Sex and Your Psyche

Sexual dysfunction is a problem for many. Here's what you can do about it.

By Michael Seeber, Carin Gorrell, published on November 01, 2001 - last reviewed on July 31, 2006

Clearly, the Bermans will need hard data to win over their critics. Their UCLA facility is enabling the Bermans to conduct some of the first systematic psychological and physiological research on the factors that inhibit female sexual function. One of their first studies suggests that the pharmaco-sexual revolution that helped some men overcome their sexual dysfunction may prove less effective for women. Their initial study of the effects of Viagra on women found that Viagra did increase blood flow to genitalia and thereby facilitate sex, but women who took the drug said it provided little in the way of arousal. In short, subjects' bodies might have been ready, but their minds were not.

"Viagra worked half as often in the women with an unresolved sexual abuse history as in those without it," Laura says. "So it's just not going to work alone. Women experience sexuality in a context, and no amount of medication is going to mask psychologically rooted, or emotionally or relationally rooted sexual problems." Laura believes the results of the Viagra study counter those who contend that FSD is simply a tool of pharmaceutical companies to "medicalize" female sexuality.

"I'm less concerned about it, because I'm aware that it won't work," she says. "And in some respects, pharmaceutical companies are closing the divide between the mind and body camps of FSD. Clinical trials of new drugs for FSD are requiring psychologists to screen participants, and that is an acknowledgement that an accurate assessment of a drug's efficacy requires a consideration of the test subjects' feelings about sex. So these physicians who may not be motivated to bring on a sex therapist are now motivated to participate in a clinical trial, and then that model becomes the norm."

Currently, the sisters are working on MRI studies of the brain's response to sexual arousal, the place where mind and body meet. And although there is a lot more research to be done on FSD, identifying it as a problem has already made a significant impact on how women perceive their sexuality. "Women now feel more comfortable going to their doctors, and they're not taking no for an answer, not being told to just go home and have a glass of wine," explains Laura. "They feel more entitled to their sexual function."

His & Hers: How To Have Them

Hers: a female orgasm can be frustratingly evasive. While about 85 to 90 percent of women are capable of having an orgasm, according to Beverly Whipple, Ph.D., vice president of the World Association for Sexology, only about one-third have had one during intercourse. That said, it's important to remember that orgasm should never be the goal.

"In goal-oriented sexual interactions, each step leads to the top step, or the big "O"—orgasm," says Whipple. "Goal-oriented people who don't reach the top step don't feel very good about the process that has occurred. Whereas for people who are pleasure oriented, any activity can be an end in itself; it doesn't have to lead to something else. Sometimes, we're very satisfied holding hands or cuddling. There would be a lot more pleasure in this world if people would just focus on the process."

Whipple also points out that the psychological ramifications of dissatisfying sexual interactions are not often suffered alone; they can cause distress in both partners. "If one person in a relationship is goal-oriented and the other is pleasure-oriented, and neither is aware of their own orientation, they don't communicate that with their partner," she explains. "A lot of relationship problems can develop. In my workshops with couples, I help them be aware of how they view sexual interactions and then communicate this with their partner."

Types of Orgasm

Clitoral Orgasm

The most common, they result from directly stimulating the clitoris and surrounding tissue. What many people don't realize is that the majority of the clitoris is actually hidden inside the woman's body. Recently, Australian urologist Helen O'Connell, M.M.E.D., studied cadavers and 3-D photography and found that the clitoris is attached to an inner mound of erectile tissue the size of your first thumb joint. That tissue has two legs or crura that extend another 11 centimeters. In addition, two clitoral bulbs—also composed of erectile tissue—run down the area just outside the vagina.

O'Connell's findings, published in the Journal of Urology, show that this erectile tissue, plus the surrounding muscle tissue, all contribute to orgasmic muscle spasms. With so much tissue involved in a clitoral orgasm, it's no wonder they're the easiest to have.

Pelvic Floor or Vaginal Orgasms

These occur through stimulating the G-spot, or putting pressure on the cervix (the opening into the uterus) and/or the anterior vaginal wall. Located halfway between the pubic bone and the cervix, the sensitive G-spot—named after its discoverer, German physician Ernest Grafenberg—is a mass of spongy tissue that swells when stimulated. Because it's difficult to locate, experts have developed a few guiding techniques:

Lying on her back, the woman tilts her pelvis upward so that her vulva presses flat against her partner's pelvic bone. According to the Bermans, this allows the penis to make contact with the G-spot, simultaneously stimulating the clitoris. Putting pillows beneath her buttocks makes angling her pelvis easier.
Whipple suggests placing two fingers inside the vagina and moving them in a beckoning motion. The fingertips should stroke the frontal vaginal wall, just where the G-spot is located.

The Blended Orgasm

This can be attained through a combination of the first two.