Sexless to Sexually Empowered: a Gynecologist’s Journey

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“Sexless to Sexually Empowered: a Gynecologist’s Journey”

a lightly edited Girl Boner Radio transcript

Dr. Bartos: 

“…you know, all these things he’s done that I’m like, oh, I’d like to try that but now isn’t a very kind of safe space to do so. 

And he just stopped. Like, he just stopped wanting to have sex.. And I didn’t know how to talk about it. Like I didn’t know how to bring it up. Even though I talked to women about how to bring it up to their partners, I didn’t take my own advice. I really screwed it up. 

August (narration): 

Long before Heather Bartos became Dr. Heather Bartos, an OB-GYN, she had lots of questions about sex. She told me she from a generation in which many women aimed to be the “perfect housewife,” her mother included, and sex was reserved for “man and wife.”

Dr. Bartos:

And so I had a lot of questions growing up. We didn’t have the internet back then. So I remember digging through—I found my dad’s Playboy stash—when I was about eight or nine, and this was the early ‘80s. And boobs were everything then. Like this was the decade of the boobs. And I just was entranced by all these boobs. I mean, I couldn’t have cared less about what was going on on the other half, which is ironic because I’m a gynecologist, but I was like, I must have these. This is every – Boobs were everything. 

He even had a boob toothbrush that was like a gag gift. And there were these hard, like plastic boobs, and their bristles were like the nipples. I just remember going, What is this for? Like, I just didn’t get it. So yeah, my first introduction to sex was really through Playboy. [laughs] 

August:

How did that impact, because I’ve heard different things about when people start developing breasts, um noticing changes. Were you excited then? Where you were like, I love having boobs. You said you were hoping to have them. Did that enthusiasm stick around?

Dr. Bartos: 

You know what? It did not. [laughs] I remember going bra shopping. You know, that first training bra that your mom, you know, horrifyingly takes you to go, you know, do at the store. And I really thought a bra was gonna make them flat again. 

I was really early when I developed; I was like in fifth grade. And I was like, “What do you mean? I still have breasts”. And she’s like, “Yeah, that’s how that works.” And I said, “but I want them to be gone now. Like, I want them to be flat again.” And it was a disappointment. Not until later did I appreciate boobs, like my boobs. 

And now, of course, you know, boobs just aren’t as big a deal as they were back then. So like, you know, and I grew up in Texas where boobs were everything. That’s where the breast implant was created, you know, down in Houston. 

So, I thought, this is it. But then I didn’t want them. I didn’t want to get any secondary sexual characteristics. I was really disappointed when I developed.

August:  

It’s so interesting how something becomes sexualized. And then that’s just what we all are —“this is what’s sexy.” Like, it’s just, it could be anything. I mean, it could be really giant ears and people start getting ear implants, right?

Dr. Bartos:  

Yes, yes. I mean, now it’s all about butts, right? Like, now it’s all butts. Everyone wants butts. And, you know, and I’m like, Now great. I don’t have a butt and I have boobs. So now I’m just like two decades behind what was hot. [laughs] 

[descending xylophone scale]

August (narration):

Questions around sex did not end up leading Heather into gynecology. In fact, as you know if you’ve listened here for a while—or perhaps from your own experience—gyncologists don’t often learn much about sex and sexuality in their training. Dr. Bartos just wanted to work with women. 

Dr. Bartos: 

I thought women were awesome. Like, I loved dealing with women. And I was like, Women are where it’s at. Like, I just liked dealing with women from like birth to like death. And so I just thought I just want to work with women. Like that was really where it started. 

August (narration):

Then, about 10 years ago, once she was already in practice for a while, she started to notice that her patients were bringing up sexual issues.

Dr. Bartos:

So that’s why I started doing all this research on sexual health. There’s very few gynecologists out there that really kind of focus on the mental and the physiological aspect of sexual health. 

There’s a lot of pelvic pain specialists and there’s a lot of sex therapists but I really wanted to kind of combine all of it together and I kind of was like—I don’t know, I’m not really a pioneer—but I was kind of out there by myself for a while thinking, What am I? Am I a sexual gynecologist? That doesn’t sound good. [chuckles]  You know, like what, what was – I was just a normal gynecologist that just likes to talk about sex. 

August (narration):

She also noticed that many patients who asked about sex had received some pretty horrible advice from other gynecologists.

Dr. Bartos: 

And it wasn’t just male gynecologists. That’s what I would have thought, wrongly. It was a lot of female gynecologists. And, again, one it’s lack of training. And two, I think it’s, it’s their own sexual issues, you know, are a part of that, too. 

I have so many women that told me, “Oh, just – they told me just to fake it till I made it.” Am I like, eeeww, that’s not a good answer. I mean, that’s just not a good answer. And so now it’s like my whole thing. I just want to like deal with sexual health issues all day because there’s just a need for it.

August (narration):

Heather now speaks openly about her own sexual challenges, too. She said that people often have the impression that, because she’s a doctor who specializes in sexuality, her own sex life must be perpetually perfect—which is not the case. 

In fact at one point, she realized that her relationship had become sexless. By then she’d been married for about 10 years and she and her husband had had two kids.

Dr. Bartos:  

And I had my kids late because I was in training. So I was 41 with my second kid, and I was in a crazy office situation. You know, we were trying to kind of keep the sex going. 

And my husband had had, he’s 10 years older, had had a very prolific ‘80s style sex life. I mean, he was still living the good old days. And so I thought, This is great because he’s gonna be able to, like, you know, all these things he’s done that I’m like, oh, I’d like to try that but now isn’t a very kind of safe space to do so. 

And he just stopped. Like, he just stopped wanting to have sex. It wasn’t me. I was still very much interested. And I was like, “Hey, let’s go for it.” And what I noticed was it it didn’t, it didn’t just hit me at one time that we weren’t having sex. 

It was, you know, how like time just kind of goes by and you go, [ticking clock] It’s been—oh, my gosh—it’s been like months since we’ve had sex. And that’s happens when you have kids and dog, you know, and all those stuff. And I was like, this isn’t, this isn’t right. 

And I didn’t know how to talk about it. Like I didn’t know how to bring it up. Even though I talked to women about how to bring it up to their partners, I didn’t take my own advice. I really screwed it up. 

I was over 40. And I thought, this is it. Like, he thinks I’m fat or he thinks I’m old or, you know, even though he was 10 years older I thought, I mean, he doesn’t find me attractive. That or he was having an affair or he was gay. 

I just determined my husband was now gay and I was gonna be one of those women like Grace and Frankie where her husband’s, now ex-husband, is now gay. And I was like this is, these are the three possible reasons. I never entertained any other options. 

So when I, when I finally approached it again and my feelings were getting hurt but I also had some moxie behind it now, because I was just pissed. [laughs]. That’s not a good combination. Desperation and pissed is not a good combo. 

And so I said something. I sex-shamed him. I said something I shouldn’t of. I basically said, “Did you wear out your dick in the ‘80s? Like doing it with everybody out – Now you can’t give it to me. Is that what happened?” Oh, man, that shut things down. I mean, it triggered him. It was really a deep wound for him. 

I was wounded. I thought wounding him was gonna make it better. It did not. And we didn’t have sex for two years. To the point where I thought, okay, I guess I’m going to have to get divorced. Like, I don’t know how this works. No one had ever said what to do when your marriage becomes sexless.

August (narration):  

Some people are happy in sexless relationships, whether they started out that way or not. And that’s completely valid. Others, including many women Dr. Bartos has worked with, endure sexlessness silently, all the while feeling dissatisfied or downright miserable.

Dr. Bartos:  

And there’s a lot of women were not taught in how to voice what we’re wanting so we would just live it in silence. They just go, “That’s okay.” And I’m like, “That’s not okay! That is not okay!” Why are we accepting this as that’s okay. 

Because as women we have higher sex drives than men, biologically, but we’ve been suppressed. For generations, we’ve been suppressed. You know, you should be a good girl. You should be chaste. You should wait till you’re married. I mean, the whole gambit. 

August (narration):

When Heather couldn’t stay silent about it, blurting out that hurtful comment once her feelings boiled to the top, she felt equally lost about what to do next.

Dr. Bartos:

I didn’t really know what to do with all this. I know I pissed him off. I know he was hurt. I know we were basically just just screaming at each other all the time. And we went to a marital counselor because we didn’t even find a sex therapist. And I don’t think he would have gone if I could have found one because the bigger issue was that I had hurt him. And then I was hurt. 

And so we had to work through a bunch of little traumas. You know, I did not know that he had been molested as a child. I didn’t know that. He had never told me. Ten years together, he had never mentioned – I didn’t know or I might not have said that. You know, I mean, I wasn’t trying to mortally wound him.

August:  

It sounded like your, your comment came from pain as well. Like, “Oh, you used to have this vibrant sex life, and now you don’t want me.” I can imagine blurting something like that out because I was so wounded and feeling less than. 

It’s so interesting how our our pain in relationship, our old wounds, they trigger each other.

Dr. Bartos:  

They do, they do. They, and they almost, they almost trigger us, which is more, right? Because like you’re in love with this person. And you’re like, I know the right spot to get to. You know, you know the right part to stab him in, you know. And then, of course, did that make our sex life better? No!!! I mean, literally, he just completely, you know, tuned out, tuned off. 

[jazz riff in minor]

August (narration):

Finally, Heather decided she had to do something. She didn’t want to file for divorce, especially not while raising their two young children.

Dr. Bartos:

So I thought, What can I do here? What am I going to do? Okay, what would I tell somebody to do? 

That’s really where I had to go. I had to think of myself as a third person. And what I finally decided was, Okay, let’s say this is a sexless marriage. Let’s say it is. Is it going to derail you from feeling like a woman in her 40s who’s awesome and who’s feeling sexy? 

There’s a great book that I love, It Takes One to Tango. And I read that book, and I thought, You know what? If I can change one thing, I’m going to change myself. 

August (narration):

She realized she had been totally relying on his approval about her seuxality in order to feel like a sexual being or to feel sexy.

Dr. Bartos:

I realized I didn’t need that anymore. If I was going to feel sexy, I no longer walked out and said, “How does this look? Does this look good?” I was like, You know what? I don’t need that. Like I’m just gonna go out there and I’m going to say, “I look good.” And I just stopped asking. 

And you know what, the compliments started coming on their own. Because I was walking through like I owned the place. And these little things started to kind of just build back my confidence that I still had something, I still had something. And if I wasn’t going to have a great, sex-full marriage, I was going to feel sex-full myself. 

And it wasn’t just about masturbating and buying toys. I mean, it was about that, too, but I was going to go out feeling sexy. Show my daughter that I don’t need a man to validate my sexuality. And things kind of started to just shift with time. It wasn’t fast. There wasn’t a magic pill. But after a while he started to just kind of notice. 

I just stopped chasing him around the room. If we had a conversation, I walked out. Because there’s this theory, right, in physics that, you know, two people are there. And if one walks in, the other one naturally wants to walk out of the circle. But if I stepped out, he naturally wanted to step in. 

I was the girl that would chase him into the next room still fighting. [laughs] I would go to the laundry room, to the tool shed. I was still having the argument. And he was, like, trying to run away from me. And I was like, I was like, “I’m not done talking to you yet.” Clearly, he was done. 

So I started to just kind of read the room, too. And I was like, Okay, he doesn’t want to talk, he doesn’t want to talk, fine. I don’t need that right now.

August:  

One thing I’m really hearing from you that I love so much is that it’s such a great illustration of sexuality being so much more than sex. Like it is that that self-empowered feeling and connection with the world and how we feel moving through a room and and all of that. Did that challenge what you thought about sex throughout your life?

Dr. Bartos: 

You know, it did. And it really kind of started to work on how I started talking to women, because I have a lot of women that don’t have partners or, you know, they were widowed, and I wanted them to still feel sexy. I thought we could feel sexy at any age. And I really work on my patients on finding women in older age groups that they think are sexy. 

One of my favorite women I like to talk about that I think is sexy as hell is Angela Lansbury who is 94 or 95 and was singing her ass off in Mary Poppins Returns, at that age, and just, I mean, just working it. And I thought that is sexy. Or, you know, Ruth Bader Ginsburg, who I thought was so brilliantly smart. That’s sexy. 

And I started looking for traits in other women, all kinds of women, different sizes, different ethnicities, and what I liked, what I found attractive about them, and I pulled it into like my sexy sphere. And I thought that’s what I want to be. 

And so I tell women, “Sexy is not intercourse. It’s not, at all. You can have a very sexy life with no penis around.” [laughs] But you have to just get what is it about other people that you love, the other women, and bring it into you and start to exude it.

August (narration):

Gradually, Heather and her husband turned toward each other, sexually and with their communication. And they’ve learned to prioritize intimate time together, no matter how zany their lives get. 

Not doing so is actually the most common sex-related challenge she hears from folks in her office.

Dr. Bartos: 

One of the biggest ones I hear a lot, and it’s actually from all ages. It really surprised me because I really thought it’d be from my 40-something plus women is, we don’t have time. We’re busy. Trust me, I get busy; I deliver babies. [laughs] I get busy. say, you know what? I said, “That’s not an excuse for us. Sexual inertia is not an excuse.” 

If we don’t work it, if we don’t put it out there, if it’s not an effort—just like working out or drinking water or whatever we want to do—if it’s not on the table as a reminder to feel this way, it’s really easy to just let it go. And I tell these women, I’m like, “Well, okay. Well, when you’re ready to put it on the table, we’ll talk some more.” 

And that shocks them because I think they think there’s a magic pill. I mean, I can’t take away the busyness. That’s 2021. That’s just life. But I can tell you how to work around the busyness. But I think a lot of us use the busyness as an excuse to not have to put forth the effort.

August (narration):

Just like her, many of Heather’s patients have to face old wounds and gaps in education, if they want to create the sex lives they desire. The timing is important, though. Not everyone is ready for those efforts. 

Dr. Bartos: 

You know, it’s funny. I will have women of all ages come see me for a sexual health consult. And I will tell them, this is not going to be quick. It’s not going to be easy. We’re going to have to unpack all of your stuff from starting when you were a little baby, all the way through. And I would say half of them never come back. Because they don’t want to do the work. 

And I’m like, that’s fine. Just it’s not time for you to do the work. When you’re ready to do the emotional work, possibly the spiritual, religious work, if that’s something for them, the physical work, the whole thing. There is no magic pill because if there was I would give it to everybody. 

There’s no judgment. It’s just you’re not ready, baby, you’re not ready.

[acoustic chord strum]

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[acoustic chord strum]

August (narration):

Dr. Bartos pointed out that so many factors can impact sexual desire, regardless of your gender. And that, contrary to a common myth, penis havers, too, experience hormonal changes, changes with age, stress, exhaustion…all of which can cause a drop in desire. 

Skimping on self-care can also fuel those changes. 

August: 

One thing I hear from people is they’re concerned about this quote unquote sex problem. They’re barely sleeping or they’re skipping lunch. The focus goes there, oftentimes, because it affects a partner. 

For me, I personally find that when I fill my own cup, the adage is pretty true. How often do you see that being a challenge?

Dr. Bartos:  

Oh, that’s huge. I mean you hit that right on the head. You got to fix your own shit first. I mean, you got to take care of yourself first. 

And I always love Dr. Andrew Weil. You know, he always used to talk about, you know, as women, we’re kind of the heart of the home…kind of a little misogynistic but I dig it. I dig the reference. 

And that the heart actually pumps blood to itself first, right out of the lungs. It doesn’t get the last bit of oxygen. It gets the, the freshest blood goes to the heart. That is important because then the heart has to function the whole rest of the body. It has to do it for everything else. So by taking the first blood it’s not selfish, it’s actually self-ful. Because now the heart can help every other organ in the body. 

We have to take care of ourselves first, not because it’s selfish, but because you’re actually going to have stronger, more vibrant life to give everybody else around you.

August (narration):

I see the value there, and the misogyny. How about this tweak on that metaphor: What if we think of ourselves as the heart of our lives, so everyone around us can benefit along with us?

Dr. Heather Bartos, and her husband are a good example. Once they were ready to do the work they needed to do, in their own lives and with each other, virtually everything improved. The marriage was no longer sexless, and they grew individually and as a couple.That’s not to say that everything’s perpetually easy, of course.

Dr. Bartos:  

What I really noticed was when we finally kind of gradually kind of came out of this sexless spell. Once we kind of both, I think, with some time, forgave each other’s wounds. I mean, that was a big thing. 

We had to kind of forgive each other, if we were going to love each other. And it just – It had to be done. No matter what we had said, it – We had to forgive ourselves for saying it and also each other for feeling that way. 

And once we got out of that, and I’m gonna be honest, we still go through spells like COVID. We weren’t like “Woo hoo! Let’s just party all the time in bed!” [laughs] We went through some sexless spells again but now we know how to navigate those better. We actually can say, “Oh, looks like we’re kind of going through a spell now. We really got to make this a priority. So let’s plan something.” 

Because we navigated it once. It’s almost like, because we navigate as a ship going through like the English Channel, we could do it again with more ease, with less pain and more honest, vulnerable communication. You know, “I’m feeling neglected. I’m feeling, I’m feeling hurt that you’re not interested.” And now it’s more like, “I am interested. I just – I’m tired. I’m this.” “Okay, then let’s make a plan.” 

And so we kind of do this kind of circle back kind of thing that therapists love to talk about, about falling back up and not letting it simmer to the point where it’s about to explode. 

[acoustic chord riff]

August (narration):

Learn more about Dr. Heather Bartos and her work at heatherbartosmd.com and check out her podcast, The Me Spot. She said it’s basically the same sex talks she gives in the office.

To learn more about factors that can impact Girl Boners, check out my book, Girl Boner: The Good Girl’s Guide to Sexual Empowerment. And, don’t forget to check out Zencastr for your podcasting needs, using the promo code girlbonerradio to save on your first three months. If you do, I want to hear what you think about it. Learn more at the discount link in the show notes.

To support the show and get fun extras, join my community at Patreon.com/GirlBoner. You can also show support with a rating and review on Apple Podcasts and by letting your friends know about it. Thanks so much for listening. 

[outro music that makes you wanna dance!]