By Meryl Davids Landau
When you were in your 20s and 30s, you probably ignored random aches or other minor physical annoyances, and they usually went away. But now those symptoms can come back — often with a different cause, and calling for more serious attention.
Until now. Finally, the art and science of The Big O for women
is getting long-overdue attention -- from doctors, from sex therapists, from
the media, and with any luck, from women's partners. Women's sexual pleasure
has become big business. There's even talk of a Viagra for women.
Some studies estimate that more than half of the women over 40
in the U.S. have sexual complaints, and a survey published in TheJournal of the American Medical Association in 1999 showed that 43% of
American women -- of all ages -- suffer from some sexual dysfunctions -- a much
higher rate than the 31% reported for men.
Not everybody buys those numbers -- some women think the
researchers weren't asking the right questions -- but no one will dispute that
for many of us, sex isn't the E-ticket ride at Disneyland that the latest issue
of Cosmo bills it to be. And it's not necessarily "all in your
mind." Problems with enjoying sex and reaching orgasm can stem from a host
of physical causes, says Jennifer Berman, MD, a urologist. "Hormonal
abnormalities, problems with estrogen or testosterone, medications like
antidepressants, prior pelvic surgery or hysterectomy, illnesses such as
diabetes, or high blood pressure and high cholesterol are just a few of the
With her sister Laura, a sex therapist, Berman co-directs the
Female Sexual Medicine Center (FSMC) at UCLA Medical Center, and she founded
the Network for Excellence in Women's Sexual Health. They take a
"mind-body" approach to sexual health -- exploring everything from
couples therapy to new research on "nerve-sparing hysterectomy,"
surgery designed to preserve a woman's sexual function in the same way
nerve-sparing prostatectomies do for men.
What Do We Mean by Good Sex?
Hold on a minute, says Gina Ogden, PhD, a sex therapist in
Cambridge, Mass., and author of Women Who Love Sex: An Inquiry into the
Expanding Spirit of Women's Erotic Experience. Before we start trying to
fix women's sexual dysfunction, maybe we'd better figure out just what
constitutes women's sexual function. "The idea seems to be that sex
is all or mainly about being physical, and that the dysfunctions are mainly the
dysfunctions of intercourse," she says. "Sex is more than physical,
therefore sexual dysfunction is more than physical. Maybe your low sexual
desire is because your mate is not meeting your needs on a variety of levels.
If you go to a sex therapist who says, 'Here's how he can have an erection and
here's how you can lubricate,' that may not be the whole answer."