Mysteries of the female orgasm

From The Bulletin
Thursday, July 26, 2007

Scientists are continuing to investigate the complexities of women's libido, writes Katherine Fleming.
A woman's libido is a tricky thing. It's so complicated it often confounds even the scientists who spend years trying to decipher it.
Hormones, psychology, age, culture, emotion and mental and physical health all play integral and connected roles in how much sex a woman wants and how much she enjoys it, so it's unsurprising that women experience higher levels of sexual difficulty than men.

About 55% of women lack interest in sex, compared with only 25% of men, according to La Trobe University's Australian Study of Health and Relationships, the most comprehensive survey on the subject, conducted among 19,307 people in 2001-02. More than 27% of women reported not enjoying sex, significantly higher than the 5.6% of men. While 29% of women reported not having an orgasm, for men it was only 6.3%.

One in four had not had sex in the month before the survey and most had sex less than twice a week. Just over 23% of men and 8.3% of women said they'd prefer to have sex daily or more often.

Monash University Professor Susan Davis, who has researched the role of androgens such as testosterone on female sexual function, says sex hormones are important, although their role isn't fully understood.

"There is a complex interaction between oestrogen and testosterone in the brains of both men and women that we don't understand well ... We have no data that really shows women with high testosterone levels have higher libidos," Davis says.

"I treat a lot of women with testosterone and some will say it does nothing for them and ... others will say it's really made a difference."

Female sexual function is also difficult to measure. Testosterone levels are not informative and while men have a readily identifiable indicator - the ability to maintain an erection - there is no equivalent for women. "There is no way to measure it except to ask questions," Davis says. "If a woman goes from being not interested to more interested, what does that mean? Is it clinically significant? The answer, if it's meaningful for that woman, is yes."

While there is an element of "use it or lose it" in some circumstances, Davis says advising a woman with low libido to have sex anyway is not the answer. "Women who are continually engaging in sex to please their partner because it is expected develop abhorrence. It depends on the relationship, but what you usually see over time is that the woman makes more and more excuses. If her partner goes to bed, she'll stay up and do the ironing or whatever until he's asleep. They will find more and more ways of avoiding sex."

Melbourne University's Professor Lorraine Dennerstein agrees there's no evidence that frequent sexual activity improves a low libido. However studies suggest women who had a high interest in sex prior to surgery that induced menopause experience fewer vaginal symptoms than expected if they continue to have sex every day afterwards.