Category Archives: Female Sexual Dysfunction

Are you getting any closer? A pocket-sized primer on female sexuality

By Clarissa Fortin

Stay curious between the sheets, friends.

Closer: Notes from the Orgasmic Frontier of Female Sexuality
by Sarah Barmak
(Coach House Books, 2016; $14.95)

If it weren’t for Sarah Barmak’s Closer: Notes from the Orgasmic Frontier of Female Sexuality I might have gone for years of my life without ever finding out what my clitoris actually looks like.

“Illustrations of it resemble a swan with an arched neck,” Barmak writes. “When I saw an closerillustration of the clitoris’s true shape for the first time I felt like a blind man finally seeing a whole elephant when all he’s ever known was the tip of it’s trunk.” I realized while reading those sentences that no one in my Catholic high school health class ever bothered to show me such an image and I’d never thought to seek one out.

I consider myself a feminist and a sexually liberated woman. Yet, there are still surprising gaps in my understanding of my own body. And that’s why a book like Barmak’s is important. Closer tackles its subject with eloquence, intelligence and humour.

The book is split into five essays that tackle the “fear of pleasure,” the history of female sexuality, the science and psychology of the orgasm, the “female sexual underground” and the politics of acknowledging female desire.

While each essay has its own strengths, I think the most effective chapter is “A History of Forgetting.” This section aligns the historical “discovery” and “loss” of the clitoris with the individual experience of a woman named Vanessa — an actual interview subject.

We first meet Vanessa on the table at the doctor’s office filming herself masturbating in order to prove to the doctor that she can indeed ejaculate. We learn that Vanessa has been having a series of problems — pain after sex, recurring yeast infections and so on — that no doctors can figure out.

From here Barmak momentarily leaves Vanessa’s story behind and turns her attention to the clitoris itself, noting that “the mapping of the human genome was completed in 2003, years before we got around to doing an ultrasound on the ordinary human clit.”

While the tendency is to see history as ever moving forward and progressing, Barmak counters that “women’s sexuality began by being celebrated, then was feared as too potent, before being downplayed and denied in the scientific era.”

The Christian church, the scientific revolution and various other factors resulted in a demonization and rejection of female bodies. It’s a generalized historical account to be sure, but Barmak does point readers in the direction of Naomi Wolf’s Vagina, a much more comprehensive book on the subject.

What makes this essay so powerful is the way it revisits and concludes with Vanessa and her struggle. Her story held up against the larger history of the clitoris itself demonstrates all too well an overall contempt for and neglect of the female genitalia.

Along with research and anecdotes, Barmak amasses a diverse collection of interviews with doctors, researchers and sex educators. I was excited to learn many factoids that I will surely whip out at dinner parties in the future — for instance, vaginal self stimulation actually blocks pain in women, and even women who are paralysed can sometimes still feel sexual pleasure because of nerves which bypass the spinal cord and communicate directly with the brain!

Barmak combines this research and traditional journalistic writing with first-person narration, bringing her own experience into the story. This means attending seminars and workshops, watching a demonstration of a female orgasm at Burning Man, and getting a vaginal massage.

Barmak is open about her own skepticism and trepidation during these investigations. “I like to consider myself open to new things,” she writes. “Yet, the idea of a strange lady’s gloved fingers all up in my jade palace falls somewhat outside my personal boundaries.” She goes through with it and the personal account makes for a richer narrative overall.

A note about the term “woman”: Barmak uses it throughout the book to generally refer to the cisgendered female experience. If I have any strong critique of the book it is that by celebrating the distinctly female anatomy, the book sometimes verges on unintentionally emphasizing a gender binary. This is something Barmak herself seems aware of. She notes on pg. 21 that “the word woman can refer equally to cisgender, intersex, genderqueer and transgender women all representing varied shades of experience.” While it’s good that the acknowledgement is there, I think a declaration like this belongs even earlier on as a note for readers to keep in mind before the book even begins.

That said, Barmak does make an effort to include the experiences of typically marginalized women such as trans women and women of colour in her narrative. “Being white affords privileges even in non-mainstream spaces of revolt such as sexuality,” she notes.

The topic is something “that requires far more depth and attention than this little book can offer,” Barmak says and while this seems like a partial cop-out for having only a few pages devoted to women of colour and trans women specifically, Barmak makes a valid point. Issues regarding sexuality faced by marginalized women warrant entire books altogether, preferably penned by a writer who has lived those experiences.

Nevertheless, I think this book would have been more complete with a sixth section devoted specifically to these issues.

At its core this book is compassionately optimistic, celebrating the innate complexity of sexual pleasure itself and arguing in favor of orgasms for all, something I can definitely get behind.

Sex educator and vlogger Lindsay Doe has a motto she repeats at the end of each of her videos: “stay curious.” Closer isn’t the definitive book about female sexuality and it doesn’t claim to be. But it made me curious about my own body, and even more curious about the wonderfully vast array of experiences we humans have between the sheets.

I recommend it to my friends of all genders, my boyfriend, my sisters, and especially the woman who started it all, my mother.

Complete Article HERE!

10 Reasons Why Women Lose Their Libido

Ladies, libido means sexual desire. Women having decreased libido is one of the most common complaints I hear in the office, especially for those stressed out supermoms. Trust me – you’re not alone, ladies. It is estimated that more than 40% of women experience some sort of sexual dysfunction in their lifetime. Here’s why, and what you can do about it.

Dried Rose On Old Vintage Wood Plates

Female sexual dysfunction can include problems with desire, arousal, achieving orgasm and sexual pain that causes significant distress in your life. More specifically, decreased libido is when you don’t want to engage in any type of sexual activity, including masturbation, and you don’t want to have any sexual thoughts or fantasies. Sound like someone you know? Let’s review some reasons why you may not want to have sex with your significant other:

1. Bad Relationship.

Fighting with your partner is an easy way to kill your sex drive. When you are angry or hurt, sex is the last thing on your mind. Fix your relationship — go to couples’ therapy.

2. Stress.

It doesn’t matter where the stress comes from, all of it can cause your libido to drop. It doesn’t matter if you’re stressed out from financial problems, from trying to get pregnant, or from worrying about your job – it all negatively impacts your libido. Stress can also lead to you being fatigued, which worsens the problem. Find ways to chill out ladies – I mediate daily to deal with stress, and that might work for you, too.

3. Alcohol and Smoking.

Both of these drugs have been shown to decrease sexual desire and satisfaction. While alcohol in moderation is okay, when you binge drink, sexual dysfunction starts to occur. On the other hand, any kind of smoking is bad – just quit!

Easier said than done, right? You have to know why you are smoking. Substitute that why with something else. For example, if you smoke because you are bored, instead of lighting up go to the gym.

4. Mental Illness.

Mental conditions such as depression and anxiety can also cause your libido to drop. Talk to your doctor and get treated. Sometimes medications used to treat these conditions can also cause a drop in libido – but not every medication does, so talk to your doctor.

crying girl

5. Birth Control.

Hormonal birth has been shown to decrease testosterone in your body, which could lead to a lowered libido. This is because testosterone is one of the hormones that makes you horny.

Other medications such as antidepressants, anti-seizure meds, opioids, medical marijuana, antihistamines, and hypertensive medications can also decrease your sexual desire. Talk to your doctor about switching your medications if you think any are giving you a problem. Your healthcare provider can also potentially switch you to a non-hormonal birth control option, like the Paragard IUD.

6. Trauma in your Past.

Negative sexual experiences in the past can cause issues with decreased libido. Women who were raped or have been victims of domestic violence may, understandably, have issues here. Going to therapy to work through your pain can help.

7. Poor Body Image.

In a world full of fake butts and boobs, it isn’t hard to image women struggling with their body image. Not thinking you are sexy enough can cause your sex drive to plummet. If you don’t like something about yourself, change it – in a healthy way, of course. Eat clean, drink water and exercise – though, keep in mind that a lot of times this is something that you have to work out in therapy.

8. Medical Conditions.

Medical illnesses such as diabetes, hypertension, thyroid disease, congestive heart failure, or cancer can all affect libido. They can alter hormones that have an impact on your sex drive. Proper treatment of the underlying disease can often improve libido.

9. Pregnancy and Breastfeeding.

Hormones fluctuate during pregnancy and breastfeeding, which can decrease your sex drive. Being pregnant can cause you to be tired and not feel sexy, which certainly doesn’t help your libido! Do your best to focus on intimacy with your partner — also, when you have the baby, get help. Let those grandparents help out with babysitting!

10. Aging.

In menopause, estrogen levels drop drastically because the ovaries aren’t working anymore. Low estrogen causes, among other things, a dry vagina, which makes sex painful. This can lead to decreased sexual desire. Arthritis in the aging population can make having sex less fun. When vaginal dryness makes sex uncomfortable, use lubricants (try a free sample of Astroglide Liquid or Astroglide Gel, which temporarily relieve dryness during intercourse). Some women find using vaginal estrogen also helps.

Complete Article HERE!

Here’s What Could Get You Committed If You Were a Woman in the 1870s

Many of things that got women committed in the 1870s would be considered normal behavior today.

By

Woman in the 1870s

Despite all the effort made today to de-stigmatize mental illness, the history of mental health and its treatment isn’t pretty. Even as late as the 1970s, lobotomies were widely practiced in the United States to “cure” things such as depression, anxiety, and even homosexuality. Now, imagine yourself in the late 1800s … let’s say around 1875. The germ theory of medicine had barely been worked out, let alone any sound understanding of the human mind and mental illness. People were still treated with bloodletting, mercury, and other dangerous practices. The definition of “insanity” was flexible, and often used to strip inconvenient family members of their money and land. Protections against being committed to an insane asylum in the late 1800s were few … and even fewer if you were a woman. With only the signature of a husband or a male guardian, women could be committed for the rest of their lives for “illnesses” that are now recognized as normal, healthy sexual behavior.

 

Complete Article HERE!

Female Sexual Dysfunction, Another Perspective

Hey sex fans,

It appears that my posting of last week, Female Sexual Dysfunction Is A Fictional Disorder, caused quite a stir.  As you recall, I was answering a question from a woman who asked if FSD, or female sexual dysfunction is real or a fictitious “ailment” that is being promulgated to sell pharmaceuticals to unsuspecting women.  I replied; “I think that, for the most part, female sexual dysfunction, or FSD, is a fictional disorder. I also think pharmaceutical companies are trying to hit on a female version of Viagra to treat this imaginary disorder so they can make a bundle, just like they did with as the male version.”

Well, that didn’t sit well with some friends and colleagues. One among them, Dr. Serena McKenzie took the most exception. She sent me a little note: “Your blog on female sexual dysfunction being fictitious is – respectfully – fucking bullshit sir.” Ok then!

I invited Serena to make her case not only to me, but to all my readers. What follows is Serena in her own words.

Flibanserin, the first and only medication available for use in reproductive aged women with low libido, becomes commercially available this week after a rocky and controversial road that led to its FDA approval Aug. 18. The view on the medication whose brand name is Addyi (pronounced ADD-EE) ranges from a historical achievement in women’s health care to an epic failure of commercialized medical propaganda. Despite the lengthy debate that has surrounded flibanserin, what most people want to know is whether it will help their sex life or not now that it is here.

addyi


First Things First

While sexual concerns can be difficult to discuss for many women and their partners, it is important to acknowledge that sex and intimacy are some of the great extraordinary experiences of being human. When sex goes badly, which statistically it does for 43 percent of U.S. women, the consequences can devastate a relationship and personal health. One of the biggest applauds I have for the FDA is their statement of recognition that female sexual dysfunction is an unmet clinical need.

Sexuality Is Mind-Body But Not-Body?

Sexuality is usually complicated, and problems with sex such as loss of libido are multifactorial for most women. Antagonists to flibanserin cite psychosocial contributions such as relationship discord, body image, or history of sexual abuse to be the most pinnacle causes of a woman who may complain of problematic lack of sexual desire, and that sex is always a mind-body phenomenon. While these factors often implicitly correlate to loss of sexual interest for a woman, they don’t always, and you cannot advocate that women’s sexuality is all inclusive of her mind, body, and spirit — and assert simultaneously that a biochemical contribution which flibanserin is designed to address in the brain to improve satisfying sexual experiences does not exist.

(c) Myles Murphy; Supplied by The Public Catalogue Foundation

(c) Myles Murphy; Supplied by The Public Catalogue Foundation

The Biochemistry of Sex

Antidepressant medications that alter brain biochemistry are notorious for having sexual side effects which can be prevalent up to 92 percent of the time, and are known to decrease sexual interest, disrupt arousal, and truncate orgasm in some women. Ironically, flibanserin was originally studied as an antidepressant, and while the exact mechanism of how a medication can impair or improve sexual interest is unknown, it should not be difficult to consider that if biochemical tinkering can crush sexual function, it may also be capable of improving it.

Efficacy Data Dance

Flibanserin is a pill taken once nightly, and has been critiqued as showing only modest increases in sexual desire, with improvements in sexually satisfying events rising 0.4 to 1 per month compared with placebo. However just because flibanserin has lackluster efficacy data, that does not mean it is ineffective, and even small improvements in sexual function can be life altering for a woman struggling with disabling intimate problems. If only 1 percent of women with low libido were to improve their sexual function with use of flibanserin, that equates to 160,000 women, or the population of Tempe, Arizona.

Blue Sky Side Effects

Flibanserin has side effects, and the sky is blue. All medications have pro and con profiles, and for flibanserin the most common consequences of use include fatigue, dizziness, sleepiness, and a rare but precipitous drop in blood pressure. Women may not drink alcohol while taking this medication. Providers who will prescribe it and pharmacies that will dispense flibanserin must be approved through what is called a Risk Evaluation and Management Strategy, or REMS, which means they are educated on advising women on how to take flibanserin safely. While a REMS program is arguably overkill compared to numerous higher risk, common prescriptions which do not require a REMS, it is an excellent opportunity for clinicians who have a background in sexuality to be the main applicants since they are far more qualified to assess proper candidates for treatment as well as continue to endorse holistic measures alongside flibanserin. Women who are interested in trying flibanserin should only obtain it from sexuality trained professionals.

The Proof Is In The Sexy Pudding

If flibanserin is worthless, the marketplace will bury it in a shallow grave quickly. Women will stop paying for it, and conscientious medical providers will stop prescribing it. Yet 8,500 women taking flibanserin were studied, over a 1,000 of them for one year, and the data suggests it will help some. Women deserve to be educated on their options, because sexual health is worth fighting for.

Changing The World, One Orgasm At A Time

We simply cannot overlook how astronomical of an achievement it is to even have a mediocre medication approved for female sexual dysfunction. Women’s sexuality has been ignored by medicine for most of history. At least now we have something to fight over.

The controversy about flibanserin is in fact magnificent, and frankly, the entire point. We must talk openly about sexuality and sexual concerns to improve them, personally for one woman at a time, but also uniformly to embrace female sexuality as a vastly larger societal allowance.

A satisfying sexual life is far more than the restoration of sexual dysfunction, it’s a thriving, multi dimensional, ever evolving weave of psychology, relationships, life circumstances, and yes can include a milieu of biochemistry and neurotransmitter pools.

Is a pill ever going to replace the vastly complicated arenas that fuse into our sexual experience? Of course not — it’s absurd and lazy-minded for anyone to suggest that is even being proposed. But it is necessary and inherently responsible to allow for all possible puzzle pieces to be utilized through the ever evolving navigation of sensuality, intimacy, and erotic fulfillment.

So will flibanserin make your sex life better? Maybe. But considering the conversation about it valuable as well as its use as merely one tool among many options to improve sex and intimacy would be the better bet. Ultimately, we “desire” sex that is meaningful, erotic, and dynamic. The journey of seeking sexual vitality deserves every key, crowbar, heathen kick, graceful acrobatics, or little pink pill that lends its part to the process, no matter how small or big, for the opportunity to discover and embrace a sexual aliveness.

Holistic physician, certified sexual medicine specialist, sex counselor, medical director of the Northwest Institute for Healthy Sexuality

Female Sexual Dysfunction Is A Fictional Disorder

Name: Sharon
Gender: female
Age: 30
Location: PA
I’ve been reading a lot lately about FSD, or female sexual dysfunction. Is there such at thing? It strikes me as a fictitious “ailment” that is being promulgated to sell pharmaceuticals to unsuspecting women. What are your thoughts?

I share your skepticism. I think that, for the most part, female sexual dysfunction, or FSD, is a fictional disorder. I also think pharmaceutical companies are trying to hit on a female version of Viagra to treat this imaginary disorder so they can make a bundle, just like they did with as the male version.

body as art

So much of female sexuality is caught up with the cultural context of a women’s role in society — family obligations, body image and patriarchal views of marriage, etc. For the most part, men aren’t nearly so encumbered. So when one talks about female sexuality, particularly when the notion of a condition or a disorder arises; ya gotta ask yourself, what’s going on here?

I too have been noticing a lot of discussion in the popular culture lately about female sexual dysfunction. My first response is to ask myself, who’s raising the issue and why? Sure some women, like some men, experience difficulties in terms of desire, arousal and orgasm, but what of it? Is it a syndrome? Is it really a dysfunction? I personally don’t think so. The sexual difficulties most people experience can be explained and dealt with in a less dramatic way then with drugs?

And here’s an interesting phenomenon; the repeated appearance of the term female sexual dysfunction in the media lately actually gives the concept legitimacy. I’m certain the pharmaceutical industry is hoping that it will. If they can make the connection in the public mind between what women experience in terms of desire, arousal and orgasm concerns and what men describe as erectile dysfunction, then most of the work is done. In other words, I think the entire effort is a marketing ploy.

female sxualityI think we can safely say that, in order to determine what female sexual dysfunction might be, one has to clearly understand what a “normal” sexual response is for a woman. This is where we traditionally run into problems. Sex science is notoriously lacking in this endeavor. One thing for certain, although both women and men have a discernable sexual response cycle, a woman’s sexual response is not the same as a man’s. Even though we can’t say with certainty what “normal” is, therapists are famous for turning difficulties into disorders. And once you have a disorder it becomes the basis for developing a drug therapy. So you can see how this becomes a self-fulfilling prophecy.

Currently there’s a real buzz among clinicians concerning the efficacy of Addyi, the so-called “female Viagra”. But most sexologists, myself included, are unimpressed. Basically, the drug in question is an antidepressant. When I heard that, red flags began to fly. Antidepressants are notorious for their adverse side effects, especially in terms of sexual arousal in both men and women. The second problem with the study was the whole notion of desire and distress. Lots of women experience diminished sexual arousal but are not distressed by it. But if there’s no distress, clinically speaking, then it can’t be considered a disorder. You see where I’m going with this, right? If there’s not a “disorder” there’s no need for a pharmaceutical intervention.FUCK

According to the research some of the women in the clinical studies leading up to the approval of the drug claimed they were less distressed by their “condition,” Hypoactive Sexual Desire Disorder, than they were at the beginning of the study. According to clinical trials of Addyi held in 2013, only 8% – 13% of the women experienced “much improved” sexual desire and only about 2 more satisfying sexual encounters per month were had. In other words, when behaviors were studied, the actual number of satisfying sexual episodes reported by these less distressed women hardly changed of all. This indicates to me that the antidepressant helped lift the spirits of the distressed women, but did nothing to increase their satisfaction with their sexual outlet.

Twice the FDA rejected Addyi for its severe side effects and marginal ability to produce the effect that it is being marketed for. And despite the fact that the drug is now available, those side effects still exist. Women who take the pill are likely to experience dizziness, nausea, drowsiness, fainting spells, and falling blood pressure. Coupled with alcohol and even hormonal contraceptives the odds of these potential side effects occurring increase. Persons with liver ailments, or taking certain other medicines, such as types of steroids are also at higher risk. On the other hand Viagra has very mild side effects that may include headaches, indigestion, blue-tinted vision and in some cases a stuffy nose.

While a man can pop Viagra an hour or so before he plans to have sex, women who are looking for increased sexual desire need to take Addyi daily for up to a month before they should expect to see any effects.

Good luck