Key Concepts

Principles of Pleasure

• Sexual desire and orgasm are subject to various influences on the brain and nervous system, which controls the sex glands and genitals.
• The ingredients of desire may differ for men and women, but researchers have revealed some surprising similarities. For example, visual stimuli spur sexual stirrings in women, as they do in men.
• Achieving orgasm, brain imaging studies show, involves more than heightened arousal. It requires a release of inhibitions engineered by shutdown of the brain’s center of vigilance in both sexes and a widespread neural power failure in females.

 

She did not often have such strong emotions. But she suddenly felt powerless against her passion and the desire to throw herself into the arms of the cousin whom she saw at a family funeral. “It can only be because of that patch,” said Marianne, a participant in a multinational trial of a testosterone patch designed to treat hypoactive sexual desire disorder, in which a woman is devoid of libido. Testosterone, a hormone ordinarily produced by the ovaries, is linked to female sexual function, and the women in this 2005 study had undergone operations to remove their ovaries.

After 12 weeks of the trial, Marianne had felt her sexual desire return. Touching herself unleashed erotic sensations and vivid sexual fantasies. Eventually she could make love to her husband again and experienced an orgasm for the first time in almost three years. But that improvement was not because of testosterone, it turned out. Marianne was among the half of the women who had received a placebo patch—with no testosterone in it at all.

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