(Judith Sachs' 4th visit to Power Surge)

Dearest:    My guest tonight is health educator, journalist and author, JUDITH SACHS. 
Judith's written more than 20 books, including "The Healing Power of Sex" and 
"What Every Woman Needs To Know About Estrogen". 



 Judith Sachs:    Hello everyone. If everyone's in agreement, I'd like to talk about sex 
tonight. I'm finishing up a new book, with sex therapist Dr. Sandra Leiblum and it's tentatively 
called, WHAT WOMEN WANT: Getting Under the Surface of Female Sexuality.  What we're doing 
is looking at the many changes that go on over the lifespan, from childhood and adolescence 
through extreme old age--how women turn on and turn off and turn around about sex.  We're 
also looking at ways in which the Internet, drugs, surgery, and society all change the way 
women think and act sexually.  I think it's really interesting that today, the entire world 
nearly shut down because hundreds of thousands of people opened an email that said, "I love 
you." Clearly we are all looking for love and affection -- even if we just get it in a few 
short words online from someone we don't even know.  So what I'd like to do is hear your 
thoughts and feelings about what sex means in your life. Is it just something you do in the 
bedroom every week, or is it a life force that helps to shape the person you are?


Dearest:    So, do you think women are starving for affection?


 Judith Sachs:    No, I don't think everyone is starving.  I think a lot of women don't pay 
a lot of attention to it until it hits them in the face, or some big change (like menopause, 
or divorce or death of a partner) makes them realize that they need something more than 
an orgasm every once in a while. 


Dearest:    I think menopause is an important place to begin because so many women think 
it's the end of their "sex lives." 


 Judith Sachs:    But many women actually find that sex is better. For instance, no more 
worries about pregnancy or bleeding. And then, too, at the perimenopause, when hormones 
start fluctuating, you can actually feel hornier than you used to when you bled every month 
(and were chasing little kids around the house).   But some women despair, because sex may 
feel drier, or they don't have the desire they used to, or their partners are less 
interesting and interested--or perhaps their partners who may be older are experiencing some 
kind of sexual dysfunction and the women think it's their fault.


Dearest:    I agree with you and I think many women here agree with you, but I also think 
that women would take back their periods, the PMS and  many discomforts associated with 
regular menopause if they could just feel "DESIRE" again.  Don't you think it goes far 
beyond vaginal dryness, but a lack of desire to be sexual? 


 Judith Sachs:    Absolutely. Desire is connected to testosterone, which begins to decline 
for many women at about age 35. Of course, you can have plenty of testosterone and still not 
be sexually aroused by your partner. Or perhaps you've been fighting more, or your mother 
died--all these things will totally reduce desire. One of the best ways to recapture desire 
(other than finding a new young man--or woman--who adores you) is to think back to what used 
to turn you on and experiment a little with what might turn you on now. Maybe an erotic 
story that you can find on the Internet, or a new piece of crotch-less lingerie, or even an 
erotic film that you watch with your partner or alone. Of course, masturbation is also a 
terrific way to discover what you like (which may be quite different from what you used to 
like when you were younger.) 


Dearest:    Why do you suppose women have difficulty talking about sex and masturbation?


 Judith Sachs:    Whew!  Well, it's because we were never allowed to.  Boys can get together 
and jerk off in the woods and it's just funny, but girls... I interviewed one woman whose 
mother would come into her room when she was falling asleep and grab her hand and take it 
out of her pajama bottoms and yank her out of sleep. Can you imagine what that did to her 
feeling that touching herself was a lovely thing to do?


Dearest:    I've always thought that masturbation was a very normal way to experience 
auto-eroticism. I've enjoyed it during marriage, divorce and in any mode. It's my body. 
If I don't understand and explore it, it will be difficult to communicate my needs in intimacy.
 

Dearest:   Guest52, go ahead with your question.


Guest52:     I have found intercourse to be painful and have tried products, yoga, 
meditation to help with DESIRE I need help


 Judith Sachs:    Yes, you do. First, have you had a gyn exam and discussed this with your 
doctor?  There is a condition known as vulvar vestibulitis that is correctable and few women 
know about it. (There's a restriction in the vulvar channel, so the entry of anything--a 
penis, a finger, a tampon, can be excruciating. Do you find that putting anything inside 
your vagina hurts, or is it just intercourse? 


Guest52:     Just intercourse and I bleed. 


 Judith Sachs:    Okay, the bleeding definitely sounds like there's something medical
going on--are you very lubricated--do you use a water-based lubricant like Astroglide? Do 
you start with insertion of just a pinky and then a finger? Have you talked to your doc?


Guest52:     Yes, and a 1000 ml vitamin E.


 Judith Sachs:    I would stay away from intercourse for a few weeks and just play--lots of 
oral sex, working your way up to manual sex--try to have an orgasm from something like 
rubbing or sucking (take the "gold standard" off the idea that intercourse is your goal. 
Then slowly go back to insertion of the penis just a little way. Orgasms are a big subject.


Guest52:     No orgasms since menopause 5 years ago.   Will keep trying.  Thank you. 


 Judith Sachs:    Very often, at menopause, the hormonal changes are so abrupt and dramatic 
that the natural peaks and valleys of pleasure get thrown out of whack. Can you have an 
orgasm from masturbation?  Using a vibrator?

Guest52:    Yes 


 Judith Sachs:    Okay... I wouldn't worry about not having orgasms from intercourse  unless 
this is VERY important to you. Show your partner what you do manually when you can come and 
see if he can mimick what you do. Tell him what gives you pleasure when he uses his mouth--
sorry, I'm assuming your partner is a man. But anyway, TALK to him/her about anything you'd 
like that's not going on for you.


Guest59:     What I miss the most is sex being spontaneous.  Now my husband and I have to 
ask each other, "are you feeling frisky tonight?  I miss the passion! Of course we have 
mellowed a bit in 27 years of marriage!


 Judith Sachs:    Well, it's impossible to be as spontaneous as you used to be. But how 
about making a date to go to a motel on the highway, or a bed and breakfast for a 
weekend. Sometimes sending each other sexy email can trigger some long-buried passion, and 
what's also fun is if you both go into a "romance" chatroom together and pick each other up. 
It's contrived, of course, but it's funny how when you pretend to put back the flirtation, 
it sometimes follows that you really do get turned on. Don't ask if he's feeling frisky - 
maybe suprise him in the shower. 


Dearest:    Judith, what about women feeling less physically attractive as they age -- for 
example, drooping breasts, lost pubic hair?  How does one deal with those issues? 


 Judith Sachs:    That's very hard. Everyone should go look at a website a friend told me 
about today--realwomenproject.com--to see some wonderful bronze statues of real women who 
look really proud of what they've got. Drooping is what the body does eventually, although 
exercise and diet can help. A mastectomy is really hard to deal with. A very understanding 
partner is a must--but also a long time in front of a mirror coming up with all the things 
you really do like about yourself--whether it's your silver hair or your big nipples. You 
have to find something that you didn't use to have when you were younger than makes you feel 
happy physically. Of course,  sex isn't just about your body... it's mostly what happens 
between your ears.


Dearest:    Thanks, Judith. Mary, go ahead, please :)


MaryO:     My comment (might be helpful for someone else): I found that it was quite 
stimulating to be on a long car ride listening to "oldies" on the radio from my younger, 
sexier days.  Brought back lots of memories :)


 Judith Sachs:    That's great -- as long as it doesn't make you feel far away from your 
exciting past. 


MaryO:     Not too far :) 


Dearest:    Can you elaborate a bit on that feeling far away from your exciting past, 
Judith? 


 Judith Sachs:    Well, what we were when we were younger is similar to the woman we are 
now, but it lacks the experience and know-how and self-confidence. I've interviewed a lot of 
younger women who are so deeply into their marriage and family that they don't think much 
about sex, and some regret  being "wilder" when they were in their teens or early twenties--
it's the desire to get a secondary virginity (like Wendy Shalit suggests). But in menopause, 
you don't have to be concerned so much with other people--you can really start to forge a 
different kind of sexuality. I think that's a reason that a lot of women have affairs for 
the first time when they hit 45 or 50. Something they never would have done at 20.



Dearest:    Don't you think a big part of the problem is that many women can't talk to men 
about their menopause, aging, feeling undesirable, etc?  How do we bridge that communication 
gap about sexuality <that doesn't necessarily begin with aging> ? 


 Judith Sachs:    Yes, definitely. Men are aging too, of course, but they don't seem to 
acknowledge it the way we do. And they don't particularly want to hear the kind of 
conversation that goes on in this room. SO important to have women around you to talk to 
about these issues. I think, though, that you can not alienate the man in your life and 
still get to where you want to be by concentrating on the present. What do you want to do 
together? Where do you want to live when  you are older? Do you think about starting a new 
business together instead of retiring? A lot of couples can get closer by finally spending 
more time either at a hobby or a new business and catch up on all the years that they just 
saw each other in passing in the bedroom and at the dinner table. I'd like to ask a question 
of the women here.


Dearest:    Go right ahead :)


 Judith Sachs:    Do any of you ever go surfing on the Net for erotic material? Either for 
pictures, erotic stories.. or do you go flirt in chatrooms?

MaryO:     no
jane:     no
Lilly:     Never!
Irish:     no
Allie:     no
Ute:     I do
Guest59:     no way!
Guest188:     nope..never
MaryO:     the kind of chats I go to, I'd better not flirt LOL
Dearest:  I don't have much time for chatting and no interest in erotic material; however,
I have enjoyed an occasional chat with bright men online, but not of a sexual nature.


 Judith Sachs:    Yeah, that's what I thought you'd say. I must say, though, that some women 
have told me that they feel really empowered by doing this. The Internet is a safe place to 
act out fantasies (unless you make dates to meet people)--where you can't be molested or 
treated badly. That is, unless you get overly involved. Also, the erotica, some of it, is 
designed for women and is a real turn-on.  For those of you who don't have the same desire 
you used to, it's a really fun way to spend an hour.


Guest84   Does Prempro cause iriritation as well a lot of bleeding? I would like to know as 
I've just been taking it for two weeks.


 Judith Sachs:    When you first start Prempro, you will probably bleed--usually about 3 to 
6 months to get the body in line, and for some women you have some bleeding or spotting all 
the time. As for the irritation, do you mean all the time, every day? Or with sex? You might 
try a vaginal moisturizer like Replens as well as a water-based lubricant like Astroglide 
for sex. 


Dearest:    Kelly, go ahead, please.


Kelly:     Dearest sort of asked my question, but here goes:  My husband doesn't seem 
interested in foreplay for me anymore, just for him.  How can I get him to do things that I 
like?  I've never had an orgasm, not even from masturbation. I'm kind of shy, too, and have 
trouble saying what I want.  Is there any hope for me? :(


 Judith Sachs:    Yes, of course there is hope.  Can you phrase it so that it's not you 
you're talking about? In other words, tell your husband that a friend of yours is having 
this problem, or that you read a piece in a magazine or heard about it in this chatroom. And 
all the women in the room suggested that the two of you spend a little longer on foreplay 
because as we get older we are naturally drier--and he could be a real help to you if he 
used his mouth, or saliva on his fingers, or a lubricant before intercourse. Give it a try! 
Good luck!


Kelly:     Yes, maybe I could do that.   Thanks


 Judith Sachs:    You're welcome


Dearest:    Judith, don't you think so much of our behavior comes from the way we were 
taught in childhood?  Women aren't taught to talk about sex, to be sexual, to be wild - it's 
like fighting a very natural feeling all the time for some. Comments?   Like, even talking 
about it here in a private chat room.


 Judith Sachs:    Yes, certainly. Some of us had very repressive upbringings. And it becomes 
harder as we become solidified in our ideas about ourselves to change what we were taught. I 
think the best way to make some changes is to read widely--like Anais Nin (I love her!) and 
Lonnie Barbach (I love her too), and Nancy Friday's books of fantasies for women. Sometimes, 
when you pretend to be a little wild and say, well , this isn't really me, I'm just trying 
on a part, you don't feel so guilty.


Dearest:    <two of whom have been guests in Power Surge>    :) Excellent answer. 
Thank you.  Guest59, please go ahead.


Guest59:     I had my testosterone levels checked, they were normal, but I still have a low 
libido.  I've taken 50 mgs.  Zoloft for past 5 years. Could it still be the zoloft or could 
I still benefit from a low-dose of testosterone?


 Judith Sachs:    It could be the Zoloft, absolutely. You might ask your doctor to try you 
on Effexor, Celexa, or Serzone--all of which are much easier on the libido, before you try 
testosterone gel or cream. If you weren't having this  problem before you started SSRIs, 
then you could absolutely attribute it to that.


Guest59:     Thank you, I'll give it a try!


Dearest:    What other medications commonly affect libido, Judith?  How about anti-
hypertensives? 


 Judith Sachs:    Yes. And antihistamines, and all sorts of mood-altering drugs other than 
the SSRIs. Not to mention too much alcohol or grass, and even cigarettes. 


Ute:     What is your opinion on natural vs. ert or hrt? I am 43 am in perimeno, and I am 
trying to follow the natural approach (Progesterone cream/Revival/vitamins) I am healthy. 
However, it's not helping with the night sweats and hot flashes. Doctor recommended Estrace  
what do you think?  PS.I still like sex.


 Judith Sachs:    I'm glad you like sex! Natural ERT or HRT (you don't say if you still have 
a uterus) may not be sufficient to deal with your flashing and sweats. Estrace is a kind of 
way-station in between the herbals and Prempro or Premarin, so yes, you might try it. 


Ute:     So you are not opposed Estrace?


 Judith Sachs:    No, but I don't know anything about your medical history--I'm not a 
physician and I wouldn't recommend anything. But ask your doctor what she thinks. 


Ute:     Thank you!


MaryO:     After we're completely done with the menopause process, does the desire for sex 
usually come back, or do we have to work at it some more? 


 Judith Sachs:    You'll be delighted to know that I talked to some women in their late 70s 
and early 80s who were really interested in sex. One woman had a lover in one city and one 
in another city where she went to give lectures and taught. Very often, the hormonal rages 
of menopause have to die down  before we can reach a new appreciation of what sex means. The 
women said that they didn't have intercourse as much (their partners were also older men) 
but that the closeness and warmth and sexual experimentation was better than ever. 


Dearest:    Judith, wouldn't it almost go without saying that the "empowerment" women feel 
as they get older would find its way into the bedroom?  


MaryO:     that's great news - thanks :)


 Judith Sachs:    Well, yes. As long as they DO feel empowered. Unfortunately, in many long-
term marriages, what was a pattern at the beginning in the bedroom gets carved in stone. 
Also, in some cases, when men lose erectile function and just don't want to deal with the 
idea of using something (a pump, an injection, a pill), they stop wanting to have sex at 
all, or blame it on the woman. Which, needless to say, takes away her power--if she still 
wants sex and he doesn't.  I think many lesbian relationships get stronger as the two women 
can negotiate better--whether or not they want to make love as often. 


Dearest:    But, as we all know, being sexual doesn't just mean having intercourse. How 
about all the other ways to share intimacy?  Isn't it all about intimacy anyway? 


 Judith Sachs:    I think so, yes. And what can be great for a couple is just snuggling, 
because the kids are out of the house, or lying in bed reminiscing about something they did 
together that was funny or meaningful, or staying in on a rainy Saturday and taking the hot 
sheets out of the dryer and rolling around in them on the bed. 


Dearest:    Don't you think many of the problems come not so much from not touching each 
other anymore, but not "talking to" each other? 


 Judith Sachs:    No, I think the touching is really as important as talking, which is also 
REALLY important. I guess you have to say, hey, I'm 50, I'm just going to blurt this out, or 
I'm just going to suck his toes, and see how totally outrageous I can be. What could be the 
worst thing that could happen if you did something like that? 


Dearest:    Personally, I've never been into toe sucking, but it sounds great :)  Let's see 
another one or two questions for our guest :) We're running late... can take another 
question or two.  Nobody here has any questions about her sex life?  Go ahead.. this is a 
private room if you feel reluctant to ask.


 Judith Sachs:    Please! Ask! The great thing about the Internet is that it's anonymous, 
affordable, and accessible.


Dearest:    What have you discovered in your research about online sex, Judith?


 Judith Sachs:    I've found that it's both a good thing and a bad thing (of course.) It's 
good in that it equals the playing field for women--they can explore fantasies, pick people 
up, pretend they're gay when they're not just to see how the other half lives, but in 
addition, it's risky. The Net is completely unregulated, and you never know what kinds of 
answers you'll get when you ask a question, or who you're really meeting online if you go 
into a chatroom. And, as in real time sex, you can lose your heart. So you have to be fun, 
playful, and always on the lookout for a scam. 


Dearest:    Thanks, Judith. Allie, go ahead.


Allie:     I know I should not complain about this, but sometimes after a lot of foreplay, I 
see to lose the lubrication.  So why does this happen?


 Judith Sachs:    Then I'd add some water-based lubricant or saliva.  Well, you reach peaks 
during sexual arousal--and in menopause, you get through the peaks faster. You may still 
feel aroused, but not be wet, because your mucous membranes aren't responding to 
stimulation the way they used to. But you can fix this mechanically... as long as you still 
feel excited, everything's just fine. 


Dearest:    I have never read or heard that orgasms change during and after menopause? 
Have you? 


 Judith Sachs:    Yes, they can and do. Many women who used to feel the "tenting" of their 
uterus during an orgasm find that that doesn't happen any more. The duration and intensity 
of the orgasm may decline as well. And some women who were able to climax from penetration 
alone now need to have their clitoris stimulated at the same time.  But then there are also 
women who experience multiple orgasms for the first time after menopause because they feel 
really relaxed and loose and eager to participate in and initiate sex.


Dearest:    Thanks, Judith.  This will be our last question.


Guest66:     How many years until hot flashes finally go away?


 Judith Sachs:    Interesting question. Some women have them for a couple of years before 
menopause, then as menses comes to a halt, they can either get worse or decline completely. 
I know women who said they had flashes for 10 years, others who said it was only a few 
months.  It's a really individual thing.


Guest66:     Going on 4 now


whinetasta:     Hi, there  Im having a bear of a time adjusting to my new hrt,  I haven't  
had a period in 5 yrs and now Im bleeding for a week now. I thought I was done with this.


Dearest:    That's not uncommon, 66. Judith, can you see Whinetasta's question above?


 Judith Sachs:    Yes. As I said to the other woman who'd recently started HRT, it's common 
to bleed for 3 to 6 months, and often it just keeps going.  It can be a pain in the neck.. 
but it doesn't mean anything is wrong, except that you have to pay for pads or tampons 
again!


Dearest:    Judith, in closing, your thoughts about the best menopause treatments? HRT? 


 Judith Sachs:    I guess I am still straddling the fence. The new information about breast 
cancer risk when you use HRT for more than 4 years really concerns me. I think that it's 
great to use for a very short time as relief of some menopausal symptoms, or if you have  
massive bone loss and your mother or sister had advanced osteoporosis. Other than that, I 
don't really like it much in any of its permutations because you're putting something into 
the body that may mess up the natural decline of estrogen. And if it leads to any type of 
cancer, that's not good.

Dearest:     Judith, we will find information about your new book at http://www.JudithSachs.com? 


 Judith Sachs:    Yes, please come to my message board at http://www.JudithSachs.com. 
I have a great time talking to and listening to women who want more out of life. 
Please visit me there! 


Dearest:    Will do. Thanks for joining us tonight, Judith. Best of luck with the new book :) 


 Judith Sachs:    Thanks so much. It was a pleasure to be here.

Read Dr. Judith Sach's first transcript
Read Dr. Judith Sach's second transcript
Read Dr. Judith Sach's third transcript



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