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Women’s Health World Abuzz On ‘Pink Viagra’ Approval, But Are Expectations Realistic?

In this June 22 photo, a tablet of Flibanserin sits on a brochure for Sprout Pharmaceuticals in the company's Raleigh, N.C., headquarters. (Allen G. Breed/AP)

In this June 22 photo, a tablet of Flibanserin sits on a brochure for Sprout Pharmaceuticals in the company’s Raleigh, N.C., headquarters. (Allen G. Breed/AP)

Everyone, it seems, has an opinion on the FDA’s approval this week of the drug Flibanserin, aka “pink Viagra,” to boost women’s sexual desire.

“This is the biggest breakthrough for women’s sexual health since the pill,” Sally Greenberg, executive director of the National Consumers League, told The New York Times.

Others have their doubts. Cindy Pearson, of the National Women’s Health Network, told NPR that approval of the drug “is a triumph of marketing over science” and added: “To have any chance of benefit from this drug they’re going to have to take it every day for months on end, years…We just don’t know what the long-term effects will be of changing brain chemistry in this way.”

Janet Woodcock, M.D., director of the FDA’s Center for Drug Evaluation and Research (CDER), said the approval “provides women distressed by their low sexual desire with an approved treatment option…The FDA strives to protect and advance the health of women, and we are committed to supporting the development of safe and effective treatments for female sexual dysfunction.”

The drug, which will be sold under the brand name Addyi, is expected to go on sale Oct. 17, according to its maker, Sprout Pharmaceuticals. And along with the potential to ignite a low (or non-existent) libido among some women, the drug comes with a boxed warning, the strongest kind, on contraindications and potential side effects, including low blood pressure, fainting, nausea, dizziness and sleepiness.

Here’s more on the site Throb, about how the drug actually works.

Still others have extreme doubts.

Emily Nagoski, a feminist sex educator and author of the book “Come As You Are,” wrote a smart, thoughtful piece on the site Medium about why Flibanserin isn’t addressing the true nature of women’s sexual desires. Here’s a bit of that piece, called: “Pleasure is the Measure:”

I believe that the folks at Sprout Pharmaceuticals — the company that owns Flibanserin, the so-called “pink viagra” — have good intentions. I believe that they want to help women who are struggling with sexual desire.

And I believe that they feel sure — as most people do— that lack of spontaneous, out-of-the-blue desire for sex is a problem. A disease.

They are wrong — as you now know.

It’s not their fault, really, that they’re wrong. Cindy Whitehead, Sprout CEO, isn’t a sex researcher, educator, or therapist. She’s a marketing professional, and she’s darn good at her job. But why would she believe anything except what mainstream culture taught her?

In fact the drug is designed — they’ve said explicitly — as though responsive desire were a disease, as though spontaneous desire were the only “normal” way to experience desire.

And that’s a problem. Continue reading

Related:

Sexting Among Adults May Be More Common Than You Think, Survey Suggests

A middle-aged woman I know recently confessed that she’s been doing quite a bit of provocative, R-rated texting with a man she’s involved with.

When I referred to it as “sexting” she was shocked. “It’s not like we’re sending naked pictures back and forth,” she said. “Just a little suggestive ‘What are you wearing?’ kind of thing. It’s fun.”

Welcome to the new world of sexting.

It turns out grownups in committed relationships are, increasingly, doing it for pleasure and “fun,” as one survey found. Also, according to researchers, the whole concept of “sexting” has evolved, or at least is evolving: from a risky, sordid and sometimes-dangerous activity among teens, to, as one therapist (more below) says, a way to add some sexual “simmering” to a relationship that may need spicing up. Even the AARP acknowledges the trend: “…the reality is that more and more of the 50-plus set, both single and married, routinely use text messaging to send tantalizing pictures and provocative words to their partner…”

Reframing Sexting

Indeed, sexting may be more popular among adults than you think.

A new survey on sexting found that 88 percent of respondents, ages 18-82, said they’d done it, and 82 percent said they’d done it in the past year (including the 82-year-old). Also, nearly 75 percent said they sexted in the context of a committed relationship, while 43 percent said they sexted as part of a casual relationship. (On the darker side, 12 percent reported sexting someone “in a cheating relationship.”) The findings were presented at the American Psychological Association annual convention in Toronto earlier this month in a paper called: “Reframing Sexting as a Positive Relationship Behavior.”

(Photo illustration by Mike Licht/Flickr, taking inspiration from the artist Edward Armitage)

(Photo illustration by Mike Licht/Flickr, taking inspiration from the artist Edward Armitage)

The survey of 870 heterosexual individuals in the U.S. also found that in general, more sexting was associated with a higher level of sexual satisfaction. More than half of the responses came from women; the average age of participants was 35, according to the study authors.

On one level, it’s not surprising that sexting is becoming more mainstream.

“If we look at how technology has been integrated into our society — it’s so much part of our daily lives — it makes sense that it would become part of our dating and sexual lives as well,” said Emily Stasko, MPH, a doctoral candidate in psychology at Drexel University in Philadelphia and the survey’s co-author, along with Pamela Geller, PhD, associate professor of psychology, ob/gyn and public health at Drexel.

Attitudes about sexting seem to be changing too. The survey found that people who sexted more rated it as more “carefree and fun” and had higher beliefs that sexting was expected in their relationships.

(Sexting, for the purposes of the survey, was defined broadly as sending or receiving sexually suggestive or explicit content via text message, mainly using a mobile device, Stasko said.)

Of course, this doesn’t mean that every grownup out there is under the covers with their phone at night shooting off racy texts. These survey findings are preliminary, and come with big caveats, Stasko says. The findings may not be representative: Participants were recruited online and responded to a posting asking them to take a survey about sexting, so the sample could be skewed toward more seasoned sexters.

Don’t Forget Pleasure

The main goal of the study was to look at sexting through a new filter, Stasko said. The practice has historically been viewed as a risky activity among teens, associated with other sexual risk-taking (like having unprotected sex) and negative health outcomes, like sexually transmitted infections. She said she and her colleagues wanted to reevaluate sexting in a new light — as a potential positive force in a relationship and a way to potentially enhance open sexual communication. “There seems to be a missing discourse about pleasure,” Stasko said. “We wanted to talk not just about risk, but also introduce the idea that pleasure is a part of it.”

The takeaway, she said, is that when sexting is wanted by both parties, is can be a good thing. “The findings show a robust relationship between sexting and sexual and relationship satisfaction,” the study concludes.

Sexual ‘Simmering’

Aline P. Zoldbrod, Ph.D., a certified sex therapist in Lexington, Massachusetts, agrees that sexting can play an important role in adult relationships.

I asked her for her thoughts on the survey, and here’s what she wrote:

Sexting is not just for hookups, as a follow up to an interlude on sex chat roulette or for trolling on Craigslist. Sexting actually has some amazing benefits for people in ongoing relationships.  Continue reading

What Teens Say Teens Should Know About Sexually Transmitted Diseases

(Planned Parenthood)

(Planned Parenthood League of Massachusetts)

By Joey Boots-Ebenfield
Guest contributor

I’ve gotten used to hearing myths and misinformation when I talk about sex with fellow teens.

And I talk about sex often in my role as an 17-year-old peer educator with the Planned Parenthood Get Real Teen Council (GRTC) — a year-long high school sexual health program for 10th-12th graders who are trained to facilitate sex education workshops and serve as resources for peers, families and communities.

If teens are uncomfortable talking about topics related to sex and sexuality, or don’t have a trusted source of information about their health, it’s easy for all kinds of misinformation to spread. And of course, there’s the Internet, where bad information is often rampant, so it’s not always a reliable place to find accurate health information.

The subject of sexually transmitted diseases (STDs) is no exception. I’ve heard some pretty interesting misconceptions about what STDs are and what it’s like to get tested. One myth is that STDs have obvious symptoms, like localized pain or some other physical sign.

In fact, this is quite the opposite! STDs often show NO symptoms. This myth is especially dangerous because it means that someone can have an STD and not even know it. As a result, many STDs go untreated, which can cause cause some pretty nasty complications. Continue reading

Women’s Anal Sex More Common And Still Taboo, Says Researcher

Sexual health researcher Debby Herbenick often says what the rest of us are merely just silently, sheepishly thinking.

A few years back, Herbenick, a researcher at Indiana University, co-director of the Center for Sexual Health Promotion, and a sexual health educator at the Kinsey Institute, raised the issue of pain during sex based on her landmark study of sex in the U.S. And here she is again, discussing the pros, cons and surprising new data on women and anal sex in America.

It’s worth reading her full report at Salon, titled Anal Sex: Science’s Last Taboo, but here’s a snippet:

That anal sex remains taboo may explain why a study about anodyspareunia – that is, pain during anal penetration – received little attention when it was published in the Journal of Sex & Marital Therapy. The study should have turned heads: It was the first research on anodyspareunia among women; it was conducted by a well-respected scientist (Dr. Aleksander Stulhofer from the University of Zagreb); and it was centered on young women and sex. That’s often the kind of research that attracts media attention (Young women sext! They get pregnant! They give oral sex! You get the picture …). However, anal sex remains such a strong taboo that this otherwise important study barely turned a head.

younglove

Except it did turn mine. Here’s why. In an incredibly short period of time, anal sex has become a common part of Americans’ sex lives. As of the 1990s, only about one-quarter to one-third of young women and men in the U.S. had tried anal sex at least once. Less than 20 years later, my research team’s 2009 National Survey of Sexual Health and Behavior found that as many as 40-45 percent of women and men in some age groups had tried anal sex. With its rising prevalence, I felt it was important to devote a chapter of my first book, “Because It Feels Good,” to anal health and pleasure — only to find that a magazine editor wouldn’t review it because the topic of anal sex was “not in the best interest of our readership.” Even though nearly half of American women in some age groups have done it! She added, “In the correct circles, I personally will be suggesting the book to those with whom I can share such a resource.”

Hmm. The correct circles. Which ones would those be? The ones where scores and scores of women openly sit around talking about anal sex between glasses of wine? Continue reading

Marriage Revisited: On Soulmates, Paramours And Avoiding Suffocation

Marriage, and how to improve it, is a bottomless pit kind of discussion.

So it’s not terribly surprising that CommonHealth’s recent post on a new, “all or nothing” model of marriage, in which researchers questioned whether we’re asking too much of our spouses, went viral.

Like sex, child-rearing and religion — everyone’s got an opinion to share.

(Wikimedia Commons)

(Wikimedia Commons)

Some commenters say they’ve had to readjust their expectations of finding the fantasy soulmate:

Deborah Rebisz wrote: “After a series of broken engagements, I went on an eight-year dating hiatus. My goal was to learn to rely upon myself for my own happiness…Expecting someone else to fill that spiritual, psychological, or emotional gap in my life was unrealistic, not to mention there was little chance of finding someone who could do all that.” Continue reading

Why ‘Perfect’ Valentine’s Sex Tends Not To Be, And A Low-Key Alternative

(Dan Moyle/Flickr Creative Commons)

(Dan Moyle/Flickr Creative Commons)

By Dr. Aline Zoldbrod
Guest contributor

It’s almost Valentine’s Day — and all the messages out there say that if you’re in a relationship, it’s time for the perfect sexual experience.

But as a sex and couples therapist, I’m going to suggest an alternative: a somewhat obscure model of sexuality and sexual pleasure that I think can provide a blueprint for a really wonderful (but maybe not perfect) sensual/sexual connection with each other on Valentine’s Day.

Added bonus: these suggestions can form the scaffolding for a loving, freeing, warm sensual/sexual bond way beyond Feb. 14 — even if you’re one of those long-married couples who have kids, logistics and technology standing in your way.

First, a bit of academic theory as background:

You may be familiar with the Masters and Johnson sexual response cycle: Human sexual response is made up of the excitement phase, then the plateau phase, followed by the orgasmic phase, and finally the resolution phase.

Not to diss Masters and Johnson’s work, because it was groundbreaking, but I’m just saying… this model has caused a lot of performance anxiety in and of itself.

Dr. Aline Zoldbrod (Courtesy)

Dr. Aline Zoldbrod (Courtesy)

My brilliant colleague, Dr. Leonore Tiefer, has criticized the Masters and Johnson model of sex because it’s so linear, so physiological, and so focused on intercourse.

My personal mantra for good sex is “connection, not perfection.” The Masters and Johnson’s model sets up an expectation that everything has to be “perfect” for sex to be good. Perfect erections in men, perfect arousal in women (stemming from who knows what? Just springing out of the air and the joy of folding laundry?), and perfect orgasms all around.

For many of us, that’s like the pressure of trying to find a perfect gift for someone we love: just fraught with trepidation.

In 1998, psychiatrist David Reed proposed a different model, one that is much more psychologically and relationally oriented. He calls it the Erotic Stimulus Pathway Theory. I’m going to adapt it here a bit in hopes that this experiment could help you have a better Valentine’s Day.

1. Seduction Continue reading

The Checkup: Yes, Really. One-Third Of Women Have Pain During Sex

A while back we wrote about a national sex survey that found one-third of women experienced pain during sex. There were skeptics back then who thought, nah, that can’t be possible, otherwise we’d be having a nationwide conversation about how to fix such a huge problem. But now, the lead author of that study, Debby Herbenick, a researcher at Indiana University, co-director of the Center for Sexual Health Promotion, and a sexual health educator at the Kinsey Institute, confirms those numbers in a follow-up survey.

The Checkup

We discuss these surprisingly high numbers, and other new findings, in the second episode of our new podcast, The Checkup, which is just out at Slate.com here. (To listen to The Checkup now, click on the arrow above; to download and listen later, press Download; and to get it through iTunes click here.)

The theme of podcast #2: “Matters Below The Waist.” This segment features frank talk about sex problems — and some solutions. We delve into Herbenick’s fascinating research on pain during sex and more (including personal insights from one of our hosts…) and speak with a physical therapist who specializes in various treatment options that can help women deal with this rarely discussed but incredibly widespread problem.

Not to leave men out, we also explore a little-known disorder called Peyronie’s disease, in which the erect penis becomes crooked, sometimes making it difficult to have intercourse. (Yes, this came up during the Bill Clinton impeachment era, and there’s more on that in the podcast.)

Herbenick’s initial survey of sex in America was the largest nationally representative study of sex in the country; her team surveyed 6,000 men and women, ages 14-94, and asked them about their sexual behavior.

Results of the latest survey (which Herbenick says were presented at an International Society for the Study of Women’s Sexual Health annual meeting) are expected to be published in several months.

In the meantime here, lightly edited, is more from my interview last week with Herbenick, also the author of several books, including Read My Lips: A Complete Guide to the Vagina and Vulva and Sex Made Easy: Your Awkward Questions Answered-For Better, Smarter, Amazing Sex:

DH: We did another national survey of sex in America. And this time, knowing that we had this stark difference between how women and men experience pain during sex – only 5% of men reported any degree of pain, and most of theirs was mild, too. We did ask a series of follow-up questions. This time, for people who did experience pain, we collected information about how long the pain lasted, where in their body it was located, whether they told their partner, what they did in response to the pain, and we also separated it by vaginal and anal intercourse.

RZ: What else did you find?

So the first thing that was important is the 30% number is still there. And that’s important because it does show that it’s a stable and reliable estimate, which some people in the media had questioned [whether] it could really be that that number of people experienced pain — Continue reading

Cancer From Oral Sex? Michael Douglas Is Not Making It Up

Actor Michael Douglas in a 2004 photo (Wikimedia Commons/US Navy)

Actor Michael Douglas in a 2004 photo (Wikimedia Commons/US Navy)

Michael Douglas: Oral Sex Gave Me Cancer, The New York Post headline blares. The story begins:

Michael Douglas has made a jaw-dropping revelation about his throat cancer: He didn’t contract it from smoking or drinking — but from oral sex.

The Oscar-winning Hollywood star set tongues wagging after he told The Guardian newspaper that he contracted HPV, or human papillomavirus, through a sex act and it developed into cancer.

“Without wanting to get too specific, this particular cancer is caused by HPV, which actually comes about from cunnilingus,” he told the British newspaper in an interview published yesterday.

Your first reaction may be suspicion that Douglas is trying to scapegoat sex when other factors could be to blame, particularly his past smoking.

‘HPV-positive oral cancer cases could soon surpass cervical cancer diagnoses.’

But in fact, a growing body of research suggests that his claim is not entirely far-fetched: Rates of head and throat cancer linked to HPV have been rising dramatically in American men. (File under: Reasons the new HPV vaccines are recommended for boys as well as girls.)

Here are some basics courtesy of the Dana-Farber Cancer Institute:

HPV is the most common sexually transmitted disease. It may cause cervical cancer and increasingly a type of throat cancer called oropharyngeal (or-o-fair-en-jeel). Unlike cervical cancer, there is no screening test (like a Pap Test) for this form of head and neck cancer. According to the American Cancer Society, there will be an estimated 41,000 new cases of head and neck cancer this year – 14,000 being cancer of the pharnyx (which includes the tonsils and base of the tongue). Most of these patients will be young and three out of four will be male.

And here’s some background from a prize-winning story in the cancer magazine Cure: “Facing The Facts: HPV-Associated Head and Neck Cancers Get A Second Look.”

HPV-positive oropharyngeal malignancies—most typically found on the tonsils or at the base of the tongue—increased 225 percent from 1988 to 2004. If current trends continue, HPV-positive oral cancer cases could soon surpass cervical cancer diagnoses, according to a 2011 study published in the Journal of Clinical Oncology.

I just spoke with Dr. Barry Benjamin, an ear, nose and throat specialist who has been practicing at Dedham Medical Associates for 35 years and has seen the prevalence of HPV-related head and neck cancers skyrocket in recent years. Continue reading

FDA Approves New Pill To Alleviate Pain During Sex

As we’ve reported, about one-third of women in the U.S. say they experience pain during sex.

There a number of non-medical interventions that can help fix the problem, such as pelvic floor physical therapy, which we’ve also written about here. Still, for some, medication may be called for, so it looks like a positive development that the FDA earlier this week approved a new drug to alleviate the pain that many post-menopausal women experience during intercourse.

MedPage Today reports that the newly approved “selective estrogen receptor modulator (SERM)” called ospemifene (Osphena) is taken as an oral tablet and “targets vulvar and vaginal atrophy resulting from menopause, which is the underlying cause of dyspareunia, or pain during sex.” There are risks, however:

The treatment, however, will come with a boxed warning stating that it may thicken the uterine lining, with the concern that unusual bleeding may be a sign of endometrial cancer or a condition that can lead to it. Continue reading

News Flash: Sex With A Condom Still Fun, Study Finds

peachy92/flickr

peachy92/flickr

News Flash: Sex is fun — even with a condom.

That’s the takeaway from a nationwide online sex survey of men and women ages 18-59, just out in the Journal of Sexual Medicine. When asked to quantify their pleasure quotient, both men and women rated their most recent sexual experience as quite high, in general, with few differences based on condom and lubricant use.

Notably, the new study, which included 1,645 respondents, didn’t ask whether people preferred sex with or without a condom. It simply asked for a detailed accounting of a recent sexual encounter. So, among those who chose to use condoms (27.5% of men and 22.3% of women in the survey) the self-reported arousal rating and other key pleasure indicators appeared to be essentially comparable to non-condom users.

“Not everyone wants to or has to use a condom, or lubricant, when they have sex,” the study’s lead author, Debby Herbenick, Ph.D., MPH, with the Center for Sexual Health Promotion at Indiana University told me via email. “But if they want to use a condom or lubricant – to make sex safer or more comfortable – it’s unlikely to have a significant impact on overall pleasure for many (but not all) people.”

(I should say here that the study was funded by condom and vibrator maker Church & Dwight. This set off my skeptic’s alarm bells; I asked Herbenick whether the company played any role in analyzing the data. She said that Church & Dwight “did not intervene in that way. Our team at Indiana University analyzed the data on our own, we wrote the papers, and we managed the review process directly with the Journal of Sexual Medicine where the study was published.”)

Of course, conventional wisdom holds that sex is far hotter without a condom. See: Christian Grey on condom-free sex in “Fifty Shades Of Grey,” p. 271:

“I scoot out of bed, too, and grab my sweatpants and a cami top, then sit back on the bed, cross-legged, watching him. I don’t want him to go. What can I do?
“When is your period due?” He interrupts my thoughts.
What?
“I hate wearing these things,” he grumbles. He holds up the condom, then puts it on the floor and slips on his jeans.
“Well?” he prompts when I don’t reply, and he looks at me expectantly as if he’s waiting for my opinion on the weather. Holy crap…this is personal stuff.
“Next week.” I stare down at my hands.
“You need to sort out some contraception.”

(Also, read this single guy’s lament in which the author blames condoms for triggering “deflationary” erectile events.) Continue reading