A DISCUSSION WITH CHARMAINE BORG

Dr. Charmaine Borg  is a Maltese lecturer and researcher at the Department of Clinical Psychology and Psychopathology at the University of Groningen in Holland. Her research and scientific findings on sexual arousal have been exposed in newspapers and magazines all over the US, notably in TIME magazine.

How common is low sexual arousal in women?

Low sexual arousal is quite problematic to define. We have to disentangle the terms ‘desire’, ‘arousal’, ‘interest’ and ‘motivation’. These terms are intertwined and it’s difficult to separate them in the case of low sexual arousal. The terms ‘low sexual arousal’ and ‘low desire disorder’ have now been combined to form the umbrella term ‘low sexual arousal and desire disorder’, with all these different disorders under this heading. When we refer to sexual arousal disorder, this can mean absent or reduced interest in sexual activity, referring to both sexual activity or erotic thoughts. It could also be that the person’s partner would initiate contact but the person doesn’t feel responsive to it. This could be context-dependent or non-context dependent. If you have low sexual arousal with your partner but then you masturbate and have fantasies about your colleague from work, then this case is context-dependent since it’s only with the respective partner that one experiences low sexual-arousal. Therefore, one has to look at the relationship as this cannot be considered a disorder.

Above: Dr. Charmaine Borg

One has to also look at the social circumstances. If a person is going through a bad phase, then arousal suffers as well. If a person has children at home and doesn’t have the time for themselves to feel sexy, then that affects arousal and the responsiveness to having sex. This also changes with the phase of the menstrual cycle, and with increased age there is decreased sexual arousal. The use of a specific drug, such as anti-depressants, childbirth and sexual trauma as well as STIs can all lead to low sexual arousal. In ageing couples, for example, there isn’t anything that the woman can take instead of Viagra, and therefore it’s difficult for her to increase sexual arousal.

How do anxiety and disgust feature in low sexual arousal for women?

Disgust and sex are both basic and functional emotions. Without disgust, we’d be eating all kinds of toxic waste and thus we wouldn’t survive. Without sexuality, we wouldn’t procreate and so we also wouldn’t survive. Yet, even though they’re interlinked, they’re also extremely contradictory. The stimuli at the core of sexuality, such as vaginal fluid, sweat, body odour and semen, are extremely disgusting when taken out of their sexual context. I’ve also carried out a study involving women who suffer from vaginismus and dyspareunia to try to understand what the emotionality they have towards sexual stimuli is. Vaginismus is usually when women cannot have sexual intercourse and dyspareunia is when women can have sexual intercourse but which proves to be painful. I had placed the subjects of study in these two different groups. When I looked at their brain activity, both groups responded in the same manner to two penetration pictures as they responded to rotten tomatoes. They responded with the same brain activity map. The result was emotionality based on disgust, rather than any other negative emotion.

Anxiety and disgust correlate a bit more. They’re both negative emotions. If a person is disgusted, they’re also anxious. When people are anxious, they tend to be more hyper-vigilant and self-protective. If you’re hyper-vigilant and you’re placed in a sexual context, you tend to perceive more ambiguous cues and you start focusing on more negative details that can lead to difficulties in letting go, which leads to less lubrication and therefore increased friction; sex becomes painful. Women with vaginismus also experience implicit cognition where they start thinking that the penis is too large, that they’re then going to experience pain and that their vagina is going to rupture. This becomes a vicious downward spiral.

Why is disgust in sexual arousal more prevalent in women rather than men?

From an evolutionary perspective, the idea is that women tend to have a higher level of disgust than men. STIs are more easily contracted by women, not to mention increased chances of pregnancy and the demands that pregnancy carries with it. I’m also working on the theory that during the more pre-pubescent phases, children find that kind of contact disgusting. However, during puberty, it’s been found that testosterone increases and therefore sexual behaviour increases, and because of this, both fear and disgust decrease. Since testosterone is higher in men than in women, this could also answer the question as to why low sexual arousal is experienced much more by women than men. This is however a complicated study since testosterone is converted to other sex hormones, like oestrogen.

Does sexual disgust differ from dyspareunia and vaginismus?

Vaginismus is when you have muscle contraction in the pelvic area and the vagina flinches to a degree where there is no way you can insert a penis, a tampon or a finger. Therefore it’s also very difficult to assess women with vaginismus because they’ll suffer from a phobia or a panic attack if you try to test their contraction in their pelvic floor muscles. Dyspareunia is pain during sexual intercourse so even if these women manage to have sexual intercourse, it’s so painful, they cannot look forward to having sexual intercourse again. However, it may be difficult to disentangle one from the other as sometimes women with vaginismus don’t really experience this severe spasm and therefore, due to the nature of these problems it’s been decided that the two should be combined under the heading ‘sexual penetration disorders’. The difference is really in severity and this is also in line with my finding that women suffering from vaginismus suffer from higher disgust responsiveness.

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