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

Are you experiencing low libido, loss of sexual desire, or intimacy challenges during perimenopause or menopause? In this episode of Pleasure in the Pause, host Gabriela Espinosa joins Dr. Anna Cabeca on The Girlfriend Doctor Show to share her deeply personal story of sexual awakening during midlife. 

Together, they address one of the most common yet rarely discussed symptoms of perimenopause: the complete loss of sexual desire. Gabriela opens up about how her libido plummeted overnight, leaving her without the language to describe what was happening—and the transformative journey that led her to become a sexual wellness coach. 

Dr. Anna Cabeca is a board-certified gynecologist, women's health expert, and hormone specialist known as "The Girlfriend Doctor." She is passionate about empowering women to reclaim their health, hormones, and vitality during midlife and beyond. Dr. Anna specializes in sexual health, intimacy, and menopause care, helping women address the "three Ds" that affect intimacy: desire, disconnect, and discomfort. She is the creator of innovative vulvar health products designed to support women's sexual wellness during hormonal transitions. Through her podcast, online communities, and clinical work, Dr. Anna provides practical, compassionate guidance for women navigating perimenopause and menopause.

Key Takeaways

• Loss of libido during perimenopause is biological, not personal failure.
• Most women don't know their own pleasure anatomy.
• Arousal in midlife requires time, presence, and communication.
• The three Ds affect intimacy (desire, disconnect, discomfort), but the three Ps restore it.
• Unpacking shame and inherited narratives is essential work.

Your body isn't broken, and menopause isn't the end of pleasure—it's an invitation to discover yourself in new ways. 

Subscribe to Pleasure in the Pause for more honest conversations about female sexuality, menopause, and reclaiming your power in midlife.

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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.

Are you feeling the weight of another year passing while navigating the changes of perimenopause and menopause? Do you struggle to make sense of midlife transitions—the shifting hormones, changing body, evolving desires, and the pressure to have it all figured out? In this intimate end-of-year solo episode of Pleasure In The Pause, host Gabriela Espinosa guides you through a reflective journey to release what no longer serves you and reclaim what matters most as you step into 2026. 

Whether you're grappling with metabolic changes, declining desire, or simply feeling invisible in a youth-obsessed culture, this episode offers evidence-based insights on the future of midlife health, sexual wellness, and longevity—plus powerful journaling prompts to help you transition into the new year with clarity, confidence, and self-trust.

Highlights from our discussion include:

• Midlife health is entering the mainstream
• Sexual wellness is finally recognized as healthcare
• Policy victories matter for your care
• New podcast segments to support your journey
• Reflection is an act of self-care

As you close out 2025 and step into the new year, remember this truth: your pleasure has no expiration date. Your body, your desires, and your wisdom matter exactly as they are right now. 

Take time this week to work through the journaling prompts shared in this episode—ask yourself what you're ready to carry forward and what you're ready to leave behind. 

Then, submit your questions for the new "Ask Me Anything" segment anonymously to [email protected] No question is too personal or too awkward—this is your shame-free space. 

Subscribe to Pleasure In The Pause so you don't miss the exciting new conversations coming in 2026, and share this episode with a woman in your life who needs permission to prioritize her pleasure and step into her next chapter with confidence.

LINKS MENTIONED:

Let’s Talk Menopause

Midlife Private Parts

Hot Document

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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.

Are you struggling with hormone therapy that isn't working? Wondering why testosterone for women is so hard to access? Feeling confused about vaginal estrogen warnings? This special Best of 2025 episode of Pleasure In The Pause tackles the most pressing questions midlife women asked this year about hormone optimization, sexual satisfaction, and reclaiming pleasure during perimenopause and menopause.

Host Gabriela Espinosa revisits the year's most downloaded conversations—featuring leading women's health experts discussing hormone therapy optimization, the truth about testosterone for women, the historic FDA hearing on vaginal estrogen, redefining sexual satisfaction in midlife, exploring fantasy and desire, and discovering the five essential pleasure principles every woman should know. Whether you're navigating symptoms, considering hormone therapy, or simply want to feel more alive in your body, this episode delivers evidence-based insights and empowering tools for thriving through midlife.

Featuring conversations with Dr. Jila Senemar, Dr. Susan Hardwich-Smith, Dr. Laurie Mintz, and Lauren Elise Rogers. 

Highlights from our discussion include:

• The "big three" hormones—estradiol, progesterone, and testosterone—each address different menopausal symptoms, and treatment should be individualized based on your top priorities like sleep, mood, energy, or libido.
• Women naturally produce more testosterone than estradiol throughout their lives, yet have zero FDA-approved testosterone products compared to men's 20+, despite proven benefits for libido, bone health, muscle mass, and cognitive function.
• Low-dose vaginal estrogen cannot be detected in the bloodstream yet carries an unfounded FDA black box warning, preventing millions of women from accessing a safe treatment that prevents 50% of UTIs.
• Only 4-18% of women orgasm from penetration alone, and less than 2% use penetration when masturbating—closing the pleasure gap requires prioritizing clitoral stimulation as the main event, not just "foreplay."
• Erotic fantasy, built on the four cornerstones of longing, taboo, power, and ambivalence, can be a healthy springboard to arousal when integrated openly rather than pushed into the shadows.
• A turned-on life in midlife isn't about performance or sexy lingerie—it's about living in alignment with what fuels your joy, vitality, and truth, whether through art, nature, movement, or intimate touch.

2025 was a turning point for women's health—from historic FDA hearings to conversations shattering decades of sexual myths and medical dogma. These six episodes represent what midlife women are hungry for: truth, empowerment, and permission to reclaim pleasure on their own terms.

As you move into 2026, remember that your pleasure isn't optional—it's your birthright. Whether you're advocating for better hormone therapy, learning what actually brings you to orgasm, or discovering what makes you feel fully alive, this is your invitation to thrive.

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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.

Struggling with vaginal dryness, decreased sensitivity, or feeling disconnected from your body in midlife? You're not alone. In this solo episode of Pleasure in the Pause, host Gabriella Espinosa shares her personally tested intimate wellness tools and self-care rituals that support vulva vitality, arousal, and sensual connection during menopause and beyond. From vaginal moisturizers and arousal oils to vibrators backed by research, Gabriella breaks down why intimate wellness isn't optional—it's essential self-care. 

Find all products on the Intimacy Holiday Gift Guide

Whether you're experiencing menopause symptoms like tissue thinning and reduced lubrication, or simply want to deepen your pleasure practice, this episode offers practical product recommendations and embodied rituals to help you reconnect with your sensuality. Think of it as your intimate wellness holiday gift guide, designed to remind you that your pleasure has no expiration date.

Key Takeaways:

• Intimate wellness is essential self-care, not optional.
• Vaginal skin care products can transform your comfort and confidence.
• Lubrication is non-negotiable during intimacy—there's zero shame in using it.
• Vibrators are wellness tools backed by science.
• Sensual rituals extend pleasure beyond the bedroom. 

Your body—exactly as it is right now—is worthy of attention, care, and pleasure. This week, choose one ritual or tool from this episode to explore.

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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.

Do you feel invisible as a woman over 40? Struggling with body image after menopause, weight gain, or breast cancer? Wondering if you're "too old" to feel sexy and confident again? In this transformative episode of Pleasure in the Pause, host Gabriela Espinosa welcomes portrait and boudoir photographer Felicia Reed for an intimate conversation about reclaiming your sensuality, worthiness, and power in midlife.

Felicia shares her personal journey through breast cancer, forced menopause, and body changes—and how photography became her path back to self-acceptance. If you've ever thought "I'll do a photoshoot when I lose weight" or felt like you've lost yourself in the roles of mom, wife, and caregiver, this episode offers permission to show up authentically, celebrate your body now, and rewrite the narrative around aging and beauty.

Felicia Reed is a passionate portrait photographer and Master Mindset Coach, as well as a resilient breast cancer survivor. With a mission to help people break free from the chains of limiting beliefs, Felicia empowers her clients to live lives of freedom and fulfillment. She encourages you to boldly ask for what you desire, reminding you that what you want wants you just as much.

Key Takeaways:

• You are worthy of being seen right now
• Boudoir photography is about reclaiming your power, not perfection
• The domino effect of female empowerment
• Menopause body changes require self-compassion, not self-criticism
• Creating visual legacy anchors your boldness

Here's your permission slip: You don't have to wait. You don't have to be smaller, younger, or different. You are allowed to invest in yourself, to be seen, to feel sensual and powerful exactly as you are in this moment.

As Felicia beautifully reminds us: "You are worthy to be celebrated, period. For no reason whatsoever. Just because."

Your next step: If this conversation stirred something in you—that quiet inner nudge to honor where you are right now—listen to it. Whether it's booking a photoshoot, speaking kinder words to your reflection, or simply giving yourself permission to take up space unapologetically, choose one small act of self-celebration this week.

Special note: Felicia is celebrating her 50th birthday this December with a special promotion—$397 photoshoots with a $1,000 gift card toward packages. Connect with her if you're ready to gift yourself this transformative experience.

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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.

Struggling with low libido, painful sex, or poor sleep during menopause? There's a science-backed wellness tool that can help with all of these symptoms and more—but it's been wrapped in shame for far too long. In this episode, we're having an honest, research-based conversation about vibrators as legitimate health tools for midlife women, and why sexual wellness is essential wellness. This episode explores how vibrators support women's health during perimenopause and menopause, backed by compelling research from the Kinsey Institute and other studies.

You'll discover why the clitoris is the primary source of orgasm for 80% of women, how external vibration improves pelvic floor health without requiring orgasm, and why midlife libido shifts from spontaneous to responsive desire. We'll bust harmful myths, discuss different types of vibrators, share practical guidance on choosing and using them, and explain how regular use can improve sleep, mood, stress levels, lubrication, and menopause symptoms. This is a shame-free, science-grounded guide to reclaiming your pleasure and vitality. 

Key Takeaways / Main Points: 

• Research shows women ages 40-65 rated self-pleasure at 4.35 out of 5 for menopause symptom relief, more effective than many lifestyle changes 

• The clitoris contains over 10,000 nerve endings and external stimulation is how 80% of women experience orgasm 

• Gentle external vibration for just 5-10 minutes, 2-3 times weekly improves pelvic floor relaxation, reduces UTIs, eases vaginal dryness, and relieves painful intercourse 

• Vibrators increase blood flow to genital tissue, restore sensitivity lost to declining estrogen, and help your body remember pleasure 

• Orgasms release dopamine, oxytocin, and endorphins that regulate mood, lower cortisol, improve sleep, and strengthen your pelvic floor

Check out Gabriella's Intimacy Holiday Gift Guide for curated vibrator recommendations, lubricants, and sensual essentials to support your journey. Remember: you deserve sensation, connection, and joy—not someday, but now.

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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.

Looking in the mirror and not recognizing your body anymore? Despite eating well and staying active, your body keeps changing in ways that feel beyond your control. Your jeans don't fit, your belly feels thicker, and your old fitness routine just isn't working.

In this episode of Pleasure in the Pause, host Gabriella Espinosa talks with menopause fitness specialist Megan Dahlman about what's really happening to your body during perimenopause and menopause—and what you can actually do about it. Learn practical, science-backed strategies to build strength, improve body composition, and feel confident in your changing body.

In her 17 years of professional training, Megan Dahlman has become the sought-after trainer for women over 40 who want to be strong and live a long, healthy life. Leveraging a degree in Exercise Science and certification as a Strength and Conditioning Specialist (CSCS), she has an uncanny ability to make fitness and nutrition simple, doable, and, most importantly, sustainable. No fad diets or trendy gadgets required!! Through her weekly newsletter, top-ranked podcast, and popular online training programs and courses, her mission is to help every woman in midlife (and beyond) feel strong, pain-free, and confident in all aspects of her body.

Highlights from our discussion include:

• Understanding body composition: It's not just about the scale—learn the difference between lean mass (muscle, bone, organs) and fat mass, and why muscle matters more than ever in midlife.
• Visceral vs. subcutaneous fat: Menopausal women store more dangerous visceral fat around organs due to declining estrogen, which explains belly weight gain even without scale changes.
• Muscle is your superpower: Building muscle improves metabolism, bone density, hormone regulation, and energy. Make strength training your primary focus and other health goals will follow.
• Know your metabolic body type: Understanding if you're an ectomorph, mesomorph, or endomorph helps you set realistic expectations and train effectively for your unique body.
• Three essential exercises: Do these anywhere—squats (10 reps), countertop push-ups (10 reps), and planks (hold for 3-5 deep breaths).
• Hormones matter: Declining estrogen disrupts cortisol and insulin regulation. Manage stress daily through walks, breathwork, and rest.
• Break the all-or-nothing cycle: Stop swinging between extreme restriction and giving up. Ask daily: "What can I do today?"
• It's not too late: Your body can still build strength and improve at any age, regardless of your starting point.

This week, choose ONE movement that feels good in your body and do it daily—not as punishment, but as an act of self-care.

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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.

Are you navigating perimenopause or menopause and feeling disconnected from yourself? This episode of Pleasure in the Pause explores how gratitude can be a powerful tool for calming your nervous system, managing midlife symptoms, and finding meaning during this transformative phase. Gabriela Espinosa sits down with Dr. Deepti Gandhi, a board-certified family medicine physician and menopause specialist, to uncover the neuroscience behind gratitude practices and how they can help you reconnect with yourself during hormonal transitions. Whether you're struggling with brain fog, anxiety, or simply feeling overwhelmed, this conversation offers evidence-based strategies and a guided gratitude practice that you can start today.

Dr. Deepti Gandhi is a board-certified family medicine physician with over 20 years of experience supporting women through menopause. As a North American Menopause Society (NAMS) certified practitioner and personal development coach, she brings both scientific expertise and compassionate guidance to women's health. Dr. Gandhi specializes in hormone replacement therapy (HRT), symptom management, and mindset tools for thriving in midlife. She maintains a private practice, works with the telehealth company My Alloy, and is a sought-after speaker on menopause and women's wellness.

Highlights from our discussion include:

• Practicing gratitude shifts neurotransmitters like serotonin and dopamine, which directly impact mood and decision-making. It also activates pro-social brain circuitry, helping you move from fear-based thinking to connection and resilience—especially important during the emotional rollercoaster of perimenopause.
• Gratitude is not about toxic positivity or bypassing difficult emotions. You must feel anger, grief, and frustration about midlife changes before gratitude can create meaningful shifts. Suppressed emotions can manifest as physical illness, so give yourself permission to process what you're experiencing.
• You don't need elaborate rituals. Dr. Gandhi prescribes gratitude just like medication—whether it's journaling three things before bed, sharing gratitude at the dinner table, or taking two minutes for a self-gratitude breathing exercise, consistency matters more than complexity.
• The decline in estrogen that comes with menopause can actually free you from people-pleasing patterns and excessive caretaking. This transition invites you to redraw boundaries, prioritize yourself, and design a new blueprint for the decades ahead—you're a trailblazer creating a healthier model for future generations.

This week, try the guided self-gratitude practice from this episode. It might just shift everything.

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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.

Have you been living with debilitating hot flashes, sleepless nights, or painful intercourse because you're terrified hormone therapy will give you cancer? What if everything you've been told about menopause treatment has been wrong?

In this urgent episode of Pleasure In the Pause, host Gabriela Espinosa reveals a seismic shift in women's healthcare: the FDA has just eliminated the fear-based black box warnings that have kept millions of women from accessing hormone therapy for over two decades. This isn't just a policy change—it's a complete vindication of the science that's been buried under misinformation since 2002.

Highlights from our discussion include:

• A Misinterpreted Study Created Two Decades of Unnecessary Suffering.
• The Real Breast Cancer Numbers Tell a Different Story.
• Hormone Therapy Rivals Statins for Heart Protection (But Nobody Talks About It).
• Your Symptoms Aren't "Just Part of Aging" and They're Not Trivial.
• Timing Is Everything for Maximum Benefit.

The era of dismissing, minimizing, and scaring women away from effective treatment is over.

This FDA decision represents more than regulatory housekeeping—it's a fundamental shift in how women's health is valued and treated. But knowing your options exist is only the first step. Now it's time to advocate for yourself. Every woman who hears this information is one step closer to reclaiming her health, her comfort, and her power. The grassroots advocacy that made this FDA decision possible—including the 26,000+ signatures collected by Let's Talk Menopause—proves that our voices matter.

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:

Ep 34 with Jill Chmielewski

FDA Press Conference

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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.

Feeling stuck in the unsettling space between who you were and who you're becoming? If you're navigating midlife transitions—whether it's empty nest, perimenopause, aging parents, or shifting identity—this episode of Pleasure in the Pause offers a transformative perspective on living consciously through change.

Host Gabriela Espinosa sits down with Ann Tashi Slater to explore the Buddhist concept of "bardo"—the in-between state—as a powerful model for midlife transformation. If you've been resisting change, clinging to what was, or feeling overwhelmed by uncertainty, this conversation reveals how accepting impermanence can actually open the door to deeper peace, creativity, and joy. Discover practical daily practices for meeting life's transitions with awareness instead of resistance, and learn how to live fully awake in the great in-between of midlife.

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.

Ann Tashi Slater is the author of Traveling in Bardo: The Art of Living in an Impermanent World. She contributes to The New Yorker, The New York Times, The Washington Post, The Paris Review, Oprah Daily, Guernica, Granta, and many others. Her speaking engagements include Princeton, Columbia, Oxford, the American University of Paris, and Asia Society. 

Highlights from our discussion include:

• Bardo as a midlife model: The Buddhist concept of bardo—the in-between state—perfectly describes midlife when we're no longer who we were but not yet who we're becoming.
• Acceptance unlocks action: True acceptance doesn't mean giving up—it allows meaningful action. We must acknowledge reality before we can move forward through any transition.
• Resistance causes suffering: It's not change itself that threatens us, but our resistance to it. Clinging to what was creates additional suffering on top of natural grief.
• Practice noticing transitions: Build comfort with impermanence by observing daily beginnings and endings—the start and end of each day, changing seasons, how you've evolved over time.

This week, notice one beginning and one ending in your day. Then ask yourself: If things could be exactly as I wanted, what would my life look like? Remember—wanting to be happy isn't selfish, it's human.

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.

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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.