Washington - When the Food and Drug Administration approved the drug Addyi (also known as flibanserin or “female Viagra”) in August, the drug's supporters framed it as a feminist victory.
Addyi was never going to be as revolutionary as the oral contraceptive pill, but perhaps it had potential to even the sexual score: No longer did men have a monopoly on pharmaceutical sexual aids. Now women, too, had a sexual booster to call their own.
But the gloss has worn off quickly. For one, the drug's effectiveness is being questioned: Women who took Addyi reported an average of 0.5 to 1 more satisfying sexual encounters each month than women who took a placebo pill. Then there was the question of whether the condition Addyi was designed to treat - hypoactive sexual desire disorder - was really a disease, or an ailment created to prime the market for a new drug.
It seems the market isn't buying in. In November, Bloomberg News reported that in Addyi's first month on sale, only 227 prescriptions were filled - compared with more than half a million when Viagra was released in 1998.
Addyi was probably always designed more for profit than for pleasure. But in a world in which women still experience less sexual satisfaction than men do - especially in heterosexual encounters, and even more so if they're single - it's worth asking: What would revolutionise women's sex lives?
I asked six experts on female sexuality what they would do enhance women's sexual satisfaction. Their answers may surprise you. And there isn't a pill among them.
Overhauling sex education
“When sex is discussed in schools, it's typically talked about in terms of what could go wrong - disease, emotional consequences and unwanted pregnancy,” sexuality educator Beverley Damelin says. “But we also need to talk about what's good about sex - about what it can and should be.”
A consequence of this approach, she says, is that a lot of young people don't understand that sex should be pleasurable for women. “There's an expectation of pain and discomfort, that sex is something they give but don't get.” A more pleasure-centred sex education would cover not just pregnancy, intercourse and STDs, but also sexual response, consent and non-penetrative sex acts.
Better medical training
According to Emily Nagoski, a doctor and author of Come As You Are: The Surprising New Science That Will Transform Your Sex Life, the average four-year medical education in North America includes just three to 10 hours of sex education. Taking sexuality more seriously would make general practitioners better able to deal with their patients' sexual health issues - and less inclined to diagnose disease where there is just normal human variation. “Would a doctor ever tell a man, 'Oh, that pain in your penis, it's all in your head'?” Nagoski said. “Doctors need to know that sex is not a drive; that orgasm without intercourse is the exception, not the rule, and that genitals are healthy and normal, no matter what their shape, as long as they are free of pain and infection.”
Getting to know your clitoris
The clitoris is more than just the fleshy button at the top of your vulva, explains Rebecca Chalker, a doctor and author of “The Clitoral Truth: The Secret World At Your Fingertips.” It's a powerful and multifaceted organ composed of 18 parts, beneath the skin's surface, that undergo changes during sexual response to create pleasure and orgasm.
“Knowing how the parts of the clitoris are arranged and work together can help us understand what happens during sexual response, or what isn't happening,” Chalker says, would give women much more power and control over their sexual pleasure.
De-emphasising orgasm
Orgasms are great, but taking the focus off climax can open up new possibilities for pleasure. “Often we see sex as a goal-oriented experience,” says Dawn Serra, a sex and relationships coach. “If women don't experience orgasm or if an orgasm takes longer than expected, often they think there is something wrong with them.” Instead of keeping our eye on the finish line, Serra suggests focusing on what is pleasurable in the moment: sexual thoughts, pleasing your partner, genital touch, non-genital touch or erogenous zones, breathing and orgasm.
Freezing your eggs
“I am currently working with at least eight women in their early 30s who feel like time is ticking for them and cannot focus on the process of enjoying dating or choosing not to date because all roads need to lead to finding your 'unicorn,'“ says Constance Quinn, a doctor, sex therapist and social work professor at Columbia University. Taking that pressure off - for instance, via more comprehensive health-care plans that allow women to freeze their eggs if they choose - would allow more women to enjoy relationships for what they are, rather than worrying about whether they have a future.
“Dating opportunities can include the search for 'The One' but also perhaps younger men for hookups and hang-outs, experiments with friends with benefits, and other guys that don't quite check all the boxes but are great in bed,” Quinn says. “You have the eggs as security and you don't have to live like you are searching for the Holy Grail every night of the week, which is exhausting and confidence-shattering. Go have great sex and feel like a million bucks.”
Feminism
You've read the studies showing that couples with egalitarian relationships have more and better sex. But gender roles aren't just about what we do, they're also about who we're allowed to be.
“Women are taught that it is our responsibility to change, adjust, or shrink in order to meet expectations, make other people feel comfortable, and protect our relationships,” says Lindsay Jernigan, a psychologist in Vermont. “The female gender role has typically given women two options: the option to be selfless, and therefore good, kind and compassionate; or the option to be selfish, and therefore demanding, pushy and non-compassionate.”
This dichotomy can make it difficult for women to acknowledge their true needs, which when it comes to sex, Jernigan says, can lead to “a loss of ... freedom and desire.” Jernigan's work is designed to help women discover “the alternative to these narrow options” - slaying narrow gender roles to show that you can be compassionate and assertive at the same time. Which sounds an awful lot like feminism to me.
Washington Post
* Rachel Hills is the author of The Sex Myth: The Gap Between Our Fantasies and Reality.