Perfectly Normal
Power Surge™ Live!
Host: Dearest
Guest: Dr. Sandra Pertot
Living and Loving with Low Libido

About Dr. Sandra Pertot

Perfectly Normal: Living and Loving with Low Libido

Dearest: My guest tonight is SANDRA PERTOT, PH.D. Dr. Pertot is a Clinical Psychologist and Sex Therapist in private practice. She has been published in Woman's Day, Penthouse, and many publications in Australia where she lives. Dr. Pertot's new book, "Perfectly Normal: Living and Loving with Low Libido", rejects the current notion that a "healthy" sex life means frequent and exciting. Instead, individuals fall along a wide spectrum of interest in sex and low libido does not necessarily mean sexual dysfunction. Dr. Pertot, thank you for joining us tonight. It's a pleasure to welcome you to Power Surge :) Welcome to Power Surge, Dr. Pertot :) Dr. Sandra Pertot: Hello to you all - I hope I get the protocol right! Dearest: You'll do fine. You're the guest. You don't have to ask any questions :) Dr. Sandra Pertot: Thanks, it's great to be here. Dearest: Dr. Pertot, you make a fascinating statement in you book, Perfectly Normal, "Despite 30 years of access to sex therapy and an increasing openness about sex during that time, the reported cases of sexual problems have not changed significantly - making for an interesting paradox." What do you think accounts for this continuing problem? Dr. Sandra Pertot: I think a large part of it is that we now expect much more from sex. We can probably all remember how sex was presented in the 50s and 60s. Now we expect prolonged, hot passion, this is reinforced in the movies and by sex therapists. SB: Sex has changed so much for me. When I was not in menopause I loved it. I miss that urge and feel there is a problem because it's not there. I makes me question if I love my husband anymore. Could that be true? Dr. Sandra Pertot: I doubt that it reflects a sudden change in your love for your husband. This is part of the problem - the belief that if I loved him I should lust after him. Charlee: Would you recommend exploring remedies for libido like boosting low testosterone? I am 55 and menopausal. I have been tested. What would you recommend? No interest whatsoever. Dr. Sandra Pertot: If HRT with testosterone helps, it's worth a try - but how long do you stay on it, and what are the side effects? It's a difficult issue. Dearest: Power Surge is primarily a community of women going through menopause -- a time when it's common to lose one's desire for sexual intimacy -- a time when everything is changing. What do you say to the woman who's feeling so physically and emotionally drained, she simply has no interest in sex? Dr. Sandra Pertot: It's true that many women experience loss of libido with menopause. I think however we need to look at exactly what makes up sex drive and good sex. It's not just a physical urge for sex, or arousal and orgasm. At times of fatigue, gentle, quiet sensual sex can be rewarding. EllenH: I am a breast cancer survivor, and I had both ovaries removed sometime after. I've been on Femara for the past 3 years and have very low libido. When I had questions for my ob/gyn he basically explained that we don't need high libido to enjoy sex, it a lot has to do with our mindset, we have to allow it. Does it ever get any better? Dr. Sandra Pertot: What he means is that many women don't experience sex drive, but once they commence sexual activity they can begin to arouse as before. What we now think helps is for the woman to identify what is in sex for her - often feeling close - and talk to her partner about what make make sex a good experience for her. It may not come back as strongly as before at the physical level, but your confidence in creating good sex can grow. EllenH: So it can increase? Dr. Sandra Pertot: Yes, for some people, definitely. MaryO: I have a low libido due to several medical issues, but I think that I'd be more interested, if my husband was more interested in foreplay. How can I tactfully get that from him without telling him his technique is wrong? An embarrassing question! Dr. Sandra Pertot: That is an excellent question! You need to talk calmly, gently and positively to him. Let him know what you want, don't focus on what you don't want so much. I guess talking about sex is embarrassing, but so is talking about menopause - give it a go. Chippewa: What do you consider "sensual sex"? Dr. Sandra Pertot: Sensual sex is sex that is about soft, gentle touch, which is not so much focused on arousal as intimacy. SturdyWoman: Sandra what kind of things do you recommend when you have very little sensation & almost no orgasm? Dr. Sandra Pertot: The difficulty is that there is not always an easy solution to bringing back sex drive and orgasm - so sensual touch is the best type, before any attempt to arouse you begins. Massage, tickles, cuddles, quietly chatting, can all be part of gentle, sensual foreplay. And sometimes the issue is that you may want sex to be brief, that's okay. SB: I find that I can get into it if I create a fantasy in my mind that he is someone else and we are being a bit wild. But then I feel ashamed and guilty after. Any ideas how not to? Dearest: Why would you want not to? If that's what works for you, SB? SB: I don't want to feel the feelings after of guilt and shame. Dearest: You've nothing to feel ashamed about. It's your fantasy - not reality. Dr. Sandra Pertot: Fantasies are great, but a lot of women do feel guilty. Using fantasy helps you turn on with your partner, even if you don't turn on to him - doesn't mean you don't find him attractive or love him any less. JunoLibra: What do you do when your husband can only get aroused through porn and I hate porn? Dr. Sandra Pertot: That is a common problem - I would want to know why he can only arouse to porn? There are programs to help him widen his sexual interest but he has to see it is important. JunoLibra: Unfortunately, he says it is this or nothing. Since I am menopausal, I don't have the urge for sex. I would like more affection, but he tells me to grow up and stop having the expectations of a teenager. Dr. Sandra Pertot: I'm afraid if he will not address the issue with you, I would suggest a talk with a counselor. Most women don't mind porn sometimes but not as the only thing. And we generally want more affection generally as well as with foreplay. So if your partner will not listen to your needs, he has to understand that you will withdraw, and that isn't what either of you want. Dearest: Dr. Pertot, many women can't experience orgasm through sexual intercourse, but can through other types of stimulation. Why do so many women think they're inadequate if they can't have an orgasm through intercourse? Dr. Sandra Pertot: I guess because that is the image that comes through in films and novels - but an orgasm is an orgasm. SB: It seems that I have to take more responsibility for my arousal than I have had to in the past. I have to do the work myself, reading something seductive and then invite him to participate. Is that true for most of us now? Dr. Sandra Pertot: I would say that is true, not just for menopausal women but all women who are busy and stressed! Preparing for sex by taking time for yourself to relax is important. Dearest: Dr. Pertot -- Would you say that lack of sexual satisfaction in a relationship or marriage is the primary reason for cheating on one's partner? Dr. Sandra Pertot: No, I don't think it is that simple - but it is one cause, and again I think it relates to our high expectations of sex. Angel0508: What is a good creme to use? My husband doesn't like me to use any. Dr. Sandra Pertot: Most women who are menopausal need to use a cream at some time - it's too painful, so impress on your husband that your pleasure is important too. If you use it as prescribed by your doctor, it is fine - and often the only thing that really helps. DonnaDale: Is Vagifem safe to use long term? Dr. Sandra Pertot: I don't think any hormone should be used in the long term. Check with your doctor for her opinion, but I would have concerns if you use it for many years. Dearest: Dr. Pertot, It's a known fact that many men find it difficult to talk about sexual issues -- and when a man's partner isn't interested in having sex when he is, he often interprets it as something being wrong with him, feels like a failure, rejected, hurt and inadequate. What ideas or strategies can you give to middle aged women for sharing with their partners that whenever we don't want to have sex, it isn't about or because of them? Dr. Sandra Pertot: This is the type of situation I talk about in my book. It takes confidence on your part, know what you want to say and tell him gently how you feel. Be persistent, tell him so many women feel as you do. Dearest: Do you think it's really going to make a difference if he knows that many women feel as we do? Dr. Sandra Pertot: Men need to feel loved, so sometimes this can be achieved by more affection without sex, and I guess you need to find as many ways to reassure him that your lack of interest is not about lack of love. Dr. Sandra Pertot: Are there any sexual activities you feel okay to engage in with him, even though you may not be physically aroused yourself? What comes through is the feeling that your partners aren't listening to you and it isn't easy to make him hear what you want to say. Soul2Soul: I am having great success with bio-identical hormones. My doctor says they are much safer than synthetic, I am highly pleased though. Any opinion? Dr. Sandra Pertot: To be honest I don't know enough about them. If you trust your doctor that's a start. Soul2Soul: They are working wonderfully well. Dr. Sandra Pertot: I would ask about side effects, or search the web. MaryO: Just a comment. I think that my husband wouldn't want more affection than sex, but I would! Finding a common ground seems to be difficult. Dr. Sandra Pertot: Yes, I see quite a few couples where it is the male who is withdrawing from sex, often fear of failure, lack of confidence in his ability to obtain or maintain an erection, but he may simply not feel the need. Differences in wants and needs are a common source of distress or conflict and take understanding to resolve. Dearest: What do you say to those who have health or weight problems, or even those who develop feelings of self-consciousness about the appearance of their body as they're aging? Dr. Sandra Pertot: Body image is a major problem in western society. I guess it depends on how much you believe your husband when he says he finds you attractive! Dearest: What about single women - where there's no history between the partners? Dr. Sandra Pertot: The easy answer would be to say you should love yourself as you are, but I know it is more complicated than that. I encourage people to focus on what is good about their bodies, but also what they have to offer as a person in a relationship. Men have their doubts and insecurities too, and often just need love and support in sex, as we do. Chippewa: I am using a bioidentical hormone, progesterone, and it is working wonderfully well for me. My vaginal dryness gone and desire up! Angel0508: Don't you think men get uninterested in sex too? Dr. Sandra Pertot: Yes, they certainly can - and it is more difficult for them because they can't have sex without arousal, whereas we can, provided we are comfortable about it. Dearest: Dr. P, what about all the medications people are taking these days? Don't many of them have an impact on their libido? Dr. Sandra Pertot: Yes, they certainly do. Almost any medication can impact on sexual functioning including common meds such as antihistamines, anti depressants, blood pressure tablets. The list goes on. Dearest: Well, we're an over-medicated society, so that probably contributes to all the sexual problems. Dr. Sandra Pertot: It doesn't help, that's for sure. SLMM36: What happens when it's the female who has no desire or interest in sex at all? What would you suggest to get the interest back? Dr. Sandra Pertot: A woman needs to feel relaxed, not tired, and secure with her partner so she can slowly work on establishing her sexual interest. These are the issues I explore in my book. It certainly isn't hopeless, but you need to work together as a couple to make progress. SLMM36: What happens when they are completely comfortable but have no interest in even satisfying the husband? Dr. Sandra Pertot: That has to be up for discussion between you - some relationships do end up coping well without sex, but unfortunately sometimes couples just don't find the common ground between them and the relationship suffers. Macrina: My husband has a high libido. I have very little. He loves me but has difficult with intimacy, which I need in order to become aroused. I mainly touch him when he needs it. Sometimes we try to make love, but it becomes so complicated for me and I start to withdraw, because I don't feel we're connecting. I can't relax. Often when he touches me I get closer and closer and then I seem to pass over orgasm. Does anyone experience this? Any suggestions for my situation? Dr. Sandra Pertot: It is important that you think about what makes sex pleasant, relaxing and enjoyable, with or without arousal, and talk to your husband about that. Help him understand that sex cannot happen as often as he would like if your needs, emotional or physical, aren't understood and met. Women shouldn't take full responsibility for infrequent sex, because often the partner isn't doing what she need to want sex in any way. I encourage women to be confident when they talk to the man, to get him to understand his part in what is happening. If he won't, he has to understand that you may need to withdraw from sex, and that is reasonable! It goes back to the issue of whether he will listen to and respect what you say about you. Angel0508: Is your book available in USA? Dearest: Yes, of course. Not mine. Dr. Pertot's. Dr. Pertot, thank you for sharing your expertise on living and loving with low libido. I strongly recommend everyone get a copy of "Perfectly Normal" by Dr. Sandra Pertot. Dr. Sandra Pertot: Thanks to you all!

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Dearest
aka Alice Stamm
Power Surge
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