In this episode of The Choice Space, Dr Lee David speaks with Samantha Evans, sexual health and pleasure expert and co-founder of Jo Divine, about sexual health, intimacy and how our relationship with our bodies can change across life. The conversation explores how physical changes, life transitions and wider social influences can affect how we experience intimacy – and how we make sense of those changes.
Sexual health is an area that many people still find difficult to talk about, despite its close links to both physical and emotional wellbeing. When experiences remain unspoken, it can be easy to assume that changes mean something has been lost or is no longer possible. This conversation offers a more open and grounded way of understanding these shifts, and how people might reconnect with their bodies and relationships in ways that feel right for them.
Changing bodies over time
Across life, bodies change in ways that are both expected and unexpected. Hormonal shifts, ageing, illness and medication can all influence how the body responds, including changes in lubrication, sensation and desire. These changes are common, yet often feel surprising when they happen.
The conversation highlights how these shifts are not a sign that something is “wrong”, but rather a reflection of how the body adapts over time. Hormones such as oestrogen play a key role in vaginal health, and as levels change, so too can comfort and responsiveness.
In everyday life, this can show up as discomfort, reduced confidence or uncertainty about what is happening. Without a clear understanding, people may assume that intimacy is no longer accessible, rather than recognising that the body may simply need something different.
Understanding common concerns
Many people experience concerns such as vaginal dryness, irritation or changes in sensation, yet may not realise how common these experiences are. These issues can affect people at different life stages, not only during menopause.
The discussion explores how factors such as medication, stress, breastfeeding and cancer treatment can all influence sexual health. It also highlights how everyday products, including those used for washing or lubrication, can contribute to irritation without people being aware of it.
In daily life, this may lead to ongoing discomfort or repeated symptoms that feel difficult to explain. Understanding these patterns can help shift the experience from something confusing or distressing to something that can be understood more clearly.
The impact of silence
Sexual health remains an area surrounded by silence for many people. Cultural messages, upbringing and lack of education can all contribute to a sense that this is not something to talk about openly.
The conversation reflects on how this silence can lead to shame and isolation. When people feel unable to name what they are experiencing, it becomes harder to seek support or explore possible solutions. This can be true not only for individuals but also for healthcare professionals who may feel uncertain about how to start these conversations.
In everyday situations, this may look like hesitation, avoidance or leaving concerns unspoken. Over time, this can reinforce the idea that these experiences are unusual or personal, rather than shared and understandable.
Language and inclusivity
The way we talk about sexual health shapes who feels included in the conversation. The discussion highlights the importance of using language that reflects a wide range of experiences, without making assumptions about identity, relationships or the type of intimacy people have.
Moving beyond narrow definitions of sex allows for a broader understanding of intimacy, including emotional connection, solo experiences and different forms of physical closeness. This helps create space for more people to recognise themselves in the conversation.
In everyday life, this may support people in feeling seen and acknowledged, rather than excluded. It also encourages a more open and curious approach when talking to others, whether in personal relationships or professional settings.
Rethinking intimacy and pleasure
There can be strong assumptions about how intimacy “should” look, including expectations around desire, arousal and performance. The conversation challenges some of these myths, including the idea that the body should respond in a particular way or that needing support means something is wrong.
Instead, intimacy is framed as something that can evolve over time. Using lubrication, exploring different forms of touch or adapting how intimacy happens can all be part of maintaining connection and pleasure.
In everyday experience, this can shift the focus from trying to return to how things used to be, towards exploring what works now. This opens up a more flexible and less pressured way of approaching intimacy.
Body image and self-perception
Changes in the body can also affect how people see themselves. Weight changes, ageing, illness or surgery can all influence body confidence, which in turn can impact intimacy.
The conversation reflects on how self-criticism and comparison can create barriers, particularly when there are strong societal expectations around appearance. At the same time, there is a growing shift towards more diverse and realistic representations of bodies.
In everyday life, this may show up as hesitation or self-consciousness in intimate situations. It also highlights how the way people relate to their own bodies can shape their experience of connection with others.
Intimacy, loss and change
Intimacy is not only affected by physical changes but also by life experiences such as bereavement or changes within a relationship. The idea of “sexual bereavement” highlights how the loss of intimacy can be experienced as a significant absence in itself.
The conversation explores how people may navigate these changes, including finding different ways to maintain a sense of connection or closeness. This may involve rethinking what intimacy means in the context of changing circumstances.
In everyday life, this can be a complex and often unspoken experience. Recognising it as a valid form of loss can help create space for understanding and reflection.
Choice Space takeaways – small, workable steps
- Notice changes in your body as part of a wider pattern across life
- Reflect on how messages about sex and intimacy have shaped your thinking
- Allow room for different forms of intimacy beyond fixed expectations
- Recognise the role of language in shaping inclusion and understanding
- Consider how self-perception influences connection with others
- Make space for curiosity about what works for you now
Closing reflection
This conversation offers a way of understanding sexual health and intimacy as something that evolves across life, rather than something that is fixed or lost. It highlights how small shifts in awareness and perspective can support a more open and compassionate relationship with the body and with others.
About the guest
Samantha Evans is a sexual health and pleasure expert, former nurse and co-founder of Jo Divine, an online company specialising in skin-safe, irritant-free sexual wellbeing products. She works with healthcare professionals across the NHS and private practice to support patients with sexual function, intimacy and pleasure, including lubricants, vaginal moisturisers and appropriate products. Samantha is also a writer and educator, producing practical resources that help normalise conversations about sex and support people to explore intimacy in ways that work for them. She collaborates with cancer and menopause charities, delivers training and webinars for healthcare professionals, and has contributed to media discussions on sexual health, including appearing in Sex, Myths and the Menopause.
You can connect via the Jo Divine website, Facebook or Instagram: @samtalkssex and @jo.divine
