Re-Framing How We Think About Sex and Menopause with Dr. Brandye Wilson-Manigat

You remember a time when sex was the best thing ever, but now, you can take it or leave it…mostly leave it. After showing up for work, your partner, the kids (two-legged or four) and their activities, and taking care of your aging relatives, you fall into bed exhausted every night. You lost your sexy years ago and you’re too tired to even think about how to get it back. You’ve become resigned to this as your new reality…you used to enjoy sex and now you don’t. You’re older…it happens, right? You chalk it up to menopause (whatever that means) and settle into the stereotypical tropes that come along with it. But Dr. Brandye Wilson-Manigat says not so fast…

“Menopause is not a death sentence for your sex drive. Most of the time, whatever ideas, thoughts, or beliefs that a woman has had about sex and pleasure earlier in her life continue to influence how she feels about sex and pleasure in perimenopause.”

The Pleasure Principle and the Menopause Myth

A certified OB-GYN and women’s pleasure coach, Dr. Brandye Wilson-Manigat, has led a thriving clinical practice providing quality women’s health services in the Los Angeles area for more than a decade. She began her libido coaching practice for women in 2013 after encountering numerous patients who believed they were “going through menopause” after experiencing a dip in their desire for sex.

“The coaching is for women who are really struggling with low libido. They just want to enjoy their sex lives again but don’t believe it’s possible. They’ll say, ‘look, I know I used to want it, and now I don’t, and I can’t figure out why’.”

It was this recurring frustration among the women she was encountering that spurred her mission to address the myths that so many of us have around pleasure and sexual desire. Being able to provide accurate information about the power and purpose of sex, and the holistic integration of its physical, mental, emotional, and spiritual dimensions are at the heart of her passion. She coaches women that when these things are in sync, they can create a long-lasting positive change in how you view yourself, your body, and your pleasure.

Dr. Brandye, who also struggled with low libido firsthand in her twenties, knows that if it’s not related to a physical concern or limitation, the lack of interest in or desire for sex is often due to a mental or emotional block, or a natural stress response resulting from fatigue.

“Whether it be with the younger women, who are just running around like crazy, doing a whole bunch of stuff — going to bed late and waking up early — or the perimenopausal or post-menopausal women who can’t get sleep because they’re experiencing mood changes or anxiety, or are having their sleep interrupted because of hot flashes,” Dr. Brandye says that the number one reason women do not want sex is that they are tired and aren’t getting enough rest.

Sleep – It’s What the Doctor Ordered

During her 1:1 coaching sessions, Dr. Brandye tries to understand as much she can about what’s going on in her client’s life so she can help them focus on the particular issues that might need to be addressed. For many of her clients this includes understanding and helping them optimize their sleeping patterns. She explains that if you aren’t getting enough sleep, then your body thinks you are chronically stressed, which puts you in a “fight or flight” mode.

“It’s during times of chronic stress when you think, ‘OK, there’s danger’ and evolutionarily your body’s saying, ‘we shouldn’t be trying to have a baby right now, so we shouldn’t be having sex’. And so the sex drive is suppressed,” she explains. “But also, if you’re in a chronic state of stress, your body has to make a decision about what hormones it’s going to make, because the hormones that are responsible for your sex drive – the progesterone, testosterone, estrogen – and the hormones that are responsible for mobilizing sugar from your liver and making sure you have adrenaline and all that good stuff, all come from the same precursor molecule. So, if there’s a pathway and a decision that has to be made, like ‘do we take our resources to make these hormones so we can make sure that we’re able to run or fight?’ Versus, ‘do we take these resources and make hormones to help you to have a baby? Your body’s like, ‘uh-uh, bump that. We might need to run. I’m gonna give you these over here instead’. So, you’ll have a decrease in those sex hormones. And that can make it difficult for you to want to have sex.”

She advises her clients that it’s important to eat well, take time for themselves (“you can’t pour from an empty cup”), and get the rest they need and deserve. Helping her clients address the root cause of their sleep disturbances can be a game-changer in helping them reclaim their libido.

The Brain is Our Biggest Sex Organ

While good sleep is critical to maintaining a healthy libido, Dr. Brandye says it’s just as important to set appropriate boundaries for our time and who we let into our space. She also explains that unlike men, who are visually aroused, sexual stimulation is also often psychological for women and we have multiple pathways to desire and arousal that must be activated.

“As we get older, we become conscious of our changing bodies. We have children and things change. Or we start to gain weight in places we’ve never had problems with. Our bodies become unfamiliar and we definitely feel some kind of way about that. Then there are the relationship dynamics with our partner and what’s actually happening in the relationship. Do I feel loved? Do I feel cherished? Or do I feel seen and heard? So, you know, there’s a lot that goes into it.”

She coaches her patients that there are many different ways that a woman can come to a place of being open and receptive to sex. And it starts in the brain. While there are about 10 erogenous zones on a woman’s body, Dr. Brandye says that the brain is our biggest sex organ and if we can activate our brain, the body will follow.

For example, when we feel seen and supported by our partner in a way that alleviates our stress and promotes our overall well-being, that can translate to a sense of feeling loved and cared for, which makes us more receptive to the physical action of sex and being able to give of ourselves and open up in an intimate way.

Re-framing Pleasure as a Need, Not a Want

Dr. Brandye recommends that women who don’t have a partner (or even those who do), develop a regular self-pleasure practice – or what she calls “solo-play”. She says this will help us become more comfortable exploring our bodies, and ultimately know what feels good to us.

“Women do a lot and are depriving themselves of a lot of pleasurable things, not only sex.”

There are also other ways of experiencing pleasure for women who aren’t comfortable with the topic of masturbation. These include savoring a great meal, appreciating your body through clothing that makes you feel great, just being in nature or enjoying a walk along the water…even reading for leisure. Dr. Brandye advises that being intentional about doing things that pour into your soul (rather than deplete it) will help you develop a pleasure practice that will make the rest of your life better.

She says that many of the women who seek her counsel through coaching often share that they don’t feel desirable, or they’re mired in the stigma that pleasure is a luxury they are not worthy of or a frivolity they don’t have time for. However, Dr. Brandye advocates that you’ve got to give to yourself first, and then you can give the surplus to other people.

A Happy, Healthy Sex Life is an Act of Self-Care

Dr. Brandye believes that having good sex is an act of self-care, because “it’s a part of who we are.” We are sexual beings with the ability to enjoy sexual activity and experience pleasure and she believes that when you shut that off, you’re literally shutting down a part of yourself.

Through her coaching, Dr. Brandye says that she wants women to feel sexy.

“And when I say sexy, what I mean is that I want women to feel comfortable in the skin that they’re in. And I want them to have confidence in themselves, that no matter what comes their way, they can handle it.”

She wants women – particularly Black women – to feel empowered about their sexual health and understand their bodies and how they work. She wants them to know that they are worthy of pleasure and know how to get it without selling their souls.

“You are worthy and deserving of pleasure and know that menopause is not a death sentence to your sex drive. If you’re not having the sex you want, let’s talk.”

To learn more about Dr. Brandye or to sign up for virtual strategy session, visit You can also follow her on Instagram (@dr.brandyemd) and Facebook (

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