Why are so many women dissatisfied with their sex lives?

Something is missing from their intimate encounters: either they're not interested in sex anymore, or they are interested but can't get aroused, or they can get aroused but have neither the desire nor the energy to follow through. Their relationships are suffering. Many women find themselves wondering what's wrong with them.

If you're a woman and any of this sounds familiar, Dr. Anita H. Clayton wants you to know that there's nothing wrong with you — what's wrong is the ridiculous fantasies you've been sold about sex, and the unrealistic expectations you cling to. We all want to make love the way they do in the movies, where the woman swoons with desire before the man even gets near her and, once he does, gasps, collapses, and hurtles headlong into orgasm in twenty seconds tops. Now, how often does that happen in real life? Not very — because in real life it takes at least that long to get your panty hose off, not to mention locking the door locked so the kids don't barge in.

In this irreverent and revolutionary volume, Dr. Clayton lays bare hidden facets of female sexuality that are rooted in the psyche and can catapult a woman either into a cathartic bout of ecstasy or against the headboard into yet another disappointment. Through compelling case histories she explores why many women would rather put up with unsatisfying sex than tell their lovers how to please them; how buried feelings about childbearing can affect a woman's erotic potential; and why an orgasm you have during intercourse is no more real or legitimate than one you achieve through other means. Dr. Clayton also shines a light on sexual attitudes thathave a dramatic impact on young girls and teens, and details how motherhood and menopause may affect but need not diminish a woman's capacity for sexual pleasure.

Dr. Clayton believes that women should have high expectations for their sex lives, but that these expectations should come from visceral, intimate knowledge of ourselves — what is normal for us and what feels good to us. She wants you to consider and eventually own the concept of yourself as every bit as sexual as a sex symbol. Indeed, the only person who should symbolize sex for you is you.

"Maybe you're tired. Or you just don't feel like it. Perhaps it's your lover's fault; he doesn't know what you like. Or there's no time, the kids take all your attention, your job drains the life out of you. Or the dishes need to be done, the laundry has to be folded, and your body is not what it used to be. Or maybe you've never understood what all the fuss is about. It's easy to find reasons not... Washington Post Book Review (read the entire Washington Post review) to have sex.

'You have to put gas in the car and you have to buy food and you have to pay the electric bill, but you don't have to have sex,' writes Anita H. Clayton in 'Satisfaction,' 'so the sex has to wait.' It shouldn't, she says. In this wry and thoughtful book, Clayton argues that most women are not satisfied with their sexual lives, but that they could be if they peeled back the layers of their own psyches to discover whatever anxieties, shame or unfulfilled fantasies lie beneath.

Clayton, a practicing psychiatrist, walks the blushing reader through the 'dark and tangled, funky and wild' world of female sexuality, from puberty to post-menopause, from hooking up to shutting down. This book is not an exploration of the female body but of the female mind — a psychological guide to sex. Clayton illustrates her points with what she describes in the preface as 'composites of several persons whose symptoms would be recognizable were they presented on their own.' For instance, there's Vera, whose husband left her after she had a hysterectomy; Toni, who can't see that her obesity is what's killing her drive; and Karla, who gets excited only when she's in a lovers' triangle. Believable (and necessary) as these composites may be, knowing that these are not real women undermines the book's otherwise frank approach.

Nevertheless, Clayton makes a compelling case that settling for mediocre sex — or no sex at all — can be terribly damaging. 'For women, sexual dissatisfaction is more a disappointment than a crisis,' writes Clayton. 'Our fundamental sense of self, our essential womanhood, isn't threatened, so the situation doesn't seem dire.' Rather than delving into the dark corners of their unhappiness, many women choose to settle in a sexless rut. But that way lies emotional disaster: 'You erode your capacity for intimacy and eventually become estranged from both your sensual self and your partner. The erosion is so gradual, you don't realize it's happening until the damage is done and you're shivering at the bottom of a chasm, alone and untouched, wondering how you got there.'

How does this happen? Do you want the short answer? Life.

Everything — from job to children to childhood to self-image to whom one chooses to love and why — affects how women view sex. 'When a woman comes in distressed about her life in general and her sex life in particular,' writes Clayton of her psychiatric practice, 'we need to stand back, look at the big picture, and then examine the details in the context of that woman's life to find a way to help her: this woman, with this partner and these children, this upbringing and this history and this spiritual belief, in this culture, at this moment.'

Often the causes of sexual distress seem far removed from the bedroom. Stephanie, for example, feared that her husband was having an affair because he wasn't pressuring her for sex, but he had stopped making advances because, overwhelmed by her job, she always turned him down. Renata blamed menopause for her lack of desire, but Clayton traced it to bitterness about her husband's poor treatment of their son.

Indeed, Clayton argues forcefully that how women feel about children and childbirth cannot be unraveled from how they feel about sex, no matter their age and prospects. 'The connection between sex and childbearing is bred in the bone and set in the psyche, and not subject to banishment by birth control,' she writes. One patient had driven herself into an anxious frenzy because she hadn't conceived a second child, yet she'd reduced lovemaking with her husband to a mechanical undertaking that didn't completely mask her angry ambivalence about staying at home with her first child.

Another denied even to herself that she was pregnant — a good Catholic girl like her would never bear a child out of wedlock. But that illusion collapsed when she gave birth in a movie theater bathroom. 'This nineteen-year-old was not ready for a sexual relationship of any kind,' writes Clayton, 'because she was psychologically unprepared to deal with its most logical outcome — a pregnancy.'

Yet despite such tragedies — and Clayton freely includes examples of patients whom she did not help — this is an empowering, hopeful book. Good, happy, joyful sex — and love — is within the reach of all women, Clayton implies, if only they would be honest with themselves about who they are and what they want. Better that, painful as it might be, than regret as life winds down. 'All those years that we might have loved each other better, that I might have let him love me, all lost, wasted, gone,' laments one of her patients. 'It breaks my heart.'

Rachel Hartigan Shea is a contributing editor of The Washington Post Book World.

" Reviewed by Rachel Hartigan Shea, Washington Post Book World (Copyright 2006 Washington Post Book World Service/Washington Post Writers Group)
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"This is one of the best-written and most understandable books on sexuality this reviewer has seen recently, incorporating both immediacy and judicious humor." Library Journal

Why are so many women dissatisfied with their sex lives?

Something is missing from their intimate encounters: either they’re not interested in sex anymore, or they are interested but can’t get aroused, or they can get aroused but have neither the desire nor the energy to follow through. Their relationships are suffering. Many women find themselves wondering what’s wrong with them.

If you’re a woman and any of this sounds familiar, Dr. Anita H. Clayton wants you to know that there’s nothing wrong with you–what’s wrong is the ridiculous fantasies you’ve been sold about sex, and the unrealistic expectations you cling to. We all want to make love the way they do in the movies, where the woman swoons with desire before the man even gets near her and, once he does, gasps, collapses, and hurtles headlong into orgasm in twenty seconds tops. Now, how often does that happen in real life? Not very–because in real life it takes at least that long to get your panty hose off, not to mention locking the door locked so the kids don’t barge in.

In this irreverent and revolutionary volume, Dr. Clayton lays bare hidden facets of female sexuality that are rooted in the psyche and can catapult a woman either into a cathartic bout of ecstasy or against the headboard into yet another disappointment. Through compelling case histories she explores why many women would rather put up with unsatisfying sex than tell their lovers how to please them; how buried feelings about childbearing can affect a woman’s erotic potential; and why an orgasm you have during intercourse is no more “real” or legitimate than one you achieve through other means. Dr. Clayton also shines a light on sexual attitudes that have a dramatic impact on young girls and teens, and details how motherhood and menopause may affect but need not diminish a woman’s capacity for sexual pleasure.

Dr. Clayton believes that women should have high expectations for their sex lives, but that these expectations should come from visceral, intimate knowledge of ourselves–what is normal for us and what feels good to us. She wants you to consider and eventually own the concept of yourself as every bit as sexual as a sex symbol. Indeed, the only person who should symbolize sex for you is you.

Anita H. Clayton, M.D., is the David C. Wilson Professor of Psychiatry in the Department of Psychiatric Medicine at the University of Virginia and holds a secondary faculty appointment as professor of clinical obstetrics and gynecology. She has chaired or served on twenty-five academic committees. Dr. Clayton is also a consulting editor for the Journal of Sex and Marital Therapy and writes a bimonthly column for Primary Psychiatry. She has been featured in numerous publications, including The New York Times, The Wall Street Journal, Psychiatric Times, and Ladies Home Journal. She is a wife and mother and lives just outside of Charlottesville, Virginia.

Robin Cantor-Cooke has worked as a writer, editor, and producer on more than forty books and tape programs. She is an adjunct instructor at the College of William and Mary and lives with her husband and two sons in Williamsburg, Virginia.