83 | The Best of 2025: Hormones, Desire & Pleasure for Midlife Women

Are you struggling with hormone therapy that isn't working? Wondering why testosterone for women is so hard to access? Feeling confused about vaginal estrogen warnings? This special Best of 2025 episode of Pleasure In The Pause tackles the most pressing questions midlife women asked this year about hormone optimization, sexual satisfaction, and reclaiming pleasure during perimenopause and menopause.

Host Gabriela Espinosa revisits the year's most downloaded conversations—featuring leading women's health experts discussing hormone therapy optimization, the truth about testosterone for women, the historic FDA hearing on vaginal estrogen, redefining sexual satisfaction in midlife, exploring fantasy and desire, and discovering the five essential pleasure principles every woman should know. Whether you're navigating symptoms, considering hormone therapy, or simply want to feel more alive in your body, this episode delivers evidence-based insights and empowering tools for thriving through midlife.

Featuring conversations with Dr. Jila Senemar, Dr. Susan Hardwich-Smith, Dr. Laurie Mintz, and Lauren Elise Rogers. 

Highlights from our discussion include:

• The "big three" hormones—estradiol, progesterone, and testosterone—each address different menopausal symptoms, and treatment should be individualized based on your top priorities like sleep, mood, energy, or libido.
• Women naturally produce more testosterone than estradiol throughout their lives, yet have zero FDA-approved testosterone products compared to men's 20+, despite proven benefits for libido, bone health, muscle mass, and cognitive function.
• Low-dose vaginal estrogen cannot be detected in the bloodstream yet carries an unfounded FDA black box warning, preventing millions of women from accessing a safe treatment that prevents 50% of UTIs.
• Only 4-18% of women orgasm from penetration alone, and less than 2% use penetration when masturbating—closing the pleasure gap requires prioritizing clitoral stimulation as the main event, not just "foreplay."
• Erotic fantasy, built on the four cornerstones of longing, taboo, power, and ambivalence, can be a healthy springboard to arousal when integrated openly rather than pushed into the shadows.
• A turned-on life in midlife isn't about performance or sexy lingerie—it's about living in alignment with what fuels your joy, vitality, and truth, whether through art, nature, movement, or intimate touch.

2025 was a turning point for women's health—from historic FDA hearings to conversations shattering decades of sexual myths and medical dogma. These six episodes represent what midlife women are hungry for: truth, empowerment, and permission to reclaim pleasure on their own terms.

As you move into 2026, remember that your pleasure isn't optional—it's your birthright. Whether you're advocating for better hormone therapy, learning what actually brings you to orgasm, or discovering what makes you feel fully alive, this is your invitation to thrive.

CONNECT WITH GABRIELLA ESPINOSA:

Instagram

LinkedIn

Work with Gabriella! 

Go to https://www.gabriellaespinosa.com/ to book a call.

Full episodes on YouTube.

The information shared on Pleasure in the Pause is for educational and informational purposes only and is not intended as medical advice. Always consult your healthcare provider before making any decisions about your health or treatment. The views expressed by guests are their own and do not necessarily reflect the views of the host or Pleasure in the Pause.