Lost Your Libido in Menopause?

Why does libido disappear in menopause — and is it ever coming back? That's the question pelvic health physiotherapist and author Lisa Fitzpatrick hears in her clinic almost every day, and it's the one we sit with in this episode.

Lisa's been treating women's pelvic and sexual health for over three decades. But it was her own menopause — arriving at the same time her relationship ended at 51 - that led to a deep unravelling and rebirth. She talks candidly about that collision, and how it became the reason she wrote Sexy Menopause.

We get into why libido changes in midlife are rarely just about hormones. Stress, safety, old trauma, and a nervous system that's never allowed to switch off all play a part — and Lisa explains why the usual advice to "just do your Kegels" can actually make things worse, not better. We also talk about the stigma that tells women to get quieter and less visible as they age, and why menopause can bring on the exact opposite: a real, useful "couldn't care less" energy.

This episode closes with one simple daily practice Lisa recommends to any woman who feels disconnected from her body — something you can start today, with your morning tea.

Full episode guide and show notes here: https://vitopia.ai/podcast

KEY LINKS

• Lisa Fitzpatrick's website: lisafitzpatrick.com.au
• Sexy Menopause (pre-order): sexymenopause.com — out 27 October 2026
• The Energy Audit for Women 40+: https://kelly-zbqk659r.scoreapp.com/
• Work with Kelly: kellynicholls.com
• Kelly on Instagram: @kellybnicholls
• Lisa on Instagram: @thelisafitzpatrick

Transcript

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SPEAKER_02 0:00

Welcome to Wellness Simplified. I'm Kelly Nichols, and this show is for busy people who care deeply about their health, but are drowning in conflicting advice and don't know where to focus. Every episode, we simplify one area of health. One habit, one simple experiment, one clear next step that will actually fit into your life. Together, let's optimize our health. One simple step at a time. If you're in the menopausal transition and you feel like you lost your libido, your mojo, yourself, this episode is for you. By the end of this one, you're going to understand why that loss of libido is actually never just about hormons. And you'll start to see this immense opportunity that comes with this period of your life and hopefully transform some of that BS that society tells us. And you will walk away with one simple practice you can start tomorrow morning with your morning tea that will help you reconnect to your body and start to reignite your mojo. My guest today is Lisa Fitzpatrick, a pelvic health physiotherapist with over three decades of clinical experience and the author of the new book, Sexy Menopause. This is a raw and beautiful episode. One to share with your girlfriends. I hope you enjoy it. Let's get into it.

SPEAKER_00 1:28

Hey Lisa, welcome to the show. Thank you so much for having me. So awesome to be here.

SPEAKER_02 1:35

Yeah, I'm really, really excited. I feel like this is going to be a very deep, juicy one. So I can't wait to really get into it. It's going to be awesome. But before we do, give the listeners kind of a bit of an insight into the guests' life. So if you could l tell us how your morning started. How do you set yourself up for the day? What's your mornings look like?

SPEAKER_00 1:57

Yeah, so my mornings always involve lots of cuddles with two beautiful dogs of mine that are Laochan breed. They're very fluffy, cuddly, cavoodle-like creatures. I have two babies to um enjoy my regulation practice with, and they sit in the bed with me and we pray and we meditate, and we have a moment where everything's really quiet because I like to get up before everything starts moving. Mo a lot of mornings I'll sit and have some tea as well. Have a tea ceremony. We I I gather with a group of women twice a week actually for that. Silent tea ceremonies are an absolutely beautiful way to start the day. And then I usually start my clinics quite early, and because some of my patients like to come in before they go to work. So a typical clinic day for me might start as at eight or nine o'clock, and then they basically spend the entire day speaking to women about their pelvic and sexual health concerns. And it's the most interesting job you could ever imagine yourself in. It's also the most uh painful, you know, job in terms of hearing all of the trauma that women experience. But like um today I had uh about five patients before we're now speaking, and I also did another podcast interview today as well. But yeah, today's actually probably my ideal day so far. Yeah, the sun's shining. I'm in a little village called Bangalore on the main street in my clinic. It's a very semi-rural sort of station, so it's like the world is relatively slow paced, and people are just very friendly and relaxed everywhere you turn in Bangalore. So I just love it here with a passion.

SPEAKER_02 3:53

Oh, it sounds beautiful. Have you lived there for a long time?

SPEAKER_00 3:56

I've been on the North Coast now in the Byron Bay Shire area for 30 years. So I can say I'm a true local now. I think it takes 20 years to get to that status.

SPEAKER_02 4:07

Yeah, yeah, fair enough, fair enough. And you're about to launch a book called Sexy Menopause. And I imagine when I just read the title, like I was feeling into that must have taken like tons of courage and vulnerability to write a book with that title, with that content, and with a level of vulnerability. So talk, tell us a bit about that. Like, how did you get the courage to do that?

SPEAKER_00 4:30

It was a really harrowing life experience, Kelly, that put me on the floor with my heart broken with a a fiance that left me, you know, at the age of 51, right as I was starting my menopausal shift. I was really, really suffering from menopausal symptoms. And I I guess I underestimated how much of a toll it was taking on my relationship. And when I got a text message one day that said, I'm in love with you, but I'm not in love with you anymore, I just about dropped to the floor and I could barely pick myself up for six months. And if you had have said to me that sexy and menopause go in the same sentence at that point, I just would never, ever have believed you because I was over, I was really putting on a lot of weight. I felt like I had every menopause symptom in the book, I was boiling alive. I felt as though all of my youthful vigour and bloom had packed up and left them left the building, and that I would be washed up, old, bitter, twisted, and incredibly non-sexual. And that was devastating to me because I've always enjoyed being in my body, and it's been a slow, long journey for me of over three decades working with bodies, working with women to empower them, working in the female sort of feminine empowerment coaching spaces and female pelvic health spaces and sexual health spaces. And I feel a bit like it was a cruel irony and a joke that the universe had played, where I was having to then come into clinic, speak positively about sex, and still in the inside think, I just don't know if a 51-year-old woman can go out and actually have sex ever again. I just don't think it's appropriate for me to be on dating apps, for me to be out single at trying to meet someone. I never envisioned this for my life. My forever person's gone. I found out he'd left for a woman who was 32 years old, which kind of almost put me on the floor again for another six months when I discovered that that's why we broke. It was the worst. And I never thought I could ever see the light. But I think what happened was I reached the rock bottom to the point where it was so low that I got to examine some of the deeper childhood traumas that I believe I was storing in the pelvic cauldron and that needed to be reckoned with for me to cross the menopause bridge. And interestingly, as I was sort of going through this reconfiguration process, which was like an accelerated container of complete reinvention, I guess, I realized that nothing could ever feel as painful or as as dark again. I was managing to retrieve parts of myself that maybe I'd also been frightened of, sitting with, not able to fully process due to the traumatic nature of them. And I think also my menopausal symptoms started to improve. And that was the big like telltale thing for me was that wow, I'm actually coming alive again. I haven't been alive for a long time. I've been in a very stressful relationship. I've been in a relationship that has elements of coercive control that I never really picked at the time. I was in self-hatred. There was a lot of negative self-sort of programming around the way that I was perceiving my identity. And I realized when I was kind of released from the shackles of a relationship that was holding me in this space, that there was a real opportunity. And the opportunity was a fork in the road that said, you could get really bitter, you could become a crazy dog lady, you could give up, you could say, right, I'm just gonna get all washed up here. And then in the clinic, meanwhile, my my verbal sort of educational sort of programming for pelvic health is it's really important as we go through midlife to maintain regular sexual health because sexual health begets pelvic health and pelvic health begets sexual health. And if we decide to go celibate, there's no judgment about that. But there is a lot of health benefits to us maintaining some kind of sexual activity. And I couldn't keep giving this rhetoric to patients if I wasn't going to start to try and heal that part for myself because there was a part of me that went, I'm never going to trust anyone with my body again. I don't even know my body anymore. What is this body? This body's changed so much with this familiar person. How will I ever be able to reveal a body in front of a new person at this age? You know, I think coming back and realizing that actual, actually, to be sexual in your 50s is a wonderful thing. It has so many advantages and benefits that we don't even really talk about. Why don't we pair being sexy with menopause and try and change some of these awful narratives that say women in their 50s can't be sexy? Yeah. That was my impetus. And yes, it takes every bit of courage I've got to put this book out there. You're right. It's part memoir. I talk about my devastation being left. It's vulnerable, but it's real. And it's what happens to a lot of a lot of women.

SPEAKER_02 10:18

Yeah, absolutely. And I think it's so vulnerable and courageous that it will speak to so many people. You say something, I forget where I read it exactly, in this about that when people get into menopause or that perimenopause-menopause stage, that they get this increasingly like I couldn't care less kind of energy, and that's incredibly powerful.

SPEAKER_00 10:40

Yes.

SPEAKER_02 10:40

Did that but that showed up for you with that combination of breakup and menopause? Do you think what do you think for people, women in general, is that catalyst to get to that? Because that's such an empowering place to get to, because we spend so much time as women caring far too much what other people think about us.

SPEAKER_00 10:58

Yeah, yeah. It was almost like the ego broke open so much in the humiliation about being left for someone 20 years younger that to me I couldn't afford to care how anyone perceived me anymore because all I could do to survive the pain was to tell everyone that I knew what had happened and how I was feeling. And it was weird because I was almost like embarrassingly oversharing. I was ringing people with the ugly cries, you know, like at really inappropriate hours too. You know, sort of like just grasping for anyone who'd listen. And then I went on a really yeah, I went on a really important pilgrimage where I did a five-week long service leave backpacking trip through Southeast Asia. And at that point, I'd kind of like been putting my feelers out to everyone I knew for support. But it but on that trip I had to really start to get my own agency back. And that was when I started to realize that I'd been in a very unhealthy relationship with myself for a long time, and that I'd slowly but surely left the building, as they say, and started to put all of my hopes and my dreams into somebody else's agenda. And I'd lost sight of this idea that actually, as a woman, we have a sovereignty to us that enables us to give birth to new life and go through a lot of different transfigurations through the pelvic cauldron. So this milestone was no different to any other milestone. But what this milestone does for a lot of women, and it did for me in this dramatic fashion, is it forced me to reckon with what was going to come with me to the other side of the menopause bridge. And so, you know, the biggest takeaway was a sense of deep liberation because liberating yourself from some of the things that did matter to you once, like what people thought of you, became the key to recovery and healing. And being answerable only to me, like my sense of spirituality became a lot more about a vertical orientation to I'm answerable to a creator that has my back. This experience is a benevolence that's working through my life to give me my life back in ways I can't even think of yet. But this is a divine rescue, what's happening. I trust that more than I trust anyone else's judgment of me now. I trust that more than I even trust myself. And my whole life has been lived in a way that's pushing my own will and agenda on that. And that poor creative life force has been trying to give me everything I wanted my whole life, but I haven't been listening. I needed to sort of give it a life experience that went, actually, Lisa, you you don't know. You you can't push your agenda anymore. Menopause won't let you. You have to surrender everything. Yeah. Even your even your deepest, deepest desire for something to happen the way you want it to. You cannot control that. You have to trust life more. And somehow that's been the key for me is not holding any part of myself back from that.

SPEAKER_02 14:32

So that deep kind of I think, yeah, I can hear that kind of deep surrender that the universe source like has your back. And rather than that, you know, I want it to look like A, B, C, and I'll take follow the to-do list to try to get there, just to surrender in that I am being divinely guided. And these experiences that sometimes seem like the most awful things are actually perfectly what I need to reveal something that I just won't let myself see otherwise.

SPEAKER_00 15:01

Yes, yes, yes. And all of our lives somehow I think there's some narrative that says to women or to many people, including men, if you have a life that implodes on you, you've done something terribly wrong. You've you've caused, you know, you're not, you're, you're off course somehow. But what but the absolute opposite happened to me with this experience, which was actually every single piece of friction and pain that you've experienced your entire life has actually brought you to this moment where the oil of your anointment's been so concentrated by the experiences of intensity that have happened. It's a really precious thing that we have as women, this life force energy that we carry, and it's a very rare and precious energy that it needs us to celebrate the the very strong contrasts, I think that we go through. And you know, I wrote about that a lot, Kelly, in this idea that, you know, we are really carrying a lot of stigmas. And those are also known in spiritual ways as stigmata. And stigmata for me was the stigma of being left for a younger woman, the stigma of being a woman solo in her 50s, the stigma of still wanting to be desirable and still wanting to have sex, you know, in my older age. All of these that really do not serve women, but get kind of, you know, pushed on us as an as a media agenda, as a capitalist agenda that help us to spend a lot of our money, a lot of our energy, a lot of our time like matter, right?

SPEAKER_02 17:01

You were talking about this kind of, I don't know, transmutation process of how do you turn this kind of grief and these feelings and then transmute them into this growth? And I just want to touch on that before we go into stigma. So if there's a woman who's listening and she's going through whether it's a breakup or it's just that period of menopause where she's feeling like she's completely lost herself, do you have any suggestions of like processes or whatever that she can go through to equally try to transmute that into something to a higher version of herself?

SPEAKER_00 17:39

Absolutely. I believe that every woman has an equal access to a very small, still quiet voice that enables her to receive divine guidance that's incredibly benevolent and supportive and kind and loving. So when we hear a voice that's negative and mean, it's not that voice. Yeah. The voice, not the one that's on all the time. That's on all the time. And it's often on speed dial, and it's often very amplified. So when it's a really intense voice, that's not the voice. The voice is very small and still and quiet. It requires us to have periods of deep, deep silence, which is why I have a silent practice every morning and also why I do my silent tea ceremonies regularly, because when we're immersed in silence, finally the noise of the world and the distractive forces that would have us really being derailed from our life purpose, we can start to release those and really hear the guidance, the internal guidance system that is always, always guiding us. It never turns itself off our entire life, and it's never too late for us to hear it either. And I think if I had one practice I'd offer women is to not be frightened to actually sit in the quiet of your own sense of, you know, your your own sense of self. Now, initially for me, that was absolutely terrorizing. Even though I've been a yoga teacher and practiced a lot of different meditation practices, I'd always pinned my attention on some kind of practice. But to actually sit with my own soul without having any scaffolding and to let myself fall and to let myself kind of be held by the cosmos, there was a lot of pain, and there were a lot of hours of me not even being able to sit upright because the pain was so bad I had to lie flat to actually cope with that practice. But I think if we can feel that moving through us, we reach, we reach that voice in a stronger way than we did before. And so what it's done for me in my life is it's given me a course correction that's enabled my compass, my the needle on my compass to point to the true north more strongly than it ever did in my old life. And I believe, women, you know, it's a spiritual awakening that menopause affords us that gives us access to that power, but it's not celebrated in society. It's it's a little bit dangerous to the status quo and to the patriarchy. It's not a very attractive thing for us to be standing up and saying, hey, the way the world's working right now, it's not good for our health. It's not good for our well-being. Yeah.

SPEAKER_02 20:50

Yeah. Totally. I love that. I love that idea of stillness. I I've definitely found that myself. I lost both my parents in a sh very, and I was extremely close to them in a short amount of time. Like they one died after the other. And it was like that very like falling apart kind of thing. But just as you're saying, in the falling apart brought about like this kind of need for that stillness. And then the stillness brings the insight that was always there, but you're so busy. So often these experiences bring us home to ourselves more and more. And I think exactly what you're saying, it doesn't need to be complicated. It's just having the the courage again to sit in stillness and not distract yourself.

SPEAKER_00 21:33

Yes, and also going back to that point I made about how sometimes we make ourselves wrong for our experiences because if I'm feeling this much pain, I must have done something terrible, you know, in my life to get to this point of pain. But I see that very differently now, and that we are never closer to the divine than we are in our kind of hardest moments. God loves us so much in our brain. Brokenheartedness that we're never more held than we are in those moments of pain. And that's actually a beautiful thing to think we could access that in our lowest points. But also what that's meant for me, Kelly, is realizing that I know life is going to throw some other curlies my way. I'm not, you know, I've lived enough years now to know because it's not over yet. Yes. But something in the surrender to what is, around how I could have been a really good girl who did all the right things, who was the sweetest partner in the world, and this still would have happened. I could have tried my hardest to not put a foot out of place, and life was always going to work out a certain way. And I now believe, you know, that we, you know, we're we do have a story and a plan that we're we're trying our best to honour and to do in the way that was intended for our highest good.

SPEAKER_02 23:05

Yeah, we just have to listen to the messages and follow the guidance instead of always, as you said earlier, tracking control to our way. You mentioned about the stigma and like this what this whole idea that women, when they hit like a certain age, whatever it is, mid-40s, whatever, that then they should become quieter and smaller and less provocative, and you know, that their libido will dry and all of that stuff, it drives me absolutely crazy. But it's so pervasive and it's so pervasive that like even when you're aware of it, you can like it's so bred into you. So yeah, I want to chat about that this year. I turned 47 and I decided stuff this shit. I'm gonna become a performing burlesque performer at 47. It's fantastic. I was like, I just I just want to like totally rebel against this idea. And I was in a group doing this, and some of the women were like, oh my goodness, I'm you know, I'm turning 30 next year and my boobs are starting to sag. I gotta do this now. I'm like, sweetheart, don't worry, you got lots of time.

SPEAKER_00 24:07

But less just for the mature woman.

SPEAKER_02 24:10

Yeah. Exactly. Exactly. So tell me, tell me about like how that's occurred to you with the women that you work for and how you rebel against it.

SPEAKER_00 24:19

Yes, yes. Um, so the stigmata that really create, I guess, a wound, which is a psychic wound that a lot of women collectively carry at once, and those stigmatas are reinforced by our own fear of stepping out of line. So in you doing your burlesque, you're you're pushing against those norms and those cultural stigmata, and you're showing other women that it's possible, what's possible. And you're also, you know, supporting this idea that we don't tend to have as many role models for ourselves, other than people who are amazing, like Madonna, who are sort of paving the way for visibility in the spaces beyond 45. And where I'd like to go with that is that there's a very alarming statistic that says between the age of 45 and 55, there's a very high rate of suicide for women. It's the highest it's ever been. And then on top of that, it's a very high rate for divorce, the highest it's ever been. Now, I was in that statistic myself thinking, how am I going to survive this? I don't even know if life's worth living after experiencing this devastation. Because to me, if I'd made it this far with someone, I was going to retire and have that lovely, calm, you know, life on the other side winding down. But unfortunately, for a lot of women like myself, we are now working till we're, you know, in the grave because our partners have not, there's no state security, you know, on those more economic levels. But having said that, that that that stigma in and of itself then changes because women in their 60s and 70s in the statistics are the happiest they've ever been. And so when I start to see, when I started to see my patients coming in in their 60s and 70s, and they're all talking about their wonderful traveling overseas and their partners and how they're liberated from all the caregiving, and that, you know, some of them have just been in a full-on celebration of life and their bodies.

SPEAKER_01 26:36

Amazing.

SPEAKER_00 26:37

And I just think, wow, that's what we've got to look forward to. And it's only a chapter time, it's a long one, but it's only a chapter.

SPEAKER_02 26:49

And what, yeah, you've described like this, you know, reclaiming sexual power in midlife as one of the most spiritually significant experiences a woman can have. What might that actually look like in a woman's life? Yes. And oh yeah, and you could explain what it you could inspire them. Like, what does that look like? What has that looked like for you? You described at the start that devastation. What does it look like now?

SPEAKER_00 27:13

Yeah, what it looks like is the celebration of us no longer having our energy tied up in a menstrual cycle. So the menstrual cycle's hijacking a lot of our energy, you know, and that energy is sexual energy, but that sexual energy goes towards our biological procreative process. So a lot of that energy will go into either avoiding getting pregnant, getting pregnant, or managing the cycle. When it stops and we face life without the fluctuations of the hormones, that sexual energy can be transmuted into spiritual energy, spiritual power, co-creative power, you name it. We have access to energy that and anointment energy as well, which is purposeful life force energy that is directed specifically through our own unique biology for the purposes of why we were given this precious human life. So every woman has a unique purpose and a unique sort of anointment of sorts that basically can be refined and concentrated due to the fact that her cycle is not hijacking her away from that very purpose. Co-creation becomes amplified. And that's really important because we no longer, some of us, some women choose not to replace estrogen. Even if we go on hormone replacement with estrogen, we are still going to find that estrogen, which gave us all this busy, buzzy, busy yet extra energy, as it leaves the building, we start to need to become very efficient with the way that we expend the energy. So when the anointment's being concentrated and focused and directed, it becomes incredibly potent and powerful and much more distilled in a way that we can't necessarily experience so much if we're trapped in the biological mindset. Now, medicine is fantastically good at gaslighting women into thinking that menopause is all about their physical symptoms. Those symptoms are hell, we're going to go into this terrible space symptomatically. Well, yes, some of the symptoms are really distressing, but every single symptom that I see in the clinic from a pelvic health and sexual health point of view is pointing towards a bigger picture of that woman's life that would suggest that she is under way too much stress, she has an unsafe partner, she has things in her life that need to change. There may be, you know, more care taken for the way that she does engage sexually. And spiritual energy can also be used for creative purposes. So rather than us deepening our sense of intimacy with another partner, some women will choose to not engage sexually and to use that to form really amazing creative projects. I have a friend at my mate who said, I don't think I can be classified as a sexy menopause or woman because I'm celibate and I've decided not to go there. And I said, Well, actually, you're probably the epitome of sexy menopause because you've planted an entire forest, you've been delivering these incredible gallery displays of her art. She's never been powerful in her creative expression. And she's you can't take your eyes off this woman's work, you know. And it's like, I don't think anything's more sexy than that.

SPEAKER_02 30:58

And she's just trying, she's just transmuting that energy, like directing it towards creativity and her creation. Yeah, totally.

SPEAKER_00 31:05

Yeah, you got it, you got it. Yes, it's fantastic if we think of it that way. And then there's no pressure for us to think that we even need to have a partner to fulfill that part of our lives as well.

SPEAKER_02 31:19

Yeah. What do you think are some of the beliefs that women tend to hold that need to die or to be shifted in order to kind of move into that new whatever sexy metaphors might look like for them?

SPEAKER_00 31:34

Uh, first of all, that it is a season of change. So it's not forever. So a lot of women say, Oh, just no libido, don't ever want to have sex again, and then I'll see them five years later, and they're like, I've got a new boyfriend, I'm really happy. You know. Actually, it was just a period of time. It was a reckoning process that you had to go through in order to choose better partner-wise, next time. The other thing that I think women also think is that, and this is why I think the suicide rate's so high, is that yes, they're always going to feel these symptoms. They're always going to feel the sluggishness or the loss of energy or the the uh the hot flushes or whatever it is, and that is not true. The other myth is that this the there's a number of women that come into the clinic who say, Am I the only patient you have who is experiencing these symptoms of urinary changes, sexual changes, gut health and pelvic health changes, and you are not alone. So to know that you as a woman are experiencing some of the symptoms that we see universally repeating themselves was why I also wanted to write my book because not every woman wants to come in and have a vaginal examination and be sort of in the microscopic container of a one-on-one session. So a book is a really discreet way for a woman to access that info up front. And I was having trouble sourcing really good conversational information. I feel like a lot of women get the very dry science from their GPs and they might get a very woo-woo conversation in Byron Bay about tantric sexual healing. Which is nothing wrong with either of those. But the middle class is a soulful, grounded, deep conversation about what's happening holistically, and us women are craving it, you know, they're coming in craving it, and we have these wonderful moments where they'll go back and tell their girlfriends what they've uh been up to, and then the conversations get more and more common.

SPEAKER_02 33:52

Amazing. Yeah, totally. And if somebody comes to well, and I'm sure this happens all the time, comes to you specifically with that issue of saying, I've lost my libido, I've lost my mojo, what are some of the the things that you might say to her, some of the advice that you might give her?

SPEAKER_00 34:10

Yes, so there's there's three things. The first one is libido leaves the body for a reason. Sometimes it's to put a a little bit of an insulation or buffer zone between a woman and what she actually wants to happen sexually. So, in a very good, healthy relationship, libido might go underground for a short time so that some of those issues that she may be experiencing in her intimate relating can actually be addressed. And when it's addressed well, we will find the libido slowly comes back in different ways. But what do I mean by that? Well, what I mean by that is a lot of women don't understand their bodies in that new way where pleasure, sensation, and ignition of the lubrication process and arousal process changes, and there's a new normal that comes in, and that new normal involves a lot more time, a lot more care, a lot more tenderness and vulnerability between two people, which often a relationship hasn't necessarily provided. So it's a real opportunity. The other thing is when someone's pelvic physiology, which I see in at least half my patients, has been locked up with stress all these years because she's been in fight or flight, she's been running for a life looking after everyone else's needs, it takes a little bit of work for us to get to the point where we're relaxing the pelvic floor muscles and physiology in order to get blood flow to the tissues, to improve the health of the tissues and the lubricating glands, and to improve the sense of comfort when there's actually some kind of penetration occurring. So the other very pragmatic advice is to make sure that we're not getting so strong and tight in our core muscles with all this Pilates, and to actually make sure we have a relaxation practice that enables us to stretch the deep hips, get some space between the sitting bones, you know, get a little bit of support for the breath to actually travel down into the belly. It does look like a pregnant belly when you breathe downwards. A lot of women, when they're in menopause, don't like to breathe down into their bellies, but we actually need to to get a rest and digest response happening for the for the health of our organs and our tissues. And then the the third thing is in the idea of a body being juicy. So that comes from us practicing good hydration, practicing good lubrication. So lubrication for the body can be really stimulated in the right sensual movement patterns around arousal, but we may need to start supplementing lubrication for something natural as well. I have beautiful natural vaginal moisturizer called Olive and B that I recommend. It's a moisturizer that helps with some of that tissue dryness that can happen. More times than not, though, when we start to squeeze and release pelvic floor muscles with a good emphasis on the release phase, we're bringing blood flow into tissue that helps it to become a lot more comfortable as well, hydrated. There is a real push now towards vaginal moisturizers that also include hyaluronic acid, which is a very moisture-improving agent that we see in hair products and skin products as well. So some of the vaginal moisturizers with HLA in them are really, really wonderful for restoring tissue lubrication, moisture, and mobility, elasticity. And then it does help a lot to have good levels of uh fitness, I guess, because we still want to get our bodies to, you know, feel comfortable in different sexual positions. So sometimes the range becomes very narrowed by hip injury, back injury, other injury. And if we can work towards getting our bodies to also move out of pain, that will improve our libido hugely. We get into a real routine with long-term partners where same sexual position, same sensation. And I think what I think menopause gives the opportunity for changing your positions, changing what you know sex to be for you. So it's a new normal. And it's a great new normal for a lot of the 60 plus year olds that I speak to in the clinic. They're like, never been better, won't tolerate bad sex anymore. I love her. That's so inspiring, right?

SPEAKER_02 39:01

Oh, that's so awesome. You you've I also read you talk about how the pelvic bowl holds traumas, joys, portrayals. Could you tell talk a bit about that and how you actually, if a woman's listening and she feels like, okay, that's me, what she can do to release that.

SPEAKER_00 39:20

Yeah, sure, sure. So it doesn't necessarily require us to go into a deep pork therapy process with a counsellor, but it does pay us to have good mental health support if we know the trauma's quite deep and quite, you know, extreme. I'm gonna start with the short-term side of that, which is the pelvic floor muscles will even remember physiologically if you have watched a really violent Netflix movie, and then you try and have sex. The studies show this is electrode-measured studies, will show that there's so much overactivity in a pelvic floor that's been subjected to a traumatic movie that it will have a lot more difficulty relaxing. And then we wonder why women have got painful penetrative sex concerns and also that they're not giving their body the 15 minutes of foreplay, lubrication, support, arousal time before penetration happens. So that's just a very short-term thing to keep in mind. The longer-term implications of trauma are that the research shows if you've been raised with a lot of religious shame, your pelvic physiology will be affected by that notion or belief that you might have that it's shameful for a woman to feel pleasure or it's shameful for a woman to experience, you know, the sensual delights of her body. I think where I would go with supporting a woman to experience safety first would be into a some trauma-sensitive yoga class would be ideal where you're getting some really nice deep hip stretches into muscles that might not have really had connection and activation for a very, very long time. And sometimes you can even find, I know when I was a yoga teacher, women would have a lot of emotional releases because when we access parts of the body that have stored up some of those deeper memories, that memory comes bursting out in the form of some tears, doesn't necessarily need a whole lot of talk, talk, talking, but it can, if it's held in a safe place, be released from that area, and then that area becomes physiologically a lot more capable of relaxation, circulation support to the tissue. Um I think also, yeah, I think you know, there's a lot of other things about libido that are I I think more in context around environmental influence, but those would be the main ones.

SPEAKER_02 41:57

Yeah, beautiful. And is there anything just purely like from a physiotherapy standpoint as far as the pelvic floor and changes in menopause?

SPEAKER_00 42:07

The major one is this absolute emphasis on contracting and going into Kegels because I need to be stronger, but actually a tight muscle is not a strong muscle. So if we're constantly upregulating into Kegels, uh Pilates, strong squeezers, and we're not emphasizing length, flexibility, the pendulum of movement, we are going to deprive those tissues of the benefits of full range of movement. Those tissues become actually weakened by that um that loss of amplitude. And so many women are experiencing this scourge due to the emphasis on core strengthening. So that's my my biggest takeaway for women is be very careful that for every 20 minutes of strength programming you're doing, you're putting in at least 10 minutes of long, down-regulating, long breath, or long breaths, long stretches to counterbalance.

SPEAKER_02 43:14

And I think that goes in alignment with in general, I feel like women, once you hit perimenopause, menopause, like you need more of the kind of yin, you definitely need like strength and all of that for sure. But cortisol is so like tightly wound at that point in your life that it's the the more kind of neutral uh nourishing practices are even more important than they were before.

SPEAKER_00 43:38

Thank you, Kelly. Absolutely. If only women could be contextualized in a society that really could see that, that this is not your body's fault. Your body is having a healthy reaction to a very unhealthy society, and the way that it's making women push is it's untainable.

SPEAKER_02 44:00

100%, 100%. With what you were saying earlier about that, not I don't give a fuck kind of attitude that can come out. And hopefully that's part of it. Like I won't be dictated by a society that tells me that I have to achieve all of this and do all of this and push and have the perfect six pack and blah blah blah blah blah. Like I can learn to tune into my body and actually listen to it and honor it.

SPEAKER_00 44:22

I love that. And and that our spiritual power far surpasses any of the physical symptoms, even though those symptoms might feel like society defines us by our pathology and our symptoms, but there's something much bigger that can overcome and surpass all of the even the relevance of the physical body becomes a moot point. But the emphasis, unfortunately, on society today is on the woman's physical objectivity. And it's a really terrible thing. And I think the other thing that needs to be named here is this idea that when we do start to speak up, a lot of men get very violent and very dangerous when women start to speak up. And we're seeing, you know, a real problem in Australian society and worldwide with women not being safe to actually say the truth of what they're feeling. And I definitely want to acknowledge that because it's all well and good for me now to say, I don't care, I'm I'm using my voice. But a couple of years ago, inside a an unsafe situation, I wouldn't have felt okay about doing that. And I I find that really distressing that that's then also foisted on a woman's body by it's the pathology in your pelvic floor muscles and physiology. It's like I don't subscribe to that all the time. Yes, there's changes, and some of those changes are happening because our nervous system's so good at telling us that something's not safe, and the pelvic floor is the first place to show it.

SPEAKER_02 46:00

Is it true about the pelvic floor and the and your throat and your jaw being all linked?

SPEAKER_00 46:08

There's a big link there between the way that we can project our voice and use the throat muscles to actually also release the pelvic floor tension. I'm I'm currently in my bangalore clinic where I work with a neck and headache physio. Um, and we we I I always make this joke that we need to work with the relaxation around the throat and neck as well as the pelvic floor to get the best possible balance in the in the nervous system and the vagal nerve as well.

SPEAKER_02 46:42

Nice, nice. That's a different type of yoga you could invent, I think, right there. I'll come up for it for sure. Bless, yes. What are some of the most radical forms of self-prioritization you've seen for these women that you're talking to and treating, or yourself, or your friends? Because I feel like that's something else that's really needed and comes online during this period.

SPEAKER_00 47:04

Yeah, yeah, radical self-care. I love it. Oh look, I think Byron Bay is full of hedonistic practices for radical self-care. I think where we do what we do well with radical self-care is we we tend to meet in nature spaces where we're really deeply connected to Earth, to Mother Earth with so many areas of practice, whether it's having, you know, our picnics and our gatherings outdoors or by the beach or around a fire or on a property. I I feel like a lot of women's nervous system regulation can be addressed and even that idea that the softening into the pelvic floor and the libido juiciness can actually be facilitated by us spending more time immersing ourselves in nature. And that can be seen as a bit of a radical movement, especially for older women, I guess, to be seen as the forest dwellers that are not necessarily integrating into society as well as they could be. And they're absolutely living their best lives, having the most wonderful time riding bareback horses and you know, doing doing the the things that I think as a child we loved doing. And I think that's a that's a big one, is that we're returning to an innocence before we sort of became sexualized as well. So we're no longer, you know, going through this puberty that brings on the cycle in order to have babies, but it's a reverse kind of puberty that takes us back to the wildness of our original nature. And whilst we can still be sophisticated in the choices that we make, there's also a part of us that comes to life when we really do allow ourselves to watch how nature does things, takes up our entire biological sort of set point back to a very healthy place.

SPEAKER_02 49:10

Is there anything that I haven't asked you that I should have asked you or that I could ask you?

SPEAKER_00 49:14

I I I I think I'm on a bit of a of a mission to educate this thing that I see in the clinic a lot, Kelly, around because the divorce rate's so high in menopause, a lot of women do not engage sexually for a year, two years, maybe three years. And because there's some changes that go on in the tissue, I'll often then see a woman coming in saying, I'm leaking urine, I'm starting to prolapse, I'm starting to have concerns with pelvic symptoms that I never had before. And when I ask how long it's been since she had sex, and she says it's been 12 months, there's a very strong correlation between pelvic floor strengthening during intercourse and during sexual engagement, and then those muscles deconditioning because they're no longer being properly activated or consciously activated, and the sexual health practice has kind of fallen by the wayside. So I'm a big believer that sexual health begets um, you know, the pelvic health journey, and that if you are planning to re-engage in heterosexual sex, it is a really good idea to invest in a really good internally inserted vibrator. So the vibrators that we get on the marketplace now are often clitoral stimulators, which is fine for particular muscle strengthening, but we still need the vaginal canal to feel healthy and comfortable with something inserted. So I do think we still need to have our phallic-shaped vibrators in our little toy box as well as those air stimulating ones. And we need to find, yeah, we need to find what works for us in that way. Yeah.

SPEAKER_02 50:59

No, awesome. I love it. And what you're pointing to, it's kind of sad, right? It's this idea that I think as women we can tend to completely like outsource our pleasure to the man. Whereas what you're saying is it doesn't actually matter. You're in a partnership, you're not in a partnership, you can bring yourself pleasure, you're the one who knows your body the most. And so there actually doesn't need to be any shift in your sexual enjoyment, whether you're in a relationship or not. And having that continuity of because your relationship with yourself never goes away. And that's really critical, whether you're in a relationship or not.

SPEAKER_00 51:37

Yes, yes, yes. I had a lady in the clinic this week, and she made my day because she said, Oh, that advice to get the vibrator has opened up an entirely new experience of my body that I never even knew was there. And I'm post-menopausal, and I never thought I could feel these sensations. And now I'm experiencing my body in this new way. And you just think, wow, that is remarkable that someone's gone their whole life without actually feeling some of these fabulous sensations that our bodies are capable of. Yeah, that also bring health benefits. That's a win-win.

SPEAKER_02 52:16

I love that. Exactly. Like, take ownership of it. You know, you do your vitamins, you go to the gym, make sure you have a couple of orgasms a week at least. Or whatever it is. That's exactly what it's beautiful. So cool. And then just to round off, I always like to leave people, if they're in that state, of feeling a bit overwhelmed with like just the one habit they can start, start with. So imagine there's a woman listening, she's in that, you know, menopausal shift, and she's really feeling like she's lost herself. Where would you tell her to start? Like, what's the one thing, the one habit that she can take on this week just to start to shift?

SPEAKER_00 52:53

Yes, I'd I'd tell her to take a moment when she's drinking her morning tea or water and breathe deeply into her pelvic floor muscles. What do I mean by that? I mean when you take a breath in, your pelvic floor muscles technically should be actually relaxing and softening rather than lifting into a more tense pattern. So when we put our diaphragmatic breath into the pelvic floor, we actually soften on the inhale and the muscles naturally recoil on the exhale. If we've been fixed in a fight or flight reaction our whole lives, or we're in stress response, we never really breathe deep that deeply and we breathe up into our shoulders instead. So five pelvic breaths, the queen of all breaths, is the ultimate practice, in my opinion, as a physio. Um learn how to do a pelvic breath pattern and um won't ever look back. It will support digestive support, it will support your libido, it will support your nervous system. It has so many benefits.

SPEAKER_02 54:04

Beautiful. So just so I'm clear on this, maybe we can do one together right now. To close. So you're breathing, you're breathing down. Take me through one. So and we can all, everyone who's listening, we can all do one together.

SPEAKER_00 54:18

We'll all do one together. So in the seated position, we'll tune in first to this idea that we have a diamond shape at the base of our bodies, which has a pubic bone at the front and a tailbone at the back, and two sitting bones on the left and right sides. So if you cannot everyone can position their weight so that your weight is distributed not too far forward or back. So we'll do a little pelvic tilt to make sure we're in the center of the pubic bone and tailbone. We also want to just check are we leaning our weight more to one sitting bone or the other? And maybe take a couple of weight shifts side to side to make that central weight-bearing support really even between the sitting bones as well. Drop your mind's eye now from the crown of your head all the way down to the base of your body until you land at a point right in the center of that perineal diamond shape. And from that point in the center of the diamond, we're going to actually take one deep breath in through the nostrils and we're going to send the breath down, down, down to the point in the center of the diamond shape, and we're going to soften the diamond-shaped area so much that we feel ourselves lightly coming into a relaxed contact with the chair underneath us. And when we breathe out, we're actually going to imagine that that diamond shape very lightly recoils back to that starting position again. So there's a slight activity level that we actually return to, which allows us to stay upright. When you breathe in again, just imagine that diamond shape expanding, softening, and opening again. Unlock any tension between the sitting bones. And then when you breathe out, just imagine everything returning to their starting position again, a slight recoil of the hammock of muscles at the pelvic floor area. That particular feeling of supporting the body into any awareness that we might have around the sitting bones gripping or the diamond shape being slightly asymmetrical, or a feeling that we're emphasizing one side or front or back leaning, weight bearing, will optimize our pelvic floor muscle function when we can stay in that perfect position of poise between going forward into life or leaning too far back into receptivity. And it's that poised position where the muscles work at their most optimum and allow us to actually really live our best kind of balance between being on and being receptive at the same time.

SPEAKER_02 57:08

Beautiful. I love that so much. And that's so simple. So everybody go out and practice that every day. Just five, you said. Perfect. I love it. I love it. And I love things like that that you can just like, you know, sprinkle into your day, having your morning tea or coffee, just to take those five breaths. Yeah. Absolutely beautiful. This has been amazing. I've loved talking to you. So could you tell the listeners how they can find you and more? And very importantly, how they can pre-order your book and all of that.

SPEAKER_00 57:38

Oh, wonderful. So if they go to sexymenopause.com, they can pre-order the book. And anyone that pre-orders the book before the launch date of the 27th of October qualifies to get a fantastic free companion guide that has 10 of my favourite pelvic health practices and sexual health practices that supports uh pelvic, yeah, the pelvic physiology in midlife. The yeah, I'm on Instagram at sexy.menopause and at the Lisa Fitzpatrick. And I, yeah, I'm looking forward to releasing the book on the 27th of October. It's available at all good online bookstores and hopefully your local bookstore. I would ask people if they like the sound of it and their local bookstore doesn't have it to go out and tell their bookstore to order it so it's in stock because yeah, I would love to think it's a love letter that reaches as many women that need it as possible.

SPEAKER_02 58:36

Yeah, and you have such a you have a really deep, um, beautiful, authentic way of writing. So highly recommend everyone to get a copy and tell, share this episode with, you know, a couple of girlfriends that you think um would need and love to hear it as well. Um, this is a great one to share. Thank you so much, Lisa. Thank you again. Thank you so, so much. Now it's your turn. Take what you've learned today and put it into action. Try the habit, run the experiment, and actually track how you go. I'll be doing it right alongside you at sharing on socials. So come find me there. Links are in the show notes. Tell me what's working, what is it, and what questions are coming up. I genuinely want to know. And if today's episode helped, share it with someone who needs it. And if you haven't already, hit subscribe so we can keep optimizing our health together. One simple step at a time. Take care. I'll see you next week.