“Only like eight girls in the history of the world have had an orgasm,” one editor on this paper said recently; there could be more, he added, but he’s been too busy with other things.
It’s not really that bad. But a major study done in 1999 did find that about one in seven sexually active women couldn’t climax or, for that matter, even get aroused enough during sex to enjoy it. Another one in five did not itch for sex at all (ironically, some oral contraceptives decrease libido). A smaller number consistently felt pain during intercourse.
Pain is more predominant among women of college age, but it is also the easiest problem to solve. Most girls will have some pain for the first time, because of a tight hymen (a fold of tissue partly blocking the opening of vagina); once they are broken in, the pain typically goes away. If it continues, says Melissa Ruwitch, a health and wellness coordinator, it’s usually because they didn’t use enough lubrication-“and that is something that’s easily solved,” she adds.
It is the absence of orgasm that puzzles doctors. Dr. Rachel Pauls, chief resident in gynecology and obstetrics at Barnes-Jewish, said that there is little clinical information on this condition. It appears to affect younger women more. If a woman is readily aroused (and most college-age girls have no problem with that), and if she feels no pain, then the lack of orgasm will be something “that’s very difficult to treat.”
Guys have received much of the blame for this. They don’t spend enough time on foreplay, many women complain; they go in like a tow truck, and they don’t know a woman’s body. But neither do many women, Pauls said. One important question doctors ask is whether the patient ever had an orgasm before. “Did she ever have an orgasm by self-stimulation? If you’ve never had an orgasm, you’re not going to know what it’s like and you’re not going to know how to get it.” Ruwitch, too, said that “learning how their bodies work is a pretty important part” in reaching a climax.
Excitement of the clitoris is touted as the key to orgasm, but it won’t help if the woman’s psychology doesn’t cooperate. “Younger women might not feel comfortable enough in a relationship to criticize their partner,” Pauls said, “or they might not expect to have an orgasm if they haven’t had an orgasm before.” There is also a misconception about age. One sexually active WU senior says she has never had an orgasm, even through masturbation-but she isn’t too worried. Eventually, she believes, she’s bound to; her age is keeping it at bay. But Pauls disagrees, saying that there is no medical reason why a woman shouldn’t have an orgasm in her late teens and early twenties.
Men’s medicine
A real problem with a group of symptoms known collectively as “female sexual dysfunction” is that no one is studying them very hard. The one major inquiry into their prevalence has only come out four years ago, and it excluded girls living in college dorms. The dysfunctions “[aren’t] something that a lot of people seem to know about, even a lot of gynecologists,” said Pauls, who is giving a talk on the subject on Feb. 12 at Barnes-Jewish.
Meanwhile, some of those who do study these symptoms have been sponsored by pharmaceutical companies, which have an interest in exposing a disease and promoting a cure. When the study mentioned above ran in the Journal of American Medical Association, the journal omitted the standard financial disclosure footnote, which would have shown that two of the three co-authors had ties to Pfizer Inc. (of Viagra fame) and other drug makers (JAMA eventually printed a correction, but not until seven issues later). And 18 of the 19 scientists who got together in 1998 to expand the definition of “female sexual dysfunction” to include sex enjoyment problems have had financial relations with drug companies.
This raises skepticism, especially among psychologists. Some see a “medicalization campaign” by drug companies trying to make a disease out of something that is influenced by complex personal and social causes at least as much as by physical ones. Dr. Pauls, for one, said that while all these factors do play a role, sexual dysfunction is a medical condition. “Male sexual dysfunction is fully recognized as physiological,” she said. “With women, we’ve been told, ‘It’s all in your head, honey.'”
One result is that women lack specific medications to increase libido or arouse them sexually. “The majority of treatments being used on women are some of the treatments that have been tried on men,” Pauls said. “Now they are trying to generalize them to women.”
WU girls will be happy to learn this fact: female college graduates are only half as likely to experience sexual pain, low sexual desire, or problems achieving orgasm as are women without high school diplomas. This is only an association; but Pauls suggested that women with more education may be more aggressive about making sure that their needs are satisfied. Our promiscuous editor can’t take all the credit.