Ep. 418: [Soapbox] Don’t Accept Sex Your Partner Doesn’t Want

Host Jessa Zimmerman welcomes back sex therapist Dr. Jennifer Valli to discuss how breast cancer and its treatments affect sexuality and quality of life, emphasizing that experiences vary widely and that similar issues can arise with aging and other medical changes. They review sexual impacts of surgery (loss of nipple/breast sensitivity, pain, grief), radiation (gradual tightening, texture and symmetry changes), chemotherapy (reduced desire via hormonal effects, fatigue, vaginal dryness from ovarian damage, and possible loss of pubic hair), and endocrine therapies like tamoxifen and aromatase inhibitors (often long-term, causing “menopause on steroids” symptoms and adherence challenges). They outline practical strategies including body mapping, lubrication, pelvic floor physical therapy, devices like the Ohnut, dilators, and evolving guidance on topical estrogen for vaginal dryness. They address responsive desire, non-penetrative intimacy, orgasm and body image, caregiver–patient dynamics, and exercises to rebuild self-compassion and erotic identity. Valle shares her own breast cancer diagnosis, treatment navigation challenges, and how the experience deepened her work, and provides her website (jennifervalley.com).00:00 Welcome to Better Sex00:45 Why Breast Cancer Matters04:20 Sex as Quality of Life06:58 Surgery and Sensation Changes09:10 Radiation Effects Over Time11:39 Chemo and Intimacy Challenges15:06 Hormone Therapy Side Effects18:54 Managing Dryness and Desire23:12 Body Image and Orgasm25:03 Body Ally Mindset27:44 Hotspots and Blind Spots28:03 Scar Study and Self Projection29:33 Caregiving Roles and Confidence31:13 Sex Therapy Tools and Covering Up32:15 When Sex Hurts and Identity Shifts33:45 Caregiver to Lover Again34:46 Erotic Image Assignment37:53 Her Breast Cancer Diagnosis40:06 Treatment Choices and Advocacy42:50 Family Support and Coping47:14 Aftereffects and Practice Changes50:17 Where to Find Jennifer Valli51:02 Final Thanks and Sign OffWant to share your personal story? Email Jessa at [email protected]:Jennifer Valli, PhD, is a seasoned psychotherapist with 34 years of clinical experience in behavioral health and psychiatry. She is a licensed therapist in Tennessee and is also nationally certified as a Sex Therapist through AASECT, the American Association of Sexuality Educators, Counselors, and Therapists, a rigorous credentialing program in sex therapy. A portion of Dr. Valli’s AASECT training was completed in the area of paraphilias and fetishes. In 2014, she completed a comprehensive post-graduate program in sex therapy at the University of Michigan. She holds a PhD in Clinical Sexology and, as a lifelong learner, earned a second doctorate from the University of Southern California focused on Macro Social Change, Innovation, and Social Work. Dr. Valli is an Assistant Professor at the University of Tennessee Health Science Center and a proud member of both the Urology and OB-GYN departments. She has given several local and national talks on sexual health including prostate and breast cancer, along with three other interviews for this podcast: men’s sexual health, fetishes and paraphilias, and sex and prostate cancer. She is so happy to be with us today.

Host Jessa Zimmerman shares a personal story from a coaching workshop to illustrate how the meaning we assign to events shapes our emotions, physiology, behavior, and ultimately our results. After waiting two hours to ask her mentor James a question and losing her chance when the room closed, Jessa initially felt angry and resentful, blaming another attendee for taking too long. By the time she reached the elevator, she experimented with a different interpretation—maybe others needed the conversation, maybe it served a greater good, and maybe she didn’t need to ask that night—and her body relaxed and her mood shifted. She later realized she found her own answer, and at a later workshop James remembered and called on her first. Jessa invites listeners to notice their relationship stories, choose alternative thoughts that help them show up better, and create different outcomes.00:00 Welcome to Better Sex00:45 Soapbox Episode Setup01:08 Workshop Question Build Up02:03 Two Hour Wait Frustration02:57 Cut Off at Midnight03:45 Reframing the Story05:19 Lesson on Mindset Cycles06:33 Try New Thoughts06:57 Outro and Credits Want to learn more about my sponsored charity? Charity: Water is committed to providing clean water to every human on the planet, 100% of your contribution will be used directly for water projects around the globe. You can learn more at https://www.bettersexpodcast.com/water.More info and resources:Secret Podcast for the Higher Desire Partner: https://www.intimacywithease.com/hdppodcastSecret Podcast for the Lower Desire Partner: https://www.intimacywithease.com/ldppodcastHow Big a Problem is Your Sex Life? Quiz – https://www.sexlifequiz.com The Course – https://www.intimacywithease.com/iwecourseThe Book – https://www.sexwithoutstress.com Access the Free webinar: Intimacy Made Easy: 3 Secrets to Bridging Libido Differences: https://intimacywithease.com/masterclass Intimacy with Ease is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.

Host Jessa Zimmerman welcomes Andre Lazarus back to discuss delayed ejaculation, defining it as a consistent difficulty reaching ejaculation that becomes a concern when it bothers the person or impacts the relationship. Andre describes common contributing factors including medications (such as SSRIs), alcohol and other substances, masturbation habits, and physiological issues, but notes that many people can ejaculate during self-pleasure and struggle mainly with a partner due to psychological pressure and performance expectations. They explore how partners may misinterpret delayed ejaculation as lack of attraction, how focusing on pleasing a partner can disconnect someone from their own sensation, and how communication and “selfish” attention to one’s own pleasure can help. Andre emphasizes de-shaming, reducing goal pressure, and calming the nervous system through simple, patient breathing, and shares ways to work with him through workshops, his Talented Lover course, and coaching at coming-closer.com.00:00 Welcome to Better Sex01:22 Delayed Ejaculation Defined03:25 Real Life Patterns06:42 Pressure and Nervous System08:31 Selfish Pleasure and Feedback13:19 Masculinity and Performance Myths18:59 Partner Support Without Pressure20:58 Calming the Nervous System22:47 Where to Find Andre24:38 Final Wrap UpFind Jessa’s resources for mismatched libido at https://www.desirediscrepancy.comBio: Andre Lazarus is a Somatic Intimacy Guide and media-recognised voice on relationships, sexuality, and embodied connection. His career has followed an unconventional path: from serving in the U.S. Marines to guiding people through the complexities of intimacy and desire. That breadth of experience gives him a distinctive perspective on courage, vulnerability, and human connection. He is best known for his role on the UK television series Virgin Island, where he appeared as a professional surrogate partner helping participants confront intimacy challenges alongside licensed therapists. The program drew national attention, and Andre’s presence on screen highlighted how intimacy work is not about performance but about safety, consent, and the courage to connect. Through his practice, Coming Closer, Andre supports individuals and couples across a wide range of needs: men facing midlife performance concerns, survivors of trauma seeking safety, long-term partners wanting to revive passion, and those exploring alternatives such as ethical non-monogamy. Equally, he works with couples committed to monogamy who want to strengthen trust and rediscover each other. His approach, rooted in the Somatica® Method of sex and intimacy coaching, emphasises learning through the body and replacing shame with curiosity. While Andre has also taught workshops introducing kink and alternative practices, he situates them within a broader conversation: how people of all backgrounds can embrace intimacy as part of their wellbeing. His message consistently comes back to honesty, communication, and self-awareness as the foundations for connection. Today, Andre balances private coaching, workshops, and a men’s online course on sexual communication with growing media visibility, including the upcoming second season of Virgin Island.www.coming-closer.comWant to learn more about my sponsored charity? Charity: Water is committed to providing clean water to every human on the planet, 100% of your contribution will be used directly for water projects around the globe. You can learn more at https://www.bettersexpodcast.com/water.More info and resources:Secret Podcast for the Higher Desire Partner: https://www.intimacywithease.com/hdppodcastSecret Podcast for the Lower Desire Partner: https://www.intimacywithease.com/ldppodcastHow Big a Problem is Your Sex Life? Quiz – https://www.sexlifequiz.com The Course – https://www.intimacywithease.com/iwecourseThe Book – https://www.sexwithoutstress.com Access the Free webinar: Intimacy Made Easy: 3 Secrets to Bridging Libido Differences: https:/

In this soapbox episode of the Better Sex Podcast, host and sex therapist Jessa Zimmerman suggests couples create explicit relationship agreements—written down and revisited during hard moments—rather than assuming they share the same expectations. Inspired by classroom agreements used at the start of a college sexuality course, Jessa proposes making agreements when partners feel calm and connected, then using them as a guide during difficult conversations. She offers five sample agreements: assume goodwill and give your partner the benefit of the doubt; use “I” statements instead of blame; approach conflict with curiosity; give yourselves permission to mess up and return gently to the agreements; and practice accountability by owning your own contributions and mistakes first before inviting your partner to do the same.00:00 Welcome to Better Sex00:46 Why Make Agreements02:12 Write Them Down02:29 Assume Goodwill03:00 Use I Statements03:30 Lead With Curiosity04:07 Permission to Mess Up04:43 Accountability Matters05:49 Try This at Home06:22 Closing and Credits

Host Jessa Zimmerman talks with Robert Johnson and Anna Osman from Shameless Care about common gaps in “full panel” STI testing and why site-specific screening matters, especially throat swabs for gonorrhea and chlamydia. Robert shares how an asymptomatic oral gonorrhea infection went undetected through standard testing and how limited clinician awareness and testing workflows contribute to missed infections; Anna explains there’s no single comprehensive “magic button” test and missed swabs are common in busy clinics. They discuss HPV’s site specificity and the importance of vaccination, differences in treating oral vs genital gonorrhea (including the need for retesting), and how reducing shame and improving education can make sex safer and more enjoyable. They outline Shameless Care’s telehealth model, at-home 14-panel kits (including oral and anal swabs and dried blood spot testing), prescriptions for treatable STIs, sexual-function treatments (including options for women), doxycycline PEP for post-exposure risk reduction, window periods, and the value of thoroughness over frequency in testing.00:00 Welcome to Better Sex00:44 Meet Shameless Care01:35 The Missed Throat Swab05:03 Why Full Panels Fail05:58 Oral STIs and HPV08:51 Treatment and Retesting09:22 Shame Free Sexual Health11:57 Beyond Testing Services15:47 Telehealth Privacy Screening18:13 At Home STI Kit20:12 Doxy PEP Explained22:47 Testing Timing and Windows27:04 Cost Panels and Advocacy28:47 No Subscriptions Promise29:40 Sharing Results With Partners31:32 Closing and CreditsSubscribe to Jessa on Substack: https://www.intimacywithease.com/substackBio:Robert Johnson is the founder of Shameless Care, a telehealth company dedicated to making sexual healthcare more accessible, more transparent, and free of judgment. After discovering that his own STI had been missed because it wasn’t tested at the correct anatomical site, he set out to help solve a problem he believes affects millions of people: too many people never get the sexual healthcare they need, and many don’t even realize it. Today, Shameless Care connects people with board-certified physicians, custom medications, and comprehensive laboratory testing right on their phones. Through educational videos, podcast appearances, and public speaking, Robert challenges common misconceptions about sexual health and telemedicine, with the goal of helping people make informed decisions and enjoy healthier, more confident sex lives.Grab your discount with code Better15 at https://shamelesscare.sjv.io/m4rrBe