7 Sex Education Lessons From Emily Nagoski's 'Come As You Are'

We discuss women and sex with Emily Nagoski, who, when she teaches a course on sexuality at Smith College, asks her students what the most important thing they learned in the class was. The majority of them have the revelation, "I'm normal!"

This begs the question, how did so many women come to feel that their anatomy, their sex lives and everything in between were abnormal?

Emily Nagoski, director of wellness education at Smith College. She teaches a course on women's sexuality. Her new book is, "Come As You Are: The Surprising New Science that Will Transform Your Sex Life." She tweets @emilynagoski.

1. There's a very wide range of women's sexual normalcy:
Emily Nagoski: "We're taught, from the very beginning in our culture, a model of sexual response that is based entirely on how men work, and so [the assumption goes] the extent to which women fail to be like men is the extent to which they fail to be sexually normal, and that's just not true...The standards, for me, for healthy, normal sex are consent, lack of unwanted pain and satisfaction. When all three of those things are there, you're doing really well. Satisfaction's complicated, though, because that's based on, 'I have an expectation of what it should be like and I either do or don't match that expectation.' And if your expectations are based on incorrect information, then you're going to be dissatisfied, not for medical reasons, but because your expectation doesn't make sense for who your body actually is."

2. There's probably never going to be a pink pill:
EN: "Since about 1999, we've had a medication to treat the most common male sexual dysfunction. And so, we've spent the last, oh, 15 years, looking for a female equivalent...The little blue pill...The big question is, where's the little pink pill? Where's the one for women? And so the last 15 years, there's been this explosion of research on women's sexual well-being, more than in the 20 years before that, and what that research has told us in the search for the pink pill is that there's probably never going to be a pink pill...Because the PDE5 inhibitors, which is what that class of drug is, increases blood flow to male genitals and it does exactly the same thing to female genitals. Unfortunately, while there's about a 50 percent overlap between male genital response and how aroused he feels, for women, there's about a 10 percent overlap between blood flow to the genitals and how turned on she feels. So, you can increase blood flow and it will not necessarily influence how aroused she feels."

3. Women haven't developed a very thorough knowledge of their own bodies:
EN: "Amazingly little has changed. Students walk into my class feeling very sophisticated, like they know a whole lot about sex, and what they know a lot about is what their culture has taught them about sex, and they know a lot about it. And that, it turns out, has very little relationship to what the science says about sex. So, halfway through my first lecture, which is about anatomy, they're sitting there with their jaws in their lap, having had their minds blown about, like, how big the clitoris actually is and what's the deal with the hymen. Things they really thought they knew that it turns out, no."

4. Desire for sex is very sensitive to context:
EN: "There are some situations, and if anybody thinks back about their own sexual history, you'll be able to identify certain periods of your life when you had really high interest in sex compared to other periods, and sometimes when it was really not so much in place. Some people are more consistent and stable across their lifespan, but for most people, it really changes a lot."

5. There's a dual control model of sexual response:
EN: "There's two parts to it, and one part is the gas pedal — or accelerator — which means the other part has to be the brake. So, the accelerator responds to all the sexually relevant information in the environment — everything you see, hear, touch, smell, taste, or imagine that your brain codes as sexually relevant and it sends the "turn on" signal. The brake, at the same time that that's happening, is noticing all the very good reasons not to be turned on right now — everything you see, hear, smell, touch, taste or imagine — that's a potential threat, and it sends a signal that says "turn off." So, arousal is not just the process of turning on the ons, it's also turning off the offs."

6. If we want to change the "ons" and "offs," we have to relearn:
EN: "There's a normal bell curve distribution of how sensitive the accelerator and the brakes are. Most of us are just heaped up in the average section. There are some people with extra sensitive, or insensitive accelerators and extra sensitive or not sensitive brakes — most of us are just average. And, from the moment we're born, our brains are learning what to count as sexually relevant and what to count as a potential threat, and that's what we can change. It's learned. There's almost nothing that's actually innately sexual, so we learn that and we can unlearn it and teach it something new."

7. There are ways to treat pain during sex:
EN: "Yeah, vaginismus is one of the most treatable forms of sexual pain. So, a brief definition — vaginismus is chronic inhibitory tone of the pubococcygeus muscle, so the muscle at the mouth of the genitals is locked up tight. And the treatment is a combination of systemic desensitization and meditation, essentially, where you learn to tighten and relax that muscle at will. So, you gradually learn to relax it when you want. It can be a source of very intense pain. A lot of couples will get to the point of being married and it's not until they want to have kids that they seek treatment because women can be fully functional, sexually, otherwise, but just not be able to experience penetration. So, it's highly treatable. When women bring reports of genital pain to their doctors, much too often, the doctors are dismissive and say that it's all in you head. So, if that happens to you when you go to a doctor, find a different doctor. There are some great books about pain and we know, for sure, there are effective treatments, not just for genital pain associated with the dryness of menopause, for example, but also for dyspareunia and for vulvodynia, effective treatments exist."

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