Berman Jennifer - For women only: a revolutionary guide to reclaiming your sex life

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Contents

To our parents:

our father for teaching us that nothing is impossible and our mother for empowering us to believe it to be true

A Note to Readers

This book is intended to help you improve your sexual health, but it is not a substitute for a physicians or psychotherapists advice and treatment. Please consult your own medical doctor or psychotherapist before embarking on any of these treatments.

Introduction

This is, at heart, a book about the female sexual response. We believe that what women and their partners learn here will eliminate much anguish and despair and help them enjoy more sexually satisfied lives. For Women Only also reflects the enormous change in the treatment of womens sexual problems in the last few years. Our book originally grew out of this exploding new field, and we are privileged to have played a part. Female sexual dysfunction is at last on the tablea recognized and often treatable disorder, which affects the general health and quality of life of millions of women around the world.

Since the first writing of this book, our efforts to help women with sexual dysfunction have taken us in exciting new directions. In March of 2004, Laura opened the Berman Center in Chicagoa comprehensive female sexual health and menopause management clinic. She and her staff offer women everything they need to overcome sexual dysfunction or explore alternative treatments for menopause. The spa-like environment houses physicians and therapists, as well as a nutritionist, yoga instructor, and gynecological physical therapist to treat the whole woman in a convenient, confidential setting. Laura is also a clinical assistant professor of obstetrics/gynecology and psychiatry at the Feinberg School of Medicine of Northwestern University.

Jennifer continues to serve as Director of the Female Sexual Medicine Center at UCLA and is a professor of urology there. The center employs the same mind-body approach to treat women with urologic and sexual function complaints since we opened it in 2001. Treatment focuses on hormonal management, pelvic floor rehabilitation and surgery. The information in this book is largely based on our work together at the UCLA center and, prior to that, when we were codirectors of the Womens Sexual Health Clinic at Boston University Medical Center, which is now closed. New research from Lauras work at the Berman Center and Jennifers continued research at UCLA have been added to bring the previous edition up-to-date.

As sisters, we have always believed that women could benefit from the same medical attention to sexual problems that was given to men. As an urologist, Jennifer has a structural understanding of what can underlie womens sexual complaints. As a therapist, Laura identifies the emotional and relationship factors that inevitably figure into the physical symptoms. Combined, they offer a more complete approach to treating womens sexual dysfunction than ever before.

We opened the doors of the Boston clinic in the summer of 1998 and have not caught our breath since. The clinic was among the first in the country to offer comprehensive treatment, both physiological and psychological, for women suffering from sexual dysfunction. Jennifer is continuing this important work at the Female Sexual Medicine Center at UCLA and Laura at the Berman Center in Chicago. We have made it clear from the beginning that while we could learn a tremendous amount from the treatment of male sexual dysfunction, we were not going to subscribe to the initial efforts of many physicians to define female impotence in masculine terms. We treat women with female sexual dysfunction in terms of four categorieshypoactive sexual desire disorder, sexual arousal disorder, orgasmic disorder, and sexual pain disordersas well as a wide variety of other problems. We offer sex therapy, couples therapy, educational counseling, medical treatment, and surgery. Laura also offers nutritional counseling, yoga and relaxation training, and gynecological physical therapy at her center in Chicago. We answer frequently asked questions: What is orgasm? How can I enhance my sex life? Am I normal? How can I get my partner to fulfill my sexual needs? Our work is exciting and rewarding. With new medical technology and medications as well as existing psychotherapy treatments, women now have more options than ever before.

Clearly, help is needed for women as much as men. Studies estimate that more than half the women over age 40 in the United States have sexual complaints. In early 1999, the National Health and Social Life Survey published in the Journal of the American Medical Association a report showing sexual problems to be even more widespread: the survey found that 43 percent of American women, young and old, suffer from some sexual dysfunctiona significantly higher percentage than that of men, who suffer at a rate of 31 percent.

And yet for most of this century doctors have dismissed womens sexual complaints as either psychological or emotional. In the nineteenth century, the Victorians believed that good women had no sexual desires at all. Even now, in our supposedly enlightened era, it is still shocking for us to hear how many doctors, female as well as male, tell their female patients that their problems are emotional, relational, or due to fatigue from child rearing or their busy jobs, and that they should take care of their problems on their own. Many doctors tell women that these are not real problems at all, just something to accept as a normal part of aging. This is particularly true of older women, although women of all ages have reported this to us.

We hope this book will continue to serve as an antidote to what women have heard for decades. The problem is not just in your head. You are not crazy, or alone, or fated never to have an orgasm or feel sexual again. Of course, we dont dismiss the importance of psychological factors. But in our experience with our patients, who come from all over the United States and the world, and from all age groups and cultural backgrounds, most problems tend to have both medical and emotional roots, and feed on each other. As at our centers, our goal in this comprehensive handbook on sexual health is to help the whole woman.

Even at the writing of this new edition, both of us feel that womens sexual complaints are still neglected by the medical establishment, and that many of the same health problems that cause erectile dysfunction in men, such as diabetes, high blood pressure, and high cholesterol, as well as many medications used to treat these conditions, can cause sexual dysfunction in women. Most women also experience diminished sexual responsiveness and loss of libido at the onset of menopause, and many have sexual complaints after hysterectomy or other pelvic surgery. Although drug companies have worked for years to treat male impotence, they are only just beginning to recognize female sexual dysfunction as a medical problem. Even female sexual anatomy is not completely known or understood. It was not until 1998 that an Australian urologist, Helen OConnell, discovered that the clitoris is twice as large and more complex than generally described in medical texts.