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 (534 Responses)
  1. Tom

    A woman is just like an oven. You have to turn on the heat before you stick in the meat!!

    February 3, 2011 at 13:54 | Report abuse | Reply
  2. mpouxesas

    well...I for one (as I am not most men...) think that you should enlighten us so we DO KNOW....then, see if we can practice the artform/new skill learned (preferably on you...) and then YOU can decide (we will leave this up to you) if we are still don't know it/don't care etc...

    February 3, 2011 at 13:54 | Report abuse | Reply
  3. Jaxson

    I am currently going through a divorce. I can honestly say that intimacy was one of, if not the largest, reason for the divorce. I read this article and said, "Holy cow, that's my wife." I will say that I do take full responsibility for my faults in the demise of our marriage, but I wish I could ask her to read this article.

    February 3, 2011 at 13:54 | Report abuse | Reply
  4. Dave R.

    It would sure help if the woman would tell the man what she wants. None of us are mind readers and many times men trying to figure out what a woman wants can be simply a guess at best.

    February 3, 2011 at 13:55 | Report abuse | Reply
  5. Bugsy


    you made the analogy of ball room dancing, in that there are unspoken cues involved... nice, except condsider this question: how much -verbal- training goes into becoming proficient at that type of activity? Trying learning that by only reading the instructors mind.

    February 3, 2011 at 13:55 | Report abuse | Reply
  6. mike

    you are right, we do not care. we used to care, but got sick of asking and never getting a meaningful response. go to sleep frustrated, won't bother us a bit.

    February 3, 2011 at 13:55 | Report abuse | Reply
    • James

      I actually had a woman tell me once that it really turned her off to be asked what she liked or if something felt good. Well guess what, our minds and bodies are wired differently than yours and we can't read your mind, so either tell us what works for you or we'll do what feels good to us.

      February 3, 2011 at 16:17 | Report abuse |
  7. sammy zoso

    It's the man's fault no matter what the problem is. What BS.

    February 3, 2011 at 13:59 | Report abuse | Reply
  8. watinka

    Maybe women, like men, should start practicing when they're 12 years old.

    February 3, 2011 at 14:00 | Report abuse | Reply
    • EmeraldCity

      How do you know we didn't?

      February 3, 2011 at 16:42 | Report abuse |
  9. Dave R.

    Re; my earlier post, I have tried asking and numerous times about what turns her on and if what I am doing does. But, when you don't get any answers, then what? It would sure help if the woman would tell the man what she wants. None of us are mind readers and many times men trying to figure out what a woman wants can be simply a guess at best.

    February 3, 2011 at 14:04 | Report abuse | Reply
  10. EmeraldCity

    As usual, after posting a significant response, the comment that I just posted – and which did not receive a moderator message or anything – has disappeared. Plus, I see that an earlier comment *to a thread* which already exists elsewhere, has been posted twice. Where the h3ll is my comment, CNN?

    February 3, 2011 at 14:05 | Report abuse | Reply
    • iduna

      mine comment disappeared too. Looks like one of the women on staff isn't liking the truth so we are being blocked from commenting.

      February 3, 2011 at 14:10 | Report abuse |
    • EmeraldCity

      Iduna – No, it's just that this site is so bad. Posts first follow each other chronologically and then a few hours later they're just thrown any which way. It's the programming.

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

      I have posted twice and neither comment was actually placed on the site.

      February 3, 2011 at 14:50 | Report abuse |
  11. Optimus Prime

    Oral skills gentlemen! love riding my man's face for an O!

    February 3, 2011 at 14:05 | Report abuse | Reply
    • dave

      Yes I'm sure you do "Optimus Prime". That totally sounds like a name a chick would choose.

      February 3, 2011 at 14:35 | Report abuse |
  12. anonymous coward

    0/10, obvious troll is obvious

    February 3, 2011 at 14:05 | Report abuse | Reply
  13. Madoshi.Net

    Two in the pink, one in the stink!

    February 3, 2011 at 14:12 | Report abuse | Reply
  14. IMHO

    Most women live in a fantasy world expecting men to read their minds and throw little tests out there for us to see if we are aware of what they want us to do. I personally don't play the games. Can't speak your mind? Outta the way! Period!

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

      True. Some women do live in that fantasy world. Plenty of men live in a different fantasy world: where the women all look like supermodels/'stars', are always ready for action, and are always willing to do things that most normal women find demeaning. (No, I'm not talking about oral, or even anal, but multiple partners, for example.)

      February 3, 2011 at 19:22 | Report abuse |
  15. Andrea M

    Not all of us. I for one am perfectly happy to let my boyfriend play video games when he gets home from work instead of expecting him to sit there doing nothing as I cook dinner. It's also rare that I request (never demand) that he stay home from going to friends houses to get guy time. In exchange he lets me have all the time I want with my friends and doesn't mind my being a giant fashion nerd. It's all about flexibility and indulging each other in our separate tastes. He can blow up his zombies and sometimes I join in, I do my sewing and designing to which he sometimes provides third or fourth hands when I need them.

    February 3, 2011 at 14:14 | Report abuse | Reply
  16. vwluvr24

    thats where good communication comes in. don't be shy, show them what you want.

    February 3, 2011 at 14:15 | Report abuse | Reply
  17. Jack

    Don't really care "what she wants." It IS all about me.

    February 3, 2011 at 14:16 | Report abuse | Reply
  18. CouldCareLess

    "I am wondering if men just don't know how to arrouse and excite women anymore???..." ->> When do suppose men forgot Jane?

    February 3, 2011 at 14:16 | Report abuse | Reply
  19. Andrew

    That's funny and arrogant. It has nothing to do with you the individual, it's the whole other gender that is the problem, not you right. Maybe your standards are too low. To presume that it's men and not you is the most ridiculous thing I've ever heard. What would you say if a guy was impugning women, because he couldn't get wood. Would you agree and say that women just don't try to get men turned on anymore. Your foolish, and it's evident what kind of man you probably get, idiots like idiots.

    February 3, 2011 at 14:17 | Report abuse | Reply
  20. Sarah

    lol, love all the guys ripping on Jane's comment and proving her point. Men don't listen. Not all men – just most. One commenter said it best when he said "as long as we're getting some, we just don't care." Truer words ne'er spoken. Bottom line is about 10% of you have what it takes to please a woman – meaning you're willing to listen and learn. The rest of you are lazy and then complain when people call you out on your inability to get a clue.

    February 3, 2011 at 14:17 | Report abuse | Reply
    • Valerie

      I agree with you Sarah. See how fast all the MEN jumped all over her? LMAO! Their nasy comments only PROVE what she says to begin with! Hahahaa! Nice job, guys! BRAVO! Oh and guys, most of us women DO NOT watch the Lifetime Channel! We have better things to do with our lives!

      February 3, 2011 at 14:20 | Report abuse |
    • @Val

      Someone is.. otherwise they'd be turned off and something else would come up. And are you saying that your man fails you even though you're mind isn't jacked up?

      February 3, 2011 at 14:27 | Report abuse |
    • "man"

      this is the point, why does it have to be man to listen and see what women want? i am tired of hearing this. why not women listen to what man want. Women are the ones, 90%, that dont have a clue. take care of the men you have and see if the man takes care of you, if not you have the wrong man, 10%.

      February 3, 2011 at 14:35 | Report abuse |
    • Meek

      Luckily my wife climaxes in 3 minutes of the 4 I have to give...

      February 3, 2011 at 14:42 | Report abuse |
    • lu


      February 3, 2011 at 15:51 | Report abuse |
    • Heather

      Nicely said Sarah.

      February 3, 2011 at 17:08 | Report abuse |
  21. GetReal

    When a man inspires my TRUST, I function just fine. That means he doesn't cheat, doesn't abuse, doesn't take two minutes to satisfy himself and assume I should respond as quickly. He shouldn't be self-destructive or mean. Too many men (women too) are untrustworthy. We're not circus animals and we don't perform on cue.

    February 3, 2011 at 14:18 | Report abuse | Reply
    • Bugsy

      but with all you're demands and requirements, you want HIM to perform like one.

      February 3, 2011 at 17:10 | Report abuse |
    • MoodyMoody

      @Bugsy, what about GetReal's requirements involve him "performing like a circus animal"? All she's asking for is a decent male human being.

      February 3, 2011 at 19:25 | Report abuse |
    • Bugsy

      @moodymoody It was subtle humor...expecting that a guy:
      "doesn't cheat, doesn't abuse, doesn't take two minutes to satisfy himself and assume I should respond as quickly. He shouldn't be self-destructive or mean"

      February 4, 2011 at 11:39 | Report abuse |
  22. Bugsy

    Judging by Janes tone, even SHE doesn't know how to get herself off. Brrrrrrr.....

    February 3, 2011 at 14:18 | Report abuse | Reply
  23. Carol B.

    Gotta love all you guys talking about how it's a woman's responsibility to be satisfied. Umm, one of the things most of us need is for the man to last longer than a couple of minutes. Too many men won't/can't. All they care about is themselves. Please enlighten me as to how I can "take responsibility" for the length of time you can last. That's entirely up to you, stud.

    February 3, 2011 at 14:18 | Report abuse | Reply
    • Will

      On a related note, I'd like to point out that the wives, girlfriends and Mississippi cousins in all those Cialis / Viagra commercials are all reasonably fit and attractive. *Of course* the medication is gonna help those men.

      February 3, 2011 at 14:22 | Report abuse |
  24. Iknowtheproblem

    It's called "Hollywood" – it's created obstacles between men and women by playing with the fantasies, not realities. Thus, men and women aren't meeting each others criteria that has been set by an entertainment culture.

    February 3, 2011 at 14:18 | Report abuse | Reply
  25. Troy

    I recommend a fantastic book "How to satisfy a woman every time, and have her beg for more" by Naura Hayden.
    This book could save the world, practically.


    You have to be physically fit, but it is fantastic for in-marriage or marriage-bound relationships.

    February 3, 2011 at 14:18 | Report abuse | Reply
  26. jas

    maybe try a lady instead of playing a blame game

    February 3, 2011 at 14:20 | Report abuse | Reply
  27. Meek

    Females need to be much hornier more of the time, just sayin

    February 3, 2011 at 14:20 | Report abuse | Reply
    • Carol B.

      If what you were giving was quality, the women in your life would want it more often. It's that simple. If men were good in bed, we'd want it as much as you do.

      February 3, 2011 at 14:22 | Report abuse |
    • Meek

      im great in bed, ive never not once not not climaxed.

      February 3, 2011 at 14:26 | Report abuse |
    • Carol B.

      You and your ilk are the reason decent men can't get enough. Why would any woman risk disease, pregnancy, etc for your 1-minute lovin? Just sayin...

      February 3, 2011 at 14:29 | Report abuse |
    • Meek

      umm i take offense at that. Its at least 4 minutes of loving.

      February 3, 2011 at 14:32 | Report abuse |
  28. Meek

    MEn & Women need to use the word sphincter more.

    February 3, 2011 at 14:20 | Report abuse | Reply
    • dave

      And moist. If you had a moist sphincter life would be good.

      February 3, 2011 at 14:38 | Report abuse |
  29. Meek

    I satisfy my wife. So does the postman, the heati fixing guy and the plumber. They say it takes a community.

    February 3, 2011 at 14:22 | Report abuse | Reply
  30. A Asiwky

    I notice that the women want men to try harder to figure out what women want. But women don't want to tell men what they want. Therein lies the problem. This is not how women communicate. Women prefer men to 'figure out' what women want! Women do not desire to communicate in a logical, rational way that men prefer. As long as this is the state of affairs, the problem will persist.

    February 3, 2011 at 14:24 | Report abuse | Reply
  31. Dave K

    If you aren't always learning, trying new things and not giving up until she is satisfied, you're lazy and doing it wrong. I am sure there are women with issues that make orgasm impossible, but I've never been with one personally... I have run into plenty of women whose expectations have been damaged by men who are too lazy or insensitive to please anyone but themselves, but that's different and a little communication and effort fixes that.
    My motto for myself is "in bed, the more you give, the more you get" and it has served me well all of my adult life. Sadly my buddies are clueless on this and don't want to hear it. So, I just smile when the rest of the guys at the office complain like sd little puppies about never getting any... lol... and they are so confused about why their wives or girlfriends are cold and distant. Maybe I am out of the norm in really enjoying pleasing my partner, but really guys, it's not that hard.

    February 3, 2011 at 14:24 | Report abuse | Reply
  32. jas

    there is a definite difference between loving someone and making love to someone. You can do one without the other.

    February 3, 2011 at 14:24 | Report abuse | Reply
  33. Meek

    Writer of this article can you call my wife, romance her... and then I can come in and finish the job. Cmon help a guy out. sheesh.

    February 3, 2011 at 14:25 | Report abuse | Reply
  34. Minorkle

    Kita Kata Koo

    February 3, 2011 at 14:25 | Report abuse | Reply
  35. brent

    Joe in Colorado is a bare faced liar....as if.... great self appraisal.

    February 3, 2011 at 14:27 | Report abuse | Reply
  36. pete

    Try the 'Spocker'- two in the pink- two in the stink. Live long and prosper.

    February 3, 2011 at 14:27 | Report abuse | Reply
  37. Len Avarfon

    Stop dating losers. That may be difficult for one who generalizes so much.

    February 3, 2011 at 14:28 | Report abuse | Reply
  38. Bugsy

    You missed the pont of why guys take offense at Janes meaasge. There isn't any 'listen and learn' i her scenario. She expects us to read her mind or take 'unspoken cues' . I have an unspoken cue for her >right herethis< Jane?

    February 3, 2011 at 14:30 | Report abuse | Reply
  39. FromJeffFoxWorthy

    You getting a b–b job is like getting a new chandalier in a haunted house

    I thought if I got some new lights you'd stay in it longer than a minute

    -–Sorry grandma, we'd just leave faster.

    February 3, 2011 at 14:32 | Report abuse | Reply
  40. George

    Jane: if I do all the things my wife asks to get her in the mood: foot massages, gifts, more touchy-feely, more helpful around the house, take tasks off her plate, etc.. and she still has a headache, is too tired, kids have worn her out, etc. whenever I try to initaite anything, what do you recommend?

    February 3, 2011 at 14:33 | Report abuse | Reply
    • froggy

      Send the kids off this weekend. Tell her you want a romantic weekend just the two of you. Tell her no housework, no talk of kids, no TV for the whole weekend for either of you. Make the entire weekend about laying in bed, going out to dinner or making a really romantic dinner together. The important thing is for both of you to set everything aside and re-discover one another. I think it's great you are doing these other things to lighten her load. Keep up with that. Just once in awhile do something totally unexpected that doesn't involve any of your usual daily activities for EITHER of you.

      February 3, 2011 at 15:13 | Report abuse |
    • wdrworm

      Well said!

      February 3, 2011 at 16:38 | Report abuse |
  41. tesla1908

    I don't buy it, Jane. You're a man online pretending to be a woman. Get a life.

    February 3, 2011 at 14:34 | Report abuse | Reply
  42. EmeraldCity

    t's amazing that the range concerning what women think is workable with respect to men and s3xuality can be so varied and extreme.

    For the most part, every man I've ever lusted after – and if we had a good chemistry – pleased me. When it didn't work anymore for us, it was simply over. But it wasn't because I was looking for a kind of technical proficiency from the get go.

    When two people are in the zone, it just works. Half the time that sort of gives a momentary pass to any lack of knowledge on each person's behalf. In my experience, whenever I wanted a man to do something and just told him what and how I wanted, he did it. But then, I'm very good about knowing how to get them off and have read literature about it (besides just experimenting). I found that half the time if they were involved and aroused, I had no problems getting off.

    I think that if you have high expectations, though, from the beginning and sit back and expect to be handled a certain way and for men to be mind readers, you are setting yourself up.

    BTW – If the chemistry is already there, innovation and experimentation for both parties (the ability to surprise) often = success.

    Let's see if this posts. D@mn CNN.

    February 3, 2011 at 14:34 | Report abuse | Reply
    • Will

      EmeraldCity wins, simply by understanding that we're not mind readers. She's a rare gem.

      February 3, 2011 at 14:43 | Report abuse |
    • B

      Emerald City is exactly right. Emerald, you didn't have a problem because you enjoyed who you were with and making them feel good? Emerald is the woman you want men. She knows what's up.

      February 3, 2011 at 17:00 | Report abuse |
    • Good one

      .. but I think the article was mainly referring to long term relationships. The point of those is to not leave when the chemistry runs out. Which is also why long term relationships rarely ever end up being "long term".
      Personally, I agree with. No need to not go for it when the chemistry is there and it alwlays is satifying, no problems.

      February 3, 2011 at 17:21 | Report abuse |
  43. Dom

    Women say just ask, but then can't give an answer. So what would you have us do, use our awesome man powers of ESP to probe the brain? I think if a clear-cut answer could be given, men would listen.

    February 3, 2011 at 14:36 | Report abuse | Reply
  44. illfixya

    It's been a while, hasn't it, Jane.

    February 3, 2011 at 14:36 | Report abuse | Reply
  45. Joe


    February 3, 2011 at 14:36 | Report abuse | Reply
  46. Me

    Says the woman that probably just lies in bed doing nothing, while her man is on top struggling to do everything for her.

    February 3, 2011 at 14:37 | Report abuse | Reply
  47. Durk

    I like to give her about 2-3 big Os during a love making session. But seriously, why do most women have this fantasy that there will be some knight in shining armor to sweep them off their feet? Quit expecting everyone around you to make you happy. Guys that are smart and figure out the con don't get suckered into all the bs and drama.

    February 3, 2011 at 14:41 | Report abuse | Reply
    • AnonGirl30

      Men should be romantic, come on.

      February 4, 2011 at 03:16 | Report abuse |
  48. vwluvr24

    George – try a little romance, even if it's borderline cheesy

    February 3, 2011 at 14:45 | Report abuse | Reply
  49. Scott

    Could we fix their brain first before we start on their $ex drive?

    February 3, 2011 at 14:45 | Report abuse | Reply
  50. Duane W

    Look, communication is key. If one partner isn't honest then the relationship in the room is always going to have an unsatisfied partner. For my wife and I, we ALWAYS keep making sure if there are changes in the mood and what we prefer. We both keep happy both in and out of the bedroom and it makes us stronger together

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