unPAUSED with Dr. Mary Claire Haver
Orgasm After Menopause: Vibrators, Testosterone & Solutions with Dr. Lauren Streicher (Pt. 2)
18 Dec 2025
In our last episode of unPAUSED, we began a conversation with Dr. Lauren Streicher about orgasm, sexual function, and why these topics are still so taboo. Because there was so much to talk about, we decided to make this a two part episode. So today, Dr. Mary Claire Haver continues this conversation. Dr. Streicher is a professor of Obstetrics and Gynecology at Northwestern University Feinberg School of Medicine, the host of Dr. Streicher's Inside Information Podcast, and the creator of Come Again, a 30 episode audio series on sexuality and sexual function. She's been at the forefront of sexual medicine for decades, pushing conversations forward that most clinicians still avoid. In this episode, we're diving into why vibrators work when nothing else does and what the research shows about vibration versus other types of stimulation. Dr. Streicher explains non-hormonal arousal creams, CBD oil for the clitoris, and whether these products actually help. We discuss the role of neurotransmitters in orgasm and walk through the FDA-approved libido drugs Addyi and Vyleesi, including why testosterone is often the preferred option for women and why pellets are problematic. Dr. Streicher breaks down the orgasm gap between men and women and explains why it actually narrows with age. She walks us through her clinical approach when a patient comes in struggling with orgasm, why pain must always be addressed first, and how to find a sexual medicine expert. We also talk about what gives her hope for the future of this field and why not every woman needs to have an orgasm for sex to be pleasurable and successful. Guest links: Dr. Streicher Dr. Streicher (Instagram) Dr. Streicher’s Inside Information: Menopause, Midlife, and More (Apple Podcasts) Lauren Streicher - Faculty Profile (Northwestern Medicine) Dr. Streicher (YouTube) Subscribe to COME AGAIN: Sexuality and Orgasm DrStreicher.com/comeagain Use code UNPAUSED20 for 20% off (This code expires Dec 23) Dr. Streicher's Podcast Dr. Streicher’s Inside Information: Menopause, Midlife and More DrStreicher’s Substack https://drstreicher.substack.com/ Gyne Hacks! (Including how to How to Get a Hands-free Free Vulvar View) Books: “Slip Sliding Away: Turning Back the Clock on Your Vagina,” by Dr. Lauren Streicher “Hot Flash Hell-A Gynecologist's Guide to Turning Down the Heat (Dr. Streicher's Inside Information),” by Dr. Lauren Streicher “The Essential Guide to Hysterectomy: Advice from a Gynecologist on Your Choices Before, During, and After Surgery,” by Dr. Lauren Streicher “Sex Rx: Hormones, Health, and Your Best Sex Ever,” by Dr. Lauren Streicher “She Comes First: The Thinking Man's Guide to Pleasuring a Woman,” by Dr. Ian Kerner “The New Perimenopause,” by Dr. Mary Claire Haver To learn more about listener data and our privacy practices visit: https://www.audacyinc.com/privacy-policy Learn more about your ad choices. Visit https://podcastchoices.com/adchoices
Chapter 1: What is the main topic discussed in this episode?
So every new episode is ready when you are.
Sex ed, we know, is all about how not to get pregnant or get an STI. It has something to do with pleasure. But the guys are not taught that. The guys are taught you should have pleasure. So that's part of the problem is that there isn't the expectation. So are they upset? I think the ones that expect pleasure are the ones who know how to have pleasure. So older women, different story.
So we have an older patient who comes into your clinic. And she says, I am struggling with orgasm. I used to have them. They're great. And I still want them. What's your first step? Walk me through.
The first step is unless you're running a sexual medicine clinic, the likelihood of that happening is about zero. Let's be honest. How many of patients when you were doing general OBGYN walked in your door and said, Hey, Dr. Haver, I can't have an orgasm. Will you help me?
The views and opinions expressed on Unpaused are those of the talent and guests alone and are provided for informational and entertainment purposes only. No part of this podcast or any related materials are intended to be a substitute for professional medical advice, diagnosis, or treatment. Welcome back to Unpaused. I'm Dr. Mary Claire Haver.
In our last episode, Dr. Lauren Stryker and I started an in-depth conversation about orgasm, sexual function, and why these topics are still so difficult to talk about, even in doctors' offices. There was so much ground to cover on this topic that we decided to split this conversation into a two-part episode. So today, we're picking up right where we left off.
If you're just joining us, let me tell you about Dr. Stryker. She's a professor of obstetrics and gynecology at Northwestern University Feinberg School of Medicine, the host of Dr. Stryker's Inside Information podcast, and the creator of Come Again, a 30-episode audio series on sexuality and sexual function. For decades, she's been leading the conversations that most clinicians still won't have.
Today, we're talking about vibrators and what the research shows. non-hormonal arousal creams and whether they work, the role of neurotransmitters and FDA-approved libido drugs like Addi and Vilisi, and why testosterone is often the preferred option for women. Dr. Stryker breaks down the problem with pellets,
explains the orgasm gap between men and women and why it narrows with age, and walks us through her actual clinical approach when a patient comes in struggling with orgasm. We also talk about how to find a sexual medicine expert, why pain must be addressed first, and what gives her hope for the future of this field. If you missed part one, I encourage you to go back and listen.
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Chapter 2: What makes vibrators effective for orgasm?
You put the unmirrored part under the toilet seat and you put it down. Now you're going to sit on the toilet seat because now it's holding it in place. Can you picture this? Yeah. So the mirror is now coming out from the toilet seat. Yeah. And you can adjust the mirror to get the perfect view. If you don't have a mirror with...
a light, you know, you can use a ring light or you can use your phone, whatever. And suddenly you are sitting on it and holding it into place and you've got a hands-free view. That's amazing. So this is right after my gyne hack on how to get your fem ring or your S-string out. If you have long nails, dental floss. You tie a long ring of un-minted dental floss, just like a tampon string.
Push it off. And then when it's time to take out your ring.
Oh, and then you'd like a tampon. You made a string.
You just pull it down. It comes down to the opening of the vagina and you just grab it out. So I have fun with this. So I have about 15 gynehex. I haven't put all of them on YouTube. People are going to be running to YouTube. This is hilarious.
Let's go through non-hormonal arousal creams. Do we have any evidence?
This is also a data-free zone. However, there are a lot of them out there. These are also compounded products. I've seen Scream Cream. Yeah, we try not to call it Scream Cream because we think that's kind of offensive. Yeah. You know, women having pleasure shouldn't be labeled as we want you screaming. Anyway, I call it just arousal cream. Arousal cream, orgasm cream. What are these?
Well, there's different combinations of products that are all basically vasodilators. They all increase blood flow. And do they work? Anecdotally, for a lot of women, they do seem to make a difference. Again... The instructions usually say use it just prior to sexual activity. I think you're better off using it on a regular basis to increase the health of the clitoris.
It can be irritating to some women. And in that episode, of course, I go through all the ingredients to look for, all the things that might help. The other arousal cream that is out there that a lot of women are using, CBD. Really? Well, think about this.
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Chapter 3: How do non-hormonal arousal creams work?
not just gynecology, but in all aspects of medicine. There's not one single medical specialty that doesn't need to know about this. Come Again is for women who at a high level want to understand what's going on, what's changing, and most important, what they can do about it. Come Again is for men who want to understand what's going on with the women in their lives. 30 episodes sounds like a lot.
But I promise you it's entertaining. Some of them are short. Some of them are 10, 15 minutes. Some of them are longer. It started out as 50 or 60 episodes. And you do it in little bites. You do little bites. And I throw in there a lot of history of this stuff. Like we talked earlier about Princess Maria Bonaparte. I love that stuff. I would love to write The history of all of it.
So a lot of fun stuff. And it really is for everyone who has a curiosity about this. And even though it's skewed towards women who are appearing postmenopause, because let's face it, those are the women that are having the biggest challenge. It is really for all age groups because these are problems that can happen at any time in life. And the most important is I'm solution driven.
It's not enough to talk about the problem. Let's talk solutions.
Well, it feels like, you know, menopause is having this renaissance and that it's this new topic. But you've been doing this work for 30... A long time.
You know, whenever we talk about how menopause is having a moment, and that makes me a little crazy because I'm thinking it's not having a moment. I've been talking about menopause for 20, 30 years, but no one wanted to talk about it. And I used to do a ton of media, you know, Good Morning America and Today Show and on and on and all these shows.
And I would always pitch to the producers, let's talk about menopause. And they'd be like, no, no, we're not. No, no. Give me another topic. And now, of course, that's all they want to talk about. And I would like to think it's because you lay the groundwork. Right. Well, there's that.
But I would like to think that there's this interest in menopause because people are acknowledging that it is important and there is some of that. A lot of it is we know there's a lot of money to be made in menopause, which is why people have to be careful with where they're getting their information.
But I am glad that this somewhat taboo topic is now being talked about, not just in the doctor's office, but with your manicurist. Right. With your friends, with your brother, you know, as it should be. That's as it should be. When women talk to their daughters about their first period, they should also be talking about their first hot flash.
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