I work in a store that sells adult toys and novelty products and, for the most part, I love my job, but one common customer experience has always rubbed me the wrong way. Quite often, a (presumably) straight couple comes in to find something to “fix” what they perceive as a problem: the girlfriend’s disinterest in sex. Instead of reaching for our bondage equipment, a vibrator, or even a sexual card game to inspire new intimacy, they always seem to inquire about our selection of “natural female enhancement pills.” I do not feign to know the personal lives of these people and I never want to judge others for their sexual desires. At the same time though, paying ten dollars for a singular pill just to “correct” the fact you don’t want to have sex doesn’t seem like it’s always a reaction to a true desire to have it. I worry that many of these couples are operating under the assumption that “sex” (possibly just penis-in-vagina sex) is somehow necessary for a “good” relationship; a belief which, when followed to its logical conclusion, requires a remedy to someone simply not wanting to do a certain activity. Of course, this is a complex, multilayered issue. I don’t want to shame (let alone blame) anyone for having this view of sex. It’s unfortunately a very normative idea that is frequently reinforced. At the same time, this understanding of sexuality is limiting, often disrespectful of one’s true desires, and, in some cases, even physically dangerous.
This compulsion to “correct” a lack of desire for sex relates to the concept of the “coital imperative.” Simply put, this is the idea that penis-in-vagina sex (AKA “PV sex”) is the only true, natural, or normal form of sex for heterosexual couples. Anything else erotically charged is expected to be preliminary “foreplay” or a fun bonus rather than sex in itself. Obviously, there are many problems with this concept. It’s related to the sex negative concept of virginity, it implies that most queer sex isn’t as “real” or “natural,” and it seems to entirely ignore the fact that many heterosexual couples do not have a penis and a vagina. Even beyond all of this, though, the coital imperative is harmful. It’s well documented that women in heterosexual relationships will frequently have penetrative sex when they have no desire for it and even when it’s painful or distressing to them. This is the result of many things such as rape culture, domestic abuse, and patriarchy, but it is also related to the idea that PV sex is “normal” in heterosexual partnerships, and having less (or none) of it is a sign of a failing relationship. A bit less harmfully, the coital imperative also pathologizes people with penises who do not easily become or stay erect, despite the fact that it’s much more common than not for this aspect of penises to change dramatically over one’s lifetime. “Male Enhancement Pills,” for example, tend to be marketed on the premise that sex is necessary, sex is when a man puts his penis in a woman’s vagina, and therefore a penis incapable of on-demand penetration must be altered.
This isn’t just an issue for cis people, either. A trans friend of mine once told me that he “only had sex once” with his ex-girlfriend (who was also trans) and didn’t know why they never made it happen again. Although I don’t know all the details of his situation, from further discussion it seemed as though he was defining “real” sex as penis-in-vagina sex and imagining all the other sexual play they engaged in as “foreplay.” This attitude is especially problematic in the context of trans sex. Not only can dysphoria make penetrative sex uncomfortable or undesirable for some trans people, but also trans people who have undergone gender-affirming treatments such as hormone replacement therapy often have genitals that work differently and might not be congruent with PV sex. The truth is, a healthy penis is not the same as a hard penis, a healthy vulva is not the same as a wet vulva, and a healthy sex life doesn’t require any penetration at all.
Even the idea that we need a “healthy sex life” requires a bit of interrogation, though. Of course, sexual health is crucial. Consent, communication, pleasure, and protection from disease and unwanted pregnancy are all very important. At the same time, sex is not a necessary part of individuals’ lives. Plenty of people don’t have sex for all sorts of reasons ranging from religious celibacy to sex-repulsed asexuality. Even asexual people who do have sex often don’t experience desire in a way that is considered normative, meaning they could be (and probably often are) pathologized. People are diagnosed with Hypoactive Sexual Desire Disorder when they experience “deficient sexual or erotic thoughts, fantasies, and desire for sexual activity.” Although this diagnosis requires the patient to be distressed about the situation, this distress in itself deserves further consideration. If someone’s never been exposed to the concept of asexuality and/or grew up in a culture that proliferates the coital imperative, their distress could easily be a result of this rather than a deeply ingrained dysfunction.
At the end of the day, if you would like to alter your sexual desires or functioning with medicine that’s your prerogative and I won’t blame you for it. That being said, it’s worthwhile to educate yourself on what’s potentially going into your body. Over-the-counter “natural remedies” to disinterest in sex (like the ones sold at my store) are probably placebos at best and, at worst, could be harmful. These types of products (for people of all genders) are usually not tested for safety or efficacy nor are they vetted by any government agency. There are prescription options as well, but those have their own downsides. The main prescription options to treat the lack of desire for sex in women are Bremelanotide injections and Flibanserin pills, both of which are known to cause numerous debilitating side effects and be upsettingly under-researched. Flibanserin pills in particular require users to take them every day and are known to be unsafe if one needs to drive in the next six hours; that’s an entire quarter of the day in which patients are unable to drive. Oh, and you should never drink alcohol if you’re taking Flibanserin pills because you’re likely to pass out. They’re not to be taken by menopausal or postmenopausal people and they were primarily tested on cisgender men despite being designed for cisgender women. It’s also marketed as “Viagra for women” which it just isn’t.
Viagra is the brand name for sildenafil and is used to increase the ability of someone’s penis to get hard and stay hard; it does not purport to create a desire for sex. Although sildenafil, too, can have harmful side effects, its effects are well documented, it’s relatively safe, and it’s taken to change a specific physical function. While erections are not necessary for the vast majority of fun sexual activities, penetrating a partner’s vagina or anus with one’s penis does generally require an erection. So, if that’s an activity you and your partner/s desire to engage in but erections aren’t easily acquired, sildenafil can be a good option. The closest thing that’s an equivalent for people with vulvas is lubricant or clit pumps. Drugs that attempt to treat the lack of desire for sex in itself are very different because, rather than facilitating the physical mechanisms of an activity everyone wants, they attempt to force someone’s body to want something it just doesn’t.
That being said, you could just really want to be hornier and/or have more sex without those desires coming from the coital imperative or pressure from a partner. In that case, I highly recommend pursuing other options. Cultivating fantasies could be a great idea. Try reading erotica or a romance novel, watching a sexy show alone or with a partner, and/or exploring some erotic hypnosis. Remind yourself not to judge your fantasies and allow your mind to wander to titillating places (even if you know they wouldn’t be enjoyable in real life). Try doing things to reconnect with your body away from normative ideas about what kind of sex you “should” be having and how often. Try touching yourself (and/or each other) without being aroused yet. Instead of operating as if erotic touch is a step on the way to penetration (or even orgasm), simply explore sensations without necessarily even needing them to be sexual. Get naked and roll around in a soft blanket. Tickle your tummy, hips, and feet with different objects just to see how it feels. Dress up in clothes with different textures and pay attention to how the fabric feels on your skin. This isn’t a shortcut to becoming aroused enough to want PV sex; these are ways to find a more erotically charged and pleasurable life.
Written by Aiden/Estelle Garrett with consultation from A. A. Anima.