What We've Learned From 'Sex and the City'

From sex toys to infertility, HBO comedy raises awareness of sexual health.

From the WebMD Archives

When a television series ends, does it really just cease to exist or do its lessons live on, like those from your last serious relationship?

That's probably something that columnist Carrie Bradshaw (played by actress Sarah Jessica Parker on HBO's Sex and the City) would scribe if her assignment were to sum up the lessons gleaned from her hit sitcom over the past six seasons. And in truth, I do feel a bit like Carrie as I take a stab at that very topic -- except that I am wearing Nikes, not Manolo Blahniks, and I am writing about the show Sex and The City, not sex in the city.

And as it turns out, this topic is as hot of some of the steamy sex scenes aired on the show over the years.

The final episode of HBO's breakthrough series Sex and the City aired on Feb. 22, and leading "sexperts" and women's health experts have a lot to say on the escapades -- and sexcapades -- of the four female friends who starred in the show.

Sex and the City covered "all issues that people face every day when they are dating and in relationships; it educated and entertained us and made it more acceptable for us to talk about these issues," says Los Angeles-based clinical sexologist Ava Cadell, author of several books, including 12 Steps to Everlasting Love.

From masturbation and sex toys to performance anxiety and infertility, "the show crossed certain boundaries where female sexuality is concerned," says Cadell, who counts herself among the millions of avid Sex and the City fans.

Importantly, viewers learned that "It's OK to be single in your 30s and 40s and its OK to initiate a relationship and/or sex," she tells WebMD.

Thanks to Sex and the City, we know that "sex toys are OK and fun and are not taboo," she says. "On the show, it's done with such humor that it becomes acceptable."

In one episode, one friend introduces another to the Rabbit Pearl vibrator, and another episode involves one of the leading ladies using handcuffs on her bed partner.


More Than Just Fun and Games

"Right now, the show is teaching women to go and get a mammogram, and that's fantastic," Cadell says, referring to the current storyline in which the promiscuous Samantha Jones (played by Kim Catrall) is diagnosed with breast cancer after consulting with a plastic surgeon about breast implants.

That said, "Samantha is not that realistic, and very few women can really relate to her sexual behavior," Cadell says. "I would have liked to have seen a little more realism and maybe to see her promiscuity get her into trouble."

"She was always having the best sex, and there should have been some consequences attached to one night stands," she says.

Such as? "Sexually transmitted diseases would have been good, or maybe rejection in the middle of sex or lack of lubrication," Cadell suggests.

"While the Kim Catrall character may carry it too far, the message that women can enjoy sexual pleasure for themselves is a good one," says New York city-based psychiatrist and psychoanalyst Gail Saltz, MD, author of the forthcoming Becoming Real.

"Samantha is a great model of owning your sexuality being proud of who you are and what you want to do and taking on the world in your own terms," agrees Pepper Schwartz, PhD, a professor of sociology at the University of Washington in Seattle and author Everything You Know about Love and Sex is Wrong.

But Sex and the City covered more than sex; the show also tackled infertility. According to RESOLVE, a nationwide infertility association, 6.1 million women in the U.S. are infertile, and on the show, Charlotte York (played by actress Kristin Davis) represented these women.

In her quest to have a child, Charlotte tried hormone treatments, acupuncture, and considered adoption. The show deftly illustrated that there are not necessarily quick fixes to this problem. As the series draws to a close, Charlotte is still trying to conceive even after a devastating miscarriage at the close of season five.

"The Charlotte character was great to have because on the outside, she looked perfect from her job at an art gallery, a Park Avenue apartment, and a gorgeous doctor husband, but she has her own issues -- he is impotent and she infertile," Saltz says.

While she did encourage her first husband to seek therapy for impotence and he was eventually able to have sex, it did not save their marriage, and Charlotte ultimately wed her divorce attorney (with whom her quest to have a baby carries on).


There's Something About Miranda

Miranda Hobbes (played by actress Cynthia Nixon) "is a smart, professional woman and the one of the four women who has the most educated professional background, but she seemed to find it mutually exclusive to a partner," Saltz says. "Women are afraid that if they have a driving profession, they can't have a man too," she says. "It is something that women worry about and it's good to bring up the conflict, but Miranda really lived it out."

However, eventually Miranda did wed her baby's father and true-love bartender Steve Brady (played by actor David Eigenberg) and the family migrated to Brooklyn.

Her Baby's Father?

Miranda became pregnant after having sex with her ex following his diagnosis with testicular cancer. At the time, the two had no plans to get back together.

All's well that ends well, but "talking about the fear of being a parent alone is great," Saltz says.


"It's wonderful how they go into things like how women with vulvodynia are highly upset and disrupted in their emotional and sexual lives and also tell you how little the medical establishment knows of the problem," says Schwartz. She is referring to Charlotte's diagnosis of vulvodynia after reporting symptoms of vaginal burning, itching, and stinging to her gynecologist. Vulvodynia is a sharp, knifelike, or burning pain around the opening of the vagina that is often unexplained.

"It's very useful to get vulvodynia out of the proverbial closet," she says.

The National Vulvodynia Association, however, thought that this portrayal did women a disservice. On the show, the doctor told Charlotte that the condition is mostly just uncomfortable.

But for many women with vulvodynia, this can't be farther from the truth, according to the organization, which is based in Silver Spring, MD.

"Sex and the City failed miserably at portraying the serious and complicated nature of this condition, particularly when the show's gynecologist indicated that it's easy to treat," says Phyllis Mate, executive director of the National Vulvodynia Association, in a news release.

But it did get people talking about vulvodynia, experts agree. In fact, it got us talking about a lot. Fetishes, swinging, homosexuality, and anal sex -- you name it, and the show covered it in some fashion over the past six seasons, and for sure they spiced up water cooler conversation on Monday mornings.

"Sex and the City is a terrific lightning rod that way," says Schwartz.

WebMD Feature


SOURCES: Ava Cadell, clinical sexologist; author, 12 Steps to Everlasting Love. Gail Saltz, MD, psychiatrist; author, Becoming Real. Pepper Schwartz, PhD, professor of sociology, University of Washington, Seattle; author, Everything You Know about Love and Sex is Wrong. News release, National Vulvodynia Association.

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