Taking Charge Of Sexual Health In Midlife With Dr Nneka Nwokolo

Dr. Nneka Nwokolo, is the co-founder of NewWoman Health, an online and in-person clinic offering holistic menopause care. She is also an Honorary Consultant Physician in Sexual Health and HIV at Chelsea and Westminster Hospital in London.

She is passionate about addressing taboos around sexual health and raising awareness of menopause among women as well as in the general population and is particularly interested in understanding the different menopause experiences of women of diverse backgrounds. Other interests include the sexual and reproductive health of women living and ageing with HIV, and the impact of menopause on HIV, as well as increasing the participation of women in research.

We name shame, trade myths for facts, and build a practical plan for safer, more joyful sex in midlife with consultant physician Dr Nneka Nwokolo. From STI testing and consent scripts to menopause changes and redefining intimacy, we get honest and give tools.

• modern HIV facts and why it matters
• rising STIs in older adults and asymptomatic risk
• condoms as baseline safety in new relationships
• how to ask partners for testing with simple scripts
• home testing versus clinic visits and when to go in
• perimenopause, dryness, pain and local oestrogen
• redefining desire, responsive arousal and “good enough”
• building intimacy outside the bedroom for better sex
• shifting shame with open talk and shared responsibility

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Chapters

• 0:00 Welcome And Why Shame Matters
• 1:58 Introducing Dr Neka Niccolo
• 5:04 Outdated Fears To Modern HIV Facts
• 12:13 Rising STIs And Why Testing Matters
• 16:40 Scripts For Safer Sex Conversations
• 23:38 Midlife Body Changes And Pain
• 28:41 Redefining Desire, Intimacy, And Enough
• 31:32 Closing Reflections And Next Steps

Transcript

SPEAKER_02: 0:00

Welcome to another episode of the Saiyans Sister Podcast. Brought to you by Wise Women Lead Founders Karen Harris Kelly and Lucy Barkas.

SPEAKER_01: 0:09

This is your space for real unfiltered conversations about womanhood, the messy, the magical, and everything in between.

SPEAKER_02: 0:17

We're here to talk about existing, thriving, and empowering ourselves and each other by connecting to our experiences and truths. And saying them out loud. So that we can feel and heal. We're called upon to name the taboos, stigmas, stereotypes, and lies that keep us stuck so we can rise and reign like queens.

SPEAKER_01: 0:41

Because when women share, we hold space, inspire action, and create change. We open up spaces and deepen relationships that bring us closer to love and a better world for all. So get comfy, grab your favourite drink, and let's say it sister. Welcome back to Say It Sister.

SPEAKER_02: 0:58

Today we're getting real raw and absolutely unfiltered. We're tackling shame today. And no matter how uncomfortable we may feel, we're going to go there.

SPEAKER_01: 1:08

Yes, we are, aren't we, Lucy? Yes, we are, because as we head into the festive period, um, even though it's now the new year, as you're hearing it, um, we're really aware that you know many women are entering new relationships or occasional pre-Christmas hookups. And this is your time to think, hmm, was I as prepared as I was I as safe as I should have been? And although, yeah, we might talk intimacy with our friends, um, we don't really talk about it in public. So intimate well-being absolutely needs to be part of the say a sister conversation, even if we might be cringing a little bit.

SPEAKER_02: 1:51

Yeah, this week we're joined by a brilliant doctor, Neka Niccolo, who specializes in women's intimate health care. She's the founder of the New Woman Health, an online and in-person clinic offering holistic menopause care. And she's also an honorary consultant physician in sexual health and HIV at Chelsea and Westminster Hospital in London. Um, I am so grateful that she's on this call with us today, and we really want to go there talking to boos, shames, STIs, midlife dating, sexual confidence, and what stops women from taking charge of their sexual health. It's also a historic moment in time. I've been looking at Instagram this morning and I'm seeing that we have this new medication that's going to come out for women that will help women with low libido and is evidence-based. And I'm super excited about that because for me, um, libido is something that definitely has impacting me at this point in time during my life stage work as a woman. Um, so we can talk about that a little bit, but but yeah, I just want to mark it as um something that feels important for women so that we can take back our power um and really reconnect into our sexual desire and um help our brains to get back on board.

SPEAKER_01: 3:05

Yeah, do you know what? Intimacy changes in midlife, whether it's how we feel about our bodies, um, you know, our looking in the mirror and seeing we have wrinkles or our body shape is changing to actual, you know, dryness, um, you know, sometimes pain. And, you know, sometimes it's literally shifting your, you know, partners for women who are out there, newly single, dating. Um, and the one message I hope to get from this is how to stay safe, informed, respect yourself, and I guess be prepared. So, yeah, no embarrassment, no judgment. And I do have to admit, I do feel completely out of the loop because um I haven't dated in eight years, and before that, I've only had like two major adult relationships. So I feel completely out of the loop with this, and hopefully, this might inspire me to maybe even consider dating again. So I just want to um welcome Nekka. Tell us a little bit about yourself and why you're sharing this message about your really important work.

SPEAKER_00: 4:18

Hi, um Karen and Lucy. Thanks very much for having me. So, um, yes, I'm a consultant uh physician in HIV and sexual health, and I run a menopause clinic, as you uh say. And sexual health, HIV, and menopause, I think are subjects that women often find it difficult to talk about. Um, and because there are lots, and because of this, I think there are lots and lots of myths and misinformation um in these areas, and I think that these can often be harmful. Um, they prevent people from accessing help when they need it, they cause embarrassment to ask for help, and also people just don't understand, I think, about what's right and what's incorrect information. So I think it's really important that people know the facts so that they can stay healthy.

SPEAKER_01: 5:04

Yeah, it's strange because you know, the last time I was in the dating game, you know, properly dating dating, um it was kind of like in the decade after the big H uh HIV and AIDS um advertisements and all of the news stories. And education about sexual health was really in the forefront, whether it's through school and colleges, it was it, I mean, it was everywhere to the point where um everybody in my generation really took it seriously um because we'd seen big tombstones everywhere, you know. And um, you know, I still have those lessons deep in my memory. But yet I guess for many women in midlife, after maybe re-entering the dating um game or you know, post-divorce, or even like you know, on their second or third big relationship of their life, may have forgotten some of those safety messages. Are you seeing that? Um, especially with these midlife women like us.

SPEAKER_00: 6:01

Yes, definitely, definitely. And I think it's it's as you say, um, many women um around this age have been in long-term relationships, so haven't necessarily needed to even think about um safe sex, uh, for want of a better, better word. You know, they they haven't needed to use condoms uh with their partners because they've been in relationships for a long time. Pregnancy is less of an issue because many of them are sort of post-menopausal, so they don't need to worry about contraception. Um, and so the things that protect them against pregnancy, or the the thing that protects against both pregnancy and um STIs, i.e. condoms, aren't really part of um their, I guess, repertoire in terms of looking after themselves. Um, but but now, you know, unfortunately, many relationships now um don't last for as long as as they used to. People um it's easier to get divorced than it used to be, maybe historically. Uh there's less of a taboo around divorce. Unfortunately, this is uh an age group in which partners may become unwell and may um and people may then um become widowed. And so that then means that um people are at at a stage where the the people that they've been having sex with for a long time in their lives are no longer there, and they're now thinking, well, um I I'd like to start a new relationship, but they don't necessarily have the tools to do it safely because they haven't needed to.

SPEAKER_02: 7:32

It's crazy actually, because as as we were talking, I was thinking about many years ago, and my mum said to me, you know, if you ever go and get an AIDS test, make sure that you don't mention it for insurance purposes because it will affect your insurance. And and for some reason that came back into my brain, and I was like, that is so crazy. Like it so this the sh for our generation, you know, the shame, the stigma, and the embarrassment element of this, you know, it's so important that we can go and get screened, go take care of ourselves, work out boundaries, um, especially if we're new to the scene or we haven't maybe even worked on boundaries before. And so I'd love to hear from you as the doctor, as someone who's out in the field, you know, what are the most common sources of shame you see around sexual health and how can we start to dismantle the shame and the taboos?

SPEAKER_00: 8:23

Yeah, no, it's a good question. And actually, I think what you've just said goes back to what I was saying about misinformation. So there was a time, a long time ago, you know, nearly 20 years ago, where um insurance companies were kind of interested in whether or not you'd had an HIV test. Because, you know, many of you will know that uh, you know, many years ago HIV wasn't a condition that could be treated, and many people were dying. The situation is completely different now. So um, with regard to HIV specifically, people with HIV now have access to really effective treatment. The life expectancy of a person living with HIV is now the same as in the general population. People who are on treatment who have a suppressed virus cannot transmit HIV to their sexual partners. Um, research shows that it's impossible actually for HIV to be to be transmitted to the sexual partners of people who have an undetectable HIV viral load. But a lot of people don't know this. And so there's a lot that is still sort of, people still remember HIV as being the way it was 20 or 30 years ago. It's a completely different uh condition. But it is um it is the source of a lot of shame. And, you know, speaking about common sources of shame, uh particularly with regard to I think older people, you know, there is a perception in society, I think, that older people don't have sex. And uh a funny but not funny example is, for example, you know, the expression you see on people's faces when someone says something about their parents having sex. There's like a look of complete horror on people's faces. And, you know, why should that be? Why should older people be perceived as not having sex? Most older people do have sex, but I think that that kind of reinforces the idea that older people having sex is something to be ashamed of. And so I think older women then struggle to come forward to um seek help. One, I think, because they're worried that there might be judgment about the fact that they're having sex. They're also embarrassed, I think, because they perhaps don't feel as clued up as people might think they should be, which is, you know, just a perception on their part. But they might think, oh, well, you know, you would think that at my age I would know better. But they haven't really had any reason to need to know better sometimes. Um, they they don't perhaps know as much about contraception or condom use for the reasons that I said before. They they aren't really necessarily aware of the issue about STIs because they haven't needed to think about that. And so I think what's really important to start with is to have conversations. And one good thing about women is that they talk to each other. Yeah, they don't always talk to each other about things like sex, but they talk to each other about lots of things that are going on. And I think that sex should be included in those conversations.

SPEAKER_02: 11:15

Oh, well, we totally agree. And, you know, as coaches who work with women and in all sorts of fields, you know, whatever's coming up for them, we we go in there and do the work. You know, sex, money, and power are the three, you know, there's the triangle of that, and and everybody has a some kind of taboo or some kind of fear program around that. And so, really, we we've truly believe that the only way, like you, is to sort of talk about it and actually start to dismantle this pyramid, which is ultimately keeping women silent, keeping them stuck, and in some ways can be deathly because you know, too embarrassed to talk, too embarrassed to get checked out. We don't want women to be sitting there and worrying. So, you know, we're with you on that, and and I want to say thank you for doing the work that you're doing.

SPEAKER_00: 11:57

Oh no, it's I love it. I love it.

SPEAKER_01: 11:59

I'm really curious. We've obviously spoken about HRV HIV, but um, for midlife women, what other infections are you seeing maybe that are like on the rise that again we just don't talk about?

SPEAKER_00: 12:12

Yeah. So I think this whole um conversation, I think what I think people need to recognize is that there's lots of research from around the world that shows that rates of STIs, so sexually transmitted infections are going up in older people. Interestingly, the highest um increase is in men over the age of 65.

SPEAKER_01: 12:37

Wow.

SPEAKER_00: 12:38

Yeah. And men over the age of 65 will be having sex with women. And so the concern then is if if there's an increased risk of STIs in this group, then women may be potentially um vulnerable to that. So um I I guess uh so the the infections that uh one uh needs to be aware of are particularly chlamydia. Chlamydia is the commonest of all of these STIs. Um infections like gonorrhea are also going up. Both of these are infections that um can be completely uh prevented by the use of condoms, so that's a that's a good thing. Um the thing about both of them is that in women they generally tend not to have symptoms. They might do, but usually they don't. So men will usually have symptoms, but women won't. And so if women don't have checkups regularly, uh infections that are there but not causing symptoms won't be picked up. And so this is why it's really, really important for women to be aware of the need to have a checkup, even if they feel that everything is okay. Yeah. Um other infections like herpes are are are also things to think about. In general, um, many people will have symptoms and so will be aware of that. But but it's infectious, but but herpes is less common than chlamydia and gonorrhea. Um but just getting into the habit of having a a checkup is is something that it's really important to do. And you don't necessarily have to go to a clinic to have a checkup. There are lots of um tests that are available online. You you um you order a test, it comes to you in the post, you take your tests, you put them, put you know, put the samples in a kit that they supply, and you send them off and you get uh your results back in a few days without you ever having the need to go to a clinic. But certainly if you have symptoms, it's good it's a good idea to go to a clinic just so that somebody can have a look and make sure that um nothing is being missed.

SPEAKER_02: 14:39

I'm an advocate for the clinics, and my one of my rules, I mean, I so I met my husband much later on in life. So Lucy got married very young, but I got married very late, and so my life was different, and well just in our own way it was different, I suppose. And I oh I made this rule for myself as I sort of was going through the different stages of my life, and I just thought, new partner, full screening. And that was the approach that I took. Yeah, and it because when I was a lot younger, I had some abnormal cells in my cervix and I had to be treated for that, and it it taught me some it taught me some very, very uh big lessons in terms of really getting things checked out. My mum's a nurse, well, she used to be, and she was like, You have to make sure you get your screenings done. So I had this imprint already inside me, and then when I did have the changes, I was like, God, this is a m this is major because this is my you know, like this is my health down here is so important. So it was quite a big journey on that side of it, and then the full screening thing, and then actually as I would go in and get the screenings done, I'd look around and think there's just women, all these different women, different backgrounds, different ages, and it was just so normalized by going in, you know, and actually the shame element wasn't there, and then you know, you kind of have these conversations with the men that you meet, and it becomes if if if you're respectful, it can be such an honouring thing. It sounds like a strange way to describe it, but for me, there's something liberating about it. So I wanted to just sort of like throw that out to any woman who hasn't been to a uh screening clinic and hasn't kind of taken that road. It might feel a bit weird at first, but actually it's a really healthy thing to do, and it's really about self-caring, I would say. Um so this matters, and I just wanted to sort of see, you know, your take on that from the doctor's side, because I'm kind of commenting on it from the patient. Um, what's your take of those women coming in and you know taking care of themselves?

SPEAKER_00: 16:38

Yeah, no, I think it's fantastic, and actually uh you mentioned something that has has really changed over the years. So I've been doing this for a really long time, and when I first started to um be involved in sort of sexual health, um uh sexual health clinics were a thing of shame, you know, and and you you knew this even from the location of clinics. So many sexual health clinics when I started were at the back of hospitals with a little sign sometimes saying special clinic. And and and it so and you'd walk down to one hospital I walked, I I worked at, there was a long corridor between the main hospital and the sexual health clinic. So you walk kind of down this corridor of shame, effectively, um, that was nowhere near the rest of the clinic. And so the idea that this was something to be ashamed of was really reinforced by just the location of the clinic in the hospital. But since then, so much has changed. Um, you know, I've worked at clinics, and there are clinics now, for example, in London, that are in the middle of the city, separated from the hospital. You know, I I worked at I've most recently worked at a clinic in Soho, and it's just um, you know, it's it's on Dean Street in Soho. Um and it's this is just a sign that actually this is something now that is mainstream and should be acknowledged. Uh it used to be that people would come to clinic only if they had symptoms. Now women come to clinic saying, oh, I've come because I just I need a checkup. And so I've just come to make sure that everything is all right. And that's the way it should be. So, Karen, the women that you uh would see in the waiting room, hopefully they're just women who don't necessarily or didn't necessarily have anything wrong, but they wanted to just be sure. And and what you what you said about what you do is exactly what you should. So have a sexual check health checkup at the beginning of a relationship, have a sexual health checkup at any time within the relationship if you're concerned about anything, and at the end of the relationship, have a checkup so that when you, you know, if you start, if you have a new partner, that you go into that new relationship knowing that everything is all right.

SPEAKER_01: 18:39

So I know a lot of my um friends are have have dated, not nobody really goes down the pub and picks people up anymore. You know, we're not going out on the You'll be surprised. Yes, you know, and and so what I'm really, I guess, curious of is like you you've got this hookup. Um it might just be a one or two date thing, um, not long-term or serious. Um I mean, my friends told me when I um became newly single, you know, the best way to get over somebody is to get under somebody, you know, all of that kind of stuff comes out, and it it just wasn't my thing. But how do we start having those conversations at that stage where it is maybe a little bit more casual rather than right, I'm gonna get screened and I'm gonna ask them to be screened because we're going to embark on this. No, it's just a Christmas fall around, you know?

SPEAKER_00: 19:33

Yeah, no, and and that's a really good point. And I but I think that um, you know, the swiping left and swiping right actually in theory should make things easier because it it because sex, you know, effectively when you're doing that for the most part, it's to hook up to to have sex. So just the idea of having sex is more acceptable. And so um I think just the implication that two people who've hooked up are gonna have sex should. In theory, make it easier to say, Well, I just want to make sure that I'm okay, and it would be really good for you to do that too. Um, I I think that the difficulty may come from the individual person. So people who aren't used to having those conversations might struggle uh to have those conversations. But I think one of you alluded to this earlier. I think just being open and being honest is really important. I think it might be hard in the beginning if it's not something that you're used to. But I think a lot of people are now much more receptive to that than um than used to be the case. You know, I see lots of women who come, young women particularly, who come come in and say, um, I'm having a checkup, and I've I've asked my partner to have a checkup too, so we're both having a checkup. And I don't think that you would be judged badly by a partner if you said, I want us to both make sure we're okay.

SPEAKER_01: 20:52

And to be honest, if they have an issue, it's a signal don't have sex with them.

SPEAKER_00: 20:57

100% agree. So yeah.

SPEAKER_02: 21:00

Wow. And are there any sort of like lines or I mean you've said a couple of things here, but just to make it really easy for a woman to be like, oh my god, you know, because actually saying it is actually quite straightforward, but it's there's stuff underneath, isn't it, that gets in in the way. Um simple line that you could say that a woman can put out there and you know, ask for what she really wants.

SPEAKER_00: 21:24

So ask for what she wants to the person she's having sex with or to a clinician? Um, to the person she's having sex with. Yeah.

SPEAKER_02: 21:33

We're a big fan of scripts over here. Like we we sort of like we'll work with our clients and we'll just like that, let's get the script down. Um now this is a simple way of asking for what you want, really. I mean, what we're saying here is like I've got a need, I need you to get checked out. Um and you have a need, I'm sure. And I'm gonna also go do that for you. So that would be my way of sort of describing it, but you may have a different way.

SPEAKER_00: 21:55

No, I think that's a really good way. I think that I think that's a really good way. But I but I think so. I think having a sort of um uh framework for a script the way that you've described it is is a good thing. But I think people will do it in a way that's comfortable for them. Um, and so I think I think one can't be too prescriptive, but I think just saying um, so I before I have sex with a new partner, I always have a checkup. Um, and I'd really like it if you would do the same, if you haven't done it recently. I think that's because that it I think that's a way to do it in a respectful way that that um makes what you think is important uh come across very nicely, but in a way that doesn't pressure the person. And I think if the person, and then I think what you do next is based on their response. There are some people, I mean, I know someone who suggested this to a new partner and they got really offended. And well, oh so are you saying, are you thinking that I have uh an STI? Are you are you saying that I'm you know promiscuous or you know? And she was like, that's not what I'm saying at all. I I just want us to be and and that rang alarm bells for her, and so she didn't go any further. So I think often people's responses to the things that you suggest give you a good indicator of of whether or not you it might be a good idea or not to so I might just get a t-shirt just saying no rubber, no riding.

SPEAKER_01: 23:23

Simple as that. Just get it out there early as possible. So just uh well, I always bring a bit of humour to it because you know, otherwise it's just I love it. I love it. There are other things about women in midlife though, you know. We we've talked a little bit about you know the body changing, especially during perimenopauses, and you know, it may need a little bit of uh lubricants to help. Yeah, um, talk to us about that, you know, because our sexual parts of us they do shift and change. They do.

SPEAKER_00: 23:58

Same, same one. What do women need to know? Okay, so I mean, and and you know, I think Lucy, I'm really glad that you brought this up because it it's an area that I think a lot of women really struggle with. I think, you know, from the changes that that start to happen in midw midlife that make them feel that they're not as attractive as they used to be, that make them feel that perhaps their partner won't be attracted to them anymore. And that I think brings with it a whole psychological and then eventually physical issue. But there are also biological changes that happen to women in in midlife as they transition through menopause that mean that things happen to them that uh may have a significant impact on their their sex life. So uh the tr, you know, so the female reproductive system, so I'm gonna get a bit medical here. Um the female reproductive system depends very much on estrogen, the health of the female reproductive system. So, estrogen, as I'm sure um your your um listeners will know, is one of the major hormones produced by the ovaries, and it it's the thing that makes that gives women the sexual characteristics that they have. It makes it the thing that makes women look like women that differentiates them um in terms of how they look from men. Um and as levels of estrogen decline during the menopause transition, the effects of estrogen become really obvious. So, uh Karen, you talked about vaginal dryness. So estrogen is necessary for the health of the vagina and the reproductive tract in general. And it's what helps um lubrication to happen, it's what helps all the secretions of the glands that live that live in the vagina work the way they should. And when you lose estrogen, all of those, all of that function changes. So um the the moisture glands uh start to disappear, and so the tissue becomes much drier. So normally the vagina should look like the inside of your mouth, and it should be moist like the inside of your mouth. And what happens as estrogen levels decline is that that changes. Um the the blood supply goes down, the lubrication goes down. Um the vaginal tissues actually physically shrink, which is a reason that some women notice that sex really becomes uncomfortable, because the the opening of the vagina effectively starts to be small, become smaller. And so that um sort of biological change that is caused by the reduction in hormones, as well as the psychological effect of um, oh, I don't feel attractive anymore, so I don't want to have sex. Uh, I don't think he he'll want to, or she, because he may have a female partner, will want to have sex with me, creates a psychological thing, accompanied by um the pain that women often experience because the vagina is dry. So you have this vicious cycle of I don't want to have sex because X, Y, Z, I equate sex with pain, so I don't want to have sex. And so it just gets worse and worse and get gets amplified. And whenever the the issue of sex comes into a woman's head, it's just associated with pain and not a good feeling. And and that I think is really challenging for a lot of women. But the thing about it is that something can be done about it, and I think this is the thing, isn't it?

SPEAKER_02: 27:18

Because I think there's such a big shift for me when I look at the how I used to be, and then I look about how I am today, and it's like uh I don't really know. It's like two separate people, um, you know, and that's quite hard to come to terms with because sometimes I just think, oh no, I used to be really sensual and much more sexual, I'm much more connected, and now these days, and we me and Lucy have talked about this quite a lot, feel almost like I'm a I'm further back, like I'm not fully as connected as I I used to be, or in the moments, even and it's it's a bit later when I'll go, Oh, that was amazing. Like I but I kind of missed it in the moment because I'm a little bit further back, and even though I'm on HRT, you know, and I have a coral footage and I've got all these things that I'm doing for myself, it's still not the same. And so there's this sort of process of going, okay, well, this is where I am today, that's okay, and not making myself wrong or beating myself up, or you know, getting a whipping stick out and saying you need to be like you were then, because it that doesn't feel right either. So it's like this sort of transition of like no woman's land, like where am I today and what's happening?

SPEAKER_01: 28:26

And apparently on the other side of it, there's that a complete breakthrough, and apparently some of the best sex women have is in their 50s and 60s. So to like you know, stay with it, it's coming, Karen.

SPEAKER_02: 28:38

Literally coming. Is that true though? I mean, from a medical perspective, does that make sense?

SPEAKER_00: 28:44

I mean, and I'm glad that you you mentioned that because Karen, it is true, and I think both of what you said um is true, and I think it depends very much on the individual individual woman. I think you know, you were saying you feel like a different person um and less connected and so on. But there is some truth in that. You're you are a different person, you're not the person you were when you were 35. And so I think that there does have to be some acceptance of that. And I'm not saying that you should expect less because you're older, but I think it it's important to maybe understand that what you will get is different, and that perhaps the things that gave you pleasure when you were younger are different from the things that gave you pleasure now that you're older, and can you get can you have pleasure in different ways? And and although you I think I think what you want for yourself is the best that you can get for yourself, I think. What that is, I think, will depend very much on you as an individual, um, but to a certain extent also on your partner. Um if you if you have a partner, um, you know, it will depend on the dynamic between you. I think you should always strive for the best that you can get. But I think sometimes, uh and I think this is the case also with HRT, which we're not necessarily speaking about specifically today, but I think sometimes there does need to be an acceptance of well, uh this is good enough. Yeah. And as long as this is good enough is not, you know, as long as you can live happily and comfortably with this is good enough, I think that that's not a bad thing, to be honest.

SPEAKER_02: 30:28

Yeah. And on the other hand, isn't it? The intimacy piece, I think, is really important as well. You know, like build intimacy is more important now than it used to be for me. Yes. And that's important, and building those that you know, those windows of intimacy in that, you know, often are not in the bedroom, actually, it's outside of the bedroom.

SPEAKER_00: 30:49

I think that's right. Yeah, and and and I think that's also another uh important point. And I'm sorry, sorry to have interrupted you. Um I think you know, intimacy doesn't necessarily, as you say, come from sex, but it's really important. And I think you know, it's well known that it's important. And so even if uh the physical act of sex uh is not necessarily what it was, can you recreate the closeness in other ways if that's what you want? And how do you explore recreating that closeness, which may not necessarily be related to the act of having sex? I think that's a really important point.

SPEAKER_01: 31:29

Wow, what an empowering conversation. Um, it's opened my eyes, um, it's made me a little bit more curious about my future. And yes, sisters, this is exactly why we have these conversations to talk about the things that maybe you can't talk to your big sister about or your best friend. Um, and that's why we bring people like NECA on to be the experts and guide us um and to bring that light to things that actually have been kept in the dark for so long. And so I'm gonna invite Karen to wrap up today's episode and then we'll get some final words from you, NECA.

SPEAKER_02: 32:08

I love having professionals on the show, it just gives so much deep wisdom and it makes everything feel much more um robust in a way, like it gives us that you know that foundational piece to go back into. And I know when I listen back to this, I'm gonna learn so much more. Um, I know that our intimate health, it's not optional, it can feel a little bit embarrassing, but really it isn't. And it's not something to hide, it's part of our power, it gives us confidence, and also we all want to have more pleasure in our lives, and we want to feel good about it, and that is I'm absolutely truthful for that. So, this these conversations for me are the bridges that take us back into something that is so deeply empowering. You know, we are here to create, we are here to have joy, and it's up to us to go out there and and make it happen sometimes. So, thank you so much, NECA, for coming on, for lifting the lid on these important topics. And to all the women out there that are listening, if you've got questions, if you want to explore something, please send us a DM. You can do that through the Say It Sister channel and come follow us. Until then, stay safe, stay empowered, and keep saying it, sister.

SPEAKER_01: 33:18

That's it for this episode of Say It Sister. If it moved you and made you think or made you feel sane, hit follow. Share it with a sister and leave us a review.

SPEAKER_02: 33:27

And remember, your voice has power and your essence is wisdom. So speak your truth and live a true and empowered life. Until next time, say it sister.