quality of life as we age.

Now based in Weaverville, North Carolina, JJ is developing a 3.5-acre "mini-farm" model for what she calls Cooperatives for Vigorous Aging (CVA). This self-governing residential arrangement aims to house four to six individuals who wish to age in place with a focus on vibrant, meaningful companionship from "vigorous old age to death." By moving away from traditional senior living residences where rules are often dictated by others, the CVA model empowers residents to maintain autonomy and set their own standards. JJ highlights that while the concept is still in its pioneering stages, it offers a radical alternative for those who want to maintain self-determination in their later years.

The conversation also delves into the significant societal barriers to intentional aging, particularly the deep-seated denial and taboo surrounding the process, which JJ notes is second only to the taboo of sex. She discusses the chutzpah and passion required to be an early adopter of such a model and the difficulty of finding fellow pioneers willing to invest in an unestablished future. Despite these challenges, JJ has found unexpected support from younger generations and has forged deep connections with her new Southern neighbors, regardless of political or religious divides.

Listeners interested in following her progress or joining the cooperative can subscribe to her Substack or reach out via email at [email protected].

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On this episode of Our Better Half, we enjoy an in-depth conversation with Dr. Sarah Girardi, a trailblazing urologist and female sexual health specialist with over 25 years of experience.

Together, we unpack the often-neglected world of older adults' sexual health. Dr. Girardi connects the physical and urological realities of aging to the broader relational and emotional aspects of intimacy, drawing on her extensive clinical background to bust long-standing myths and advocate for the well-being of her patients.

A primary focus of the discussion revolves around the biological realities of aging and the critical importance of proper anatomical education. Dr. Girardi emphasizes that recurrent urinary tract infections (UTIs) in women—regardless of whether they are 20, 60, or 90 years old—are frequently tied to sexual activity, making sexual health history a vital component of standard urological care.

Furthermore, she addresses the widespread misconception that painful sex or a compromised sex life is just an inevitable part of growing older that women must accept. Through her practice, Dr. Girardi uses direct, empathetic tools—like using a mirror during exams—to help women understand their own changing bodies and reclaim their sexual vitality. She notes that while physical intimacy changes over time, a lack of compliance from one's anatomy doesn't mean intimacy has to end; rather, partners can discover new ways to pleasure each other beyond standard penetration.

The episode also highlights major medical milestones and clarifies the science behind female sexual health treatments. Dr. Girardi discusses the historic November 10, 2025, FDA announcement that officially removed the decades-old black box warning on topical vaginal estrogen, a decision rooted in safety data reviewed during an intensive hearing in September of that year.

She explains that topical vaginal estrogen is not absorbed systemically, but instead safely restores a low pH and healthy lactobacillus to the vaginal ecosystem, serving as a powerful defense against life-threatening conditions like urosepsis in older women.

Shifting the conversation to non-hormonal desire medications like flibanserin, Dr. Girardi clarifies the public discourse surrounding the "Female Viagra" misnomer. She notes that while Viagra works on a purely physical level by maintaining blood flow to an erection, female arousal and desire operate through complex neural pathways in the brain.

Ultimately, Dr. Girardi urges both patients and practitioners to reject a compromised quality of life, navigate past historical fears like the 2002 Women's Health Initiative study, and embrace the healthcare solutions women rightfully deserve.

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Our guests this week are two accomplished sexuality professionals – Ms. Sue Goldstein and Dr. Irwin Goldstein.

Sue and Irwin Goldstein have been titans in the field of sexology for some time now; they were there on May 14, 1998 when the first article on sildenafil (Viagra) was published with Irwin Goldstein as the first author.

Ms. Sue Goldstein, a graduate of Brown University, is Sexuality Educator and Clinical Research Manager at San Diego Sexual Medicine (SDSM), responsible for sexual medicine educational programming and clinical research. She works with the SDSM team to develop clinical research projects, write protocols and oversee clinical trials. Ms. Goldstein co-authored When Sex Isn't Good to provide education and empowerment to women with sexual dysfunction. She is an associate editor of Textbook of Female Sexual Function and Dysfunction, and Female Sexual Pain Disorders, and author of multiple peer reviewed papers. Ms. Goldstein is past president of the International Society for the Study of Women's Sexual Health (ISSWSH). She served on committees in the International Society for Sexual Medicine (ISSM) and Sexual Medicine Society of North America (SMSNA). She is also a member of the American Association of Sex Educators, Counselors and Therapists (AASECT), the Association of Clinical Research Professionals (ACRP) and the International Society for Medical Shockwave Therapy. Ms. Goldstein, an ISSWSH Fellow, received the Distinguished Service Award from ISSWSH in 2017 as well as from SMSNA in 2017, and along with her husband, the Transformatory Team Award from ISSM in 2024.

Dr. Irwin Goldstein has been involved with sexual dysfunction research since the late 1970s. He has authored more than 380 publications as well as multiple book chapters and edited 7 textbooks in the field. His interests include surgery for dyspareunia, sexual health management post cancer treatment, persistent genital arousal disorder/genital dysesthesia, physiologic investigation of sexual function, and diagnosis and treatment of sexual dysfunction in all genders. Dr. Goldstein is Director of Sexual Medicine at University of California San Diego East Campus, and sees patients in his private practice, San Diego Sexual Medicine. He is a Clinical Professor of Urology and Voluntary Clinical Professor of Obstetrics, Gynecology, & Reproductive Sciences at University of California San Diego. He is past Editor-in-Chief of the International Journal of Impotence Research, The Journal of Sexual Medicine, and Sexual Medicine Reviews. He is Past President of the International Society for the Study of Women's Sexual Health (ISSWSH) and the Sexual Medicine Society of North America (SMSNA). He holds a degree in engineering from Brown University and received his medical degree from McGill University. The World Association for Sexual Health awarded the Gold Medal to Dr. Goldstein in 2009 in recognition of his lifelong contributions to the field, in 2012 he received the ISSWSH Award for Distinguished Service in Women's Sexual Health, in 2013 he received the Lifetime Achievement Award from the SMSNA, and in 2014 he received the Lifetime Achievement Award from the International Society for Sexual Medicine (ISSM). He is happily married to his college sweetheart Sue, and together they have three children and five grandchildren.

Listeners, if you would like to reach out to Ms. Sue Goldstein and/or Dr. Irwin Goldstein, check out the San Diego Sexual Medicine website!

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Lara Krawchuk has been practicing as a clinical social worker for over 30 years, specializing in grief, living losses and trauma in her psychotherapy practice. She has an intimate connection to the losses people suffer and is an expert in holding the "tough stuff" for her clients. Lara has a tremendous capacity for helping her clients maintain hope and move towards healing.

Lara offers trainings and continuing education classes through her clinical practice and in affiliation with The Portland Institute for Loss and Transition. She is passionate about teaching helping professionals how to exquisitely listen, help heal burdens and make our broken-hearted world a better place. She shares her wisdom using a potent mix of scholarly knowledge, creativity, compassion, and wit in her many CEU classes, podcast interviews and book chapters.

Lara has been a beloved adjunct professor at the MSW program at the University of Pennsylvania for almost two decades where she teaches courses on clinical practice and loss and grief. She simply adores the Internal Family Systems (IFS) model! She is a certified IFS therapist and Level 1 Consultant. She has done countless hours of training with many highly respected lead trainers and absolutely loves helping clients and helping professionals find their way to this magnificent model of care.

Listeners, if you'd like to get in touch with Lara, visit the Healing Concepts website!

If you are interested, check out this Meaningful Grief Healing Retreat!

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Peggy J. Kleinplatz, Ph.D. is Professor in the Faculty of Medicine and Director of the Optimal Sexual Experiences Research Team at the University of Ottawa. She is a clinical psychologist, Board Certified in Sex Education and is a Diplomate and Supervisor of Sex Therapy. She is a Fellow of the American Psychological Association. She was awarded the Prix d'Excellence in 2000 for her teaching of Human Sexuality. She has a particular interest in sexual health among older people, disabled and marginalized populations. Kleinplatz has edited five books, notably New Directions in Sex Therapy: Innovations and Alternatives, (Routledge, 2nd Edition), winner of the AASECT 2013 Book Award, Sadomasochism: Powerful Pleasures with Dr. Charles Moser (2006) and Sexuality and Ageing (2015) with Dr. Walter Bouman.

She is the author with A. Dana Ménard, Ph.D. of Magnificent Sex: Lessons from Extraordinary Lovers, winner of the Society for Sex Therapy and Research Consumer Book Award 2021. In 2015, Kleinplatz received the Professional Standard of Excellence Award from the American Association of Sexuality Educators, Counsellors and Therapists. In 2021, Kleinplatz received a Distinguished Sexual and Gender Health Revolutionary Award from the Medical School of the University of Minnesota. Her clinical work focuses on eroticism and transformation. Her research, writing, teaching and clinical work have been intended to challenge, expand and diversify the field of sex therapy.

Listeners, you can get in touch with Peggy and her team of researchers at Optimal Sexual Experiences and learn more about her bio and publications through the University of Ottawa!

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Dr. Sheryl Kingsberg is the chief of the division of behavioral medicine at MacDonald Women's Hospital/University Hospitals Cleveland Medical Center and Professor in Reproductive Biology, Urology and Psychiatry at Case Western Reserve University. Her areas of clinical specialization include female sexual disorders, menopause, pregnancy and postpartum mood disorders, and psychological aspects of infertility.

Dr. Kingsberg's primary research interests are in treatments for female sexual disorders, genitourinary syndrome of menopause (GSM) and reproductive mental health. She is an Associate Editor for Sexual Medicine Reviews and sits on the editorial boards of the journals Menopause and Climacteric. She has over 100 peer-reviewed publications and numerous book chapters and has co-edited a multidisciplinary textbook on treating female sexual disorders.

Dr. Kingsberg is a past president of The Menopause Society and The International Society for the Study of Women's Sexual Health. She currently serves as the Advocacy Committee Chair for The Menopause Society.

And for full disclosure, Dr. Kingsberg was the principal investigator on the research for Milli, one of our sponsors.

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Our guest this time is an old friend, Joan Price. Joan is an award-winning author, speaker, sexuality educator, advocate for ageless sexuality, and truly the inspiration behind much of what we do here at Our Better Half! She's written numerous books, did a great video with Jessica Drake just a few years ago, and just reissued her amazing book, Naked At Our Age, and it's better than ever! She reviews sex toys for older bodies and often laughingly says, "somebody's got to do it!" She speaks about senior sexuality all over the world. And she's 82!

Joan has been on our show before, and we love her work. So, listeners, you are in for a treat as we catch up with one of our favorite people. Please join us in conversation with the inimitable Joan Price, sexuality educator extraordinaire!

If you'd like to get in touch with Joan, you can visit her website, and check out her interview in the New York Times that Rosara is quoted in!

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As always, thanks for listening!

Our guest this time, Jane Epstein, is a nurse practitioner and a Menopause Society certified provider. She's also an AASECT Certified Sex Counselor. She lives and practices in Albuquerque, New Mexico. Jane graduated as a nurse practitioner from the Yale University School of Nursing in 1989, followed by a one-year training in Adolescent Medicine at Yale Medical School. She practiced adolescent medicine for over 25 years before transitioning to adult women's health and sexuality counseling.

Jane first gravitated toward the topic of sexual health while working with adolescents. In the life of an adolescent, developing into a sexual being seemed to be the biggest thing happening– and the one that adults wanted to address with adolescents the least. In 2016, she gave a popular TEDx talk entitled, "Why We Need to Talk to Girls About Sex", which addressed female sexual pleasure, including masturbation, for young women. It's a great talk!

Since many sexually active young women know so little about sexual pleasure, Jane wondered when and where adult women learn about sexual pleasure. Her independent research, including interviews with menopausal women across the country, revealed that many women did not learn to orgasm until taught by their (usually) male partners. And many never learned how to prioritize their own sexual pleasure during partnered relationships.

Subsequently, Jane became a Menopause Society Certified Provider and an ASSECT-certified Sex Counselor. She sees patients in Albuquerque, New Mexico for perimenopause and menopause care, as well as sexuality counseling. Her goal is to help women enjoy pain-free and pleasurable sex, as well as to optimize health through the midlife years and beyond.

Jane spoke to our co-hosts Dr. Sabitha Pillai-Friedman and Dr. Jane Fleishman about the effects of genitourinary symptoms of menopause (GSM), the benefits of topical estrogen at different ages, the current research on hormonal therapies for younger women, older women, and transmen who have a vagina. She gives practical tips and breaks down the research in a language that makes lots of sense.

If you'd like to check out the article she cited in the show, click here.

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Our guest this week is Dr. Jenn Pollitt! Jenn Pollitt, PhD is the Assistant Director of Gender, Sexuality and Women's Studies and an Assistant Professor in the College of Liberal Arts at Temple University. She holds a PhD in Human Sexuality from Widener University. Dr. Pollitt currently serves on the Board of Directors of the Woodhull Freedom Foundation, a national organization dedicated to advancing sexual freedom as a fundamental human right through policy, law and education. With over 15 years of experience as a sexuality educator, Dr. Pollitt has developed and taught a wide range of undergraduate and graduate courses on topics including Men & Masculinities, Sexuality and Disability, Porn Literacy, Sexuality Education, and Pleasure. She has also created and facilitated trainings and curricula for professionals in nonprofit organizations, corporations, and labor unions—working with groups such as Lambda Legal, the American Medical Student Association, and Philadelphia's Men's Center for Growth and Change.

Dr. Pollitt has developed the first comprehensive sexuality education course for law students, which launched this fall at Temple University's Beasley School of Law. Her work focuses on sexual and erotic agency, LGBTQIA+ rights, reproductive justice, and the intersections of sex, law, and policy. She also examines the influence of popular culture as one of the most powerful—and under-acknowledged—sources of informal sex education in the U.S. Dr. Pollitt's work and commentary have been featured in the New York Times, Washington Post, Slate, Psychology Today, HuffPost, Business Insider, The Philadelphia Inquirer, The 19th News, NPR, WHYY, and Doctor Radio.

Listeners, you can find information about Dr. Pollitt and her publications here!

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As always, thanks for listening!

Our guest this week is Dr. Amanda Olson! Dr. Olson is a pelvic health physical therapist, entrepreneur, author, and global educator with a passion for empowering men and women and advancing conversations around pelvic health. She has dedicated her career to breaking stigmas around pelvic health, developing innovative solutions to improve quality of life, and supporting patients with conditions including cancer, incontinence, pelvic pain, pelvic organ prolapse, endometriosis, and MRKH syndrome.

Dr. Amanda Olson is the president of Intimate Rose, a successful pelvic health device company that includes tools for managing pelvic pain, holds multiple patents, and has authored six peer-reviewed journal articles as well as the book Restoring the Pelvic Floor for Women. She is also the recipient of the Elizabeth Nobel Award, the highest honor bestowed in the field of pelvic health. She has collaborated with clinics worldwide, transforming lives through her tools, teaching, and consulting. As an advocate for patients with sensitive issues, and medical innovation, Dr. Olson is committed to bridging the gap in pelvic and women's healthcare and bringing education to underserved patient populations.

If you want to catch up on other shows, just visit our website and please subscribe! We love our listeners and welcome your feedback, so if you love Our Better Half, please give us a 5-star rating and follow us on Facebook and Instagram. It really helps support our show!

As always, thanks for listening!