How to Have An Amazing Sex Life While Undergoing Fertility Treatments: with Dr. Sadaf Lodhi

Have you ever felt like sex is a chore while on the fertility journey? Or like you are so stressed about when to have sex and when to abstain, that any notion of an enjoyable and life-giving sex life is gone? 

If so, listen to today's episode with Dr. Sadaf Lodhi, a board certified OBGYN who focuses on sexual health and intimacy in her concierge gynecology practice. 

In this mind-blowing episode, we discuss:

• newer models of sexual response and responsive desire
• navigating sex as work and reframing this concept
• increasing emotional intimacy, which leads to increased physical intimacy 
• the power of mindfulness and sensate focus to improve the experience of intimacy
• midlife issues such as body image and perimenopause 

Warning: this episode does bring up the topic of sexual trauma and healing from trauma

From Dr Sadaf Lodhi: As a practicing OBGYN in New York for over 20 years, my mission has always been to empower and educate women. I am the founder and CEO of Femme Vie Health, a concierge gynecology practice serving patients in New York, and I have a telehealth practice for those in Michigan. While I assist patients in all aspects of female health, I focus on sexual and menopausal health as well as intimacy coaching. I believe that all women, regardless of their backgrounds, have the potential to live life to its fullest.

Guest Links
Website: www.femmeviehealth.com
@drsadafobgyn for Tiktok and IG

As always, please keep in mind that this is my perspective and nothing in this podcast is medical advice.

If you found this conversation valuable, book a consult call with me using this link:

https://calendly.com/loveandsciencefertility/discovery-call

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Please don’t let infertility have the final word. We are here to take the burden from you so that you can achieve your goal of building your family with confidence and compassion. I’m rooting for you always.

In Gratitude,

Dr. Erica Bove

Transcript

I just wanted to mention before starting this episode that we do discuss sensitive topics such as sexual trauma and healing from trauma. So if that might affect you to listen to that material, I just wanted to share that ahead of time. You do not need to listen to this episode. And if you do find that it's hard to listen today, please do get the support you need.

Hello, my loves. Welcome back to the Love and Science podcast. I am so thrilled to have an amazing guest today, Dr. Sadaf Lodi. She's a friend, she's a colleague, I've known her for about two years at this point. And she is a board certified OB-GYN who specializes in sexual health for women. She practices in New York and also has a virtual practice for patients in Michigan.

She is the CEO and founder of Fem V Health, which is the concierge GYN practice.

And she really specifically focuses on sexual and menopausal health, as well as intimacy coaching.

And she has this belief, as I do as well, that all women, regardless of their backgrounds, have the potential to live its life to the fullest. And so, you know, here we are. And I invited her on to talk about the fertility journey because we all know that sexual health, sex being sometimes purportive, sometimes not, like it all gets very murky. And in the spirit of having our best life, I'm so honored to have Dr. Sadaf to talk to us today about how we can do that. So welcome, welcome.

Thank you so much, Dr. Bovee, for having me on. I'm so excited to be on your podcast.

Yay. And we've had other conversations before, but we haven't quite ever talked about this in particular. So I think it's going to be really interesting to sort of think about what we can do, what we can improve, and how we can embrace this aspect of life. So I'd love to start by understanding a little bit more about, you know, when you see women in your practice who are struggling with their sex lives in general, like let's not even talk about the fertility journey, but when women are struggling, what is your approach to help them to start to feel better?

Yeah, I mean, it really depends on what it is that they're struggling with, right? So we, so there was a study that was done, it's called a precise study. And it was a questionnaire that they sent out, it was the International Society for the study of women's sexual health, and they actually have this study in one of their slides. And so the precise study was a questionnaire that was sent out to lots of women throughout the US, thousands of women rather.

And what they noted is that sexual dysfunction typically starts in midlife and midlife they defined as ages between 40 and 65. And what they noted was that about 44% of women had some type of sexual dysfunction that came about. Now, of course, women that are younger also have sexual dysfunction, but it tended to peak right around midlife. And women that were older also had some sexual dysfunction, but they weren't really bothered by it. The precise study actually talks about sexual dysfunction that then can result in distress, right? So and that sexual dysfunction can be either problems with arousal, libido, orgasm, or any type of sexual dysfunction.

But those are the three that they focused on. And what they noted was that, I believe it was, and I'm trying to remember the number, about 12% of women that experienced any type of sexual dysfunction had distress associated with it. The number one form of sexual dysfunction that women came about with was actually libido. And they noted that about trying to think of the numbers offhand, but I believe it was around like 38% of women experienced decreased libido, and about 10% of those women experienced it with distress. So when we talk about sexual dysfunction, we talk about problems with sex, we talk about problems that causes the patient distress, because if it's not causing the patient distress, then it's a problem.

Yes. And I mean, I think if you we have to ask the question, because a lot of us, especially with limited time in our medical practices, you know, or like, boom, boom, boom, with your pap up to date as your mammogram up to date, but those sexual health questions, I think take a longer time. But I think when we actually ask those questions, I mean, I find in my practice that many, many, many of my patients are having terrible sex lives. And if you don't ask, you'll just never find out.

Right. Yeah. But yeah, I mean, I agree with that 100%. I think that we just don't have times, right? Like we think about the things that are gonna kill somebody, right? Really, right, right.

Right. Really cause them a lot of problems. So you know, we worry about like cervical cancer. So that's what we're asking about pap smears, making sure those are up to date, we're, you know, talking about colon cancer, we're talking about breast cancer, we're talking about breast cancer screening, we're talking about bone density, we're talking about all these things, you know, that can potentially really harm somebody. But when we think about sex life, right? Yeah, we don't see that as really causing harm, but it actually can, because we know that sexual health is a big part of a person's overall health. And that's how somebody sees themselves, how somebody sees their own body image, how they feel about themselves, whether or not they feel sexual, and it can really cause a lot of mental trauma that we don't see. So we don't ask about it.

That's right. And as you were saying, you know, we think about the, I got chills thinking about it, like the pap smear and the mangram and all that health care maintenance stuff, like this sort of loss of sexuality, right? Cause many, not everybody, but many people had it at one point and it sort of goes away over time. It's like a form of emotional death. Yeah. And maybe even physical, I mean, cause people feel dead inside, but it's like, you know, you can be sure, like your cervical cancer screening is up to date, your mammogram, check, check, check. But if you're walking around like a zombie, like a shell of a person, that's not any real quality of life, right? So it's this emotional death, I think that is very much underdiagnosed, but you know, the good news is, right?

There's, there's things we can do about it. So thankfully in your practice, you have, you have time, you've built your practice to have the time you're able to really ask those deeper questions.

And so then how do you start to help people to start to enjoy their partner and themselves again?

Like, how do you help people to like wake back up in that sense? Yeah, absolutely. So, you know, so many things, there's so much to what you just talked about. And I think that, you know, you and I talked a little bit about this offline, but that, you know, a lot of times women end up thinking that sex is a chore, right? Because they're so busy with everything else in their lives, right?

Like, so they have to take care of the kids, and maybe they're a single mom, right? Maybe they're, they're doing it, maybe they have two kids, you know, and are super busy, and they just, so sex just ends up being another thing on their to do list. So how do we change that, right? And so one of the ways that I tell women that perhaps they can do is they can ask for help. I think a lot of times women will take on everything for themselves and not, you know, and have a hard time asking others for help. So if you're asking others for help, be very specific as to what you're asking them to do, right? Maybe you want them to watch your kids for an afternoon, right? So you have that time to yourself, maybe for an evening, maybe a sleepover, something like that, be very specific so that the other person knows what it is that you need to help yourself out so that sex doesn't become a chore, right? Maybe you need them to maybe you hire somebody to do your laundry, you know, clean your house, something like that, so that you get those things off your plate, right?

And then what you do is when you are with your partner, you try to establish that emotional intimacy that you once had, perhaps, right? And hopefully you had that emotional intimacy, because we know, according to Rosemary Basson, who is this great researcher out of British Columbia, she came up with a human sexuality model, you know, you and I probably both learned about Masters and Johnson, and they talked about, you know, this very linear model, right? Where you had like, you know, you had a, you had plateau, you had orgasm, you had excitement, you had, you know, this whole thing, and it's just very linear. And after orgasm, it's done. And, you know, you're all done. The thing what she says is she added in desire and arousal. And what she says is that for someone to be open to some sort of sexual stimuli, there has to be some emotional connection, there has to be that emotional intimacy, and that emotional intimacy will then allow that person to be open to sexual stimuli, barring they have anything external, like what we talk is the social things that can affect you from responding to sexual stimuli, such as, like you mentioned, you know, all these chores, right? Or maybe sex negativity, or maybe trauma, maybe abuse, all of those things that can definitely impact a person responding to sexual stimuli. So as long as they have either dealt with them or have never experienced them, then they open. And what she also talks about is that, you know, we have in our mind, we have these thoughts that, you know, sex should always be spontaneous, that it has to be like in what we see on TV, it has to be like people ripping off each other's clothes, just having sex like crazy everywhere, you know, but that's not really what happens, right? Yeah. Even a lot of times in long term relationships, we see what's called responsive desire. And, and what she says is, you know, because a lot of times when you read some books, they'll talk about this spontaneous desire, and they talk about responsive desire.

And what she says is there's really no such thing as spontaneous, but really that all of it has been responsive. Meaning like, even if you are just dating somebody for the first time, right, you're still thinking about like, what you're going to wear that night, where you're going to know what that night is going to look like, what's going to happen at the end of the night, you know, and, and you're anticipating, you're looking forward to it so that you're open to some sort of sexual stimuli if it happens, right. So in your mind, everything has always been responsive. It's never spontaneous, right? It may seem like it's spontaneous, it is something that you're thinking about so that you're priming your brain, so that it does happen. So it's so interesting.

Yes, yes. Yeah, yeah. So yeah, but that's basically what I was going to say is that it's right. That's such a fantastic way of looking at it, right? So it doesn't make the person that doesn't have that spontaneous desire feel bad, right? So what she says is that once you're open to the sexual stimuli, she says what you notice is that the arousal, so the physiologic arousal actually happens before the desire happens. So a lot of women will say that, you know, I just don't feel the desire, right? Like, sure, if my husband wanted or if my partner wanted to have sex, sure, I'd have sex, right? But I just don't have the desire. But what she said, you don't actually have to start with desire. You have to be open to the idea of it. Yeah, you start doing things, you know, maybe it's touching, maybe it's, you know, being mindful when you're starting to have some foreplay and things like that, that then the desire starts to happen. And then that will lead to physical intimacy, which then leads back to, you know, the physical. So you'll have the physical intimacy, which leads to more emotional intimacy. And then that circle continues. That's so fascinating, because I feel like most of my clients are female physicians, you know, most of them are in there at the very youngest mid to late 30s, you know, that's sort of where it starts. And then many of my clients have crossed 40, you know, in the 40s to mid 40s. And so that's really the bulk of the people I see. And all of us in this generation, learned the previous model and maybe somewhere deep within us, even if we are lucky enough not to have trauma or any of those things, like we have this model in our minds of how it should be. And I'm all about like, you know, whenever I say this is how it should be like smashing that with a sledgehammer, because there's so many other ways. And so maybe part of it is actually reframing how we think about sexuality and sexual desire. And because I think those of us who are type A high achieving female physicians are like always looking for areas where like we're doing it wrong or we could be doing it better. And so this is not an opportunity to shame ourselves.

It's to say, wait, maybe there's a whole different model. And if we can start to think about it differently, that might open up some new avenues for different experiences. So thank you for sharing that. I think that's, you know, very enlightening. And I'm glad that we're making progress. I wanted to shift to think a little bit about, you know, the experience of a female physician with infertility and sort of what that looks like. And some women have one child and secondary infertility, some women are really trying to build their families for the first time. Other women, you know, have recurrent loss, as you know, because you're a nobody doing yourself and really have had loss after loss, and they're struggling to build their families. And so not only are most of these women trying to work as attending physicians and take care of the patients and, you know, many have a partner and try to be a wife, a spouse, like then also the fertility journey, as you know, is like a part-time job at least because you're trying to go to the fertility clinic every other day for ultrasounds and blood work. And, you know, and then maybe if somebody is not doing IVF and just, you know, not just but like sort of choosing the ovulation induction, you know, now and now I got a figure in time intercourse into this whole equation or, you know, sure you could have sex like now, but like then when you're about to approach your egg retrieval, you got to stop and then start. So I feel like all these impositions of the fertility journey can create this sort of like unnaturalness of the typical sort of flow of sexual health, right? Because there's all these rules and restrictions. So let's talk a little bit about how you would approach somebody in that particular situation with those different layers of complexity. Yeah. I mean, there's so much going on there, right? I mean, I think that, you know, being a physician, first of all, as you know, you're a physician, I'm a physician. We both know that there's so many demands on being a female physician, right? Not only just being a physician, but being a female physician. And then especially when you're trying to conceive, I mean, that's always in the back of your head, right? You're always thinking like, Oh my God, okay, today, is it today? I need to go and do this today. I need to go do that. Maybe today I need to have time sex today. Right? So it's always there in the back of your mind. And it just becomes so routine. And so like, there's no excitement, there's no joy anymore. It's just like, like you said, it's just like another part-time job that you're just trying to get through. And I think for those women, I think what we have to do is we have to step back a little bit, right? So I think what we need to do is start to create that emotional intimacy that you once had with your partner and start there. Because when you have that emotional intimacy, then that sexual intercourse or that physical intimacy that you're going to have is going to be more meaningful. And it's also going to result in more emotional intimacy. But when you think of it as a job, then there's no emotion attached to it. And it just becomes something you have to do to get to end result. That becomes a chore and nobody enjoys chores. Nobody likes to do a chore, right? So then you start to resent that. And it just changes your whole perception of what intimacy is and what sex is, right? So I think what we need to do is maybe step back and get back to maybe just holding hands, right? So how do you create that emotional intimacy that you had is, I would look at the easy things that you could do, right? Perhaps hold hands when you're going for a walk. Create some time out of your day just for that person. We're not having to think about all of those fertility issues, right? Where you're not thinking about, okay, is it time to conceive?

Is it time for my injection? Is it time for an ultrasound? Where you're not having those thoughts, but just going out in nature and going for a walk, holding hands, right? Maybe cuddling on the couch, maybe doing like a six second kiss, maybe making a meal, creating a meal together, right? Doing all of those things that perhaps you enjoy doing with that person a long time ago, but now things and your fertility journey has gotten in the way and now nothing is joyful anymore. So I have to go back and find all the things that you liked and try new things, right? That's what creates the excitement in a relationship, right? Maybe try something that you've never tried before, whether it's a new food, maybe it's a new activity, maybe it's a new sport, maybe it's whatever, you know, whatever you enjoy doing, maybe it's a new sex position, right? Who knows? Whatever it is, right? Maybe be a little bit more not so timed and rigid, but maybe let things just kind of happen.

And yeah, there are things that you can do. So there's mindfulness, and I think we're going to get into that a little bit, but I think just trying to create that emotional intimacy that you once had will start to enjoy things a little bit more. Yes. And also like touch that is not like has a directed goal of like, and we are going to deposit sperm in the right place at the right time.

You know, I think just being like, Oh, it feels good to hold this person's hand. Oh, it feels good to linger in a kiss. Oh, it feels good to listen to our favorite music together. Just really connecting, you know, in those ways, I think can really build that foundation of, and that, you know, I always tell my, you know, my patients and my clients like, okay, well, if you quote unquote have to have sex this day, then like you said, like maybe do something different, maybe go to a hotel if you can do that, you know, maybe dress up or, you know, maybe like invite somebody to a date. Like, you know, I request your presence at the, you know, like just this, think outside the box, add a little personality to it because I know if it's, if it just becomes a chore and, I mean, and actually, I mean, I think we don't talk about this enough. Like, I would say at least 40% of them that I see have sexual dysfunction specifically related to like having to perform at a certain time. You know, again, I will also say for people in the situation, we all know as OBGYN, this whole timed intercourse doesn't mean like you have to have sex in the next hour. And maybe you only do have an hour. So I'm not trying to minimize that, but like, I really do mean that like, it's not like the egg goes poof right away. Like there is, as long as the sperm is waiting for the egg, there's usually some, you know, sort of some latitude in terms of timing. So I think sometimes you just understanding the physiology and like, what is the actual window? Because we, you know, oh, I'm not going to be with my partner. Oh, this is, this is going on. Like, what do I do? But just sort of taking some of the pressure out of it and saying like, okay, sure. Like, you know, like I said, I did my taxes yesterday. Okay. Like, you know, like just sort of thinking about it as not like this, this huge thing that it has to like take all the joy out of everything, but just like, okay, this is part of it. And actually I can sort of make this something that's still part of like a broader version of sexuality. Exactly. You know, when you mentioned about men having erectile dysfunction, I mean, that's so true. Because men then all of a sudden they start to have performance anxiety. And so then they have that erectile dysfunction because they're so worried about performing, right? Because now you have this time window. Right. And all of a sudden they can't get an erection because they're so worried. They're so in their head about getting an erection that the more you worry about it, what's going to happen? Yes. So that's like antithetical to having a pleasurable experience because there's so much anxiety in there. And so, and then it's like Viagra, you know, it just creates this, I've also heard people say like, Oh gosh, like I better not tell them I'm ovulating because then, you know, it could just create all this weirdness around us.

And so like, these are the things that I navigate with my patients and clients every single day.

Like, you know, it's, I don't know, like how to kind of in those moments where it's like, okay, it would be beneficial to do this at this time, but like how to kind of help calm the nervous system so that we don't actually have this aversion to our partners because of all these sort of concerns of quote unquote failure. Yeah. Yeah. You're so right. Right. And so I think it's about kind of reframing and trying to not be so much in our head, but just being present in the moment.

Right. And so this is kind of what I was talking about a little bit before is there's something called sunset focus, which I absolutely love. And it's fantastic for people that have experienced, let's say trauma or abuse, but you don't even have to, you know, like if thankfully, if you've never had that experience, then you can still use this modality and a lot of sex therapists use it. And what it really is is that it really is basically bringing your senses into what it is that you're doing and you focus on the touch, the pressure and the texture just coming from your fingertips.

Right. And you're exploring somebody else's body just for the sake of your own enjoyment, not for their enjoyment, not to get them aroused, not to get them an erection, not for anything, not even for an orgasm at the end, nothing like that. There's no end goal. The end goal is really just about you experiencing touch as if like you were an alien for the first time, experiencing somebody else's body and you're just touching for the sake of touching. That's it.

That's the only thing we're doing. Right. And so that's really causing you to really be present in the present moment. And also there's a woman, her name is Lori Brotto, Dr. Lori Brotto, and she is a sex therapist or actually rather, I believe she's a psychologist. Again, she is in British Columbia. So her and Rosemary Bassen work a lot together. And so she actually created, wrote a book called Better Sex Through Mindfulness. And this book is fantastic. I love it. And she also talks about and has had done studies that have shown that women. So she took this group of women that came into her office for a decreased libido. Okay. And what they did is they group these women into like this, and they had 90 minute sessions with them over the course of six months. And what they noted for these women, because the women's, you know, their chief complaint was decreased desire. What she noticed after the six months is that after these women routinely practice mindfulness, just in their daily lives, and then were able to incorporate mindfulness into their sexual practices, that they noticed an increase in lubrication, increase in desire, an increase in arousal. Without medicine, so interesting, without medication. So there was no medication, in fact, in her book, you know, and I still have to finish her book, but she talks that the medications and there's only really have three medications really for libido. One is off label, which is testosterone, the other two are FDA approved, one was approved in 2015, it's called flabanserin. The other one is berylloneinimatide. And they both work at the level of the brain. And they increase the dopamine in the brain. But the thing is, is that in her book, and Dr. Laurie brought his book, she says that she really doesn't believe that she, she states and she shows through her research, that her mindfulness actually works better than those medications do help with libido. That's fascinating. Right. And so she, she really teaches women how to practice mindfulness in their daily life. And it could just be like just, you know, really focusing on maybe your steering wheel, right, or really focusing on, you know, and she does this, I love this, because actually, I, I did this with a group of women in my retreat that I host in Morocco. And, you know, we took a raisin, and she describes this whole, basically, this raisin experiment that she does, she describes it all in her book, and it's fantastic. And what she does is she gives a per, you know, each woman a raisin, right. And so what she does, she asks them to take a look at the raisin, you know, kind of feel it, how does it feel in your hand to look at the ridges, look at, you know, really just examine this raisin, right. So what she's doing is just teaching mindfulness. And you're saying to really focus on the raisin, feel how it feels, how it touches, blah, blah, then you put in your mouth, and you supposed to put in your mouth without biting it, rolls around in your tongue, yeah, to feel all the ridges, the flavor, all this. And then finally, at the very end, you bite it, and you see what the flavors are that come out from this raisin, right. So in this whole experiment that she has you do, it's really a practice in mindfulness, and really paying attention to your senses. And what are you tasting? What are you smelling? What are you? What does it feel like? Right? What is the touch like all of those things so that you can bring that to your physical intimacy, and that in itself will increase your libido.

That is so interesting. And as you were speaking, and by the way, a retreat in Morocco sounds absolutely amazing. So just repeat that. Sign me up, please. I wanted to just sort of mention that as we think about self-compassion, which is one of the biggest ways that I help women navigate their fertility journey, mindfulness, based on Dr. Kristin Neff's research, is one of the three pillars of mindful self-compassion. And so thinking about this link of mindfulness and embodiment, we need our bodies to engage in sexual intimacy activity experience. And if we're disconnected from our bodies, like we talked about before, we could even be dissociated from the whole experience. So using mindfulness as a way to become embodied, to be in the present moment, it may increase our self-compassion and increase our experience of pleasure and being in our bodies and all of it. It's fascinating. That's exactly it. So a lot of women, especially when they feel that sex has become a chore, right? Like, especially when they're trying to conceive, and it's just a chore. It's just another thing they have to do is just, okay, fine, we need to have sex today. Boom. That's all for our checklist next. We go to the next thing, right? It brings them back. It brings them back to their body. So they're no longer spectators. They're no longer disassociating themselves from their body. And just, it's not something that's happening to them, right? It's something that they are doing with their partner. And so now they are becoming one with their body. And so when you become one with your body, then you enjoy things a lot more, right? You're experiencing, you're tasting, you're touching, you're using your senses, so that you are completely in the moment and you're not thinking about. So, you know, I mean, you know, Erica, when we talk about like really being in the moment and really using our senses, it's hard to be somewhere else when you're still focused on this raisin or whatever it is, or on the touch or on touching somebody else's body, right? Because you're really examining it. You're really touching it. You're really seeing how the kiss is tasting, right? How the body smells. And it's hard to be somewhere else because you're so focused on what you're doing. So when you're still focused on what you're doing, you're really going to enjoy that, right? Yes, absolutely. Yes. Keep going. No, I was just, because then you're no longer, you know, disengaged, right? You're not disassociated. You're, you're in yourself, you're in your body, and then you can really just experience the moment for what it is. That's right. And I'm hearing we need to give ourselves permission to do this, right? Like we need to give ourselves permission. We have to, we cannot be mindful in a fast paced, multitasking experience. Like to do, to do list has no place here is what I'm hearing you say. Yeah. And you know, it's so funny. You should say that because, you know, that's the, that's the book that I'm writing. So it's called the give yourself permission, a woman's guide to experiencing pleasure in her relationship. Oh, wow. I did not know that for our listeners. I had no idea. Yep. Yep. That's my book. That's my book. That's going to be coming out hopefully by the end of August, September. Wow. That's what I'm writing.

Say that that's the whole thing, right? That's with allowing yourself and give, and oftentimes, Erica, and you probably see this in you with your patients is that we don't give ourselves permission to enjoy, right? Because we're so busy and we think like we had, we have to keep just, you know, attending to our tasks and next and next and next. And we don't stop. And we don't give yourself permission to enjoy, just enjoy what we're doing. That's right. And you know, we have rules and other aspects of life that we just say, okay, well, today is the day I, like you, you work in the Bronx, like today's a Bronx day. And this is a day. So like, you know, maybe the rules aren't so bad, you know, maybe it's just like, okay, we're abstaining today. Okay.

Like this is a day. So maybe minimizing some of those externals and just being like, okay, this is part of the flow. And you know, when we do get to have intimacy, like, you know, we're going to really be present. And so I think that there's that like, really thinking of like, you know, this is so much bigger than procreation. This is so much bigger than providing a sperm sample. This is like a life force. This is a creativity. This is a connection. And, and many people believe connection to their, our divine, right? So this is, this is so much bigger than ourselves. And we need to slow down and figure out how to connect with that to be able to understand and embrace and experience the full magnitude of what it is. Right. So powerful. Love it.

Yeah. So, um, so I think that, you know, if women are able to just connect to their own bodies, to connect to that experience, I think that they can really change their fertility journey and not make it so work. Right.

And when, you know, in one sort of thread, I wanted to pull out from what you said is like, this is for us, you know, as women, like, I think if we're like so many of much of our lives, you know, female physicians stuff included is like serving other people and doing this, you know, in our communities and everything. It's like, this is one aspect. And yes, there's the partner dynamic that's not to be minimized, but it's like, if I, okay, let's, let's use running. I'm running a half marathon this weekend. If I use running as an example, sometimes it's hard to get my running shoes on, right? But I'm like, I'm going to feel so much better after I do this. I'm going to be so much stronger, so much more connected in nature. Like it is going to serve me to go on this run.

I will tell you, it's a lot easier to get those running shoes on. And today it was like, I don't know, 28 degrees or I mean, we're like, what, an hour and a half apart from each other.

Like, you know, I had my hat on, I had my gloves on. Like I was like, I really didn't want to go out in the cold, but I'm like, it's going to serve me to do this. I will feel better during and after this experience. And I think that analogy works for, you know, sexual intimacy too, is like, it is going to serve me to participate in this experience. And during and after, you know, I will benefit. And I think unless we can, unless we can at least say that that at least part of that is true for ourselves, then it will remain in the chore obligation serving category. And it just won't be able to have the fullest potential. Yeah. Yeah. I love that. And I love the, the reframing, right? And that's really so important, especially when you have something that has become something that you used to enjoy, that has now become a chore, right? Is how can you reframe that? And I like your analogy of you're running because, right? And it becomes a monotonous after a while, right? Yeah. Yeah. Running and doing that. And I'm, I'm excited to hear about your half marathon that where you, but I can tell you so many, you can wear a different outfit. You can choose different running shoes. You can bring different snacks along the way today.

I wore running. So like, this is the whole thing is like, you know, the analogy is maintained to the sexual experiences. Like, like, Oh, I'm just running for miles today or whatever it is, but I can take a different route. I can, you know, take more time, take less time. Like there's infinite possibilities. It's not checking a box. It's like, wow. You know, even today I had an errand to do that. I forgot to do this morning. I was like, Oh, I'm just going to jog by this place and drop off the thing. Like I didn't care that I felt like I looked ridiculous. Like, like there are infinite possibilities of how, and we get to choose, we get to choose.

So permission, permission to have that experience. Um, I wanted to make sure to ask you, you know, what about this whole experience of being midlife, so to speak, and maybe we've gained some weight related to the hormones. Maybe we sort of don't feel as attractive as we used to. There's body image stuff that's crept in. Maybe we're, you know, starting to age and start to feel the perimenopausal stuff and vaginal dryness and all the stuff that you specialize in your practice. Right. Like, how do we navigate those very real bodily transitions in the process of the fertility journey and trying to have an enjoyable, healthy sex life? Yeah. I think that's a fantastic question.

You know, I think that what we have to do is we have to deal with ourselves and I think it's new set, you know, with compassion, right? And realize that not everyone gets to experience these changes, right? So we are very fortunate actually, if we get to experience these changes in life that happens, you know, whether it's going from perimenopause to menopause to, you know, whatever that journey looks like to just be able to age, I think is just such a privilege, right? And that not everyone is looking at what's happening in the world, you know, and things like that, that not everyone has the ability to age or, you know, lives that long to age. So I think it's actually a real privilege that we're able to do it. So that being said, doesn't mean it's not hard, right? Like, I think that is trying to conceive and I think a lot, and you see this all the time. I mean, this is, these are the people that we have women, right, that you deal with is that, you know, as physicians, we've given so much of our lives to medicine and to patients and to others, that now we have to kind of give that same love and compassion back to ourselves. And it starts with just understanding that, yeah, you know, time has passed and things have changed, but we meet ourselves where we are right now, right? We don't love ourselves after we have our first baby or after we, you know, achieve our goal. We love ourselves right now as we are. And I think that that is the most important thing, that we don't delay that love and compassion for ourselves, that we have to just accept where we are right now and then move forward from there because we can only give what we have, right? If we don't show ourselves love and compassion, then it's hard to give that to somebody else. So I think it starts with ourselves. I think it starts with accepting where we are and then maybe getting the help that you need. So if you're over, you know, I know we talked about, but if you're over the age of 35, right, and you've been trying for at least six months, then it's a brilliant point you go and see somebody like yourself, like an infertility doctor, and get going on that journey right away, especially if having children is really, really important to you. Again, there was, you know, a famous actress that, you know, she just published a book on menopause. And she talks about her journey how like, you know, she turned 36. And she decided, okay, now is the perfect time, because she was busy acting before. And now is the time that she wants to get pregnant. And then she realized, Oh, my God, I'm in perimenopause, you know, she's having hot, she's having night sweats, she's having this brain fog. And she's like, Oh, my God, I miss my chance. I wanted to have children, you know, and how did this happen? And, and then she didn't have anyone to talk to, you know, so a lot of this happens where I think that if you start to experience symptoms, like these hot flashes and nights, and you know, perimenopause can begin in your late 30s, it can begin in your early 40s. And for some women, that's the beginning of their fertility journey. You know, I know that some women start in their 40s, right, their fertility journey. Really, really important to get the help and the support that you need and find out who are the people you want in your close knit circle, right, whether that's your spouse, whether it's maybe, you know, perhaps you need a therapist, maybe you need somebody to talk to, maybe you need somebody like yourself, right?

So, and you a sexual health doctor, you know, I think what I tell my clients and my patients is you need your A team, and especially as female physicians, we take all the responsibility on ourselves. But like, I would say if I had a cardiology problem, I would not try to go to myself because that's not my, you know, zone of genius. And so, you know, so get the help you need, get the help you need at home. You know, who cares? You know, I, one of my clients just recently got a personal chef because she was like, you know what, like, I'm going through IVF, and I'm a busy professional. And my husband's busy. I'm like, I don't want to have to start dinner at 7pm every night. And, and, and I'm helping someone by employing them. And so really, like, get the help you need at home, get the medical support that you need, get an REI you adore if you can, get a sexual health doctor, like, you know, a coach like you who can help you navigate this, this process. And again, I mean, wouldn't it be great if we could say, okay, well, yeah, I'm going to like, increase, you know, improve my relationship and my sex life and everything. And then we'll resume the fertility journey. But but sometimes we have to do these things concurrently, because there's just not that luxury of time. So get your A team and give yourself permission, because there's so much support out there. But we need to deserve, we need to believe that we deserve the support. Otherwise, it will remain inaccessible to us. Right? Right. Absolutely. Right. You have to know that you are worth everything that you are investing in others, that you're worth that investment as well. And so it's really important to get the help that you need and get the support that you need, right? And then try to change that narrative from sex being a chore to being that you enjoy, and something that you look forward to. And like you said, you can always change it up, you can go to a different location, you can the backseat of your car, whatever, you know, whatever strikes your fancy, I mean, whatever makes it more enjoyable for you, you know, to excite you. So yeah, I am just blown away. And I think that, you know, I can't wait to re listen to this recording. I think you know what you said about, like, meet yourself where you are, give yourself the love that you deserve right now. I kind of feel like that's the key to everything.

And so I am so, so grateful that you shared your wisdom with us today. I am so grateful that our listeners have access to you and you have your own podcast too. So please tell our listeners, where they can find you and maybe some of them will even be able to work with you and go and like me, put it on the wish list to go on your retreat in Morocco. That's right. So thanks so much for the opportunity. I loved being on. So I am on social media at Dr. Sothev Oweeji Wai'an. I talk about intimacy coaching. I also do, you know, focus on perimenopause, menopause, sexual health, sexual dysfunction. I have a practice in Chappaquan, New York, so in Westchester County, so not too far away from you. And I also have a podcast called the Muslim Sex Podcast. That's a podcast for everyone.

And Dr. Bovee has been on it twice now and has shared her wisdom on that podcast. And also I have a retreat that we host in Morocco. We did it last year. Last year was our first inaugural retreat. We had such an amazing response that people really, really enjoyed. I really enjoyed.

I'd never gone to Morocco before. And if I say like the people and the food and everything was so amazing and just the lens, I mean, it was just so gorgeous. And it's the first time I ever done a hotter balloon ride. So that was fantastic. I love it. Yeah. And so this year the retreat is really sold out. Yeah. And we have, we have twice as many people going. And so we are definitely putting people on the waitlist for next year. So I will put you on the waitlist. Please, please do.

Yeah, it's fantastic. We have actually now three or four people already on the waitlist for next year, but it is such an amazing experience. And we focus the whole time. The focus is on you, the person, you know, and we talk about perimenopause. We talk about menopause. We talk about sexual health. We talk about sex coaching. We talk about nutrition. We went to an argon farm, argon oil farm and olive oil farm. And we were able to see how it's manufactured and tasted. And we did some cooking classes. They were amazing. We learned how to make Moroccan food. We just went an herbalist. I mean, it's just really such a phenomenal experience. It really is fantastic.

I mean, listening to other stuff that my other content is like, go on the trip. Like if you need to delay your whatever by like a month, like, you know, fertility does not decline a month. And so plan the trip, have other things outside of the journey to look forward to. And I mean, I believe this is a perfect opportunity. I also wanted to highlight your books. And so I just purchased my copy of made for more two. And what is the name of your chapter in that?

I can't think of it right now, but it was so powerful. It's no such thing as failure. Yes.

Right. So that is absolutely beautiful. And so I can't wait to read your chapter in that book, which is a bestselling book right now. And you also have this book that you are writing, which I actually on my list, my very short list is to write a book in the next three years. And so I will need to pick your brain about that. When is, when is your book coming out?

Yeah, so we're planning on it being out by the end of August, September, early September, because I wanted before my retreat. So I can give it to the women. Yes, that's a beautiful goal. So I cannot wait to read that book. We will all stay tuned. And Dr. Sadaf, such an honor to be in your world to hear your thoughts, to know how you serve women and how you make their lives better. So thank you for, thank you for your friendship. Thank you for being you. And I cannot wait to continue the collaborations. Oh, you're amazing. Thank you. I really appreciate it. Thanks so much for having me.

Thank you. You're welcome. Until the next time. Bye.