Recently, I joined with two colleagues to produce a “continuing medical education” unit for the American College of Obstetricians and Gynecologists (ACOG). Our topic was “Vibrators and Other Devices in Gynecologic Practices” (if you’re a health care practitioner, you can investigate the CME offer here).
I was joined by Mary Jo Rapini, a sex psychotherapist and long-time friend of MiddlesexMD, and Debra Wickman, a gynecologist who teaches at the Banner Good Samaritan Medical Center in Phoenix. We talked about a 2009 study in the Journal of Sexual Medicine that says that 52.5 percent of women have used a vibrator; that led us to talk about the roughly half who have not.
A number of myths might get in their way, and we hope we made some progress in busting them.
Myth #1: Vibrators are for people whose relationships are in trouble. Based on what the three of us have seen, the opposite is true. As Mary Jo explains, “Vibrators are for couples who want to explore, who want to try new things, who want to play and have fun in their sex life.” Couples who share that desire are typically interested, trusting, and care about each other.
Myth #2: Vibrators make it hard to have an orgasm any other way. I’m happy to debunk this one with a medical reality: As the muscles involved in orgasm grow stronger, orgasm becomes easier and more intense. Vibrators are good at stimulating—and they don’t get tired or fumble, as we sometimes do as we lose a little strength and dexterity. Staying sexually active with a vibrator will increase your responsiveness to manual stimulation—that’s just the way we work.
Myth #3: There’s something sinful about a vibrator. Again, it’s Mary Jo who addresses this most directly. She’s had a number of conversations with faith leaders on her patients’ behalf, when religious concerns weighed on their minds. The ministers she’s talked to are invariably in favor of keeping marriages strong, and maintaining physical intimacy is a natural part of those relationships.
Myth #4: Vibrators are only for self-stimulation. Vibrators are good for self-stimulation, and that’s a good option for women who want to maintain their sexual health when they’re without a partner. But they’re also part of intimacy for couples. They’re especially good for couples who see a need to slow down and spend more time in foreplay. Which, now that I think about it, could be any of us who’ve achieved midlife!
If you’re among those who haven’t tried a vibrator, I support your right to decide for yourself. Here’s hoping, though, that none of these myths is what’s standing in your way.
As we saw in the last post, vibrators were developed by doctors in the late 1800s to replace the “pelvic finger massage” they routinely administered to female patients. The massage was intended to relieve symptoms of “hysteria” or “neurasthenia,” such as anxiety, sleeplessness, and general malaise. Done successfully, it induced a “hysterical paroxysm,” which offered temporary relief to patients. By some estimates, over 75 percent of women suffered from these symptoms.
By the early 1900s, small electric vibrators had a comfy niche in middle-class homes right on the shelf between the toaster and the electric iron. At the time, they were perceived as medical devices that had nothing to do with sex.
The porn industry, however, was not so easily deluded. In the late 1920s, early porn films embraced the gadget for its own version of “doctor.” In this context, the “hysterical paroxysm” looked unmistakably like (gasp!) an orgasm. Once that connection was made, the veneer of the vibrator as a nonsexual treatment for a medical condition became uncomfortably hard to sustain, and the vibrator quietly disappeared from respectable society and doctors’ offices.
It became so utterly invisible, in fact, that in the 1970s only 1 percent of women had ever used one, according to the Hite Report, a famous study of female sexuality. “This was perhaps unsurprising, given that most vibrators by then were modeled on a very male notion of what a woman would want–a supersized phallus–replicating, in other words, the very anatomy whose shortcomings had precipitated the invention in the first place,” writes Decca Aitkenhead, in the Guardian.
At the heart of the matter was that:
Rachel Maines, author of The Technology of the Orgasm, the seminal work tracing the history of the vibrator, commented in an article in the Daily Beast, “In effect, doctors inherited the job of producing orgasm in women because it was a job nobody else wanted. The vibrator inherited the job when they got tired of it, too.”
That many women were not completely (or at all) satisfied by ordinary coitus was a source of confusion, frustration, and threat to some men. According to the Hite Report, most women can reach clitoral orgasm through masturbation. But the idea of women masturbating was also extremely threatening.
“I have read debates between doctors over whether women should be allowed to ride bicycles or whether the pleasure they might induce from the seat made it an unacceptable moral hazard,” writes Erik Loomis in “The Strange, Fascinating History of the Vibrator.”
Lest you think that we’ve evolved beyond these repressive and delusional ideas and that female sexuality is more acceptable today, think of the recent diatribe against a college student who spoke in favor of requiring health insurers to provide contraception. Or the statements alluding to “legitimate rape,” or the suggestion that a woman can’t get pregnant because her body “will shut the whole thing down.”
Have we really come all that far, Baby?
In any case, the discredited vibrator slunk back into view in the 1960s, first as a kinky sex toy and then as a symbol of women’s sexual liberation by feminists.
In a major national study of sexual behavior conducted in 2009, of over 2,000 women surveyed, 52.5 said they had used a vibrator.
If nothing else, the peculiar story of the vibrator should help us recognize how strongly we are influenced by cultural messages. A vibrator is not a medical device nor is it some unsavory symbol of sexual deficiency. For those of us who need extra stimulation to keep our sexual parts lubricated and functional, it’s just one important tool.
Just released on September 21, Hysteria is a light comedy about a dark and silly time. So touchy is its topic, in fact, that it took the producer, who is a woman, about ten years to find a studio willing to back the project. So unnerving is the topic that the author of the book on which the movie is based, who is also a woman, lost her job as an assistant professor when it was published.
Hysteria, the movie, and the book, titled The Technology of Orgasm by Rachel Maines, explore the modern history of the vibrator. And a surprising story it is. The movie, which stars Maggie Gyllenhaal and Hugh Dancy, approaches the topic with a comedic touch. It is described by Movieline.com as “spirited, a jaunty trifle that’s low on eroticism but high on cartoony coquettishness.”
But beneath the silliness—because, really, how else can this be portrayed?—lies the basically true story of the invention of the vibrator. The unnerving truth may be that the paternalistic and harebrained notions that led to the invention of the vibrator continue to entangle themselves in our “modern” cultural psyche. The movie, but more insistently the book, raises some instructive and faintly unsavory questions about embedded cultural expectations regarding women and sex.
First, we’ll look at the vibrator story, and then, in a future post, we’ll explore the cultural attitudes lurking beneath.
If you’ve ever read novels from the late 1800s—the Victorian period in England—such as those by Jane Austen or the Brontë sisters or Edith Wharton in New York, you may have noticed a certain… reticence… a naiveté, an innocence about sexual matters. “Making love” in these novels refers to the most innocuous verbal expressions of admiration. Respectable women were corseted, cosseted, and shielded from turbulence of any sort. The preoccupation of a young woman was to attract a suitable match, and having done so, she was to run an efficient household and be an asset to her husband. Little was heard of her henceforth.
Having read many of these novels, I’ve often wondered how children were ever conceived.
So I was amazed to discover that these same respectable Victorian women were prescribed a very unusual medical procedure by their doctors to alleviate emotional afflictions, which were diagnosed generally as “hysteria” or “neurasthenia.” Symptoms ranged from anxiety and nervousness to headache and sleeping difficulty to abdominal “heaviness.”
A procedure that seemed to temporarily relieve these symptoms was known as a “pelvic finger massage,” typically administered by those very proper doctors. The goal of this treatment was to induce a “hysterical paroxysm.”
So—to put it in contemporary terms—doctors were masturbating their female patients to orgasm in order to relieve the sexual (and other) frustrations that women in this era commonly experienced. And this in a culture that viewed a glimpse of ankle as risqué.
“It's very difficult to imagine that 100 years ago women didn't have the vote, yet they were going to a doctor's office to get masturbated,” said Gyllenhaal in an interview with the UK’s Guardian.
At the time, however, the procedure wasn’t thought to be sexual. In fact, doctors considered it routine, tedious, and boring.
“Annoyed doctors complained that it took women forever to achieve this relief,” writes Eric Loomis in “The Strange, Fascinating History of the Vibrator.” Yet, since repeat business was virtually assured, doctors weren’t complaining about the steady income.
So, they invented a machine to do it for them. Thus the vibrator was born.
Early models ranged from comic to frightening. A steam-powered vibrator called the Manipulator, invented by an American doctor in 1869, required the patient to lie on a table with a cutout at the business end. A moving rod was powered by the steam engine in another room.
Lack of mobility was a problem with this contraption—a doctor was committed to a large, stationary object that consumed two rooms. And if the engine was coal-powered, who did the shoveling?
The next model was electric, and the battery only weighed 40 pounds. This was developed by Dr. J. Mortimer Granville, our erstwhile hero in the movie Hysteria. So it was that the vibrator predated the invention of the vacuum cleaner or the electric iron by over a decade. I ask you, where are our priorities, ladies?
Despite their size and lack of attention to attractive design, the things worked. From over an hour of manual manipulation, a woman could now reach “paroxysm” in five minutes.
But progress marches on, and by the turn of the last century, more domestic households had electricity, and vibrators had become small, portable, and widely available. Reputable magazines and catalogs sold them alongside the toaster and the eggbeater. A woman could buy a “massager” for what a few visits to the doctor cost, and thus the medical profession lost its cash cow.
Advertisements in magazines like Women’s Home Companion, Sears & Roebuck, and Good Housekeeping promised that “all the pleasures of youth… will throb within you” and “it can be applied more rapidly, uniformly and deeply than by hand and for as long a period as may be desired.”
It beggars the imagination to believe that no one through all these decades considered that massaging a woman’s genitals had anything to do with sex. And in fact, the Guardian article states, “Despite the lack of evidence to suggest otherwise, it seems unlikely [that women really did not know what they were buying]–and the manufacturers surely knew what they were selling.”
This level of schizophrenia is the vexing conundrum at the heart of the vibrator phenomenon.
In a future post, we’ll explore the more recent history of the vibrator and the questions suggested by this massive blind spot.
I get occasional questions about erotic use of various household objects. I am, after all, long trained as a physician, so safety and hygiene are among my first concerns. And, since starting MiddlesexMD, I've seen some very well designed vibrators, dilators, and dildos that I know are safe, easy to clean, and designed specifically for older women's pleasure.
That said, I encourage women and their partners to be playful. These are the things I would look for to be safe: Are there sharp edges, seams that might pinch, protrusions that might surprise you? Can you clean the material thoroughly—before and after use? Is it compatible with any lubricants you might use? And, less clinical but just as important, will it make you feel like a valuable, sexually alive person?
With those cautions, have fun exploring.
I'm glad to hear that a vibrator has been helpful to you! Women our age often need extra stimulation for arousal and orgasm, and many find that a vibrator provides just what they need. If you're looking for more, here are some things you might consider:
Thyroid disorders are not typically a significant factor for libido or orgasm. A bigger issue is expectations: The majority (probably at least 80 percent) of women cannot have and never have had an orgasm with intercourse alone. Most women need more direct stimulation. As we get older and in the absence of estrogen, having an orgasm without direct stimulation becomes even more difficult. It may not be realistic to expect to have an orgasm with intercourse or penetration.
A vibrator can be a great addition for that direct stimulation. You might want to try one with a warming lubricant, and see what happens! The Gigi2, Liv2, and Siri2 are three options we have offered at MiddlesexMD that have more intense stimulation than some others on the market. I have seen some amazing results from women who hadn’t had an orgasm in years because of medications that interfere with orgasm or medical conditions that make orgasm more difficult. They were successful using these products, so give it a try and good luck!
Urinary incontinence for women is usually classified as "stress incontinence" or "urge incontinence." Losing bladder control during sexual stimulation is most likely urge incontinence: The stimulation of the area nerves causes the urge to urinate and then contraction of bladder muscles (for some women it's just a strong urge, for others it's actual leaking).
While it poses no risk to you or your partner, it is definitely undesirable! Make sure to empty your bladder just before sexual activity. See your doctor to rule out a bladder infection. Performing regular Kegel exercises may be of benefit. The type, duration, and location of stimulation may influence the urge; more practice may help you better understand cause and effect. Certain positions may decrease leakage (for example, woman on top or side-lying position).
There are medications for urge incontinence that could be trialed just before having sex. Taken 10-60 minutes before sex play, the medication can decrease the urgency sensation and actual loss of urine.
This issue can really interfere with sexual expression, so addressing it sooner than later is important. See your gynecologist or urologist to further discuss which of these options are best suited to you based on your medical history.
Hi everybody. My name is Julie. I’m a writer here at MiddlesexMD. My credentials for writing about sex at midlife are… Well… I have reached midlife. And I enjoy sex.
Despite almost 30 years of togetherness with the same guy. Despite aches and pains, stress and too little time, and all the physical surprises of menopause. Despite all of that, we are nowhere near ready to hang up our sheets.
So when my own friend (we served undergraduate years together) and doctor (my own menopause doctor, because I’m lucky), Dr. Barb, asked me to help her develop her website, I jumped at the chance. I needed to learn about this myself. What better way?
I’ve been writing for years and years, and for many years researching and writing on health topics. But I have never written about sexual health. Barb is teaching me—you would not believe the size and density of these textbooks.
So, day one, lesson one, Basson’s Model. I had no idea that there is a difference between Sexual Desire and Sexual Arousal. I really always thought they were the same thing, or flip sides of the same impulse, or something. Because that’s the way I’d experienced it for most of my life. Arousal and Desire arrived on my doorstep, it seemed, instantaneously.
But they are considered distinct aspects of the sexual experience. And now that menopause has slowed me down a bit, I understand better.
We can achieve arousal with or without desire. We can have comfortable, enjoyable, emotionally satisfying sex with or without desire. That is, we need arousal for sex. But we don’t need desire. We like it. We want it. We enjoy it. But we don’t need it to engage in sex or get a lot out of our sexual experiences.
The easiest way for me to tease these ideas apart is this way: Desire happens in your head. It’s an idea. Arousal happens all over. It’s physical. Certainly the idea can spark a physical response. But it works the other way more often for women. Sexual stimuli—physical sensations, emotional feelings, sights, sounds, smells—arouse us physically. Our arousal readies our bodies for sex and can breed desire.
So, when we start talking about the kinds of sexual problems women may experience with menopause, the distinction becomes very important. Are we having difficulty with arousal or with desire? Or both?
What used to follow automatically from sexual stimuli—the arousal part—may now take more time and more stimulation. We may have to ask for and give ourselves more help and support to become aroused. This isn’t a lack of desire, but a greater need for stimulation.
We may be receiving all the same sexual stimuli that we always have, that always worked before, but we don’t respond to it as readily. We love our partners just as much or more. But our bodies just don't respond as quickly now. Or we may now have physical or emotional limitations or illness or medications that muffle the effect of sexual stimulation.
This was lesson one for me. A real eye opener. I used to worry that I didn't feel the same desire as I did when I was in my 20s and 30s. Worry isn't the word. It upset me. I am much more relaxed about it now. I'm learning to tune in to stimulation, to appreciate and notice my body's response more. And that helps a lot. Well, I suppose writing about sex every day doesn't hurt either...
There have been and will be many more lessons. Some embarrassingly basic. Some I wish I’d known 30 years ago. I will always be willing to show my ignorance in these matters, followed by Dr. Barb’s patient teachings.
Meantime, I’m gathering up all my favorite stimulants: I’m with Reka, a visitor from the last post, on the potency of Dr. Gregory House. And Dr. Andrew Weil too (his relaxation tapes have an opposite, unadvertised effect on me). I have a thing for David Strathairn. Indian food. Tango/dance movies. And I have this special drawer in my bedroom…. And you? Care to share?
(Anonymous sharing is always welcome. Or make up a name, if you like!)