Sexism makes female sexual dysfunction a hidden problem

By Emily Griffith

The first time I had sex, it hurt. A lot. I have vaginismus, which refers to painful intercourse. I’m sure this is a pretty common occurrence for many people, so I just shrugged it off. After all, sex education taught me that pain is something to expect the first few times you have sex, and that if my partner couldn’t get an erection it was ok – it was just nerves. I never once heard that the pain may continue, and I suspect this is the case for a lot of women. When it continued for more than a year, I finally conceded that something must be wrong.

Female Sexual Dysfunction, often abbreviated to FSD, is a catch-all term for a range of different conditions, from painful sex to lack of arousal. Around 43% of women and 31% of men have reported some degree of difficulty in their sex lives. Despite the higher number of women reporting difficulties, Erectile Dysfunction (ED) is more widely recognised in mainstream media and the amount of research into it also far outweighs the research into FSD. Much of the research into both ED and FSD is very Viagra-centric – but scientists are not even sure whether this works for women.

Unsurprisingly, due to the lack of research, doctors are pretty clueless when it comes to FSD. When I first told my doctor that I was unable to have penetrative sex, it was automatically assumed I had a lack of sexual desire due to depression and anxiety. But I have a high sex drive. I was also shouted at and told to relax when the doctor was having a hard time examining me. I didn’t get the diagnosis I expected – in fact, the doctor didn’t even give the condition a name. I was made to feel as if FSD isn’t a common problem.

I was eventually referred to a gynaecologist after waiting 6 months for an appointment. I felt excited that I’d finally have an answer to my problem, completely putting my faith in what I thought was an FSD specialist. Hope started to fade when I didn’t even see myself represented on the posters in the waiting room. It was clear that if I was here, it was for help with post-menopausal dryness or pregnancy problems.

There are a range of treatments available for all types of FSD. These include lubrication, psychosexual therapy, Botox injections, numbing gels and vaginal dilators. Dilators range in size from a tampon to average penis size and are designed to help you relax and get used to the sensation of having sex. I’d heard about these through different forums, and they seemed to work for some women, in conjunction with therapy.

During my appointment, the gynaecologist suggested I try vaginal dilators. I was pretty excited, as I’d heard good things about them. But my excitement was short-lived when the gynaecologist’s assistant didn’t seem to understand what vaginal dilators were, and then told me that the hospital didn’t have any. I asked if I could get them on prescription. They’re a medical aid, so why wouldn’t I be able to? I was advised, however, that I’d probably be better off spending £50 to buy them on eBay. I couldn’t resist making a joke that I’d better make sure I didn’t get a second-hand product. She also advised that maybe, just maybe (but probably not) I’d be able to get them at a local pharmacy. This is completely unacceptable treatment for such a common problem.

I’ve also been given a numbing gel that is supposed to help with the pain, but that option is problematic in itself. What is the point of having sex if you can’t feel it? Am I expected to lie back passively? Yes, I want to remove the pain, but I also want to feel something.

The examination was a painful experience that didn’t answer any questions. I’ve been put on a waiting list for an indeterminate amount of time for various scans and psychosexual therapy. It’s a long process, and only time will tell whether any of these things will work for me – it’s pretty much just ‘suck it and see’. There’s no little blue pill.

The great thing is, dilators and psychosexual therapy work for a lot of people. The problems lie in the diagnostic process, the availability of dilators and other treatment options, the amount of research into FSD, and the general lack of visibility. If you’re suffering and not being heard, keep going back to your doctor and demand that you be taken seriously. Always get a second opinion. FSD needs to be talked about a lot more. It’s not acceptable that women are suffering, ignoring pain and feeling inadequate when there are adverts for Viagra on TV.

Emily Griffith is a freelance writer specialising in at-home activism and mental health. She tweets at @AtHomeActivist and blogs at The Agoraphobic Feminist.

Photo: Huffington Post

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4 thoughts on “Sexism makes female sexual dysfunction a hidden problem

  1. jointhedots

    Sorry to hear about your bad experience but I would like to say I had much better experience. Just sharing so that women aren’t put off seeking help not to minimise your poor treatment. I got a gynecological appointment about 6 weeks after seeing GP and got given set of vaginal dilators there and then. My coming out as bisexual was also treated matter of factly

  2. jo

    Not to detract from the point made, i broadly agree there is a disparity here, but male erectile disfunction is fundamentally a vascular disease. It is the occlusion of the fine vasculature in the penis that prevents erection, the problem is physiologically specific allowing for the development of pharmacologically effective treatments (viagra and viagra like medicines). Male ED is an early stage indicator of the onset of what is probably serious cardiovascular disease. Instead of rejoicing that there is a cure for a ‘failing’ sex life it would perhaps be wise to feel concernd about your heart. There is indeed a great deal of mythology that has grown up around ED treatments and the cardiovascular issues are all too often lost to the detriment of the sufferers heart health.

    FSD is, at least scientifically, not as well charectorised and the physiological mechanisms are relatively complex, there isn’t a ’simple’ vascular explanation. This makes it difficult to develop a single pill solution. Much of the scientific research into FSD topics has focused on post menopausal women and addressing vaginal dryness and a measured lack of desire, post menopause. Problems faced by younger patients have not been so fully explored. Work should be done.

    1. pip

      Oddly, it is only this week – prior to reading this article – that I even stopped to consider FSD. Suddenly, an important veil has been lifted from my eyes, and suddenly yes, I’m rather angry that this has never been an issue, whilst we all know about men’s problems in this area. And yes, this fact does reflect potentially life damaging, systemic sexism. I have no doubt there’s more to it, but there is certainly this.

  3. Sarah

    I’m sorry to hear about the pain you’ve experienced, and I agree that all too often women’s difficulties with sex are dismissed or ignored (because sex is primarily about male pleasure and women are expected to suffer for it, right?). I definitely agree that we need more honesty to address these kinds of issues.

    But I also have concerns about rushing to diagnose or ‘give the condition a name’. Our society has a long history of pathologizing women’s lack of arousal or pain during sex as something that a medical intervention can fix – and that’s not always the case. I would argue that difficulties with sex are often (but not always) NOT a problem with the individual woman, physical or psychological, but linked to structural problems of male dominance and privilege over women.

    Often women want sex less frequently than their male partner because they are exhausted – doing the majority of domestic work and childcare, as well as the mental work of remembering, scheduling and planning for their relationships, families and work lives. Orgasm is easier when you focus on the present and the physical, and let go of worries and stresses. But it’s hard to let go, get aroused and enjoy sex when you have a mental chores list a mile long. I can see why the prospect of a pill for arousal is tempting, but it doesn’t address the structural inequality.

    Sometimes it’s that men are not prepared to spend time stimulating women to a state of arousal. Cultural norms have shaped sexual practices around the primacy of male pleasure and the male orgasm through penetration. Many women feel embarrassed about not being able to ‘achieve’ vaginal orgasm and apologize to their partners for the time it takes them to orgasm. It’s sometimes just easier to use lubricant than to get a man to take the time to stimulate you.

    Pornography has also had the effect of distorting male expectations around what is physically satisfying to women. Sometimes women experience pain during sex because men are treating their bodies like masturbatory tools, or are acting out fast and aggressive porn-style fantasies. Painful sex might simply require the man to change what he is doing physically – rather than giving the woman a dilator or a numbing gel so that she can tolerate the whole thing.

    Also, maybe some women just desire sex less often than their male partners, and then they’re made to feel they have a low libido. Is it really bad simply to desire sex less? It’s only a problem if you’re expected to be constantly sexually available for your partner. I appreciate that many women want to have an active sex life and are frustrated by their own lack of physical responsiveness, but some women simply do not often have the desire for sex – and that is only a problem because of the cultural premium we place on women satisfying men’s sexual needs, whatever their own. Even psycho-sexual therapy just makes it the woman’s ‘problem’ that she has to resolve.

    I find it disturbing that women would report lack of arousal or pleasure during sex to their doctor and immediately face a diagnosis of their own ‘dysfunction’, and a prescription. Firstly, it may be a problem relating to women’s inequality, or their sexual partner. And secondly, lubricants and numbing gels clearly have more to do with ensuring women’s bodies remain sexually available to men, than increasing women’s sexual appetite and pleasure.

    Clearly some women do have physical problems that prevent them from enjoying sex, despite the most sensitive and attentive partner and despite their own enthusiasm for sex, as you describe in your own case.

    But as Jo points out, the physiology of increasing women’s arousal is not as easy to remedy as men’s. The term ‘FSD’ covers a whole spectrum of difficulties, and many of the treatments developed for it so far (like testosterone patches) have damaging side-effects and offer no real results.

    There’s an interesting documentary on this subject called ‘Orgasm Inc.’ (available on Netflix) that explores the pharmaceutical industry’s interest in defining this as a ‘disease’ that they can ‘cure’, and the effect this has on women. The documentary showed women who were convinced they had FSD because they could not achieve orgasm through penetration alone (???) and were encouraged by doctors to pursue treatments like implanting electrodes into their spinal cords. One woman had part of her clitoral hood removed (because of her “failure” to achieve orgasm through penetration) and nearly bled to death when her stitches broke.

    I’m aware that this is not the situation described here. You emphasize that you have a high sex drive and want to be able to enjoy penetration without pain, which is completely understandable. But I want to venture that we should be cautious about diagnosing women with FSD, without first exploring the full range of causes for their pain, or lack of sexual arousal and pleasure.


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