In 2008, the Mayo Clinic published a case study of treating compulsive sexual behaviors with pharmaceuticals:
A male patient first presented to a psychiatrist (J.M.B.) at age 24, with the explanation, “I’m here for sexual addiction. It has consumed my entire life.” He feared losing both marriage and job if he could not contain his burgeoning preoccupation with Internet pornography. He was spending many hours each day chatting online, engaging in extended masturbation sessions, and occasionally meeting cyber-contacts in person for spontaneous, typically unprotected, sex.
The story is a familiar one. A young man seeking sexual activities outside of his marriage or relationship experiences guilt because of his compulsive behaviors. He feels he cannot stop and is at a loss for solutions. He wants to be good, by whatever measure his culture dictates, but feels he can’t.
The term “sex addiction” is the new darling of sensational media. The narrative of an addict is a compelling one, their struggle with external forces in the world leaves much room for pity. After all, this isn’t their fault but the fault of the pesky stimulus hijacking their tender neurological reward circuitry. Right?
Not really. The picture of compulsive sexual behaviors is far more complicated than (male) brain + (non-monogamous) sexual stimulation = addiction. Dopamine may indeed play a role in all compulsive behaviors but the narrative of porn as an external factor that takes over your system is a false (and overwhelmingly Christian) explanation that fails to recognize sexual histories and user conceptions of sexuality.
Vaginas are magical. These self-cleaning, elastic, muscular life and love canals that can give amazing amounts of pleasure to their owners and others are sophisticated in both design and function. But with great complexity comes the great potential for system hiccups.
The common umbrella term for many hiccups is “Vulvovaginitis” and describes any irritation of the vulva or vaginal areas. Often the irritation comes in the form of painful swelling or itching caused by an external factor irritating sensitive mucous membranes. (Ever gotten something in your eye, be it infection or irritant? Same idea. ) Many cases of vulvovaginitis occur because of an imbalance of naturally occurring bacteria and yeasts and sometimes parasites or viruses.
But don’t fret! These are easy to remedy. Here’s a handy guide to the more common causes:
The tired trope of aggressive male sexuality is a pervasive one. The story goes like this: because men are full of testosterone and sperm as well as unhindered by the consequence of pregnancy, their sexuality is naturally brutish and promiscuous. Testosterone fuels aggression, billions of sperm want hundreds of outlets and nature failed to offset these desires with physical dangers associated with reproduction.
The compliment to this heterocentric sex story is that women, with their limited eggs, lack of testosterone and pregnancy burden are naturally chaste and self protective. Any sexual adventurousness or licentiousness is only done to please men and keep them around so they will help with the child rearing.
A simple and neatly packaged explanation of human sexuality. But it’s wrong. Let’s do some debunking. Continue reading →
I don’t know if you can help me, but maybe you know somebody who can.
I am 34 years old and unable to have a penetrative, penis-induced orgasm. I have been having clitoral orgasms since I was 18. Just about anybody can make me orgasm with their finger or mouth. I can also come if I touch my own clitoris during penetration. But nobody has been able to make me come from penetration alone.
I have two amazing male partners right now, one of almost three years, and the other of almost one year. Both of them are open to helping me and trying different things, but so far unsuccessfully.
I know that I have trust issues. I know that I don’t fully trust either one of my partners and am not sure I am emotionally able to fully trust any man.
I don’t know what other emotional blocks I may have.
Please let me know if you have any recommendations for me.
Thank you! Blocked Vagina
Dear Blocked Vagina,
Thanks for writing to me about this; your question is a very common one among women.
First things first: an orgasm is an orgasm is an orgasm. Popular culture (women’s magazines especially) push the idea that there are different types of orgasms. Not really. Continue reading →
People love explaining human sexual behavior with evolution. If a behavior exists, it must be because of evolution…right?
In a recent study, among 827 women who self-reported on sexual behavior and fantasies, those women in the 27-45 age range reported the highest frequencies of sex and fantasy. The study authors explain this with evolutionary theory: older women compensate for their aging uterus by being hyper-sexual. Essentially, they’re saying an aging female brain incites more sexual desire in order to compete with younger (and ostensibly more attractive) females.
Here are my critiques of this analysis:
Nulliparity. If the evolutionary explination is correct, you would find that nulliparous women (those that have never borne a child) would have higher rates of sexual fantasy and behavior than women in their age cohort with one or more children. Pregnancy and childbirth are hard on the human body so it makes sense to level off sexual desire with age if a woman has already had children and women with no children would have more of an impetus to be hypersexual. An earlier study by the same researcher found no difference on account of having children or not.
Does not account for fecundity. Women with higher fecundity (fertility) would be less likely to need this adaptation because they get pregnant easily.
Fails to address social factors. The social taboo against female desire for the sake of desire can compel younger women to avoid sex and actively resist fantasies. Factor in roommates, ability to assess or obtain a sexual partner and sexual confidence, and an argument for social conditioning emerges.
Simplifies evolutionary theory to explain one strategy. Multiple mating strategies and behavioral adaptations exist within the same species. I’ve written about oversimplification of evolutionary theory in media before.
No cross-cultural or longitudinal comparisons. If the “cougar” approach to mating is indeed an evolutionary adaptation, you would find this phenomenon in many locales and points in history. I checked into data from the Kinsey Studies and the evidence is a bit muddled concerning frequency. Women reported a gradual rise in solitary sexual practices (ie jillin’off) but the website summary does not state when that behavior begins to level off.
I freely admit my bias when it comes to evolutionary explanations, especially concerning desire. The biggest reason is that the evidence is contrary to my experience as well as many of my female friends. When I was a teen my sexual desires came into conflict with basic social acceptance. I felt horny but I didn’t know what to do. I didn’t even realize that masturbation was an option for me. Instead, I supressed everything I felt between my legs and was constantly frustrated. One time, at 16, I was so horny I actually cried.
And no wonder. If the recent public outrage and ridicule of Taylor Momson’s vibrator comment is any indication, young women are still being shamed about their sexual desire.
I’m not in Time’s “old lady” category just yet (27-45, WTF?) but I definitely fantasize more and have more sex. Why? I don’t feel ashamed about it. Simple as that. Cheers to getting older and learning when to not give a fuck about others’ opinions.
Note: I am not saying that biological factors are meaningless in this case. Rather, a completely biological explanation is insufficient to explain human sexual desire.
Hi, a few semesters back I was in Dr. [So and So's] courses at SFSU. You were my aide, I’m not sure whether you still do teacher’s aid stuff or not but I remember how knowledgeable you were about the topic of human sexuality and I have a longstanding question and debate I need answered by someone who know what they’re talking about. The question is: does men’s prejaculation contain sperm? I know it comes from a different part and is not manufacutred in the same place but I’m wondering whether it is in fact produced with a sperm count. If you could help me at all that would be wonderful! Thanks
Yes, it *can*. Here is why.
Semen is made of two parts: seminal fluid and sperm. Most of seminal fluid originates from the seminal vesicles, followed by fluids from the prostate, bulbourethral (aka Cowper’s) glands and a teeny bit from the testes. A small amount of that fluid contains sperm, somewhere under 10%.
For sperm to survive the urethral journey it must travel in an alkaline instead of acidic environment. Enter the alkaline leaning precum.
Although precum is there to clear it out, and give a little lube love, residual sperm can reside on the tubes and exit with the fluid. One easy solution: pee. Urinating beforehand will kill the straggling sperm. Urinating after ejaculation will kill any straggling sperm. The lesson? Sperm in pre-ejactulate is possible but pee will kill it. Pregancy from precum is not very probable, in my opinion.
Is precum in guys like vaginal wetness in girls? Is it a similar process? (-question asked during a sex ed talk.)
No. Vaginal wetness comes internally from transudation (water content in plasma pushes past cell walls when blood vessels/capillaries become engorged) and externally from the Bartholin’s (greater vestibular) glands. Lubrication is part of the arousal process in females and can vary greatly due to a long list of factors.
Precum, on the other hand, occurs for a very different reason: to prep the urethra for safe sperm transportation. Urine and semen both pass through the urethra in males. Because urine is acidic enough to kill sperm, males secrete a small amount of fluid prior to ejaculation to create a more alkaline environment.
Be aware: precum still contains enough sperm to impregnante someone.