Empathy: menopause like pregnancy

We talk a lot about long-term couples growing together emotionally—but what happens when their physical selves begin to change, too?

As we age, our bodies change, and those changes can have a real impact on intimacy, confidence, sexual function, and relationships. In this episode, we take an honest and often lighthearted look at what happens to both women and men as they grow older—and why these changes are something couples should face together, rather than allowing them to create insecurity, doubt, or blame.

We’re joined by Dr. Castillo, a fellowship-trained Female Pelvic Medicine specialist and the founder and director of Swan Medical Intimate Wellness in Los Gatos, California. Dr. Castillo brings extensive expertise in the changes that can occur as a consequence of childbirth, aging, and menopause, as well as the emerging treatments designed to improve sexual health and overall quality of life.

We start with women, exploring some of the most common changes in sexual function that occur with age, including the impact of menopause and shifting hormones. We also talk about the enormous beauty standards women face—and whether men might need to start “playing the game” a little more when it comes to maintaining their physical health and appearance.

Then we turn the conversation toward men. What changes can they expect as they age? What treatments and options are available? And, yes, we even ask the question you may have been wondering about: Are penile fillers for increased girth actually a thing?

Most importantly, this conversation is about removing the shame and stigma surrounding sexual health. Aging doesn't have to mean giving up intimacy, confidence, or connection. Understanding what is happening to our bodies—and knowing that there are options—can help couples approach these changes with compassion, humor, and a willingness to work through them together.

About our guest: Dr. Castillo completed his OB/GYN residency at St. Barnabas Medical Center in New Jersey before completing a three-year fellowship in Reconstructive Pelvic Surgery and Female Pelvic Medicine at the Cleveland Clinic Foundation. After five years of clinical practice at Kaiser Permanente, where he oversaw resident research and education and taught medical students as an Assistant Clinical Professor at Stanford University, he founded the first private Intimate Wellness Center in the San Francisco Bay Area.

Dr. Castillo remains actively involved in clinical research and serves on several women's health advisory boards, helping shape emerging therapies and advanced treatment protocols for conditions that affect intimacy and quality of life.

His mission is to address the root causes of common symptoms associated with aging while empowering women to embrace longevity and helping erase the stigma surrounding female sexual health through education, seminars, and compassionate care. To learn more go to https://swanmd.com, and mention Shameless Sex for a special gift.

And click here to set up a free 15 minute consult to discover if you are in menopause

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