Good Reasons for Bad Feelings

by Randolph M. Nesse

  Most couples muddle through their differing desires with some combination of acceptance, denial, satisfying the partner despite a lack of desire, masturbation, and humor. However, the classic line from the comedian George Burns applies all too often: “About marriage and sex . . . After marriage you can go longer . . . and longer . . . and longer . . . without sex.” Natural selection did not shape a mechanism to coordinate levels of sexual desire. That is not just too bad, it is a tragedy.

  The situation a patient described in the ER one night is common: “My wife doesn’t want to have sex, and I don’t know what to do. I want to stay with her, but I also want to have a sex life.” I recall vividly the succinct advice the patient received from the senior doctor: “Well, you have four choices: you can go to sex therapy; you can get a divorce; you can have an affair; or you can stay in the marriage and masturbate. You just have to choose.” Providing such terse advice after only a brief conversation seemed brusque to me, but it nailed the quandary experienced by millions.

  You would think that some culture would have found a solution that could maintain long-term, mutually satisfying relationships and full sexual satisfaction, but all solutions involve trade-offs. Enforcing monogamy causes dissatisfaction. Allowing sex with others arouses jealousy, conflicts, and breakups. Most cultures have emphasized controlling sexuality to preserve relationships. Now, however, some people are trying to control attachments to preserve sexual opportunities. Some whose sex life consists of casual hookups avoid having sex repeatedly with the same person to avoid attachment and subsequent grief when the relationship ends.

  It is so easy to talk about having sex, as if most couples just have plain intercourse, and that is that. However, desires for special kinds of sex cause plenty of problems. Wanting oral sex or not is a common source of conflict. The deep connections among sex, submission, and domination take us to a different realm, one that has been explored in depth by early evolutionary psychiatrists.27 Some couples enjoy bondage and discipline games, but for many more, trying to get a partner to play that special role is an exercise in manipulation and frustration. In a very old joke the masochist says, “Whip me”; the sadist replies, “No.”

  Fetishes are fascinating. Why do some people require four-inch heels or shiny black leather for sexual arousal? “People” is not the right word—big-time kinks are overwhelmingly a guy thing. A woman wrote to a sex advice columnist to ask, “Where can I find a man who doesn’t have such perversions?” The columnist’s reply: “In the grave.”

  You would think that natural selection would ensure that men consistently prefer intercourse with women because that would maximize the likelihood of pregnancy. However, some men would rather get a hand job while in handcuffs. Getting aroused by cues that are not quite spot-on harms fitness for females much more than for males.28,29,30 For females, choosing a good mate is essential because the number of children women can have is strictly limited by the enormous investment required.31,32,33 For males, anything that somewhat resembles a mate, or has been associated with a mate, might be worth pursuing; the costs are low, and the reproductive benefits could be big. That is why men have a tendency to imagine that small friendly gestures are sexual invitations, a phenomenon UCLA evolutionary psychologist Martie Haselton explains using an expanded version of the Smoke Detector Principle, error management theory.34

  This doesn’t explain fetishes, however; it only explains why they are less costly for men. Many fetish objects are things that are especially salient to a toddler, such as feet, shoes, and being spanked, suggesting that early imprinting may connect such cues to desire.35 One patient reported he could only get aroused by getting someone to put him in diapers. Such fetishes seem like pathological side effects of a system that connects certain stimuli to libido early in life, to no purpose I can imagine.

  Arousal and Its Absence

  Lack of sexual arousal is not only more obvious for men than women, it is more harmful to fitness. The causes are many, including drinking, fatigue, medications, atherosclerosis, neurological damage, hormonal problems, and anxiety. All except the last are simple failures of the mechanism, for one or another reason. Anxiety, however, is a different matter. Having an erection subside in the face of danger is unwelcome but, as suggested in the book Zoobiquity: The Astonishing Connection Between Human and Animal Health,36 possibly lifesaving if someone nearby is likely to attack or, possibly worse, gossip. This can initiate a vicious cycle. Fear about performance adequacy causes anxiety that decreases performance, causing more anxiety and worse performance, in a feedback cycle that a frustrated partner can aggravate dramatically by a humiliating comment.

  Biotechnology has solved most such problems. Who would have predicted, twenty years ago, that a drug could make erections reliable? Viagra has been a miracle for millions. The market for erectile dysfunction drugs is now about $4 billion a year.37 Pharmacology has changed the sexual world, to the pleasure of many men and women—and the dismay of some women, who had thought they were done with all that.

  Arousal difficulties for women are less obvious but more common. Lack of physiological arousal for women usually goes together with lack of psychological arousal, but sometimes the mind is eager but the flesh balks. No drug has yet been found, however, that reliably increases female arousal. Sometime soon such drugs probably will be discovered, and the sexual world will change again. How? Now is the time to predict the unexpected consequences. You first.

  Climaxes Out of Sync

  Books about sexual disorders all have whole chapters about premature ejaculation in men but nothing about premature orgasm in women. They all have chapters about women who experience delayed or absent orgasms but give only a nod to men with the same problem. No book explains why it is men who climax too quickly and women who climax too late or not at all. This lack of synchrony may be an especially unfortunate example of natural selection maximizing reproduction at a cost to happiness.

  Why female orgasm exists at all has inspired a contentious debate that continues despite the arguments in more than fifty published papers. Those on one side argue that female orgasm gives specific fitness advantages, perhaps by selectively taking up sperm from preferred partners or increasing bonding.38,39,40 Spirited opponents, whose position is well summarized by Elisabeth Lloyd’s comprehensive review, say that female orgasm is a by-product with as little adaptive significance for women as nipples have for men.41

  A recent evolutionary sophisticated perspective by Günter Wagner and Mihaela Pavličev suggests that orgasm had its origins in the mechanism in many species that induces ovulation after mating, and that female orgasm in humans is a vestige of that system.42,43,44 They also note that the clitoral equivalent in other species is inside the vagina and its displacement outside is a product of natural selection. Their conclusions seem sensible. However, even if female orgasm is a vestige, the tendency for men to climax before women needs explanation. One possibility is that orgasm is slower in women simply because the mechanisms that regulate it are not subject to selection. However, studies show that the speed of reaching orgasm is influenced by genes but not by other things such as social or marital status.45,46

  An alternative explanation is that pregnancy is more likely for women who have slower orgasms than their partners and men whose are faster. Ejaculation that is genuinely premature, that is, before entry, poses huge costs to fitness. But that is rare compared to climaxing “before the person wishes it,” as premature ejaculation is sometimes defined. On confidential surveys, a third of men report premature climax.47 The definition William Masters and Virginia Johnson used—unable to continue until the partner is satisfied 50 percent of the time—would boost the percentage higher yet. A study of 500 couples found that the duration of intercourse ranged from under half a minute to more than forty minutes, with an average of about five minutes.48 Following the usual definition of pathology as the most extreme 1 or 2 percent, climax in less than one minute is co
nsidered abnormal.49 However, some primates ejaculate in seconds. Five minutes is a relatively long time. Is the long duration of human intercourse, as some have suggested, to scoop out sperm that may already be there from another man?50,51,52 To cement the emotional bond? Or is it just an accident of physiology? Despite available data on sex in many primates, no answer is confirmed.53

  Maximizing reproduction requires that a man’s climax occurs when the penis is in the right place to get sperm to the egg, then stopping.54 Continuing intercourse can pull sperm away from their path.55,56 So after orgasm men experience extreme sensitivity that benefits their genes; too bad about what is good for their partner’s pleasure. A refractory period that makes repeated intercourse impossible for an interval of minutes to hours further ensures that there is time for the sperm to get on their way.

  For a woman, any genetic tendency to sometimes stop intercourse before her partner ejaculates will be selected against. Imagine, for a moment, if women had the same sexual response cycles as men. They would often have orgasms before their partners, then become sensitive and stop, making conception exceedingly unlikely. Such a system would have dire fitness costs, but early orgasm is not a problem for women. They take much longer than men to reach orgasm, 75 percent never reaching orgasm from intercourse alone in one study.57 After a climax, instead of stopping, most women are happy to continue for a time, and some go on to have multiple orgasms. A few, however, become sensitive or sore and want to stop. You would think it would be easy to find out how often women want to stop intercourse after orgasm but before their partners ejaculate, but I can’t find a published scientific study. On the internet, however, many women report becoming extremely sensitive and stopping intercourse after having a climax. If that happens to more than a very few women, it would select for delayed orgasm.

  Given these complications, it is not surprising that lack of synchrony is common and that climax is consistently faster for men. The results from one large national survey showed that 25 percent of women but only 7 percent of men could not reach orgasm. Climaxing too early was reported by about 30 percent of men but was not even measured for women.58 In another study, only 10 percent of women reported consistently reaching orgasm by intercourse alone.59 According to a 2013 survey by Elizabeth Armstrong, men reported orgasms three times more often than women in short-term relationships, but the rate of orgasms went up dramatically for women in long-term relationships.60 It is unclear if that is explained by stable relationships or by men not rushing and learning what to do.

  The global conclusion is simple: men have no trouble reaching orgasm, while many, or even most, women do. According to a 1999 study published in The Journal of the American Medical Association, 43 percent of women suffer from “female sexual dysfunction.”61 That figure spurred debate and better research that challenged the idea of using the male pattern of sexual response to define what should be normal for women.62

  A proximate reason for lack of synchrony is the location of the clitoris. If it were located a bit closer to the vagina, it would receive more stimulation during intercourse, resulting in faster orgasms—even if perhaps fewer pregnancies. The logic is compelling, but the hypothesis needs to be tested. Here is the study: find 1,000 women who are not using birth control, measure the location of the clitoris, and see if women whose clitoris is further away from the vagina have fewer orgasms but more babies over the course of a decade. Some studies are as impractical as they are unethical.

  A more feasible study would measure the distance between the clitoris and the urethra to see if orgasms are more common if the clitoris is located where it gets more stimulation. Princess Marie Bonaparte did the study and published the results in 1924 under the pseudonym A. E. Narjani.63 The princess, a great-grandniece of Emperor Napoleon I of France, had difficulty reaching orgasm. She also had obsessions, anxiety, and other symptoms, perhaps because her mother died within a month of her birth and her father was far more interested in his studies of glaciers than in her.64

  In 1925, she turned for help to Sigmund Freud, who was soon seeing her for two hours each day, while tapering off his relationship with Lou Andreas-Salomé, another woman admirer.65 When the princess declared her love for him, Freud was reportedly delighted. Bonaparte was not only beautiful and royal, she was rich—really rich. Her mother’s father owned property in Monaco, including the casino. When the Nazis threatened Freud, she paid the ransom to get him to England.

  It was to Bonaparte that Freud said, famously, that there was one question he had never been able to answer: “What do women want?”66 We don’t know if she replied, “Reliable orgasms,” but it seems likely. Bonaparte was not only searching for help for herself, she was a scientist trying to explain the problem. The study she conducted measured the distance between the clitoris and the urethral opening in 200 women and asked 43 of them how often they had orgasms. She concluded that orgasms were more frequent in women whose clitoris was positioned to get more penile stimulation. She took her theory seriously, arranging to get experimental surgery in 1927 to relocate her own clitoris, even publishing a description of the surgical technique.67,68 The procedure did not work. Her love life was nonetheless active, including a long affair with French premier Aristide Briand, among other men. She later cofounded the Paris Psychoanalytic Society and practiced psychoanalysis until 1962.

  A 2011 article by sex researchers Elisabeth Lloyd and Kim Wallen reanalyzed her data, along with data published in 1940 by the psychologist Carney Landis.69 They confirmed Bonaparte’s basic hypothesis that the location of the clitoris influences the frequency of orgasms. This whole approach is, of course, penis-centric, neglecting fingers, tongues, and vibrators, which are more effective ways to reach orgasm. It also illustrates the human tendency to try to figure out what is “normal” and to neglect the huge variation among individuals, couples, and cultures that influences how couples have sex. However, Bonaparte gets credit for doing remarkably bold science on a delicate good question nearly a century before her successors.

  Relationship Problems

  For humans, sex involves much more than choosing partners, arousal, and climaxes. For most of us, intimate relationships are the most meaningful in our lives. They are also fraught with conflict, for good evolutionary reasons. Some of those reasons were summarized in chapter 9, but some are specific to sex.

  For most primates, fathers contribute little to reproduction other than sperm and perhaps some protection of offspring.70 The intense collaboration of male and female primates during the years of arduous child-rearing is, with few exceptions, distinctive to humans.71,72,73 What selective advantages could possibly have shaped mechanisms that bind couples into commitments that involve years of child care and fewer mates? The key is that our mating patterns are like those of birds and for the same reasons.74,75,76,77,78,79 Birds form partnerships to build a nest and rear offspring because they must. A single bird can’t gather enough food. Even if it could, being away from the nest would leave the eggs to cool and the chicks to predators.

  Human babies are born profoundly helpless, months premature compared to the babies of other primates. One parent cannot provide the care needed. What benefits can compensate for the enormous costs of providing twenty-four-hour care for months and extended care for years? The benefits of having a big brain and culture.80 The heads of babies who matured several months longer in the uterus would not fit through the pelvic opening, endangering the life of both baby and mother.81 Also, big brains become maximally useful if they are exposed to years of learning and opportunities to absorb cultural knowledge.82,83

  Other clues confirm the peculiarities of the human reproductive strategy.84,85 Most female primates have short periods of fertility each year that are advertised by red buttocks, pheromones, and provocative behavior. Female humans not only do not advertise their fertile periods, they are often completely unaware of them, to the consternation of women using the rhythm method to prevent pregnancy.
Although some scientists disagree, several see concealed ovulation as useful because it can make a partner more confident of paternity.86,87,88 Fighting a woman’s established partner to mate only once is rarely worth it because on any random day, pregnancy is unlikely. So concealed ovulation gives men in sustained relationships greater confidence that they really are the fathers of their long-term partner’s babies. This, in turn, shapes the motivation to provide long-term care to a child, half of whose genes are almost certainly the same as his. Comparative studies make it clear that the full picture is more complex, but the core idea remains important.89

  The selective advantages of mutually supportive pair bonds shaped the mechanisms for maintaining them. One is the deep emotional attachment that develops between members of a couple.90 Another is regular sexual intercourse, with its arousal of oxytocin and its tendency to facilitate emotional bonding.91,92 Couples have sex during pregnancy and lactation, when no babies will result. But sex at those times nonetheless increases reproductive success by maintaining the pair bonds that are crucial to raising successful offspring.93

  Those mechanisms help to maintain relationships, but they are unreliable in the long term. The anthropologist Helen Fisher has summarized cross-cultural studies to argue that the average human mating relationship lasts about seven years.94 Men who have a tendency to want sex with women other than their primary partners tend to have more offspring than other men.95,96 So it’s not surprising that most men have a roving eye, at the least. In most of the hundreds of different human cultures, men are not prohibited from having more than one partner if they can afford it.97 That doesn’t mean women like it. A man’s relationship with another woman can transmit disease and can reduce the time and resources available to the first partner and her children, so the tendency for women to object to such relationships is easy to understand.