Science of Sex: Female Sexual Dysfunction

May 19th, 2018

Welcome to my latest installment of Science of Sex. I’ve officially be doing these for more than a year and have more planned! If you want to check out my archives, click here. Otherwise, enjoy this month’s post!science of sex - female sexual dysfunction

Today we’re venturing into the realm of female sexual dysfunction, just what it is, and why that title might not actually be helpful.

At its heart, female sexual dysfunction is an issue with sexual functioning in a woman. This can include a number of conditions and concerns, but four of the main ones are:

  • Desire : Many women and sometimes their partners describe their lack of spontaneous desire as a dysfunction. However, studies show that women are more likely to have responsive desire than men. This is not a dysfunction as much as it is a difference in sexual function. Furthermore, some have suggested that the traditional stages of arousal may not apply as well to women whose arousal process is more cyclical. It’s also important to understand that a woman’s sexual brakes are often quite touchy (learn more about this). Finally, low desire often corresponds to relationship issues, so it’s not so much a sign of sexual dysfunction as it is one of relationship dysfunction.
  • Arousal: Female sexual dysfunction can also present as a lack of physical arousal. This highlights further incorrect assumptions or beliefs about female sexuality. First, it doesn’t take into consideration that women are much less likely to experience concordance – an alignment between mental desire and physical arousal – than men and, secondly, it ignores the variance in a woman’s natural lubrication.
  • Orgasm: Some women may describe their inability to orgasm through sexual intercourse as dysfunction, but multiple surveys have found that the majority of women need clitoral stimulation to orgasm and very few achieving orgasm solely through penetration. At least one study reports a group of women who prefer penetration/sex with their clit stim as a way to get off.
  • Pain: Too many women experience pain during intercourse (in fact, at least one study has found that the bar for good sex for women is so low that they simply describe it as sex that is not painful). This is often remedied by increasing foreplay to encourage arousal, using lube and improved sexual communication. While conditions such as vaginismus and endometriosis can lead to pain during sex, painful sex can also be a symptom of poor technique and can often be ameliorated by changing the script.

Of course, there are other types of dysfunction, including those that center on physical issues and are not rooted in psychological or romantic distress. But the solution or treatment to any one of these “dysfunctions” may not be at all alike to the treatment for any other dysfunction.

The problem is that the term sexual dysfunction itself is not well-defined, and female sexual dysfunction is even more poorly defined because the umbrella term lumps together so many potential issues, including those that may be easily rectified by a better understanding of female sexuality. Furthermore, having a stronger grasp on female sexuality would show that some so-called dysfunctions are simply functions of sexuality in women that do not need to be pathologized. Of course, it’s not like men don’t suffer from this. It’s not a dysfunction if men ejaculate within ten minutes — it’s the norm — but the deep-seated misunderstanding of female sexual function had led to a lot of suffering.

Fortunately, doctors have devised questionnaires such as the aptly-named Sexual Function Questionnaire, and other tools to more readily diagnose sexual dysfunctions and focus on the root of the problem, whether it may be physical, relational, or a combination of factors. Sex therapists and educators are also making great strides in adjusting public and personal views of normal and healthy sexual function. For example, Dr. Emily Nagoski has written about desire and arousal in her book Come As You Are, Dr. Laurie Mintz shed light on clitoral stimulation in her own book Becoming Cliterate, and Dr. Lori Brotto helps women experience greater sexual function in her recently-released book Better Sex Through Mindfulness.

It should come as no surprise that women working on sexual research and providing sex therapy offer unique insight into female sexuality and what truly is dysfunction. If you’re interested in that topic, check out my post on  about the Women of Sexology

Further Reading

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Science of Sex: The Women of Sexology

December 30th, 2017

Welcome to the tenth installment in a feature on Of Sex and Love: Science of Sex. In this monthly segment, I discuss the science of sexuality in an easy-to-digest format that’s accessible to the casual reader. I will also follow up with some extended reading material for people who want to know more about the subject of each post.

I try to update Science of Sex every second Saturday of the month, so check back soon.  This month’s incredibly late Science of Sex post is a departure from previous posts, but it’s one that I hope you will enjoy.

Science of Sex Women of Sexolofy

While the last few months I’ve posted about what is happening in the science of sex, I decided to depart just a bit this month and discuss the who of science and sex. Specifically, I’d like to focus on the women who researched and studied, taught, and fought for our sexuality. I do this not to minimize what efforts of men but to maximize the efforts of women who were all too often overlooked — and sometimes still are. We’ve all heard of Kinsey and Grafenberg and Bancroft and Janssen. Now, I’d like to introduce you to some lesser-known names!

Marie Bonaparte

You’ll more often hear Bonaparte listed as a French princess, which she was, but she was also a psychoanalyst and friend of Freud. After growing tired of her inability to orgasm, Bonaparte took matters into her own hands. It’s to her credit that we have the rule of thumb (albeit, this was unknown to me until earlier this year, so women’s voices still need to be promoted!). After consulting with hundreds of women, Marie suggested that the reason that so many women were anorgasmic wasn’t because of what was in their heads: it was because of what was between their legs.

The rule of thumb states that if the distance between a woman’s clitoris and vaginal opening is more than the length from the tip of thumb to the first knuckle (around 2.5cm), a woman is unlikely to achieve orgasm through intercourse because the clit won’t be stimulated.

Virginia Johnson

You’ve likely heard of Virginia Johnson’s work if you’re interested in sex research, but her name always followers her partner and husband, William Masters. Together, the pair discovered different stages of arousal, that women could achieve multiple orgasms and that flexibility of a vagina when it comes to penetration. Johnson contributed to something great, but it wasn’t perfect. Early research with Masters encouraged conversion of gays, which Johnson didn’t approve.

Johnson seems a complicated woman, and neither her professional and personal relationship with Masters is no less complex. But who knows what we would know without her?

Lisa Diamond

Lisa Diamond examined the fluidity of woman’s sexuality, which she published under the name Sexual Fluidity: Understanding Women’s Love and Desire. Diamond’s research supports the idea that many women experience a sexual fluidity that may not be properly addressed by existing labels. Lisa Diamond also suggest that a woman’s sexuality has more variables, including menstruation, than a man’s.

April Burns

April Burns surveyed girls and young women to discover their attitudes and behavior toward sex. The result is sometimes frustrating and disappointing (a comparison between oral sex and performing a chore or taking a test was common) but always enlightening (oral sex is one way in which these girls felt empowered in their sexual encounters — perhaps the only way). Burns has also examined the relationship that young women of color have with sex.

Debby Herbenick

It wasn’t until I read Girls and Sex that I realized how many women defined good sex as sex that was simply without pain. I guess I had been fortunate.  This knowledge comes from the results of several studies that Debby Herbernick has contributed to. Of particular note is the National Survey of Sexual Health and Behavior, the most extensive sexual survey of recent years, Herbernick and her team at Indiana University released results in 2009 and 2012 that offered a look into modern bedrooms, just like Kinsey or Johnson had done decades prior.

Katherine Bement Davis

Davis was the superintendent of a woman’s prison and used her network to survey women about topics such as sexual orientation and desire. Although she isn’t often credited for her work and it took the world a while to accept the results, Davis was a proponent of both the idea that homosexuality in women wasn’t pathological and that women had sexual desires much the same as men.

Evelyn Hooker

Evelyn Hooker worked with the gay community to perform psychological evaluations in an attempt to remove the stigma of homosexuality as a mental illness or insanity. In the end, she surveyed two groups of people, one gay and one straight, and produced results that were virtually indistinguishable from one another.

Celia Mosher

Mosher was studying sex well before Kinsey, and it even earned her the moniker of the “sex scholar.” Mosher was responsible for a Victorian sex survey, the earliest of its type. Unfortunately, the results of the survey weren’t published until after her death. The results showed that women were not ready to admit that their sexual desires were nonexistent or abnormal.

Lori Brotto

More recently, Lori Brotto has studied the disconnect that women often experience between mental and physical arousal. Brotto’s research suggests that the way that women multitask and tend to be detached from their bodies contributes to this. Brotto suggests mindfulness as one possible solution. However, Brotto’s research also indicates that in the sexual moment, men and women experience fewer differences in desire than most people believe. Another myth Brotto is helping to dispel is how much testosterone affects a woman’s desire.

Sari van Anders

Van Anders has also looked into the role of testosterone and arousal, finding only an indirect link. She has researched responsive desire in women and the interplay between thoughts and desire. The van Anders lab frequently tackles topics about sex, women, feminism, gender, and diversity, going so far as to research how to perform feminist research.

Marie Stopes

Stopes not only penned the first sex manual in England, but she also opened the country’s first reproductive health clinic in 1921, she used it to gather data about contraception. Her clinic inspired others and eventually led to the Family Planning Association.  The Marie Stopes Foundation still promotes access to contraception around the world and continues research into abortion.

 

Emily Nagoski

Emily Nagoski has done a ton to educate the world about sexual desire, especially as experienced by women, as well as risk and sexual behavior. Hers is the book that introduced me (and many others!) to the dual-control model of sexual desire and is also responsible for me finally coming to understand my body’s stress response cycle. I’ve referenced it countless times since reading it.

Do yourself a favor, boys and girls, and read Come As You Are. Nagoski’s blog, The Dirty Normal, contains helpful entries and comics to further illustrate these concepts.

Beverly Whipple

Finally, we have a name with which many of you may already be familiar. Whipple has orchestrated over 170 studies into sexuality, the best known of which may be on the G-spot. A paper she helped write on the topic in 1981 was the first publication to use the G-spot, which she named in honor of Dr. Gränfenberg, who had earlier studied it. Her studies have also found how food affects the G-spot, “diets heavy in spicy chilies may block the naturally occurring analgesic affect of the G-spot, therefore causing childbirth to be more painful,” women who can think themselves to orgasm and those suffering from persistent genital arousal disorder.

Whipple has received many well-deserved awards and commendations for her work, which covers myriad angles of sexual response.

One of the things that I love about nearly all these women was their attention on women’s sexuality. When men wouldn’t take it seriously, women took up arms to shed light on the subject.

This list is by no means comprehensive. There are those whose work has been overlooked, is still in the process, or are simply unknown to me. I relish the thought of learning about more women researching the field of sexuality, so please leave comments with anyone who should be added to this list!

Further Reading

Several books I’ve read provided me with information for this post, and I’d like to recommend them in addition to the usual articles and studies that I post. They include Bonk by Mary Roach, Girls and Sex. I’d also recommend checking out Masters of Sex; although, I haven’t had a chance to read it.

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