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Does female sexuality need to be fixed?
February 3rd, 2011
09:51 AM ET

Does female sexuality need to be fixed?

Ian Kerner, a sexuality counselor and New York Times best-selling author, blogs about sex on Thursdays on The Chart. Read more from him at his website, GoodInBed.

At Good in Bed, many of our experts are buzzing about a new documentary called "Orgasm, Inc." Directed by Liz Canner, the film chronicles the race by pharmaceutical companies to get FDA approval on “pink Viagra”—a pill to help treat female sexual dysfunction, or FSD.

The problem with this approach? As the film demonstrates, there’s no clear definition of FSD, which makes it difficult to determine whether it’s a problem that needs “treatment” or simply an example of the differences between male and female sexuality. The truth is that no one really knows what FSD is: Some people liken it to male sexual dysfunction, but there are major flaws with this comparison. It’s easy to tell when a man has premature ejaculation or erectile dysfunction. Female sexuality is less obvious. Women just don’t show clear-cut physical signals when they’re aroused.

Another reason that FSD is tough to define is because we tend to label men who don’t climax during sex as “dysfunctional.” Yet an estimated 75 percent of women never orgasm from penetrative sex alone—suggesting that this is normal, not problematic. So maybe we shouldn’t be focusing on “fixing” female sexuality, but changing the ways we have sex so that women more consistently orgasm. Even researchers can’t agree: In 2000, the Journal of Urology offered a few definitions on FSD, including:

• Lack of interest in sexual activity
• “Phobic avoidance” of sexual contact with a partner
• Inability to attain or maintain sexual excitement
• Difficulty attaining orgasm
• Genital pain or pain during intercourse

More than a decade later, there’s still no consensus on which, if any, of these definitions is accurate. And experts aren’t the only ones who are confused: Although studies suggest that the drug flibanserin could be the new “female Viagra,” the FDA recently declined to approve its use for FSD. In one 2010 study from the American College of Obstetricians and Gynecologists, researchers found that women with low sexual desire who took the medication for 6 months had an 18 percent improvement in their libido. But the FDA rejected flibanserin just a month later, saying it failed to completely prove efficacy in treating FSD.

Some critics say we shouldn’t be “medicalizing” sex at all and don’t need a pill to treat a condition that may be “all in her head.” After all, lots of women often simply aren’t in the mood for sex, or are distracted by life’s stresses, or just need to start using lubricant. That doesn’t mean they’re dysfunctional. In fact, it may just mean they’re normal: To that end, sex researcher Rosemarie Basson has proposed a new framework for thinking about female sexual response, one that places the importance of emotional intimacy and relationship satisfaction at its center. Basson’s framework contends that female sexual arousal is more complex than a male’s and depends more intensely on factors such as relationship satisfaction, self-esteem, and previous sexual experiences.

To me, the issue of FSD isn’t black and white. Sure, FSD isn’t as physically obvious as male sexual problems: Viagra works by increasing blood flow to the penis, giving a man an erection, while flibanserin appears to affect the neurotransmitters (chemical messengers) in a woman’s brain that influence desire. But that doesn’t mean that FSD doesn’t have a physiological component. Side effects of medications (including some antidepressants, blood pressure drugs, and birth-control pills), shifting levels of hormones, stress and anxiety, obesity, and conditions including diabetes and multiple sclerosis can all lower a woman’s desire. So FSD—if it indeed exists—isn’t simply perception, just as it’s not solely physical. My guess is that’s a combination of brain and body—although whether a drug can effectively treat FSD remains unseen. Emily Nagoski, the author of The Good in Bed Guide to Female Orgasms, says, “There’s no such thing as a sexual dysfunction that’s 'all in your head.' Neither is there a sexual dysfunction that’s 'all in your vagina.' There is only the embodied mind. Thus education and behavioral training change physiology.”

Ladies: 5 ways to feel sexy again

In the meantime, there’s no reason why women who want to want sex should suffer with low desire. Prescription testosterone cream may help boost desire women who have low levels of this important sex hormone, as can devices such as the Eros device, which uses a gentle vaccuum pump to stimulate blood flow to the genitals. And don’t discount all the “natural” ways that both women and men can increase sexual desire, from trying new things between the sheets to increasing intimacy outside the bedroom.


soundoff (491 Responses)
  1. Charlotte

    Jane, the responses of these poor, pathetic and impotent men to your post just proves that they still mistakenly think that somehow it's a "problem" that women are not as simpleminded as they are and are not instantly aroused just on their say-so. Women are not SUPPOSED to be superficially aroused. We as a species are mammals and women were designed to only be easily aroused when they are most fertile (i.e., in heat -just like a mare or a cat or a doe). For these pathetic, shallow slobs to fail to understand this and then get all defensive and puerile just shows they are not worthy of a woman.

    February 3, 2011 at 17:22 | Report abuse | Reply
  2. Dr Bill Toth

    My poor male brain hurts trying to figure out how a drug company could spend millions of dollars on developing a drug for a situation that isn't clearly defined physically or pyschologically, doesn't have a clear set of symptoms, and a "cure" that can't be measured. Live With Intention, DrBillToth.com/blog

    February 3, 2011 at 17:22 | Report abuse | Reply
  3. Amy

    It's hard to get in the mood when one's husband can't ever get it up due to medical issues. I need a new solution.

    February 3, 2011 at 17:25 | Report abuse | Reply
    • ABA

      I'm sorry Amy....That sucks!

      February 3, 2011 at 17:30 | Report abuse |
  4. Isha

    Viagra was originally for women how does no one know this (if you did great) I think it's about time they actually cater to women. It's horrible some think all woman can do it on command. However I think they should do away with all and any study wasting money for issues as these and focus on only import and necessary problems of the world. Wether a man can't get an erection or a woman for lack of a better word sucks but it's not a necessary thing to cure/fix/help. Not now anyways with all we have on our plates.

    February 3, 2011 at 17:25 | Report abuse | Reply
    • MoodyMoody

      It IS important to many people; this is something that can ruin lives. I don't think that a drug is the best fix, but I disagree as to the worthiness of the study. The issues you mention don't affect some people and therefore aren't real to them.

      February 3, 2011 at 19:56 | Report abuse |
  5. RabiaDiluvio

    There are a lot of reasons for women to experience FSD. Trying to cover them all with one label and one magic pill is a bit like trying to fit the Pittsburgh Steelers under one umbrella.
    There are a lot of reasons, for instance, for a woman not to have desire. Some of them are hormonal or physiological. Some are psychological. There really can't be a "female viagra" because what will work for one kind of "FSD" will not for another or could possibly even make it worse.

    February 3, 2011 at 17:26 | Report abuse | Reply
  6. X

    Here's an idea....Buy a book with different styles, fantasies etc in it...Mark the pages you want to try give it to your partner have them mark the pages they want to try, and then talk about which ones your both willing to give a try.

    No need to be embarrassed, no need to not communicate and it gives you good ideas at trying to stuff you wouldn't have thought off.

    Worked for us, and after 15 years still going at it strong.

    February 3, 2011 at 17:28 | Report abuse | Reply
  7. RabiaDiluvio

    Too much Harlequin Romance, not enough reality.

    February 3, 2011 at 17:29 | Report abuse | Reply
  8. A John for Jane

    Email me Jane... I'll fix everything.

    February 3, 2011 at 17:29 | Report abuse | Reply
  9. Rich

    Thats the big problem life aint a Disney Movie

    February 3, 2011 at 17:34 | Report abuse | Reply
  10. FogHornLegHorn

    Does this include anal?

    February 3, 2011 at 17:35 | Report abuse | Reply
  11. NOLADY

    WOW! Men (or women for that matter) don't respond well to anger in the bedroom!! And I don't think there is a bedroom in the world where everything is perfect 100% of the time. That passion stuff DOES exist in men just as it does in women - just has to be with the right partner.

    February 3, 2011 at 17:36 | Report abuse | Reply
  12. FogHornLegHorn

    I like long walks on the beach, after anal.

    February 3, 2011 at 17:36 | Report abuse | Reply
  13. hunnykins

    @AndreaM – Amen, sister. Me and the Mr have been married almost twenty years, and we still respect each others needs for separate hobbies, video game time, and shared responsibilities. We've had our rough times too, life is life, but through it all we've grown closer. I would say we are lucky, but we both know it takes work and compromise, too. I think that in itself has helped keep our intimate life exciting and active. Reading comments from people who have to beg for physical attention, I know I wouldn't want to live like that. I know that being a man, my husband couldn't live like that. I don't begrudge him his interest in the physical, and I enjoy loving almost as much as he does. I say "almost" because I do my best to keep up, but really, he's a man.

    February 3, 2011 at 17:49 | Report abuse | Reply
  14. AAW

    The problem isn't women, its marraige. Matrimony is the number one cause of FSD. We must stop this evil and outdated practice before it's too late! Women unite, save your libido (and your man's sanity) SAY NO TO MARRAIGE!

    February 3, 2011 at 17:50 | Report abuse | Reply
  15. jpk

    If you want to make love to a woman Sat. night you better get started on the Monday before. Women are more emotional and relational than men. If you are emotionally and relationally intimate with a woman all week long she will feel like she is important to you. Take the time to understand her and persue her. Respect her feelings and opinions. Take her shopping and know her dress size and what she likes. Don't have angry outbursts or act controlling because this will scare her. She wants to feel safe, secure, loved and understood. I'm a guy and have learned this from making many mistakes.

    February 3, 2011 at 17:51 | Report abuse | Reply
  16. X2

    (Mostly) Stable Woman = prozac junkie.

    February 3, 2011 at 17:51 | Report abuse | Reply
  17. rascalot

    "Women just don’t show clear-cut physical signals when they’re aroused."
    You don't know women...

    February 3, 2011 at 17:53 | Report abuse | Reply
  18. scroo yoo

    My ex had this problem where if i wasnt around strange penises would end up in her mouth.That was also what caused all of her bruises

    February 3, 2011 at 17:54 | Report abuse | Reply
  19. pollywog

    what a ridiculous comment. I bet you've never even considered that the problem might be with you, not the women you date?

    February 3, 2011 at 17:54 | Report abuse | Reply
  20. Steve

    PIITB (Put It In The Butt)

    February 3, 2011 at 18:10 | Report abuse | Reply
  21. Funinthesun

    Thats why God made available Thailand for us men to relax and play

    February 3, 2011 at 18:27 | Report abuse | Reply
    • MoodyMoody

      One less place to get off now that John Wregnall has been convicted of abusing so many Thai boys...

      February 3, 2011 at 19:58 | Report abuse |
  22. NunyaBiznis

    Why do women fake orgasms? Men don't care. We're already getting laid.

    February 3, 2011 at 18:29 | Report abuse | Reply
  23. Mike dallas texas

    why are we wasting time on this subject again

    February 3, 2011 at 18:39 | Report abuse | Reply
  24. Ituri

    I realize there are real physiological issues for both genders sechually speaking, but I'm astonished at how they try to ignore the psychological issues.

    We live in a culture soaked in anti-womanism and mysoginism. Our major religion finds women who enjoy sechs to be wh ores, espeicially if they dare have it outside marriage in a real life situation. We make a hobby of breaking women down, attacking Planned Parenthood, and trying to illegalize their health care options, even as we ignore the social causes for those problems.

    When we teach our little girls that sechs is bad and dangerous, then we wonder why they can't enjoy it as adults even in stable relationships, its honestly a little silly.

    For example, a friend of mine was formerly Christian, and she can't hardly be touched without a sense of panic setting in. Even though she's no longer religious and is much healthier in mind, she panics at the attempt of int imacy. She's been well programmed, and it may take a long time for her to come to grips with what Christianity did to her.

    February 3, 2011 at 18:50 | Report abuse | Reply
    • EmeraldCity

      @Ituri – Hold up a moment. You say that she panics the moment she's touched and that Christianity did that to her?

      How do you know it was Christianity?

      February 3, 2011 at 22:06 | Report abuse |
  25. WhatIwant

    Hey guys you want a women to tell you what she wants well here it is! 1. To go to work, make my own money, pay my own bills and to not USE a man for anything. 2. To have a man as a partner to share my life with on equal terms. 3. To have se@ 4 times a month because I really just don't want it more that that. Hey theres nothing wrong with me, I have a great husband who is wonderful in bed. I just don't see why I should have to do it more than that if I don't want to just because a man wants to have it more times. Why should a women have to desire it more than she does just cause the man wants it more. Any hey, go make your own dinner, wash your own cloths, clean your own house, and give birth to your own kids – no reason a man shouldn't have to do the double duty that women do. Did I mention I pay all of my own bills and don't use any money my husband makes. Oh yeah, that's why I got divorces because I took away his manhood by being a equal partner instead of using him for his money.

    February 3, 2011 at 19:14 | Report abuse | Reply
    • ThatsNice

      A relationship with you sounds wonderful. You sounds exactly like what most men want…..

      March 11, 2011 at 16:16 | Report abuse |
  26. M

    So, wheres the article about Women's inability to fullly satisfy their Men? Oh I get it. Since guys are so simple and easy to please, you don't have to do anything. Sorry to inform all you Women out there, but a Guy getting off is nowhere near to actually being satisfied. Just because its easier doesn't mean you're doing it right. I'm gonna start lasting 30 minutes during a B. J. and we'll see how your tune changes. I'll just blame your inability to please.

    February 3, 2011 at 19:47 | Report abuse | Reply
    • Sari

      Ever read Cosmo? Pleasing your man articles entirely fill that magazine- not that the advice works, as every man is different. But that's where they are.

      February 4, 2011 at 02:11 | Report abuse |
  27. mysolution

    I expect an orgasm every time. My orgasm is the price of admission to my body. No penetration until you satisfy me first with oral. Instructions offered, of course.

    February 3, 2011 at 19:50 | Report abuse | Reply
  28. Tom Leykis

    No, what guys need to do is dump women who are problematic. A woman, or women, gets dumped enough times then maybe they'll figure it out and change how they act, but don't count on it. Guys have been letting women get away with murder for too long. I lead a charmed life because I stick to young women, under the age of 32 years old who are hot. When the bloom is off the rose, I move one. It's that simple.

    February 3, 2011 at 20:28 | Report abuse | Reply
  29. Michael

    I dont know where any of these women are from but I have several relationships going on and each one of the women I am with have nonstop multiple orgasms! I am not a stud horse or am huge and I am not bragging or trying to make myself sound cool or perfect I am by far not. But never in my life have I met and been with a unsatisfied female! it is me that after a couple of hours have to just ask have you had enough to each of them. I think that I would find it a pleasant challenge if I ever do come across one of these poor ladies that have a hard time reaching orgasm. I am a thoughtful man that does listen to my partners needs and try to fulfill their desires and yes a few of my partners are married and come to me for attention that who knows maybe they have that problem at home. I do not believe a pill is always the answer to peoples problems this world has pills for everything from fingernail aches to you name it! I think it has to do with how most people are so used to instant gratification that they have just lost touch with intimacy and love.

    February 3, 2011 at 21:32 | Report abuse | Reply
  30. Michael

    I dont know where any of these women are from but I have several relationships going on and each one of the women I am with have nonstop multiple orgasms! I am not a stud horse or am huge and I am not bragging or trying to make myself sound cool or perfect I am by far not. But never in my life have I met and been with a unsatisfied female! it is me that after a couple of hours have to just ask have you had enough to each of them. I think that I would find it a pleasant challenge if I ever do come across one of these poor ladies that have a hard time reaching orgasm. I am a thoughtful man that does listen to my partners needs and try to fulfill their desires and yes a few of my partners are married and come to me for attention that who knows maybe they have that problem at home. I do not believe a pill is always the answer to peoples problems this world has pills for everything from fingernail aches to you name it! I think it has to do with how most people are so used to instant gratification that they have just lost touch with intimacy.

    February 3, 2011 at 21:33 | Report abuse | Reply
  31. Good Advice

    My advice for women that don't have desire or can't reach orgasm is to buy and use the Magic Wand. I saw it on Oprah and it completely changed things for me. It's pretty amazing! Husbands and boyfriends-buy this for your lady!

    February 3, 2011 at 22:27 | Report abuse | Reply
  32. Good Advice

    My advice for women that don't have desire or can't reach orgasm is to buy and use the Magic Wand. I saw it on Oprah and it completely changed things for me. It's pretty amazing! Husbands and boyfriends-buy this for your lady!

    Also, try to make love to your hubby every 2-3 days. If you don't use it you lose it. Hard to explain but it's great to stay intimate and close-even when you get busy.

    February 3, 2011 at 22:32 | Report abuse | Reply
  33. stuntborg

    I'm thinking of becoming gay. Women are such pains in the hiney...

    February 3, 2011 at 23:29 | Report abuse | Reply
  34. jenn

    No, male brains need to be fixed.

    February 4, 2011 at 01:44 | Report abuse | Reply
  35. Sari

    What about women who want it ALL OF THE TIME? Seriously, I have a libido that wears out 99% of men. I tried anti-depressants for the supposed libido killing effects, and it made it worse. *sigh*

    February 4, 2011 at 02:08 | Report abuse | Reply
  36. Ilene at MAZE

    Corrected link http://tinyurl.com/4jyvoqv. Great debate!

    February 4, 2011 at 09:57 | Report abuse | Reply
  37. DemandingHelp

    Woman who have libido problems due to Menopause, or PCOS, or other illness should have a medical option for help! (And, testosterone isn't the answer- because many woman with PCOS have higher testosterone than normal.) I think whether women have FSD or not should be based on not some idea of "normal" or what other people experience, but what is normal for them. If you used to be a certain way, or have a certain level of libido, and then you don't anymore... it is devastating. There is nothing like going to your doctor for help and having them say "oh, that's just the nature of your illness, there's nothing we can do." ... but they make Viagra for men???? -If you told a Dr. you couldn't breathe, eat, be happy, sleep, use the toilet etc. right anymore... they'd do something about it... Why not this?

    February 4, 2011 at 11:21 | Report abuse | Reply
  38. Tony

    One word: Tongue. If you use it well and often to the most important organ, the skin, and let your Tongue do the walking.

    February 4, 2011 at 12:44 | Report abuse | Reply
  39. Orgasmitron

    I'm 21 and plow women left and right... when I get older and begin to have more women problems, I will begin buying younger ones and continue to treat them like objects and plow them continuously throughout the rest of my days.

    February 4, 2011 at 12:58 | Report abuse | Reply
  40. francisca

    wowowowowowowowowowowowowowow wat u want me to do about it

    February 8, 2011 at 13:47 | Report abuse | Reply
  41. Hesham

    there's 18- reading this !

    February 10, 2011 at 06:48 | Report abuse | Reply
  42. Desiree

    The stuff dreams are made of is possible, if the chemistry is right. It's keeping it going when it's stuck in among daily life that is hard or impossible in some cases. For 19 yrs I had an open marriage (my husband was gay but we didn't want to split until the kids were grown). I had one "extra" lover the entire time and after 19 yrs he still made my knees weak just walking towards me and got me aroused by just talking to me. It was still that way when we tried living together but only for about 6 mo. Then reality of day to day set in and we fell apart. But I wouldn't have traded one second of our time together. I'm not advocating cheating (though open marriages can work if done correctly)... I am making the point that it's the finances, housework, family stuff and day to day that put the kibash on passion. Now I'm married to a great guy and we're monogamous. We've yet to have one fight in 10 yrs, that's how peaceful we are. We do ok in bed, but it's not that passion of old. Seems the chemistry that makes a great marriage for everything else, doesn't work for passion... or something of the sort.
    Have a great day, folks 🙂

    February 28, 2011 at 08:46 | Report abuse | Reply
  43. just sayin

    Im sure most of the guys writing on this blog are Fat Lazy Losers who don't get laid unless they pay someone... Pretty sure every guy that's talked highly of himself and degraded women as' plow or old rosebuds' are Winners and True Charmers.. That actually cant get a decent women to give them the time of day, due to all the senseless rubbish that seems to come out of their holes.

    March 11, 2011 at 13:21 | Report abuse | Reply
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