Sex. Nowhere is the interplay between body, psyche and hormones as clear as with the love game. And there is little more lack of knowledge in women. “And it really doesn’t matter what background or culture someone has, what training she has had,” says clinical psychologist and sexologist Bianca van Moorst.
Every day Van Moorst (59) sees the consequences of that lack of knowledge among women in her consultation room in OLVG hospital in Amsterdam. Just like her colleagues, psychiatrist Mireille Boerma and gynecologist Dorenda van Dijken, with whom she cooperates a lot, including on the MenopausePoli. That’s why they wrote a book together, Brain, hormones, sex. About the life phases of a woman.
Van Moorst: “The influence of hormones on women’s complaints, such as stress, thyroid or sex hormones, goes so much further than the transition. From an early age they have influence on the brain, body, the psyche and on sexuality.”
Do doctors and psychologists know that too?
“Healthcare providers often still look strongly at a complaint from their own field. We see that multidisciplinary look, luckily, are coming more and more. But also for the young psychologists in training that I am teaching, it is really an eye -opener that they have to ask their menstrual cycle and hormonal anticonception, endrogone in their female patients. just a little to penetrate. ”
Women still make less sense, more pain and less often an orgasm during sex than men
More and more is known about female sexuality, such as the anatomy of the clitoris. Do more women have good sex now?
“According to the latest figures from the Rutgers Foundation, that is still not the case. Women still have less sense, more pain and less often an orgasm during sex than men. 27 percent of women between the ages of 18 and 80 suffer from pain during sex with the penis in the vagina. Even in women under 25 years of age it is.”
That’s a lot. What is going on with young women?
If it hurts, you go too fast. Many women, and also their partners, don’t really know what they need to get sexually excited. Only when you are really excited do your vulva, vagina and clitoris swell and your vagina will become moist. If you also relax the pelvic floor muscles, the penis can painlessly inside. Sometimes as a woman you just need more time.
“It may be that the other person wants faster than you. Or that you actually don’t want it at all. Many young people find it difficult to talk about that together. What I find shocking: that a lot of young girls experience penis-in-vaginasex pain and find that normal.”
Isn’t that a bit part of it?
“No! Also that first time should not hurt. Then exactly the same mechanism plays. That gastric fall is also such a myth. That is not a fleece, it is a kind of man that just moves with that. It often still tears. It often remains visible even after births. The bleeding that some women have at the first time. So many myths about sexuality. “
What does that excitement sometimes ‘do not’?
“Sex is just like any emotion: there is an incentive and our brain is on that. That can be something you see, hear or smell, or a reminder or fantasy. Your brain sends more blood to your genitals in such a sexual stimulus. That happens unconsciously, it goes on and off all day.
“Sometimes, if you are aware of it and the context is suitable, you can make that starting sexual arousal bigger. A lot is needed to make it go well. A healthy functioning body of course, but also psychological peace. And the right environment. That is very underestimated. I hear so often: the door of the bedroom is always open, because the children have to come in.
Sex should be like shared dining, with all kinds of tasty snacks to share
What is the biggest myth about sex?
“That sex consists of foreplay, penis-in-vaginasex with hopefully an orgasm, afterplay. As you used to get a starter, a main course and dessert in a restaurant. Because of all the generations you can still hear that, especially among heterosexual people of course.
“But sex should be much more like Shared Dining. We take all kinds of different tasty snacks and we share them. And you think one is a bit tastier, you can do that a little more. I think the other is better, I get that more. Penis-in-Vaginasex can then be one of the options, but not the only option. ”
Do women feel less like sex than men?
“Women score in the studies lower on sexual desire than men. The question is: what are they not in the mood for? That remains an important question. I try to learn to find women with sexual problems: what do you like? Where do you need? Many women in the transition are too tired because of sleep shortage, or do not feel like being in hand, but most of the women would still be in hand, would be in hand, would still be in hand in hand, would still be in hand in the bench. more.”
In a quarter of the women around the transition, penetration hurts too much. The vagina wall becomes drier and thinner due to the fall in estrogen. But that is not the culprit, do you write?
“No. Women with that vulnerable skin can also have great penis-in-vaginasex if they take enough time to get well excited and they can relax their pelvic floor.”
Supplementing the missing estrogen with hormone supplementation therapy often helps?
“It is always both biology and psyche and relational. Sometimes you can first start with local hormone therapy to make the vagina more flexible and better blood blood. But meaning and excitement do not come from a jar. Many doctors give local estrogen and are never talking about sex. Or worse, a pain relief with Lidocaine, so that women, so that women, so that women, so women, so women, so women, so women, so women, so women, so-to-women, so women-in-sings Being able to have women in the cold.
“Even without hormones you can enjoy sex. We see that, for example, in women with hormone -sensitive breast cancer. They get long -term hormone inhibitors, so that less estrogen and testosterone are produced. And that is killing For your mood and for your sex. They are crackling and sex gets slow as a steam train starts, if it already starts.
“We are not allowed to give hormone therapy, sometimes not locally. But if they take more time, look for what is still nice, then some of those women who get back to sexual response. Then perhaps have to adjust their usual sexual repertoire. But if they can make that change, they are often very happy.”
Are there also women who feel more like after the transition?
“Certainly! That often has to do with that context. Those women often describe that they now have more time with their partner, the children are out of the house. Moving no longer only has to be after eleven o’clock, it is just nice at noon. It is often women who now really know how their body works, with partners with whom they are talking about it.