Category Archives: Female Sexual Dysfunction

Female Sexual Dysfunction, Another Perspective

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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

Bum Rap

Name: Skye
Gender: Female
Age:
Location:
The reason I am writing is because my boyfriend and I have been together for about a year, and we’ve been having some problems with sex. The problem is that I have difficulty getting to a climax. The problem with this is that my boyfriend feels like he has not accomplished anything if he can’t get me off (which generally nobody is able to do). The only way that I am able to climax is during anal sex and my boyfriend does not want that all the time and has become skittish about doing it at all because of some difficulties with this earlier in the relationship (I am not very experienced).
This issue is starting to drive a wedge between us, and neither of us wants to break up over this. So we are asking for some advice as to what we can do, or what we can try. One thought that I have had is that maybe I am nervous when I’m with other people because while I have difficulty climaxing when I’m with somebody, I have no difficulty at all when I’m alone.
Please give us any advice you can, or point us to somebody who might be able to help us.
~Skye

Ok, let’s take this apart piece by piece, shall we? You’re unable to cum through partnered sex, despite the willingness of your BF to try and please you as much as humanly possible, right? But you are orgasmic; I mean you can cum when you are by yourself, right? This suggests to me that you are suffering from performance anxiety. a150455_xlf

While performance anxiety is mostly talked about in terms of men and their erection problems, they don’t have a monopoly on the annoying issue. It’s an arousal phase concern and we all have an arousal phase regardless of our gender.

I’d be willing to guess that since you say you are not very experienced with sex, you may be creating a level of anxiety that short-circuits your pleasure. Sad to say, this often plagues younger women the most. Young women tend to have less self-esteem. And if they are new to sex, they may not know what they are doing, which can be not only frustrating, but also distracting.

So let me ask you a few questions. First and foremost, what’s going on in your mind when you are having sex with a partner? Are you focused on the pleasure you are giving and receiving? Or are you focused, like so many people on something other than that?

a96261_xlfIf your mind is busy with how you look, or how you smell, or if you are wondering if that birthmark of yours is too obvious. Or if you’re worried about how accomplished you are at performing a particular sex act; then you may have performance anxiety. If you anxious about what your partner thinks of you, if he’s turned on by you, or loves you, or is just bangin’ away at you like a side of beef; then you may have performance anxiety. If you’re afraid to let go and have a screamin’ meme of an orgasm, because it might not look lady-like, or you’re not sure you can trust the person who’s bumpin’ you enough to just relax and enjoy the ride; then you may have performance anxiety.

It also appears from what you say that your BF could also be developing a complex since he’s unable to pleasure you to climax. So let’s see if we can nip this in the bud before it gets to be a full-blown dysfunction.

Many women report that their partnered sex is not as satisfying as their solo sex, because they’re not able to stimulate themselves in the same fashion in partnered sex as they do when they’re jillin’ off. If you are self-conscious about showing your partner the particulars of gettin yourself off, or too intimidated to incorporate a vibrator in your love making, you might not be getting the kind of stimulation you need when you need it. Thus you might be aroused, but not to the point of lettin’ one loose…if ya catch my drift.a6402_xlf

I am also very curious about another thing you mention. You say; “The only way that I am able to climax is during anal sex and my boyfriend does not want that all the time and has become skittish about doing it at all because of some difficulties with this earlier in the relationship.” That’s downright amazing. Butt fuckin’ get you off, but not traditional, cock in cooch, sex? Holy cow! How did you come to be so well acquainted with anal sex when you claim you are not very experienced with sex in general? I’d be very interested in hearing more about that, don’t cha know.

Finally, may I suggest that you and the BF take advantage of Dr Dick’s How To Video Library. It is chock full of swell videos that you guys can watch together. This might be the very thing ya’ll need to break open a conversation about the kind of sex you are having as opposed the kind of sex you both desire.

a168705_xlfA lot of the videos in my library will teach you how to ask for what you need and want. How to shake things up and add some spice to your sex play. You’ll learn new ways of pleasuring one another. And, most importantly, how to relax and enjoy yourselves. Once you guys learn how to effectively communicate with one another about sex, you will have gone a great distance in clearing the air of unnecessary sexual anticipation. You’ll both be able to relax into the event itself and enjoy yourselves more. Here is just a tiny sampling of titles to look for:

Women’s Sexual Satisfaction
Personal Touch: Toying With Pleasure
Nina Hartley’s Guide To Couples Sexploration
Expert Guide To Female Orgasms
Guide To Bondage For Couples

In my How To Video Library you’ll be able to search by stars, like Nina Hartley or Tristan Taormino. You can search by Directors, like Michael Perry or Jamye Waxman. Or you can search by topic, like cunnilingus, toys or anal pleasure. And the best part is that this wealth of information is right there at your fingertips.

Good luck

SEX WISDOM With Lara Eardley — Podcast #391 — 09/25/13


Hello sex fans! Welcome back.facebook dec 2012

I know, let’s take an audio field trip to the land down under to visit with one of the most exciting women I’ve ever met. She is a pioneer in her field. She is an author, an activist, and advocate for pelvic floor strength. In a minute the incomparable, Lara Eardley will join us. But. before she does, I want you to prepare yourself to be bowled over. Laura is a powerhouse of passion and I’m pretty sure we will be treated to the full force of her signature SEX WISDOM. Buckle your seat belts, sex fans!

Lara and I discuss:

  • Being passionate about pelvic floor muscles;
  • Good, responsive and supple muscles prevent incontinence;
  • Education, education, education;
  • Sexual fitness;
  • Her study of Buddhist tantra, sexual medicine, and energetic work;
  • 6000 years of cultural knowledge;
  • Awareness and evolution;
  • Bliss;
  • Ejaculation control and life-force energy conservation;
  • Self-cultivation.

Lara invites you to visit her on her site HERE! Don’t miss her YouTube channel HERE! And she also on Facebook HERE! And Twitter HERE!

 

Click on the cover art below for more information about Lara’s books and her DVD.

pelvic floor DVD     Enchantress Book Cover     enchantress

BE THERE OR BE SQUARE!

Look for all my podcasts on iTunes. You’ll find me in the podcast section, obviously. Just search for Dr Dick Sex Advice. And don’t forget to subscribe. I wouldn’t want you to miss even one episode.

Today’s podcast is bought to you by: Dr Dick’s Stockroom.

drdicksstockroom.jpg

You’ve lost that lovin’ feelin’

Name: Heather
Gender: Female
Age: 36
Location: USA
I have been married for 10 years. I told my husband 6 years ago that I was not physically attracted to him anymore. I stopped wanting sex from him, because he just turned me off. No matter what he does — cleaning, cooking, running me a bath, eat me and so on but nothing works. I start to get wet and as soon as he gets started but I dry up like a prune what should I do? I have not had good sex in a long time.

Well, if you’re not attracted to him anymore, you’re not attracted to him anymore…plain and simple. But what I don’t get is, how come you’re old man is still hangs in there after six years of disinterest on your part? Is he some kind of glutton for punishment?he & she hips

If I was your long-suffering hubby and I was doin all this stuff, including cooking, cleaning and eatin’ out your pussy, I’d sure as hell demand an explanation for your attitude change. Of course, maybe he likes being the doormat. Some men really get off on being dominated and treated like shit. Is that why you are no longer into him, because he’s behaving like an emasculated pussy?

Or is there something else he’s done that has put you off? Did he gain weight? Does he not attend to his personal hygiene? Did he become a Republican? Ya know, things like that. If it is something he’s done or failed to do and he can change his behavior to better suit you, maybe you oughta clue him in on this.

haven't had sex in a whileHowever, if it’s not something he’s done or failed to do, but it’s you. Then he needs to know that too. You did say that you dry up like a prune. Are you using lube with your penetrative sex? Perhaps it’s your libido that’s gone south, not his relative attractiveness? Sometimes women get these two things confused. And there are any number of things that can mess up the arousal phase of your sexual response cycle.

Do you have sexual fantasies? Do you masturbate? Are horny for anyone else — either real or imagined? How’s your health? Are you on birth control? Are you depressed? Sleep deprived? Are you putting on the pounds? Could you be experiencing early-onset menopause? As you can see, there are innumerable reasons for a decrease in libido.

At any rate, Heather, you really need to get to the bottom of this, and soon, six years is a mighty long time to live like this. I’d look for a sex-positive therapist to connect with, if I were you. Clearly, you’ve been unable, in six years, to discern the cause of your attitude change on your own. It’s irresponsible to continue to drift with the status quo.

Good luck

Name: Pete
Gender: Male
Age: 33
Location: Florida
I’ve noticed that some of the skin on my dick is starting to wear away from me masturbating…there is no blood or anything like that. Just the skin turning light in color around head of my dick. I think it’s my grip. Is there a way the color will come back or have I rubbed the skin cells to death. I masturbate about 3-4 times a week. I’m not in a relationship and prefer masturbation over random sex.

Your dick skin is wearing away??? Really? What are you handling your unit with, darlin’, sandpaper?

You say you think it’s your grip. Ya think? Hey Pete, are you using lube when you stroke? Or are you just yanking away down there with wild abandon using a dry hand? If you’re not using a good jack off lube like, Spunk Lube then ya better start right away! This stuff is also great for use with condoms.jeans 1

As to the rather sudden coloration change on your dick, I’d be willing to guess that it has nothing to do with jerkin’ off, even like a maniac. More likely it’s a genetic condition known as vitiligo. And the coloration change is actually a loss in pigment. This is not a health concern. Really! Nor is it contagious. So you don’t have to worry about it in that regard. If it is indeed vitiligo, there’s nothing you can do about it. It’s irreversible, but it can and does spread.

Here’s a relatively easy way to self-diagnose this pesky, but benign condition. While naked as a jaybird, squat over a mirror. If what you have is vitiligo, you will also see the same kind of color changes (or more properly — loss of pigment) around your asshole. You may also notice it on your elbows and knees. If you are fair-skinned, the loss of pigment will be less noticeable then if you have a darker complexion.

If it’s not vitiligo, you might consider a check up with your physician. But I pretty much can guarantee you that unless you are absolutely ruthless in your masturbation technique, manhandling yourself is not the cause of the color change on your joystick.

Good luck

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