on the 'pink pill' and 'perfect' sex

NPR’s All Things Considered covered the question of a “pink pill” for women – a medical treatment for low sexual desire.

The piece ends this way:

Carla Price says she would like to try flibanserin. Marriage counseling and a hormonal cream have helped, she says. But not enough.

“Even though it’s better, it’s not perfect,” she says. “I would gladly take risks of side effects to keep my marriage and my relationship.”


Which strikes me as a very, very important idea.

Carla, whom we meet at the start of the piece, is 50 and has experienced a radical decrease in her interest in sex after 15 years of a great sex life with her husband, despite still being totally in love and not being particularly stressed. So she has no idea where her desire went.

As a sex educator, I feel like I might have some insight to offer, maybe?


Let’s try:


Dear Carla,

I love that things have gotten better, and I love that you’re actively engaged in the process of creating the sex life that you want in your life and relationship! Hooray!!

I’d love to know, what does “perfect” look like? If you could wave a magic wand and have exactly the sex life you wanted, what would it be like?

(Does it involve swamping fatigue and nausea? Because unfortunately those are the side effects you’re risking – at least, those are the ones described the women I’ve talked to who have taken Flibanserin as part of the clinical trials.)

Because you’re interested in Flibanserin, I’m going to guess that maybe part of your answer about “perfect” sex includes spontaneous, out-of-the-blue desire for sex – which is what the drug promises.


And that’s the first place where I think I might have some insight to offer.


Spontaneous desire is fun, for sure, and it’s what our culture teaches us to expect desire to be like, for sure. But it’s not the only healthy, normal way to experience desire. There’s also responsive desire.

Responsive desire works like this: you’re in neutral, just cruising the internet, say, and your partner comes over and starts touching your arm in a warm, affectionate way, and your body responds with, “Oh, right, sex! That’s a good idea!”


Michele Weiner-Davis, in her TED talk about “sex starved marriages,” talks about it.


At minute 12, she describes how her clients explain their experience of responsive desire:

“Michele, I wasn’t in the mood for sex when my partner approached me, but once we got into it, I had a really good time!”

That’s responsive desire. And it’s normal. Very common. And healthy! Not a disease requiring medical treatment, but a different desire style requiring different strategies for making it work in a relationship.


Now, this is not to say you should ever do anything you don’t ENJOY. That would only lead to resentment and suffering. But it does suggest that you can maximize the sexual potential in your relationship by doing things you LIKE and seeing where it takes you, without expectation or pressure or guilt.


Low desire is a relationship issue, not a medical issue. (How many single women are worried about not wanting sex enough?) So I’m guessing your “perfect” involves having a sex life that is satisfying to your partner, right? And so if you had a different partner, your “perfect” would be different too.

And that’s the way it’s supposed to be. Your perfect sex life is a unique thing, co-created between you and your partner. Desire emerges in response to the whole context of your relationship and your life.


Which brings me to the second place where I think I might have some insight:


It can be tricky, letting go the idea of ideas we’ve all been taught about what our sex life is “supposed” to be like. We’re “supposed” to have spontaneous desire. And we’re supposed to have sex however many times per week (or month or year or lifetime). And we’re supposed to have orgasms a particular way….

And we might experience our sexualities the way we’re “supposed” to. Or we might not. It doesn’t mean we’re broken; it means we were taught to expect the wrong things from our bodies.

The secret – the magic trick – is not just understanding what your sexuality is really like – as in, “It turns out I have responsive desire,” or “I have orgasms from clitoral stimulation, not vaginal stimulation,” etc. The magic trick is *loving *what your sexuality is really like! As in, “I love my responsive desire,” “I love my clitoral orgasms,” etc.

Welcome and embrace your sexuality as it is, rather than trying to make it something it doesn’t want to be, and it will blossom and thrive.


And that brings me to my last little bit of advice.


Does your “perfect” include pleasure, too? I bet it does.

Culturally, our ideas about what makes great sex often includes a lot of things about WANTING sex and about HAVING sex… and not quite so much about ENJOYING sex.


As a sex educator, I’ve found that the single most important thing a person can do to improve their sex life is to ENJOY the sex they are having – whatever sex that might be – as long as it’s WANTED.

Sex researcher and educator Robin Milhausen said it better, though. When I was in Canada researching my book, I asked her what she felt like was the best advice she’d ever heard or given her students about sex.

And she said, “Ask yourself, ‘What kind of sex is WORTH HAVING?’ And then create that kind of sex in your life.”

Worthwhile sex can include spontaneous desire, and it can include responsive desire. How you want sex is only part of the picture though. How you like the sex you’re having is an important and overlooked part.


To conclude: Responsive desire. Embrace and welcome your sexuality as it is – even the parts that aren’t what you expected them to be. And think through what kind of sex is worth having… then see what you can do to create it in your life and relationship.