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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.


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

Death Is Way More Complicated When You’re Polyamorous

By Simon Davis

death become her

Screencap via ‘Death Becomes Her’

In February, Robert McGarey’s partner of 24 years died. It was the most devastating loss McGarey had ever encountered, and yet, there was a silver lining: “I had this profound sadness, but I don’t feel lonely,” McGarey told me. “I’m not without support, I’m not without companionship.”

That’s because he has other partners: Jane, who he’s been with for 16 years, and Mary, who he’s been with for eight. (Those are not their real names.) And while his grief for Pam, the girlfriend who died, was still immense, polyamory helped him deal with it.

There’s not a lot of research into how poly families cope with death—probably because there’s not a lot of research about how poly families choose to live. By rough estimates, there are several million poly people in the United States. And while polyamory can bring people tremendous benefits in life and in death, our social and legal systems weren’t designed to deal with people with more than one romantic partner—so when one person dies, it can usher in a slew of complicating legal and emotional problems.

“Whether people realize it or not, the partner to whom they are married will have more benefits and rights once a death happens,” explained Diana Adams, who runs a boutique law firm that practices “traditional and non-traditional family law with support for positive beginnings and endings of family relationships.”

Since married partners rights’ trump everyone else’s, the non-married partners don’t automatically have a say in end-of-life decisions, funeral arrangements, or inheritance. That’s true for non-married monogamous relationships, too, but the problem can be exacerbated in polyamorous relationships where partners are not disclosed or acknowledged by family members. In her work, Adams has seen poly partners get muscled out of hospital visits and hospice by family members who refused to recognize a poly partner as a legitimate partner.

McGarey and his girlfriend Pam weren’t married, so the decision to take her off life support had to go through Pam’s two sisters. The money Pam left behind—which McGarey would’ve inherited had they been married—went to her sisters too, who also organized Pam’s funeral.

This kind of power struggle can also happen among multiple partners who have all been romantically involved with the deceased. The only real way to ensure that everything is doled out evenly is to draft up a detailed prenuptial agreement and estate plan. Adams works with clients to employ “creative estate planning” to ensure that other partners are each acknowledged and taken care of.

Adams is a big proponent of structured mediation as a way of minimizing post-mortem surprises, like when families discover the existence of mysterious extra-marital partners in someone’s will. It’s much better to have those conversations in life than on someone’s deathbed, or after death.

But many poly people remain closeted in life and in death, according to sociologist Elisabeth Sheff, who has studied polyamorous families for 15 years and authored The Polyamorists Next Door: Inside Multiple-Partner Relationships and Families. A person might have a public primary partner—someone they’re married to, for example—plus other private relationships. That can make it harder to grieve when one of the non-primary partners dies, because others don’t recognize the relationship as “real” or legitimate in the way the death of a spouse might be.

Take, for example, something like an employee bereavement policy. Guidelines from the Society for Human Resource Management spell out the length of time off given in the event of the death of a loved one: a spouse, a parent, a child, a sibling, in-laws, aunts, uncles, grandparents. Unsurprisingly, extra-marital boyfriend or girlfriend is not on the list. (Actually, “boyfriend” and “girlfriend” aren’t on the list at all.) It’s possible for an employee to explain unique circumstances to an employer, but in her research, Sheff has found that some poly people prefer not to “out” themselves this way. People still disapprove of extra-marital affairs and some poly people, according to Sheff, have even lost their jobs from being outed, due to corporate “morality clauses.”

It’s similar, she says, to the experiences of same-sex couples who are closeted. “It’s much less so now because they’re more acknowledged and recognized, but 20 years ago, it was routine for [the family of the deceased] to muscle out the partner and ignore their wishes—even if [the deceased] hadn’t seen their family for years and years,” Sheff said. “They would come and descend on the funeral and take over. Or when the person was in the ICU. That same vulnerability that gays and lesbians have moved away from to some extent is still potentially very problematic for polyamorous people.”

Legal recognition of polyamorous unions could provide some relief. After the Supreme Court struck down the Defense of Marriage Act in 2013 and legalized same-sex marriage in 2015, calls for legalizing plural marriage have only become louder. Adams noted that an argument put forth in Chief Justice John Roberts’s 2015 dissent may provide a legal foothold for legalization advocates. “As Roberts points out, if there’s going to be a rejection of some of the traditional man-woman elements of marriage… those same arguments could easily be applied to three or four-person unions,” she said in an interview with US News & World Report earlier this year.

In 2006, Melissa Hall’s husband Paul died at the age of 52. Both were polyamorous, but Paul’s death presented “no special problems,” since they were legally married and Hall had all the rights of a spouse. Instead, she found unexpected benefits in dealing with her husband’s death: In particular, she told me that “being poly made it easier to love again.” Since they had both dated other people during their life together, Hall knew her husband’s death wouldn’t stop her from dating again.

In traditional relationships, it’s not uncommon for people to impose dating restrictions on themselves to honor the desires of their dead spouses, or to feel guilty when they start dating again. Of course, you don’t win if you don’t date either, as people eventually get on your case to “move on with your life.” All this goes out the window when you’re polyamorous, where dating doesn’t necessarily signal the end of an arbitrary acceptable period of mourning.

More partners in a relationship can certainly mean more support. It can also mean more people dying, and with that comes more grief. In an article about loss among polys published in the polyamory magazine Loving More, one man wrote: “Those of us who have practiced polyamory through our lifetime must be grateful for the abundance of love in our lives. But having those wonderful other loves means we must accept a little more grieving as well, when our times come.”

Is the trade off worth it? McGarey certainly seems to think so. “There is more grieving, but… we are held and cradled in the love of other people at the same time.”

He compares his relationship to the Disney movie Up, which starts with a guy falling in love and marrying his childhood sweetheart. “And then [she] dies, and he turns into this grumpy old man because he lost his love,” McGarey said. “I don’t see myself turning into a grumpy old man. I don’t know if I can attribute that to poly, but maybe that’s why.”

Complete Article HERE!

Balls and Scrotums: Low Hangers and Tight Purses

Hey sex fans,

I found a sweet article that compliments one of my most popular posts evah:  Great Balls of Fire!

by the balls

Balls, testes, testicles, plums, bollocks, gonads, knackers – all held in the scrotum, cum-sac, nut sack, ball bag or whatever your favourite description might be. It’s been my observation that balls run a distant second to the all-conquering shaft and cock-head when it comes to guys checking each other out. When was the last time you heard or read the line similar to “great balls mate – I’d love to suck on those juicy plums while I wank off” and if you did, would you think it a bit bizarre, a bit off colour? While cock size talk is paramount talk about balls just doesn’t do it for most guys. Pity, as you can be missing a treat.

  • Our family jewels, our package is something many of us take for granted, so let’s take a few moments to reflect on the similarities as well as the differences.
  • They produce sperm and testosterone – and that equates to an explosion of taste as well as giving us our horniness. That’s the best tag team I can imagine.
  • They can hang evenly, but more commonly they hang with one higher than the other, normally the higher one being the right one. What about your own? Checked lately?
  • Temperature variations can make a difference – the warmer the environment the lower the hang. Our jocks can affect our balls and the sac by being too tight and/or too hot. Hence the enormous variation in underwear and the inevitable journalist question – “Briefs or boxers?” Tension can be another factor in tightening the ball sac.
  • And for the scientifically inclined: Sperm is most prolifically produced where the temperature is 3.6 degrees lower than body temperature, that is at 35 degrees Celsius or 95 degrees Fahrenheit.
  • Hairy balls and shaving. Scrotums generally have some degree of hair on them. Have you noticed how hot and sticky shaved balls can be on a hot day? Hair can assist in the cooling effect on the balls. So weigh up shaving for sexual intrigue and sexual tension against comfort and cool balls. Read more about shaving in my earlier blog: “Wax, Shave or Trim?” (February 2014).trucknuts
  • The majority of us have two balls, but we could adequately function on one. An artificial one can be inserted into the scrotum for cosmetic reasons.
  • Men can get testicular cancer. Remember to check your balls every few weeks for any signs of abnormality. If there’s any indication of a lump, a swelling or any form of pain, go immediately to your doctor. Testicular cancer needs to be detected early but with any of these indicators you must appreciate that it needs investigating for whatever reason there is the oddity. Whatever your age, don’t be embarrassed about discussing it with your medical authority. A good time to check them is when you’re under a shower.
  • Cockrings and other penile and scrotal devices can have a painful and devastating effect on the balls if blood supply is interrupted or restricted. They should only be worn for limited amounts of time, with 30-45 minutes being a maximum. Read more in my blog of September 2013 “Cock Ring / Penis Ring – A Beginner’s Guide To A Stronger Erection!”
  • Bruised balls – if your partner has squeezed your balls too hard, you’ve slapped your balls too hard against a friendly buttock while you’ve fucked or otherwise over-exerted or bruised your balls then you may need to seek medical advice. Depending on the severity, bruising tends to dissipate of its own accord over a day or two.
  • Big balls – research is beginning to suggest that possibly men with big balls are in fact producing a higher rate of testosterone which can lead to heart disease in some circumstances.

With such a huge variety of balls and scrotum on our male partners, just be prepared that as you sexually explore more and more men, you’ll be amazed at the variety on offer. Lick and gently nip the scrotum. Individually or together gently roll the balls in your mouth. Let cock-rings and other toys stretch and otherwise highlight the plums – then polish them with the palm of your hand. Suck on an ice-cube before putting your cold mouth on to his balls and see the reaction. Notice the reaction in some men when their nipples are teased or squeezed that there is a direct connection to the balls and his shaft.

Whilst I acknowledge the overwhelming interest in body muscles, cock sizes and inviting arse cheeks, perhaps we should be checking out his balls with equal enthusiasm. I know I do!

Complete Article HERE!

Notching the belt

Hey Doc,

So I’ve asked you a question anonymously before and you were a huge help so here I am again.
My names Mike and I’m 17 years old. For some reason it takes me a ridiculously long time to “finish” with my girlfriend. It’s not her, because this has happened with about 4 or 5 other women before her. It’s an annoying flaw that it takes me about 90 minutes to finish, if I finish at all. My GF and I get tired and eventually just stop because it’s too tiring and just plain tiresome. Is it performance anxiety or something? My first time having sex was anal with a girl, and I have done anal with girls many times before so it was a lot tighter than vaginal intercourse, not sure if that affects anything… I am really tired of lasting so long; I just want to be done when she is, much earlier.

I’ll be glad to answer any questions or anything you might need to know,
Thank you so much in advance, Mike.

finger fuck00445Where to begin, Mike? You’re 17, you’re having performance problems with your GF and you have had with about 4 or 5 other women before her. Holy Cow! you certainly are a sexually precocious lad, aren’t you?

I can’t help but notice a bit of sexual bravado in your message. I don’t know if that’s intended or if it’s more of a subliminal message. Either way, I have a feeling that there is some belt notching goin on here and that may be the root of your problems.

Here’s why I say this. There is nothing in your message that communicates that the sex you’re having is fun, or that it’s play. All I hear is that you’re a young man on a mission. You want to get off in a timely fashion and you’re currently being frustrated in that pursuit. You sound so goal oriented and your sex sounds like a task, rather than a playful adventure.

Us men folk get like this sometimes; and we’re the poorer for it. We’re all about solving a problem instead of enjoying the moment. The curious thing about this is that enjoying the moment is often the best way to solve a sexual performance problem.bryan_tony_box

When I hear men and/or women talking about their sex life like it’s work, I know there will be problems ahead. And you, Mike, sound like your sex is way more work than fun. If you were a sex worker or a porn star, I’d understand your predicament. But I suspect that you are neither a sex worker nor a porn star. You are, however, a young man who has, for one reason or another, scuttled all the joy and wonderment from your sex play. And that, my friend, is a crying shame…and at your tender age too. How do you suppose you’ll behave when you’re an old man of 25?

This path you’re on will continue to lead you into a sexual wilderness. You will become increasingly frustrated in your efforts to cum “on time”…and I use that term in quotes, because you’re all about bangin’ something rather than pleasuring and being pleasured by someone.

The comment you make about the difference between butt sex and pussy sex also tells me a lot about the kind of tightness you need to get off. I’d be willing to guess that you have a death grip on your johnson when you wank; am I right? Obviously your average asshole is a tighter orifice than your average pussy. But, if you were really turned on and enjoying the mutual pleasure available to you and your partner, instead of worrying about busting your nut during the fuck itself, you could jettison all those “shoulds” you have when you’re supposed to be enjoying yourself in the company of your lover.

beltWhy not stop what you are doing and take a look at why and how you are doing it. You may surprise yourself with what you find. And if you are man enough, have a heart-to-heart chat with your GF and get her feedback on what she encounters when she fucks you. Again, I’d be willing to guess she’d have some timely advice to offer you on how to fuck and get fucked.

Good Luck

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