Menopause has many advantages and we have the best sex in our 40s: at least that's what gynecologist and bestselling author Sheila de Liz says. We asked some questions.
Your book is called "Outrageous. Everything About the Fabulous Female Body" – and it is, especially outrageously amusing. Gynecologist Sheila de Liz is not only an entertainer, she also has a job: She wants to educate women. At least we learned a lot in the interview.
Barbara.de: Your book says that you age when you don't have sex. Why?
Sheila de Liz: Women who remain sexually active for longer definitely do not age as quickly vaginally. This is because of the blood flow and the hormones that are released during sex. The following often happens to women who do not have sex: hormone production decreases, the mucous membrane around the vagina becomes thinner, then it hurts and this leads to avoidance behavior. This is how the slow decline of sexuality begins. But if you do something about it early on, continue to have sex, and increase blood flow, the vagina ages more slowly.
Just the vagina?
No, everything else too. I think those who have sex don't generally age that quickly. My patients, who are over 70 and still have an active sex life, are generally fitter. They have fewer diseases of old age, they are mentally younger, they travel a lot more and do more sports.
Do you need a partner for this?
Under no circumstance. Masturbation is wonderful, and a toy from the sex shop can also help. "Use it, or lose it," I always say. It's not tied to a partner: it's about staying sexually active because that seems to conserve.
Speaking of preservation, you write that menopause has many advantages for us women. What do you mean?
Before menopause, we are very keen to please everyone. But we can go back even further, everything starts much earlier. Before puberty, we knew very well who we were and what we wanted, even if we weren't even aware of it. But then in puberty the hormones come and mess everything up. You start chasing after things and because of the influence of estrogen, which you still have in your 20s and 30s, you keep wondering how you look and how you can bind a partner to yourself. You want to make everyone happy, the husband, the children, the mother-in-law, the neighbors and the parents' council at school. One tries to be everything for everyone. That's normal and okay, that's how our society works.
"Testosterone gives us energy and a clear head"
And then?
From the end of 30 the quality of ovulation begins to decrease. As a result, the hormonal supply fluctuates, first the progesterone decreases, then we have less estrogen. This leads to the fact that you no longer want to please everyone. One day many women wonder what they actually wanted – and many then take what they used to want. They get back some of the self-confidence they had before puberty.
What else happens during and after menopause?
We have more testosterone again, which gives us energy and a clear head. Many women are stronger and more stable and absolutely no longer ready to be told every shit. They feel like they know who they are and what they want – and that that's so great. I want to communicate that this time is extremely important.
But aren't many menopausal women also doing badly?
But it doesn't have to be. I am a midlife advocate for women's medicine. It used to be said that you had to go through it. However, many women cannot sleep, sweat all the time or are constantly irritated, which is very frustrating. There is now very, very good and sensible medicine for women going through menopause. 20 years ago women were given nasty synthetic hormone preparations that were artificial and completely overdosed. There are now bioidentical hormone treatments that are precisely tailored to the needs of the body. This is how you can stabilize women and enable them to develop their full potential.
Speaking of potential: At one point in the book you also say that women over 40 have their best sex …
This has to do with the higher testosterone levels. On the one hand there is a falling level of estrogen, which is why we care less what others think or whether we have cellulite or a stomach, on the other hand we have the testosterone level that has not yet fallen, which makes a healthy libido.
So far it all sounds positive. However, they also say that women in their mid-40s should ideally stop drinking alcohol. Why?
Yes, I know that makes me unpopular. There are women who drink every day, but as we get older we tolerate it less and we gain weight much faster. It also has an estrogenic effect and produces unhealthy belly fat. We don't recover that well from it either, we need several days for it. Of course, there is nothing to be said against a glass of wine on the weekend, it is not forbidden, but it is simply not beneficial if you want to stay fit.
"My aim is to educate women so that they are no longer afraid"
You also write that women don't know much about their bodies overall. What exactly do you mean by that?
It starts with the anatomy. Some don't know what a vagina is and what a vulva is. Many cannot tell where their clitoris is. I have seen women who cannot explain what and where the cervix is. Every day I experience that women don't know how the pill works or why they bleed. But they can't help anything: In German schools there is hardly any talk about the female body, and many doctors treat patients as if they were stupid and didn't understand anything anyway. I have seen really educated patients who are judges and teachers and yet know very little about their bodies. It shouldn't be like that.
How do we best change that?
For example, we can explain to daughters, even when they are little, what can be seen externally, such as the labia. Then later that there are three holes that are not so easy to see but that have different functions. It's different with boys, they know their penis. It has long been ignored that a woman has a clitoris, that she has a sexuality that has absolutely nothing to do with the male penis, because it sits on the outside and not on the inside. Above all, it serves to satisfy women. Incidentally, many men do not even want to know or accept this. It is completely normal not to orgasm vaginally, the vagina is not made for that. That's what we have the clitoris for.
What would you advise a woman who does not orgasm vaginally?
Always clitoral stimulation. This is often ignored during intercourse. You can also use aids for this, hands or a vibrator. But there are still enough idiots who think that they don't need this, that pure sexual intercourse is enough to satisfy a woman.
Among other things, did you write the book for these men?
No, my aim is to fully enlighten women so that they are no longer afraid, so that they are no longer insecure, so that the sexual, female identity can finally be transported into the 21st century. I would like to empower women: So that we are just as familiar with our body, our sexuality, our cycle and our hormones as we are with make-up techniques or with how many calories a banana has.
Dr. med. Sheila de Liz, born 1969 in New Jersey, came to Germany at the age of 15 and studied medicine in Mainz. Since 2006 she has been working in her own practice for gynecology and obstetrics in Wiesbaden. "Outrageous. Everything about the fabulous female body" has been published by Rowohlt Verlag and costs 16 euros.