HEALTH | summer 2004

Viagra or an Rx for Sex?
What women really want in bed

by Sheenah Hankin

“I lied to my gynecologist,” Marilyn, a married, midlife woman told me. “I was too embarrassed to tell him that I haven’t had sex for months.”

“I don’t know why, but I just don’t feel turned on since my baby was born,” reported Jane, an overweight young mother.

An oft-cited (and sometimes criticized) 1992 study by University of Chicago sociologist Edward O. Laumann labeled 43 percent of American women as “sexually dysfunctional.” (In the not-so-distant past, those women would just have been called “frigid.”)

But women are not like faucets that get jammed up and will not turn on. We’re all naturally sexual — the survival of humankind would otherwise be in jeopardy. If women are convinced they’re physically dysfunctional, however, drug companies can make money off them.

Pharmaceutical giant Pfizer has made a fortune from the little blue pill Viagra, which acts as an erector set for men who, to be blunt, can’t get it up. For almost 10 years, Pfizer’s been keen to develop a pink version for women’s so-called dysfunction. In February, however, they gave up: The women in their study just didn’t find Viagra that much of a turn-on.

Why? Because Viagra is not an aphrodisiac. It increases blood flow to the penis, and for 20 percent of women in Pfizer’s study caused an increase in vaginal lubrication. What it doesn’t do is create women’s desire, arousal or orgasm.

Let’s be frank: Women are not sexually “dysfunctional.”

Let’s be clear: Many, many women are sexually dissatisfied.

So, what turns us off?

Turn-off number 1: Fatigue

The two-career family is the norm today. Add child care and household chores to a 9-to-5 job and high-energy sex gets pushed to the bottom of a long list of responsibilities. Without enough rest, the brain will vote for sleep, not sex.

Turn-off number 2: Troubling Emotions

Anger heads this list. Many women I work with blame their partners for not assisting them enough in the daily grind. Some then sulk and passively withdraw from intimate connection.

Anxiety is anger’s close companion in the no-sex-tonight league. I’ve heard many women complain of feeling fat, ugly or too old, and this self-criticism undermines their confidence. Confidence is sexy; shame will keep a woman from wanting to get naked. Underneath the anger lies self-pity; underneath the anxiety lurks selfloathing. Both squelch sexual desire.

Shame may also inhibit women from seeking the extra stimulation they could use to feel more sexy. For example, soft porn was shown in a recent Emory University study to equally arouse both men and women. Yet many women I work with are too embarrassed to watch videos with their partners. Similarly, some women fear they’ll be labeled “slutty” — that popular high school insult — if they tell their partners directly what kind of foreplay turns them on.

Turn-off number 3: Antidepressants

Worldwide sales for antidepressant medications rose to a stunning total of $12 billion in 2002. I’ve seen firsthand in my practice how the side effects of the SSRI drugs (Prozac, Zoloft, Paxil, et al.), although temporary, markedly decrease sexual arousal and orgasm.

There is still no pill for instant confidence, but there are solutions to sexual “dysfunction” that can be applied with no negative side effects: Learn to manage with comfort and reassurance your self-pity (blaming others) and shame (blaming yourself ).

Ask your partner for what you want rather than suffering without it. Make sex a habit. For those in long-term relationships, I suggest Rx sex once a week, minimum. No exceptions, no excuses. Procrastination and avoidance of sex will only increase anger and anxiety.

And Viagra won’t help at all.

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Sheenah Hankin is a psychotherapist in New York City and author of Complete Confidence (Regan Books, 2004).