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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

A Story With A Happy Ending

Name: Nathan
Gender: Male
Age: 37
Location: Dallas
I’m a married guy with a great wife and 3 beautiful kids. A couple of weeks ago, I went to a masseuse I found on Craigslist. I don’t have a lot of experience with massage and thought I would be safe going to a guy instead of a woman. The guy was really nice and did a good massage, but somehow I popped wood near the end of the massage. I was really embarrassed, but he was like totally ok with that. Then he asked if I wanted a happy ending. I didn’t even know what that was till he started to massage my ass and blow me. I have to admit it was totally amazing. I never felt anything like it before in my life. My wife sometimes will give me oral sex, but nothing like this. I blew a load like nothing I ever did before. I though my insides were coming out of my cock. I was amazed and scared and confused and I could hardly sit up. Then the guy said I had a real healthy prostate. I said, WHAT? And he said he was massaging my prostate while he was sucking me off. I can’t stop thinking about this. I want more but I feel really guilty and I’m afraid this is going to make me gay.

What a great story, Nathan. But we need to clear up a few things. A masseuse is a female practitioner of massage. A masseur is a male practitioner. This is a common enough mistake, but I thought you should know the proper usage for further reference. Because you can see how a little unintended slip like this will make all the difference in the world. If you say a masseuse gave you a blowjob that’s totally different from getting a blowjob from a masseur, don’t ‘cha know.massage_butt.jpg

I’m gonna also guess you never had a prostate massage before this encounter with the masseur. A prostate massage coupled with your first blowjob from a guy…hell, you are lucky your insides didn’t shoot out your dick along with your spooge. I’m joking of course, but it does stand to reason that you had such an intense and explosive orgasm and ejaculation. That’s precisely what a prostate massage does, honey.

Now, let’s see if we can figure out why you can’t stop thinking about this. It doesn’t take a rocket scientist to analyze that either. This was a peak sexual experience for you. I mean, beside the mind-blowing release, the means by which you had this orgasm — the guy’s finger in your ass and the guy’s mouth on your dick were both unexpected and apparently unprecedented. So I figure you had very little time to cognitively respond to the stimuli before things came to their explosive climax, so to speak, as it were. And you did say you were already relaxed and aroused by the massage, right?

I’d be willing to bet that if you had some emotional distance from the experience you would realize your body was simply responding to the stimulus it was receiving. Your dick and your prostate weren’t able to distinguish the gender of the person diddlin’ your ass and suckin’ your dick. And since your brain was occupied with all these new sensations you had little time, if any to process and possibly protest. And maybe you wouldn’t have protested even if you could. Maybe you wanted to take this little walk on the wild side. Trust me, lots of guys do.

come as you areNow that the event has passed, you have plenty of time to process. And process you are…to within an inch of its life…if ya ask me. This experience looms so large for you because it is forbidden fruit, so to speak. It upsets the apple cart of your cozy and predictable heterosexuality. I mean it’s one thing to pop wood on a massage table. It’s something totally different to blow a wad while a guy is givin’ you head.

And now that you have all this time on your hands to keep pouring over and over this in you head, the event has taken on a proportion it probably wouldn’t have otherwise.

Let me put your mind to rest, one blowjob from a guy…even an earth-shatterin, prostate-massagin’ blowjob, like the kind you got from this fabulous masseur…won’t make you gay. Nor does wanting to repeat the experience make you gay. All this experience really tells us is that you like a good blowjob and you now know where to get a really fantastic one when next you want one.

Think about it this way. Say you went to a Chinese restaurant and, to your great surprise, had the best dim sum ever. You were so impressed with the food that you’ve been eager to return to this particular eatery for another go at those tasty vittles. Does this desire for yummy dim sum make you Chinese? I don’t think so…that is unless you were Chinese before you went to the restaurant.

Finally, the guilt you’re experiencing, where might that be coming from? There are so many sources one would be hard-pressed to come up with an exhaustive list. But let’s look at the top contenders.hands & butt

  • You’re married with a family. You had a sexual experience…unplanned as it might have been…with someone other than your wife. BINGO!
  • Our culture’s buttoned-down sex and gender stereotypes — who can do what to whom. BINGO!
  • The dictates of our sex-negative society about what is proper and what is not in terms of sexual exploration and experimentation. BINGO!
  • The shame of possibly being labeled a fag. BINGO!
  • The fear of your own desires and where they might lead you. BINGO!
  • The allure of the forbidden and the explosive charge the illicit. BINGO.

The experience you had with that masseur, Nathan, is so highly charged, both culturally and sexually, that it will take some while for you to find your balance once again. In the interim, my I suggest that you postpone any judgments about yourself or what the incident might imply about you until you’ve have some emotional distance and the time to calmly process all of this. In the final analysis, I think you’ll come to the conclusion that this is a relatively harmless sexual outlet. The masseur is providing you a service…I mean beyond the obvious. He is providing you a safe, secure non-judgmental environment to exercise and expand your sexual repertoire. Think of it like a place you go to learn about the wonders of sexual dim sum.

Good luck

Putting A Ring On It

Name: William
Gender:
Age: 30
Location: UK
Hi There
I am new to this scene, and I have very little experience in anal sex and I am seeking your help and advice. I am a top but I have a problem keeping my dick hard or staying hard during anal sex. I find it harder to fuck an ass compared to fucking a pussy. Here is the problem: Once I get my dick hard, put on a condom and start fucking, my dick sometimes goes soft on me. Is that normal? How can I keep my dick hard long enough in the ass to enjoy the fuck? Sometimes even when my dick is hard, I find it hard to penetrate an ass. I use lube, so what am I doing wrong? People in gay porn can fuck and fuck like there is no tomorrow. I want to enjoy anal sex too!! Any advice? Please let me know if there is anything I can do to improve in this area?

Boy, you’re in luck, William! One of my most popular tutorials, Finessing That Ass Fuck — A Tutorial For a Top, is waiting for you.  Check it out! It will answer a lot of the questions you have about butt fucking. You should also know that this is the companion piece to my tutorial for ass fuckin’ bottoms handsomely titled: Liberating The B.O.B. Within. Don’t know what a BOB is? No to worry, all will be explained.

gettin it from behindBut before you disappear to do your homework, I’d like to address one of the specific issues you raise, about keeping your dick hard while fucking. You are right to point out that fucking an ass (male or female) is different from fucking a pussy. But regardless of what hole you’re invading, a nice hard stiffy is essential.

Are you familiar with a cockring, William? If not, I suggest you acquaint yourself with these amazing low-tech wonders. Here’s what you should do. Mozie on over to the Dr Dick’s Sex Toy Reviews site and search for my tutorial, Cockring Crash Course. (The search function in the sidebar will assist you.) Prepare yourself to be sorely amazed at the variety and functionality of these little devils.

Cock rings can create larger, firmer erections. Since blood flow enters your dick through arteries deep inside your dick, and leaves it through the veins near the surface of your tool; wearing a cock ring can help to keep more blood inside your dick shaft. And as all you rocket scientists know, blood is what causes erections in the first place. Also some men claim that wearing a cock ring intensifies their orgasm.armour up04

And while you’re on the sex toy review site, use the CATEGORY pull-down menu in the sidebar and look for cockrings. You’ll find it under the last heading, Sexual Enrichment. This will bring up all the cockrings we reviewed, and there’s a load of ‘em, don’t cha know.

I recommend the flexible and/or adjustable cockrings. These are generally made of stretchable rubber or leather. For the more daring there are the metal variety. These may look pretty, but they can be a bitch to put on and to take off. Here’s how ya do it.

  1. Pull your ball sack through the ring first.
  2. Follow this by popping each of your balls through the ring one at a time.
  3. Now bend your cock down and pull it through the ring.

As you can see, putting on one of these little buggers before you have a raging hardon is gonna make it a whole lot easier. To take the cock ring off, simply reverse these steps, pushing your flaccid cock back through the ring first, followed by each of your balls and finally your ball sack.

It’s absolutely essential that you not wear an inflexible (metal) ring for longer than a couple hours. Make sure you don’t buy one that is too small either. If your dick is turning an angry red or worse, purple, or it is cold to the touch, you’re in trouble. Take that ring off immediately. If you don’t you will risk serious injury to your precious johnson. Remember people, play smart with all your toys!

Good luck

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Pride Goeth Before The Fall

Name: Jen
Gender: female
Age: 59
Location: North Dakota

I’m a widow and I am so sad. The fellow I’m going with, I really love him, but I can’t have an orgasm with him. I was able to have an orgasm with my husband who is passed away. And I can when I am playing with a toy by myself.

He has such pride and I don’t want to hurt his feelings, because it would take me about a half hour of foreplay to get there.

Thank you for your message, Jen. Your concern about your man and his inability to rock your world is, sadly, a very familiar complaint. I hear it from women all the time.pride

You say that your man is prideful and that you don’t want to hurt his feelings. But are you really willing to sacrifice your sexual wellbeing on that altar? I hope not. Even prideful men can learn something about pleasuring the woman they are with.

Let’s just say that this guy your dating knew how to pleasure all the women he has ever been with previous to you. That pedigree doesn’t make him an expert on pleasuring every other women he will meet, and that includes you.

Allow me to share with you the exchange I had with another woman in your situation. Perhaps my advice to her will be helpful to you. This is from…

Name: Zoe
Gender: female
Age: 25
Location: Boise
I learned how to masturbate when I was 12. From that first time I’ve loved how it makes me feel. No matter how good my lovers are; they never come close to the pleasure I feel when I’m touching myself. I like the intimacy I have with my boyfriend, but he’s not very good in the sack. I’ve been trying to get him to watch me masturbate, or we could masturbate together, so that he’d know how to touch me and make the bells ring. Unfortunately, he’s really straight-laced and he thinks my suggestion is perverted. He resists every time I bring it up. Sometimes after we have sex, I wait for him to fall asleep then get myself off. Is this selfish?

selfish-man

You betcha it’s selfish, selfish as all get-out. Not you, Zoe, but the bonehead you’re fuckin’. This is a classic, “you can lead the horse to water, but you can’t make him drink” sorta deal. Only here we have a “you can lead the horse’s ass to the mysteries of pussy, but you can’t make him appreciate them.”

I gotta ask, what makes a sexually enlightened chick like you hook up with and stay with bozo like him? Do you actually think that he’s gonna magically come around one fine day and let you lead him to nirvana? I think not. You know why I think this? It’s because you’ve created a monster — an “all I need to worry about is me gettin’ off in my girlfriend’s snatch” kinda monster. And that’s one scary kinda monster.

I am of the mind that it’s fruitless to try to get an obstinate partner, like your guy to do something he doesn’t want to do. The nagging alone will harden his resolve to resist. This does not mean you’ll never get your way. It just means that you have to go about this in a completely different way than, “oh honey, won’t you please cum and watch me jill-off? In the numbskull’s defense, he may be missing the point completely. He may not understand why you want him to watch you pleasure yourself. So if your agenda is to get him to be a better lover, that’s how you’re gonna have to approach the big lug.

First off, he needs to be told, in no uncertain terms, that he’s not the Hercules in the boudoir he thinks he is. This is gonna sting his ego like crazy and it might very well be the end of him and you altogether. But I assure you, risking this is much better than maintaining the status quo. Because, with each passing fuck, he will be more convinced then the fuck before that he’s da man.im_da_man

Once you burst his bubble, you’ll need to immediately inflate a new one for and with him. Us men folk can’t live very long with out our illusions. Begin this inflation process by taking some responsibility for this predicament. Own up to keeping him in the dark about his lack of sexual prowess. Then tell him that there’s a very easy and fun fix for the problem. Maybe if he understands that you want to jill-off for him as a tutorial, he’d be more compliant.

I’d be willing to guess that if you made this presentation more of a game or a role-play scenario then a seminar he’d be more receptive. Why not try something like this. Introduce a blindfold into your sex play. Have him strip down to his jock for you, then blindfold him. It’s gonna be his job to get you off without using the magic wand he has stuck in his jock. The blindfold will necessitate that he use his hands (and mouth) to find and pleasure you. While you tease his dick inside his jock guide his hands to your pussy. He’ll no doubt be fumbling around at first, so you’ll have to encourage him with some dirty talk, or actually use his hand to jill yourself off. Just remember keep it fun and playful and keep his dick safely tucked away.

You can see how this little exercise could be educational for him without being emasculating. Once he figures out that there’s more to sex than the old in and out, he might actually cum around, so to speak. Similarly, you might, on another occasion, submit to the blindfold yourself and have him use your hand to jack himself off. In time, you be able to do away with the blindfold altogether. But then, you might want to introduce restraints of some sort. While he’s buck naked and restrained put on a hot and horny show for him. Tease him with your self-pleasuring, but don’t let him touch you. Maybe rub yourself with his stiff cock. Since he’ll be unable to resist, it will be like masturbating with his pecker. Doesn’t that sound like a load of fun for all concerned?

Good luck

The Great Porn War

Name: Jennifer
Gender: Female
Age: 23
I am 23 years old and I like lesbian and gay porn. It’s been my favorite since I discovered it a few years ago. But my boyfriend hates the thought of people of the same gender having sex. I don’t like hetero porn, and that’s all he uses. Is there any way I can get him to enjoy my kind of erotica?

porn.jpgYour boyfriend a dreadful drag, huh? What’s he afraid of, do you suppose? Ya think he’s afraid he’ll pop wood while he’s watchin’ gay porn with his girlfriend. That’ll surly to shake his masculinity to its foundation. I mean, it’s one thing for him to get a boner when he’s checking out the queer stuff by himself — and you know he does! It’s another thing all together for him to get hard watching two dudes fuck while he’s with you. It’s clear to me that your BF has issues, darling. And I think you know that too.

Now I’m not suggesting that he has to like everything you like, or that you have to like everything he likes. A couple can have a really healthy relationship despite differences in the kind of smut each prefers. But matters of taste aside, I think a smart chick, like you, knows that porn is as much a political statement as it is a sexual statement.

Here’s what I mean. Most straight porn features male identified sex — exclusively. That’s probably why you, and 90% of your sister women, don’t like it. The producers of most of the stuff in this genre create it with a predominately straight male audience in mind. And you can pretty much count on it exploiting women in the process. Gay porn does not exploit women, for obvious reasons and lesbian porn is the most radical of all. It is unabashed female identified sex. No female exploitation there. Of course, I’m talkin’ about real lesbian porn, not the caca that simulates girl-on-girl sex that gluts the “straight” porn marketplace.

Most straight males get off on hot girl-on-girl action in straight porn, because the performance represents male identified sex. In fact, one of my good gal pals in the porn business often says that girl-on-girl sex in straight smut is about as far away from authentic female sexuality as gay porn, which has no women in it. i just can't

I’m gonna go out on a limb here, Jen and guess that you’re a little too radical for Mr. Whitebread. But if you think that he’s worth the effort involved in loosening him up, start by reassuring him that there will always be a place in your heart for his johnson even when you’re enjoying a sweet lesbo fantasy. If you really want to enjoy yourself with your guy while you enjoy your dyke porn, give him permission to do a voice over for the movie you’re watching together. Tell him you want him to pretend he’s a porn star and he’s gonna appear in the next scene with the two chicks you’re watching. Watch the lezzie scene together and then have him tell you what’s gonna happen in the next scene when he catches the two naughty vixens. Perhaps you could suggest that he roll play that with you after the movie. Ya see, Jen, you’re gonna have to trick the monkey into watching what you want, cuz he ain’t gonna open his mind all by his-own-self.

Deprogramming him of his homophobia may be a bit more challenging, but there are ways. You could start by telling him that everyone knows that no one sucks a guy’s dick like another guy. And so you want to pick up a few pointers from the pros before you go down on him again. When the big cock-sucking scene begins start grabbing at his package. We all know he’s gonna be hard as a rock. Those repressed types are so damned predictable. Now if at all possible start blowin’ him with the same vigor as the dudes in the movie. Blowjobs are the great equalizer. Mr. Whitebread will be enjoying himself so much he’ll hardly have time to reflect on how radical he’s becoming.

lesbian pronIn the end, I don’t think you should compromise and watch hetero porn unless he’s willing to compromise too. Of course you both could watch your chosen porn privately, but where’s the fun in that. Or you could just trade-off one scene of his for one scene of yours. Or compromise with some hot bisexual porn. There’s not a whole lot of really good bi porn out there, but there is some. Just be discriminating. Life is just too short for bad smut.

You could try dueling porn. Two screens, two TVs or a TV and a computer screen, each playing a different type of porn. Or you could really throw caution to the wind and have a full-blown fuck-O-rama — multiple screens with multiple images all going at once. It’s so easy to do these days with the proliferation of computers tablets, phones even, and online porn. And just about every household has at least two TVs and two computers lying around. So knock yourself out, girl!

It’s clear to me, Jen, that you’re gonna have to take the lead in this. You being the more enlightened one. I believe that your arousal will arouse him. And if your fire doesn’t ignite his, simply throw the bum out!

Good luck Ya’ll