Venus Inferred by Laura Letinsky
The drama of coupledom, in full color. /photography/ |
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Faraway, So Close by Samantha Wolov
The second winner of our emerging photographer's contest says relax, it's just sex. /photography/ |
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Film Reviews by David Diehl, Bilge Ebiri and Logan Hill
Capote doesn't skimp on homoeroticism; Occupation: Dreamland's soldiers wonder how they wound up in Iraq. Plus, Date DVD: The Outsiders. /film/
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Dark Magic by Lily Oei
With their new fantasy film, MirrorMask, Neil Gaiman and Dave McKean make sex symbols out of bearded men in rubber masks. /film/ |
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Sex Advice From . . . Bakers by Fiona Byrne
Q: If you could take one item from the bakery into the bedroom, what would it be?
A: Vanilla mousse. It's light and buttery. You'd have to put plastic down though. Cleanup would be a bitch. |
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Monsters in a Box by Neal Pollack
Searching for generational significance in this season's glut of horror shows. /tv/ |
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Miss Information by Erin Bradley
It's Virgin Week! Plus: your letters to a serial cheater. /advice/ |
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Revolution Girl Style Now! by Kara Jesella
Ariel Levy's Female Chauvinist Pigs pretends third-wave feminism never happened. /books/ |
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Ms. World by Lynn Harris
Hail to Geena Davis and Commander in Chief. /tv/ |
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Scanner by Ada Calhoun
The Right declares war on pornography, because the other wars (drugs, Iraq, terrorism) are going so well. |
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The First Time: Transactions by Elizabeth Patton
The first time I dated a sex worker, he fed me fantasies; I fed him food. |
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Bad Sex With . . . Steve Almond by Steve Almond
Chestfro Agonistes. |
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Horoscopes by Neal Medlyn
Your week in sex. |
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Natural Impulse by Isaac White
Frolicking in an enchanted forest. |
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Lurking in the Background by Bilge Ebiri
Ricky Gervais upstages himself in Extras. /tv/ |
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Film Reviews by Mike D'Angelo, David Diehl and Logan Hill
Quirky gang film Dear Wendy features celebratory breast-baring; Steal Me, a teen's Oedipal complex. Plus, Date DVD: Garbo. |
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There's a sex scene in the 2001 film Y Tu Mama Tambien that may qualify as the most timeless in cinema history. No, not the menage a trois
cited in countless personals ads as "sexiest onscreen moment," but the
one in which when Julio has finally wrangled a moment alone in the
backseat with the older woman, Luisa, whom he and his best friend both
hope to seduce. Zippers are fumbled, penetration is achieved, and
ecstasy ensues, about thirty seconds into the act — for one of them.
"Si! Si! Si!" Julio cries. After a moment, we
see bewilderment, then a telltale look of disappointment, spread across
Luisa's face.
What man hasn't encountered that humiliating
look? "Don't worry about it," I remember my first girlfriend telling me
when I was sixteen and did not yet cringe at hearing those four words.
I wouldn't consider myself a premature
ejaculator — well, not anymore. But a recent study by Johnson and
Johnson puts my chances of suffering from the condition, simply in
virtue of being an adult male, at one in three. The study's timing
isn't coincidental. Pending FDA approval, Johnson and Johnson will
market the first pill intended to treat premature ejaculation (PE) in
2006.
Clinical studies sponsored by the company show
that men with PE last nearly three minutes on dapoxetine (up from an
average of fifty-five seconds). Such a brief improvement may not sound
very encouraging, especially
It's tempting to view dapoxetine as Viagra for the overly efficient lover. |
considering
that men who took a placebo lasted for nearly two. Still, according to
Dr. Jon Pryor, the urologist who conducted the trials for Johnson and
Johnson: "Those who had a minute or less improvement had no change in
their level of sexual satisfaction, while those with more than a minute
improvement noted an improvement in overall sexual satisfaction."
On paper, it's tempting to view dapoxetine as
Viagra for the overly efficient lover, a quick-fix for a problem that
doesn't necessarily call for anything more. After all, for those who
already spend less time enjoying themselves than avoiding a hasty
climax by picturing Ann Coulter au naturel, what's the harm?
The ads for dapoxetine, if they are anything
like those for Viagra, Levitra and Cialis, will likely claim that
there's no harm at all. (But instead of men throwing footballs through
tire swings, prepare for more complicated innuendo: sand sifting slowly
through hourglasses, baseball games going into extra innings.)
Unfortunately, even if I am a premature
ejaculator, I'm not likely to know it. While as many as thirty-four
percent of men suffer from the problem, according to Pryor's studies,
other surveys suggest that as few as ten percent of men think they do.
Ultimately, there is no indication of how many of those who are anxious
(or not) should be.
For all its reported ubiquity, it isn't easy
getting a PE sufferer to go on the record, either. While former
presidential candidates and football stars have hawked impotence drugs,
googling "premature ejaculation support groups" produces only a
smattering of anonymous discussion boards among the countless
advertisements for snake oils, pelvic muscle strengthening regimens,
and anesthetic creams, aimed at preventing the gun from going off until
the third act.
So where are all the premature ejaculators, the
grown-up Julios? According to one of the PE sufferers I spoke with, a
thirty-seven-year-old television writer who would rather be called Jon
than by his real name, they've been shamed into hiding. "No one
will talk about it on the record, because it's so tied into virility
and manliness," says Jon. "It's worse than not getting it up — there
are medical excuses for erectile dysfunction, but if you have PE you're
just a little boy. That's the perception."
For years Jon relied on the time-honored method
of many a hair-triggered college student: he would get hammered before
every date he went on. Then he stumbled on the squeeze and stop-start
methods popularized by Masters and Johnson in the 1970s. The first
technique, more or less self-evident, involves slowing down before the
point of no return; the second is not unlike tightly gripping a garden
hose to halt its flow.
According to most sex therapists, neither
approach is entirely effective. Neither is dapoxetine, which increased
sexual satisfaction only fifty percent of the time during trials. Yet
in spite of already having developed a treatment for the condition,
Johnson and Johnson has yet to define PE in a way that explicitly
defines who needs treatment. Rather than relying strictly on
ejaculation time, the study takes into consideration "different aspects
of this condition, including distress, interpersonal difficulty, sexual
satisfaction, lack of control over ejaculation, persistency, and
latency time."
Why such a complicated definition? One reason,
says sexologist and PE specialist Michael Metz, is that drug companies
are learning that simply restoring "virility" to patients doesn't
create long-term profits. "Many studies suggest the dropout rate after
an initial trial with Viagra or Levitra is forty to eighty percent,"
says Metz. "Couples just stop using it or don't renew their
prescription. The drug companies are changing their ads to feature not
just a guy, but a couple. The suspicion is the drug doesn't help the
couple feel integrated, or the woman even feels it undermines her role."
While erectile dysfunction is fairly easy to
observe, PE may not be so evident, depending on the man's performance
standards. Quite to the contrary, says Italian urologist Francesco
Montorsi, who has studied PE globally. "In some areas, such as the
Middle East, coming quickly is perceived as a sign of the virility of
the man," he says. The self-reported sexual satisfaction of such a man
is unlikely to be reduced by his admirable swiftness.
So why do some urologists, such as Dr. Marcel
Waldinger of the Netherlands, recommend that doctors rely strictly on
latency time or IELT (two minutes, usually) to determine if a patient
suffers from PE? Much as it sounds like the metric a group of frat boys
might use, that standard avoids some of the pitfalls inherent to
self-diagnosis.
"Twenty to thirty percent of couples have one minute or less of intercourse, but it's not a problem," says Metz. |
According to Jon, many men may have an
unrealistic idea of what their staying power should be. "We've seen the
movies reinforce the paradigm of Tom Cruise and some hot blonde coming
at the same time, which probably doesn't often exist," he says. When it
takes a half-hour for the blonde to orgasm, Jon says, it's not clear
whose "fault" it is — or whether anyone is to blame at all. Conversely,
men who simply don't make the effort to please their partners by
lasting longer might be incorrectly categorized as premature
ejaculators.
Again, cultural standards play a role. The 1948
Kinsey Report found that three-quarters of men orgasmed within two
minutes; a 1974 study found that number to have increased to ten to
fourteen minutes. Some researchers, like Montorsi, attribute the
lengthening of intercourse duration to faulty data. But others, like
evolutionary biologist Elizabeth Lloyd, author of The Case of the Female Orgasm,
say one factor above all else explains the increase in anxiety over PE
at the end of the twentieth century: the increase in anxiety over the
female orgasm.
"Kinsey himself thought that quick ejaculation
was a sign of health and virility; he was very adamant about it," says
Lloyd. "He was annoyed when people implied there was a problem with
early ejaculation. He felt it was a sign of superior masculinity."
Lloyd contrasts Kinsey with Masters and
Johnson, who paid far more attention to the female orgasm. "With rising
awareness of women's desire to have orgasms and her sexual prowess and
need, this put more pressure on men to perform and sometimes to view
themselves as early ejaculators," she says.
Unless one relies strictly on IELT to define
PE, it is impossible to fully separate the question of premature
ejaculation from the female orgasm, according to Lloyd. Problems that
co-exist with PE include low libido and anorgasmia on the part of their
partners. Men may speed themselves up when they sense that their
partners are not enjoying themselves. In fact, Masters and Johnson
eschewed IELT all together, defining a PE sufferer as one who
ejaculates more than fifty percent of the time before his partner
orgasms.
From a marketing perspective, it makes sense to
isolate problems in male and female sexuality, says Lloyd; one can then
aim two different solutions at each couple. In that sense, the sexual
politics of the Masters and Johnson era, which suggested that women who
didn't orgasm had poor lovers, unwittingly assisted the drug company's
quest to treat "sexual dysfunction" with drugs.
In fact, says Lloyd, PE is better defined as an
abnormality (one standard deviation away from the norm) rather than as
a dysfunction, i.e. a disorder requiring treatment. She suggests that
the poor sexual satisfaction reported by couples who suffer from PE has
more to do with a loss of intimacy, rather than from lost orgasms.
"There isn't much reason to conclude that
intimacy needs to terminate with male orgasm," she adds. "It's very
clear that women's ideas about good sex are not centered around
intercourse. Only a maximum of twenty-five percent of women reliably
have orgasm from intercourse, and thirty-three percent never do in
their entire lives. When you ask about PE and sexual satisfaction, it
is barking up the wrong tree."
But if Lloyd is correct that PE affects men
more than it does women, the problem may not be so severe after all. A
1992
study of American sexuality, the National Health and Social Life
Survey, suggested that unlike impotent men, those who suffer from PE
are no less happy or physically satisfied than those who do not.
"Twenty to thirty percent of couples have one
minute or less of intercourse, but it's not a problem," says Metz. But
he
PE isn't nearly as severe a problem as the drug companies have prognosticated — yet. |
is
quick to point out they don't oppose the approval of dapoxetine as a
treatment. He merely hopes, as many sex therapists do, that the drug's
marketing won't further misconceptions about what good sex is.
"If a clinician is trying to help a man, we
need to use all the possible resources," he says. "In some cases that
will mean medication, but it should never be the sole treatment.
There's a huge possibility the medication will further discourage the
man and couple if it doesn't work."
Johnson and Johnson says it will be careful to
avoid promoting anxiety on the part of the public. "We would take a
very responsible approach to bringing it to market," says spokesperson
Julie Keenan. "We'd be respectful of condition, partner, and targeted
to an appropriate age and population with the condition."
Keenan adds that doctors have used
antidepressants such as Zoloft and Paxil for years to treat premature
ejaculation,
and
dapoxetine works similarly, without producing such unwanted side
effects as lowered libido. (Nausea and diminished enjoyment are
reported, however.)
Nevertheless, Leonore Tiefer, a professor of
psychiatry at the NYU School of Medicine, argues that
erectile-dysfunction-drug advertising has already set an unhappy
marketing precedent. "We're already seeing the disease marketing
campaigns: you could be faster, you could be more satisfying," says
Tiefer. "The idea of a disorder is completely absent. We can be assured
there won't be any clinical reality to the marketing campaign. It will
be marketed for everyone to use."
According to Tiefer, it isn't likely that PE is
anywhere near as severe a problem as the drug companies have
prognosticated — yet. What may change that, Tiefer says, is the
direct-to-consumer marketing campaign likely to follow the drug's
approval by the FDA. Evidence suggests that direct-to-consumer ads have
exerted tremendous pressure on physicians to provide patients with
drugs they have seen advertised on TV, even when those prescriptions
are not medically warranted or even advisable. Worse, says Metz, few
physicians follow up with their patients.
"We know with Viagra, guys will go to a
physician and insist they want the pill," he says. "Physicians should
say great, but call me in a month."
Still, it's hard to argue against the right of
men such as Jon to learn about and have access to the drug. "Ninety
percent of the time, especially before I met my wife, I was more
worried about not coming than I was about enjoying myself," he says.
"The drug probably could have changed that."
Let's hope it does. But given how
anxiety-ridden sex already is, let's also hope that the cure's hype
isn't any worse than the disease itself. n°
| ABOUT THE AUTHOR: |
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A recent graduate of the Columbia Graduate School of Journalism, Justin Clark has written for L.A. Weekly, Psychology Today, Black Book, Architecture, Fuse, and The Fader,
among other publications. He is currently researching a history of the
American child prodigy, and writing a mystery novel set in Los Angeles.
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©2005
Justin Clark
and Nerve.com |
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