Even in fields like urology, where male sexual pleasure and orgasm are considered integral, women’s sexual health “is seen as hysteria, a Pandora’s box, entirely psychosocial medicine, not real medicine,” said Dr. Rubin, who is also the education chair of the International Society for the Study of Women’s Sexual Health. “Sexual health and quality of life are not things we focus on for women.” (In contrast, Viagra has been one of the most lucrative pharmaceutical drugs of recent decades, earning tens of billions of dollars for Pfizer since its introduction in 1998.)
Gynecology, on the other hand, is much more focused on fertility and disease prevention. “We don’t do a great job of talking about sex from a pleasure-based perspective,” said Dr. Frances Grimstad, gynecologist at Boston Children’s Hospital. “We talk about it with a view to prevention. We try to prevent STIs”, or sexually transmitted infections. “We are trying to prevent pregnancy, unless you are trying to get pregnant. We are not talking about sexual pleasure.
Dr Helen O’Connell, Australia’s first female urologist, recalled that in her own medical training the clitoris barely made an appearance. In the 1985 edition of the medical textbook “Last’s Anatomy” that she studied, a cross-section of the female pelvis omitted the clitoris entirely, and certain aspects of the female genitalia were described as “poorly developed” and a “failure” of the genitals. male genitalia. training. Descriptions of the penis went on for pages. For her, this widespread medical disdain helped explain why her urologist peers worked to preserve penile nerves during prostate surgeries, but not during pelvic surgeries in women.
Dr. O’Connell set out to study the complete anatomy of the clitoris using microdissection and magnetic resonance imaging. In 2005, she published an in-depth study showing that the external node of the clitoris – the part that can be seen and touched – was just the tip of the iceberg, the equivalent of the head of the penis. The complete organ extended far below the surface, comprising two teardrop-shaped bulbs, two arms and a shaft.
By not appreciating this anatomy, she warned, surgeons working in this area risk damaging the sensitive nerves responsible for pleasure and orgasm, which run along the top of the shaft. In procedures such as pelvic mesh surgeries or urethral surgeries, “things are potentially in the crossfire,” Dr. O’Connell said. “You always have to think about what’s underneath, what’s hidden in plain sight and what you’re potentially changing.”
Increasingly, women are talking about injuries they have sustained in this area during routine procedures. One of them is Julie, a 44-year-old office manager in Essex, east London, who lost her ability to have an orgasm in 2012 after minimally invasive hip surgery to treat back pain. She shared her story publicly in The Telegraph last year, using only his first name to avoid discrimination by future employers.
During a Zoom call in January, Julie described waking up from anesthesia with throbbing pain around her clitoris. Her surgeon told her it was just a bruise and it would fade. A few months later, she found that she could no longer have an orgasm. When she tried it, “it was literally like someone pulled a plug out of the socket,” she said. “Everything is dead.”
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