Orgasms as Medicine: De-Stigmatizing Sex & Pelvic Wellness in Perimenopause with Dr. Rena Malik

Dr. Rena Malik, board-certified urologist and sexual medicine expert, has the most frank conversation about female sexual health you'll hear anywhere. She covers pelvic floor dysfunction (incontinence affects 1 in 3 women), the genital urinary syndrome of menopause (80% of women will experience changes), and the orgasm gap—plus why same-sex couples don't have this problem. Dr. Malik breaks down low desire in midlife with actual treatment options, explains responsive vs. spontaneous desire, and tackles the hard conversations about pornography's impact on our kids. Whether you're dealing with changes yourself or supporting someone who is, this episode removes the shame and gives you actionable solutions for better sexual and pelvic health. Episode Overview (timestamps are approximate): (0:00) Intro/Teaser (4:00) Pelvic Floor 101: Anatomy and Function (8:00) Urinary Incontinence (14:00) Tight Pelvic Floor & Pelvic Floor Dysfunction (18:00) Strengthening Weak Pelvic Floor (21:00) Pelvic Organ Prolapse (POP) (29:00) Menopause & Genito-Urinary Changes (33:00) Female Arousal & Clitoral Anatomy (37:00) Responsive Desire & Maintaining Sexual Connection (44:00) The Orgasm Gap (49:00) Pornography & Realistic Expectations (55:00) Pornography Use & Sexual Function (1:00:00) Types of Orgasms (1:03:00) Semen Retention & Orgasm Frequency (1:08:00) Low Desire in Women (1:16:00) Arousal vs. Desire (1:19:00) UTIs & Bladder Health (1:23:00) BONUS: After-Party with Dr. Stephanie Resources mentioned in this episode can be found at https://drstephanieestima.com/podcasts/ep447 We couldn’t do it without our sponsors: BIOPTIMIZERS - Magnesium Breakthrough contains multiple types of magnesium plus cofactors like B6 to enhance absorption. Visit https://bioptimizers.com/better and use code BETTER to save 15%. ONESKIN - Harness the power of peptides for fuller hair and glowing skin. Save 15% at https://oneskin.co/better with code BETTER. BON CHARGE - Achieve glowing skin, gain more energy, and uplevel your recovery practice with a suite of red light products. Get 15% off at https://boncharge.com/better with code BETTER. AG1 - I take my AG1 Omega 3s first thing in the morning once I'm home from the gym. Subscribe today to get a 1-month supply of AG Omega-3 with your first AG1 order! You’ll also get their Welcome Kit with everything you need to get you started. Get it now at https://drinkag1.com/stephanie. **************************** P.S. When you're ready, here are two ways Dr. Stephanie can help you: Subscribe: The Mini Pause — My weekly newsletter packed with the most actionable, evidence-based tools for women 40+ to thrive in midlife. Build Muscle: LIFT — My progressive strength training program designed for women in midlife. Form-focused, joint-friendly, and built for real results. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.