Women’s Desire and Integrative Sexual Health Coaching with Women’s Health Coach, Dr. Rose Schlaff, DPT, WHC, IF

Dr. Jessica Drummond 00:00:03 Hi and welcome to the Integrative Women’s Health Podcast. I’m your host, Doctor Jessica Drummond, and I am so thrilled to have you here as we dive into today’s episode. As always, innovating and integrating in the world of women’s health. And just as a reminder, the content in this podcast episode is no substitute for medical advice, diagnosis, or treatment from your medical or licensed health care team. While myself and many of my guests are licensed healthcare professionals, we are not your licensed healthcare professionals, so you want to get advice on your unique circumstances. Diagnostic recommendations treatment recommendations from your home medical team. Enjoy the episode. Let’s innovate and integrate together. Hi, and welcome back to the Integrative Women’s Health Podcast. I’m your host, doctor Jessica Drummond, founder and CEO of the Integrative Women’s Health Institute. Today I have such a fun and special guest, Doctor Rawcliffe. Doctor Rose has been a part of IUI for quite some time and for all of the health and wellness professionals listening, and for every woman or person with a vulva listening, you are going to get some very specific clinical pearls out of this episode.

Dr. Jessica Drummond 00:01:39 I want us to start thinking about women’s and sexual health beyond just getting people out of pain. But in the same way, we help with performance coaching, with elite athlete coaching, with collegiate athlete coaching, we want to help our clients really fully reach their goals, not just solve the acute pain, although of course, that’s a part of it. So take that mindset and get your notebook out to get ready to take notes, because you are going to learn so much from our guests today. And before I let doctor Rose introduce herself, I would love to have her share with us as a part of that introduction how learning women’s health, coaching skills, coaching skills in general, how working with our master coaches and being a really active part of our community has impacted her career because she has a really fascinating career that some of you might be curious about.

Dr. Rose Schlaff 00:02:49 Yes. Oh my gosh, I’m so happy to be here. And I reach out to Jessica once a year and I just say nice things. I’m like, I can’t tell you how much I appreciate I-we and you changed my life personally and professionally.

Dr. Rose Schlaff 00:03:02 So this is my annual reach out to tell you that.

Dr. Jessica Drummond 00:03:07 You do. And it’s so nice. If anyone wants to tell me nice things about their career, please do it any day. I love those emails.

Dr. Rose Schlaff 00:03:15 So a little bit of background on me. I did my undergrad in bio and psych double major, so I had a psychology background, even coming into the women’s health coaching program. So got my doctorate in physical therapy. And when I was in undergrad, I kind of wanted to be a sex therapist. I kind of wanted to be a physical therapist. And lo and behold, pelvic floor muscles. I was like, this is perfect and ended up directly out of school, out of my doctorate program. At my dream job, I was working at a place called San Diego Sexual Medicine, working with world renowned sexual medicine physician Irwin Goldstein. He is kind of the the grandfather of sexual medicine and leads the only sexual medicine fellowship in the country. So if you are working with a sexual medicine doctor, Doctor Goldstein probably trained them at some point over my years being there, every single person that walked through the door would get seen by pelvic physical therapy, sex therapy, and bisexual medicine.

Dr. Rose Schlaff 00:04:14 So I got really clear on the medical, the biological, psychological, the relational factors that impact sexual wellness. That same time, I started training the sex educators, counselors and therapists that go through University of Michigan’s program. So I was in professional heaven, and personally, my health was completely exploding, and I was going through the medical system trying to get answers. I was getting a lot of medical gaslighting. Oh, all your numbers are normal now. You should be fine. I felt very lost. I didn’t know where to go and found my way to Jessica’s program. I’m so grateful for it. And I always tell people that are thinking about the program. I joined it thinking functional nutrition is going to heal me, and what I actually needed was the coaching. And I think that’s probably the case for a lot of people.

Dr. Jessica Drummond 00:05:09 Yes. Absolutely. Yes.

Dr. Rose Schlaff 00:05:13 Going through that coaching program, not only did it make me a much, much, much better clinician and pelvic floor physical therapist. It showed me that professionally, there was something available to me that wasn’t just working as an employee or owning my own physical therapy practice.

Dr. Rose Schlaff 00:05:30 I knew I didn’t want to own my own practice, and you really opened my eyes to this possibility that I could have a life that honored my purpose, that helped people and also supported my mental and physical health, and started using those practices in my clinic. Had another medical Experience that I ended up leaving my full time job and just going completely into my coaching practice that I had started during the Women’s Health Coaching certification, and I was able to heal my body, my brain, emotionally, physically, while still making money from home because of my coaching skills that I learned from Iwai. I cannot tell you how grateful I was at that time. You know, I wouldn’t have been able to do physical therapy. I really wouldn’t have. And it would have either been completely on disability or no income. I’m not sure, but I’m so grateful that I had that background and I had started this business because you and your program showed me it was possible. And it’s been so fun to I lovingly refer to it as like Frankenstein approach.

Dr. Rose Schlaff 00:06:43 Right. Like your coaching program, the Women’s Health Coaching Program really was the foundation of everything else that I built and anything that I learned along the way to try to heal myself from, you know, I went and got a hypnosis certification. I went and got functional neurology trained. I went and do even deeper into nutrition with you, you know, continuing in your membership and other programs and working directly with you as well. And every single thing I’ve learned, it’s made me a better clinician. And now I’m able to talk to my clients and let them know. I, too, have struggled to navigate the medical system. This is not the end all be all. There’s so much more we can do to help you. I became the person I wish I had had back when I had that original experience where I spent two years completely hopeless before I found you, and so grateful that I’m able now to combine the functional nutrition, the holistic coaching strategies with my other modalities to offer this really trauma informed sexual wellness coaching, and to take people from a place of either having pain or discomfort during intimacy.

Dr. Rose Schlaff 00:07:58 Or maybe they’ve just had a change in libido and going to a place where their relationship is better than ever. Their sex life is better than ever. They’re lit up, they’re vibrant, they have more energy. They’re happier, they’re feeling better. They’re sleeping better. I had someone reach out to me like, oh, I’m not emotionally eating anymore. I’m like, oh, side effect, right?

Dr. Jessica Drummond 00:08:19 Yeah, absolutely.

Dr. Rose Schlaff 00:08:22 So I’m grateful every single day for you personally. Professionally. I’m so grateful. So it’s it’s such a gift and a full circle moment to be here with you today and then also be teaching with you in March too. So I’m so excited.

Dr. Jessica Drummond 00:08:38 Thank you so much, Rose, and I really hope that your story inspires so many of our listeners. And just thank you so much. As I said, it’s so nice to hear how people take this education and take this shift in perspective and really create things that don’t exist very much otherwise. And so let’s dive right into the work that you’re doing, because I think it’s so important and so inspiring.

Dr. Jessica Drummond 00:09:11 And it will really show our listeners how they can take all of these various pieces of their professional journey, combine it with coaching, and combine it with their personal healing experiences, and even lead with their own personal healing. Because at the end of the day, we know that corporate medicine does not care about you and so you get to be well. I love how you call your company. Be well with Rose, because being well as a coach, as a provider is part of what inspires our clients to be well as well. For everyone tuning in. What should they be listening for? Why should they stay for this conversation? What are we going to be sharing with them today?

Dr. Rose Schlaff 00:10:05 Yes. Well, thank you so much for having me. I would love to get into how the pelvic floor, how the nervous system can impact not just sexual wellness, but optimizing sexual wellness. So we’re really going to be talking about perimenopause. We’re going to be talking about pelvic pain. We’re going to be talking about just how libido changes over a lifespan, and what simple techniques that we can use as holistic practitioners to support our clients better so that they can not only have pain free intimacy, but pleasurable intimacy that they want to have.

Dr. Jessica Drummond 00:10:40 Excellent. So in the world of women’s health and wellness, there’s a lot of conversation about pelvic pain, sexual pain, low libido, especially for women with complex chronic pain, especially for women navigating many stages of life from postpartum to perimenopause. But rarely do we really dig deep into helping people go from being truly uncomfortable in pain, having bad experiences to past the point of just acceptable sexual experiences to more pleasurable, more connected, really deepening that sexual experience in healthcare. And yet we would if we were working with an athlete or someone who had a very complex job, take them sort of all the way back to their elite level function, if you will. And so I think when it comes to sexuality, we might be stopping our connection and support and intervention too early, no matter what perspective that we’re coming to help women with, whether we’re in coaching or mental health support or physical therapy, occupational therapy, nutrition, gynecology, we might be just getting people to the point of acceptable. And how do we define acceptable to where their goals really are?

Dr. Rose Schlaff 00:12:20 Absolutely.

Dr. Rose Schlaff 00:12:20 And I think you’ve highlighted so many important pieces here, because when I think about what is optimal, right, what is acceptable, what is optimal? I see it as this scale. Imagine the gas tank on your car, right? Empty is when we are actually in a place where we’re feeling the need to avoid sex. Maybe that manifests in your relationship like, oh, I’m pulling my hand away when my partner starts to be cozy with me, because I don’t want them to get the wrong idea. Maybe that manifests as intimacy is painful. Maybe it has previously been painful, or maybe there’s been a previous emotionally painful experience. So that’s kind of the far empty range. And then that middle range, like midway full on the gas tank would be. I enjoy intimacy when I have it, but I would rather read a book or, you know, watch my reality TV than do it. And I’m never really in the mood. I really have to kind of talk myself into it. And for me, I think that every person individually has to determine what optimal is for their own sexual wellness.

Dr. Rose Schlaff 00:13:27 But for myself and for many of my clients, that looks like having intimacy that is pleasurable, that is desired. Right. We’re craving it. We’re excited for it. It’s something like, you know, imagine it’s our favorite dessert that we’re savoring, that we can’t wait to get home. Like, think about you saved some of your favorite Thanksgiving dessert in the freezer, and now you’re like, oh, I can’t wait to get home and eat that. And I think that that conversation starts with, what does successful sex look like to you? And this is an individual question to be asking our clients. And many of us have never thought about that before. And it’s really not health care providers fault. We just aren’t given the trainings to facilitate these kinds of conversations. And even just having a bit of curiosity and a bit of open ended questioning, right? Reflective listening can make a big, big difference to start to have these thoughts provoked.

Dr. Jessica Drummond 00:14:27 So it is very similar to the coaching communication model in that we’re saying to our client, okay, what is your vision of great sex.

Dr. Jessica Drummond 00:14:38 What is great sex look like for you. What is Excellent intimacy. What does that look like specifically for you? I love that question from a coaching model, and I can hear someone in the audience right now saying, I’m a physical therapist. You know, I’m a health coach. I’m afraid to open that can of worms. Where do they begin?

Dr. Rose Schlaff 00:15:06 I love generalizing. So my background is a pelvic floor physical therapist, so I pull from that lens. But just like you would say, many of my clients notice changes in their bladder function and their bowel function. And the pelvic floor has a lot to do with those functions. And I might be asking you some questions about that. Are you open to sharing? Right. So bringing it into general, I would say something along the lines of during this life stage, I’ve heard from a lot of my clients that they’ve noted changes in their intimate life. Those changes have impact their relationship dynamic. Those changes have impacted their ability to connect or stay present during intimacy.

Dr. Rose Schlaff 00:15:44 Is that something that you want to discuss with me today? We could talk about some of those things. We could talk about some strategies. Or would you prefer to focus on something else. And so you let somebody opt in or out. And so you generalize it. And then you make an offer. Right. And make an invitation. That’s where I would start. And I think just like we do in the IUI program. Right. With lots of practice coaching with fellow student coaches, practicing this with your colleagues, we aren’t practiced at asking about sex. And so we might kind of come out garbled or awkward and, and saying to a colleague, can I just practice this spiel that I’m going to give to my clients? You’ll both probably learn more and get more comfortable before you’re in front of an actual patient or client.

Dr. Jessica Drummond 00:16:34 Yeah, so I think training in coaching communication skills and then deepening your own comfort with communication about sex and sexuality and being comfortable with whatever your clients feel comfortable sharing with you is really about how we deepen that in the same way that as we get more and more comfortable with all kinds of topics in women’s health, from menstruation to menopause, to what the postpartum experience is, to being a safe space for our clients to talk about abortion care and miscarriages and the real breadth, I think, of what women’s health is.

Dr. Jessica Drummond 00:17:19 It is helpful. And probably a decade ago, I was in a course in pelvic PT where there was a challenge. I don’t remember who taught it, but it was kind of like before you start having these conversations, just assess where you are so that you can be sure that you are a safe, open space of mindful listening for people to share what they need to share. And then I think it’s really just incorporating all the tools you learn through our health coaching programs of mindful listening. What is their vision? What is healthy and desirable and joyful sex look like? And when you feel really comfortable that this is essentially a regular function of most people, it becomes easier to apply the coaching skills in that way.

Dr. Rose Schlaff 00:18:17 Absolutely. And I do want to highlight too, I think a lot of us, you know, a lot of your listeners may be medical professionals themselves. I think a lot are. And we just aren’t given that communication training. You know, I got out of seven years, I had my undergrad in psychology, my doctorate in physical therapy.

Dr. Rose Schlaff 00:18:36 I had a double major undergrad bio and psych, and I never learned how to have these types of conversations and to communicate in this way until I went through your program. And I do think that is the foundation for the way that I coach these days. And the other piece that I wanted to circle back to is a lot of people, when you ask, what do you want your sex life to look like? They just don’t know. And so the other piece that sometimes I’ll play with is, how do you want to feel in your body, you know, how do you want to feel? And then we kind of illuminate what that looks like along the way. And I always call my clients and I like, think about or sexy scientists. Right. So we’re we’re like exploring together and we’re going to find what you like, you know. Think of it like a buffet. And we’re going to offer you many, many different types of strategies. And that’s why I’m so excited to be partnering with you in the future to offer these kinds of trainings for other professionals, because creating that one two punch of baseline coaching skills that you get in the IUI program with some specific somatic informed sex counseling strategies, can really make a big difference in somebody’s outcomes and get them back to that elite level.

Dr. Jessica Drummond 00:19:54 I love that because I think what you’re highlighting here is so many people just never really think about this in terms of having options. Being able to think about what they might like, being able to think about what they might ask for, how they want to feel. Even when we have good sex education, which is of course, even rarer and rarer in terms of just biologically good sex education. It’s almost never about. How is that experience supposed to feel? What do you want it to feel like? Who do you want to be connected with? Who do you not want to be connected with? Like, what Parts do you want to emphasize? And I think it’s also very normalizing. To help people understand that it’s totally fine. If that’s very different in your 50s than in your 20s.

Dr. Rose Schlaff 00:20:47 Right. The other piece I want to highlight here is, I think that so many people, when they get to me, they can’t even imagine, they can’t even visualize. And I do want to normalize that.

Dr. Rose Schlaff 00:20:59 And I think that I’ve seen that there’s a three step process to get from that empty tank of being in that avoidance around intimacy, or kind of dreading intimacy, to moving to that place where we’re really excited and engaging. And that three step process, the first step is optimizing the physiology. And I think sometimes even when doctors or medical professionals do try to help, they try to skip to the third step, which is like try some wine or lube or maybe a different position or, you know, role play or go try some lingerie. And it’s like, those aren’t bad things. Although I’ve never in almost a decade of talking about sex, I’ve never recommended someone go get lingerie. Not that it’s bad, it’s just not something that I prescribe. Right? It’s like it can be a Band-Aid when we haven’t addressed the first two steps. And the first two steps are optimizing the hormones and the physiology. That includes the nervous system. That includes the pelvic floor, that includes all of the domains of functional health that we look at through IUI.

Dr. Rose Schlaff 00:22:04 And that second step is really understanding why our foot is on the break when it comes to sex drive. Right? Like what’s sneakily holding us back from getting excited, getting in the mood, you know, is it thoughts that we have that are connected to our body, that are connected to our past experiences, that are connected to our religious upbringing, our family upbringing? Is it potentially just, you know, your partner drops their towels on the floor of your bedroom and you look at it and you’re like, well, it’s gone now, right? Like, right. So there are some obvious ones and some kind of sneaky ones, and we can get really creative here. But until we address those first two steps, sometimes people can’t even imagine the vision. Or sometimes people are are like, okay, I can imagine the vision. But I’ve tried all of step three and none of it worked. So I must be broken. And you’re not. We’re just missing some crucial steps here.

Dr. Jessica Drummond 00:22:59 Yeah, I think that’s so important because in a coaching model we’re going to start with the vision.

Dr. Jessica Drummond 00:23:04 But as you said, often people really have no idea what their vision is. They maybe have never experienced really good connected sex that let them feel the way they want to feel or they did so long ago they don’t really recognize themselves. I think for most women.

Dr. Rose Schlaff 00:23:20 That’s exactly.

Dr. Jessica Drummond 00:23:21 Right. Yeah, it’s not really about the partner, at least initially, although it can be, of course, but at least initially, it’s more like what happened to me. And so from a coaching standpoint, I think that space you’re talking about. Of curiosity is so important. First of all, normalizing this is so common, which it absolutely is. And then it’s like just curious, like what could that look like? And I think you highlighted something that’s really important for our patients are struggling with complex chronic pain conditions, complex chronic illness. You know they enter perimenopause with endometriosis, with Hashimoto’s, with post-viral illnesses, with me, CFS and chronic pain conditions and migraines, etc. it’s very rare for women to come into midlife, and sometimes even pregnancy and postpartum with absolutely no underlying health issues.

Dr. Jessica Drummond 00:24:29 About 80% of women in midlife have at least one autoimmune disease. So there’s an energy limitation that I would love for you to talk about. I think that step one of look, it’s hard to even think about sex when I don’t have the energy to get dressed in the morning or make it through my workday. Is is really all I can do or keep my children alive. Today is kind of all I can do.

Dr. Rose Schlaff 00:24:59 Yeah. And and when we’re working on such little energy, of course the nervous system is going to be in that sympathetic overdrive of, you know, there’s not enough there’s not enough energy to do all the things I need to do today. There’s not enough time. And I think that this really tees us up to talk about why that optimization is the first step. And I do love to ask people about their vision. And if we’ve got it, Great. I love talking about the physiology and the physiological underpinnings to behavior. I think it is the greatest gift that we can give ourselves from a self-compassion standpoint.

Dr. Rose Schlaff 00:25:39 When we understand the biology of why our energy is low, when we understand the biology of why our moods are up and down, when we understand the biology of why our libido is low. It’s not something that’s broken within us. It’s, oh, I’m not putting the right gas in my car. And so I’m looking at some of the basics to mitochondrial health. We’re looking at sunlight. We’re looking at sleep. We’re looking at nutrition. We’re looking at stress. We’re looking at, you know, I offer a functional neurology and hypnosis techniques because I’m constantly curious about how can we in a world that is focused on capitalism, urgency, go, go, go bright synthetic lights, right? There’s a lot to our system that we’re dealing with environmental toxins. We’re dealing with all these things on a daily basis. How can we quickly and easily shift the nervous system to a more regulated place? And so in addition to really optimizing nutrition, sleep, stress, mitochondrial health, or also looking at ways that we can optimize the nervous system and give people tools that they can use themselves in 30s or less, that can just be built into a day instead of like, oh God, I got to get to this hour long yoga class at the end of my day, and I’m already so exhausted and just barely getting through.

Dr. Rose Schlaff 00:27:04 It’s just probably not going to happen for most of the people you described.

Dr. Jessica Drummond 00:27:08 Yeah. So what are just 1 or 2 examples of those kinds of energy shifting and nervous system regulating tools?

Dr. Rose Schlaff 00:27:18 So everybody likes to talk about the vagus nerve. It’s very sexy. I like to hang out with all the best friends of the vagus nerve. Anything in the brain stem plus the cerebellum. So when I talk to my clients, when we’re thinking about what makes up the brain. Right. We’ve got the old brain, which is the cerebellum and the brain stem and the amygdala, and it’s all about survival. And when energy is low, we’re obviously going to prioritize survival over our executive function. You know our social charming our newer brain. So when we’re thinking about this I like to say like I’m in San Diego, LA is about two hours away. Like if there’s a big traffic jam in San Diego, think about the brain stem and the old brain. Like San Diego. There’s no way we’re going to make it to LA, which is like the prefrontal cortex, like the new brain.

Dr. Rose Schlaff 00:28:06 So we really have to prioritize getting that old brain feeling safe. And safety is determined by how accurately we can predict. And our eyes are one of the best predictors. Six of our 12 cranial nerves actually innervate the eyes. They’ve seen that eye movements can release dopamine, they can actually decrease emotional distress. And I have seen shifts in my clients and sometimes as little as 10s. So for anyone who’s listening, who’s not driving a car, you can try this with us.

Dr. Jessica Drummond 00:28:42 Yes. A little red light.

Dr. Rose Schlaff 00:28:44 If you’re driving.

Dr. Jessica Drummond 00:28:45 Do not attempt this. Yeah.

Dr. Rose Schlaff 00:28:47 Go ahead. So usually when I teach this, I pick some type of range of motion. Could be neck. You know, I’m just tilting my neck side to side to see how tight that is. Sometimes I’ll just put my feet together and rotate my whole body. But you can assess a range of motion if you’re doing this with a client or yourself. You can also assess a subjective measure, measures that I like to use in this realm.

Dr. Rose Schlaff 00:29:10 Or like how busy is my brain? You could just use a stress measure. You could use like sometimes I’ll call it a Sasha Fierce measure. Like how open to intimacy are you? Like, how sexy are you feeling right now? And so we can track it before and after. So I’m gonna just test my neck range of motion here. And, you know, I’ve got, like, maybe four out of ten tightness. So I’ll teach you a couple different exercises. One is simple. You just start looking around the room. And if we think about what we do on a daily basis, the majority of our time is spent looking at a screen or a computer. And that really mimics our fight or flight thing. Usually in nature, we’re only super, super focused on one point if we’re trying to fight it. True.

Dr. Jessica Drummond 00:30:00 Yeah.

Dr. Rose Schlaff 00:30:01 Really true. So looking around our environment, it orients us. That lets us know that we’re safe. The next thing that we want to do, which kind of mimics grazing in the field, would be just to focus on a point in front of you and start to expand your awareness left, right and up and down.

Dr. Rose Schlaff 00:30:17 And I love this one because it’s sneaky. You can do it at a weird family interaction and in a secret way it can be.

Dr. Jessica Drummond 00:30:24 During a while you can be looking at that person, but still just kind of, you know, seeing more broadly.

Dr. Rose Schlaff 00:30:30 Yeah, yeah. Or you can even like look to each family member’s face. That’s eye movements. You know, you’re just kind of moving around side to side. The other thing about the eye movements is they activate both sides of the brain, which just that bilateral activation, just like walking it really settles the brain. So the peripheral vision, we’re going to focus ahead of us and just expand the awareness side to side and up and down. So we’re not moving the eyes. We’re just kind of expanding the awareness. Sometimes I’ll even have people make bunny ears. So we’ll put the bunny ears, like in the peripheral vision and see how far can I see without moving my eyes.

Dr. Rose Schlaff 00:31:06 Eye on every time?

Dr. Rose Schlaff 00:31:08 That’s a sign, right? Yeah, that’s a yawning, sighing, mouth watering, eyes watering.

Dr. Rose Schlaff 00:31:14 These are all signs to look for to notice. Tummy gurgling if your nervous system is shifting. So the last I exercise that we could do is another bilateral activation one. So we’re literally just, you know, I could use each side of my computer. you can also give yourself two thumbs up in front of you and look from thumb to thumb. So you’re just talking two eyes right, left right, left. And so that’s bilateral activation. And that’s six of the 12 cranial nerves. Because remember things that wire together fire together. And we love that okay I’m going to retest my neck. That is like zero out of ten tight. It was four out of ten tight to begin with. So it can have a quick shift. Just one of those could create a shift. There’s a lot more that we can teach. And and we will teach in our class together. I’ll go through some more. You can do a lot of tongue exercises. You know, you can work on the nerves that do sensation for the face.

Dr. Rose Schlaff 00:32:16 Trigeminal nerve. So, so many different ways to very, very quickly signal safety to the body.

Dr. Jessica Drummond 00:32:25 Yeah, I love that because I think we forget that we’re animals. Right? And the core of anything feeling really good is being in a place of nervous system safety. And sometimes that feels very hard. Like I have to rewire all of my childhood trauma before I can ever feel safe. And yet, the reality is, sometimes just eating a high protein meal or moving your eyes in a certain way, or standing outside and taking a few very slow, deep breaths like we do, have strategies that shift nervous system safety pretty quickly for most people. Now, of course, there are circumstances where people are living in an intense or a more acute lack of safety. But even then, moment to moment there can be safety created.

Dr. Rose Schlaff 00:33:25 Right? And I think that there’s so many different ways we can generate safety for ourselves. These techniques are one. But we can also talk about cellular safety. Right. Something like blood sugar.

Dr. Rose Schlaff 00:33:36 Are you signaling to your cells that you’re going to have a steady supply of energy? Or is your blood sugar swinging up and then crashing down and swinging up and crashing down? And especially if you’re one of those people that resonated with. Yeah, I’m exhausted. I’m running the kids here and there. There’s no way I could even think about sex. One of the biggest determinations of energy is blood sugar balance. There’s a study done on marital satisfaction, and the women who had less stable blood sugar were less satisfied and got annoyed with their partners more often.

Dr. Jessica Drummond 00:34:11 That is not surprising at all. Well, I’ll tell you, my husband and I both. We just put our CGM on for the standard checkup every few years. But you’re absolutely right. I mean, the word hangry exists for a reason. Yeah.

Dr. Rose Schlaff 00:34:28 Yes. And so it can impact how you feel about your partner. It can impact your energy and willingness to even, like, have capacity to try. And I like to shift the idea.

Dr. Rose Schlaff 00:34:41 We haven’t even really talked about responsive desire yet. And I think that’s such an important piece of this puzzle is, you know, only 15% of women and people with Vulvas one five experienced desires spontaneously. The rest of us experience a combination of contextual desire, which is like on the beach with a mai tai. I’m good to go.

Dr. Jessica Drummond 00:35:02 Right on vacation. Yeah.

Dr. Rose Schlaff 00:35:05 And responsive desire, which I think responsive desire is fascinating. I think a lot of it is in our control. And basically, responsive desire is all about our body responding to an external cue. I call this the desert stomach desire. Right. Say you’ve eaten. You’re not hungry. You come over to a friend’s house. They’re making fresh baked cookies. You’re like, wow, okay, I’m very interested in that. I wouldn’t say that I was desiring food because I’m full. But now I’ve gotten a responsive desire. And, you know, the three things that make responsive desire work are a low pressure, low stress and little bit sexy environment.

Dr. Rose Schlaff 00:35:43 And so stress. You know, we can talk about that from a cellular perspective. That ties into everything we were talking about is optimization of the nervous system of the physiology. The other thing that I want to share here is an optimized nervous system and a safe. A cellular safe body doesn’t mean that you feel calm all the time. It is flexible. Look at our pets, who are either zooming around or sleeping right. Our nervous system is designed to have this, like, up and down wave of action and inaction. And fascinatingly enough, women and people with vulvas actually experience the most genital arousal midway through sympathetic nervous system. That’s different for people with penises. People with penises can be totally relaxed in parasympathetic and experience max arousal. But I think that’s that smell the cookies responsive desire difference. Right? I think we need a longer runway right to preheat the oven versus a microwave.

Dr. Jessica Drummond 00:36:45 Absolutely. And I think we have to keep circling back to the fact that the environment is very stressful for people, the capitalist environment, the sugar environment, the toxic environment, the computer environment, everything is straining to the nervous system in an accelerating pace.

Dr. Jessica Drummond 00:37:07 Like, if I look at my practice over the last 30 years, there’s more and more and more every year that I think we’re not even really calculating for the level of stuff our physiology needs to deal with. But what I think is so positive about this is that let’s say you spend one hour a week just attuned to shifting your nervous system back, and you set up a comfortable space for responsive desire. There’s a feedforward loop of nervous system healing when you actually do have satisfying and connected and comfortable and pleasurable intimacy, it’s sort of nourishing to the nervous system versus other things you’re sort of prepping for, and then they are more stressful. So like you’re building up your body to tolerate more stress. Whereas this even though there may be some sympathetic activity, it’s like a nourishing form of sympathetic activity. Does that make sense?

Dr. Rose Schlaff 00:38:10 Yes. And there can be so much nourishing, sympathetic activity. Like a dance party, right? It’s Christmas, it’s Christmas. Right? Like that gets exciting. That fills us our soul.

Dr. Rose Schlaff 00:38:21 And I think people are afraid of sympathetic. And it’s nothing to be afraid of, right? We’re meant to have this balance. And I think the biggest thing that I would love for people to take away from this is the question no longer becomes, am I in the mood? It’s am I open to creating spaciousness so that I could get in the mood right? Am I open to creating an environment? Because think about that vacation example. A vacation doesn’t just happen. There’s a lot of planning and boundaries that go into it. And so it’s like, could we create once a week, a one hour block, a two hour block, a three hour block where we’re creating a little mini time where it’s like, all right, this is my little mini vacation mode, and there’s no pressure on the outcome. Right? There’s no pressure on penetration. There’s no pressure on orgasm. But for me, you know me personally. Successful sex just means pleasure. And connection can look so many different ways and successful sexual experiences, whether or not they involve orgasm, whether or not they involve penetration, lead to more openness and more interest in future experiences.

Dr. Rose Schlaff 00:39:33 It’s that snowball effect, and I always tell people it’s really hard to get that ball rolling again once we’ve kind of come to a stop, but as soon as we get it rolling, it’s easier and easier and easier.

Dr. Jessica Drummond 00:39:43 Yeah. That’s lovely. So we’ve talked a lot about strategies for optimizing cellular safety and nervous system safety. Is there anything else just in terms of sort of tips that as the ball starts rolling down the hill for our clients, we can be supportive of helping them maybe guide it in the direction that they want to go as they learn things through this experience?

Dr. Rose Schlaff 00:40:12 Absolutely. I love resources like OMS and Dipsy. You know, like if you sprained your ankle, you might use a brace for a little bit and then you would get stronger, right? So. OMG. Yes, it’s an educational library. It is explicit. It’s people with vulvas demonstrating what makes them feel good. And it’s such a fabulous resource because so many of us learn to touch ourselves or our partners in one way, and we just continue to do that again and again and again.

Dr. Rose Schlaff 00:40:41 And that’s why when we say, you know, what do you want sex to look like in the future? You know, we don’t even know where to go. And so having a menu like that presented to us is a great first step. Then we can be sexy scientists and start to explore. Dipsy is another resource that I love to give people. So many of my clients tell me, you know, okay, responsive design is a thing, but I don’t really know what to trigger it. And dipsy is great. It’s an audio resource and so it’s sexy audio stories. They’re short. You can really tailor it to what you want. And a lot of people that I’ve worked with when it comes to porn or when it comes to visual things, they’re like, are these actors paid well, you know, was this an ethical environment? And it really like kind of takes us out of the experience. Whereas dipsy, we know it’s completely ethical. It’s completely, you know, like everybody is paid well.

Dr. Rose Schlaff 00:41:36 It’s it’s well sourced. So that’s something where, you know, we might get less distraction and could more be in the energy of it. So those would be the first step of like ideas to start exploring. And then I really recommend that people start to make their own red, yellow and green list. So starting to get clear. And I take people through a process where we start this, you know, spice level mild, where it’s not sexual at all. It’s just, you know, shoulder massages or or, you know, hand touches. Right. But spice level mild all the way up to spicy. And we’re starting to just get clear on what parts of my body really love touch. How do they like to be touched? Firm pressure. Light pressure. Fast, slow. Like my knees. Really like to be touched. Not even in a sexual way. It’s just like, oh, that’s something that I discovered. And I think so often we just don’t know our bodies from a pleasure lens.

Dr. Rose Schlaff 00:42:35 We know where hurts on our bodies, but starting to map out that pleasure. And once we’ve got our green zones, then especially for those of us who, you know, say you’ve got kids at home, say you’ve got just the barest amount of energy, energetic resources, mental resources, and you have to make one more decision. At the end of the day, you’re like, please don’t make me. I have people actually create like a jar of green. So then they once they know their favorite things, it’s like, oh, rub my shoulders, great, kiss my forehead. And it’s this way to connect where nobody has to be the leader, right? Everyone can just be like, it’s like meal prepping, but for intimacy.

Dr. Jessica Drummond 00:43:18 Okay, I like it. Yes. Really simplifies the process for sure. So one other question I have. So in pelvic floor rehab we use vibration. We use vibrators in combination with dilator for pelvic floor myofascial therapies and self myofascial therapies. You know, there are a lot of good vibrator companies or other sex toy companies.

Dr. Jessica Drummond 00:43:46 And you mentioned dipsy, which I had not heard of, but there’s one I know of called Vibes only that is a combination vibrator with it has like an app with some of the sexy stories and things like that. So there are tools like this that exist. What do you think about using tools? Does that help people get curious or explore their curiosity? Does it feel overwhelming? Where do you add that?

Dr. Rose Schlaff 00:44:16 It’s a person to person decision, right? Versus like who’s overwhelmed versus who’s curious? I am always like a big fan of adding tools, right? If I was going to hand mix a, you know, food versus like an electric mixer or like hand brush my teeth versus electric toothbrush, it’s going to be a more intense, better clean, right? And so it’s like, especially if somebody is working their way back to pleasure, why not make it as easy as possible? And when I work with people, I work individually. I also work in partnership. So sometimes I’m talking to both partners, and sometimes there are a lot of thoughts and feelings that come up about, oh, does that mean I’m not doing a good enough job on my own? Or oh, it’s better to have a quote unquote all natural or completely organic, orgasm with no devices.

Dr. Rose Schlaff 00:45:08 And we really challenge that narrative. We really challenge that narrative. And I, I love to offer individualized options. Right. I’ll say, you know, if you know that you do well with a suction type toy, this is a great option. Or if you’ve never tried a suction type toy, try this to start with vibration here internal stimulation. Here we talk about a couple different options to try for toys because again the idea is just exploration. Sexy scientists right?

Dr. Jessica Drummond 00:45:41 Yeah I like that because I think when we keep that coaching communication model at the forefront of what makes this person comfortable, what makes this person excited? What makes this couple finding more joy and connection? What gives that feed feedforward? You know, I think especially for people that have invisible disabilities, sometimes you need a little bit of help. Energetically from an energy standpoint. So.

Dr. Rose Schlaff 00:46:12 Absolutely.

Dr. Jessica Drummond 00:46:13 You know, this is another reason to integrate vibrators and other toys, because sometimes we’re dealing with a true energy debt. And yet we want this area to be nourished because it actually helps the recovery from that energy debt because of that nervous system, nourishment and also the connectedness.

Dr. Jessica Drummond 00:46:35 Nourishment, I think, is very important when you’re talking about overall safety. So I really think that the good thing about most women’s health and wellness professionals, and especially those with a coaching mindset and skill set, we think of everything in a very personalized way. And I think when we’re open to that curiosity, to holding safe space. This is easy to explore because it’s an extension of how we do everything right.

Dr. Rose Schlaff 00:47:09 And I think that as practitioners, we really need to release the outcome ourselves, right? If I have a strong personal belief that every person needs to add a vibrator to their sex life because it’s going to make them so much better, right? Like then people feel pressured, then they’re pushed and and maybe that just doesn’t. No pun intended vibe with your client, right? Right. And so, you know, just getting curious with your own biases. And where are you pushing for certain things or letting the client lead the experience and bringing it back to that general. Right. Saying something like, A lot of my clients find that when they add a toy, pain actually decreases.

Dr. Rose Schlaff 00:47:50 Or a lot of my clients find that when they add a toy, they’re actually able to stay more present in the sexual experience. And and they feel more connected to their partner, right? So bringing it back to the general, because sex can be so steeped in shame, it can be so easy for us to feel alone. And we really, really want to try to shine as much light on all of the experiences that happen in the bedroom, just so our clients and ourselves know that whatever’s going on, we’re not alone, we’re not broken. There’s always hope for healing. And I also want to highlight, too, if you’re listening to this and you’re like, you know what? I identify as asexual. I never am interested in having sex again. That is perfectly fine, too. And I think in this conversation, we need to make space for that spectrum. And I always say that sexual dysfunction is in the eye of the beholder. If you say you want it to be different, there’s always tools that we can use to shift it.

Dr. Rose Schlaff 00:48:50 But if you’re perfectly happy, great. We don’t need to pathologize you. We don’t need to fix what’s not broken for you.

Dr. Jessica Drummond 00:48:58 I love that because yeah, the reality is some people are just not interested either for a short period of time. And again, that may not be pathological at all. I could think postpartum. I could think knee deep in defending a PhD dissertation. You know, I could think there’s lots of scenarios where you might just have your attention in other places, or you just might be really content and happy otherwise. And that’s absolutely fine, too. But I think when we circle back to perimenopause later postpartum recovery, or just women who feel like they’ve lost themselves along the way somewhere, I think that many women want to rediscover this. They just get stuck with how to start, because you’re exactly right with what you said at the beginning. A lot of the sort of general information is like, oh, just try a glass of wine, just try the sexy lingerie. But it’s really much deeper than that in the sense of first you have to feel safe.

Dr. Jessica Drummond 00:50:12 You have to feel that you have tools to regulate your nervous system, and you have to know what you’re looking to accomplish or experience. And I think bringing it back to those, you know, the first two steps that are skipped makes it a healing experience, not an experience that’s more performative or that you have to try to just do.

Dr. Rose Schlaff 00:50:38 Yeah. And that is something I really, really want people to pause on. Like if you are having performative sex or obligatory sex in the moment, we do it to keep our partners from being disappointed, and it comes from a loving place. It comes from a positive place. But I do see that it can cause harm in the trust of the relationship and in your openness to intimacy and in your journey to actually, genuinely, authentically enjoying intimacy for yourself. And so anytime we’re in a cycle of like really regularly having obligatory sex or sex that we feel like is kind of performative or for another person, we want to pause that and get curious and see what’s possible here.

Dr. Rose Schlaff 00:51:25 How can we, you know, maybe we toggle some of these levers and then find something that feels really nourishing and good for both of you, because we want that authentic, deeply connected and pleasurable relationship for you long term.

Dr. Jessica Drummond 00:51:40 Absolutely. Well, thank you so much for sharing all of this wisdom, Rose, and I’m so excited to have you come and teach our students at the Integrative Women’s Health Institute and our membership program. So we’ll be sharing all of the information about how to join your course. In our show notes. Anything else you want to share with us before we wrap up?

Dr. Rose Schlaff 00:52:03 Just that there’s always hope. I’ve heard so many people say, you know, oh, I, you know, I was sexual in my 20s or my 30s, but I’m a mom now or, you know, oh, I’m past menopause now. There’s that’s just a different time of life. And if this is something that you have hope for, there’s always hope for you. There’s science behind it. We see it in the evidence.

Dr. Rose Schlaff 00:52:23 We see it in, you know, the experiences that I’ve seen over the years working with clients. So there’s always hope. And I love connecting with people after these types of things. So if anything resonated with you, please reach out to me on Instagram at Bellwether Rose or email me. Be well with Rose at gmail.com. I have a free training that people can access if they’d like. In the meantime, it’s at Bell with Rose. Com slash more desire and I offer free 20 minute phone calls. If you’re listening and you’re like, I don’t know where to start. I don’t know if this would be helpful. Yeah, you can find that at. Be well with Rose. Com slash schedule now. So please reach out. I think that there is a lack of good sexual health information out there in the world. And even if I’m not the right fit for you, there are other people that are.

Dr. Jessica Drummond 00:53:20 So absolutely. Yes. I think knowing that there’s always hope starting there and then staying in a space of safety and curiosity is really such at the core of what you’re talking about.

Dr. Jessica Drummond 00:53:35 So if you want to connect with Rose, you want to follow her and learn more about this very just, I think, energizing and optimistic and really beautiful perspective on sexuality and intimacy at any age and stage we will list all of the links in the show notes, and I can’t wait to dive deeper in our course, so we’ll talk again soon.

Dr. Rose Schlaff 00:54:00 I’m so excited! Thank you so much for having me.

Dr. Jessica Drummond 00:54:03 Thank you. That was such a fun episode with Doctor Roche. I’ve known her for a very long time, as you could probably tell by our introduction. And she really has such an energy of expansion. So, like many of us, she has had her own personal story of health struggles, of the medical gaslighting, of just trying to navigate a system that is not centered on the health and healing of women. So I hope this episode really inspired you to, you know, take that notebook full of clinical pearls and see how you can think about your client’s nervous system is better. How you can think about integrating intimacy and connection and sexual pleasure into your practice.

Dr. Jessica Drummond 00:55:00 Whatever that practice looks like, where can you be a safe space for your clients who are trying to get pregnant, who are recovering from pregnancy, who are postpartum, who are dealing with their first sexual experiences, who are navigating histories of trauma? How can you create a safe space for women as they transition through perimenopause and menopause to be hormonally healthy, to be cellular, healthy, and have all the resources that they need, even if they’re not entirely with you. Maybe you are collaborating with Doctor Rowse or other sexual health counselors, with other sexual therapists, with other providers. But that coaching model at the center of helping clients navigate a complex system when, quite frankly, women’s sexuality is not something that is prioritized by our medical system. To me, to say the least. In fact, women’s sexual health and safety is absolutely not prioritized by our current health care model. And so you have a really important opportunity to utilize your coaching skills to deepen your coaching skills in the world of pelvic health and pelvic pain and perimenopause, specifically to help people who have questions and have challenges and have sadness and detachment and relationship issues and chronic pain.

Dr. Jessica Drummond 00:56:36 Just a really challenging story with sexual health. You have an opportunity to be that safe space to ignite that curiosity, that sexy scientist mindset. So I hope you learned some really fun lessons today that you can integrate into your own lives, into your practice. And if you have any questions, absolutely reach out to Doctor Roach. She’s there, she’s listening, and I can’t wait to see you again next week. Thank you so much for joining me today for this episode of the Integrative Women’s Health Podcast. Please share this episode with a colleague and if you loved it, hit that subscribe or follow button on your favorite podcast streaming service so that we can do even more to make this podcast better for you and your clients. Let’s innovate and integrate in the world of women’s health.