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_**chapter three**_

**Anatomy and Sexual Response**

My pussy is a very lovely, shorn, shapely, and soft thing.

LET'S BEGIN WITH A TOUR OF YOUR SEXUAL ANATOMY. Regardless of how you relate to your body—whether you're comfortable being female, love your genitals, hate your genitals, or feel your body is the perfect expression of who you are—your sex life will be enhanced by understanding what's going on down there.

#  **Anatomy**

The official term for the female genitalia is _vulva_. Some of us prefer _pussy, cunt,_ and other names. Our genitals include the clitoris, labia, and vagina. The fleshy area over the pubic bone is called the mons. Our perineum, anus, and breasts can also be quite sensitive to sexual stimulation.

Truth is, there are women who don't know where or what their clit is—and there are even lesbians who have never held open their labia and looked at themselves. Why? Well, for starters, we're not exactly encouraged to look at our genitals. If only we were presented mirrors, speculums, and Annie Sprinkle DVDs with those first packages of sanitary pads or tampons…. (As far as I'm concerned, sex ed would best be team-taught by Betty Dodson and Annie Sprinkle, and not your boring, uptight 5th grade science teacher. _A New View of a Woman's Body_ and _The Clitoral Truth_ should be required reading. For both girls _and_ boys. _"Can you spell c-l-i-t-o-r-i-s? No diploma for you, Johnny!"_ )

Add to the lack of basic information about our bodies the complicated relationship many lesbian, bisexual, and queer women have to gender. Some of us experienced considerable pressure to look and act "feminine"—when we didn't feel feminine inside. We may be questioning whether we consider ourselves to be women at all—female anatomy notwithstanding. Others of us found that our natural femininity made our sexual choice suspect—and, because we looked, dressed, walked, and talked like "normal" women, we felt invisible as lesbians. As a preteen, you may have felt you failed at being the little girl your parents had so wanted. That made it hard to relate to the anatomy diagrams in the package insert that came with your first box of tampons.

Finally, one out of three girls is sexually abused before reaching adulthood. Sex was the site of our pain. No wonder so many of us are shut down, having only a vague notion of what's going on between our legs.

So, let's take a guided tour of our genitals.

##  **Clitoris**

The glans of the clitoris is the most sensitive spot in your genital area. If you draw your finger up from your vaginal opening in one long stroke, you'll find your clit at the top of the vulva. (If you like, visualize a clock, with your vaginal opening at six o'clock and your clit at midnight.)

When you refer to your "clit" you probably mean the part of the clitoris on the outside of your body. How big is a clitoris? Clits come in a wide variety of sizes, shapes, colors, and sensitivities. Clits can be so tiny you can hardly find them or as big as the first joint of your thumb. Female-to-male transsexuals taking testosterone can develop clits as large as 3 inches long.

The exterior body of the clitoris is made up of the glans (or head), the hood, and the shaft. The glans is the most sensitive part of the clit, analogous to the head of a penis—only far richer in nerve endings (6,000 to 8,000)1 and thus more sensitive. Your clitoral hood drapes your glans and keeps it moist and sensitive—still, touching your nonaroused or unlubricated clitoral glans can be irritating or  even painful. If you gently hold your clit between your thumb and forefinger, you can feel the shaft.

Hardly the little "nub" described in outdated sex guides and anatomy texts, the clitoris is a complex structure of erectile tissue, much of which surrounds the urethra—no surprise to women who experience ejaculation with orgasm.

The Federation of Feminist Women's Health Centers identifies 18 distinct parts of the "complete" clitoris, most of which you can't see, all of which function as a whole to produce sexual pleasure and orgasm.2 Such an extensive description of the clitoris helps explain why a person's sexuality can be decimated by female circumcision or by surgeries imposed on intersexed infants.

**Illustration 1. Female Anatomy (External)**

How did the women of the FFWHC figure this out? In the 1970s, while researching a book on reproductive health for women, they came across the conventional descriptions of women's sexuality, which didn't make sense when viewed alongside their own experiences. In true '70s feminist style, they formed a consciousness-raising group and got to work. They looked at each other's genitals, took pictures, made films of themselves masturbating, and studied human anatomy. The result was the book _A New View of a Woman's Body_.3

Another researcher, working almost 25 years later, used a different strategy. Dr. Helen E. O'Connell, of the Royal Melbourne Hospital in Australia, dissected human cadavers. "The pyramid-shaped mass of erectile tissue" she saw, "far larger than previously described," bore no resemblance to the anatomy she learned in med school.4 "There were glaringly obvious defects in some books—like the book that I learnt anatomy from when I was training for my surgical exams just had no description [of the clitoris] at all.5

Two of O'Connell's ten specimens were from premenopausal women who exhibited "more extensive erectile tissue" than the typical elderly cadavers found in research settings.6 "Welucked out,"she said, "one of our cadavers was 36 years old. She looked like an Amazon." 7

Even _Gray's Anatomy_ failed to identify or describe the nerves and blood vessels that go to the clitoris—which are among the FFWHC's 18 parts of the clitoris related to sexual pleasure. "For a surgeon," said O'Connell, "that's unacceptable." She concluded that current anatomical descriptions of female human urethral and genital anatomy are inaccurate.

That lack of respect for women's anatomy can have serious consequences for women undergoing radical hysterectomy and other surgeries. Men who undergo surgery for prostate cancer benefit from the "tons of studies about how to prevent impotence after radical prostectomy," as one expert in gynecological anatomy said. "Given this beautifully detailed knowledge of the interrelationship between the female urethra and sexual organs," the researcher continued, "it should be possible to develop similar nerve-sparing operations for women." 8

O'Connell found that the crura (or legs) of the clitoris "flare backwards into the body," extending into the vaginal wall on either side of the urethra. (Think of a wishbone, with the clitoral glans in the middle and the crura as the legs.) Called the "vestibular bulbs" in traditional anatomy texts because they sit on either side of the vaginal opening, the "clitoral bulbs" (so named by O'Connell) are analogous to the bulb of erectile tissue at the root of a penis, though, O'Connell says, "the bulbs are more prominent in females." The clitoris, she concludes, is far larger than the tiny structure depicted in conventional anatomy texts.

But why does any of this matter to you? If you think of your clitoris as an extensive sexual organ—one that protrudes at the top of your vulva, reaches down to flank the vaginal opening, extends into the vagina, and cradles the urethra—your concept of touching your clit just might take on new dimensions!

**Illustration 2. Female Anatomy (Internal)**

##  **Labia**

The _labia majora_ are the large outer lips of your vulva. These are what some women call their pussy lips. They're usually covered with hair, and the skin is the same texture and color as the rest of you. Among women who shave their genitals, this is the area that's most commonly shorn. The _labia minora_ are next as we move inward. These are asymmetrical, delicate folds of tissue with the same texture as mucous membrane. Generally hairless, they become quite slippery during sex. Some women's inner labia are long, extending outside the labia majora; others are smaller and tucked away inside the labia majora.

##  **Vagina**

The opening of the vagina sits below the clit and urethral opening, and above the perineum and anus. The vagina is made up of very elastic tissue that opens up and expands during arousal (and childbirth, of course). When not aroused, the walls of the vagina touch—we do _not_ have a big "hole" in there.

The outer third of the vagina contains the most nerve endings, and most women find it to be more sensitive than the deeper areas of the vagina. The opening and G-spot are the most responsive to the subtleties of movement and touch; the deeper areas are more responsive to the pressure of thrusting. The vagina ends in the cervix, the knoblike opening to the uterus through which menstrual blood passes. Some women love to have their cervix pounded; others hate it. Be careful not to bruise or abrade your cervix.

I love my cunt, for sure—the way its lips pucker, the way it hungers to get some. My cunt and I are partners in crime! Arrest us for being too hot!

The vagina isn't a passive receptacle. The opening of the vagina is quite muscular. Surrounded by the pelvic muscles, the vagina will contract with pleasure, gripping a finger, dildo, or hand.

##  **G-Spot**

The G-spot is named for Ernst Grafenberg, an ob-gyn—but let's think of it as the girl spot. Since Grafenberg, Beverly Whipple, Deborah Sundahl, Carol Downer, and many others have discovered so much more about the G-spot and its role in pleasure and orgasm.

The G-spot isn't a magic button, but rather an area of tissue that feels a bit rougher in texture than the rest of the vagina walls. You can find your G-spot by inserting a finger into your vagina and making a "come hither" motion toward the front wall of the vagina. The G-spot is actually the urethral sponge, or _corpus spongiosum_ , an area of tissue surrounding the urethra, which runs along the front wall of your vagina carrying urine from the bladder to the urethral opening. (The urethral opening is located below your clit, just above your vagina.) You can also think of the G-spot as your female prostate; like a man's, it plays a role in ejaculation.

Some women ejaculate with G-spot stimulation; some ejaculate with clitoral stimulation. Some like G-spot stimulation, but don't ejaculate. And others find G-spot stimulation too intense to be pleasurable. (More on the G-spot and ejaculation in chapter 4, Orgasm.)

##  **Perineum**

Between your vagina and anus sits a small area of connective tissue, the perineum. A lot of women like pressure here during penetration, and licking or nibbling during cunnilingus. This tissue is also somewhat elastic—it stretches during childbirth to allow passage of a baby's head. During her pregnancy, Susie Bright discovered that "perineal massage" recommended by her childbirth preparation teacher was much like fist-fucking. "I could see why immediately," she wrote. "A hand going inside my pussy is a little like a baby's head trying to move outside into the world. How exciting! For the first time I felt a surge of confidence about my chances for a successful labor." 9

##  **Anus**

The anus is a very sensitive area, ripe for erotic play. In Victorian porn, it's called the "little rosebud." Made of delicate tissue, rich in nerve endings and blood vessels, the anus is quite responsive to sexual arousal.

The anus is guarded by two muscles—the external sphincter, which consists of voluntary muscles (you can flex them), and the internal sphincter, which consists of involuntary muscles (they seem to open and close according to their own will—like blinking—though with practice you can learn to relax these, too).

The anus is short, just an inch or two long, leading into the rectum, which is about 4 to 6 inches long, and ending in the rectosigmoidal junction, the opening to the sigmoid colon. From there, the colon leads to the intestines. The rectum offers no equivalent of the cervix; there's no stopping point. Things really can get lost in there, so precautions are a must when inserting an object into your anus. Dildos and butt plugs must have a flanged base (bigger at the base than the top), and insertive toys, like anal beads, must be securely fastened to their strings.

The tissue of the anus engorges with arousal and is quite expansive; you can fit a finger, a dildo or penis, a butt plug, or even a whole hand inside your butt. The lining of the anus and rectum is very, very delicate, and will tear easily—another reason to be extremely careful in choosing insertive anal toys and to always use lube.

In biological males, the prostate gland, located on the front wall of the rectum a few inches from the anal opening, responds to stimulation similarly to the G-spot. You can insert a finger into the rectum and use that come-hither motion to find a partner's prostate. Male-to-female transsexuals, both pre-op and post-op, can enjoy prostate stimulation.

##  **PC Muscles**

Finally, the pubococcygeus (PC) muscles are the set of muscles that run through your pelvic area in a figure eight. These are the muscles you exercise when you stop the flow of urine midstream—or grip your lover's finger. Developing these muscles will heighten your experience of orgasm; prevent incontinence when laughing or sneezing, or in old age; and generally help you become more aware of  sensations in all areas of your genitals. Kegel exercises (named for the gynecologist who popularized them) involve squeezing your muscles as if you were shutting off the flow of urine. Inhale as you contract your PC muscles; hold the contraction for several seconds; and then exhale as you relax. Do this ten times. Then push out ten times. Repeat. Do this daily—on the bus, in traffic, and while watching your TiVo.

##  **Breasts**

Many of us enjoy breast play—so much so that it gets its own chapter in this book. Unless you have health concerns or plan to breastfeed, you may not have sought out information on the anatomy of your breasts.

Our breasts are composed mostly of breast tissue and fat. Although the size of your breasts is genetically determined, your breast size will change as you gain or lose weight. One breast may be larger than the other. The size or shape of your breasts has no bearing on their responsiveness to sexual stimulation.

The areola surrounds the nipple; it's darker than the rest of the breast. The areola darkens and swells in response to sexual stimulation. The nipple becomes erect when stimulated; some women's nipples invert when aroused. (Dr. Susan Love calls these "shy" nipples.)10

Breast sensitivity varies from woman to woman, as well as at different points in a woman's menstrual cycle and over the course of her lifetime. PMS (premenstrual syndrome) and pregnancy can intensify breast sensitivity, and menopause can lessen breast sensitivity. Women who have cystic breasts may find breast play very uncomfortable.

#  **Sexual Response**

How do you know when you're turned on? Does your clit throb? Can you feel a pulsing at the mouth of your vagina or at the opening of your anus? Do you feel nervous or fluttery? Do you notice small contractions of the sphincter muscles? Do you feel yourself getting wet? Do your nipples get erect? Are you aware of your nipples brushing against the fabric of your clothing? Can you smell your own juices?

You may be familiar with the Masters and Johnson model of sexual response. In the 1960s, William Masters and Virginia Johnson identified four stages of sexual response: _arousal, plateau, orgasm,_ and _resolution_.11 Theirs became the standard model of describing what happens when we're sexual. Helen Singer Kaplan added a fifth stage, _desire_ ; she posited that before there is arousal, there's desire.12 In the 1980s, Joann Loulan joined the chorus, adding a sixth stage: _willingness_. Loulan suggested that even if there wasn't desire, there could be a willingness to feel desire.13 Don't worry if your sexual response fails to follow any of these models. Human sexuality varies greatly from person to person, and even from day to day.

So why would it be useful to have a model of sexual response? Well, knowing generally how human sexual response works can help you understand your own experience. You can learn to notice your own sexual rhythms. Then you can decide what aspects of your sexual response you might like to develop more. Models such as these can give you a language to help you describe your experience, one that others may understand. However, if theories bore you—or, worse, make you feel inadequate—just skip them. You don't have to be a sexologist to have a fabulous sex life.

Understanding your own sexual response, however, _will_ help you create the sex life you want. Try masturbating in front of a full-length mirror, or with a hand mirror between your legs. As you stimulate yourself, you'll get to see your particular sexual responses in action. You can become acquainted with the visual cues of your sexual arousal. (You can even insert a speculum—available from www.The-Clitoris.com, women's health centers, and some sex toy stores, such as Toys in Babeland (see chapter 20, Resources)—and grab a flashlight to see what you look like on the inside when you're turned on.)

During _arousal_ , your heart rate and blood pressure increase. You may feel warm. A sexual flush may appear over your face and chest. The breasts enlarge. Your nipples become erect; later in arousal, your areolas swell and your nipples may seem to retract. The clitoris engorges with blood and becomes erect, growing bigger. The inner labia swell and darken in color. You get wet. Your vaginal walls lubricate and the whole vagina expands. The uterus engorges and lifts,  expanding up to twice its normal (not pregnant) size. Your vagina opens. Your sphincter muscles may relax or contract.

A friend told me that women once wore lipstick to symbolize the sexual engorgement of their labia during arousal—a reasonable explanation of why women who wore bright red lipstick were said to be "loose." Whether or not the story is true, my friend (happily) now can't look at a woman's freshly painted lips without thinking of the engorgement—and resulting darkening and deepening of color—during arousal.

The _plateau_ stage is the state of peak excitement right before orgasm. The vagina opens up and balloons out. The clitoral glans is tucked inside its hood. The areolas continue to swell. You may notice that you can take more nipple stimulation. Muscle tension increases all throughout the body, as the heart rate continues to climb. You find yourself breathing faster and deeper. The sex flush becomes more pronounced. The labia minor may turn a deep red or wine color. The vagina opens into what's called the orgasmic platform. The outer one-third of the vagina further congests with blood.

_Orgasm_ is a series of involuntary muscle contractions in the vagina, uterus, and anus, releasing the blood that's been stored in the erectile tissues of the genitals. Most sources report that the contractions occur at a rate of slightly more than one per second; generally an orgasm will involve anywhere from just a few contractions to 10 or 15 of them. Of course, the intensity and duration of the orgasm will vary greatly. During orgasm the heart rate peaks. Breathing is faster. (More on orgasm in the next chapter.)

_Resolution_ is the stage in which the body returns to its nonaroused state. You experience a release of tension. The heart rate and breathing return to normal. Sex flush disappears, nipple erection fades, the glans of the clit once again protrudes from its hood. The labia return to their nonaroused color and size.

Do women get "blue balls"—that painful state of unresolved arousal that men talk about? Yes—if after reaching a very high degree of arousal you don't come, it takes a longer time for the vascular congestion to ease, which can be uncomfortable—or exciting!

#  **Sexual Response over a Lifetime**

Just as your experience of arousal and orgasm does not necessarily follow Masters and Johnson's four-stage model, your experience of sexuality over the course of your lifetime will not necessarily follow the linear model we've been given.

And what linear model is that? As children we are supposed to be asexual. Then we hit puberty and get interested in boys. (If we get interested in girls, we must be confused.) Our sexuality matures: we like dick—but not _too_ much and only when we feel an emotional connection to it. Then we hit menopause and the sexual portion of our lives ends with the cessation of reproductive functioning. Gender development is supposed to follow an equally linear path.

Of course, this model bears little resemblance to anyone's real experience. (In fact, if you're reading this book, you've already strayed far from the path.) _Real_ sexual response develops individually (and messily!) over a lifetime—it doesn't ratchet through one neat stage after another.

_I had a rough time trying to figure out who I was during my adolescence…. I'm just glad that an eating disorder, shagging some guys, and some experimentation with drugs helped me figure it all out. As I am only 25, I still have a few major life changes to go…. But the main one was the realization that I am not heterosexual. My sex life increased a zillion percent after that._

You'll likely go through many subtle and not so subtle evolutions in sexual response and desire throughout your life. If you've come out as lesbian, bisexual, transgendered, queer, or kinky—or all of the above—you've already experienced the process of developing your sexuality and gender expression from the inside, rather than from others' expectations.

_I am very proud of the fact that since I stopped fucking men, I went from a girl who spreads her legs and waits for it to someone very active and very top!_

Many women say sex gets better and better as they come to know and accept themselves. The more you explore your sexuality—without judgment—the richer your sense of yourself as a sexual being.

**_MTF Prostate = G-Spot_**

My partner and I recently started reading _The Whole Lesbian Sex Book_ together and find it interesting and useful so far. One sentence caught my attention and got me to make a connection I hadn't thought of so I decided to pass it along.

As almost an aside you wrote that male-to-female transsexuals (pre- and post-op) can enjoy prostate stimulation.14 Having always thought of myself as female, the fact that the prostate is not removed during gender reassignment surgery always seemed somehow unfair (like some vestigial male anatomy left there to taunt me). But as I looked again at the little sentence in the book, I realized there was something wrong.

After surgery I read a lot about anatomy. I remembered reading that, while I still do have a prostate,the vagina is now _between_ the prostate and the rectal wall.This is important because if my doctor ever does a prostate exam, she won't find anything using the usual procedure. She will actually need to find my prostate by feeling through the vaginal wall.

Suddenly, it all came together—since my gender reassignment surgery, the prostate is in about the same position and should function very much like a G-spot. _Cool._

I've mentioned this to my partner, and I am looking forward to her helping me test my theory.

_I love being who I am now as a sexual being—everything, all my 42 years—adds up to the moment. Tough-assed femme to the core who needs the tender as much as she needs the slam and fury. I own all aspects of me now in ways I never dreamed possible. And I feel like I'm gonna rock it that much more every year that I'm on the planet. I like to take long steps in tall heels. That's my sexuality._

##  **Gender Transition**

How does the process of gender transition inform sexual response?

Trans-Health ("the online magazine of health and fitness for transsexual and transgendered people") surveyed its readers on the subject of trans sexuality in 2001.15 Only about 30 readers responded to the survey questions; yet even among this small group, there is a range of sexual interests and concerns. A few identified their gender as "other"; the rest were evenly split between male-to-female (MTF) and female-to-male (FTM) transsexuals. Half "expressed some degree of sexual fluidity; their interests had changed since transition, occasionally several  times." Nearly all the MTFs said they wanted to experience vaginal penetration. Nearly all the FTMs expressed a desire to "put their cocks in other boys' bottoms."

Many had transgendered partners. Some reported no sexual problems; some, problems related to coming out as trans; and others, problems related to their sexual physiology. Interestingly, many said that being able to view sexuality from more than one gender perspective benefited them.

Gender transition is a time of self-discovery. Some people liken it to a kind of adolescence for grown-ups. Ask a 30-year-old man appreciating his chest for the first time, or a 40-year-old woman caressing her own round hips and soft skin.

More on gender transition in chapter 14, Gender (Not Destiny).

##  **Depression**

_Certain medications for depression flattened out my sex drive so that my lover had to do with no sex for months at a time while I wore my gray flannel bunny nightgown around the house and then slept in it. A far cry from my collection of very sexy lacy lingerie._

Nothing kills an otherwise healthy sex life like depression. Depression can severely diminish libido. It's hard to muster much interest in sex when you're barely getting through the day. Even more frustrating is that some medications available to treat depression often reduce sexual desire and functioning. Not all women experience sexual side effects while on antidepressants. Some notice no change whatsoever. For many, just not being depressed kick-starts their libido enough to overcome the effects of antidepressants. But for the huge number of women who do experience sexual side effects, they're a real problem. It's disheartening to finally come alive again—only to feel robbed of one's capacity for erotic pleasure. You certainly cannot fault yourself for grieving over the loss of sexual pleasure.

It's difficult to create a mood of openness and curiosity when you've just been through a major depression—but that is what's called for. If ever there was a time for self-exploration, this is it.

Antidepressants can affect your sexual response in a number of ways. You might not be able to reach orgasm. You get really turned on, but can't quite get  over the edge, no matter how many vibrators you wear out. You might have disappointing orgasms—barely a ripple compared to what you used to enjoy. Your sensation may be muted. One woman described it as being touched though velvet. Finally, you may have no interest in sex whatsoever, even though your depression has lifted.

Quite often, anorgasmia (inability to reach orgasm) passes after a few weeks on an antidepressant. A temporary bout of anorgasmia may have an odd benefit. If you were previously goal-oriented in your approach toward orgasm ( _wham bam come_ ), you probably have never experienced a sexual plateau stretching on indefinitely:

 _I've never been as turned on in my life as when I first went on Zoloft. Even though not being able to come was freaking me out, I was stunned by how wet and open I could get. I could practically fit my whole hand inside me._

Of course, after a month or more of arousal-without-orgasm, you may not be so impressed.

An antidepressant can interfere with your ability to feel sensation. You might touch yourself in your usual way and feel nothing. All systems are go—you engorge, you get wet, your muscles contract—but you don't feel it. You can have an orgasm so muted and distant that it feels like it's happening to someone else. This is not your imagination. Some neurotransmitters, like dopamine, facilitate sexual function while others, like serotonin, reduce it.

Here's where an experimental attitude helps. If you can detach from your frustration and disappointment (I know, I know), you may be able to locate your pleasure as you experiment with touch and sensation. A completely different touch may produce some sensation. If you previously used a vibrator, try your own fingers. If you are used to light, indirect clitoral stimulation, go for something more direct. Never tried a vibrator? Time to go shopping.

If you can't come—but you do find touch pleasurable—try focusing on sensation rather than orgasm. If sex doesn't end with orgasm, how might it end? Rather than stop in failure (after exhausting every possible means to reaching orgasm), decide in advance that you're going to engage in a session of touch and  sensual awareness for, say, 20 minutes. When the need to come builds toward frustration, stop. Back off, relax all the muscles that have contracted in orgasmic tension, take a few deep breaths, and start again. Approach pleasure in a different way: notice what produces a yummy sensation rather than what you think will get you off.

##  **Antidepressants or Orgasm Suppressants?**

Most notorious for negative sexual side affects are the SSRIs (selective serotonin reuptake inhibitors), the class of drugs most frequently prescribed for depression. While medications like Effexor, Paxil, Prozac, Zoloft, and others have helped many overcome debilitating depression (and no doubt saved lives), they have also been known to cause sexual problems for many who take them.

Psychiatrists and other physicians have come up with a few tricks, such as combining two different antidepressants—for instance, coupling an SSRI with another type of antidepressant, such as Wellbutrin, that doesn't seem to adversely affect sexual functioning. Tianeptine, a French drug, seems to be as effective as other drugs in treating depression, but without the sexual side effects. It hasn't been approved by the FDA for use in the U.S. yet.16

Physicians can also closely monitor patients to find the precise dosage that ameliorates the symptoms of depression while minimizing adverse side effects. Landing on a treatment that works for you can take months of persistent effort—no small task for someone suffering from depression.

Health-care practitioners have come up with other creative solutions as well. Some recommend testosterone for women used in conjunction with an SSRI. Small doses of testosterone can add a bit of zip to the libido, they say. Likewise, some women who take an SSRI report an increase in libido when it is combined with Dehydroepiandrosterone (DHEA), an adrenal hormone used by bodybuilders. (DHEA use has also been linked to acne and mood swings.) There hasn't been sufficient research on DHEA or testosterone to know whether long-term use by women will lead to other health problems.

You can try Viagra and other recent drugs developed for men. Researchers have begun studying the potential of Viagra to help women who report negative sexual  side effects from SSRIs (or "iatrogenic serotonergic antidepressant medication-induced sexual dysfunction,"17 to those in the know). Viagra will not give you back your sense of yourself as a sexually whole person. But it may help you achieve physiological arousal and orgasm. (See "Does Viagra Work for Women?" in chapter 4, Orgasm.)

Some women who suffer from depression have found it helpful to combine lower dosages of an SSRI with Saint-John's-wort or other herbal and nutritional remedies such as yohimbine and ginkgo. Others have abandoned SSRIs altogether, favoring herbal alternatives. (See "Herbal Supplements," below.)

You might be helped by combining standard treatments (like medication and psychotherapy) with alternative strategies, such as light treatment18 and acupuncture. 19 In one study of acupuncture as treatment for major depression, more than half of the women in the study achieved full remission.20

Others may find nutritional counseling (for instance, aspartame has been linked to depression in those predisposed to it21), exercise, meditation, and spiritual work as helpful as transitional medical treatments:

 _In the past, I often found myself in the vicious cycle of getting depressed (for whatever reason, girlfriend-related or not), then losing my sex drive, then being depressed because I have no sex drive. I talked to a few doctors about it, and they told me to regulate the foods I ate, and wanted to put me on medication, but I decided to meditate my way to a better outlook (which also reflected on my sex drive), and it's worked surprisingly well._

Of course, decisions regarding management of depression should be made with the help of a health-care practitioner who is knowledgeable about the available treatments and respectful of the needs of lesbians, bisexuals, and transsexuals. For many of us, that is easier said than done.

##  **Finding Help**

Most physicians spend less time learning about human sexuality—roughly 12 hours of classroom instruction—than you spent learning to drive a car. Homophobia may creep into the doctor/patient relationship in a variety of ways. Your  physician may downplay your concerns about your sex life. She may feel uncomfortable talking to you about sex between women (or any sex at all). Your physician may view lesbians as not sexually "active"—since they presume we're not having sex with men. More subtly, it might be assumed that if you're not partnered, you aren't interested in having sex.

**_Herbal Supplements_**

Herbalists can rattle off a long list of remedies for low libido and other sexual problems: Siberian ginseng, motherwort, ginkgo biloba, fenugreek, black cohosh, wild lettuce, and wild oats (as in "sow your wild oats").

Many herbal and other plant-derived supplements (called _phytochemicals_ ) are marketed as sexual enhancers. Some have been studied in controlled research settings, others not. Often studies focus on erectile function in men; we have to extrapolate. Will an herbal remedy purported to help men get erect help women get erect? Get engorged? Get off? The lack of research or understanding of how these remedies work—or whether they work—doesn't discount the fact that some women find them helpful. But it does make it harder to know what to try.

Three herbals often associated with sexual functioning in women are ginseng, yohimbine, and ginkgo biloba. Ginkgo biloba has long been known to support circulatory function; that may explain its helpfulness in promoting physiological arousal. In one recent study, ginkgo biloba extract was found to "alleviate symptoms of antidepressant-induced sexual dysfunction related to all phases of the sexual response cycle"—in both men and women.22 Recent research suggests that yohimbine may help with antidepressant-induced anorgasmia. Ginseng is reported to enhance sexual drive.23 And motherwort is said to help with lubrication.

Commercial supplements often make vague promises of "enhanced libido" or "enhanced performance." Sometimes it's unclear what aspect of sexual functioning they are trying to ameliorate.24 Does this product promote orgasm? Sensation? Lubrication? Overall sexual energy?

Don't underestimate herbal and other plant-derived remedies. Humans have a long history of making use of phytochemicals to ameliorate all sorts of troubles and to support healthy functions of the body. That they are powerful also brings with it a caution. Some of these have strong side effects or may produce adverse reactions when taken in combination with antidepressants and other medication. Some may include Saint-Johns-wort; if you are already taking an antidepressant, watch it. Others may promote estrogen production or contain phytoestrogens; if you have breast cancer and have been told to avoid isoflavones, stay away from these. Consult a healer knowledgeable in herbal remedies, such as an acupuncturist.

Susun S. Weed has an encyclopedic knowledge of herbal remedies for women. Her website (www.susunweed.com) features articles on women's heath and information on the Wise Woman Center, located in upstate New York, where she offers workshops.

Generally, these are supplements one takes daily for a period of time. They don't work like Viagra—you don't take ginseng and get wet half an hour later.

Of course, many health-care practitioners do quite well with lesbian, bisexual, and transsexual patients—especially since so many of us fill the ranks of the health-care industry. Now that sexual side effects of antidepressants have gained such notoriety, many health-care practitioners have become quite comfortable discussing libido and medication. Whether you're seeking the help of a psychiatrist, physician, or therapist, the best strategy for reclaiming your libido is to find someone who will work with you. Here are some questions to ask yourself when choosing a health-care professional:

• Do you get a gut sense that this practitioner will treat you respectfully—regardless of your gender identity or sexual choices?

• Do you feel comfortable talking to this practitioner? Does he listen to you?

• Does this practitioner have other lesbian, bisexual, or transsexual patients or clients? Who's recommending this individual?

• Is the practitioner qualified to answer your questions regarding the best course of treatment for your depression?

• How many hours of formal training in human sexuality has this practitioner received?

• Does the practitioner support you in prioritizing sexual satisfaction in your sex life?

Resources such as Kink Aware Professionals (www.bannon.com/kap) provide referrals to health-care professionals who are sensitive to the needs of lesbians, gays, transsexuals, sex workers, and S/M and fetish devotees. The Gay and Lesbian Medical Association (www.glma.org) offers referrals to queer-friendly physicians in the U.S. Local announcements lists, like San Francisco Bay Area's BA-Sappho, are also sources of referrals. The resources section of this book lists many helpful contacts for those seeking support and care. Your local women's, transgender, or queer community center may also provide referrals to health-care professionals.

##  **Illness and Disability**

Any disability, medical condition, or medical treatment that affects blood pressure, blood flow, muscles, or nerves can affect one's ability to orgasm. These may include diabetes, multiple sclerosis, spinal injuries, and high blood pressure. Nerve damage can affect the sensitivity of the clitoris, making it either numb or too painful to touch. Some women suffer from oversensitivity. For seemingly no reason, their clit or nipples are too sensitive to be touched at all. Conditions like attention deficit disorder (ADD) that interfere with one's ability to concentrate can make orgasm difficult.

Surviving cancer and the treatments for it can affect sexuality. Many women who undergo chemotherapy experience a chemically induced premature menopause, with all the associated symptoms, like loss of vaginal lubrication and elasticity.

Hidden disabilities like fibromyalgia, chronic fatigue, and crohn's disease can have a particularly frustrating impact on sexuality. Feeling fine one day but experiencing genital touching as painful the next can make it very difficult to sustain interest in a sex life.

Often the first sign of arousal many of us notice is lubrication. So, if we don't lubricate, we may not "feel" aroused. Lubrication, of course, is affected by our menstrual cycle, aging (with the loss of estrogen in menopause, many women lubricate less), and medications—even antihistamines can dry you up.

If you aren't lubricating, you may think you're not turned on. What to do? Well, for starters, invest in your sexual pleasure by purchasing some lube. (More on lube in chapter 17, Sex Toys and Accoutrements.) Second, start noticing your other signs of arousal. Do your nipples harden and become more sensitive? Do you feel a fluttering in your belly? Can you feel your PC muscles contract?

Finally, ask yourself how _you_ feel about your capacity for pleasure. Want to come faster? Want to take longer? Want to have deeper, more satisfying orgasms? Want to come even one time in a night? What's important is that _you_ develop your sexuality in directions that bring you the most pleasure—regardless of what others may think or what you've been told is possible for you.

##  **Perimenopause and Menopause**

_I'm finally admitting that my sexuality (or at least how I express it) is changing as I get older. That my desires are getting more interesting as my physical sensations are changing. I've become more diffuse. I find more aspects of women—and myself—erotic. It's less about this act or that act, more about nerves and skin…it's just more._

How do our sexualities evolve as we get older? What is the relationship between fluctuating hormone levels in midlife and sexual energy? How do hormonal changes affect blood flow and genital engorgement? Nipple sensitivity? Clitoral sensitivity? Overall skin sensitivity?

Some women experience reduced sensitivity to stimulation and difficulty reaching orgasm:

 _Yes, the older I get, the harder it is for me to have orgasms. I also don't think they are as strong or satisfying as they used to be._

Others report just the opposite—intensified sensitivity and stronger orgasms:

 _My breasts are very sensitive, more so now that I'm going through menopause. I like fingers, but gently, and it can't go on for too long or it starts to irritate me._

How much of libido is hormonal, anyway? Many women _do_ experience a drop in libido during menopause—though many do not. One study followed 326 women aged 35 to 47 for four years. Less than a third reported decreased libido.25

Hormones aren't alone in influencing sexual energy during perimenopause and menopause. The editors of Power Surge (www.Power-Surge.com) report: "A drop in libido at this time in a woman's life may be due in part to physical changes that can occur at menopause, including hormone changes, changes in vaginal tissue and lubrication, fatigue, sleep disturbances, hot flashes, night sweats, and increasing general health concerns. Mental and emotional contributors include stress, changes in body image, relationship issues, and changes in sexual expectations." 26

When the challenges to libido are so complex—and interconnected with such complexity—what can you do? There are some factors you can suss out: You can have your thyroid tested (unrelated to menopause, but an easy problem to rule out). You can get a blood workup and check your hormone levels. You may discover a hormonal deficiency.

But it's unlikely you'll be able to trace your lowered libido, difficulty reaching orgasm, or other sexual concern to a single cause. Instead, focus your attention on ways to sustain and support your sexual well-being. And there are many:

• Masturbate—often, daily if possible. Frequent sexual stimulation will help keep your libido going. Susun S. Weed writes, "My Rx for low libido is 7 orgasms a week, whether you feel like it or not. You can do one a day or all in one day. Continue for at least 3 months."27

• Keep a sexuality journal. Track your erotic highs and lows. How often do you masturbate? Have you noticed changes in sensation? Orgasm? In your fantasies?

• Talk to your partner. One woman wrote, "I had a hot flash during sex about a week ago and I was embarrassed (not sure why), but I still had a wonderful time. I think being with a woman who's close to me in age helps. Just talking about it helps."

• Make sure you are well aroused before vaginal penetration. You may notice that you are slower to lubricate or that your vaginal walls are more sensitive.

• Use lube. Magazine articles aimed at women in midlife often recommend commercial products for "vaginal dryness." Some of these may contain ingredients that "lower the pH of the vagina, which helps prevent overgrowth of bacteria in vagina,"28 but your favorite lube will do just as well.

• You can address vaginal dryness with herbal remedies. Carol Leonard, of the Feminist Women's Health Center, recommends Vitamin E, motherwort, and natural progesterone cream made from wild yam roots. She, too, recommends lube (she offers recipes for "natural" homemade concoctions) along with drinking two quarts of water a day. She also cautions against the use of estrogen creams, which have "potentially serious risks."29

• Exercise. Move your body, get your heart beating and your blood flowing. Along with general health benefits, the improved blood flow to the pelvic  area will nourish genital tissue.30 Declining vascular flow to genital tissue, which is not uncommon in perimenopause, can impair your ability to experience sexual arousal.

• Don't forget your Kegels. Your PC muscles need exercise, too.

• Take good care of yourself. Sexual energy is related to overall well-being. Make sure you eat well, get enough sleep (not always easy during menopause), and attend to health concerns.

• Consider that lowered libido, reduced sexual response, and inability to orgasm may be due to medication—particularly antidepressants. (See "Sex and Depression," above.)


Input: "Write a detailed paragraph discussing various herbal supplements and hormonal treatments that can help women enhance their energy and libido during menopause. Mention the herbs ginseng and ginkgo biloba, and reference Christiane Northrup's book 'The Wisdom of Menopause' and Susun S. Weed's book 'New Menopausal Years the Wise Woman Way'. Also discuss the potential effects of low testosterone levels on libido and sensitivity, and mention Dr. Susan Rako's recommendations for treating this issue. Finally, discuss the use of DHEA and its potential effects on libido, and mention the Women's Health Initiative study on estrogen and its potential risks. Emphasize the importance of actively regenerating sexual energy and suggest resources for further information."

Response:
Just for a few days, stop thinking hormones and menopause and estrogen replacement, and instead think about how to get your sexuality back, in the sense of losing the tension, the anxiety, and feeling yourself open, really open so that people who walk by you stop and think, "Ah, she's open!"

**NANCY FRIDAY**

• Many women look to herbal supplements to enhance energy and that feeling of well-being. Herbs like ginseng and ginkgo biloba can give your libido a boost. (See "Herbal Supplements," above.) _The Wisdom of Menopause: Creating Physical and Emotional Health and Healing During the Change_ , by Christiane Northrup, is a wonderful source of information on dong quai, chasteberry, and black cohosh. Also check out _New Menopausal Years the Wise Woman Way: Alternative Approaches for Women 30-90_ , by Susun S. Weed.

• Low testosterone levels may be the cause of your lost libido. One study found that women with low testosterone levels were four times as likely to report low sex drive.31 Testosterone deficiency may also be responsible for decreased sensitivity in nipples and clitoris and diminished orgasm—or difficulty reaching orgasm at all.32 Testosterone may produce the sexual urge you're  looking for. This is _very_ low dose testosterone; it should not produce male secondary sexual characteristics. Some gynecologists prescribe Estratest (a combination of estrogen and testosterone). Others prescribe low-dose testosterone in the form of a topical gel or cream or as a sublingual tablet. Dr. Susan Rako, author of _The Hormone of Desire,_ recommends 2 percent testosterone in petroleum jelly (prepared by a compounding pharmacist) applied directly to genital tissue "to jump-start" the libido. This is followed by low-dose orally prescribed testosterone.33 If you think you may have a testosterone deficiency, work with a health-care provider to determine if testosterone will be helpful for you, and in what dose and form.

• DHEA is an androgen and a precursor for testosterone; in some women, DHEA raises testosterone levels sufficiently to improve libido. Some health-care providers recommend DHEA for libido loss; others don't. Some researchers say that DHEA strengthens the immune system, fights fatigue, and lifts depression. It is said to increase feelings of well-being and enhance libido.

• Once widely prescribed for symptoms of menopause and to reduce the risks of heart disease and osteoporosis, estrogen and estrogen-plus-progesterone have been discredited by the Women's Health Initiative (WHI) study, which found both to be ineffective and potentially dangerous.34 Still, many women weigh the risks and decide that taking estrogen is the best course of action for them.

You _can_ replenish libido. In spite of physiological changes and health concerns, regardless of whether you take hormones or botanical supplements, you can maintain your erotic life force. Sexual energy needn't be something that just happens to you—up in good times, down in bad. You can actively regenerate sexual energy, in much the same way you renew your energy overall. When you begin to think of your libido as self-generating, you have tremendous power over the course of your sexuality throughout your life.

And just how do you do that? The book you're holding is a good start. You'll find plenty of suggestions and sources of additional information throughout the following chapters.

#  **Suggested Web Link**

THE CLITORIS.COM

www.the-clitoris.com

SOURCE OF QUOTE

Nancy Friday, interviewed on www.Power-Surge.com


Input: "Write a detailed chapter discussing the topic of orgasm in women. Start by emphasizing that orgasms can be had through self or partner play, and that there is no 'right' way to have an orgasm. Discuss the different ways women can enhance their orgasmic capacity, including tips and techniques. Mention the term 'Pillow Princess' and 'Do-Me Queen'. Discuss the issue of taking too long to reach orgasm and provide six specific techniques for coming more quickly or reliably. Discuss the concept of preorgasmia and anorgasmia, and provide suggestions for women who may be struggling to orgasm. Discuss the effects of Viagra on women and whether or not it is recommended. Finally, discuss the different ways women can reach orgasm, including through clitoral stimulation, penetration, nipple play, fantasy, and other intense sensations such as pain. Provide examples of different orgasmic experiences and emphasize that all experiences are valid."

Response:
_**chapter four**_

**Orgasm**

_Orgasm is leaving my body and coming back anew_.

SO, ORGASMS! You can have orgasm-directed sex by yourself or with a partner. If it's all about getting off, that's fine. You can also have sex without orgasm, and that's fine, too. Most of us want that release of coming.

Many women are completely happy with our orgasmic capacity. Others want to come harder, quicker, longer, more easily, more often, more transcendently, or more meaningfully. You may wonder if you're doing it "right"—and you may have had lovers who pressured you to respond differently than was natural for you.

You _can_ enhance your capacity for orgasm—and you'll find plenty of tips and techniques throughout this book to help you do just that. In fact, here's the first one: _You're fine just the way you are._ Even if you've never had an orgasm, you're not defective in any way. Your experience of sexual pleasure is uniquely yours and no less valid than anyone else's. Sex is not a competitive sport.

_I would love to be able to have an orgasm more easily than I do. But when I have them they are incredibly intense._

Do you start coming as the first drop of moisture hits your panties? Perhaps you come ten seconds after the vibrator touches your clit, and you don't feel complete until you've come nonstop for an hour. Good for you.

_I orgasm and cum very easily. Just the brush of a woman's wet tongue on my clitoris causes me to orgasm._

_I can come every few minutes for several hours._

Does the term _Pillow Princess_ ring a bell? Or _Do-Me Queen_? So what if you don't consider one or two (or three or four or five) orgasms sufficient? Even if every dyke you've ever loved has had to seek medical intervention for repetitive stress injury, there's nothing wrong with you. How much pleasure is too much? It's _your_ call. (You can enjoy yourself indefinitely without stressing your partner—see below.)

#  **This Is Taking Too Long**

Perhaps your partners have complained that you're a "hard come," taking too long to reach orgasm. Too long for whom? If it takes 30 minutes of perfect clit stimulation, with just the right touch in just the right spot, for you to reach orgasm, you're fine. Enjoy the attention.

If you'd like to come more quickly or reliably, however, here are six specific techniques you might try:

• Experiment with different positions or activities. Switch from oral sex to penetration or clitoral stimulation. Get on top. Find out what works for you.

• Make sure you're really turned on before you even _think_ of attempting to come. Human sexual response isn't linear. Back off, do something else, and then come back to your arousal.

• Buy a vibrator. Many women find the strong, consistent stimulation of a vibrator to be the surefire aid to achieving orgasm.

• Touch yourself. Play with your clit while your girl's going down on you, while she's penetrating you, even while she's touching you.

• Breathe into your pelvis, move your pelvis, don't clench—let go.

• Fantasize. What are the images or scenarios that make you sizzle? It's OK to fantasize during partner sex. You can invite your partner into your fantasy, too—tell her a story as she reaches for your clit.

If you come only by your own hand or vibrator, you're no less a sexual partner. You can incorporate masturbation into partner sex in a way that will be incredibly hot for both you and your partner. You'll find suggestions throughout the book for what to do when your lover's tongue or hands—or even her strap-on—get tired. (These will also help out with your partner's fatigue and that pesky repetitive stress problem.)

_I need my vibrator; it's very difficult for me to come by any other method. I can have an orgasm from oral sex, but it's hard for my girlfriend to keep up the constant, unchanging stimulation that I need. I need repetitive movements, and it takes a while._

If you don't happen to have an earth-shattering orgasm every time your girlfriend makes love to you, it doesn't mean that she's a bad lover or that you've fallen out of love. It may be that you're just not getting the right stimulation to send you over the edge. You may be too stressed. You may not know your partner well enough, trust her enough, trust _yourself_ enough, or feel safe enough to give it up in that moment. Just how vulnerable you care to be varies from day to day.

_I don't always have the most intense orgasms that I know I can have. It depends on my psychological readiness to be thoroughly opened._

Orgasm is about pleasure. It's not about your girlfriend's reputation or bedpost notches—that's _her_ problem. That she may be gratified by your coming is great—but it's not the point for you.

However you come, how easily, how hard, how often, you have a sexuality that's yours and yours alone. You're not broken, gluttonous, selfish, oversexed, defective, or perverted (unless thinking of yourself in these terms turns you on). You needn't compare yourself to some mythic example of sapphic perfection.

#  **If You Can't Have an Orgasm**

If you've never had an orgasm, or aren't sure if you've had an orgasm, you may be preorgasmic, a term that presumes that you _can_ become orgasmic. (See chapter 6,  Masturbation, for suggestions on learning to orgasm.) There are many reasons why you may never have had an orgasm or may find it very difficult to reach orgasm. Chief among them are lack of information about your body and sexual response, dissociation, and trauma from sexual abuse.

You may be _anorgasmic_ (not having orgasms) for physiological reasons. These include a range of health conditions—and the medications used to treat them. Depression and antidepressants are notorious for wreaking havoc on one's ability to come. Even the hormonal changes of pregnancy and menopause can affect orgasm. (See chapter 3, Anatomy and Sexual Response.)

You may wonder if you'll ever get your sexual response back.

Most likely you _will_ regain your capacity for pleasure and orgasm. In the meantime, take the advice given to the woman who has never had an orgasm. Go back to the beginning. Grab your lube, your favorite vibrator, unplug the phone, prop your beautiful self up on some pillows, and pretend you are masturbating for your very first time.

#  **Does Viagra Work for Women?**

In short, yes—for _some_ women and _one_ specific sexual function: physiological arousal. Drugs like Viagra, Levitra, and Cialis will not make you think sexy thoughts. You can take Viagra before the Big Date, but it won't restore the ongoing flow of erotic energy in your life.

Many women have tried Viagra and other drugs with much success. While Viagra (sildenafil) was developed to help men overcome erectile dysfunction, it's increasingly being taken by women.

Viagra works by increasing vasoactivity—that's blood flow. Blood flow leads to engorged tissues, which leads to clitoral erection, and voilà: physical arousal.

_I was so hot. I didn't realize I was that turned on, and then suddenly, my cunt was so open my partner fit her whole hand inside me right away. Then she put a huge butt plug up my ass. And this was without much in the way of a warm-up._

_I hadn't had a real orgasm in months (I'm on Effexor), but I found myself coming and coming and I couldn't stop._

This is pure physiology in action.

Should you try Viagra? Naturally there is a raging debate on this one, with medical researchers, sex educators, women's health activists, and pharmaceutical companies all taking positions on whether or not female sexuality can (or should) be aided by the little blue pill.

Viagra will not revolutionize your orgasms. It may offer you pleasure—and that, in itself, is worth a lot, especially to a woman who may not have been experiencing much between the sheets lately.

Make sure to consult with a health-care provider—one who's actually seen you (not just processed your Internet order)—to find out if such medications are safe for you.

#  **How Do You Come?**

_I continue to have better orgasms as I get older. In my 20s, I rarely had a vaginal orgasm, and my clitoral orgasms were fine, but not as yummy as now._

How do you reach orgasm? Women come from all sorts of stimulation. Most women require clitoral stimulation to reach orgasm—from vibrators, fingers, tongues, or surfaces to rub up against.

Many women find nothing sends them into orbit quite like a tongue and lips licking, sucking, and nibbling on their clit. For others, oral sex is just not intense enough to bring them to orgasm.

_The tried-and-true tongue-to-clit method is still the only thing besides my Hitachi Magic Wand that never fails to bring me to orgasm._

Many women come from penetration—either vaginal or anal—without any clitoral stimulation at all.

_The first time I came with a partner, it was a vaginal orgasm—my girlfriend was finger-fucking me. That's still how I come best, and I can have many, many orgasms in a row that way._

Others find their orgasms are intensified when clitoral stimulation is combined with penetration, either vaginal or anal.

_I don't come without clitoral stimulation. But when vaginal penetration is added, it's like a deeper experience; it reaches into my insides and clenches me with intense pleasure._

Different kinds of stimulation produce difference experiences of orgasm. Some women make clear distinctions between the orgasms they experience from clitoral stimulation versus penetration.

_Vaginal orgasms feel as if they happen deeper in my body; they feel more like contractions. A clitoral orgasm is sharper, more like an intense tingling that spreads over my body. I'm multiorgasmic, and I need one of each to feel really satisfied._

Some women reach orgasm with sufficient attention to their nipples. Others come from fantasy and mental stimulation. Tantra practitioners move erotic energy through their bodies, experiencing energy or whole-body orgasms.

_I have very intense concentration and my mind becomes my orgasm. I can ride it for a fairly long time._

Some women come from pain and other intense sensations of S/M play—and some tops are known to come simply from administering to their bottoms.

_My favorite way to come is from caning someone. We don't need any other contact but the cane with her ass, to make me come—if I can hurt her enough. I come from doing, rather than from being done._

_I can come from pain. From clitoral stimulation. From hard fucking or fisting. I can come just from having my nipples pinched hard. I can come from sufficient mental stimulation with no body contact._

#  **Getting Her Off**

_I love orchestrating someone else's orgasm._

Rarely do sex guides give sufficient attention to the pleasures of facilitating another's orgasm. Discussions of orgasm are typically about getting them, not giving them. Yet getting a partner off is central to lesbian sex. It's thrilling to feel a woman come in your mouth, to find yourself gripped between her powerful thighs, or to feel her vaginal contractions clamp down on your hand.

_It is CRUCIAL that my mate has an orgasm—my jaw can lock up and I won't stop until I feel her body pop and her moans quicken and muffle and she tries to run away from me._

Taking turns pleasuring one another is a wonderful way to enjoy sex. But not all women have reciprocity as their goal. What if your partner doesn't want to have an orgasm? Does that mean she identifies as a "stone butch"? Maybe. Maybe not. Why not ask her? You can't predict gender identity by whether or not someone is orgasm-focused. See chapter 14, Gender (Not Destiny). It also doesn't necessarily mean she's shut down, self-hating, or unable to have orgasms.

Ask your partner how she feels about orgasm and what kinds of sexual attention she likes for herself. She may share with you profound feelings about her gender and sexuality. She may feel completely gratified by your sexual encounter. After your strap-on stud has finished riding you through more orgasms than you can count, she may simply be spent.

_Truly, all I care about is pleasing my femme. Sometimes I don't have any orgasms at all, and neither one of us feels that the session is missing anything. Now, if my girlfriend didn't have an orgasm, I imagine that we would feel differently. We have different sexual roles._

Your partner's experience of your orgasm isn't vicarious. Think of your partner's lips, hand, or pelvis as a conduit for sexual energy. As your body is humming with orgasm, your partner is riding that wave with you. She may indeed feel your orgasm from her heart to the bottom of her toes.

#  **Multiple Orgasms**

Women can and do have multiple orgasms. Which doesn't mean you _should_ have multiple orgasms or even that multiple orgasms are more satisfying than ordinary single orgasms.

_I'm not multiorgasmic and that's OK with me because the ones I already have nearly break the bank._

But many women do find that one orgasm leads to another, with very little time elapsing in between.

_After she fucks me really hard, if my partner goes back to my clitoris and plays roughly with it, I will usually orgasm again, and again, and again…._

Rather than relaxing into afterglow, these women go right back to the plateau stage and come over and over. Some women experience this as a series of smaller orgasms; others experience orgasms that increase in intensity and duration, leading up to a really big bang.

_Sometimes I have smaller orgasms before the big one. After the big one, I get ticklish and it's hard to be touched. But if my partner works past that point I have powerful orgasms over and over._

How do you achieve multiple orgasms? In _The Good Vibrations Guide to Sex,_ Cathy Winks and Anne Semans offer three rules for achieving multiple orgasms: "back off, breathe, and move." After you come, and your clit is too sensitive to touch, back off without entirely ceasing stimulation. Winks and Semans suggest switching to a lighter or less direct touch. Then, breathe. Breathing oxygenates your body and keeps the energy flowing. And move—move your pelvis, your legs, your feet. "Let the energy build back up in your genitals. Within a few minutes, excruciating overstimulation may well give way to excruciating pleasure…."1

_The only way I reach multiple orgasms is if my partner just doesn't stop when I tell her to. Then they're in rapid-fire succession._

#  **Tantra and Extended Orgasms**

You may experience extended orgasms, one long delicious coming that seems to last and last. Or you may ride the edge of the plateau almost indefinitely, without actually coming.

What if we viewed orgasm not as a peak (sharp rise, sharp drop) but as a wave or flow of sensation and energy? Margo Anand, author of the classic _The Art of Sexual Ecstasy: The Path of Sacred Sexuality for Western Lovers,_ suggests that instead of thinking of orgasm as an _explosion_ —sending energy outward—we think of it as an _implosion_ and redirect the energy upward and through the chakras, or energy centers, of the body.2

Mikaya Heart distinguishes between multiple and extended orgasms. In her book _When the Earth Moves: Women and Orgasm,_ she defines extended orgasm as a state of "continual sensation" that can last up to six hours, while multiple orgasms are discrete "ongoing individual orgasms with a break between each one, and then more stimulation to bring on the next one."3

You may experience energy orgasms or whole-body orgasms. "Many women think that if an orgasm doesn't feel like a clitoral orgasm, then it must not be an orgasm," writes Annie Sprinkle. "They are limiting themselves." 4

_Sometimes when I'm being fucked, I feel my head separate from my torso—and not in any sort of get-thee-to-therapy dissociative way, but rather in an ecstatic rush of sheer exquisite sensation._

Annie Sprinkle delineates seven different kinds of orgasms—among them, whole-body orgasms, energy orgasms, and "megagasms"—"the tsunami of all orgasms…an intense full body experience, a deeply emotional experience, and for some a deeply spiritual experience."5

Want to expand your experience of orgasm? Expand your attention. You may think that more attention to your pussy is the answer to improving your orgasmic capacity—and it well might be. But for an experience of orgasm that enlarges your entire understanding of sex, expand your awareness to include your whole body: cunt, torso, face, limbs, ass, muscles, organs, juices, and breath.

Especially breath. Tantra teachers and orgasm coaches all agree: Through conscious breathing practices, you can become aware of energy as it moves through your body. You can also become more aware of your sensations.

_Breathing deeply, allowing the breath in and out without pushing it, helps create a fuller sensation through my whole body._

Sensory awareness not only increases pleasure, but it helps you to know what's going on with you. Are you breathing? Rapidly? Shallowly? _At all?_

Do you contract your muscles as you approach orgasm? Try another strategy:

 _I prolong orgasm by relaxing and softening my muscles, which gives my orgasms a more sensuous quality. I get a suffusion of pleasure opening and expanding down my legs._

If you prefer the "big bang" to the continual wave, you might actually find extended or energy orgasms frustrating. But if you want to experience a long, unfolding ride, you may want to learn more about Tantric practices.

Body Electric is a great place to start. Celebrating the Body Electric for Women, a weekend-long workshop offered in several U.S. cities, includes instruction in breath, movement, and touch techniques. The Women's Sexuality Center in Southern California offers the Lesbian Tantra Weekend along with other courses. Well-known Tantra teachers like Jwala, Annie Sprinkle, and Barbara Carrellas also offer workshops in various locations.

Even if you don't live anywhere near a Tantra workshop (or the ones in your area are hopelessly heterosexual), you can learn some basic practices that you can apply to the sexual realm. Conscious breathing and sensory awareness are two practices taught by nearly every somatic discourse. Yoga instructors, Alexander Technique teachers, bodyworkers, and somatic healers all talk about breathing and sensation.

You can read about many aspects of conscious sex on www.Tantra.com—and search their directory for teachers and workshops near you. Books like _The Multi-Orgasmic Couple (_ written for heterosexuals) and _The Tao of Natural Breathing_ (exceptional on breathing; _not_ a good source of information on women's sexuality)  do an excellent job of presenting the Taoist principles underlying even the most Westernized applications of Tantra.

#  **Ejaculation**

_I like to ejaculate. I mean, I can really flood the bed._

Female ejaculate is produced in the paraurethral glands. Ejaculate isn't urine, though it may contain small traces of urine. The clear fluid may contain vaginal lubrication, cervical mucus, and fluid from the uterus, and has a similar chemical composition to male ejaculate (minus the sperm).

How much fluid is ejaculated varies from woman to woman. Some women spurt streams of ejaculate into the air. Others leave a pie-sized puddle on the sheets. The amount of lubrication we produce is quite individual and is affected by menstrual cycle, age, health conditions, and even medications like antihistamines.

A lot of women feel self-conscious about what they perceive to be peeing during sex, mistaking ejaculate for urine. You can reassure yourself by urinating before sex.

For some women, ejaculation precedes orgasm. They experience a gush of wetness right before orgasm. For others, ejaculation and orgasm are separate phenomena. Ejaculation may be experienced as a feeling of release with a nice big spray of come—but not the same level of intensity as other orgasms. This may or may not feel satisfying.

Some women like having sex with women who gush or ejaculate; others find it a big mess. Place a waterproof pad (you'll find them in the incontinence aisle of your local pharmacy) under a towel to protect your bed.

Much has been written lately about "G-spot orgasms"—orgasms resulting from G-spot stimulation and accompanied by ejaculation. Some women ejaculate with G-spot stimulation. Some ejaculate without any penetration at all. Others simply don't ejaculate.

How can you learn to ejaculate? You can explore your urethral sponge or G-spot with a firm, curved dildo or your fingers (particularly if you have long arms  or a short torso or are particularly flexible). Make sure you're well aroused. (One review of the scientific literature regarding female ejaculation, published in the _Archives of Sexual Behavior,_ cited "full tumescence" of the vagina as a requirement for ejaculation.)6 Insert your fingers or dildo, aiming for the front (anterior) wall of the vagina. Stroke this area with a "come hither" motion. If you use your fingers, you'll feel the difference in texture between this area, which is rough, and the rest of the vaginal walls, which are smooth. Some women like to stimulate the opening of the vagina just below the urethra. You can also press down on your pelvis with your free hand, applying pressure just above the pubic bone. Stimulate your G-spot until you feel intensely turned on and like you're about to pee. As you approach orgasm, push out, as if urinating. The stream you produce is ejaculate.

Check out the bibliography in chapter 19 for books, DVDs, and videos on G-spot stimulation and ejaculation.

_Please include something on the topic of female ejaculation. I had a horrible experience last year in a damn Ivy League graduate school (social work) class with a professor who, in a course on human behavior in the social environment, made a big deal about how teenage boys masturbate more and are more sexually aware than girls because they have visible results. I contacted her outside the class to cite some textual evidence on female ejaculation (rather than anecdotal evidence), and she basically dismissed it all with the valid point that there simply hasn't been enough research published on the matter. Why am I interested in this? Well, my lover is a kick-ass ejaculator. Not all the time, but on demand. If I ask her to squirt for me, it usually happens. It's quick, and quiet, and quite arousing. Just at the point of orgasm, she gets very wet, but not normal wet…more like water, and my hand gets kinda pruneish, like when I've been in the bath too long, and then it's a sudden_ O _, after which there's a big ole wet spot on the sheets. Love it. How she knew she could is beyond me…. We were talking once and she said very casually that she thought she could ejaculate, but that she'd been afraid of it, and always managed to hold back during orgasm. The next time we made love, I asked her if she would let it all out for me, and she did. Amazing._

#  **Suggested Web Links**

ANNIESPRINKLE.ORG(ASM)

www.anniesprinkle.org

BODY ELECTRIC

www.bodyelectric.org