Ep.184 Menopause, Microbiome & Libido: A Urogynecologist’s Guide to Midlife Intimacy

If you can talk about hot flashes and wrinkles but freeze up when the conversation turns to sex, this episode is for you.This week I’m joined by Dr. Betsy Greenleaf, the first female board-certified urogynecologist in the U.S., to talk about everything we don’t discuss enough in midlife: pelvic floor health, recurrent UTIs, vaginal dryness, low libido, pain with sex, and what’s really going on with your microbiome and your mojo.We dig into the gut–brain–sex connection and how stress, antibiotics, diet, and hormone shifts in menopause all collide to affect your pelvic health, your confidence, and your desire. Dr. Betsy breaks down why so many women over 50 struggle with recurrent urinary tract infections, vaginal odor, and irritation—and why the answer isn’t just another round of antibiotics.We also get real about:Recurrent UTIs & vaginal infections in midlife and how the vaginal and gut microbiome are connectedWhy vaginal estrogen is such a game-changer (and what to do if you can’t tolerate certain forms)Pelvic organ prolapse, incontinence & fecal incontinence—what’s actually happening and when to seek helpHow probiotics, fiber, and fermented foods support pelvic health and sex driveThe truth about low libido in midlife, stress, and why “sex and stress can’t coexist”What we know (and don’t) about the G-spot, squirting, and the O-ShotWhy self-pleasure counts as pelvic physical therapy and how “use it or lose it” is very realReframing intimacy when you’re dealing with pelvic pain, dryness, or body confidence issuesDr. Betsy’s Pelvic Floor Store and what’s actually worth putting in your cart (lubricants, devices, and more)This conversation might make you blush, but it might also change how you think about your body, your pleasure, and what’s possible for you in midlife and beyond.🎧 Listen in if you’re a 50+ woman who’s tired of suffering in silence and ready to feel comfortable, confident, and connected again—down there and everywhere.You can find Dr. Betsy Greenleaf at https://www.instagram.com/drbetsygreenleaf/Her Pelvic Floor Store https://pelvicfloorstore.com/_________________________________________If you’re doing “all the right things” and still feel stuck, adding a layer of support may be an option. I’ve partnered with a trusted telehealth platform offering modern solutions for women in midlife—including micro-dosed GLP-1 and other peptide therapies.https://elliemd.com/michelefolan - Create a free account to view all products.Follow us on Instagram https://www.instagram.com/askingforafriend_pod/✨ Sign up for my weekly newsletter: https://michelefolanfasterway.myflodesk.com/i6i44jw4fqLike to connect? Email me at [email protected] Transcripts are created with AI and may not be perfectly accurate.Disclaimer: This podcast is for general informational purposes only and does not constitute the practice of medicine, nursing, or other professional healthcare services. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your qualified healthcare provider with any questions regarding a medical condition.