Sexual Health and Intimacy for All Bodies

In this episode of The Choice Space, Dr Lee David speaks with Samantha Evans, sexual health and pleasure expert and co-founder of Jo Divine, about sexual health, intimacy and how our relationship with our bodies can change across life.

The conversation explores how changes in hormones, health and life experiences can affect desire, comfort and confidence. They discuss how common issues such as vaginal dryness, irritation and reduced sensation are often misunderstood – and how small, practical changes can make a meaningful difference.

They also reflect on why sexual health is still difficult to talk about, both for individuals and healthcare professionals. Samantha shares insights into how shame, lack of education and cultural messaging can prevent people from seeking help, and why open, informed conversations can support both physical and emotional wellbeing.

The discussion highlights the importance of inclusive language and avoiding assumptions about age, identity or relationships. It explores how intimacy can take many forms and how people can reconnect with their bodies – and with others – in ways that feel right for them.

This is a thoughtful and practical conversation about understanding change, reducing self-judgement and finding new ways to approach intimacy across different stages of life.

Key moments

00:00 Why sexual health matters
02:30 Common intimacy concerns
06:00 Vaginal dryness and irritation
09:30 Ingredients and product awareness
12:00 Inclusivity in sexual health
14:30 Why it’s hard to talk about sex
18:00 Intimacy, grief and loss
21:20 Myths about desire and arousal
23:30 Aging, identity and assumptions
25:10 Body image and confidence
27:30 Self-criticism and kindness
29:00 Choosing intimacy on your terms

About the guest

Samantha Evans is a sexual health and pleasure expert, former nurse and co-founder of Jo Divine, an online company specialising in skin-safe, irritant-free sexual wellbeing products. She works with healthcare professionals across the NHS and private practice to support patients with sexual function, intimacy and pleasure, including lubricants, vaginal moisturisers and appropriate products. Samantha is also a writer and educator, producing practical resources that help normalise conversations about sex and support people to explore intimacy in ways that work for them. She collaborates with cancer and menopause charities, delivers training and webinars for healthcare professionals, and has contributed to media discussions on sexual health, including appearing in Sex, Myths and the Menopause. 

You can connect via the Jo Divine website, Facebook or Instagram: @samtalkssex and @jo.divine

10% discount code for Jo Divine: CHOICESPACE (£5 minimum spend on full priced products excluding P&P) ENDS 30/6/26 

About the host

Dr Lee David is a GP, CBT therapist and author specialising in mental health and wellbeing. Lee has written many books on CBT, mindfulness and teen wellbeing, and speaks regularly at conferences and in the media. Away from work she enjoys running, hiking, singing in a choir and spending time outdoors with her family. You can find Lee through her website and on Instagram, TikTok (@dr.lee.david), Facebook and LinkedIn.  You can find more about her books, wellbeing courses and therapy here:  https://linktr.ee/dr.lee.david 

Transcript

SPEAKER_01 0:00

Irritant free sexual lubricants and vaginal moisturizers, maybe consider investing in a simple pleasure product for yourself. But the other thing that's really key is communication. We don't talk to our partners enough. We're actually not telling our partner what the problem is. That's when you can open up this intimacy with your partner and have that connection. But for a lot of people, when they say we've started talking, that's made such a difference. This no longer works for me. Can we try this? And the most important thing to say to people, you know, sex is meant to be noisy, messy, embarrassing, consensual, pleasurable, and most of all fun, whether it's on your own or with a partner.

Dr Lee David 0:49

I'm Dr. Lee David, GP, CBT therapist, and author. Changes in sexual health and intimacy are something many people experience as their bodies change through age, illness, or life transitions. People may notice shifts in desire, in confidence, or in how their bodies respond. Yet this is an area that many people still find difficult to talk about. And when these experiences remain unspoken, it can be easy to assume that intimacy is no longer possible. But in reality, there are many ways to understand these changes and find new ways to reconnect with our own bodies and with others. I'm delighted to be joined today by Samantha Evans, sexual health and pleasure expert, former nurse and co-founder of Joe Divine. Sam, huge welcome. Could you start by introducing yourself and telling us a little bit about your work at Joe Divine?

SPEAKER_01 1:47

Yes, I am Samantha Evans, the co-founder of Joe Divine with my husband Paul. Joe Divine is an adult retailer and we only sell skin-safe products and irritant-free sexual lubricants and vagina moisturisers. My background is nursing, so I use a lot of my knowledge to write practical sexual health and pleasure articles, signposting people to product recommendations and also to the wider world with pelvic health physics, psychosexual therapists, oncologists, gynacologists, and I work in the menopause community too. And for me, it's really important that people are still able to enjoy good sexual health and pleasure because it's really good for you, both physically and mentally. And actually, a lot of people give up because they don't know what to do, they have a physical problem, sex is painful, partner might have erectile dysfunction, they may have a health condition, may no longer have a partner, and they're missing the intimacy. And also, people, you know, are on their own, and solo sex is really good for you too. But I realised having a nursing background, this was never part of my nurse training. It's still not part of medical and nursing training. And so healthcare professionals struggle to open this conversation and they don't know what to recommend. So Joe Divine is a resource for people to find ways to enjoy great sex, but also for healthcare professionals as well. I give webinars and I educate healthcare professionals to give them the confidence to have these conversations with their patients that can make such a difference to people's physical and mental well-being.

Dr Lee David 3:19

It's just so important to have the information, to be able to have these conversations openly, to understand how different bodies may respond and to and to have that sense that this is an important area. It brings many positive health benefits, it connects us emotionally to other people, and it's a really important part of life. I think people can assume perhaps at different points in life that it's something that's no longer accessible to them, that this is something I just have to let go of. And obviously that doesn't have to be the case at all, does it?

SPEAKER_01 3:52

No, not at all. Our oldest customer is 95. You know, we have a lot of older customers. Our customer base is 18 to 95 that I know of. So it is really important. And I think people don't know how to find this information. They don't know what is suitable to use for intimate use. They never have used pleasure products before. And, you know, they don't want to go onto a website that's got hundreds and thousands of products. So for us, it's about curating those products and also, you know, signposting people to products that we actually know are really good for them. That means that they can enjoy intermitting pleasure solo with a partner, with several partners, in a new relationship, you know, wherever they are in that part of their life.

Dr Lee David 4:34

And I know when we were talking previously, you often give people phone advice. People will ring up for advice about products, and you have a lot of conversations that perhaps people have find it hard to have elsewhere. And people actually open up and share things that it's not easy to share with friends and perhaps with health professionals as well. What kind of sexual health or intimacy concerns do people most commonly bring to you?

SPEAKER_01 4:59

Well, predominantly it's vaginal dryness. It's common and it happens to people of all ages. It's not just an old lady thing. It's not just something that happens in menopause, you know, our hormones impact upon our vaginal lubrication. And also when you're pregnant, when you're breastfeeding. I mean, lots of women have no idea when they're breastfeeding that, you know, it's important to use good sexual lubricants when they're going to have any form of sexual intimacy. Impact of medication, people don't understand that they're um antihistamines, you know, we're coming up to the tree pollen season soon, and people don't realise that they're taking an antihistamine every day. It dries up all secretions, including your own natural secretion. And also obviously things like chemotherapy, and yes, yes, obviously menopause, and as you get a bit older, but also you can feel aroused but still feel dry. So using a really good lube can make such a difference. It helps you to get started. Ah, that's how I use it. Um, you know, and then it means that I can carry on enjoying sex later. It doesn't mean that I don't want to have sex, it just means that my body's not responding in the way that maybe it should do, but use a good lube and then it actually gets things going. The other thing is obviously we help people, a lot of people going through menopause who've got vaginal um genitourinary symptoms. So, you know, the dryness, the tightness, because the skin, the tissues have shrunk due to the depleting estrogen levels, they're getting recurrent infections like thrush and UTIs. So I always signpost them back to their GP to get vaginal estrogen, which can transform their genitourinary health. But also it's important to have an intimate regime using good vagina moisturisers, good sexual lubricants, only washing your vulva with water. No one needs an intimate wash. And, you know, maybe investing in a pleasure product because vibrations promote the blood flow to the tissues of the vulva and vagina. That promotes your natural lubrication, it promotes sensation, it feels nice. You can use them on your own, you can use them with a partner. And also we advise a lot of people going through cancer treatments, so predominantly breast cancer patients and those with gynea cancer, though we do have people with bowel cancer, and men who've gone through prostate cancer treatments, and also men who've had prostatectomies as well, because that impacts upon erectile function.

Dr Lee David 7:05

Oh, so there's a whole range there. And I think we often think in the choice space about looking at well-being alongside the physical health. So, for example, for women who are in the menopause who may be experiencing vaginal dryness due to oestrogen depletion, then having vaginal estrogen is really important, isn't it? As a huge impact. And alongside that, then there are other things as well. And I think it's looking at that broader approach that also moisturizer. And I don't think that people often think about moisturizing vaginally. We don't want to get wrinkles on our face, but actually it's also important to think about the whole body when we're thinking about moisturization. You've talked about lubrication, and I think there's something about finding the right form of lubrication that works with your body and doesn't trigger other symptoms. Is that something that comes up for you quite frequently when people contact you at Joe Divine?

SPEAKER_01 8:03

Yes, because we only sell irritant-free sexual lubricants and vaginal moisturisers. We discovered when we set up Joe Divine that actually it was the ingredients in the lubes have been causing all the infections, that light bulb moment, which a lot of women get when they talk to me. They go, Oh, yeah, actually, I'm using that bubble bath, or I I use bath bombs, or yeah, actually I've been using that moisturizer, or scented menstrual products, perfume condoms, we've got scented toilet paper. They're doing things that actually are detrimental to their intimate health. So for me, it's educating people about why ingredients matter and healthcare professionals. So I say to people, be an ingredients detective, always check the label. So you need to avoid glycerin, glycols, parabens, dyes, perfume, alcohol, glitter. Can you believe that's actually in lube? Things like CBD, we don't know what that does to the microbiome, your friendly bacteria of your vagina. But if anything stings, itches, burns, gives you thrush, you must stop using it straight away. And also, people assume that they can use things out of the kitchen and bathroom cupboard. Just because it's slippery doesn't mean to say that it's been designed for intimate use. And what you're doing is you're disrupting your friendly bacteria, the pH of your vagina, and this will actually cause irritation and things like thrush and irritate the urethra that you pee out of, but also it would exacerbate those genitourinary symptoms that you're actually seeking help for. So I always say to people, if you take one thing away from any talk that I give, it's please be an ingredients detective.

Dr Lee David 9:31

Right. So what I'm hearing there is how important it is to really minimize unnecessary chemicals, perfumes, things that are not designed for vaginal use and that many people may react to and can cause irritation. So you mentioned for washing, using water, using moisturization as we've talked about, and then really being aware that things that you might not think of, so having a bath with a bath bomb or adding additional products, and it may be that it's been fine, but actually, if you're more sensitive in midlife, for example, so you might have been okay in your 20s and 30s, but then as we go towards that perimenopausal period, we're just more sensitive. And so these extra ingredients become one more thing that creates that irritation that then can really interfere with our sex life, but also can make life generally uncomfortable. We c we can have a lot of distress and discomfort all the time from vaginal irritation and as you mentioned, urethral irritation if it's getting uncomfortable to we, and you know, that's something we're obviously going to need to do on a regular basis. So it really feels important to highlight that awareness of products and what's in them.

SPEAKER_01 10:42

Yeah, no, very, very much so. And as you said, things change. So I've had people going, but I was able to use this leave for years, and now suddenly I can't, and I had about two or three bouts of thrush, and I'm going, well, actually, it's probably because things are changing inside your vagina, the pH has changed, the estrogen is slowly disappearing, and actually this product really isn't working for you, and it's so important that you look for something that's good for you. I always also say to people is that if you care about what you eat and put on your skin and your hair, then think about what you're using intimately, what you're going to be putting on your vulva and inside your vagina too. And it's not just somebody with a vulva and a vagina. We hear about men who find that they get penile irritation, they get anal irritation. So again, you do actually have to be aware of all the products that you're using. And the same goes for condoms. Some condoms are lubricated with irritating lubricants, and people think they have a latex allergy when they actually uh have an irritation to the lubricant that's actually on the condom. So we all we sell condoms that are lubricated with silicon lewd because you get less irritation. People struggle even to use sexual lubrication because of embarrassment, and they think that they should always be wet as soon as they're touched. And actually, we need to get over to people that actually can transform your sexual pleasure and your intimate health when you actually use good sexual lubricants.

Dr Lee David 12:04

That's a really important point you're making about the the breadth of people who may be impacted by this conversation. And I know you talk a lot about inclusivity around sexual health and intimacy. Why do you think that's so important?

SPEAKER_01 12:21

Because people enjoy sex in so many different ways. Therefore, we should just not just be talking about penetration because lots of people don't have penetrative sex. You know, some people don't identify as female, but they've still got female reproductive organs. So it's about the terminology that you use as well and ensure that actually you do include everybody when you're having this conversation. So when I talk about sex after hysterectomy, I will talk about women, but I talk about people. And it's the same about childbirth and menopause. And it means that no one is left out of this conversation or thinks I can't use those products because they're only for women. Actually, you know, these products are for anybody who actually needs to use them. So that's what's really important to me is that we don't miss anybody out of this conversation. And the same when it comes to cervical screening tests, and the same for people who have disabilities, because there's always this assumption, oh, well, they're in a wheelchair, they're not going to be having sex. Well, actually, they're probably having more sex than you, and they're probably far more creative with their sex life because they're having to be, you know, and we have to dispel these myths. We have to dispel the myth about older people that, oh, you can't possibly be having sex. Well, actually, she might be swinging from the chandeliers every night with a different partner. I feel like these assumptions need to be dismissed because we need to be open-minded when we're talking to people. And I often talk about same-sex couples that, you know, they could both be going through the menopause and have completely different menopausal symptoms. So they have the whole myriad of menopausal symptoms, which it's almost like doubling up. Again, it's really important that we're acknowledging all these people and the things that they may be going through that can be impacting upon their intimacy and pleasure.

Dr Lee David 13:59

Yeah, so then it's about seeing people as individuals and what are their needs and trying to address those broadly and have those conversations. As you say, it's about not making assumptions about anybody and asking questions with curiosity, with interest, with compassion, and just being led by that person. I always think it's about trying to find what matters to every person that we talk to as a professional, and then trying to support them to make choices that work for them, that fit their priorities, fit their values, fit their needs, and their personal relationships. Why do you think it is so hard for people to talk about sex?

SPEAKER_01 14:37

I think a lot of it goes back to upbringing, to cultural upbringing, to religion, lack of education. We don't talk about this. Let's face it, you know, the menopause was called the change. Everybody whispered, you know, it's only in the last sort of five years that, you know, I've been part of this, the menopause movement. And we feel like it's a revolution, which is great. Finally, my generation and younger women who go through the menopause are now talking out about it. But also, I advise people who feel so much shame about their bodies. They may have been in an abusive relationship. I have people who don't understand their intimate body at all. And this is why also I think it's important to use the correct terminology. We have a lot of, you know, nicknames and things, and it's very funny, yes. You know, for me, using the words vul with vagina clitoris is really important. However, social media do actually censor us for using the correct terminology because it's seen as dirty or rude. And I think it's really sad when I hear from these people the shame that they hold about their bodies. And the other group that we do talk to are the people who their partner may have died or they may have a health condition, which means they can no longer enjoy intimacy together and they experience sexual bereavement. And often when you talk to them, they say, I can't tell my daughter or my family that I'm missing the sex, you know, I'm missing that physical intimacy of my partner who I love very much. You know, and I I think actually that can lead to things like depression. Had one lady who bought herself a sex toy and she says, Well, I've actually been enjoying my toy every night, and I don't need antidepressants or sleeping tablets anymore. And I've told my GP, this is what I needed. Yes, it doesn't replace my husband, but it's the physical intimacy that I needed. Talking about it is really difficult for some people and also for medical and healthcare professionals. If they come across as being embarrassed, it makes their patient feel embarrassed. And it is getting much better. I've been doing this for 19 years, and I work with amazing healthcare professionals who are so proactive at talking to their patients. They will ask that question, well, how are things? You know, how does it feel? Are you enjoying sex? You know, they're actually opening that conversation instead of waiting for a patient to say, actually, doctor, you know, there's this issue, and they can't use their words, or they've got the hand on the door, and then you suddenly realize there's actually more that they do want to ask you. It's taken them such a long time to pluck up the courage to actually raise the topic. Healthcare professionals don't have enough time. So being able to signpost patients to Jodie Vine and to me, you know, and if they don't know what to advise, then they can say, I know a woman who can help you.

Dr Lee David 17:14

I know you do a lot of work talking about it, and and hopefully all of these conversations we're having are starting to chip away at the silence and make it something more normal to talk about. I was really struck by the idea about grief and that impact of the loss of a sexual relationship and how that could occur, perhaps due to physical changes that mean that with a partner who may still be living, but actually there's there's changes that make it harder to have that intimate relationship. And so that's when the creativity around how to approach intimacy for all those individuals and coming back to inclusivity, not making assumptions, and having a hopeful approach that actually there are things that can make a big difference. We just need to sit down and understand what is getting in the way, what are the challenges, what do we need to do that might help? So recognising that loss can happen in lots of ways. And again, loss could happen with someone who's been bereaved, and that sense of loss of the intimacy of the person generally, and then how that is often expressed. So a sexual relationship is often an expression of a loving relationship. And I loved that story about somebody who didn't need an antidepressant and they found that using a sex toy was a really powerful way to reconnect with somebody that they lost, thinking about that person, developing that relationship and bringing that into the here and now with positive feelings feels like a really healthy approach to try and navigate the loss. I'm sure it doesn't eliminate the loss, but actually it might help them to feel closer to the person that they have lost. This is the choice pause, a short tool you'll hear in every episode, drawn from my books and therapy practice. Each time with something different to help you pause and choose your next step. Today is a pause for reconnecting with your body. Take a slow breath in and a longer breath out. Let your shoulders soften. Allow your hands to rest wherever they feel comfortable. Sometimes our relationship with our bodies changes. This might happen with age, illness, hormonal changes, or other life transitions. You might notice your body responding differently to how it used to, or that you've lost a little confidence or trust in your body. Perhaps intimacy feels more complicated than it used to. And when this happens, it's easy to start judging your body, blaming your body for why things feel different, or assuming that something important has been lost for good. For a moment, see if you can widen your attention. Notice the support beneath you, your feet on the floor, the steady rhythm of your breathing. Notice that your body is still here, still carrying you through your life. Perhaps you can gently acknowledge my body is changing. I can meet this with curiosity, I can see my body with kindness, acceptance, I can notice all the ways that my body brings me joy in life. And from here, just think about one small supportive choice. You might take a moment to notice any sensations in your body without judging them. You might choose to speak openly with a partner about what feels comfortable or needed right now, or simply give yourself permission to learn something new about what your body needs or how to nourish your own unique body. Now, as you continue with your day, remember that you can pause, check in, and make one small choice in line with your body's needs at any time. Do you hear many myths or misunderstandings about sex and intimacy that come up time and time again?

SPEAKER_01 21:25

Well, the biggest one is that you need to be instantly wet as soon as you're touched, you're aroused. And as I've talked about the fact that, you know, I had vaginal dryness and I could feel really aroused, but actually I still felt dry, and I still feel like there's this barrier to some couples using leave. But also, I think even though sex toys are available everywhere in the supermarket, online, from Jodie Vine, people still think of them as from shops down a dark alley and the packaging's very salacious. The world's moved on. Design of sex toys is incredible, you know, they're very innovative, lots of toys don't even look like sex toys. And I think that people still have this. Issue that there must be something wrong with me if I need to use a sex toy. Also in menopause and certainly post-cancer treatment, your sensation can change. So you end up with decreased sexual sensation. And also over time, in a long-term relationship, things that used to work for you no longer work. Like we said about, you know, that bath product or the lubricant. So actually getting yourself a simple little bullet vibrator to use on your clitoris during sex play together can make such a difference. It's about enhancing your pleasure and the sensations that you can enjoy and having fun because you can have a real giggle and there are toys for people with a penis and a prostate. And it's about having fun together and dispelling those myths. We also have nursing and care home residents who are customers too. And again, we have followed people going from their own home, elderly people, into a care home and then into a nursing home. They're buying our products or their partners buying the products for them and they're using them in the care home. And again, just because you've gone into a care home doesn't mean to say that you're no longer feeling sexual. And also we do know there is an issue that people, when they go into care, they often conceal their sexual orientation, which is really sad.

Dr Lee David 23:14

There's a whole narrative there about lots of areas. One of them's about empowerment through age. So recognising that as people age, that we mustn't have assumptions about many things, many aspects of life, and sexual relationships is one. And actually, there's probably many others that we assume that people no longer want to engage in all kinds of different parts of life. And actually, as we age, it's really healthy to want to continue to grow, to develop, to be sexually active, to do all the things that matter to us. And I think that sometimes some of the people I work with through therapy have a belief that aging means I'm shriveling away, that I'm no longer as valuable, that I can't take as much space up in the world. And there's a lot of stuff about the body and appearance that's very negative. And we do a whole lot of work about just reclaiming aging and actually how it's a sign of power, of knowledge, of wisdom, and this sense that you can become stronger, you can do physical training, you can build your muscles up post-menopause, which is really powerful. And I just also feel so sad about people who feel the need to hide their sexuality in a care home or a nursing home, and how for so many reasons sexual health is one, but actually just identity and feeling understood and accepted just feels so important that we're able to be more actively inclusive and not make assumptions about people. And I think that is something that we can challenge in in life. I think is really important for us as a society to be moving forwards with. A lot of the work I would do is with people who have concerns about body image. So there's a lot of shame around bodies that might change, perhaps relating to the menopause or aging. It might be due to physical changes after an operation, or there's lots of reasons that our bodies change through life. And I wondered if you come across that as a barrier to sexual health and intimacy.

SPEAKER_01 25:10

Well, personally, I gained a lot of weight in menopause, and it's been the one thing that's really impacted upon my body confidence. I do weight and resistance training and been doing it for about three years, and it's made such a difference to my physical and mental well-being. And I've changed the shape of my body, but I think it's actually about feeling comfortable in your body. There are people out there doing amazing stuff. We're seeing people now who've got a stoma, you know, and they're talking about it, they're showing their bodies. Let's just talk about this. People who've um have lost a limb, and we've got so many more people now who've got different bodies through health issues and surgeries, because I think there's a lot of shame held in that respect as well. And I'm currently working with a group now, and it's menopause and stoma. So it's great that we're addressing that. And I think also women are our bodies, we're constantly being criticized, and we've got fantastic people, actors, celebrities in the press who are really good role models, and they're constantly being picked at for the way that they look as well. We don't do it quite so much with men, but um, I think we're getting more and more vocal about it. We're seeing so many more role models, older models now, and flamboyant models, and people just looking incredible and embracing their wrinkles because that's life, and you've gone through that, and those wrinkles are what's happened to you in your life. I don't feel that they should be pressurized to get rid of the wrinkles, to lose all this weight just to conform to an image that the press are saying that we should look like. Having said about men not being affected, there are a lot of men now that actually feel like they need to be doing things to their image and their bodies too.

Dr Lee David 26:48

I think actually it's growing in men, and there's that sense of needing to be muscular or needing to have a certain body. So that sense of body shame I think is is actually becoming more apparent. I don't think social media helps, but I I completely agree actually, Samantha, that we're seeing more aging female stars who actually look amazing as they age, and they're not there's less focus on trying to hide the aging process and more focus on stepping into age as a power play of being actually this represents me and the sense of beauty that can come through age. And I think for me it's it's about being kinder to ourselves because I think there's a lot of self-criticism, there's a lot of body shaming, and and we can be our own worst critics, and so that's something that we can work on, which is learning to develop skills and being kinder to ourselves, and you can train your brain to do that, and whether that's relating to our body or to other areas of life, I think it's massively important. And so I like to think about towards or away step. So I choose to look after my body, and how I choose to do that can can really vary. I choose to have a sexual relationship if I want to, it's it's all a toward step, and none of it is an away step. An away means I'm doing it because I feel bad if I don't. Perhaps I'm avoiding sexual intimacy because I feel ashamed about my body, so I don't want to show it to people. And a toward step is, well, I care about intimacy, so therefore I'm going to bring the body that I have, which has got bits that I like and bits that I slightly struggle with, and that's okay, that's just the real me. And I'm going to embrace intimacy with my own body and not with a body that I think I'm supposed to have, which I don't think any of us have really got those. I don't think they're real, you know, for the vast majority of people. So it's about choosing, do I want a sexual relationship? And again, that's a positive choice. I choose to step away, and actually that's because it's something that my value is I I've got other things to do, I actually am quite happy, or actually I really choose to lean into that because it's something that really brings me joy and it brings me connection with my partner. And so, whatever we're choosing, it's not because we don't feel good enough or because we feel that we need to prove something, but because it's in line with who we want to be. And I think that's a really powerful way to look at it. Yeah, and that's actually a fantastic way to look at it actually.

SPEAKER_01 29:12

And I personally haven't really thought about that. Yeah, that's something I've done personally, you know, embracing my new curves, getting fitted with a really good bra. I've got a fantastic husband who has always encouraged me and boosted my confidence. Actually, it affects the person that you love, the person that you're intimate with too. If you don't love yourself, and then they love you to bits and they think you look great, and that can be difficult too. So I think actually trying to embrace that makes such a difference. It's about all those little things, the little pockets of joy during the day that you can find or during the week that just boost your mood and actually say, Well, I do feel feel better about myself. And in midlife, women can feel that they've lost themselves, but it's actually enjoying, as you said, towards, and I think that's a a really good thing to be to do.

Dr Lee David 30:00

I I I like that. And the other thing I'd probably add is thinking about body image, we often start comparing. We compare ourselves to others, and and we always compare negatively, don't we? We always feel less, we feel like our body doesn't match up. And I think as soon as you start comparing, there's that sense of judgment. How am I doing? And that actually is quite stressful, and it very rarely leaves us feeling better about ourselves. So I really encourage people to let go of judgment of uh how's is my body good enough? And actually just move to what can my body do? How can I work with the body I have to enjoy life in a way that works for me? And actually, that's much less about how it looks and much more about how do I look after my body, how do I connect with people through my body, how can I find joy through moving my body, and that might be through sexual intimacy, it might be through going for a walk in the in the woods or looking at nature, it might be giving a hug to somebody that we love and having that form of intimacy as well. And and our body is actually amazing, even when it's changing, even when we may have been working with disabilities, with changing weight, with aging changes, all of those things. There may be pain, but yeah, our bodies are still kind of incredible, actually. And I think it's trying to embrace that sense of how can I make life work for me and find little pockets of joy by using my body in ways that are that are good for me personally.

SPEAKER_01 31:29

Yeah, very much so. And I'm of the generation where we had special K cereal, we ate the low-fat yogurt, but now you look back and you think, gosh, why were we depriving ourselves of nourishing food? So I love food. We try and cook from scratch. I've got a husband who bakes bread, I've now got a son who bakes bread. You know, we're very, very fortunate. And I think it's about not just nourishing your body with food, but with everything around you. On the other hand, there is this wellness industry which is extreme, and people are having diets that are not good for them in midlife, and they're eating ultra-processed powders and goodness knows what, and rattling with supplements. I always say to them, it's really important that you're actually nourishing yourself because if you're nourishing your body, then that actually impacts upon your sexual function too. You we all know when we've eaten rubbish foods, we actually feel rubbish, and then you're not actually going to feel like wanting to be intimate with anybody as well. So it is about looking after yourself and future-proofing for you know whatever's going to come, as you say, the exercise, weight training, connecting with nature and nourishing your body, but also your mind too.

Dr Lee David 32:38

For many people, sexual health and intimacy can be a form of nourishment, can't it? It's actually a way of valuing our bodies and enjoying our bodies and giving ourselves emotional nourishment, relationship nourishment, connection and intimacy, and all of that is actually really powerful. So I I hadn't thought of it in that way, but I think that's actually really true.

SPEAKER_01 33:00

No, it is, and actually I would say I get really irritable if I don't have sex. We both do, and and I and I think it's that connection, and it's not just about a physical intimacy, it's all those little looks that you do across the room, or you share a joke, or you literally hold hands together when you're walking on the beach. It's all those things throughout your day that you're able to do, and I think people lose that connection when they're struggling and any form of sexual play is off the cards. I'm going, you still need to be intimate though. You can still kiss and cuddle on the sofa, you can still sort of have those gazes and stares at each other and a wink or something, leave each other those little notes. And I think again, that is nourishing for any relationship to maintain that connection, even if you can't be connected intimately in the way that you want to be at that time. So you know, I had ladies say, I'd forgotten we actually had stopped holding hands. So they were holding hands again. She said, And I love it. Um, but she's I don't know when that happened. And it's actually getting people to think, well, when did that happen? We're sitting on different sofas, or you know, they're upstairs in the bedroom, I'm downstairs watching Netflix, and it's those yeah, people want to do that, and that's absolutely fine. But if it means that you're disconnected and you don't want to be, then that connection can be so nourishing too.

Dr Lee David 34:20

Yes, and I think when we're thinking about sexual intimacy, then it feels like we also need to have that broader intimacy so that then that feels like a positive space. Otherwise, if we're not being touched a lot of the time, and not everybody enjoys hands holding, but but many people do. And so again, it's about what are my needs? Am I someone who likes a back massage? Do I like to hold hands? Do I like someone stroking my hair? Or am I someone who actually I find that quite annoying? So my my partner's learned not to do that, and we find different ways to connect. Perhaps we connect through talking, we connect through discussing something that we we're both interested in. So I think it's again back to that inclusivity where we notice what creates intimacy for me and how do I build this relationship with this actual person, not just an idea, but the reality of the person that I'm in the relationship with. I wanted to go back to something you mentioned earlier, which is you talked a little bit about pelvic health physios and psychosexual therapists. And could you just tell us a little bit about when you might recommend either of those so that people know. I think again, this is something that people don't even know is an option, and so they might not know that that's something they could benefit from.

SPEAKER_01 35:35

Well, often I'm advising people who are experiencing painful sex, and there's so many reasons for that. There are a lot of pelvic health conditions. I had vaginismus, but there's a whole broad term called vulvadinia, and that covers so many different pelvic health issues. So basically, pelvic health physios are the experts, they look at you the way you stand, they look at the whole pelvis, they look at the whole genito-urinary system, they look at your bowel, your bladder, your vagina, and your pelvic floor. Often I say to people, I think it's important that you see a pelvic health physio to assess whether or not you need some treatment. Sometimes they can be buying a dilator kit, which we have a set of five dilators, and these are designed to open up the vagina to dilate it. And the liftless is the size of my smallest finger, and then the bigger one is bigger, it's apparently the size of an average penis. And I often say to them, Have you seen a pelvic health physio? No, but they're actually buying this product to try and resolve some problem themselves that maybe they haven't gone to their GP to ask for advice, or they may have gone and not got the advice that they needed. So then they can see a pelvic health physio. And also, pelvic health physios see people post-childbirth, because that then prevents things like urinary incontinence, which is common but not normal. And also, urinary incontinence impacts upon intimacy because people worry that they're going to be incontinent during any form of sex play. After after cancer treatment, the impacts of radiotherapy can actually cause the tissues of the vagina to shrink and again they become tight and dry. So dilation therapy is recommended. But a pelvic health physio can assess your pelvic floor muscles and also people that I have to do my kegel exercises, my pelvic floor exercises. But actually, a lot of people are doing them incorrectly, and a lot of people don't need to do them because they actually have a tight pelvic floor, which is why penetration or going for a smear test feels painful. So the pelvic health physios are incredible, they also help people who've got a prolapse, these are weaknesses in the wall of the vagina and the bladder, and it causes a bold. And a lot of women have a prolapse, certainly after childbirth, but of different degrees, it's when it's impacting upon you and you are feeling it and it's impacting upon sex play, it's impacting them when you're peeing and pooing, you know. So the physios can assess so much, and your GP can prescribe you. Most hospitals will actually have a physio, pelvic health physio in the physio department. There are long waits in the NHS, and there are private physios. And I do say to people, if there's a long wait, then invest in a session if you can afford it, because it will be well worth it. And then the psychosexual therapists, again, we work with a lot of them because I do speak to people who have things like vaginismus. So the psychosexual therapists actually will explore different things that are happening to people because obviously the brain is the biggest sexual organ and the impact that has upon you. So a lot of women who have vaginis will see a pelvic health visio and a psychosexual therapist who can help them to relax and actually identify what is causing this. And often people can track back into when they were younger or an incident that happened that is actually causing them to protect themselves, which is why this pelvic floor is tightening. Sometimes there's no reason for it at all. And these painful pelvic health issues. I think a lot of the physios would love to see people earlier. I think there's a long wait, some people leave things, and by the time they get to see them, and the psychosexual therapists, the conditions got worse, and then it takes longer to recover. But people don't realise that these healthcare professionals exist. And I don't think enough people are being signposted or referred when it would make such a difference. So again, they're important people to help people to regain their sexual function and reclaim their sexual pleasure. And that might be different. It might just be different to what they'd enjoyed before, might be even better. I often hear that from cancer patients that actually, well, we hadn't really thought about our intimate relationship, and actually now we've really had to think about it, and we're having more fun because we're playing in a different way and we're using really good products, and we've actually become very creative.

Dr Lee David 39:38

I love that. And and it comes back to what we've really talked a lot about, which is recognition, having these conversations, really trying to understand what's going on, and that may well involve seeking a specialist like a pelvic health physio, might involve having some psychological support, it might be both, and it's not making assumptions, but actually finding out and having these conversations that mean that people understand what they're being affected by, and then they've got choices, haven't they, about what they can do and how they can address it, and it will be different from so many different people. But I think without that information, it's really hard to make a healthy choice. And so I think for me, that's really fundamental that's come out of today is for people to ask questions and to seek information, understand their bodies, reduce the shame, and start having more open conversations with people. So for someone listening, we always do a choice-based takeaway, which is a bit of advice that you might give. If someone wants to make one or two small steps that improve their sexual well-being or their intimacy, what small steps would you advise, Samantha?

SPEAKER_01 40:52

Well, we always recommend free lubricant. So maybe consider investing in a simple pleasure product for yourself, enjoy that on your own. And if you're in a relationship, introduce it to a partner. But the other thing that's really key is communication. We don't talk to our partners enough. We're actually not telling our partner what the problem is. When you can open up this intimacy with your partner and have that connection, for a lot of people, when they say we've started talking, that's made such a difference. This no longer works for me. Can we try this? And the most important thing to say to people, you know, sex is meant to be noisy, messy, embarrassing, consensual, pleasurable, and most of all fun, whether it's on your own or with a partner. And I think we lose sight of that sometimes when people have a medical or a surgical condition that impacts upon their function, or they've lost a partner, or that partner no longer can be intimate with them. And I think the most important thing is we actually say to people, this is about pleasure and fun. And it's really good for you.

Dr Lee David 41:53

I love that. And I think I'd build on it and say, have that connection, look for ways to physically connect. If you're someone who enjoys physical connection or touch, then weave in a little bit more touch into your day, holding hands, giving someone a foot rub, giving someone a hug, just increasing a little bit of that physical connection because we are wired to feel connected. And for many of us, our nervous systems really respond to that sense of feeling safe and feeling connected to other people physically. And I'd also just add a reminder to be a little bit kinder to ourselves, to let go of comparison about our bodies, to let go of shaming ourselves about our bodies, and just be more accepting. So we don't have to love every part of our body, but what we can do is find joy through using our bodies in ways that are positive, move in ways that feel good, find physical touch in ways that feel good, and actually give ourselves permission to use our bodies in ways that really work for us. And I think for me, though those would be really key. So just to finish, Samantha, how can people find you if they'd like a bit more information about you or about Joe Divine?

SPEAKER_01 43:04

So the website's joeedivine.com. There are hundreds of sexual health and pleasure articles on our blog. We only sell skin-safe pleasure products and irritant-free sexual lubricants and vaginal moisturisers. I'm also on Instagram, Sam TalkSex, and you can Joe Divine's on Instagram, Joe.divine. You can DM me, you can call us, you can email us. And we have a health brochure that gets given out in the NHS, which we created with our local hospital in Tunbridge Wells. And we also have a catalogue, which is quite old-fashioned, but again, inclusive, because some people aren't online. And so it's important that we make sure that we're actually accessible to everybody. We're here, we're happy to help you. Um, no question is daft. And most of the time when people ask me a question, I normally say, Oh, I've written an article about that, oh, I've done a video about that. And if I don't know, I will sign post to the experts because it's an holistic approach, whatever your sexual orientation, gender, disability, or health conditions.

Dr Lee David 44:00

Thanks for listening to the Choice Space Podcast. I hope this conversation has offered a little room to pause, breathe, and find your way forward. You'll find links to the Joe Divine website and to Samantha's Instagram account in the show notes, as well as a discount code for Joe Divine. If this episode has been helpful, please download it and share with someone else who might value the conversation as well. Please consider leaving a rating or a review on whatever podcast platform you're listening on. It really does help people to find our show. This episode was edited by L. Dixon.