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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.

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

The Heartbreak of Male Performance Anxiety

I get a dozen or so messages a month on this topic. I’ve written about it in numerous postings and spoken about it in several podcasts, but still the email comes.

One of the real bugaboos for anyone, regardless of gender, is living up to our own expectations of sexual performance. So many things can get in the way, literally and figuratively, of fully enjoying ourselves and/or pleasuring our partners.

The arousal stage of our sexual response cycle is particularly vulnerable to a disruption. And when there’s trouble there, there’s no hiding it. A limp dick or a dry pussy can put the kibosh on all festivities that we may have hoped would follow.

However, performance anxiety can strike any of us, regardless of age, and at just about any point in our sexual response cycle. This is a particularly galling when it seems to come out of the blue. And regaining our composure can be more far more difficult than we imagine.

Today we will be focusing on male performance anxiety.  I’ll address female performance anxiety at a later date.

Here’s Bob, he’s 26:
Doc, this has never happened before. But I couldn’t get it up tonight, and this chick was H.O.T. Now I’m not gay at all, but I haven’t had sex in about 3 years because I was locked up…so I masturbated pretty regularly, about 3 or 4 times a week. But I can’t figure out why I was soft… the only thing I can think of is I ate clams tonight and I’ve never had them before. Could it be that or should I get checked out?

It weren’t the clams, darlin’! And I don’t think you need to get “checked out” either…at least not right away. If you could back away from the situation a bit and stop freaking out, I think you’d discover the source of your problem all on your own.

Here’s the thing—while you were out of commission there in the slammer, you relied, as you say, on jerking off. Okay, cool. We all do what we gotta do. Now the first time you try to score after your release…you go soft. This tells me you have a mild case of performance anxiety. We all get that from time to time.

There’s probably nothing wrong with you or your johnson. You just got the jitters first time you tried to get you some after being away, that’s all.

The anticipation of boning this H.O.T. chick—fueled by some predictable self-consciousness; what with just getting out of the big house and all—pulled the plug on your wood. No surprise there, right?

What I don’t want to see happen is for you to replay the incident over and over in your mind’s eye til that’s all you can think about. If you do, this proverbial molehill will become a mountain. You’ll then bring all this anxiety to your next encounter, setting yourself up for even more disappointment. You can see how this shit can snowball? If you interpret every less than satisfying encounter as a failure, your fears will become self-fulfilling. You’ll begin to avoid partnered sex and you’ll develop a full-blown sexual dysfunction. And your self-esteem will take a nosedive, too.

If you’re preoccupied with your performance, it’s less likely that you’ll be fully present during sex with a partner. This pretty much fucks up your sexual responsiveness and any hope for spontaneity. Why not just relax into the whole sex thing and not try to prove your manhood with your pecker?

Then there’s Steve with a slightly different take on this meddlesome problem:

My partner and I have been together for just over 3 years now in a monogamous relationship. I am the top and he the bottom. Our problem is not premature ejaculation on his part, but his inability to have an orgasm at all. No matter what I try and even if he masturbates, sometimes it is impossible to get him to cum. Is this a medical issue? Have you ever heard of this?

Delayed ejaculation is the difficulty one has ejaculating even with a firm erection and sufficient sexual arousal and stimulation. This problem is not uncommon. For most men, delayed ejaculation occurs during partnered sex more frequently than while masturbating. In fact, 85% of men with delayed ejaculation can usually cum by jacking off. However, in partnered sex, the guy may be unable to ejaculate at all, or only after prolonged partnered stimulation. This problem can be very frustrating and cause distress for both partners involved, as you already know.

What causes delayed ejaculation? Well, it could be a number of things. It could be something as simple as performance anxiety, or inadequate stimulation, or there could be neurological damage.

I don’t want to be too reductionist here, but most of us experts believe that the majority of instances of delayed ejaculation aren’t physical in nature, but rather are the product of psychological concerns. Simply put, there’s a difference between the psychosexual response we have when we are alone and the one we experience with a partner. There’s probably nothing wrong with your partner’s unit. It’s all in his head…or his mind, to be more exact. If I had to guess, I’d say he’s got a real bad case of performance anxiety.

When I see this sort of thing in my private practice, I always begin the therapeutic intervention by calling a moratorium on fucking of any kind. This immediately takes the pressure off the couple. From there we begin to rebuild the partnered psychosexual response one step at a time. We begin with sensate focus training (Sensate Focus is a series of specific exercises for couples that encourage each partner to take turns paying increased attention to their own sensations. More about these helpful exercises in the weeks to come.), stress reduction and relaxation exercises. These applications are designed to reduce performance pressure and instead focus on pleasure. The idea is to get them to stay in the moment; absorb the pleasure present without worrying about what is “supposed” to happen.

Finally we address as frankly and openly as possible any fears or anxieties that they may have—as individuals or as a couple. I have the greatest confidence in this method; it succeeds over 90% of the time.

Ok, let’s recap shall we?

Overcoming sexual performance anxiety is dependent on five simple things.

  • First, a guy needs to be attuned to his sexual response cycle — arousal, plateau, orgasmic and resolution phases. He should know what kind of stimulation he needs at each phase to fully enjoy himself and satisfy his partner.
  • Second, the more worried a guy is about a performance issue, the more likely that problem will present itself. A bad experience in the past can often set the stage for its recurrence.
  • Third, don’t be afraid to talk this over with your partner. Withdrawing from your partner or shying away from sex altogether will only increase the likelihood that the problem will persist.
  • Forth, be proactive! Fearing the loss of your sexual prowess or feeling sorry for yourself is counterproductive. Confront the challenge head on. Employ sensate focus training stress reduction techniques and relaxation exercises to help you push past this temporarily impasse and regain your self-confidence.
  • Fifth, free yourself from the mindset that your dick is the center of the universe. Your manhood or your capacity to be a great lover does not reside in your genitals. Expand your sexual repertoire. Remember, pleasure centers abound in your body as well as your partner’s.

Good luck!

There Really Isn’t Any Bad News for People Who Like to Masturbate

by Martha Kempner

logo-40b3359ffcbc2c0f73dcb295eaaf087c62a05314a9e0e77bec11bce10e74c628

Masturbation is such an under-appreciated form of sexual activity. It has been blamed in urban legends for everything from hairy palms to lack of productivity, and has a reputation of being reserved for those who can’t find anyone else to have sex with them. But that’s just not true. Most people masturbate. It feels good. It carries no risk of pregnancy or disease. It can take as much or as little time as you have. And it’s relaxing. So why have media outlets warned readers that they might be doing it too much or the wrong way?

Recently, in a December 15 article titled “We’ve Got Bad News for People Who Love Masturbating,” Maxim’s Ali Drucker tells readers: “If you or someone you love frequently enjoys doing the five-finger shuffle, there’s a study that suggests they might face negative effects over time.” The article actually points to three pieces of “research” that seem to suggest masturbation isn’t as good as other forms of sexual behavior, that one can become addicted to it, and that the “grip of death” can make men incapable of experiencing pleasure any other way.

Well, RH Reality Check has good news—these conclusions are largely based on junk science and misunderstandings.

masturbationThe first study Drucker cites, originally published in Biological Psychology, is called, “The post-orgasmic prolactin increase following intercourse is greater than following masturbation and suggests greater satiety.” Prolactin is a hormone that is released by the pituitary gland. Its main function is to stimulate milk production when a woman is lactating, but it also plays a role in the sexual response cycle. According to the study, which was first published about ten years ago, prolactin is released after orgasm as a way to counteract the dopamine released during arousal. Some scientists believe that the more satisfying the experience is, the more prolactin levels will go up afterward.

For this study, Stuart Brody and his colleagues compared data showing prolactin levels after penile-vaginal sex to those after masturbation and found that levels after intercourse were 400 percent higher than after masturbation. They interpreted this to mean that intercourse is more physiologically satisfying than masturbation.

On the surface, this conclusion isn’t surprising. Many people don’t view masturbation as the same as a shared experience with a partner. It doesn’t tend to produce the same physical or psychological feelings. But that doesn’t mean it’s not a fun and satisfying way to spend a few minutes (or hours, if you’re ambitious or bored).Masturbate-a-Thon_Logo

When I read the study, I did not interpret it to say that intercourse was better than masturbation, just that our biological reactions to different sexual behaviors were different. I had never read anything by Professor Brody before and reached out to him, assuming that people were overstating his results and that he did not mean to discourage masturbation. I thought, what sex researcher would ever want to discourage masturbation?

However, he replied, “Instead of any fresh quotes, I attach my review paper on the evidence regarding health differences between different sexual behaviors.” He sent me a different article, a literature review in which he says in no uncertain terms that penile-vaginal intercourse (PVI) is the best kind of sex and that “sexual medicine, sex education, sex therapy, and sex research should disseminate details of the health benefits of specifically PVI.”

masturbating womanAs a sex educator, I can’t imagine telling anyone that penile-vaginal sex is inherently better. For one thing, not everyone is in a couple, and not all couples have a penis and a vagina between them. And even for cisgender heterosexual couples, PVI is only one of countless potentially pleasurable behaviors. Moreover, many women find it less satisfying and less likely to end in orgasm than behaviors that incorporate clitoral stimulation.

But Brody not only thinks it’s the best form of sex—he thinks we sometimes do it wrong. He writes that “PVI might have been modified from its pure form, such as condom use or clitoral masturbation during PVI.” He also explains that Czech women who were vaginally orgasmic were more likely than their peers who didn’t have orgasms through PVI to have been taught during childhood that the vagina is “an important zone for inducing female orgasm,” concluding that “sex education should begin to be honest” about sexual behaviors.

I thought we’d moved on from the idea that we should all be having heterosexual, penile-vaginal sex in its “pure form” (missionary position?) and that women who couldn’t orgasm this way were both bad at sex and shit out of luck.

Colleagues in the field told me that many of them ignore Brody’s studies because he makes wild inferences based on soft science and, as implied by his research, is wedded to the idea that for sex to have the most benefits it needs to include PVI.

Nicole Prause, a researcher who has written critiques of Brody’s work, told me via email that, “His work almost exclusively uses data from other researchers, not his own, meaning the design is never really appropriate for the claim he is actually trying to make.” She went on to say that Brody’s studies on orgasm are often based on self-report, which is notoriously unreliable. Although the study Maxim cites was based on blood tests, “He has never once verified the presence of orgasm using a simple physiological measure designed for that purpose: anal EMG. Many women are thought not to be able to reliably distinguish their orgasm, so his purely self-report research is strongly suspect. If this is his area of focus, he should be studying it better than everyone else,” she concluded.female_masturbate.jpg

But Brody’s research on prolactin isn’t the only questionable science that Maxim relies on for its cautionary tale on masturbation. The article goes on to discuss the role of oxytocin and dopamine and points out that there’s less oxytocin released during masturbation. This is probably true—oxytocin is known as a bonding hormone and is triggered by contact with other people, so it’s not surprising that it’s not released when you’re orgasming alone. The Maxim article, however, argues that if the brain is flooded with dopamine (a neurochemical) during masturbation without the “warm, complacent, satisfied feeling from oxytocin,” you can build up a dopamine tolerance, or even an addiction, and get into “a vicious cycle of more masturbation.”

David Ley, PhD, a clinical psychologist and sexuality expert, explained in an email that many people describe dopamine as the “brain’s cocaine,” but this is an overly simplistic way of looking at it. It doesn’t mean we’re at risk of desensitizing our brain or getting addicted to jerking off. Ley wrote:

It appears that there are many people whose brains demonstrate lower sensitivity to dopamine and other such neurochemicals. These people tend to be “high sensation-seekers” who are jumping out of airplanes, doing extreme sports, or even engaging in lots of sex or lots of kinky sex. These behaviors aren’t caused by a development of tolerance or desensitizing, but in fact, the other way around—these behavior patterns are a symptom of the way these peoples’ brains work, and were made.

OK, dopamine isn’t cocaine and neither is masturbation: We’re not going to get addicted if we do it “too” much.

But, wait, Maxim throws one more warning at us—beware the “death grip.”

Though the article describes this as “the idea that whacking off too much will damage your dick,” the term, which was coined by sex advice columnist Dan Savage, is more about getting too accustomed to one kind of stimulation and being unable to reach orgasm without it. There is some truth to this—if you always get off using the same method, you can train your body to react to that kind of stimulation and it can be harder (though rarely impossible) to react to others. There are two solutions, neither of which involve giving up on masturbation: Retrain your body by taking some time off from that one behavior and trying some others, either by yourself or with a partner, or incorporate that behavior into whatever else you’re doing to orgasm (like clitoral masturbation during intercourse).

male_masturbationIn fairness, the Maxim article ends by acknowledging that masturbation can have benefits, but I still think it did its readers a disservice by reviewing any of this pseudoscience in the first place. As Ley said in his email, “This article, targeted towards men (because we masturbate more), is still clearly pushing an assumption that there is a ‘right kind of sex/orgasm’ and that masturbation is just a cheap (and potentially dangerous) substitute … That’s a very sexist, heteronormative, and outdated belief based on a view of sex as procreative only.”

So for a different take on it all: Sure, there might be more prolactin and oxytocin produced during intercourse than masturbation, but that does not mean that masturbation isn’t enjoyable or worthwhile. You won’t become addicted to it, but you might want to mix up how you get to orgasm or just incorporate your preferred stroke into all other sexual activity.

What you shouldn’t do is view the Maxim article—or any of the research it cites—as reasons not to stick your hands down your own pants.

Complete Article HERE!

How the penis disappeared from the sex toy

jimmyjane-form-2-01

by Hannah Smothers

You’ve seen what a penis looks like. Sure, there are variables that make each one a little different—the world is beautiful that way—but, generally speaking, they all fit a certain mold.

As the male sexual organ, the penis was designed to transport sperm from one body into another. As an added feature, the penis can also summon orgasm in a female partner during this process. But we know this isn’t always the case. While a healthy male organ works pretty well for its intended reproductive purpose, there are some design flaws in terms of maximizing female pleasure.

LILY 2So what if you could redesign the penis, make it a little bit better? Which pieces would you change, and which would you keep? Erasing the need for reproductive functionality, would you scrap the whole thing and start from scratch? In the end, would this magic device—capable of bringing women waves of pleasure—even resemble the penis in its current human form?

Welcome to the world of modern-day vibrators, a place largely devoid of the original pleasure device.

As sex toys have become increasingly sleek and modern—taking cues from the minimalistic designs of like Apple and Ikea—one clear trend has emerged: They no longer look like human penises. In fact, they no longer look human at all—which, according to designers, entrepreneurs, and sex therapists alike, is a very good thing.

Kitschy and grotesque

The first time the American public saw a non-human organ used to stimulate sexual arousal was in the early porn films of the 1920s. Over the previous few decades, small home appliances marketed under the guise of medical necessity (to cure the female ailment of “hysteria“) had become commonplace—kind of like how we now see “personal massagers” advertised in Brookstone. But in the new black-and-white pornos of the ’20s, audiences saw these appliances used for very non-medical purposes.

zini-deux-293x300And once the public was confronted with the idea that these devices could be used strictly for pleasure, the products disappeared from women’s magazines and reputable store shelves.

Vibrators made a second coming about 30 years later, during the sexual revolution of the 1960s. But even though Americans were talking about sexuality more openly than ever before, we still weren’t totally cool with the idea of incorporating these objects in our sex lives. In response, early industry leaders made them as outlandish as possible: Rotating glitter-dicks, two shafts emerging from one testicle-shaped base, rubber duckies that secretly vibrated. We displaced the awkwardness of using machines as sexual aids by turning these aids into novelty objects, or toys.

But there was a big problem with this approach. Since the products were advertised as “novelties,” not health aids, they were held to lower standards than medical devices and other things we put inside our bodies. The cheap toys were unsafe, ugly, and ineffective. And not at all sexy.

“I don’t think anyone has ever said, ‘I want a vibrator that looks like a bunny rabbit and a penis all smashed together,’” Ti Chang, the female co-founder of sex toy and jewelry design company Crave, told me. “I think the sex toy industry has really had a lot of male voices—it’s been men designing products for women, so it tends to be very male anatomy centric. Like, ‘Oh, it’s sex, she wants a big cock, so we’ll just make lots of different colors of cocks, and to make this really silly, we’ll put a little rabbit on it.’”

Companies like Doc Johnson—a leading novelty company for decades, notorious for its line of Zini DonutRealistic Cocks—offer a good example of the “she wants a big cock” mentality that dominated the industry during the late-20th century. Robert Rheaume, the president of high-end sex toy company JimmyJane, charmingly described these hyper-realistic dildos as the kind of severed penis you’d get if “there was an Orc from Lord of the Rings walking around, and they cut his penis off.”

He also argued, by nature of them being just so grotesque, they’re not very sex-positive. He put it to me this way: “Let’s say you and I are well into our sexual relationship, and I pull out this giant, Doc Johnson, 15-inch cock,” Rheaume said. “You might be like, WOAH, where’s that going? Get out of my apartment right now, I’m leaving—call me a taxi, call an Uber. It’s just intimidating and scary for some people.”

Kitschy, intimidating, grotesque—all are terms you could use to describe the sex toy market up until the early 2000s. The poor designs, cheap rubbers and plastics, and incredibly dick-centric domain of products presented itself as an untapped valley of junk, just waiting for a messiah. This is what Ethan Imboden, the founder of JimmyJane, realized upon walking into an Adult Novelty Manufacturers Expo a little more than a decade ago.

“As soon as I saw past the fact that in front of me happened to be two penises fused together at the base, I realized that I was looking at the only category of consumer product that had yet to be touched by design,” Imboden said in his 2012 Atlantic profile. Coming from an industrial design background, and lacking the desire to manufacture what he saw as landfill products, he left his job designing everyday consumer products to launch JimmyJane—a sex toy company that would put safety, design, and sex-positivity first. Around this time, a small, luxury intimate toy company in Sweden called LELO started doing the exact same thing.

post-phalic 01The kitschy sex toy industry was primed for a big change, and companies like JimmyJane and LELO were ready to usher it in.

Disrupting the dick

Skeuomorphism is a concept in technological design that describes our tendency to retain tactile aspects of the physical world as we move more of our lives onto screens. At Apple, for example, skeuomorphic design was thought to ease the transition from the real to the virtual. Turning a page on your Mac or iPhone would closely resemble turning a page in a real notebook, paper sounds included. If you can recreate the physical aspects of a very familiar, tactile world in the flat, virtual reality of an operating system, designers have long believed, maybe more people will feel comfortable using the product.

In sex toy design, this has translated into manufacturing dismembered penises and inventing crevices meant to resemble human vaginas and mouths. But why—if women and couples are looking for something more than their own, very real human parts—would they want a plastic knock-off of those same parts in bed? Just as some people argue that retaining archaic, physical traits of notepads on our iPhones is unnecessary, companies like JimmyJane and LELO saw retaining the original design of human organs as unnecessary and outdated.

Of course, there will probably always be a market for straight-up dildos—which are different from vibrators—and which, by nature of their intended internal purpose, must resemble a human penis. But female-oriented vibrators allow more room for innovation.

With this in mind, JimmyJane and LELO’s emphasis on design, coupled with major tech advances of the early 2000s, allowed these pioneering sex companies to essentially reinvent the penis. “Technology drives the industry—it’s tech, tech, tech,” Patti Britton, a clinical sexologist in southern California, told me. “Everyone’s going for the faster, the most options for control, as well as these really unusual and really sophisticated designs.”post-phalic 02

Those sophisticated designs are now pretty commonplace, and they look nothing like human parts. The design shift comes as a result of technological advances, yes, but also reflects a pretty significant ideological shift. Vaginal penetration, as we now know, isn’t necessarily the key to female orgasm, and penises aren’t naturally shaped to stimulate the elusive G-spot. Skeuomorphism started disappearing from the industry, and the dick was reinvented—and ultimately displaced.

Luxury investments

When sex toys start looking less like severed organs, it gets easier for consumers to take them seriously. And when consumers start to take them seriously, it opens up room for a luxury class of sex toys—something that LELO and JimmyJane, especially, have capitalized on. Most of LELO’s products start at more than $120, though the company also boasts a 24-karat gold plated vibrator for $15,000. As Steve Thomson, LELO’s global marketing manager, told me, creating toys that last a lifetime, like a nice espresso maker or television, is “a way of challenging assumptions about the sex toy market as a whole.”

“There’s always going to be a place for novelty goods and phallic-shaped items,” Thomson said. “But I don’t believe that’s the future of sex toys in any way. People are moving away from the assumption that it’s purely a substitute for a partner.”

post-phalic 03To Thomson, as well as industry leaders at JimmyJane, Crave, and the numerous other companies that have joined the modern sex toy craze, the future of sex toys is in making objects that fit easily into a consumer’s everyday life. That’s why, as technology improves, we see things like app-controlled panty vibes and vibrators equipped with memory that will store your favorite sexual patterns.

Along with loosening cultural values around discussing sex—almost everyone I interviewed cited the Fifty Shades of Grey franchise as a major breakthrough—the shift in toy design has transformed the industry from a $1.3 billion a year industry to a $15 billion a year industry in revenue alone. “If it’s okay for the modern mom to have dialogue about Fifty Shades of Grey, sexuality and masturbation, I think it gives us complete permission to have these conversations and to make these products available,” Rheaume said.

He’s not wrong. Research shows that not only are more women using toys, they’re owning up to using more toys. Consumers are literally taking their orgasms into their own hands, and they’re commonly paying upwards of $150 to do so. Is it worth it to buy a vibrator that costs a bit more than something you might find at your neighborhood adult novelty shop if it means it’ll last longer and isn’t toxic to your body? Absolutely.

But not everyone can afford it, and while some products come with a money-back, orgasm guarantee—they don’t always work as advertised. Has design for the sake of being beautiful, and innovation for the sake of being advanced, displaced the actual functionality of the vibrator?

That’s what was bothering Janet Lieberman, a mechanical engineering grad from MIT and enthusiastic sex toy user. Facing repeated disappointment in the toys she bought, Lieberman realized she was in a unique position to utilize her expertise to make things better. The technology was good, but she saw it going in the wrong direction. There was a sort of machismo attitude slipping into products designed for women—who cares if your device can track your orgasms, give you Bluetooth feedback, and looks like modern art if it doesnt work?

Now, as co-founder and lead engineer for the New York-based sex toy company Dame, she’s ushering in the newest wave—and quite likely the future—of sex toy design.

Women come first

One of the big problems with the sex toy industry is how male-driven and controlled it’s been throughout most of its history. Sure, the men at LELO and JimmyJane have women’s desires in mind—both Thomson and Rheaume told me about the extensive research measures their companies take when designing new products. JimmyJane, for example, relied on data about average labia size from the renowned Kinsey Institute when creating its new Form 5 vibrator, which is designed to simultaneously stimulate a woman’s labia and clitoris.

And to make sure the products hitting the market are truly effective, the leading companies also rely on demo communities—women who test new prototypes and provide detailed feedback. But, as Lieberman argues, there’s a difference between running a product by a demo audience and having a woman—the target consumer of the product—involved each step of the way.

And so, it’s becoming increasingly common to see women-run sex toy companies, or to see women involved in the design and engineering process, according to industry insiders. “If they’re products for women, you kind of want women everywhere in the process so they’re making the right priorities,” Lieberman told me.

A female designer and engineer, for example, might know right off the bat whether something is going to work. It’s not that men don’t take all the important components into consideration—after all, some of these products are used mutually between partners—it’s just that women are more likely to understand the various nuances in their own anatomies, and take those into consideration in the engineering process.

While enabling sex toys to track activity and communicate long distance via the internet—both features on the newest models—is cool, Lieberman and Crave’s Chang both stressed a personal mission to deliver what sex toys have long promised: really fantastic orgasms.

“Having an orgasm is like a birth right, you should have it!” Chang said, in a sentiment famously voiced by Nicki Minaj and, more recently, Amy Schumer. In her process at Crave—which steers clear of trying to mimic anything anatomical—function always comes first.

Lieberman and her business partner, Alex Fine, took a similar approach when building Dame’s first product, a couple’s vibe called Eva. “I wouldn’t say that one of our primary goals in designing this was that we wanted it to be beautiful,” Lieberman said of the device, which resembles a futuristic beetle. “We wanted it to be accessible, but we put function ahead of form.”

They also wanted to make sure the cost wasn’t prohibitive—a sex toy that’s too expensive can actually detract from sex, she argues. Eva sells for $105, a price-point Lieberman attributes mainly to the device’s high-quality silicone and the rigorous research and design process that went into it. Lieberman likens the Eva to a pair of really good headphones: You can hear the music, it sounds incredible, but you aren’t super aware of the fact that there are two small speakers in your ears.

Lieberman acknowledges that before sex toy designers could think about getting back to the core purpose of the industry, consumers needed to be introduced to beautiful, high-end luxury products. But the next wave of sex toys will likely follow her function-over-form philosophy—and encourage an even bigger audience to come.<

So, are we moving toward a world where penises, and human sex organs, are obsolete? Of course not. We’re just moving toward one where we can do better than what the average human body has to offer. As Patti Britton, a certifiable expert in all things sex, put it, there will always be an element of humanity that can’t be captured by even the most elaborate of sex toys.

“We’re still human beings—we’re skin and bone and flesh and energy,” Britton told me. “So far we really haven’t matched that one in the lab, we may one day. But I think, overall, humans will want to be with humans. That’s how we’re wired.”

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