If you've ever wondered why your sexual desire disappeared—or worried that its absence means something is wrong with you—Dr. Terri Vanderlinde wants to ask a few more questions before anyone starts handing out blame, shame, or another quick fix.
Are you in pain? Are you exhausted? Do you feel connected to your partner? Do you have any privacy, time, or energy left? And if you were transported to a perfect deserted island with no work, bills, children, notifications, or laundry, would you want sex then?
If the answer is yes, you may not have a sexual problem. You may have a lifestyle problem.
Women's sexual health and low desire are often discussed as though desire exists in isolation. But women do not leave their mental load, hormonal changes, physical discomfort, resentment, trauma, body image, or unfinished household tasks outside the bedroom. All of it comes in with them.
Dr. Vanderlinde spent more than 30 years as an OB-GYN and later pursued additional training as a certified sexual counselor because medical school and residency had not prepared her to answer one of the concerns she heard most often from patients: "I have no desire."
She had been trained in disease, reproduction, surgery, and physical symptoms. She had not been adequately trained in the clitoris, pleasure, intimacy, sexual communication, or the complexity of women's desire.
So she went back and learned.
In this direct, candid conversation, Dr. Vanderlinde and Dr. Robin Buckley explore why pleasure belongs in women's healthcare and why so many women still feel embarrassed to talk about it. Women are often more comfortable reporting pain, bleeding, or a lump than saying they are not enjoying sex—or that they do not know what they enjoy at all.
That silence has consequences.
Women cannot clearly communicate what feels good if they have never explored their own bodies. They cannot advocate for different touch if they interpret feedback as criticism. And couples cannot build a satisfying sexual relationship if every kiss is assumed to be a contract for intercourse.
Dr. Vanderlinde makes an important distinction between intimacy and sex. Intimacy can include communication, affection, kissing, massage, playfulness, emotional connection, and touch without a required outcome. When every form of closeness is treated as the beginning of intercourse, women may begin avoiding all touch because they do not want to start something they feel obligated to finish.
The solution is not to pressure women into more sex. It is to expand the couple's definition of connection.
That may mean making out without going further. Giving each other massages and asking what pressure feels best. Trying something new with curiosity instead of performance anxiety. Introducing vibrators or other sexual wellness tools. Or simply creating a conversation in which "I like that" and "I don't like that" are treated as useful information rather than a judgment of someone's competence as a lover.
The conversation also addresses one of the least romantic but most accurate realities of desire: exhaustion matters.
When one partner is carrying the children, the house, the planning, the appointments, and the invisible labor, doing the dishes can become a form of foreplay—not because sex is a transaction, but because shared responsibility creates time, energy, and emotional space for intimacy.
Dr. Vanderlinde also reflects on the years when she and her husband were both working demanding medical careers and raising children. They consciously accepted that sex would be less frequent during that season. What mattered was recognizing what was happening, staying connected as a team, and refusing to turn the temporary reality into evidence that the relationship had failed.
The episode widens into a larger conversation about women's health advocacy, reproductive education, and cultural change. Through her work in Ghana, Dr. Vanderlinde has seen how information, trust, consistency, and respect can help communities shift long-held beliefs. Her lesson applies everywhere: meaningful change rarely happens by shaming people. It happens by giving women knowledge and allowing them to make informed decisions about their own bodies.
In This Episode, We Talk About:
- Low sexual desire in women and why stress, pain, fatigue, trauma, and relationship strain may matter more than libido alone
- The difference between intimacy and sex and why physical connection should not always require intercourse
- Women's body literacy and the importance of understanding the clitoris, pleasure, pain, and changing physical responses
- Communicating sexual needs without turning preferences into criticism or failure
- Perimenopause and sexual changes, including why familiar forms of touch may stop feeling good over time
- Mental load and desire and how shared household responsibility can create more emotional and physical space for sex
- Using vibrators and sexual wellness tools as part of healthy exploration rather than evidence that something is wrong
- Advocating for women's healthcare through education, informed choice, and honest conversations across generations and cultures
This conversation is for the woman who has been told her low desire is entirely her problem. It is for the woman whose body has changed, whose life is overloaded, whose partner does not understand what she needs, or who was never taught that pleasure is a legitimate part of health.
So if you've ever felt disconnected from your own body, struggled to explain what you need from a partner, or wondered why women's pleasure is still treated as optional healthcare… this episode's for you.
Learn more about Dr. Terri's powerful work for women's health care and education in Ghana: Amenyo Foundation