Our sexuality and desires evolve as we do. As we navigate physical, emotional and social changes that happen in middle age and beyond, our needs change.

Dr. Laurie Betito joins us to deep dive into this topic, including: 

• Common myths about sex and aging
• Creating desire when spontaneous desire wanes
• What changes to expect as your body ages, and what impact that has on sex
• Why sex is often better as we age and/or mature in our own confidence
• Sex is GREAT for you!

🌟 Guest: @drlauriebetito

📝 Show notes: www.onairella.com/dr-laurie-betito

🎧 Related episodes:

▶️ 364: "The Pleasure Problem"

▶️ 308: "Low Libido, Low Sex Drive"

⏰ Time Stamps:

[00:02:08] Evolution of sexuality

[00:06:23] Desire changes in long-term relationships

[00:10:45] Spontaneous desire vs. responsive desire

[00:17:03] Body image and aging confidence

[00:24:40] Empowering sexuality in women at every age

[00:28:10] Pleasure is essential in sexuality

[00:30:19] Sexual activity and aging

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Welcome, you're on air with Ella where we share simple strategies and tips from people who are doing something better than we are. Whether it's wellness or relationships to just living better and with more energy or changing your mindset to accomplish more in your own life and succeeding however you define it. This is where we share the best of what we're learning from the experts and we're learning more every day. Live better, start now. Hey, you're on air with Ella, and today I am joined by Dr. Laurie Betito. Her bio is so very long, I could keep you here all day just based on that. But Dr. Laurie, could you please tell us who you are and what you do?

In short, I'm a clinical psychologist and sex therapist. I've been practicing for over 34 years, almost 35 years. I've spent my entire career talking about sexuality. bringing sex education, science-based, evidence-based science education to the masses. And I started doing that first through radio, and I'm based out of Montreal, Canada. And then I started a podcast, so the name of the show is Passion. I continued with that, so it's Passion with Dr. Laurie. I wrote a book called The Sex Bible for People Over 50. Between writing and television and radio and a full private practice, I'm pretty busy.

Well, we are happy you are here, and I want to talk about several things today. And the first thing I want to talk to you about is sex and aging. Now, this audience, this podcast family that we have here, comprises people of all different ages, Dr. Laurie. But one of the things that I want to do today is demystify some of the misconceptions about sex after a certain age. And frankly, I don't even care what that age is. Sex is different. in your 20s than it is in your 30s than it is in your 40s and so on. And that's the conversation I'd love to have with you if you're up for it.

Absolutely. And I think instead of sex and aging, we could talk about just the evolution of sex or the evolution of our sexuality, because we're all different and we different things happen to us at different times. The only thing is we do know that postmenopause, we know there's a role of hormones. There is definitely hormones do play a role in all of this. So there is something to be said about what happens to our bodies postmenopause. And there are physical changes. There are actual physical changes, but being aware of what's coming or what we can look for, not look forward to, but what we can look for, we can find the solutions to deal with those better. And then we learn how to sometimes we have to just redefine sexuality. So what was once what what worked in our youth or younger may not work later on. And so I try to teach people to have and be open to have the communication about sexuality because you have to keep talking in order to continue to feel the pleasure too, because your partner needs to know, oh, that doesn't work for you anymore. Oh, okay. So tell me what works. All right. Well, let's discover it together. So that conversation needs to stay open throughout. So, and that's true for any age group.

All right. I like that so much more. Let's talk about the evolution of sex. And can you, I know that all generalizations are false, but can you provide a sort of a generic general overview of what a typical evolution might look like for somebody?

You're right. It's generalizing because everybody is quite different, but there are certain things that seem to be more common than others. So what I've noticed is that relationships go through phases, right? So at the beginning of a relationship, we tend to be driven by, I would say, lust hormones, if you will. Like there's something that happens in the brain when you meet somebody new and it's exciting. And that new factor creates that lusty feeling, which makes us feel in love. And then we move from that like there is research on this that shows that that hormone or that that chemical in the brain does fade after say anywhere from a year to two years or so into a relationship and at that point we would consider the relationship as a long-term relationship. So it can change the way we desire sexuality. So at the beginning of a relationship, both people have a lot of spontaneous desire for sex. We think about each other, we're horny. Every time we see each other, we want to have sex. Fast forward, now you're living together. Now you've got all these other things going on. Now desire is not so easy to muster up. Like it's not just there, just like it was before. Now this happens to be more true of women than men, although men also can lose that oomph and that desire. But we have to make the distinction between interest and desire. Interest means, if you hear a woman say, look, I want to, want to, like, I want to feel that, that's interest. I'm interested in sexuality. I know my body gives me pleasure. I know that I, it's fun. Like, I know all these things intellectually. I just don't have the get up and go. Like, I don't have the spontaneous, like, yeah, let's do this now, or I'm horny, I want you now. Which is the difference between the spontaneous desire, that feeling of I'm horny, I want you, versus the responsive desire. Meaning, I want to have sex with you. I want to be with you. We just have to get it started. It's about kickstart. You have to kickstart the passion or you have to kickstart the desire And you do that by saying yes to sex, but saying yes to stimulation. Like you have to be stimulated. So the stimulation happens before the desire. And that's the difference. So at the beginning of a relationship, the desire happens before the arousal. Fast forward, the arousal needs to happen before the desire, if that makes any sense. We need an understanding of that because women panic. I see women in my practice all the time, their husbands or partners send them in saying there's something wrong with you. How come you don't desire like I desire? I haven't changed or you made me think you were such a sexual person at the beginning of our relationship. Now look at you. So there must be something wrong with you. So if we don't redefine how sex needs to happen and what we need to get us there, we're going to be left frustrated, upset. And I see a lot of women in this situation thinking there's something seriously wrong with them. And in fact, they're not.

This is critical because what I hear you saying is that this may be time based, sure, but it's not age based. And that's a very common misconception. Exactly.

So I see couples in all age categories with the same problem. I have seen 25 year olds with the same problem. They've been in long term relationships with the same person since they're 19. I've seen this in 30s, 40s, 50s, and beyond. This is not an age-related thing. It's the length of the relationship thing. And so you know when we say like, like relationships take work, they do take work because they take work to put to make sure we keep that on the radar, to make sure we do the things that stimulate our desire to, to just want to be together again not desire for sex but want to be together want to be intimate together, all of that. And what I noticed for women is that the context for them does matter. It's not just about I'm horny, let's have sex, it's more about are the conditions in this relationship right for me to be sexual, right? If you're, if you had a fight in the morning, and you're still brewing over that fight because it hasn't been resolved, and your partner comes to you at night and says hey want to have sex, you're going to say no like if that isn't what's going to motivate you to have sex, it just isn't it isn't how you're going to resolve it, whereas for him it might be the way he resolves it, and that's fine. But that doesn't necessarily work for women. So what I've noticed is that when women, women are the most open to sexuality when they feel that warmth in their heart for their partner. But how do you get that warmth in your heart? You have to be able to look at your partner and be able to say, oh, isn't that sweet? Or, oh, what did he do? Look what he did for me. That was so thoughtful or I really felt validated or whatever it is that those conditions have to be there. Or he he's helped me out with the kids like he told me to go and chill for awhile. He was going to take care of things. Well, that makes me more open to want to be close.

There are so many women's heads nodding right now as you are speaking and their partners like can we go and she's like did you empty the dishwasher?

And he's like, forget the dishwasher. Like, but that's the difference is that women have all these details in their brains and they have a harder time shutting that down. Men seem to be better. And I, listen, we could learn a thing or two from guys and how their brains work. But I think it's just the way our brains work is that they're able to switch it off. Like I can switch it on and off. Not all men, again, there's like, I'd say a good 25% of men probably think the other way, the same way that women do. And then there's 25% of women who I think act out more like men do. So I don't want to generalize to the entire race or the entire gender. So there's a lot of things in our brain. And until we learn how to shut off that stuff, to be able to focus on ourselves and our body and our pleasure, it's going to be difficult. Otherwise, women get into this rut thinking that they're having sex for their partner, not for themselves. And then it gets into the whole chore thing, like, oh, God, something else I got to do. for somebody else. But we need to own our pleasure and we need to demand our pleasure, frankly. It's like, hey, I'm entitled to my pleasure. My body can do it too. And this is what I need to get there.

I want to highlight something that you said that I think is so important. You said interest and desire are different and people who have been in a longer term relationship and they need stimulus or arousal in order to create desire. You can do that without apology. So all I hear you saying is that spontaneous desire might wane, but that is irrespective of responsive desire. Is that a fair statement? Yeah.

I, I, yes, absolutely. Okay. You start looking at desire a little bit differently. We understand how it works. Then it's like, Oh, so I'm not dead. You know, like a lot of people think they're like, I'm just dead now. Like I have nothing. I'm not, I don't feel like I don't have that spontaneous desire for sex. So it must be that I have to give it up now or that's just the way it is or what have you, but No, because when I speak to women and I ask them, all right, so you don't have any desire for sex, but what happens when you do have sex? And the majority say, oh, it's great. It's great. When we have sex, it's really great. Like, I love it. I have an orgasm. We're all happy. And then men are like, well, if it's so great, why don't you want it more? Well, because it's a process that has to happen every time. Now I use the analogy of like going to the gym. You have some people that are gym rats. They live by the gym, right? They love it, love it, love it. For the majority of us though, if you tell them, look, you have to, you're going to commit to going to the gym. You need to go at some number of times a week, whatever. And you need to go before work and you have to get up at 5.30 in the morning to go. OK, you're going to you're going to commit to it. So, yes. But every morning when that alarm goes off, you're going to be like, oh, crap, like I don't feel like it. Oh. And then but once you get going. Once you get dressed and you're in your car and you're at the front, at the gym, you're not turning back. You're going to enjoy that workout. And what are you going to say after the workout? Oh, that was great. That was awesome. I feel good. Like this was good. And, but then you would think that that good feeling would motivate you to go back the next day. You go through that same process again, and you're talking to yourself. You're saying, no, no, come on, Laura, you got to, got to get your ass in there. You got, you you've committed to this, you know it's good for you, you know you're going to feel good. So you go through that process, which puts you into the conditions and makes you make the choice to have to go to the gym, just like you need to choose to have sex.

And you also pointed out something really important. And that is that the woman tends to feel like she is broken or is told that by her partner or by some other resource. And what you're articulating instead is just that this is a very natural evolution. This is not the shutting down of your womanhood.

No, it's just it's a re a redefinition of your sexuality is definitely is nothing to do with being broken and none of that. And I think for the most part, this is how women operate and they continue to be sexual. Like if they feel understood and if their partners know, OK, what are the conditions my wife needs? Like every woman or partner, every woman needs to know what works for her. When for me, if I come home from work and the kitchen is spick and span, well, I'm like, oh, I'm so grateful. Thank you. That was so kind. Like I didn't even have to ask you. I'm open. I'm much more open if he suggests sex. You see what I mean? So then I can make the choice to say yes. So it's about giving us the motivation to do it. not just driven by, yes, it's pleasurable. Yes, all of that is there. And this is where so much of it is psychological. Like this is why they haven't been able to come up with a pill to create desire in women, because there's too many factors that come into play. You can't give a pill to fix a relationship. I've spoken to some women who will say to me, like, look, I'm attracted to my husband. I love my husband. I want to have sex with my husband, but God damn it, he's like a third kid in the house and I can't stand it. And so they build up these resentments and then they start to view their partner as another child they have to take care of. And that kills their desire right there.

It takes two and everything that you're describing requires communication. And I love that this equips women with the words that they need to help their partner understand that this is a two person responsibility. This is a two person job. right so men stop sending me your women because that you should come i need to educate you let's pivot a little bit and let's talk about some of those physical changes that do happen Dr Laurie as we evolve and what should we expect versus what are some of the biggest myths that we can dispel? Because I'm in my late 40s and I think things get better. So I don't know what you think and what you've observed, but talk to me a little bit about what we can expect and what we shouldn't.

Right. So the research does point to sex getting better with age. It's a question of quality over quantity and also a difference. What we need or what we see as sexual can be a little bit different. What gives us pleasure, what gives us joy, what gives us a satisfactory sex life might be different. Whereas when we were younger, maybe having intercourse was the big thing. As you get older, it's other things that seem to matter that make us satisfied with our sex life. The biggest myth is that we're not satisfied with sex later on. That's not true. We actually get more satisfied, more comfortable in our bodies, more free with our bodies. And we're able to get past the judgment. It's like, we don't care anymore what people think. It's about me now. And so for many of us, at least in my circle and talking to I'm in my late 50s, so talking about this with friends, this is what we see. It's like, no, no, no, this is about me. I'm going to demand what I want, when I want, and this is what feels good, so this is what I'm going to say. So we have more of, I think we develop more of a voice as we get older, which certainly helps. Older women tend to be more self-assured, even though they have bodies that are far from perfect. The men don't seem to care about that. It's about the confidence. It's about the taking charge of one's sexuality that's attractive.

Can we rabbit hole on that for just a second? Because if we accomplish one thing today, Dr. Laurie, I want to talk about body image and vulnerability with your partner. I, I don't, I don't know how else to say this. So I need you to say it because you're the doctor, but your partner does not care about that little role or what you look like in brighter light versus dimmer light. Or, and if they do, they should not be in that space with you. Like they're just happy to be there.

Right. And I've spoke to many, I've asked that question to a lot of guys and they're like, well, I just want you to be naked. I really don't care. Just give me naked. Otherwise we'd all be in trouble because how do we, how do we age with a partner then? Like I have parents who are in their, um, in, in their late eighties. So close to like in their late eighties who are like crazy for each other. And my father looks at my mother with lust all the time. I'm like, you know, she's 87 years old. He still lusts after her. So he finds her beautiful because as we age, what we find beautiful also changes. It doesn't mean that we are not turned on by a young body. Women are just like men are, but it's fantasy. There is a difference between what we look for in fantasy It doesn't translate into what we want in real life. Your real life body is your body, and that's what matters. It's real life. Do not compare yourselves to the women that men are watching in pornography. Because if they do that, and if they knew that we did that, because we do do that, we compare, we might say, oh, well, my husband doesn't look anything like that guy. Well, we're never going to be happy, and we're never going to have desire for our parties. It doesn't work that way. Sexual attraction doesn't work that way. We know the difference between what's fantasy and what's reality. And most of us live with people who have imperfect bodies. I don't know how many perfect bodies there are out there. There really aren't. It's fine because attraction goes way beyond the body. Your partner loves you for you. not just your breasts that may be an inch lower this decade, but like, who cares? They don't care. They just want boob.

And confidence and your comfort in your own skin, honestly, even if you're faking it till you make it is so much sexier than insecurity. And, and that's not even the real reason. It's not do it for them. It's do it for you and just trust like you're beautiful and they are just happy to be there.

And you're right, like do it for you. It's your time. We have to be grateful that we're aging. Not everybody gets the opportunity to age. You want to age, this is what aging gracefully means. It's loving the fact that you're aging. And I'm happy to be here and it's okay.

Yeah, I'm happy to be here and it's okay. And by the way, you partners should be even happier to be here. Dr. Laurie, let's pick up that thread and talk about what changes people can expect with their bodies as they mature and as our bodies change. What is reasonable to expect?

Well, so as we age, and again, aging can happen, I don't know, like women can go start being perimenopausal in their 40s and I just spoke to a woman today she's not even close to menopause and she's 57 so who the hell knows right goals for right that happens. So with the loss of estrogen. comes some effects on the body. Estrogen creates elasticity for our skin, our tissues, which is why we wrinkle a bit more and our skin is drier. You also have to moisturize your vagina because that is the tissue that gets thinner with age. The only thing that seems to get thinner with age is that. When something is thinner, it's also prone to tiny little tears that can cause a lot of pain with intercourse. So that happens. Then it's also the vagina canal can shorten with age as well. We know that, but we do know that with regular sexual activity, whether it's solo with a vibrator or a partner, you keep the blood flow going. And as you keep the blood flow going, it helps to keep the muscle kind of vibrant and more elastic, like any other muscle, right? You stop using a muscle, it atrophies. The vagina atrophies as well. So it's important that we keep that going, either alone or partnered, doesn't matter. So those are some of the major changes, but you know, women, I suggest that women should always use a lubricant. I particularly go for lubricants that are silicone-based or more slippery-based, not to be used with silicone sex toys, but you can with a partner, that's fine. So something that lasts longer, water-based, some water-based tend to dry up and it's not as comfortable. So you want to adjust. Sometimes women, because they have pain, need to adjust their positioning. So maybe when you were younger, it could go really deep and it felt good. Now that your vagina is a bit shorter, maybe it'll be more painful if your partner goes too deep. So try to find positions where you control the depth Things like that. Something else that happens to some women, not all again, is lack of lubrication or less lubrication, so you need the extra lubrication. Also, women tend to need more clitoral stimulation, so just more intense stimulation. You think of it as some of the nerves in that area may get dull, and so you need to activate the other nerves, and so you have to be able to use more even during sexual play with your partner using a natural vibrator like clitoral stimulator at the same time. Also recommended for women is to talk to your doctor about getting intravaginal estrogen creams. So that also helps keep the moisture in the vagina. It doesn't go, not much goes through the bloodstream. So it's not, you don't have to worry. It's not like taking hormone replacement therapy. It's different. And this gives you some help in the vaginal, in your vagina. So aside from those things, nothing much else really happens. I mean, of course, as we age, we can develop other problems like arthritis and knee problems, back problems. I mean, but those are, I actually talk about these in my book because you have to, you can adjust. You don't just give up sex because one thing is broken. You adjust with a new thing. So this is why it's an evolution. We talked at the beginning about your sexual evolution. The evolution is we discover new things. We discover new things that can help us enjoy sex in a different way.

Dr. Laurie, if you could go back and tell yourself, Dr. Laurie, or just speak to the 20-something, early 30-something population, what do you wish you had known, wish a Dr. Laurie had shared with you, Or how do we set ourselves up for a happy, fulfilling sex life?

So I can't really talk about myself because even from a younger age, I was always pretty confident in my sexuality and I didn't much care what people said really as much. So that's different. But I did have daughters and I had to raise daughters. So I kept thinking, what do I want my daughters to know? And what I taught them, what I wanted them to feel is to be empowered by their sexuality, meaning not to do things they did not want to do, to speak up, to make choices. And whatever choice it was, it was OK as long as it was their choice and not to feel like they had to do, they had to have sex to just to accommodate someone else or to please someone else or because it was expected of them. So I tried to make them be more critical, like think critically about, do I want this? Does this work for me? Is this okay? Am I getting something out of this? And if I'm not getting something out of this, what is the problem? Where does the problem lie? So I would love to tell younger people that if you see that you're not, like something is not happening for you, check it out. call a therapist who sometimes, I can't tell you how many times I just see people one session and one session is enough for them to learn a little bit about how their bodies work and what they need and the conditions that they're having sex. Sometimes it's the conditions that people are having sex in that don't work for them. And women wonder, I can't orgasm.

I don't know why.

I'm fine on my own, but I can't with a partner. So I look at, well, what's happening when you're with a partner? Well, I don't, I haven't really been in a relationship. It's just hookups. I said, well, maybe hookups don't work for you because maybe you need a little trust and maybe you need to be more intimate and maybe you need other things. So let's look at that. So we have to be able to, I want women to just feel like they can control that they have a say and control over their sexuality and to speak up, really to speak up when it's not okay. We are a generation, at least my generation was raised to be good, like be a good girl, don't raise a stink, don't make trouble, don't cause drama, blah, blah, blah. So what happens? You submit, but submission is not the same as consent. And so what I wanted was to empower girls to have enthusiastic consent, not to feel like they had to submit. And I tell women in long-term relationships as well, if you feel you're submitting, because women have told me this, I feel like I'm being assaulted, even by their own partner. That cannot be good for the marriage, right? So you can't feel like you're just submitting to shut up your partner. Let's figure out what the problem is first. Let's work on that because then it doesn't work for the long-term, that kind of thing. So that understanding of how sexuality evolves for people in long term relationships is important so that we can at least it's a starting point and then Let's address the issues that are getting in the way. Like nobody has a perfect life. Everybody has hurdles and everybody has challenges. And but what are those challenges and how do they impact you and how do they impact your sexuality? Because believe me, everything you go through will impact your sexuality in some way.

And it is never too late to put your own desire first.

Oh, God, no. And your pleasure. I would say your pleasure. Oh, yeah. That's the other thing I would tell my younger self. Pleasure is good. And pleasure is okay. And I've told my own daughters this. You're doing it because it has to feel good for you. If it doesn't feel good, we need to talk about what's wrong. We need to talk about why it doesn't feel good. And it's a part of sex education. It isn't a part of sex education. Nobody wants to talk about pleasure when they're talking to kids about sex. But why the hell are they having sex to begin with? Because it feels good, yet nobody wants to say so. Because, oh my God, that means I'm going to, I'm promoting it somehow. This is not about promotion. This is about empowering to be able to put it off if you want to, to say, I'm not going to feel pressure to have sex with you. I'm not ready. I want to wait.

And that's perfectly okay too. Well, and this, I know we could go on and on about this, but really when you take pleasure out of it, then I think people are having sex for all sorts of reasons that have nothing to do with their own pleasure and probably aren't healthy. What I think really resonates about what you're saying is no matter your age, no matter the tenure of your relationship, it's never too soon, right? Or too late to put your own pleasure first. Otherwise, what are you doing there? Right.

And I think you have to, like a lot of people will just give up on, we'll just say, well, I don't really feel like it. So I'm not really missing anything. And that's fine. Like, I don't judge people who just want to put it away and, and get pleasure from other things in life, but your body can still give you pleasure. So why not use what your body can do? And one of the, the first chapter in my book is about the, the science behind an active sex life. So what does it do? it boosts your immune system, makes you feel younger, actually makes you look younger. I mean, there's a long list of good reasons to continue to be sexually active, not to mention it helps your relationship and helps you feel close and all that stuff. So there's plenty of research out there. If you need convincing, there is plenty of research out there that says having regular sex does a lot of wonderful things to your body. I think it helps your skin. Oh, yeah. It helps your skin. Listen, there was a study that showed that women who are sexually active look seven years younger on average than women who are not. So I believe it. Yeah. There's work in that area.

I believe it. Okay. Everybody write that down. All right. How old do I really? Who needs Botox? Dr. Laurie, you are a font of information. I'm going to link to all of your resources. What is your favorite place for people to find you? What's a great starting place?

So the starting point, which has my links to the TED talks and information about the book and my podcast is drlaurie.com. D-R-L-A-U-R-I-E.com and then people can download all that stuff right from there.

I'll make it super easy. Dr. Laurie, thank you so much. Thanks, Ella. It was such a pleasure. Okay, that's a wrap. I hope you enjoyed today's show and got something out of it that you can use. If you did and you want to learn more, find me on Instagram at onairwithella or open the show notes for this episode and get all the links at onairella.com. There's no with, it's just onairella.com. Thanks for listening. Thank you for sharing the show and thanks for inspiring me. You are quite simply awesome.