Low Desire After a Baby or in Menopause: What a Neuroscientist Taught Me

The first time I heard Dr. Nan Wise, I was in my car with my boys, listening to Science Vs. We listened to that podcast together all the time, and the episode that day was the most popular one the show ever made. It was called Orgasms. Yes, I played it with my kids in the car, and yes, we had a great conversation about it afterwards. That is how we roll in my family.

Nan was the researcher at the centre of that episode. She is a cognitive neuroscientist at Rutgers who scanned women's brains in an fMRI machine during orgasm, with volunteers who, in her words, donated orgasms to science. I could not stop thinking about it.

Months later, when I decided to start The Hole Shebang Podcast, hers was the first name I wrote down. I messaged her on Instagram expecting complete rejection. She was a famous neuroscientist and I was a physiotherapist in Dundas, Ontario with a podcast that did not exist yet. She wrote back almost right away: "I would love to." Then she sent me her book, Why Good Sex Matters. I told her she had made my day, and I nearly cried, which tells you what her yes meant to me. That became Episode 1 in September 2024, and it is still the most downloaded episode we have ever made.

One hundred episodes later, she came back. She promised she would, and she is the kind of person who keeps that promise. Episode 100 might be the most useful hour of free help we have ever put out, and I want to tell you what is in it, because it was made for the two women I see in my clinic more than anyone else. The first is the new mom whose desire disappeared somewhere between delivery and month eight of broken sleep, quietly wondering if it is ever coming back. The second is the woman in perimenopause or past menopause who has started to believe that part of her life is over. Nan's message to both of you is the same, and it starts in the brain.

Your desire is not gone. It changed shape.

Postpartum and menopause look remarkably alike inside the brain. Both are steep drops in estrogen, one for a season and one for good, and both quiet the out-of-nowhere kind of desire. Nan calls that spontaneous desire, and she draws a line between it and receptive desire, the kind that can be kindled. With enough safety and the right conditions, arousal comes first and the wanting follows. If you have been waiting to feel like your old self before you touch anyone, that wait can be long. Set up the conditions, and let the wanting catch up.

The work starts outside the bedroom

When desire drops, more pressure to have sex fixes nothing. Nan calls the alternative healthy hedonism: rebuilding your capacity for pleasure in ordinary life first. Savouring one square of chocolate instead of inhaling the bar. A few minutes of gratitude. Real rest, and a large dose of self compassion. Pleasure creates good feelings, and good feelings make room for more pleasure, which is the exact opposite of the stress loop that shuts everything down. Her research even suggests the brain barely separates an imagined pleasure from a lived one, so anticipating something you love starts doing you good before it happens.

The pleasure playground

My favourite idea in the whole episode. Kids at a playground do not plan how they are supposed to play. They show up and use what is there. Nan's invitation is to bring that same spirit back to intimacy: your whole body, every sense, curiosity instead of performance. On the episode she walks through her "get in touch" plan for couples step by step, slowing everything down and touching to feel rather than to perform. And she has real hope to offer, because some of the best sex people report having comes later in life, once the pressure to look a certain way falls off.

One clinical note from my side of the room. If dryness or pain is part of your story, postpartum or in menopause, the brain starts bracing for that pain and desire drops further to protect you. That is exactly where pelvic health physiotherapy and Nan's pleasure-first approach work together, and it is what we treat every day at Blueberry Therapy.

The kind of person she is

I wanted to write this post to celebrate Nan as much as the episode. When I created The Pleasure Principle Conference, I knew before I finished the thought who I wanted as my keynote speaker. I asked. She did not hesitate, and she and her husband travelled from New Jersey to Hamilton for our inaugural year in 2025. The night before the conference, we shared a dinner I will remember for a long time. She is generous, she is brilliant and she is the same warm human off stage as on.

She said something in our first conversation that I have repeated to patients, to friends and to myself ever since: pleasure is not a luxury, it is a necessity. One hundred episodes later, I believe it more than I did then.

Where to listen

Episode 100 of The Hole Shebang, The Pleasure Playground with Dr. Nan Wise, is free at podcast.blueberrytherapy.ca. Start with Episode 1 if you want to hear where it all began. And if pain or dryness sounds like your body, our pelvic health physiotherapists can help. Book a discovery call at blueberrytherapy.ca.

Nan, thank you for saying yes to a stranger in your Instagram messages. You changed what this podcast became, and me along with it.

Questions I hear all the time

Why is my sex drive so low after having a baby?

Estrogen drops steeply after birth and stays low while breastfeeding, and your brain shifts into caretaking mode, which quiets spontaneous desire on purpose. It is common, it is normal and it is workable. Neuroscientist Dr. Nan Wise explains what is happening and what helps on episode 100 of The Hole Shebang podcast.

Is it normal to lose interest in sex in perimenopause or after menopause?

Yes, and it does not mean desire is finished. The estrogen shift of menopause quiets the spontaneous kind of desire, but receptive desire, the kind that responds to the right conditions, stays available at every age. Many women report some of their best sex later in life.

What is receptive desire?

Receptive desire is desire that follows arousal instead of leading it. You may never feel struck by wanting out of nowhere the way you once did, but with safety, time and the right conditions, arousal can come first and the wanting catches up. Sex researchers consider it as normal and common as spontaneous desire.

How do I get my desire back naturally?

Start outside the bedroom. Rebuild your capacity for pleasure with savouring, rest and self compassion, take the pressure off intercourse, and slow way down with your partner. If dryness or pain with sex is part of the picture, a pelvic health physiotherapist can treat that directly.