Orgasm Problems, Desire and Sex Points with Dr. Bat Sheva Marcus

“Orgasm Problems, Female Desire and Sex Points with Dr. Bat Sheva Marcus”

a lightly edited Girl Boner Radio episode transcript

August (narration):

Dr. Bat Sheva Marcus told me that she learned basically nothing about sex early on—but she was always really interested the topic. She told me a funny story about one of the few times sex came up in her family.

Dr. Marcus:

So my father was this biochemist who always was trying to explain science. My younger brother—so he was about five years younger than me—so maybe I was 15, and he was 10. So something about a sperm and an egg, cuz that my father was very clear about. We understood that chromosomes, those things were important. 

August (narration):

So she and her dad and her brother were walking across the street on their way to a swimming club. 

Dr. Marcus:

And my 10-year-old brother says, “Yeah, but I don’t understand. How does the egg and the sperm get together?” 

August (narration):

Bat Sheva said she can still see her father’s face when he heard that: how do the sperm and egg get together? 

Dr. Marcus:

He was like, he was like a deer in headlights. And he said, “Oh, you could kind of figure it out. Think like two test tubes. How would you get one product into another product? 

That is literally what my father said. I’m standing there going, I cannot believe I’m hearing. 

That night I kind of went to my brother’s room. I said, “Listen, let me tell you how sperm gets its egg.” 

That is like a classic of my parents. I knew nothing. I had to look everything up in books, which I did. There wasn’t even internet when I was growing up cause I’m such a freaking old lady. 

August (narration):

Dr. Marcus also grew up in a pretty traditional Jewish Orthodox family. 

Dr. Marcus:

Sex education in general sucks. Like, we just do a terrible job the United States, but in the religious communities it’s even worse, because it comes with all this crazy mythology. 

August (narration):

When I interviewed Dr. Marcus for my Girl Boner book, she shared some of the myths that are prevalent in Orthodox Jewish communities. 

There’s a huge fixation on avoiding “spilling the seed,” or sperm, only ever from a penis into a vagina. So many Orthodox couples think the only sex they can have is intercourse. There’s also a big lack of focus, or even acknowledgment, of female pleasure.

Limiting messages like these are probably why she had some…interesting beliefs about sex and procreation as a kid. More recently, told me another story about something that happened when she was in the fifth grade.

Dr. Marcus:

I was in Bible class, because we went to a religious school and a big chunk of our day was like Bible and prophets, all that stuff. We’re reading an original text. 

August (narration):

And it had to do with somebody getting pregnant. 

She told me that Bibles could make pretty great sex education, since it has so much sex in it, but they skip those parts in schools. 

Dr. Marcus:

Anyway, the teacher says, “so you know you guys all go and have to get pregnant,” and she just keeps going. And I raised my hand and I said, “Yeah, this is what my Dad told me. You pray to God, right? You pray to God and you get pregnant.” 

Okay, there’s a part of me that thinks that that’s a little bit true. There is an X factor that is not always so explainable. But having said that, that’s not how you get pregnant. 

August (narration):

So there’s little Bat Sheva sitting in class, offering what she really thought was how babies are made, when the girl behind her starts laughing her head off.

Dr. Marcus:

Myra Brodsky, I still remember her name. And I was like so embarrassed. And then at recess, Myra Brodsky set me straight.

August (narration):

And that is how she learned how babies are really made. From there, she continued to talk to friends and read all of the books she could to learn factual information about sex. 

Years later, the Myra Brodsky story sort of picked up again in her own family.

Dr. Marcus:

I was at the dinner table one night, and I was telling this story to some friends. And my daughter, who was 12 at the time, looks up and goes, “Oh, my God.” She said, “I think I was just somebody else’s Myra Brodsky.” 

Somebody else had said something to them that was just absurd and she was like, “No, no, no, no. This is how you have a baby.”

August (narration):

And no, she didn’t suggest prayers. In true Myra Brodksy form, she shared the scientific truth, because her mother, Dr. Marcus, broke that cycle of silence around sex and the body with her kids.

Dr. Marcus is now a veteran sex therapist who has treated women of all ages. She’s the founder and director of Maze Women’s Sexual Health center, holds a PhD in human sexuality and has been nicknamed the “Queen of Vibrators” and the “Orthodox Sex Guru.”

Throughout her work in sexuality, she has bumped up against this myth almost daily: “that all great sex comes naturally and effortlessly, and by extension, that when it doesn’t, something is wrong with you.” To which she’s known to say, “Give me a break.”

Her new book, Sex Points: Reclaim Your Sex Life with the Revolutionary Multi-Point System, aims to help women women analyze and improve the complex variables at work in their sex lives—with advice rooted in science and practicality, and none of the “just wear lingerie” or “have a glass of wine” type advice women often hear.

While Sex Points is geared toward cisgender women, she believes it can benefit most anyone who’s struggling with sexual conundrums – whether your’e male, female or nonbinary and whether you’re in a monogamous or non-monogamous relationship or single. One of her core beliefs is that better sex is always possible.

[a few bars of upbeat music]

August:

In your new book, you talk about the physical and the emotional and how complicated that blend is for great sex. And you’re also so encouraging of good sex being possible for everyone.Why do we need to understand that complicated blend in order to have a good sex life?

Dr. Marcus:

I think the same way we’ve had crappy sex education, we’re living in this myth that our sex life is all based on what people call psychology, our relationship and how we feel about ourselves and our body and shame and how we feel about partners. 

And all that stuff is super, super important. But I think it misses an entire element. We’re also very much a product of our physiology, right? Of our hormone levels, the medications, birth control pills, other kinds of medications we may be getting on, anti-anxiety medications…

August (narration):

…how much sleep we’re getting, how we’re eating… All of those things, she said, have a huge impact on our sexual function and our interest in sex. One thing we very often miss, at least in adulthood, is the impact of hormones.

Dr. Marcus:

It’s so interesting. I feel like pre-COVID, when we could go to the movies, if you saw two 17-year-olds sort of standing in a movie line and they couldn’t keep their hands off each other, your first reaction would not be Oh my god, they must have had this really deep, meaningful conversation. He must have sent her really beautiful flowers. Your first reaction would be the hormones are raging.  And yet, somehow, as we get older in our 30s, in our 40s, in our 50s that’s all discounted, and people are just always, “oh, it’s all about the relationship. It’s all about the communication.”

August (narration):

She said that’s such an outdated way of thinking. While relationships and communication are hugely important, Dr. Marcus told me that focusing only there is such an outdated way of thinking. In Sex Points, she breaks down the many different factors that can impact our sexuality, including medications that may hurt or help—such as birth control pills.

August:

I’ve heard from many people who’ve said that birth control made their sex drive lower. And when they told their doctor, their doctor was like, “Oh, that’s not a side effect.” And they’re like, “Well, I’m experiencing this side effect.” 

Dr. Marcus:

One piece of this is women learning to trust themselves. And they’re being told constantly by doctors that it’s in their head. I don’t blame doctors exactly... They’ve trained to basically if they see something then that’s great and they fix it. And if they don’t see something or they don’t understand something, they never say, “I don’t know.”

August (narration):

Instead, she said, they often say in some way, “it must be psychological.”

Dr. Marcus told me she doesn’t want to come across as anti-birth control pills. She knows they’re incredibly helpful to many folks.

Dr. Marcus:

But I feel like people have to be honest. They can do a huge number on your vulva and your vagina. Your both your vagina are extremely hormonal-mediated, like they’re very sensitive. 

So, a lot of women start with pain and have that same story. And the doctors are like, “Oh, no, not that birth control pill.” Yes, if that’s bothering you, then you know what’s going on.

August (narration):

Depressive moods, sometimes severe ones, and reduced sex drive are also potential side effects of the pill. But like all medications, they affect people differently.

Dr. Marcus:

Now some people say their desire is better on the pill because they’re not worried about getting pregnant and they don’t have to think about those things. We have to be able to respond individually to women that way. 

It’s really time that people understood this idea that your sex life is not working just the way you want it—it isn’t because one thing is off. We want to look at a host of things and try to get you points in each of these areas so that you can hit a certain point threshold and have rockin’ sex. 

August (narration):

Those points she mentioned are a system she walks readers through in her book. She breaks down things like age, hormone levels, medications, relationships and more to help you see which areas of your life and health are helping or hurting your sex life. And she gives you resources for increasing your points in practical ways. 

Dr. Marcus speaks about challenges in this realm from professional and personal experience. I told her that my heart skipped a beat when read that at a certain point, her orgasms stopped. She went from really wonderful, pleasurable, orgasmic sex to being unable to experience climax at all. 

Dr. Marcus:

There were actually two times in my life when I, quote unquote, “lost my orgasm.” And I learned so many lessons from it. 

August (narration):

The first time, she wasn’t a sex therapist yet. She’d been dealing with a lot of anxiety issues and had started taking the SSRI medication, Prozac, which was brand new on the market.

Dr. Marcus:

I loved Prozac. Prozac made me feel like a person for the first time in my life. And then all of a sudden, I couldn’t have orgasms. And I went down that rabbit hole, that classic rabbit hole, oh my god, it must be my relationship. And we were a young family with little kids. And there’s always stress in a relationship. 

And so by accident, I asked the psychiatrist, “Couldn’t be related, right?” And the psychiatrist was like, “oh yeah.”

August (narration):

“Oh yeah.” The psychiatrist said that Prozac totally was related. 

In fact, sexual issues are one of many possible side effects of SSRIs. One study showed that 42% of cisgender women taking these medications reported struggling to have orgasms. SSRIs can also cause arousal and desire issues.

Dr. Marcus:

And that goes back to that birth control conversation that our medical providers need to be more clear about what side effects are. 

So that was the first time and honestly a vibrator saved my life.

August (narration):

So many benefits of vibrators. The second time she lost the ability to experience orgasms she was in her early 50s, so six or seven years ago. She told me that this story is embarrassing to tell, but I think it’s also an important one. At the time, she said she was “clumsily heading into menopause” and unlike with Prozac, which stopped her orgasms suddenly, these challenges cropped up gradually.

Dr. Marcus:

They got weaker. They got harder to have. They showed up sometimes. And I was like, what am I doing wrong? Like, I’m a sex therapist; I should know better than this. 

August (narration):

Dr. Marcus knew to slow down and take her time to get turned on before penetration. She tried that, and fantasizing more. But none of these efforts were working.

Dr. Marcus:

I’m like taking longer, fantasizing more. I’m doing stuff. And then it’s only hit me that it was my testosterone level that had dropped. 

August (narration):

Starting on testosterone brought her orgasms back.

That’s a common issue for many folks, of all sexes and genders. Low estrogen, low testosterone or both can cause drops in desire and other changes that can make sex less fun or appealing – such as vaginal dryness and irritation and fatigue.

Dr. Marcus:

…and that just goes back again to our idea that everything is going to be psychological when there’s such a physiological piece. 

August (narration):

Dr. Marcus said she completely understand why so many people fear menopause and the impact that aging may have on our sex lives. But she also wants us all to know that, regardless of our own particulars, there’s so much hope to be had.

Dr. Marcus:

I totally get the scariness of it because things do get very challenging at different times in people’s lives. Every different stage in life there is just other challenges, other road bumps, and that’s fine if we realize that our sex life is not gonna be like smooth sailing, it progresses and changes, then you can deal with everything. 

This myth that, you know, you stop having decent sex after you hit 40, it’s so sad. And it doesn’t have to be the case, as long as you’re willing to put some work into it. It may be that’s easier to have a sex life in your 20s but honestly that’s not even true because a lot of women have pain in their 20s, and then in 30s, sometimes women have babies. There are challenges at every single stage of your sex life, but the good news is, if you go in knowing that, they’re almost always fixable.

August (narration):

In a chapter of Sex Points about feeling less turned on or excited when years have passed in a long-term, monogamous relationship, Dr. Marcus explores the idea of affairs and points out how they can really juice things up in the bedroom. She wrote, “When you have an affair, you have a new person to fantasize about and that new person likes new and different things and introduces you to new and different things, suggests things you didn’t consider, encourages your o explore parts of yourself that until now you haven’t explored.”

But of course, she adds, affairs are a breach of trust that risk your relationship. They’re unethical, incredibly time consuming, and often go from “heady days of high sex drive” to a “crash or careen into serious depression, anger” and irreparable damage. 

A far better alternative, she said, is having an affair without having an affair. Basically fantasize about having one. You could do so by reading erotica or coming up with your own spicy story…or making a point of imaging yourself having sex with some hot person you’re attracted to.

This can be especially important for women, she said, who are less likely to allow themselves to freely fantasize. 

Dr. Marcus:

 There’s a lot of pieces to this. One is that we would love to believe that women do great with monogamy. And that has not been my experience, and then there is data that suggests that that is not the case, right? 

And I think culturally, we love the idea of “women are fine with monogamy. They’re just great.” And in my experience, the most interesting thing happens is that men whine about monogamy, right? Men who are choose to be in monogamous relationships kind of whine about it, complain about it, make jokes about it, and then are actually not too unhappy having sex with the same person for long term, maybe because they’re willing to fantasize or flirt or play around in their brains more. 

Women, on the other hand, feel so guilty about not wanting their partner, their regular partner, but really wanting the fireman that I think they just shut down. 

August (narration):

A lot of that data she mentioned was gathered by sexuality researcher Dr. Meredith Chivers. 

There are lots of theories on why women may be less happy with monogamy than men, and I thought Dr. Marcus raised an important and interesting one there. 

I personally think that barriers that keep women from feeling connecting to our own sexuality is huge reason we may feel the need for the added bursts of brain chemicals that come from novel experiences, such as a new partner. Women still do most domestic work and emotional labor at home, for example, and receive so many harmful messages about needing to be “pure” or sexual in particular kinds of ways, which fuel sexual shame. We’re also more prone to stress, anxiety and depression than men; so are LGBTQIA+ folks. There are many ways to kick those feel-good chemicals up, thankfully—whether we want multiple partners or not. 

Although side note, let’s also create a better world for us all.

After interviewing Dr. Marcus, I asked my mailing list in a survey about their own relationship to fantasies… about 60% of people who responded said they fully embrace fantasies. Nearly 40% said they’ve struggled at times to do so. And most of those who said they struggle identify as female.

Dr. Marcus:

We’re in a society, August, that we walk that line between what a fantasy is and reality. Where did that happen? Women have a much harder time. Again, it’s back to that thing, like men don’t seem to have a problem when their brain is like revolving around million people. They just realized that’s just, that’s just fantasizing. But women, I cannot tell you how many women come in and they say like, they feel like they’re being like, unfaithful somehow, if they’re thinking about, I don’t know… Name a movie star. August, who’s your favorite movie star?

August:

Oh, my gosh. The first person who came to mind was my first crush when I was a kid was Steve Urkel.

Dr. Marcus:

Geeky guy? Totally, totally. So where we come up with this idea that Steve Urkel and your brain is going to mean you actually really want to be having sex with him. 

August (narration):

A little side note… I think I was a bit young to imagine having sex with him then. I’m sure I imagined going on dates with Steve, though.

Dr. Marcus:

It’s such a weird phenomenon. And it’s such an unhelpful one to women. 

August (narration):

So if you’ve been less interested in sex within a long-term relationship, challenging the messages you’ve absorbed about fantasizing can really help. Fantasizing is not cheating. If you get that, but still struggle with shame because of messaging you’ve absorbed, try fantasizing about you and your partner having wild, erotic adventures—with or without additional people. Honestly, I recommend those fantasies regardless. 

Dr. Marcus told me it’s really clear to her that there are other options if novelty is what you’re missing—such as opening your relationship, which works really well for some people. But many people really want to stay happily committed to one person, she said—which, from a desire standpoint, takes work. Thankfully, that work can be pretty fun and fulfilling, once you get into it.

One step she recommends is re-igniting the spark by keeping a sense of mystery or mystique in your relationship. Or rather, realizing there already is some mystery.

Dr. Marcus:

That means really digging deep to find what it is about that person that you may not know, because we think we know our partners really, really well, and we do on some level. But some of that is just us convincing ourselves that we do because it’s much more comforting to do that. 

And some of that is really looking for the elements of your partner that you don’t know. So that may be going to work with them or picking up something, a skill, doing something that they’re really good at that you’re terrible at, right? And sort of being willing to go vulnerable there and realize that there are parts of this other person that you don’t know because that in the end is hot. Your erotic brain likes new and different. 

August (narration):

When there is a problem in your sex life, it can be difficult to sort it all out. I asked Dr. Marcus, when we’re in that space and want to make changes, where do we begin?

Dr. Marcus:

That is such a complicated question. And that actually is why I wrote the book and it starts with that quiz because I feel like that is ultimately, August, the biggest, most central question that I get asked. 

August (narration): 

People don’t actually ask her, “where do I begin?” though. She said they usually say some variation of “what is the problem?” They want to know “the” problem and what to do about it, stat. “Like a light switch,” she said, “off/on.” 

But that’s not a helpful way to think about your sex life. Instead, Dr. Marcus told me she takes this approach in her book: “think about your sex life as, you need to hit a 100-point threshold and then you’re good to go. And those points can come from all the things that [we’ve] been talking about.” That’s why her book out with the quiz she mentioned. 

Dr. Marcus:

It breaks into four quadrants: desire, arousal, orgasm and pain. And at the end of that, you see, oh my god, I have…40 points in desire, but I have 10 points in pain. And that’s where I need to begin. I need to begin with the pain.

Your sex life is not a chemistry experiment, obviously, but it’s such a great way to kind of get started and kind of understand where your starting points can be.

August (narration):

When I asked Dr. Marcus to share a little bit more about this point system, she cited an example, which I think not only illustrates how her book works, but the many ways different aspects of our lives and bodies can influence everything from desire to orgasms.

Dr. Marcus: 

So let’s take Tammy, who’s a 19-year-old girl who’s in great health and has tons of hormones coursing through her system. She’s walking around with 90 points, and she can have sex pretty much with anyone anywhere. She could meet somebody on an airplane and have sex in the bathroom with no space—well pre-COVID—and she’s gonna have good sex, right? 

Now, let’s take Tammy a few years later. She meets this hot, new guy so it’s hot, new and erotic. We know what that’s like. 30 points there. She falls madly in love. That’s another 30 points. So now Tammy’s at 150 points. And she’s great. It doesn’t matter if hot new guy does something really, really, really irritating. Or if work has her exhausted. She can give up those points. And she’s still nicely above that 100 range. And she’s doing fine, right?

August (narration):

For a while, at least. If you visited her six years later, Dr. Marcus said, you might find Tammy still totally loving the guy—but the relationship isn’t hot, new or erotic anymore. Still, she’d have about 120 points, well above that 100-point threshold. 

Dr. Marcus:

That’s okay until she has a child and the child’s banging at the door, and now she’s down to 100 points. It’s fine until her hormone level drops. And there are little bumps in the relationship… She gets on birth control pills and that has an impact. Any of these things can have an impact that drop the point level below that 100 points. And so that’s where I try to use that as the model: can we get you above 100 points? 

August (narration):

So let’s say you get there; back to above 100 points. I asked Dr. Marcus about the benefits she sees:

Dr. Marcus:

When you’re in a relationship and you’re having no sex—and some couples have decided that’s the way they’re gonna live., and I am not trying to change anybody’s life; that’s fine—but I will tell you that for most couples, it feels different when you’re having sex. 

Women will say to me “if I come home at the end of the day, and I see my partner’s socks on the floor, and we haven’t had sex in a while, I want to take those socks and I want to stuff them down their throat. Like, I just want to kill them. But if we’ve been having good sex, I pick up the sock, I laugh, and I dump it in the hamper.” 

[Sex] changes the way we experience our life with our partner and I really, really believe with yourselves. There’s something so elemental about our sexuality, and primitive maybe even, about our ability to connect to our sexual selves. 

That’s why it’s in all the songs and why people talk about it so much. I think they get it wrong. I think they make it literally a kind of mystical romanticized thing as opposed to understanding that it’s like the rock core at the center of who we are. When we’re feeling good about our sexuality and we’re feeling good about our ability to feel sexual and be sexual, it just changes everything, August. I mean, that’s my experience. What do you think?

August:

I think it changes the way we move in the world fully: our moods, the way we greet the day, the way we interact with people, beyond our partner, if we have one… I feel much more balanced and just like myself.

Dr. Marcus:

I feel like there’s something about feeling comfortable in our sexuality and the opposite is true, too. For the women who are feeling stuck, they’ve just shut it all down because they don’t really know what the matter is or they don’t really believe that there’s help. I feel like they start separating from themselves, in a way. And that feels sad to me, either black and white rather than color, or just part of you that doesn’t feel as alive. 

And so if you’re listening to this and you’re somebody who’s thinking to yourself, oh my god, I really haven’t thought about this in a long time because it’s too painful to think about. I will tell you that it can be helped. It really, really can be and it just needs to have a little kindness for yourself and a little patience with yourself and a little faith that, this can be different and you can re-access your sexual self.

August (narration):

To learn more about Dr. Marcus and her work, visit drbatsheva.com and follow her on Instagram. Find Sex Points: Reclaim Your Sex Life with the Revolutionary Multi-Point System most anywhere books are sold.

*****

For a special bonus segment, including her thoughts on “Viagra for women,” join me on Patreon at patreon.com/girlboner. 

Stream the full episode up above or on your favorite podcast app! It includes Dr. Megan Fleming‘s thoughts on experiencing orgasms during intercourse if you wish to, versus only solo, which is the case for a listener and her partner. 

To check out some awesome cock rings and couples sex toys that can help in that area, head to thepleasurechest.com. The Romp Juke Vibrating cock ring that can make erections harder and add clit stim at the same time. Click “Couples Toys” to find great options from WeVibe and more. While you’e there, grab some lube! Lube, too, can make arousal stronger and orgasms more likely for everyone.