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Sexual Satisfaction: All in Our Heads?

by Dr. Barb DePree MD

I saw a headline that irked me in’s Broadsheet a week or two ago. I couldn’t quite put my finger on why it bothered me until I wrote a post about the cancelation of the flibanserin project last week.

The headline was “Forget the pink pill, try a placebo.” The article opened by saying that “Researchers are desperate to discover ‘female Viagra,’ but Cindy Meston says sugar pills might hold the key.”

Meston, a clinical psychology professor at the University of Texas at Austin, co-authored a study, published in the Journal of Sexual Medicine. Reviewing data from an earlier clinical trial of a drug treatment for low sexual arousal, she noted that about one-third of the test subjects who were given a placebo instead of the actual drug reported they had more “satisfying sexual encounters” during their “treatment.”

The Broadsheet reporter takes these findings as “a reminder that in the rush to ‘treat’ female desire, there is one organ researchers can’t forget: the brain.”

That’s a conclusion I certainly agree with: Mindfulness influences our sexual behavior. More simply, when we think about sex, we have more sex.

So let me get back to what bothered me about that headline: Yes, the brain is a critical and often under-estimated part of women’s sexual response. But it doesn’t function alone. It requires and interacts with hormones, which trigger physical responses that depend on our circulatory systems and tissue health. And the brain functions within the context of our histories and cultures and relationships.

Suggesting that a placebo is the answer for every woman’s sexuality oversimplifies and trivializes the issue. (In most clinical studies, by the way, placebos get about the same 30-percent response rate, so this study isn’t remarkable by that measure.)

Meston herself isn’t proposing that placebos are the answer: “Expecting to get better and trying to find a solution to a sexual problem by participating in a study seems to make couples feel closer, communicate more, and even act differently towards each other during sexual encounters.”

That’s definitely the first step—to be intentional about taking control of and improving our own sexual experience, involving our partners when we can. Any pattern at all that helps to focus our attention will help—whether it’s a before-bed routine with a partner, a sensual lotion that’s part of our self-care, or even taking a sugar pill.

But if that’s not enough, it’s because while it’s in our heads, it’s also not in our heads.


  • FYI the Emotional Bliss vibrators that we carry @ MiddlesexMD have more intense vibrations than most of the vibrators. I recently had a patient with MS and on some meds that interfere with orgasm, she hadn’t had an orgasm in over 5 years. With use of Womolia vibator she was able to achieve an orgasm! She was quite pleased, me too.

    barbdepree on

  • My brain wants it, I want it. Sexual satisfaction is too ambiguous a term. I have closeness, sexy thoughts, someone to play with, sexual activity, all very satisfying, but no orgasm for months and months.
    I need a vibrator for that one I’d say. I just need to get a bit more money to afford a little buzz buddy, once I decide which one is going to suit me best.
    My MS has disconnected my brain and my clitoris. I’m hoping a vibe will make the connection for me.

    Kitty on

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