What Does Your Libido Reveal About Your Life?

MAUREEN CAVANAUGH (Host): We all know the stereotype, women who are busy with family and work, who are cooking dinner, answering e-mail and helping out with homework all at the same time, might not show much interest in having sex at the end of the day. And whenever that stereotype is mentioned, it's usually in the context of how much strain this very tired woman is putting on her husband and family. But a new book is putting a different spin on that old stereotype. It asks the question, not what a woman's low sex drive is doing to her relationship but what it's doing to her. The book is called "Healthy Sex Drive, Healthy You: What Your Libido Reveals About Your Life." It’s a pleasure to welcome author Dr. Diana Hoppe. Dr. Hoppe is an OB-GYN in private practice here in San Diego. Dr. Hoppe, welcome to These Days.

DR. DIANA HOPPE (Author): Thank you very much, Maureen.

CAVANAUGH: So, okay, we’re inviting our listeners to join the conversation. If you’ve got questions about your sex drive or what your libido reveals about your life, give us a call with your questions and your comments. Our number is 1-888-895-5727. Dr. Hoppe, why did you write this book?

DR. HOPPE: That’s a great question. I wrote it for various reasons but I think the main one is that so many of my patients were asking, Dr. Hoppe, what can I do about my sex drive? And is my drive normal? And I don’t really think about sex that much, my husband or my partner does and why is that? And why is – is this normal? Abnormal? And is it potentially not healthy for me? And so I actually looked further into it and started doing research within female libido, and I started realizing how it really can be an indication of how your general wellbeing is. That is, if you’re having a good relationship with yourself and your husband or your partner sexually and having intimacy, you’re probably happy and doing well in other aspects of your life. So I actually had different reasons to write it but it actually was very informational and intriguing.

CAVANAUGH: Now this book is aimed at women. How – Do many women overlook the fact that sex is part of a healthy life?

DR. HOPPE: Yeah, I think that women – we, as women, just don’t think about sex as much as men and that’s partly when – Also, I have a chapter on brain differences, and it gives more information as to why you’re different than a man, how men and women are different. And men think about sex just way more than women do, and that’s a physiological thing. So that’s also – brings up like women just don’t see it as a high priority where men put it as a very high priority in their life. So looking at just brain differences can give a lot of understanding as how we’re different. And women normally tell me that once they get involved, like get kind of, you know, into sex and get in varying – intimate with their partner, then they actually start enjoying it. It’s just they don’t think about it that much. And that’s a very common and normal thing for women.

CAVANAUGH: And I also think that there’s a difference in the way that men and women view sex as part of a healthy life. Men accept that, you know, having sexual relationships, having sex itself, is part of maintaining their health whereas I don’t think women really look at it that way. And that’s not a good thing for them, is it?

DR. HOPPE: Right, and I think women see sex more as a way to become more intimate and connected emotionally with their partner and men see it more as a physical release, which is not necessarily a bad thing but I think that if we start understanding what the motivation is behind it and how men maybe could romance a little bit more and women can understand that men actually do have a physical drive to have sex, and then get a better balance of how to make each partner happy in that regard is very important.

CAVANAUGH: I’m speaking with Dr. Diana Hoppe. She is an OB-GYN in private practice here in San Diego. She’s written a book, "Healthy Sex Drive, Healthy You: What Your Libido Reveals About Your Life." We’re taking your questions and your comments, 1-888-895-5727, that’s 1-888-895-KPBS. So how do you determine – can you determine with how a patient presents herself to you whether or not, you know, she is – has this healthy libido, she has this healthy activity in her life?

DR. HOPPE: Well, it actually comes up during the discussion of kind of social history and how she’s feeling about her relationship. Is she married, not married, is she sexually active, does she have any pain or problems with intercourse, how much is she exercising? And normally when we start getting into the kind of social lifestyle things, things start coming up about the job, the kids, how maybe he’s not helping as much around the house, how she’s feeling overwhelmed, and then the concern about how she’s just too tired.

CAVANAUGH: Umm-hmm.

DR. HOPPE: And then we kind of have to break it down and say, well, what areas are you doing things that maybe you don’t have to? I mean, you know, we can’t be superwomen. Like you said, you know, bringing home the bacon and frying it up in a pan…

CAVANAUGH: Right, right.

DR. HOPPE: …and then being all ready to have this hot, you know, fulfilled sex. So I think women have to put things in perspective and realize that, you know, there’s only so much time in the day and that this is an important part for them. Not just for their partner but also for them.

CAVANAUGH: And, you know, part of your – the question, part of the title of your book is ‘what your libido reveals about your life.’ So what is libido?

DR. HOPPE: Libido is really – I like to call it the urge to merge. And it’s the urge to really be close to your partner in a physical way but it also can be emotional in, you know, basically an intimate way. So when I talk about sexual intimacy, I really talk more about caressing, touching. It does include intercourse but it’s, you know, some couples may not be able to do that and sometimes women just want a physical connection. They want to feel emotionally connected and being close to their partner.

CAVANAUGH: And so does that actually define a healthy libido in women?

DR. HOPPE: Yes, so if you’re actually having a good relationship with your partner, maybe it’s not having sex per se but it’s actually, you know, holding hands, walking on the beach, talking honestly about things, touching, maybe massage, cuddling, all of that is actually beneficial because it helps release something called oxytocin and oxytocin is the bonding hormone and that gives a sense of kind of calm and connection and it’s a very healing thing for the body.

CAVANAUGH: I’m wondering, is it possible for a woman to have, you know, to be really healthy in all other aspects of her life and this is the one area that really is not working for her and yet, you know, and not have any ill effects from it.

DR. HOPPE: Yes, I mean, I think there’s some times where a woman may have a partner who may not be able to have sex or maybe just not part of their life anymore. And I think when I – that’s, again, where I clarify what is sex. It’s not just intercourse, it could just be hugging, caressing, etcetera. If they are happy with their relationship and they’re getting fulfilled, that’s absolutely wonderful. I think the problem arises when there’s a discrepancy between what the partner, the husband may want and what the woman wants. And sometimes what – some women want more sex than their husband so that also comes up and then how to find that balance. So I don’t think if she’s actually happy with her relationship and the state of the relationship, it’s great but there’s sometimes a woman will say I feel guilty that I kind of… Because he can’t perform for various reasons, and she might feel guilty then to try to pressure him so she just kind of negates that part of her life. And that’s where I think, you know what, there’s things we can do for men with their issues, there’s lots of possible treatments, and there’s a way to make it kind of still part of your life and not just negate it as a done deal.

CAVANAUGH: One of our listeners called up. She couldn’t stay on the line but she says that she’s a busy mother and she feels that there are lots of reasons why she can’t enjoy sex at the end of the day, that, you know, she’s just – doesn’t want it. Now, let me ask you, let me – Before you address this question specifically, I’m wondering if, indeed, a woman has no desire to have sexual intimacy, is there automatically something wrong with her?

DR. HOPPE: No, and that’s what I’m trying to say, that that’s also why I wrote the book. You had asked that initially. I wanted to clarify that it’s normal for women in general not to think about sex. They have so many things they’re thinking about. Our brains multi-task. We think about what we have to get at the store, what’s the soccer group, get the schedule organized, do your work. There’s multiple things to do that women just don’t see it on the list of things of high priority. And so I wanted to clarify that with women, that it’s normal not to. But it also is something to look at and say, well, what am I doing? Am I being overly stressed by my life? Am I putting too much on my agenda? You know, don’t volunteer for the PTA and the soccer club and do five million things because having a good relationship with your partner is a very important part of your life. And that doesn’t mean just physically but emotionally, and spending time together, even if it’s just having dinner together, walking on the beach, discussing things honestly, that’s going to improve her overall health and her ability to manage her life much better than running around with your head cut off.

CAVANAUGH: My guest is Dr. Diana Hoppe. The book is "Healthy Sex Drive, Healthy You.” We’re taking your calls at 1-888-895-5727. Maria is on the line from San Diego. And good morning, Maria. Welcome to These Days.

MARIA (Caller, San Diego): Good morning. Thank you for taking my call.

CAVANAUGH: You’re welcome.

MARIA: I have a question. I’m a mother of two. And my sex drive is much, much lower than it was before I was pregnant with kids. And I’m wondering if there is – if this is something that will stabilize and normalize, go back to normal, or is this something that I’m going to have to get used to and live with for the rest of my life?

CAVANAUGH: Thank you for the call, Maria.

DR. HOPPE: Maria, may I – How old are your children?

MARIA: They’re very young. Yeah, one is three months old, the other one is two.

DR. HOPPE: Yeah, and I think that – that just in itself brings up some interesting points in that once you just have a baby, let’s say you’re breastfeeding, you’re just got – basically taking care of that baby and your two-year-old, there’s not a lot – there’s not that much time left for your husband and for you. And I think that’s where it’s good to talk to your husband and say, you know what, I’m feeling really tired, I don’t have a lot of energy to have sex, can you help me around the house? How can we work together to like still have some form of intimacy but I’m just, you know, not having the same energy like I did before. So I think communicating with your partner and really seeing how you can make life a little bit easier for you, if possible, and then making time to be physical with him, and I think if he can help around the house, help with some of the chores, see where you’re coming from, that really would help the relationship.

CAVANAUGH: As an OB-GYN, you see women when they’re going through periods of not – of having other things to be concerned about…

DR. HOPPE: Absolutely.

CAVANAUGH: …besides, you know, romance and sex. And I’m wondering, are there – can we plot different areas, different times in a woman’s life when her sex drive is just automatically going to be lessened?

DR. HOPPE: Yes. And that’s where, Maria, you come into play because post-partum is a time where definitely your sex drive decreases and that’s normal because if you’re breastfeeding, your estrogen levels, the estrogen in your body, is less, you’re going to have less thoughts about sex, you actually may even have some pain with sex just because the breastfeeding causes different hormonal changes in your body. And so it’s very normal not to have a high drive at this time. Another time would be peri-menopause or menopause, another time where hormone changes can definitely cause a rollercoaster with regard to libido. And even in the monthly cycle, if you think about when are you thinking about sex more than others, mid-cycle when the estrogen levels peak is when women think more about sex. And then like day 21 of the 28-day cycle they’re not going to really be thinking about sex, it’s more kind of the progesterone dominant and they may be a little more lethargic and just sex is not a real priority. So that’s another reason why I wrote it, to have women understand there’s normal cyclical changes in libido within a woman’s lifetime.

CAVANAUGH: So if this is normal, if this is a normal part of a woman’s body ruled by her hormones, is there any reason that you should actually try to change that?

DR. HOPPE: It’s not change that but it’s more to realize what’s happening and then keep it in balance. So that, yes, right now Maria – with Maria, she’s got a three-year-old (sic) and a two-year-old. It’s - They’re going to grow and then they’ll get to one and two and, obviously, get older and that’s when you have to start putting the priorities back and say, you know, right now we may not have as much sex as we had before we were married or had children but now as we move forward, let’s put it as a definite priority in our relationship. Because once the sex starts going away or the physical intimacy, sometimes the relationship emotionally can get really fragmented.

CAVANAUGH: Now, if Maria had called up and said her children were 8 and 10, how would your advice change?

DR. HOPPE: Yeah, I think when they’re 8 and 10 they tend to be, you know, not as dependent on…

CAVANAUGH: Sure.

DR. HOPPE: …mom at that time. And so that’s when you – it’s really important to make date nights. Make nights or weekends you go away. Put it as an in-your-calendar, a set thing. And that maybe have a night your husband can make dinner.

CAVANAUGH: Umm-hmm.

DR. HOPPE: You know, he can do some things to make it a little more romantic, make it easier for mom so she doesn’t have to plan everything. I think women just love if a man can actually plan something and make it work, and have a nice weekend, like a spa weekend or just have some time they can just relax. And so I think that’s when Maria, if she were – had, again, older children, she and her husband would really sit down and say, okay, let’s make this weekend, we’re going to go away. And it doesn’t necessarily have to be a go-away. It could be that the kids stay at the neighbor’s for a night or two nights. And I think having like a cul de sac, like a block that could work together and say, okay, one night you’re going to take the kids on Friday night and we’re take next weekend, so it doesn’t really have to take that much money. So there’s ways to do it with a little imagination.

CAVANAUGH: That’s an interesting idea but just to get back to what we were talking about with the age of the kids, is the difference between a hormonal function within a woman that is basically saying, look, you have other things to be concerned about right now, and her sex drive won’t be too high as opposed to when perhaps the kids are a little older thinking about this as more of an emotional blockage.

DR. HOPPE: Exactly. Right. And so like sometimes women, they start focusing so much on the children that they take away the focus of what – herself as well as her husband or her partner. And that’s when you have to kind of realign and say, okay, am I happy in this regard or am I just doing everything for everyone else? You know, women tend to be caretakers, which is what their role is, but not 100%, 24/7, do they need to be doing that. They need to give something back to themselves and also realize the importance of the relationship with their partner.

CAVANAUGH: I’m speaking with Dr. Diana Hoppe. She’s written a new book, "Healthy Sex Drive, Healthy You: What Your Libido Reveals About Your Life." It’s aimed at women. And we will continue taking your calls when we return from a short break. You’re listening to These Days on KPBS.

CAVANAUGH: I'm Maureen Cavanaugh. You're listening to These Days on KPBS. And thanks to our technical director Kurt Kohnen for that incidental music. My guest is Dr. Diana Hoppe. She is the author of the book, "Healthy Sex Drive, Healthy You: What Your Libido Reveals About Your Life." Dr. Hoppe is an OB-GYN in practice here in San Diego. We’re taking your calls at 1-888-895-5727. Let’s take a call to start out with. John is calling us from San Diego. Good morning, John. Welcome to These Days.

JOHN (Caller, San Diego): Hi. Thanks for taking my call.

CAVANAUGH: You’re welcome.

JOHN: So I have a psychologist friend and we were speaking about couples therapy the other day and he was telling me about years ago there used to be a drug or some sort of prescription chemical used in couples therapy to make couples, you know, more intimate. It had something to do with releasing serotonin levels or something. I was wondering if that is still in practice or if there’s something similar that’s used these days.

DR. HOPPE: Well, John, it brings up an interesting point because you’re asking about like is there a drug that can actually like help a woman’s drive or a man’s drive. And there’s actually a drug that they’re looking at right now and the FDA is considering and that’s called Flibanserin. That is a new compound, a new drug, so that was probably not referring to what your friend had said. But definitely couples therapy in itself is helpful. There’s not real one drug that we use in therapy to increase libido for women. I think for men we’ve found that Viagra or the other medications for erectile dysfunction definitely can help a man feel better about his sexual drive and just be able to perform better in case it’s a psychological issue. For women, it tends not to be a blood flow thing – that Viagra increases blood flow, which is great, but not for a woman who, in the brain, it really is serotonin and it’s dopamine and it’s neurotransmitters that are really regulating her drive. And there has to be a lot of things in place, in alignment, for a woman to actually be aroused and be thinking about sex and wanting sex. So that’s where I think the book – I really try to clarify the differences in men and women and that men have much more of a reflexive way of feeling about sex drive. In women, it tends to be a little bit more complicated and definitely above the belt, in that regard.

CAVANAUGH: Now this drug, Flibancerin, it was – We heard about that just last Friday because it was denied – It was declined by the FDA for some reason. Why was that?

DR. HOPPE: It actually was an agency that gives some recommendations to the FDA.

CAVANAUGH: Oh, okay.

DR. HOPPE: So it wasn’t actually the FDA per se declining it. It was actually an agency that was – that looks at certain medications and then gives an opinion to the FDA. And from their opinion, they felt that it didn’t have sufficient data to actually be released for women for low sex drive. And actually it was studied in women with something called hypo-active sexual desire disorder, which is a very limited subset of women, looking at women who have a total lack of desire and a loss of desire and it causes them to be stressed in their relationship or concerned, so it’s a certain DSM-IV, actually a psychiatric diagnosis. And so I think the FDA is going to look at it further later this year and then determine specifically what’s going to happen with Flibancerin. But that was just an agency that would give its recommendation…

CAVANAUGH: I see.

DR. HOPPE: …to the FDA.

CAVANAUGH: I see. And if, indeed, this drug or some other drug were to come on the market that was aimed at increasing female libido, it would be aimed at increasing some chemicals in the brain…

DR. HOPPE: Exactly.

CAVANAUGH: …is what you’re saying.

DR. HOPPE: Exactly right. Most likely it would be something with dopamine or serotonin and this drug that I mentioned acted at different receptors, the Serotonin receptors in the brain. And I think it brings back to John’s question about therapy, in women it’s a multitude of factors that goes into drive and so if they’re resentful or angry at their partner, if there’s things the partner has done, let’s say infidelity, financial mistakes that would’ve devastated the family, those things have to come out and be discussed because a woman will pretty much harbor that and that’s going to be like something that’s going to inhibit her really from thinking about sex because she has all those things in her mind. Whereas men tend to be able to kind of let those things go. Women’s brains think and remember details, specific details, and so that’s where therapy can be really helpful just to release some of that anger and resentment.

CAVANAUGH: We’re taking your calls at 1-888-895-5727. My guest is Dr. Diana Hoppe. And let’s hear from Colleen calling from Poway. Good morning, Colleen. Welcome to These Days.

COLLEEN (Caller, Poway): Hi. I just would like to know, I’m a – I went through menopause at 40 and I have 5 children and I’m wondering—I’ve 45 now—how I can get my sex drive back either through hormone replacement or I have a fabulous life, a fabulous husband, but I just can’t seem to get that aspect of my life back, and I wanted to know if I could get some help with that. Thanks.

DR. HOPPE: Great question. I think – Let me ask you, so you went through menopause at 40. Were you ever placed on any hormone therapy after that?

CAVANAUGH: Colleen, are you there?

COLLEEN: Yes, I am.

DR. HOPPE: So, I’m sorry, did you get – after you went through menopause at age 40, did you ever receive any hormone therapy?

COLLEEN: Yes, for about 6 months, I was on a hormone patch but it caused bleeding so they took me off of it.

DR. HOPPE: Okay, because there’s ways we can give hormone therapy that you don’t bleed…

COLLEEN: Okay.

DR. HOPPE: …and it can help restore your libido. I’d probably first start with – You have, obviously, your uterus is still in? You have not had a hysterectomy?

COLLEEN: No.

DR. HOPPE: Right. So we would give you a combination of estrogen and progesterone. Progesterone would…

COLLEEN: Umm-hmm.

DR. HOPPE: …help protect the uterus. Estrogen’s going to definitely help make the vaginal tissues basically more supple, more lubricated so you won’t have pain during sex. The estrogen will also help the brain think about sex. And then after that, I’d probably see how you’re doing. If that’s still not helping, potentially I would add testosterone cream to the regimen to help have more thoughts about sex and desire. So definitely there’s things you can do about this.

CAVANAUGH: Now I’m interested in your response because we’ve all been told that estrogen therapy is risky for women. Is it the difference between prolonged estrogen therapy and targeted estrogen therapy?

DR. HOPPE: Yes, it gets pretty complicated because that big study you’re mentioning is the…

CAVANAUGH: Right.

DR. HOPPE: …WHI, which is the Women’s Health Initiative, released in July of 2002. And further analysis of that study has shown that if you take estrogen at a certain time—so timing is important—as well…

CAVANAUGH: Ahh…

DR. HOPPE: …as duration. So if you start estrogen therapy earlier, it actually will be protective for the heart and it will help with your bones, obviously, and cognition and other things. But with regard to heart disease, it definitely will be protective if you start earlier. The breast cancer issue gets kind of convoluted because we’re thinking it may be the synthetic progestins that are the problem because women who are on estrogen alone in that big study showed decreased risk of breast cancer. And, see, and I think the media didn’t really help us that much with that study so I think having a really good discussion with your doctor, specifically an OB-GYN that has this data on hand and knows presently what’s happening to give you the best information so that then you can make the decision because there are risks and benefits but there are also a lot of benefits that I think women don’t get the information about.

CAVANAUGH: Let’s take another call. Susan’s calling us from San Diego. Good morning, Susan, and welcome to These Days.

SUSAN (Caller, San Diego): Oh, hello. I was driving on the freeway and I heard what the doctor said about older women and I couldn’t wait to get home to say you are so wrong. Thank God. I’m 86, going on 87, and I have a sex life that you will dream about. So cheer up. Things are really looking good at the very end. That’s it.

DR. HOPPE: I want to tell you, though, I totally agree with you. I said in general there are times where it can go down. I think it’s wonderful. I have patients who are in their eighties just like you.

SUSAN: Yeah, oh boy.

DR. HOPPE: They’re having sex two or three times a week, even more, and they’re totally happy. I think that’s absolutely wonderful.

SUSAN: Yes. Uh-huh. Yeah.

DR. HOPPE: So keep it up. I’m not disagreeing with you at all. I just wanted to give the point that at certain times there may be a decrease. Keep it up, congratulations, and more to you.

CAVANAUGH: Susan, more power to you. Allison is calling us from San Diego. Good morning, Allison, welcome to These Days.

ALLISON (Caller, San Diego): Good morning. Thanks for having me on the show. Hey, I just wanted to give a comment that I’m kind of upset about the double standard and all the measures that there are to increase a woman’s sex drive and keep a guy, you know, with Viagra and all the pills and the hormones, like the women’s sex drive is the problem. Why don’t we have pills to decrease men’s sex drive? I’ll take my comment off the air.

CAVANAUGH: Thank you, Allison.

DR. HOPPE: Good point. I think that, again, balance is an issue so a woman, like what is normal for a woman? It varies. And that men have a higher sex drive than women. That’s just a basic given.

CAVANAUGH: Right.

DR. HOPPE: To make a man’s sex drive go down, you’d probably have to give him something that would inhibit testosterone which would mean he would not have the same kind of, you know, manliness to him. And I’m not saying that’s right or wrong but I’m saying that’s why they never made a male birth control pill. A, because they couldn’t give anything that would help – that would decrease the testosterone. Men weren’t willing to do that.

CAVANAUGH: But isn’t still the male sex drive, the male body, really even the standard for medicine and women are also – are always sort of trying to catch up and…

DR. HOPPE: Right, and luckily now we’re doing a lot more studies on women. I think previously they thought men and women were equal, that they were the same. Obviously, we know that is not true, so you can’t take a result in a man’s study and…

CAVANAUGH: Right.

DR. HOPPE: …and then take it to a woman. So now we’re having many more studies in women that are being done which will give us a better idea of what’s happening. I totally agree with you about the double standard. I think it has to be like what does a woman – where does she feel happy in her relationship and how much sex does she want? And then how much does her partner want? And then what other ways can they feel connected? It doesn’t have to be just having sex.

CAVANAUGH: Right, so with this focus on women, what are some of the health benefits of sex and physical intimacy that perhaps women have never been taught or they ignore?

DR. HOPPE: Yes, some of the things in – When I was doing the writing for the book, I found that various health benefits were it helps the immune system. And it has to do, again, with how you’re feeling with sex. If you’re feeling that intimate, emotionally feeling calm and happy, that’s going to actually release certain things in the body that are going to be helpful, endorphins and certain chemicals. That helps make the immune system stronger so it helps prevent against certain, they said, viruses and diseases, it can make you sleep better, it can ease depression, it can actually help with heart health. So that if you have a good relationship with your partner, there’s – that’s not filled with resentment or anger, you actually can have a 34% decreased risk of cardiovascular disease. So I think the relationship is what has to be important, it’s not just having sex because I have some women who say, you know, yes, I do, and I just lie there. Well, that’s not really being helpful to her partner for herself because that could actually be causing more negative reaction going on rather than how can she be happy in this relationship as well as her partner.

CAVANAUGH: But the important part of – the most essential part, I think, of what you’ve said, is the fact that, indeed, if you’re having a good sex life, you’re go – might even be physically healthier.

DR. HOPPE: Exactly. It’s not to say if you’re not in a sexual relationship, like that’s if you’re single…

CAVANAUGH: Umm-hmm.

DR. HOPPE: …that that’s a bad thing, it’s just that if you’re in a relationship with someone and having a good physical intimacy, normally that also means you’re probably emotionally and more spiritually and just feeling more connected overall, so it’s a general wellbeing.

CAVANAUGH: I want to ask you just quickly about some of – the reason that you decided to self-publish this book because I think that it really goes to what you’re trying to do with "Healthy Sex Drive, Healthy You.” You submitted this to a publisher and it was accepted.

DR. HOPPE: Correct. And the publisher, in all their own right, they wanted to market it and have a title that was very snappy and so they had wanted a title ‘An Orgasm A Day Keeps the Doctor Away.’ Now I can understand it’s, you know, kind of catchy but it really didn’t focus on what the book was about because I don’t believe just having an orgasm a day in itself is going to be meaningful. It has to be what’s behind that and if you’re actually like the 86 year old who’s having sex as often and she’s happy, that’s wonderful. She’s in a great relationship. But if it’s just having sex just to have sex, that’s not the premise of the book. It’s all the things that go behind what makes a woman think about sex, what makes her body feel, you know, like self-esteem is a major issue. How is she taking care of herself with sleep? So all those things are involved, and that’s why I see it as a wellbeing, and it’s not just a have an orgasm and you’ll be fine.

CAVANAUGH: Because you make the point in the book that it’s – not only does sex make you healthier but being healthier also increases your interest in sex.

DR. HOPPE: Exactly. So if you feel good about your body, let’s say you’re exercising a few times a week, you’re feeling toned. A lot of women feel much better about their bodies, they’re going to feel more attractive and have more of a drive than if you’re kind of feeling, you know, that extra 10, 20 pounds just really doesn’t make me look good. And, really, men want to be with their women. They want to make women happy. And I think we tend to be very critical of our bodies. Some of that’s the media, some of it’s just life, but I think if we can just be more accepting of these are our bodies and let’s make the best of it, we’d have a lot more fun.

CAVANAUGH: Like our friend Susan, who’s 86.

DR. HOPPE: Exactly.

CAVANAUGH: Let me just say one thing, too, as part of the material that came with your book, it’s all these lists of foods and things that can help perhaps increase your libido. Do you really go along with that kind of thing or does that kind of just come down to us from tradition?

DR. HOPPE: Yeah. I kind of made a little joke in the book about that because it’s kind of a fun chapter. I think that it depends how you view it.

CAVANAUGH: Umm-hmm.

DR. HOPPE: I think if you think it’s an aphrodisiac, sure it could be one, like oysters. There’s certain foods that definitely contain certain chemicals that can help with hormone production and let’s say with chili peppers, it might make you feel somewhat flushed and kind of hot. So that may think, oh, this is an aphrodisiac. So I think it depends on how you’re seeing it and how you’re viewing it. Definitely, those foods are good for you and I think that it’s mostly fiction versus fact.

CAVANAUGH: Dr. Hoppe, thank you so much for speaking with us today. I really appreciate it.

DR. HOPPE: Oh, thank you so much.

CAVANAUGH: Dr. Diana Hoppe is the author of "Healthy Sex Drive, Healthy You: What Your Libido Reveals About Your Life." Dr. Hoppe will be speaking and signing copies of her book, "Healthy Sex Drive, Healthy You” this Saturday at 10:30 a.m. at Earthsong Books in Del Mar. And if you’d like to comment, you can go online, KPBS.org/thesedays. You’ve been listening to These Days here on KPBS.