“Think outside her box.”

~  Ian Kerner, PhD., She Comes First

Prologue

Part of the mission of Mating Straight Talk is to explain and demonstrate the evolved behavioral sex differences between men and women.  Sex differences in mating strategies and modes of sexuality serve essential evolutionary purposes.  Recently, I have written about the difference between spontaneous desire (the sexual excitation system predominant for men) and responsive desire (the sexual inhibition system dominant for women).  I outlined how women might “turn off their brakes” (their sexual inhibition system) and maximize their responsive desire.

The research on maximizing responsive desire revealed the difference between men and women related to how novelty triggers sexual desire.  Female boredom in monogamous relationships is an unpleasant reality; it is caused (in part) by the lack of novelty and surprise.  To be clear, women are not, in general, wanting non-monogamy; they are not seeking new or multiple partners as a result of this “sexual malaise.”  But, in addition to “boredom” and the challenge of “designing” the best context for sex (with sufficient “freshness”), there are other barriers to female satisfaction.

Barriers to Female Pleasure

There is an over-reliance on sexual intercourse as a practice and as a definition of sex.  Men and women lack basic knowledge of female anatomy and pleasuring techniques.  The orgasm gap is bigger than the pay gap and has more legitimacy as a behavioral problem.  Add a toxic dose of shame, trauma, and physical pain — and it is a wonder that anyone is getting laid or enjoying it when they do.

Sexual Techniques Do Matter

My focus in Mating Straight Talk has never been on the techniques of sexual practice.  (Psychological “operations” are more interesting than the operation of a vibrator.) But techniques are relevant to the success of a sexual relationship between a man and a woman.  Sexual practices and the “gendered” psychology that “contain” those practices further illustrate the differences between men and women.

She Comes First

As most women everywhere will attest, when it comes to understanding female sexuality, most guys know more about what’s under the hood of a car than under the hood of a clitoris.  Ian Kerner’s book  She Comes First – The Thinking Man’s Guide to Pleasuring a Woman may be the definitive guide to oral sex – where the mystery of female satisfaction is solved, and the “tongue is proven mightier than the sword.”   I encourage readers, especially men, to read this book.  It addresses the over-reliance on sexual intercourse and the lack of knowledge of female anatomy.

Sex and the Frustrated Man

Also, I must acknowledge the considerable insights of author and sex educator Kaye Smith, Ph.D.  Much of this post is adapted from her article, “Sex and the Frustrated Man,” first appearing in Medium.

“Widower Fears Impotence Will Kill New Relationship” 

That was the headline of the column featuring a letter written to “Dear Abby.”  A man lost his wife, had his prostate removed because of cancer, and wanted to start a new relationship.  Worried that he could not perform sexually and be rejected, he asked Jeanne Philips, “Is it possible to have a good relationship with someone without intercourse?  Or do you think I am doomed?”

Yes — Some Women Are Fine with No Sex

Philips’s answer was revealing.  She told this man that many women would value his warmth, affection, intellect, etc. and that he would be in demand, even if he could not perform sexually.  Philips described a common state of post-menopausal female sexual desire – a “responsive desire” (as defined in earlier posts) that is happy with a non-sexual yet romantic relationship.  This is a “desire” functionally over and done; it is latent but not consciously seeking revival.

But C’mon, There is More To Sex Than Intercourse!

Most importantly, it is what Phillips did not say that was interesting, if not troubling.  Phillips said nothing to educate this man (or her readers) about the diverse world of sexual practices that do not include intercourse – that do not require an erect penis or penetration with that penis.  In this post, I will address the problem of “sex-is-intercourse” and other norms or conditions that place barriers to pleasure for women (especially) and men in their sex lives. I will also address the physiological changes that can make sex unappealing for post-menopausal women.

Why Women Lack An Interest in Sex — Revisited

In my prior post (Why Women Are Bored in Monogamous Relationships), I reported the research of Marta Meana about the loss of female libido.  Meana cited three reasons women gave to explain a lack of interest in sex: 1) the institution of marriage produces too much routine, 2) overfamiliarity of sexual practices and loss of novelty, and 3) the de-sexualization of roles – the incongruity of being a mother and a wife.

“Dead Bedrooms”

A  few studies (1) in the U.S. indicate about 1 in 7 marriages are largely “sexless” — characterized by little to no sexual intimacy (“dead bedrooms” is a popular subreddit). Typically, this happens because one member of the relationship refuses to engage in sex.  It is most often the woman.

Male Sex Deficit

In a controversial paper on the male sex deficit, Catherine Hakim (former London School of Economics professor) cited several worldwide studies conducted over the last 30 years that found women reported less sexual interest, lower desire, and more conservative behavior. About 30% of women struggled with low sexual desire compared with 15% of men, and it was the most commonly reported female sexual problem.

“The sex differentials in sexuality remain large, substantively important, and are found in all cultures, including the sexually liberated societies of Scandinavia.” — Catherine Hakim

Kaye Smith (“Sex and the Frustrated Man”) is a strong advocate for female sexual capacity and empowerment.  She agrees with Hakim:   “I believe there is enough research data to support the idea that men overall do report higher rates of libido, sexual interest, and motivation than women and are probably often frustrated with the amount of sex they’re having.”  (Stay tuned for my post on May 11 for further discussion of “dead bedrooms” and the “male sex deficit.”)

Pleasure Roadblocks

Some sexual norms act as roadblocks to women.  A woman can be compromised in her ability to enjoy sex, talk about her desires, feel comfortable in her body, demand sexual equality, or even know when she is turned on. If women do not develop a strong connection with their sexuality, it can play out in the bedroom as sexual apathy.

“Crappy sex is like chowing down on Big Macs as your main source of nutrition.  It does a number on your libido like the one fast food does on your heart.”  ~ Kaye Smith

Problematic roadblocks include:

1. Sex-is-intercourse
2. “Clitphobia”
3. Sexual “lockjaw”
4. Trauma
5. Pain

1. Sex-is-Intercourse

In my March 29 post, Turn Off the Brakes!  Making the Most of Female Responsive Desire, I shared the advice of Emily Nagoski that adding sexual novelty does not need to include new techniques or new toys.  True enough.  But it could include new techniques and toys — and it may require some!  As I explained in Why Women Are Bored in Monogamous Relationships, women need a variety of stimulation for sexual fulfillment (from the same man).  The same sex over and over, especially if it is intercourse, could be a barrier to sexual satisfaction for some women.

“I Did Not Have Sex With That Woman!”

When former president Bill Clinton was accused of sexual impropriety, he insisted with a straight face that “He DID NOT have sex with that woman” (Monica Lewinsky) because all she did was “blow” (fellate) him.

Today, if we asked a thousand straight teenagers and young people, “What is sex?” most would probably say vaginal intercourse — usually to male orgasm.  Note to “Dear Abby” — that is sexual reductionism at its finest.

Vaginal Intercourse is Overvalued

Vaginal intercourse is overvalued, while other sex acts are undervalued. Sexual reductionism is deeply problematic for female sexual pleasure and has a ripple effect on how we think about sex.

Why is “Intercourse-equals-sex” Problematic?

• Most women can’t come from penetration alone.
• Clitoral stimulation winds up as a mere appetizer to the main meal of intercourse, which drastically reduces female sexual pleasure.
• Many men aren’t good at intercourse due to premature ejaculation, erectile dysfunction, or bad technique.
• Some women experience sexual pain from intercourse. Sexual pain is a widespread problem for women, is rarely discussed, and often increases with age.

• “Sex-is-intercourse” ignores the vast array of other sexual practices and aids: the use of lips, tongue, fingers, and vibrators (what author Valerie Frankel calls “outercourse”) — as well as dildoes, plugs, and other sensorial “toys.”

The sex-is-intercourse norm leads to the marginalization of all acts that aren’t about a penis in vagina (PIV).  Ian Kerner says, “cunnilingus is not foreplay, it’s coreplay.”

2. “Clitphobia”

Where’s the Clitoris?

Often, the clitoris is nowhere to be “found” because of a lack of identification and naming.  This starts when a baby girl is born, and we mislabel her anatomy as a “vagina.”  The vagina is the birth canal; it’s not the correct term for visible lady parts.  The correct term is “vulva.”   The primary female sex organ is the clitoris, the equivocal organ to the penis.

Never Heard of It

In a study conducted jointly by Minnesota State and Royal Roads Universities on clitoral knowledge, researchers found that most participants had never heard of the word “clitoris” until they were well into their teens — often after becoming sexually active. One young woman said, “I don’t remember ever being told that a clitoris is a normal part of a female’s body.”  We apparently have a fear of the clitoris, and in some parts of the world – extreme loathing as well.  Female circumcision (clitoridectomy) occurs in parts of Asia and Africa for cultural and religious reasons.

Clitoral Landscape

In The Clitoral Truth, author Rebecca Chalker delineates eighteen parts of the clitoris based upon the research of the Federation of Feminist Women’s Health Centers.  Most well-known and perhaps most important in “outercourse” is the clitoral glans or head of the clitoris, which has 8,000 nerve endings, twice as many as in the head of the penis and more than any other part of the human body.  Inside the vulva are the legs of clitoris that flare downward like a wishbone on either side.  The “legs” are surrounded by erectile tissue known as the twin “clitoral bulbs.”  Even lesser known is the “urethral sponge” that lies on the ceiling of the vagina.

There is no Specific G-Spot 

According to Kerner and other sex educators, “the G-spot is nothing more than the roots of the clitoris crisscrossing the urethral sponge.”  Nicole Prause, an acclaimed neuroscientist and sex researcher on sexual stimulation, says the anterior wall of the vagina does not have any heightened area of sensitivity that can trigger orgasm – there is no G-“spot.”    A lot of fuss has been made about the difference between a clitoral orgasm and a G-spot orgasm.  Although the urethral sponge is attached to the vaginal ceiling, it is considered an integral part of the clitoral network, says Kerner:  “A G-spot orgasm, like all female orgasms, is a clitoral orgasm.”

The Orgasm Gap

Since a woman’s clitoris “does not exist,” it has received inadequate attention in the bedroom. Which leads to the “orgasm gap.”  Depending upon who you read, 10-26% of women are not orgasmic at all.  Over 60% of women who are orgasmic are not happy with how often it occurs.

According to one study (2) (see “Differences in Orgasm Frequency” in Appendix), while 75% of men routinely orgasm during a sexual encounter, only 29% of women do.  Sixty-five percent of straight women were orgasmic compared to 95% of straight men.

Orgasms with Intercourse

Women can receive clitoral stimulation by penile penetration that presses against the clitoral glans and hood and by possible stimulation of the legs of the clitoris or urethral sponge.  But the heavy lifting for clitoral stimulation leading to orgasm is stimulation to the glans and clitoral hood by practices other than intercourse.  Michael Castleman of AARP says only 25% of all women reliably have orgasms during intercourse. “That means 75% of women of all ages must have direct clitoral stimulation to experience orgasm.”

Orgasm Gap Disappears with Masturbation

The orgasm gap disappears during masturbation and same-sex encounters. Sex researcher Shere Hite found that women who masturbate regularly orgasm 96% of the time.

The orgasm gap occurs for one simple reason: neither the woman nor her partner give the clitoris its due attention. They both expect a female orgasm to arrive the same way as a male orgasm – by intercourse. But it doesn’t, and she doesn’t say anything.

3. Sexual “Lockjaw”

Why don’t women say anything? Why do women continue to tolerate the intolerable? Women put up with a lot: pressure to have sex, hapless foreplay, no orgasms, and pain.  So why do women have “sexual lockjaw?”  One word says Smith:  “shame.”

Shame

Writer Yael Wolfe (“What Sexually Frustrated Men Need to Understand About Their Partners,” Medium, 2019) describes how women have been a primary target of our culture’s sexual shaming.  “We’ve been shamed for our body size, for having body hair, for having smelly vaginas [vulvas], for expressing desire, for not expressing desire, for masturbating, for not masturbating, for our sexual fantasies.  You need to understand how hard it can be to allow our bodies to move in ways that will bring us pleasure.”

She Doesn’t Want to Hurt Her Male Partner

Toxic sexual shame for women means she turns herself into a pretzel for the straight male orgasm — no matter the cost to her emotionally or physically.

One of the biggest problems with “hetero-sex” is the idea that a woman’s satisfaction is her partner’s responsibility, and if he can’t bring home the bacon, he’s not a man. The male ego can be fragile and insecure and can be both aggressive and defensive in bed.  Most women are socialized to prioritize their relationships even at the expense of their own needs.  Women keep their mouths shut to avoid making male lovers feel inadequate and to avoid shaming them.  However, when women stay silent, desire can go dormant and eventually disappear.

4. Trauma

Many women experience trauma. Sexual abuse is rampant in our society. One out of 6 women will experience a rape or an attempted rape in their lifetimes, according to the Rape, Abuse, and Incest National Network (RAIN). Survivors are more likely to report distress, experience PTSD, and contemplate suicide than non-survivors.

Sexual abuse can have a profound impact on sexuality. According to a study of 1664 women, those who had been abused reported more issues with body image and expressed more discomfort getting undressed in front of a lover. They also used contraception less often and reported more sexual and relationship dissatisfaction.

Close Contact Can Be Triggering

Sex involves close intimate contact, which can be a trigger for some people. Being touched might reactivate the anger experienced from abuse or molestation.

Survivors often check out of their bodies and disassociate while being abused.  Disassociating can be a way of handling an unbearable trauma. Unfortunately, while this helps them survive at the time, it can linger as a side effect.  Leaving your body behind while you float in the ether isn’t a recipe for a passionate, connected sexual experience.

5. Female Pain

Pain During Vaginal Intercourse

A study by Debby Hebernick (3) and colleagues found that 30% of women and 7% of men reported pain during vaginal intercourse.  Most of the reports of pain were mild and short duration.  About 72% of women and 15% of men reported pain during anal intercourse.  Women reported more moderate or severe pain than did men.  Researchers concluded that “large proportions of Americans do not tell their partner [have lockjaw] when sex hurts.”

According to the North American Menopause Society, up to 45% of postmenopausal women find sex painful due, in part, to increased vaginal dryness and thinning vaginal tissue caused by falling estrogen levels.

Conditions Causing Pain

Pain can occur for many reasons.  Several poorly understood medical conditions can wreak havoc on a woman’s sex life: including vulvodynia, lichen sclerosus, and pudendal neuralgia.  (See Appendix).

Irritable bowel syndrome (IBS) can also cause pain for women during deep coital penetration.  Women with IBS also report a lack of sexual desire and difficulty getting aroused.  Lack of arousal can lead to insufficient lubrication.  (IBS is 1.5-3 times more common in women, but it can also cause premature ejaculation or erectile dysfunction in men.)

Sometimes pain occurs because of an overly tight pelvic floor or hormonal birth control. The pill reduces testosterone, which can be implicated in the most common sexual pain problem in premenopausal women: provoked vestibulodynia, a form of vulvodynia.

Conclusion

A significant barrier to sexual pleasure for women is an over-reliance on sexual intercourse as a practice.  Men and women lack basic knowledge of female anatomy and pleasuring techniques.  Let’s get educated about “outercourse” and create an environment where it is easy and natural to talk about sex.  Men will also have more pleasure when women have more sexual agency.  Shame is unnecessary!  In a world with courageous and compassionate straight talk about sex, trauma and pain can be reduced.  Let’s bring down the barriers.

References

1. Donnelly, D; (1993). “Sexually inactive marriages”; The Journal of Sex Research, Vol. 30, Issue 2.

2. Frederick, D., et al. (2018) “Differences in Orgasm Frequency Among Gay, Lesbian, Bisexual and Heterosexual Men and Women in a U.S. National Sample.” Archives of Sexual Behavior, 47, 273-288.

3. Herbenick, D. et al., “Pain experienced during vaginal and anal intercourse with other-sex partners: findings from a nationally representative probability study in the United States.” Journal of Sexual Medicine, (2015), April, 12 (4): 1040-51.

Appendix

Female Pain – Physical Conditions that Prevent Sexual Pleasure

Vaginal Atrophy

According to the Mayo Clinic, vaginal atrophy (atrophic vaginitis) is thinning, drying, and inflammation of the vaginal wall.  Vaginal atrophy occurs most often after menopause when a woman has less estrogen. It not only makes intercourse painful but also leads to distressing urinary symptoms.  Because the condition causes both vaginal and urinary symptoms, doctors use the term “genitourinary syndrome of menopause (GSM)” to describe vaginal atrophy and its accompanying symptoms.

Not all menopausal women experience GSM.  Regular sexual activity (with or without a partner) can increase blood flow and help maintain healthy vaginal tissues.  Treatments include vaginal moisturizers, water-based lubricants, topical forms of estrogen, and other therapies.  Seek the advice of a trusted specialist to explore all options.

Vulvodynia

Vulvodynia is chronic vulvar pain without an identifiable cause.  The location, constancy and severity of the pain vary.  Some women experience pain in only one area of the vulva, while others experience pain in multiple areas. The most common reported symptom is burning.  Pain at only one site surrounding the vaginal opening is called localized vulvodynia, or Provoked Vestibulodynia (PVD), and occurs during or after sexual intercourse, tampon insertion, or gynecologic exam.

How Hormones Impact Women’s Sexuality

From: “The Biochemistry of Lust: How Hormones Impact Women’s Sexuality,” Medium, October 6, 2019.

Kaye Smith, Ph.D. tells the story of estrogen, progesterone, testosterone, and DHEA and how hormones work in the female body.  She discusses how much a woman’s desire issues are hormone-related and how hormone replacement (HRT) works.

Differences in Orgasm Frequency – (from study Abstract; see reference above.)

There is a notable gap between heterosexual men and women in the frequency of orgasm during sex.

Researchers examined how 30 different traits or behaviors were associated with frequency of orgasm when sexually intimate during the past month.

Participants included a large U.S. sample of adults (N = 52,588) who identified as heterosexual men (n = 26,032), gay men (n = 452), bisexual men (n = 550), lesbian women (n = 340), bisexual women (n = 1112), and heterosexual women (n = 24,102).

Heterosexual men were most likely to say they usually-always orgasmed when sexually intimate (95%), followed by gay men (89%), bisexual men (88%), lesbian women (86%), bisexual women (66%), and heterosexual women (65%).

Compared to women who orgasmed less frequently, women who orgasmed more frequently were more likely to: receive more oral sex, have longer duration of last sex, be more satisfied with their relationship, ask for what they want in bed, praise their partner for something they did in bed, call/email to tease about doing something sexual, wear sexy lingerie, try new sexual positions, anal stimulation, act out fantasies, incorporate sexy talk, and express love during sex.

Women were more likely to orgasm if their last sexual encounter included deep kissing, manual genital stimulation, and oral sex in addition to vaginal intercourse.

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