The inspiration for this piece is from one of our favourite books, “Come As You Are”, by Dr Emily Nagoski. Dr Nagoski has pulled together 10 years of research into women’s sexuality, and shares an essential exploration on how female arousal, desire, autonomy, pleasure and orgasm works, and provides tools for women to create and sustain a fulfilling sex life.
So many of our patients that are experiencing sexual pain will tell us that they feel “my vagina is broken” or “my vagina isn’t normal”. Another common observation in our practice is how little awareness women have about their own pelvic anatomy and sexual function. One of the most powerful tools to help is to educate women on ‘what’s what’ down there. Whilst looking at an image or a model of a vulva can be helpful, many women will find this hard to relate to and can’t identify all of the parts of the vulva on themselves. It can be extremely enlightening for women to learn what is normal in relation to their own anatomy and about sex.
There are many myths surrounding sex that can perpetuate negative self-belief and fear and create more problems in the bedroom. Let’s explore some of them.
MYTH #1: All vagina’s look the same
TRUTH: There is a huge degree of variation in how each vulva (which is the name given to the external parts of the female genitals) looks. Whilst all the parts that make up the vulva are the same (eg inner and outer labia and clitoris), they can all look quite different in terms of colour, shape and size (just like all the parts of our face are made of the same features, but each person’s face is unique).
MYTH #2: Women should be able to orgasm with penetration alone
TRUTH: More than 70% of women will NOT reliably orgasm with penetrative sex, and this is healthy and normal. The clitoris is a highly sensitive organ where blood flows during sexual arousal. It is the external genital organ (ie like a penis in a male) that can extend all the way into the vagina. For most women, some degree of clitoral stimulation is required for a woman to orgasm.
MYTH #3: A woman is only truly aroused when they have produced enough natural lubrication
TRUTH: Female lubrication does not a correlate directly with arousal. This term is called arousal non-concordance. The way a woman knows if she is aroused is if she feels in herself that she is.
MYTH #4: Women should be able to become aroused spontaneously
TRUTH: Both men and women can either have spontaneous desire (a sudden or immediate desire for sex) or responsive desire (feeling desire for sex only if someone else initiates it) and both of these types of desire are normal. We can think about our ‘turn ons’ and ‘turn offs’ for sex like brakes and accelerators. These increase or decrease our desire for sex. The challenge is figuring out what turns on and turns off our brakes and accelerators. Sexual desire and pleasure is highly dependent on context, and creating the right context for both partners is important to improve arousal and sexual desire.
MYTH #5: Sex can be painful, and having a glass of wine and relaxing before sex will help
TRUTH: Sex should never be painful. Using alcohol as a way to relax is a common strategy that women will try to reduce pain with sex, but this approach will not necessarily change the protective response of the brain to produce pain and muscle spasm with sex. This suggestion is often quite unhelpful for women and can often lead to other risky and negative behaviours.
Many of these points are discussed in detail in Dr Nagoski’s book Come As you Are
. It is a fantastic and relatable read targeted at women who want to learn more about their sexuality, sexual function and transform their sex life. To learn more about the book and to work through the strategies and real life examples that Dr Nagoski discusses in her book, visit her website https://www.emilynagoski.com/home