The PGspot - Let's Talk About Sex (With a Pro) - an Interview with Dr. Maureen Ryan

What happens when partners experience mismatched desire—or when sex starts to feel like just another item on the to-do list? In this insightful episode, I’m joined by Dr. Maureen Ryan, a sexual health counselor, nurse practitioner, and nationally certified health coach, to unpack some common yet often unspoken issues in relationships.  

We explore how couples can navigate different levels of sexual interest, the importance of prioritizing intimacy in busy lives, and how mindfulness and being truly present can enhance sexual function and connection. Dr. Ryan offers practical strategies, thoughtful perspective, and a compassionate voice that helps normalize the ebbs and flows of desire.

Whether you're in a long-term relationship or on a personal journey toward better sexual wellness, this conversation will leave you with tools to reconnect—with yourself and your partner.

If you want to learn more about sexual health, sexual dysfunction, or how to improve your sex life, follow me on Instagram at @thepgspot or check out my website at doctorpattyj.com for blogs and resources related to sex positivity and real talk about sexuality.  As as always, stay curious, stay empowered, and stay you.

Transcript

Speaker 0:08

Welcome to the PG spot, where our goal is to take the X out of sex by breaking down the barriers that prevent open communication about sexual health. I'm Dr. Patty Jalomo, a dual certified nurse practitioner, pelvic floor therapist, and certified sexual counselor. I'm here to provide expert insights, debunk myths, and empower you to embrace your sexual wellbeing. Whether you're looking for answers or simply curious, join us as we open up the conversation around sex, intimacy and everything in between. I want to take this opportunity to acknowledge that some content may not be appropriate for all listeners. I'm a huge proponent of honest and accurate information regarding sexuality. But I'm also mindful that this should be age appropriate. Therefore, if you are under 18, this may not be the podcast for you. Additionally, some of the language used in this podcast may be offensive to some listeners. Please take these things into consideration before going forward with your consensual participation in this podcast. The opinions expressed by myself or my guests are just that, and these opinions are neither expected or required to be shared by all listeners. The information that is provided is for educational and entertainment purposes only, and should not be mistaken for individual medical advice if you do find the information that we cover in the PG spot helpful, interesting or informative, please rate and review the podcast wherever you're listening from. If you think this information is important, I would love for you to share it with your friends or family. This is a great way to get the information out to more people. So thank you for listening and let's get on with the show.

Patty 1:47

Today's guest is someone who brings compassion, expertise and a deep commitment to helping people reconnect with themselves and their partners. Maureen Ryan is a nurse practitioner with dual certification in adult and women's health. A national board certified health and wellness coach, and an AASECT certified sexuality counselor. She works with individuals and couples in a confidential virtual setting to address a wide range of intimacy and sexual health concerns everything from low desire, erectile dysfunction, performance anxiety, and the impact of menopause or cancer treatment. Her goal is to help people experience deeper connection, satisfaction, and joy in their intimate lives. Maureen also holds a doctorate in nursing practice and is an improved continuing education provider through the California Board of Registered Nursing and AASECT. She's passionate about educating healthcare providers on how to confidently address sexual health, recognizing how essential it is to overall wellbeing and quality of life. So thank you, Maureen, for being here with me today. Let's talk a little bit about what it is that you do, kind of how you got into sexuality counseling. Can you share a little bit about your background and what led you to specialize in sexual health and specifically in sexual counseling?

Maureen 3:05

Yes. So, I worked in a woman's clinic. for almost 10 years. And when I was there, you would think that if a woman's struggling with intimacy or sexual concerns, you would talk to your GYN provider, ob, GYN. And, I know a lot of my patients were struggling with that, but I really didn't ask 'em about that because I didn't know how to respond. So I didn't know how to help them. I saw people struggling, and I just thought. We can do a lot better than this, that we really need to help people address what's most important to them. And that's relationships and, connection. so back then I thought, you know what? I would like to help people with this. So I got certified as a sex therapist, in Florida. It was a year long program. But, what I found was that approach didn't really work for me because it was really like about what's, you know, let's find the dysfunction and labeling people as something's wrong with you. And, and that's not the way it is. People, you know, oftentimes people with low desire, that's actually a functional response to a dysfunctional relationship. So, and, and life is complicated. We have peaks and valleys, we have lots of stressors. I found that the coaching approach worked best. So then I went on and became, a health and wellness coach. So I'm a national board certified health and wellness coach, and that approach really, works the best because I talk to people about what's important to you. What do you want to be different? Why does that matter to you? I help them find their motivators. we talk about barriers, and barriers would be labeled as the dysfunction. so maybe, you know, low desire, erectile dysfunction, arousal.

Patty 4:44

correlates together and plays in, you know, to each other too. So. That's a great way to think

Maureen 4:49

Yeah.

Patty 4:50

Okay.

Maureen 4:51

Yeah.

Patty 4:52

I noticed on your website you have a lot of, information about, provider education and also a course that you offer. So tell us about the course that you offer for, individuals or couples.

Maureen 5:04

the course I have now that's available is really for providers.

Patty 5:08

Okay.

Maureen 5:09

So it's, patient centered sexual health conversations, like how to talk to your patients about sex, there are so many people, so many providers who really wanna be able to help their, their patients, but they just need some, some tools to open the dialogue and to feel like they can help, somebody move forward. Patty, you know, there's not a lot of people who are highly trained in sexual health I really feel passionate about helping other providers become more comfortable. But I actually, I do have a, a program also up now that's, it's, postmenopausal concerns about -vulvo -vaginal health. for postmenopausal women.

Patty 5:43

that for providers also? Is that for,

Maureen 5:46

There's one for providers. They can get CE credit. CE credit is available through AASECT as well as California Board of Nursing, but then there's one that I just tweaked so it's just for lay people too,

Patty 5:56

Okay. And then, what about the, Guide for Women's Sexual being, the Discovering Desire? Is that just a program that you used to work through with your patients?

Maureen 6:05

I use it with my patients and then when I get groups together, I have more informal groups. They're not set up right now. it is something that I'm gonna do again in the near future. But yeah, so what I find is so many women struggle with low desire. for all sorts of reasons. we have a mind, our beliefs, our thoughts. We have a heart and emotions and connection and resentment and anger. all those things that can interfere with emotional connection and then a physical body that can also, have some struggles that way. So, that's very common and you see that all the time.

Patty 6:41

That's probably the number one that I have when patients, especially menopausal patients come in. It's always decreased desire. What's wrong with me?

Maureen 6:51

Yeah.

Patty 6:52

You know,

Maureen 6:53

Right. And there's a lot to explore with that because sometimes there is nothing wrong with you. maybe you're just not desiring the kind of sex you're having.

Patty 6:58

right. And that's what I,

Maureen 6:59

Yeah.

Patty 7:00

and that's a difficult thing, in an office visit setting because time is so limited and I tell patients

Maureen 7:05

Right.

Patty 7:06

a lot of different things that can affect that. I noticed just looking through that course that, it mentions really working on, kind of starting from a place of a neutral state. You introduce the idea of initiating sexual encounters from a neutral state. Can you explain what that means and why that can be powerful and helpful?

Maureen 7:25

Okay. It's very helpful. I should say that workbook you're talking about, that can be available for people, so you can put on your website or however you link to it and people can download that because I think it's really helpful. I think it normalizes what a lot of, women's experience with sex is as well as men too, especially as they get older. I equate sex to like the gym sometimes. There's so many reasons to work out and be strong, right? We can talk about that for the next hour. And there's so many reasons to have a healthy sexual relationship too. It adds so much value to your life and meaning and connection and love and, all sorts of beautiful things. What happens is if you're not connected with your why, like why do I work out? Why is my, sexual relationship important to me? You can forget it and put it on the back burner and nothing's gonna happen, or you're gonna be having, you know, just ho hum sex just to crossed off your list. And that's no fun for anybody. You have to find your motivator. Just like the gym, you drag yourself to the gym because of all your why's. And then you start working out and blood starts pumping. You're like, okay, I'm feeling better. And when you're done, it's like, wow, I'm really glad I did this. I feel so much better and I feel healthier. And all of those reasons. And it's like that with sex too, because oftentimes I'm gonna say the majority of time people in long-term relationships, they do start from a neutral place. Like for instance, this is typical, uh, you just get everything done for the night. kids in bed, house cleaned up, and then you sit down and you're like, I'm gonna watch my Netflix show. Right? I've been looking forward to, and then you get the look from your partner, like, oh boy, I know what they want. Well, instead of rolling your eyes and being, You know, not very

Patty 9:05

Excited about that.

Maureen 9:06

You have to like pause there and say, you know what? There's a lot of reasons why it would be good for me to just go and see what's possible because all the reasons why, sexual intimacy is so important in a relationship. 'cause it really is the glue for a lot of people.

Patty 9:20

prioritize that. You know, you have to really put time and effort into making that important in your relationship.

Maureen 9:29

especially if it's important to at least one person in the relationship, they have a really solid relationship, solid friendship, commitment, then great. But when one person, when it's important to one person, then it's important to both, or it should be. Figure out a way to meet the needs. starting from a place of neutral, like, okay, not really feeling it, but I'll see what's possible. So you, you start, touching skin to skin contact, the body starts to get relaxed, the touch feels good, then the body healthy body's gonna get aroused. And then as the arousal builds, like the prefrontal cortex, blood flow slows down and you become more present in the moment, less distracted. And now. There's desire. instead of like desire coming first, and then arousal, which is how a lot of people think it should be it's flipped. the body has to get aroused, so, so you want to be there. So it's like you don't wanna play the game until the third quarter, the game. You gotta show up and start playing the game

Patty 10:25

exactly right.

Maureen 10:27

Yeah.

Patty 10:27

so how can creating pleasurable contacts and sensations help women develop desire, even if they aren't initially feeling in the mood?

Maureen 10:37

Okay, so that's, um, taking time to include the whole body in essential,

Patty 10:44

Mm-hmm.

Maureen 10:44

experience because what happens all too often is that it goes right to, there's an erect penis, okay. Act on it and coming intercourse. And it's like, very rare is it that that's enough time for a woman to get aroused and switch gears. And become more present in her body, and that comes with arousal. So I think that I often advise people to slow down. I like the sensate focus exercises because that slows things down. It includes the whole body and touch. There's no goal.

Patty 11:15

the listeners don't know what the Sensate focus concept is?

Maureen 11:19

Yeah. And I have to like really encourage my patients too, because at first they think like, oh my God, it's weird. We have to do our homework. And they're really resistant. So we talk about that when I explain it to them. And then I say, by the third time, you're gonna love it. And they usually do by the second or third time. But anyway, so Masters and Johnsons that they're sex researchers back from the seventies, when Virginia Johnson was a little girl. And she'd be upset. Her mother would soothe her by just slowly stroking her arm or her cheek or her head. And that was very calming to her. And then when Virginia Johnson started working with couples who experienced a lot of, sexual performance anxiety, she thought, I wonder if that would help them. So what this ev about to is this, series of exercises, touching exercises that are non goal oriented. when you first start out, it's not about arousal. I always tell people like, um, you don't, don't include, don't touch anything under a bathing suit the first time. Because I want people to relax. So they set aside time. They don't talk during it, and they take turns giving and receiving touch it's whole body touch. And it's not like massage touch. It's light, feathery touch because that activates more sensory fibers in the skin. So the, the focus of this is to stay connected to sensation. What are you feeling in the body, and also to trigger relaxation, the relaxation response and take any goal out of The purpose of this, so you take turns giving and receiving touch for 15 minutes if you can. and I tell people to set a timer on their phone because they'll think like 15 minutes, they'll think like, oh, five minutes, and they start looking at the phone. No, it'll ding when it's 15 minutes.

Patty 13:00

Because otherwise you're going to be distracted by trying to watch the clock, right?

Maureen 13:02

right. So again, I just ask them, just focus on what am I feeling? What am I feeling? What am I feeling? and so that helps people discover other places in the body that feel good. It slows things down into more of sensual experience. and it also, you're touching in that, nurturing way, affectionate way. It releases oxytocin, the, feel good hormone.

Patty 13:26

Right?

Maureen 13:27

Mm-hmm.

Patty 13:27

I think that leads into, you know, the next question, that deals with really just broadening the definition of sexual intimacy. I think in our culture we're programmed to think of sex as penis in vagina or penis in anus penetration, But sex can be

Maureen 13:43

Right.

Patty 13:44

so much more than that. And for vulva owners, it probably is important for it to be much more than that.

Maureen 13:50

Yes. You know, it's interesting, and you probably see this too, Patty, like sometimes when a couple starts to struggle with a sexual dysfunction, like painful sex or erectile dysfunction, they can't have intercourse like they once did. Sometimes couples will give up and think it's over. But others who are, more resourceful and, they'll explore like, what else is possible. And then they'll start to slow things down and make things more essential. like the sense focus, discovering things that feel good that way, and oftentimes find it to be much more pleasurable than just the 1, 2, 3, 4, you know, goal oriented sex, which, can get old after a while.

Patty 14:27

And just being curious, you know, I think that's, an important part. And by using that sensate focus, then you're really focusing on the sensations that you're feeling, how it's, you know,

Maureen 14:38

Mm-hmm.

Patty 14:38

you're receiving that touch. And yeah, that can just open up a lot of, opportunities

Maureen 14:43

Sometimes I'll ask people to consider putting a blindfold on both of them this is not for everybody, but for some people who are comfortable with it, it's really nice because if you, take away sight, then your other senses become heightened and so you really feel, and you really are using all of your senses to be in the moment and, explore each other's bodies. a lot of people are really self-conscious of their bodies. So if they have a blindfold on and their partner has a blindfold on, nobody can see anything. They're not worried about like, oh, do I have a, flabby butt

Patty 15:20

And then you just can't be present and

Maureen 15:23

So it doesn't matter what position you're in, nobody can see anything.

Patty 15:26

That's a great idea

Maureen 15:27

You can just be in your body.

Patty 15:28

I love the blindfold idea

Maureen 15:29

For both people. For them both to be able to.

Patty 15:31

speaking of being present, focusing on mindfulness, how do you define mindfulness in the context of sexuality or sexual function? I know we talked about that presence the brain is the biggest sex organ. So many times we get in our way because, like you mentioned with body image just thinking about, what do I look like? What would be some practical ways that women can to be more mindful or more present their bodies?

Maureen 15:56

So, the cognitive distractions, like the mind that won't stop, that's like, you know, you're intimate and you're thinking about doing the laundry or what you have to do at work tomorrow. So you're missing out on everything. So, um, mindfulness is about being in the present moment, and how do you get there sexually. You get there by connecting with your senses, by being in your body. So oftentimes people are, when they're intimate, they're outside, like, kind of critiquing, like, what do I look like? Or, you know, being critical of their bodies they're not in their body. I ask people to try to put their center of focus, their presence inside their body, so in their heart, and then move from there out. So I am in my body and I'm experiencing this event through my senses, through my hands, through my skin, through my eyes. I'm fully present in my body. And with my partner. that means I'm no longer in my head, So connecting with senses. when my mind starts to think about what I have to do tomorrow I come back and maybe put my full attention on my hands. What am I feeling or what does the skin to skin contact feel like? what do their muscles feel like? really using senses Too many of us don't live in our bodies. We're in our head all the time. We're thinking, and we're, you know, we live in our heads. So, how do you learn to get back in your body? We do it on a day-to-day basis by stopping and noticing and being present. when you're washing your hands, actually feel the water, feel the soap. Feel yourself, lathering up your hands, drying your hands when you're in the shower. Pause, feel the water. do you feel it on your back, on your face? what's the temperature when you're shampooing your hair, feeling the shampoo, shaving your legs, putting on lotion, like actually being present in your body. And that's what Sensei Focus helps you to do. It helps you be present and connect with sensation. Because again, with sensate focus, what are you focusing on? What am I feeling? What am I feeling? What am I feeling?

Patty 17:51

by incorporating those things in your everyday life. You know that that in turn eventually will help sexually to be able to more easily get back into your body. A lot of, eating plans and dietary things, yeah. just really stress slow down or even put your fork down in between bites, really chew the food so many times. Be able to, focus on how the food actually tastes. 'cause it's kinda the same thing with that. We just snarf it down and. You know, and then you're, yeah, and then you eat everything. if you are more present and mindful about eating, you find that you actually get full faster without having to the whole meal, it definitely plays into a lot of different areas,

Maureen 18:35

So that's something that people can, you know, just because it's a healthy thing to do, you know, to appreciate the food in front of you. That's a great place to practice every day.

Patty 18:45

Just practice.

Maureen 18:46

Yeah.

Patty 18:47

and like you said in the shower, I love that too. Just because, you know, feeling that warmth of the water, the smells of the soap, you know, all of those things are just great ways to, really slow down and practice that mindfulness And then it makes it so much easier to not get in your head during sex and bring that into your, sexual life too.

Maureen 19:05

You know, also like walks outside. So mindful walk where you're actually like looking, looking at the trees and the things are blooming now where I am. The sky is blue. It's been gray for a long time. So things are green and blue, just feeling the breeze on your face and the sun, on your skin, things like that. just pausing and being fully present in your body.

Patty 19:28

Yeah, just, incorporating, getting that, that, parasympathetic nerve system going, you know, just to slow

Maureen 19:34

Yes.

Patty 19:36

Yeah.

Maureen 19:36

Yeah.

Patty 19:37

Well, definitely, you know, we talked about how stress and anxiety and getting in your head, you know, can affect arousal. But also orgasm. You know, I have oftentimes patients that maybe have never been able to reach orgasm, and a lot of that is, really focusing on the sensations and practicing and, getting that presence. are there other areas of sexual health or sexuality you feel that, um, being present and mindful can be helpful?

Maureen 20:06

Yeah. Well, and also presence, mindfulness, but also empathy for your partner too. I've had a lot of couples lately where it's like one person has decided they no longer wanna have a sexual relationship, and, that's important to the other person they have a real hard time putting themselves in their partner's shoes and that can build up a lot of resentment and feeling not wanted and rejected and a lot of loneliness and really could be the downfall of a lot of relationships. When you were talking a few minutes ago, you said something that made me think of this couple that was really this cool couple. So, I call him my, did I ever share this with you? The minimum requirement couple.

Patty 20:43

yes, I love it. But share it with everybody else.

Maureen 20:47

All right. So I was at Eon for, um, a conference and it was mostly like therapists and sexual health, experts. And there was a couple, their workshop was canceled last minute, and so they ended up in ours. So they're like this couple in their sixties. They had raised four kids. They'd been together a long time and, um. In general, like, you know, marriage is up and down, but a healthy, successful couple. he said when they got married he said to her, I need to have sex once a week. I know this about myself, it's important to me. and she said, I can do that, but I need my back rub for 15 minutes before we do anything sexual because it's hard for me to relax and that would help me relax so I can be present. And he said, I can do that. So I think it's important to have discussions about like, what are my minimum requirements? I'm not okay being in a, a relationship where I can't have sex because my partner doesn't want it. Now, obviously there are times when it's a really dysfunctional relationship and, there's reasons absolutely not to, or, You know, so there's, I mean, I'm not saying, I'm saying that, you need to look at every, every couple is different and but just saying, Nope, I'm done shutting it down, that's like, you know, that's a tough one.

Patty 22:07

for sure. And you know, even like you say, having empathy for your partner, but also having those conversations and finding out why, oftentimes in my practice, I'll see women who have pain with intercourse. Maybe it's due to menopause, vaginal dryness, you know, that type of thing. Instead of understanding that sexuality is an important part and their intimacy is an important part of their life. you know, they're just like, Nope, I'm done. It just hurts, you know? So, uh, again, having a

Maureen 22:36

Yeah.

Patty 22:37

is interested enough to say, well, you know, let's look at this further. Let's figure out why this is an issue for you, and, then see what can be

Maureen 22:46

Yeah.

Patty 22:47

to help with that.

Maureen 22:48

and Patty and I feel the same way. If somebody's having pain, don't do something that causes pain.

Patty 22:53

Yeah.

Maureen 22:53

that's gonna set up a pain cycle and it's a sign. Something's going on. There's a lot of things that can really help with, if we're talking about postmenopausal, just, painful sex. and that's why we need to educate people and help them be able to experience what they want in their relationships.

Patty 23:09

Yeah. All right. is there anything that we missed or anything else that you want to share with

Maureen 23:15

We can talk forever about, we can talk forever. There's so, there's so much to talk about, so many, challenges that come up and I just love when I help people reconnect and they're like, you know, happy again and feeling loved and special and, uh, it's a really good feeling to do that. we work in a good area. Patty, you and I.

Patty 23:39

Absolutely. All right, well, I appreciate you taking the time to come on and talk to me and all the listeners today. So where can, um, everybody find you if they want to learn more about what you do now, do you, practice or see patients outside of your state?

Maureen 23:57

I do, I do. So, um, I do that when I put on my coaching hat. I'm a national board certified health and wellness coach, so I can see people All over the country. I'm licensed in New York State as a nurse practitioner, so the roles are a little bit different. they can find me on my website. my name's Maureen Ryan. It's just, Dr. Maureen Ryan, which is just dr maureen ryan.com.

Patty 24:19

And I'll put that in the show notes so that people can, find you there. Anything else you wanna say today?

Maureen 24:24

Don't give up. don't try not to let, um, you know, people build up walls because they get hurt and they never find a way to communicate. And to, I always say like, the, where I always like to start is like, seek to understand. Like, it's really important to understand where your partner's coming from, what they're feeling, but in, not in a defensive way. Like we wanna get rid of all the defensiveness and we wanna hear each other. And I think that's a, a place that a lot of people never get to so they never get unstuck.

Patty 24:57

That's very important.

Maureen 24:58

Yeah. But when there's empathy kindness and caring, you can do a lot and really improve a relationship.

Patty 25:04

All right.

Maureen 25:06

Hmm.

Patty 25:06

well, take care. I will probably talk to you soon, and thank you again for coming on.

Maureen 25:13

Thanks, Patty. I appreciate it. Okay, bye.

Speaker 25:21

That's it for today's episode. Thanks for listening, and be sure to rate and review the podcast on whatever platform you're listening from and share it with your friends. That's a great way to help reach new listeners and make this a more sex positive world. Also, I'd love your feedback and questions, so send me a message. It's at email@doctorpattyj.com, and that's doctor spelled out, D-O-C-T-O-R-P-A-T-T-Y- j.com. Until next time, stay curious, stay empowered, and stay you.