Psychology of Sexual Dysfunction

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Afterward, the patient is given a physiological evaluation. Different probes are used to determine vaginal pH balance, the degree of clitoral and labial sensation and the amount of vaginal elasticity. "Then we give the patient a pair of 3-D goggles with surround sound and a vibrator and ask them to watch an erotic video and stimulate themselves to measure lubrication and pelvic blood flow," Jennifer says.

The identification of FSD (female sexual dysfunction) has been called everything from the final frontier of the women's movement to an attempt by the patriarchy to shackle women's sexuality. But given the success that drugs such as Viagra have had in reversing male sexual dysfunction, the Bermans found an unexpected amount of criticism from their peers. "The resistance we got from the rest of the medical community early on was surprising to us," Laura says, explaining that the urological field in particular has been dominated by men.

Clearly, the Bermans will need hard data to win over their critics. Their UCLA facility is enabling the Bermans to conduct some of the first systematic psychological and physiological research on the factors that inhibit female sexual function. One of their first studies suggests that the pharmaco-sexual revolution that helped some men overcome their sexual dysfunction may prove less effective for women. Their initial study of the effects of Viagra on women found that Viagra did increase blood flow to genitalia and thereby facilitate sex, but women who took the drug said it provided little in the way of arousal. In short, subjects' bodies might have been ready, but their minds were not.

"Viagra worked half as often in the women with an unresolved sexual abuse history as in those without it," Laura says. "So it's just not going to work alone. Women experience sexuality in a context, and no amount of medication is going to mask psychologically rooted, or emotionally or relationally rooted sexual problems." Laura believes the results of the Viagra study counter those who contend that FSD is simply a tool of pharmaceutical companies to "medicalize" female sexuality.

"I'm less concerned about it, because I'm aware that it won't work," she says. "And in some respects, pharmaceutical companies are closing the divide between the mind and body camps of FSD. Clinical trials of new drugs for FSD are requiring psychologists to screen participants, and that is an acknowledgement that an accurate assessment of a drug's efficacy requires a consideration of the test subjects' feelings about sex. So these physicians who may not be motivated to bring on a sex therapist are now motivated to participate in a clinical trial, and then that model becomes the norm."

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Currently, the sisters are working on MRI studies of the brain's response to sexual arousal, the place where mind and body meet. And although there is a lot more research to be done on FSD, identifying it as a problem has already made a significant impact on how women perceive their sexuality. "Women now feel more comfortable going to their doctors, and they're not taking no for an answer, not being told to just go home and have a glass of wine," explains Laura. "They feel more entitled to their sexual function."

READ MORE ABOUT IT: For Women Only: A Revolutionary Guide to Overcoming Sexual Dysfunction and Reclaiming Your Sex Life Jennifer Berman, M.D., and Laura Berman, Ph.D. (Henry Holt & Co., 2001)

Next: Achieving the Big "O"

Last updated: 8/05. Last reviewed 11/05

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