Pleasure in the Pause: Midlife Conversations About Menopause, Sex & Pleasure

This one is a little different. For over 100 episodes Gabriella has been the one asking the questions. This time, Sally Mueller, co-founder and CEO of Womaness, turns the tables. And what comes out of that conversation is one of the most practical and honest discussions this show has ever had about intimate wellness, comfort, and what it actually means to take care of this part of your body.

Womaness is a brand that has been modernizing the conversation around menopause and intimate wellness through education, community, and thoughtfully designed products that support women from head to toe. Gabriella has been a proud Womaness brand partner for several years because she genuinely believes in their mission. In this episode she shares her personal story, her own five-step intimate wellness routine, and a recent experience that reminded her why consistency in this area of self-care is not negotiable.

The biggest message throughout? Intimate wellness is not about sex. It is about comfort, confidence, connection, and quality of life. And you deserve to prioritize it.

Womaness has generously offered listeners of Pleasure in the Pause an exclusive 20% discount on their intimate wellness collection. Visit womaness.com and use code PLEASURE at checkout.

Products mentioned in this episode:
- MELT For You vaginal inserts — internal hydration and tissue support
- Daily V Soothe — external comfort and ongoing moisture
- Coco Bliss — rich external moisture for intimacy and everyday comfort

Use Code PLEASURE for 20% off all Womaness Sexual Wellness products

Sally Mueller, Co-Founder and CEO of Womaness, is transforming the conversation on aging and menopause. An expert in retail and brand innovation with a proven track record for trend forecasting, she has worked with major brands like Target, Who What Wear, and VERSED skincare. Inspired by her own health journey and a lack of modern menopause resources, Sally created Womaness with co-founder Michelle Jacobs. The brand offers expert- and doctor-backed solutions, fostering a movement that empowers women to celebrate life after 40. With over 20 years at Target Corporation in Apparel Merchandising and Marketing, Sally is an industry leader celebrated for her business acumen across fashion, beauty, and lifestyle.

Highlights from our discussion include:

• Why intimate wellness is about comfort, confidence, and quality of life — not just what happens in the bedroom
• The difference between hydration and lubrication, and why most women need both
• Why silence around intimate health creates shame, and why speaking up changes everything
• How to advocate for yourself with your partner and your doctor when it comes to intimate health changes
• Why being proactive about intimate wellness — before symptoms become severe — is the most important shift a woman can make
• The role of self-pleasure in supporting tissue health, body connection, and overall wellbeing 

Your comfort matters first. Not anyone else's. And the changes that come with perimenopause and menopause are common — but suffering through them in silence does not have to be. There are solutions, there is support, and there are products designed specifically to help you feel comfortable, confident, and connected to your body every single day. 

Use Code PLEASURE for 20% off all Womaness Sexual Wellness products.

CONNECT WITH SALLY MUELLER:

Womaness: https://womaness.com/collections/menopause-sexual-health-and-feminine-care

Womaness Instagram: https://www.instagram.com/mywomaness/

Sally Mueller LinkedIn: https://www.linkedin.com/in/sally-mueller/

Episode with Ashley Kelsch 

CONNECT WITH GABRIELLA ESPINOSA:

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The information shared on Pleasure in the Pause is for educational and informational purposes only and is not intended as medical advice. Always consult your healthcare provider before making any decisions about your health or treatment. The views expressed by guests are their own and do not necessarily reflect the views of the host or Pleasure in the Pause.

For more than 20 years, Robyn Parets lived with chronic illness, anxiety, and a body that always seemed to be fighting something. She saw countless practitioners, tried everything she could find, and kept pushing through — the way high-achieving women do. What she did not understand was that underneath every diagnosis, every symptom, and every exhausting flare was a nervous system that had simply lost its way home.

It was not until she discovered nervous system regulation and somatic breathwork that everything began to shift. Her body remembered what safety felt like. And from that place of safety, real healing became possible.

In this installment of the Return to Her series, Gabriella sits down with Robyn Parets, yoga teacher, breathwork facilitator, and nervous system coach, for one of the most personal and practically rich conversations in this series. Robyn shares what 20-plus years of survival mode actually felt like in her body, the moment on the floor after a treadmill collapse that changed everything, and the two things that finally moved the needle after decades of searching. She also guides listeners through a simple breathwork practice they can begin using today.

Are you ready to awaken your sensuality and feel more empowered in your body? Access the FREE Pleasure Upgrade Bundle at https://www.pleasureinthepause.com/gift.

Robyn Parets is a yoga teacher, somatic breathwork facilitator, and nervous system coach who helps others find their way back to safety, regulation, and aliveness after years of chronic stress, illness, and dysregulation. After more than two decades navigating chronic illness including POTS, Lyme disease, SIBO, and mold toxicity, Robyn found her healing through brain retraining and somatic breathwork and now guides others through the same journey. She and Gabriella met at the Omega Institute in Rhinebeck, New York, during an intensive nervous system training. 

Highlights from our discussion include:

• What 20 years of living above the window of regulation actually felt like in Robyn's body and how she finally recognized it as survival mode
• The treadmill moment that became her turning point and why she knew on the floor that she was the only one who could heal herself
• How brain retraining works and why repetition is the key to creating new patterns in the brain and nervous system
• Why feeling safe in the body is not just an emotional experience but a physiological prerequisite for healing
• The physiological sigh, a simple two-breath practice that tones the vagus nerve and helps bring the nervous system back to safety in minutes
• What life looks and feels like on the other side — from black and white to technicolor 

When Gabriella asked Robyn what she would say to the version of herself who was still searching for answers and still pushing through, her answer was short and completely whole.

You are brave. And you can do hard things. And the power exists within you to make the changes you need.

That is the heart of this series. And it is the heart of this conversation.

If this episode resonated, subscribe to Pleasure in the Pause and share it with a woman in your life who has been white-knuckling her way through something she cannot quite name. And if you want to go deeper into nervous system work, Robyn's details are in the show notes below.

If you're seeking to reclaim your pleasure and vitality, join Gabriella at⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.pleasureinthepause.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ for this enlightening journey into the heart of female pleasure and empowerment.

CONNECT WITH ROBYN PARETS:

New England Breathwork Website

New England Breathwork Instagram

Robyn's Instagram

CONNECT WITH GABRIELLA ESPINOSA:

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LinkedIn

Work with Gabriella! 

Full episodes on YouTube.

The information shared on Pleasure in the Pause is for educational and informational purposes only and is not intended as medical advice. Always consult your healthcare provider before making any decisions about your health or treatment. The views expressed by guests are their own and do not necessarily reflect the views of the host or Pleasure in the Pause.

Have you ever found yourself in a meeting, searching for a word that used to come effortlessly, or suddenly losing your train of thought in front of a room full of people? Have you quietly wondered whether you are losing your edge, your confidence, or your ambition — without ever connecting it to what is actually happening in your body?

Menopause does not wait until our careers wind down. It arrives right in the middle of them, when women are leading teams, growing businesses, mentoring others, and stepping into some of the most influential years of their professional lives. And yet it remains one of the most underaddressed issues in both medicine and the workplace.

In this episode of Pleasure in the Pause, Gabriela sits down with Dr. Arianna Sholes-Douglas, board-certified OBGYN, integrative women's health expert, and author of The Menopause Myth, for a wide-ranging and deeply honest conversation about what menopause is actually doing to women at work, what it is costing companies and the broader economy, and why Dr. Arianna refuses to frame this transition as a decline. She calls it an evolution. And once you hear why, you will too.

Are you ready to awaken your sensuality and feel more empowered in your body? Access the FREE Pleasure Upgrade Bundle at https://www.pleasureinthepause.com/gift.

Dr. Arianna Sholes-Douglas is a board-certified OBGYN, integrative women's health expert, nationally recognized speaker, and author of The Menopause Myth: What Your Mother, Doctor, and Friends Never Told You About Life After 35. She is the founder of Tula Wellness and Aesthetics in Tucson, Arizona, and host of the Stay Juicy podcast. After her own perimenopause awakening led her to leave traditional medicine and build an integrative practice focused on the whole woman, she became one of the leading voices helping employers understand that menopause is not just a women's health issue. It is a workplace issue. 

In this episode, we discuss:

• Why even a trained OBGYN missed her own perimenopause — and what that tells us about the gap in menopause education
• The real cost of untreated menopause in the workplace: $1.8 billion lost annually in productivity and $26.6 billion in overall healthcare costs
• How brain fog, ADHD-like symptoms, and loss of executive function show up for high-achieving women at the peak of their careers
• Why Black and Latina women are disproportionately impacted economically by the menopause transition
• What employers can do right now to support women through this transition and stop draining institutional knowledge from the workforce
• Why Dr. Arianna calls menopause an evolution rather than a decline, and what that reframe changes for women in midlife 

Dr. Arianna's advice for women listening right now is simple and radical at the same time. Err on the side of doing too much for yourself. Because even then, you will probably not be close to what you actually deserve.

Menopause is not the end of your most productive, purposeful, and powerful years. For so many women it is where they finally begin. If this episode gave you language for something you have been living without words for, please share it with someone who needs it too.

If you're seeking to reclaim your pleasure and vitality, join Gabriella at⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.pleasureinthepause.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ for this enlightening journey into the heart of female pleasure and empowerment.

CONNECT WITH DR. ARIANNA :

Dr. Arianna's website

Book a consultation at Tula Wellness & Aesthetics

Purchase her book on Amazon

Podcast on Spotify and Apple and Youtube (available on all major platforms)

Follow her on socials:⁠⁠⁠⁠⁠⁠Instagram⁠⁠⁠⁠⁠⁠, ⁠⁠⁠⁠⁠⁠Facebook⁠⁠⁠⁠⁠⁠, ⁠⁠⁠⁠⁠⁠TikTok⁠⁠⁠⁠⁠⁠, ⁠⁠⁠⁠⁠⁠LinkedIn⁠⁠

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The information shared on Pleasure in the Pause is for educational and informational purposes only and is not intended as medical advice. Always consult your healthcare provider before making any decisions about your health or treatment. The views expressed by guests are their own and do not necessarily reflect the views of the host or Pleasure in the Pause.

When was the last time you asked yourself what you actually want?

For many women, menopause is the first time that question becomes impossible to ignore. The body is changing. Desire is shifting. And relationships that have been running on autopilot for years are suddenly asking to be looked at more honestly.

In this episode, Gabriela sits down with Sari Cooper, AASECT-certified sex therapist and founder of the Center for Love and Sex in New York City, for one of the most expansive and shame-free conversations this show has ever had. Sari explains why menopause is often the elephant in the therapy room, why low desire is almost never just hormonal, and how the concept she calls sex esteem — knowing what you want, owning it, and communicating it with confidence — changes everything for women in midlife.

They go places this podcast has not gone before. Consensual non-monogamy. Gray divorce. The erotic mind. Infidelity and what comes after. And throughout all of it, the invitation is the same: approach your sexuality and yourself with more curiosity and less judgment.

Are you ready to awaken your sensuality and feel more empowered in your body? Access the FREE Pleasure Upgrade Bundle at https://www.pleasureinthepause.com/gift.

Sari Cooper is an AASECT-Certified Sex Therapist & Supervisor and Founder and Director of the Center for Love and Sex (CLS), a boutique group practice specializing in sex therapy, couples counseling and individual clients challenged with erotic and sexual disorders. She created Sex Esteem, LLC to provide coaching, books, blogs and Talks to the public on critical cutting-edge insight on how to center one’s sexual pleasure in dating, ‘relationshipping’ and mating.

Highlights from our discussion include:

• Why menopause is still the elephant in the therapy room and what it will take to change that
• How to tell a partner what is changing in your body in a way they can actually understand
• Why low desire is almost never just hormonal and what the full picture actually looks like
• What sex esteem is and the three things it requires: consciousness, confidence, and communication
• Why taking penetration off the table can actually be the most liberating thing a couple does together
• What consensual non-monogamy looks like in practice and when couples start considering it
• Why gray divorce is so often initiated by women and what menopause has to do with it 

If you're seeking to reclaim your pleasure and vitality, join Gabriella at ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.pleasureinthepause.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ for this enlightening journey into the heart of female pleasure and empowerment.

Sari ends with something I want every woman in this community to carry with her. Sexual and erotic agency begins with yourself. Give yourself permission to slow down, check in, and locate where it is that you feel pleasure, desire, or even just interest or curiosity. Start from there.

Before we can ask someone else to understand us, we first have to understand ourselves. That is what sex esteem is really about. And this episode is a beautiful place to begin.

If this episode resonated, subscribe to Pleasure in the Pause and share it with someone who needs this conversation. And if someone came to mind while you were listening, that is your sign to send it to them.

Resources mentioned:
Sari Cooper: centerforloveandsex.com

LinkedIn: https://www.linkedin.com/in/-sari-cooper-center-for-love-and-sex/ 

Instagram: https://www.instagram.com/saricooperofficial/ 

CONNECT WITH GABRIELLA ESPINOSA:

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Full episodes on YouTube.

The information shared on Pleasure in the Pause is for educational and informational purposes only and is not intended as medical advice. Always consult your healthcare provider before making any decisions about your health or treatment. The views expressed by guests are their own and do not necessarily reflect the views of the host or Pleasure in the Pause.

You know the feeling. You have been going since morning — emails, deadlines, the relentless doing. Your nervous system has been in full output mode for hours. And then evening comes, your partner moves in close wanting to connect, and your body just shuts down. Not because you don't love them. Simply because you have nothing left to give.

If you have ever thought "I want to want, I just can't get there from here" — this episode is for you.

In this solo episode, Gabriella introduces one of the most powerful and underused concepts in relationship science: co-regulation. Rooted in polyvagal theory and the science of connection, co-regulation is what happens when two nervous systems help each other find their way back to safety, warmth, and presence. It is not about sex. It is not about performance. It is about the small, intentional acts of connection that happen all day long — and that make intimacy feel possible again by the time evening comes.

Are you ready to awaken your sensuality and feel more empowered in your body? Access the FREE Pleasure Upgrade Bundle at https://www.pleasureinthepause.com/gift.

Highlights from our discussion include:

• What co-regulation is and why our nervous systems are never operating in isolation
• The difference between co-regulation and codependency — and why leaning into your partner is biology, not weakness
• Emotional intimacy and emotional attunement — what they are and what they feel like in the body
• How the window of regulation connects to intimacy and why connection is genuinely out of reach when we are outside it
• Five practical ways to kindle connection with your partner without pressure, expectation, or any destination in mind
• Why pleasure does not begin with desire — it begins with safety 

Co-regulation does not require a perfect relationship or a perfect moment. It requires willingness. And the understanding that connection is not something that happens to you. It is something you and your partner create in the smallest, most ordinary moments all day long. 

If you're seeking to reclaim your pleasure and vitality, join Gabriella at⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.pleasureinthepause.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ for this enlightening journey into the heart of female pleasure and empowerment.

Resources mentioned:

Free Embodiment Tune-In Audio → Download Here

Ep 107 — From Survival Mode to Self-Connection 

Ep 91 — Colette Jane Feehr and The Cost of Quiet

Book: The Nervous System Reset by Jessica McGuire 

CONNECT WITH GABRIELLA ESPINOSA:

Instagram

LinkedIn

Work with Gabriella! 

Full episodes on YouTube.

The information shared on Pleasure in the Pause is for educational and informational purposes only and is not intended as medical advice. Always consult your healthcare provider before making any decisions about your health or treatment. The views expressed by guests are their own and do not necessarily reflect the views of the host or Pleasure in the Pause.

Most women step into perimenopause the same way Gabriela did — in the dark, without language, without a roadmap, and without anyone telling them what was actually happening in their bodies. The anxiety, the brain fog, the rage, the fatigue, the loss of libido — they could feel it all, but they could not make sense of it. Dr. Mariza Snyder felt the same way. Even after 17 years of clinical experience supporting women through this transition.

In this episode of Pleasure in the Pause, Gabriela sits down with Dr. Mariza Snyder for one of the most layered and honest conversations this show has ever had. This is a deeply intergenerational conversation and together they bridge that gap and pass the wisdom forward.

Are you ready to awaken your sensuality and feel more empowered in your body? Access the FREE Pleasure Upgrade Bundle at https://www.pleasureinthepause.com/gift.

Dr. Mariza Snyder is a powerhouse advocate for midlife women, leveraging 17+ years as a practitioner, author, and speaker to spark a massive movement for women in perimenopause and beyond. With her top-rated Energized with Dr. Mariza podcast, she’s a trusted guide, offering science-backed solutions for perimenopause and metabolic health. Her new book, The Perimenopause Revolution, is the ultimate resource for women ready to take charge of their health and embrace perimenopause with resilience and confidence. Check out her website, drmariza.com, for solutions to thrive. 

In this episode, we discuss: 

• The often-overlooked connection between hormones and the nervous system
• How to distinguish what's hormonal from what may be years of accumulated stress and over-functioning
• The role of rage as a messenger rather than something to suppress
• The practical tools women can use to move through this transition with greater resilience

You are not going to be the same woman on the other side of this transition. That is not a warning. That is a promise. Perimenopause is equally as destabilizing as it is transformative — and the more you understand what your body is doing and why, the more you can move through it with clarity, compassion, and a sense of what is actually possible on the other side. 

If you're seeking to reclaim your pleasure and vitality, join Gabriella at ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.pleasureinthepause.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ for this enlightening journey into the heart of female pleasure and empowerment.

CONNECT WITH DR. MARIZA SNYDER:

FaceBook: https://www.facebook.com/drmarizasnyder/

Insta: https://instagram.com/drmariza/

YouTube: https://www.youtube.com/drmarizasnyder

LINKS MENTIONED: 

Episode 107 — From Survival Mode to Self-Connection https://www.pleasureinthepause.com/blog/nervous-system-reset-for-midlife-women 

Episode 106 — The Menopause Gut with Cynthia Thurlow https://www.pleasureinthepause.com/blog/midlife-sobriety-and-returning-to-yourself-with-ashley-kelsch 

CONNECT WITH GABRIELLA ESPINOSA:

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Work with Gabriella! 

Full episodes on YouTube.

The information shared on Pleasure in the Pause is for educational and informational purposes only and is not intended as medical advice. Always consult your healthcare provider before making any decisions about your health or treatment. The views expressed by guests are their own and do not necessarily reflect the views of the host or Pleasure in the Pause.

What if the question is not why can't I quit, but what is this doing for me?

In this installment of the Return to Her series, Gabriela sits down with Ashley Kelsch, writer, coach, and somatic practitioner who helps midlife women change their relationship with alcohol and reconnect with themselves. Ashley spent a decade running a sexual wellness shop in Austin, where women quietly confided things in dressing rooms they were not sharing with anyone else — and underneath it all was the same thread. Disconnection from their bodies, their desires, and their needs, often soothed with a glass of wine.

This conversation explores what women are really reaching for when they pour that glass, why alcohol can feel like relief, confidence, freedom, and connection, and what happens when we discover those things were never in the wine to begin with. They talk about the difference between being uninhibited and truly inhabited, why midlife often feels like a crisis when it is actually an awakening, and why women's sexual pleasure is their birthright, not something to wait for or outsource.

This conversation is not really about alcohol. It is about what happens when a woman stops outsourcing her aliveness and starts coming home to herself.

Are you ready to awaken your sensuality and feel more empowered in your body? Access the FREE Pleasure Upgrade Bundle at https://www.pleasureinthepause.com/gift.

Ashley Kelsch is a writer, coach, and somatic practitioner who helps midlife women change their relationship with alcohol and reconnect with their bodies, desire, and aliveness. After a decade running a sexual wellness retail space in Austin, Texas, she became a life coach focused on dating, sex, and relationships before discovering the common thread connecting so many of the women she worked with — gray area drinking as a way of outsourcing relief, confidence, and connection. She has been alcohol-free for over four years and recently was accepted into the Somatic Experiencing Institute to deepen her trauma-informed work. 

Highlights from our discussion include:

• Why Ashley believes women don't have a drinking problem, they have an aliveness problem
• What women are really looking for when they pour that glass of wine — and why it is an exhale, not the wine itself
• The four-part framework: reveal, reclaim, rewire, rebuild
• The difference between being uninhibited and being inhabited
• Why alcohol affects women's bodies differently in midlife as hormones decline
• Why pleasure and sensuality are self-care, and why a glass of wine is not
• One simple practice — pause before you pour — to start reconnecting with what you actually need 

Sobriety is not really about stopping. It is about what you find when you do. Ashley's story is a reminder that so many of the things we reach for outside ourselves — wine, distraction, escape — are often pointing us toward something we have been taught to disconnect from. The work is not abstinence. The work is coming home. 

If you're seeking to reclaim your pleasure and vitality, join Gabriella at⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.pleasureinthepause.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ for this enlightening journey into the heart of female pleasure and empowerment.

CONNECT WITH ASHLEY KELSCH:

Website

Instagram

Substack

LINKS MENTIONED:

Episode 107 — From Survival Mode to Self-Connection

CONNECT WITH GABRIELLA ESPINOSA:

Instagram

LinkedIn

Work with Gabriella! 

Full episodes on YouTube.

The information shared on Pleasure in the Pause is for educational and informational purposes only and is not intended as medical advice. Always consult your healthcare provider before making any decisions about your health or treatment. The views expressed by guests are their own and do not necessarily reflect the views of the host or Pleasure in the Pause.

Have you ever lain awake at 3am, heart racing, mind running through a list of worries you cannot seem to turn off? Or maybe it is the opposite — you move through your days flat, numb, going through the motions of a life that looks perfectly fine from the outside while feeling strangely absent from it on the inside.

Both of those states have a name. And neither of them is a personal failing.

In this solo episode, Gabriela shares one of the most foundational concepts in nervous system work — the window of regulation — and explains why understanding it as a map of your biology rather than just your emotions changes everything. Drawing on her recent immersion at the Omega Institute with nervous system educator Jessica McGuire, and weaving in her own deeply personal story of survival mode, perimenopause, and coming home to herself, Gabriela walks you through what dysregulation actually looks like in midlife, why it so often gets mistaken for a character flaw, and two simple practices to begin returning to your window right now.

This is not just an episode to listen to. It is one to feel.

Highlights from our discussion include

• What the window of regulation is and why it is a map of your biology, not just your emotions
• What hyperarousal looks like in midlife women — including the version that looks like overachieving and perfectionism 
• What hypoarousal looks like — the flat, numb, going-through-the-motions version so many women recognize 
•  Why stress followed by genuine recovery builds resilience, and why overriding your own limits destroys it
• How adverse childhood experiences connect to a more difficult perimenopause transition 
• Two guided practices — exteroception and containment — to return to regulation right now 
• Why regulation is not a wellness trend but the foundation of sleep, desire, digestion, and connection 

The window of regulation is not about becoming someone who never gets dysregulated. It is about building the capacity to return — more quickly, more gently, more reliably — to the place where life can actually be lived. 

If you heard your own story somewhere in this episode, your nervous system is not broken. It is doing what it learned to do, sometimes a long time ago, in a body that is now changing. That is not a flaw. That is information. And information is where we begin. 

If you're seeking to reclaim your pleasure and vitality, join Gabriella at ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.pleasureinthepause.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ for this enlightening journey into the heart of female pleasure and empowerment.

Links Mentioned: 

The Nervous System Reset by Jessica McGuire Website

Ep 75

Ep 106 Cynthia Thurlow

Dr. Dan Siegel Website

CONNECT WITH GABRIELLA ESPINOSA:

Instagram

LinkedIn

Work with Gabriella! 

Full episodes on YouTube.

The information shared on Pleasure in the Pause is for educational and informational purposes only and is not intended as medical advice. Always consult your healthcare provider before making any decisions about your health or treatment. The views expressed by guests are their own and do not necessarily reflect the views of the host or Pleasure in the Pause.

What if the brain fog, the broken sleep, the mood swings, the weight that won't budge, and the libido that has gone missing are not a collection of separate problems? What if they are one connected story and the missing piece of that story is your gut?

In this episode of Pleasure in the Pause, Gabriela sits down with Cynthia Thurlow, nurse practitioner, bestselling author, and host of the Everyday Wellness podcast, to explore her groundbreaking new book The Menopause Gut: Balance Your Microbiome to Reclaim Your Health in Midlife and Beyond. Cynthia has spent a decade working exclusively with midlife women, and what she keeps seeing is this: women doing all the right things and still not feeling like themselves. Her book offers a fascinating new lens through which to understand why, and what to do about it.

Cynthia Thurlow is a nurse practitioner, two-time TEDx speaker, international speaker, and CEO and founder of the Everyday Wellness Project. With over 25 years of experience in health and wellness, she is a globally recognized expert in perimenopause, menopause, intermittent fasting, and women's metabolic health. Her latest book The Menopause Gut: Balance Your Microbiome to Reclaim Your Health in Midlife and Beyond is available everywhere books are sold.

In this episode, we discuss: 

• What the gut microbiome actually is and why it sits at the center of midlife health 
• The estrobolome — the part of your gut that processes and eliminates estrogen — and why it matters on HRT 
• How the gut and brain are connected through the vagus nerve and what that means for mood, anxiety, and desire 
• Why 90% of serotonin is made in the gut and what that means for midlife mood swings 
• How trauma history contributes to weight loss resistance and early menopause 
• Practical starting points: protein, fiber, sleep rituals, strength training, and the power of saying no 
• Why supporting your gut ripples out into energy, vitality, mood, and pleasure

My hope is that this episode helps you see your symptoms as one connected story — and gives you a clear, practical place to begin.

Cynthia says it simply: major in the majors. Before the supplements and the protocols and the testing, it is the basics — how you eat, how you sleep, how you manage stress, and how honestly you honor your own limits — that move the needle most. Your gut is not a separate system. It is the ecosystem everything else depends on.

If this episode resonated, subscribe to Pleasure in the Pause and share it with a woman in your life who has been doing all the right things and still not feeling like herself. And grab Cynthia's book — it is one of the most practical and comprehensive guides to midlife health I have come across.

If you're seeking to reclaim your pleasure and vitality, join Gabriella at⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.pleasureinthepause.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ for this enlightening journey into the heart of female pleasure and empowerment.

CONNECT WITH CYNTHIA THURLOW:

Website

Instagram

Podcast

Substack

CONNECT WITH GABRIELLA ESPINOSA:

Instagram

LinkedIn

Work with Gabriella! 

Full episodes on YouTube.

The information shared on Pleasure in the Pause is for educational and informational purposes only and is not intended as medical advice. Always consult your healthcare provider before making any decisions about your health or treatment. The views expressed by guests are their own and do not necessarily reflect the views of the host or Pleasure in the Pause.

Hormone therapy after breast cancer is one of the most nuanced and emotionally charged conversations in women’s health.

For decades, many women have been told the answer is simply: no.

No discussion.
No nuance.
No consideration of quality of life, sexual health, bone health, brain health, or the individual woman sitting in the exam room.

But what does the research actually say?

In this episode of Pleasure in the Pause, I welcome back Dr. Susan Hardwick-Smith, board-certified gynecologist and certified menopause practitioner, for a grounded, evidence-informed conversation about hormone therapy after breast cancer.

This is not a conversation about ignoring risk.

It is a conversation about understanding risk clearly, asking better questions, and making informed decisions in partnership with your physician.

About our guest: Dr. Susan Hardwick-Smith is a Board-Certified Gynecologist and certified menopause practitioner specializing in women's midlife wellness, hormone optimization and sexual wellness. She is the founder of Complete Midlife Wellness Center in Houston, TX, and the best-selling author of "Sexually Woke- Awaken the Secrets to Your Best Sex Life in Midlife and Beyond." She also hosts the popular podcast "Empowering Midlife Wellness." Dr. Susan is the recipient of the Texas Super Doctor award over a dozen times, as well a multiple time recipient of H-Texas magazine's Top Doctor and Top Doctor for Women awards. She also has been chosen as one of Houston's "3 best rated" gynecologists several consecutive years. Dr. Susan is also an ICF certified life and leadership coach, multiple time marathoner and Ironman triathlete, and mother of 3 teenagers. 

Highlights from our discussion include:

• What the Women’s Health Initiative actually found — and why the headlines created so much confusion
• Why breast cancer type matters when discussing hormones
• What the research shows about hormone therapy and breast cancer recurrence
• Why some women on aromatase inhibitors may still be able to discuss options like progesterone, testosterone, and vaginal estrogen with their doctor
• How to prepare for a more informed conversation with your physician
• Why collaborative decision-making matters in women’s healthcare
• The importance of considering quality of life, sexual health, bones, heart, and brain health — not just risk 

My hope is that this episode helps you feel more informed, more empowered, and more confident asking questions about your own body and care. 

If you're seeking to reclaim your pleasure and vitality, join Gabriella at⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.pleasureinthepause.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ for this enlightening journey into the heart of female pleasure and empowerment.

Resources:

Dr. Susan Hardwick Smith: https://drsusan.com/ 

Instagram: https://www.instagram.com/drsusanofficial/ 

Bluming review article in Cancer journal (2022): https://pubmed.ncbi.nlm.nih.gov/35594465/ 

Menopause Society consensus paper (January 2026): https://www.imsociety.org/statements/position-papers-and-consensus-statements/ 

Hormone Replacement Therapy After Breast Cancer: It Is Time Avrum Z. Bluming, MD LINK - https://bit.ly/4st0uji Menopausal Hormone Therapy for Breast Cancer Patients: What Is the Current Evidence? LINK - https://bit.ly/41leKyt

American Urological Association Guidelines on GSM 2025 https://www.auanet.org/guidelines-and-quality/guidelines/genitourinary-syndrome-of-menopause

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The information shared on Pleasure in the Pause is for educational and informational purposes only and is not intended as medical advice. Always consult your healthcare provider before making any decisions about your health or treatment. The views expressed by guests are their own and do not necessarily reflect the views of the host or Pleasure in the Pause.