Paleo and Sex: How to Have a Ravenous and Kickass Female Libido

Paleo and Sex: How to Have a Ravenous and Kickass Female Libido

Sex is one of the most important things we do.

Desiring sex, therefore, is one of the most important things we can feel.

According to a Journal of the American Medical Association (JAMA) study reported on in February 1999, about 43 percent of women (compared to 31 percent of men) suffer sexual inadequacy for one reason or another.  Interestingly, this is thought to actually underestimate the real level of sexual dysfunction in the U.S.  Yikes.

What follows is a description of the physiological components of female libido, how to maximize those components, and then a discussion of the psychosocial components.  The psychosocial components are the trickiest to get a handle on, but they are also treatable with proper therapy (if necessary), love, empowered embodiment, and raging, well-deserved confidence.

Need more information to find you raging, well-deserved confidence? Check out my bestselling book on women’s health.

What factors play a role in female libido?

Specific foods are not in reality relevant for female libido, except for how they may temporarily increase testosterone levels (a la oysters).  Instead, all of the physiological factors that influence female libido boil down to long-term sex hormone levels and balance.

First, absolute levels of hormones are important: for example, the greater amount of sex hormones in the blood, the sexier a woman will feel.

Secondly, balance is also crucial.  For example, estrogen is not typically considered important in arousing a woman’s sex drive.  But having clinically low estrogen levels–that is, estrogen levels below the baseline for proper sexual function–prohibits absolutely any kind of sensation a woman might have in her clitoris. That’s scary.

This is the effect that all hormones have on sex drive, generally:

1.Testosterone: Increases female libido.  Testosterone is the hormone primarily responsible for sex drive in both men and women.  When women with hypoactive sexual dysfunction disorder are treated with testosterone, for example, they often experienced increased sex drive.

Higher testosterone levels also enlarge the clitoris (good to know if yours is shy!), but unfortunately if other hormone levels do not rise along with testosterone, symptoms of hyperandrogenism such as facial hair           and acne may manifest themselves.  For this reason, testosterone supplementation is not an advisable method of increasing female libido.

2. Estrogen: Crucial at baseline for sexual function.  It is also the primary hormone responsible for vaginal lubrication.  However, estrogen is a testosterone antagonist, so the more estrogen a woman has in her               system, the less testosterone she has available to pump up her libido.  Estrogen dominance therefore is one of the greatest culprits in contemporary Western sexual dysfunction.

3. Progesterone: Another testosterone antagonist.  Having elevated progesterone levels relative to the rest of the sex hormones prevents a woman from achieving orgasm.

4. Prolactin: Not talked about very often, since it’s primary role is in lactation, but it is also involved in pituitary-ovary signalling.  Increasing prolactin levels increase vaginal lubrication and sex drive.

5. Luteinizing Hormone: Highly correlated with sex drive.  LH is a pituitary hormone that triggers ovulation in a woman.  Many researchers believe LH is one of the primary game-makers in sexual arousal.

Because of the role each of these hormones play in female libido, the menstrual cycle demonstrates a clear pattern in fluctuating libido for most women.

So how does the menstrual cycle affect female libido?

Testosterone levels rise gradually from about the 24th day of a woman’s menstrual cycle until ovulation on about the 14th day of the next cycle, and during this period women’s desire for sex has been shown, in general, to increase consistently. The 13th day (the cusp of ovulation) day is generally the day with the highest testosterone levels.  It is also the day on which LH spikes.   Ovulation, therefore, and no surprise here, is typically the randiest time of the month for a woman.  In the week following ovulation, the testosterone level is the lowest and as a result women experience less interest in sex.

During the week following ovulation, progesterone levels increase, and this often results in a woman experiencing difficulty achieving orgasm. Although the last days of the menstrual cycle are marked by a constant testosterone level, women’s libido may boost as a result of the thickening of the uterine lining which stimulates nerve endings and makes a woman feel aroused. 

Also, estrogen levels are at their lowest throughout menstruation and into the follicular phase (the first two weeks of the cycle) so women experience the least vaginal lubrication at this time.  Because testosterone and estrogen are both increasing, however, sexual desire is ramping up again in time for ovulation.

What factors influence these hormone levels, and how do we make the best of them?

Estrogen Dominance:   As I mentioned above, estrogen is a testosterone antagonist.  When estrogen levels are too high relative to testosterone levels, female libido plummets.  Women can become estrogen dominant by consuming too much soy (since soy acts as an estrogen in the body), by being overweight (since estrogen is produced in fat cells; see my book on healthy weight loss here), and by being stressed out (since estrogen can act as part of the inflammatory response).  Women with estrogen dominance often experience symptoms of PMS, too, which does nothing to help libido.

Birth Control Pills: Birth control pills are another way that women can become estrogen dominant.  But that is not the only way they negatively effect female libido.  Progesterone levels are often elevated out of the normal range on birth control pills, and testosterone sometimes plummets.

Yet the effects of birth control pills on women is wholly unpredictable.  Increasing levels of one hormone might decrease another, or might increase them exponentially, depending on how the woman’s HPA axis and ovarian feedback mechanisms work.  Women also experience a whole range of side effects on birth control pills ranging from acne to suicidal depression.  Birth control pills are no laughing matter, and their effect on female libido is wide ranging.

All that said, since birth control really is so unpredictable, birth control can play a stimulatory role on female libido, especially if she has chronically low levels of sex hormones in her blood.  Some women feel like a million bucks on estrogen pills.  If that is the case, however, birth control pills are only putting a band-aid on the problem, rather than solving it at its core.  That often requires looking at physiological problems that deplete sex hormone levels such as low body fat, stress, and energy deficits.

See Birth Control Unlocked for more information on birth control options outside of the pill.

Testosterone blockers:  Some women get on testosterone blockers to help them with symptoms of hyperandrogenism or problems in their menstrual cycles that come from high testosterone production.  However, blocking testosterone is as good as eliminating it entirely.  Spironolactone and flutamide are the two most commonly used testosterone blockers.

Hypothyroidism:   Up to ten percent of women have clinical or sublicinical low thyroid issues.   Hypothyroidism is significantly linked to low libido. T3, the active form of thyroid hormone, is crucial for the proper functioning of cells and organs.  Without T3, the reproductive system barely manages to inch forward.  Sex hormones suffer greatly, both at the ovarian level as well as in production at the hypothalamic and pituitary levels.

Hypothyroidism is caused by a wide variety of problems.  Hashimoto’s thyroiditis is a an autoimmune condition that accounts for the vast majority of Western hypothyroidism.  This can be mitigated by eliminating modern toxins, specifically wheat, dairy, and omega 6 vegetable oils, from the diet, and also by paying attention to gut health with gut-healing diets such as the GAPS diet or the one I recommend in Sexy By Nature.

Iodine-deficient diets can cause hypothyroidism.  This used to be uncommon in western countries, since western countries iodize their salt, but sea salt often does not contain much iodine in it.  Moreover, many Americans are now eschewing salt for “health benefits” (this is misguided), so their iodine levels are suffering.  The solution to this is to consume iodized salt, or to perhaps supplement with kelp for a while.  Iodine supplementation is tricky, however, and should build up slowly a la the recommendations of Paul Jaminet.

High intake of raw cruciferous vegetables can hurt an already suffering thyroid gland.   Yet more importantly, low-carbohydrate diets contribute to hypothyroidism. Glucose is required for the conversion of T4 to T3 in the liver, so without adequate glucose supplies the body’s thyroid functioning suffers.  This is a problem that many paleo women wrestle with.  Adding just 50 or 100 grams of starchy carbohydrate to a daily diet, however, can increase energy, improve sleep quality, improve quality of skin and hair, and also boost reproductive function.

Repairing sub-clinical hypothyroidism has also been shown to remove ovarian cysts and help anovulatory women both ovulate and menstruate.  For more on hypothyroidism, see Chris Kresser‘s work.

Stress:  Stress is a psychological libido-killer, but it also has a physiological analog.   When stressed, the body produces cortisol.  Cortisol has a negative feedback effect on the hypothalamus, and it can inhibit all of the hormonal signalling that comes out of the hypothalamus.  The hypothalamus is responsible for inciting pituitary function, so stress plays a very real role in inhibiting reproductive function.  As many as five percent of women suffer reproductive symptoms of chronic stress.

Low Dopamine:  Dopamine is the most important neurotransmitter for sexual prowess and reproductive function.  Fortunately, dopamine deficiencies are very often corrected with the introduction of exercise into someone’s daily life.  Almost nothing increases dopamine levels as well as exercise does.  (Although sex also has potent dopamine-releasing effects: skin-to-skin contact shoots dopamine levels through the roof.  But then dopamine levels plummet post-orgasm, creating withdrawal-type symptoms.  This is how the body reinforces sexual behavior.)

Some women have reported to me personally the return of menstruation from amenorrhea after resuming regular sexual activity. They were as surprised as I was.  Yet perhaps we should not have been so surprised. Dopamine is a potent neurotransmitter and, coupled with serotonin, can significantly up-regulate sex hormone production.

Low serotonin: Though excess serotonin has been linked to decreased arousal, serotonin also increases prolactin levels.  Prolactin is important for vaginal lubrication and for sexual arousal.  Ways to increase serotonin levels include adequate protein ingestion (.5 g/lb of lean body weight each day), adequate sun exposure, and perhaps most important of all, adequate sleep.

Low Body Fat/Excess Exercise/Energy Deficits:  These three phenomenon almost always manifest in tandem.   Yet the end result is the same: with low body fat, with excess exercise, and with caloric deficits, the body detects starvation.  Leptin levels plummet, and the hypothalamus stops thinking that the body is sufficiently fed.  Without leptin, the entire pituitary sex hormone cascade is not enacted.  No LH, no testosterone, no estrogen, no prolactin, no progesterone.  Body fat is unquestionably crucial for all reproductive function.  Female libido just happens to be the one that’s the most fun to explore once proper body fat levels are restored.


Psychological factors effecting female libido:

There remain the psychological aspects to increasing female libido.  And of them there are many.  Perhaps a woman’s libido has been killed by a negative sexual experience.  Or perhaps the woman is too stressed out by other factors to care about sex…or perhaps sexual relations between two people are strained because they can’t stand each other outside of the bedroom even more than they can’t stand each other inside the bedroom.  Perhaps a woman’s lover is an ugly lump.

Many of those factors are outside my realm of expertise.

Some of them are inside of it, however, and fiercely.


Women need first to think they are sexy.  I am so tired of women comparing themselves to others, and always thinking that beauty is relative.  Beauty is not relative.  It is everywhere.  And in everyone.   If she is beautiful it does not mean that you are less so. Period.  I don’t care if you have a chubby stomach.  I don’t care if you think your hair is boring.  I don’t care if your right boob is larger than your left.   Not a single other person cares either.  At all.  The only person who cares is you.   No one wants to make you “perfect” but you.

You don’t have a single thing in the world to apologize for.  No one is looking for apologies.

Instead, people are looking for statements.  They are looking for fun.  They are looking for inspiration, for character, and for life. 

In that way, what other people want from each other is not necessarily for them to meet some ridiculous standard but instead to make them feel good.   Whether that’s through sharing of your self-love, through your wicked personality, or through your liberated and unapologetically wild fantasies is totally up to you.  The point being that confidence and self-love are the most important factors for actually being attractive.  Sure, classic “looks” may follow, but only after a woman has convinced others that she is worth looking at.

Not a single person in the world wants to sleep with an apologizer.  “Sorry, I don’t like who I am,” does not necessarily read like a 5-star resume. People won’t be throwing themselves at that.  What they will instead throw themselves at is: “I am different from what you expect.  But that’s an asset.  I am worthy like you wouldn’t believe, and I am going to rock your world.”

Confidence is key.  Beauty is key.  And the thing is– damnit–it’s not faked confidence.   It’s not faked beauty.  You really are beautiful.  You really are unique.  You really are a natural, sexual, alive, vibrant woman.   You do not have a thing in the world to apologize for.  You are who you are, and you love being yourself, and you can share yourself powerfully and joyfully with others through sex.

This kind of self-love is why people get laid.  It’s not because they have perfect torsos and racks as big as wombats.   It’s because they have hot souls.

So confidence is important. So important, I wrote a book on how to find it through food and lifestyle.  There’s one other crucial aspect I can speak to.   It’s this:



Look.  Sex is natural.  Sex is so natural, in fact, that it’s the very reason we all exist.  And sexual desire is natural.  It is, by extension, the very reason we all exist.  For that reason, along with many others, there is not a single immoral aspect to having sexual desire or having sex.  Period.

And sex is not gross. 

And a woman’s desire is not gross.

And a woman’s vagina is not gross.

And a woman having sex is not gross and not a slut.  

Or maybe she is a slut, but that’s cool because that’s natural, too.

Men who don’t understand any of that are not real men.

The whole point being that American culture is a culture in which sexuality, and female sexuality in particular, is a dirty thing.

That is not okay.

It’s so not okay.

It is, in fact, plain old wrong.  Sex is natural.  If a woman (or man!) wants to be delighting in it, and more power to her.    She is embracing her natural body.  She is embracing her natural desires.  She is owning her own confidence.  And she is exalting in the vibrancy of her very existence.

If that’s not hot, I don’t know what is.


High fives for sex!


The Myth of Female Sexual Complexity

The Myth of Female Sexual Complexity

Today is a day for ranting.

Today is a good day.

Here we go.


Have you ever heard someone say “the female body is so complicated?”

Have you heard female genitals referred to as complex, mysterious, strange, alien, or elusive?

Have you ever heard the female orgasm described as “impossible” in large part because “it’s just more difficult to make it happen for women than it is for men”?

Perhaps you have heard the female body described this way your entire life, so none of this seems strange to you?

This is exactly the case for nearly every woman and girl in America today.

Today, we live in a world in which the female body is a “mystery.”

It’s complex. It’s elusive. (By the way, if you can get it to orgasm, you are a hero.)

Most people probably just basically think these sorts of statements are true. “Sure,” you may say. Of course that’s true. It just makes sense.

And even if people think that this whole mysterious idea is incorrect, it’s likely that they don’t find it problematic. So they don’t care all that much. What’s the big deal? Who cares if the female body is thought of as mysterious or not? Should anybody care? Does anybody care?

This girl does:

Stefani Ruper



And she cares a lot. Here’s why:

The Myth

I believe that “female complexity” – especially with regard to genitals – is a myth.

I believe we have constructed this myth over the course of centuries and decades. Throughout Western history, men have been considered normal. But women have been abnormal, deviant, tempting and even devilish. (Trust me, I study religion for a living.) Men have been the status quo. Women have been The Other.

Men’s bodies have been acceptable, and women’s bodies have not. Men’s bodies have been studied extensively and treated well, and women’s bodies have not. Men’s bodies have been applauded for their ability to rape, dominate, and insemniate, and women’s bodies have not.


Men’s pleasure has been and today continues to be thoroughly studied, advocated, and glorified. Think of all of the pop culture references to oral sex performed on men. Think of ‘milk shakes’ bringing all the boys to the yard. Think of Christina Aguilera in Eminem’s Slim Shady and who she gave head to first.

Think of all the drawings of penises you see scribbled over journals, lockers, graffiti walls, and even people’s faces when they pass out drunk. Think of being asked to join the “pen 15” club when you were in junior high school. Think of the way in which it is acceptable to say “penis” in public, but everyone kind of lowers their voice when they say “vagina.”

Think of all the Cosmo articles about how to please your man. Think of the expectations placed on your ability to perform oral sex on a man, starting from a young age. I very, very clearly remember a good friend of mine disappearing behind a factory with a boy to pleasure him when we were twelve years old. Twelve! She did not receive sexual attention from a man in a loving manner until years later. I also remember the high amount of pressure placed on me and my girlfriends as we began journeys into sexuality and adulthood, and needed to give our partners oral sex or else we were prude. I am by no means saying that the way we behaved was awesome. Nor am I saying that we need to stop teenagers from being sexual. Not at all. Neither  is the case.

But what I am trying to demonstrate is that in our culture, male pleasure is very significant, and the male reproductive organs are much more acceptable than the female.

Nowadays, our culture is definitely less skitish about female pleasure, don’t get me wrong. But that doesn’t mean any significant battles have actually been won.

Deconstructing the myth

I believe that the whole idea that the female body is sooooo complex guys omg arises out of our culture’s attachment to and acceptance of male pleasure. It is a fabrication. It is a lie. It (subconsciously) justifies our persistent denial of female sexual equality and needs.

And it needs to stop. Now.

Imagine, if you will, a culture in which the female sex was dominant.

Is it not easy to reverse the roles? Is it not easy to imagine vulvas scrawled on subway doors, lewd pop culture images of men pleasuring women, and penises shunned as abnormal and complicated to please …. whereas vulvas are celebrated for their simplicity and ease for pleasuring?

Consider a diagram of each the male sexual organs and the female sexual organs.

If you remove as many mental biases as you can, can you not perhaps see that the penis and the vulva are actually not all that different? That they are actually not all that more simple or complicated than one another? In fact, the general anatomy of these two structures is the same, and made out of the same tissue! A clitoris is simply a small version of a penis – or, a much better way to put it: a penis is simply a large version of a clitoris. Lips are the female equivalent, more or less, of testes. And then there is a vagina, in which a penis can go. The female anatomy is not a huge mysterious complexity. It is not. It simply is NOT.

We only think it is, because we have been told it is.

I invite you then to think about what it takes to sexually pleasure male or female genitals. In our culture, we always say, “it’s so easy to please a man” and “so hard to please a woman.”

But  please. Excuse me. At least you can breathe when you perform oral sex on a woman. You cannot always really do so when you perform oral sex on a man, because there is oftentimes a large object in the way of your wind pipe.

And is it all that more “simple”?

No! It isn’t. (And I can say this, I really can, with experience, because I have sexual relations with all genders.) The penis has good erogenous zones and bad ones, just like the female genitalia do. And it can be approached in many different complex ways, just like the female genitalia. Some people like some actions, and some people like others.*

Period. End of story. Everybody has preferences. It’s not just women.

We think women are harder to please because we have come from a history of shunning the female body.

Now: it may be slightly easier to bring a man to orgasm, especially young men (seriously, wow)… BUT data collected in hospital studies actually tells us that when women and men masturbate, it takes them the exact same amount of time to orgasm. 

This fact is alarming, because what it means is that we have literally convinced ourselves that women cannot orgasm simply because (many) guys simply don’t want to make it happen…

and used something like “but female genitalia are so complicated!” as an excuse.

Guess what, everybody.

Not that complicated.

Broader implications

You might  think then… so what?

“I don’t care all that much about sex.”

“I don’t care all that much about physical pleasure.”

Well, to be honest with you, I don’t either.

But I care about this so deeply because it is a part of an underlying problem:

when women are ignored, denied,  mistreated, or misunderstood sexually, it means that they are being ignored, denied, mistreated, and misunderstood in other realms, too.

None of it is separate from anything else. Our culture’s attitude towards women permeates all aspects of our lives. 

Because we do this. We think that women are mysterious. 

Men are simple, we say. Women are complex!

Men are rational. Women are emotional and impulsive.

Men are straightforward. Women are circular.

Men are sane. B*tches be crazy.

These things are all very real, and very problematic.

So what do we do about it?

Chipping away at one specific angle of gender misconceptions at a time – and especially one as emotionally charged as sex organs – will go a long way toward making a more equitable, compassionate and empathetic future for the sexes.

I really believe it will. I do, I do.

-We get more open (pun unintended but awesome) in general about the vagina and the whole vulva.

-We become more comfortable with the words themselves. Vulva. Vagina. Clitoris. Vulva. Vagina. Clitoris.

-In fact, we make a point to emphasize the words ‘vulva’ and ‘clitoris’ because ‘vagina’ – the one that’s most well-known – is only the most famous one because it’s the part a man puts his penis in.

-We teach those words to young people as easily as we do other sexual terms.

-We have discussions with our lovers about how to please us. We don’t expect that people just know. In the culture we live in especially, that’s just not in the cards. It’s not necessarily fair. So we have to communicate openly and lovingly with our partners about what works for us and what doesn’t.

-We stand up for our right  for sexual pleasure, along with all other kinds of reciprocity and empathetic treatment.

-We talk with young boys and girls about gender dynamics, and the history of gender imbalance.

-We educate young people about the physiology of both male and female bodies equally, and do not do so with language that discourages comfort with the female body.

… and that’s all I’ve got for ideas for now.


Do you have any ideas about what we can do?

Please let me know! I feel very strongly about this (not like that wasn’t obvious)….

So any input you have would be great!!


Finally, take a look at these three awesome books, which are the cornerstone of my sexual know-how and a big part of the reason I wrote this blog and feel this way:

She Comes First: The Thinking Man’s Guide to Pleasuring a Woman

He Comes Next: The Empowered Woman’s Guide to Pleasuring a Man

The Guide to Getting it On: A Book about the Wonders of Sex

And this post:

The Real Reason Women Orgasm Less Than Men


I believe that "female complexity" - especially with regard to genitals - is a myth.



*The fact that we call the penis “simple” in fact I think has been detrimental to male pleasure, too – because it stops hetero women and queer men from treating this organ with the detailed attention it deserves.

The real reason women orgasm less often than men

The real reason women orgasm less often than men

There are a lot of myths in Western culture that make me furious. Here is one I’ve been thinking about a lot recently:

Women orgasm less than men because NATURE SAYS SO.

According to one large-scale survey of American adults, women have about one orgasm for every three that men have. That is thirty percent. Women orgasm thirty three percent as often as men do.

How do we account for this difference?

The standard means by which Americans explain this difference by suggesting that women’s bodies are simply bad at orgasms.  “It’s complicated!” we say. “Women are delicate flowers!” “Sometimes women orgasm and sometimes they don’t.”

Because NATURE. (Here’s what I have to say about a woman’s nature!)

Where does the idea that it’s a biological imperative that women orgasm infrequently come from?

1) Sigmund Freud. Freud famously argued that an orgasm without vaginal penetration was an “immature” orgasm. The idea that women could orgasm without (GASP!) a male organ inside of her was terrifying for the man. This theory has of course been seriously disproven. Masters and Johnson later showed that stimulating the clitoris on the outside of the body and the vagina on the inside is two different ways of stimulating… get this… the clitoris, because it’s actually a pretty big body part that exists both inside and outside the body. It’s the whole pleasure experience of the woman, period. So. There’s no such thing as an “immature” orgasm. They’re all on the same organ.

All the poor women who think there’s something wrong with them because they don’t orgasm from penetration alone – well. They (YOU) definitely need to know this. It’s all the same organ. And, in fact, more than 75% of women need some sort of external stimulation to orgasm.

Anyway. Freud said that the clitoris was bad and should be ignored.  People (men) really liked how much easier this made their lives. It rationalized what they were already thinking anyway. So the idea stuck, and stuck hard. 

Pun intended.

(For a radically alternative view to Freud, see the electrifyingly awesome book on sex in human history, here.)

2) Accidental ignorance

30% of women and 25% of men don’t know where the clitoris is.

A lot of people, I believe, are accidentally ignorant. Whether its because of a lack of good sex ed or because of the misogynistic culture in which we live (see points below), they simply can’t make heads or tails of female anatomy. It’s not really their fault – and I’m not mad at anyone for accidental ignorance. We are all victims of negativity in our culture in one way or another, and this is simply one of them.

One of my favorite books on this topic is She Comes First: The Thinking Man’s Guide To Pleasuring a Woman by Ian Kerner!  It does a FANTASTIC job of explaining where the clitoris is, how to find it, and what it wants!

3) “What you need is what I need.”

Even for a lot of people who do know where the clitoris is and who are interested in female pleasure, they simply go about it all wrong. Here is something that almost all people do subconsciously:

We treat other people the way we’d like to be treated.

At least in the bedroom, anyway.

So this is what sex ends up looking like: Women act a bit like a tease with men, touch them gently, don’t go right for the male organ right away. (Very, very generally speaking.) Because women generally tend to be more gentle and patient and appreciative of suspense in the bedroom.

On the other hand, men tend to go right for the goods. (At least, this is what Men are from Mars Women are from Venus tells me.) And when they want to increase pleasure, they go harder and faster. Because men generally enjoy it when things are harder and faster.


So let it be known, lads and ladies. You’re doing each other backwards. Think about the psychology of the human being you are with. Don’t assume that they like the style you like. Generally speaking, pleasure tends to be a bit complementary, with women’s bodies responding more positively to lighter touches and men’s to firmer. And if not – well. The right thing to do is ask.

(Here is my favorite book on pleasure for both partners, including psychological stuff. Here’s my favorite for women alone. Here’s my favorite for pleasing guys.)

4) Fear.

“I know women can receive pleasure, but I’m afraid I’ll look stupid if I let anyone know I need help.”


We live in a world in which men are expected to be perfect and manly and not need help. Plus, people are generally very fearful of vulnerability. Sex is already a profoundly vulnerable act. But what if you go into it and say openly “I don’t know what I”m doing!” That is perhaps the most vulnerable act of all. Of course – in that act there is a LOT of strength. It takes a lot of strength to confess ignorance. But it is a highly vulnerable and potentially volatile situation.

We can work to overcome by this developing our skills for acceptance, patience, and open communication. Men are cultured to be incommunicative. We tell them from day one that they should be strong, silent, unemotional types. But that’s just… that’s not right. If we can help make our culture one in which vulnerability and communication are highly prized values, then we can more easily navigate intimate spaces like the bedroom.

5) Misogyny.

Obviously, this is the worst one, and the one at which I concentrate my fury. It says:

“I know women can receive pleasure, but I really can’t be bothered to do it.”

That’s what The Men think.

This is what The Women think:

“I like orgasms, but I really want my partner to think I’m sexy and like me. I feel terribly self-conscious. I am going to please him first and not ask for my own.”

Six months ago, I met a man who was totally lovely and charming and kind. We went up to his hotel room. He pushed me on the bed and put his penis in me and intercourse-d me for maybe ten minutes, saying conquesting things like “this *ss is mine tonight.” He had an orgasm, and then “we” were done having sex.


Stefani was never a part of that sex. Afterward, I just laid there and sort of looked at him. I knew I should have had some fiery feminist thing to say, but I still couldn’t believe that that was it, he wasn’t going to invest in my pleasure at all, I thought surely there must be more coming. But there wasn’t. That was it.

When I say we live in a misogynistic culture that denies female pleasure, this is what I’m talking about. Of course this was a singular situation, but there are so many similar situations that happen on a day to day basis, I don’t even know where to start.

Misogyny — that is, this culture we live in that prioritizes men’s needs over women’s, and which tends to dehumanize and objectify women — makes us (both women and men) think a lot of bad things.

Misogyny makes us think the male orgasm is more important than the female.

It makes us think guys are lusty fellows, and that women are lusty objects.

It makes us think guys enjoy sex but women enjoy the mushy emotional things like cuddling.

It makes us think women are dirty and immoral if they act on sexual desire.

It makes us think, as was the case with my mystery hotel man, that sex is an acceptable form of conquest.

Come to think of it, it makes men want to conquer women in the first place.

It makes us think men have a valid sexual need, and that women are obligated to fulfill that need (see The Man’s Rights Movement or GamerGate or that punk on the shooting spree or any other incidents from 2014).

It makes us think men are sexual and women are sexy.

It makes us think the male orgasm is what makes sex successful and fulfilling.

It makes us think the male orgasm is the END OF SEX. (Hey guys, you have HANDS AND A FACE, I’m just saying.)

To demonstrate that what I’m saying isn’t crazy, I’d like to pull some quotes from an academic article by Elizabeth Armstrong and her colleagues, in the context of another article posted at Alternet.

Elizabeth Armstrong and her colleagues conclude that women’s orgasm rates are strongly related to her evolving relationship with her partner, the activities they include, and his investment in her pleasure.  The more times a woman is with a man, the more she orgasms. Women in relationships in fact orgasm up to seven times as frequently as single women do.

Qualitative research on men’s motivations confirm the last piece.  “I’m all about making her orgasm,” said a man interviewed for their study. “The general her or like the specific her?” he was asked.  “Girlfriend her,” he responded, “In a hookup her, I don’t give a shit.”

Women know the difference. Said one: “When I… meet somebody and I’m gonna have a random hookup… from what I have seen, they’re not even trying to, you know, make it a mutual thing.”

Expecting an orgasm from a male hookup partner is even seen as demanding and rude. One woman explained how she felt like she didn’t have the “right” to ask for an orgasm: “I didn’t feel comfortable I guess. I don’t know. I think I felt kind of guilty almost, like I felt like I was kind of subjecting [guys] to something they didn’t want to do and I felt bad about it.”

Out of nerves, insecurity, or a lack of entitlement, women often prioritize men’s pleasure too. Speaking of hookups, one woman insists: “I will do everything in my power to, like whoever I’m with, to get [him] off.”  My own research confirms that college women often fully accept that hookups usually don’t include orgasms for women. “Even if I was in charge,” said one, “I did not make sure I was being pleased.” “The guy kind of expects to get off,” said another, “while the girl doesn’t expect anything.”


The bottom line is this: women orgasm less than men do for many complicated, interwoven factors. But they are all social factors.

When you remove social barriers to orgasm, women in fact far outstrip men in orgasmic performance. 

That’s right.

Not only do women match men in potential number of orgasms biologically, but in fact we do it more. 

How do we know this?

Well. Women who sleep with women have  many more orgasms than heterosexual women. Women also have no problem experiencing  orgasm through masturbation. The same women who frequently have orgasms during masturbation report  many fewer orgasms when they’re with a partner.

Even the idea that women simply “take longer” than men is a myth. It takes women the same amount of time to orgasm during masturbation as it takes men, on average, to have an orgasm through intercourse:  four minutes.

So here’s the bottom line of the bottom line: 

Women orgasm less than men do because of the social forces of our culture, that live in both the brains of both men and women.

And then we come up with this idea, that no, it’s not our culture’s fault, it’s actually our biology’s fault.

And then we have a seriously powerful rationalization for ignoring female pleasure on our hands.

Saying that the female body is bad at orgasms gives guys (and gals) a free pass.

It is simply easier to go on thinking that female pleasure is “complicated.” One one side of the coin, it lets guys be lazy and feel properly accomplished in the sack. On the other side, it lets us women avoid having to stand up for ourselves and explore and demand equal attention.



So I challenge men to overcome fear and ignorance and help us. Even more importantly, I challenge us women to become better communicators about this. I challenge us to explore our own bodies and sexuality, and to learn what we like and dislike. I challenge us to tell men. I challenge us to be unapologetically sexual. I challenge us to own the real sexual power of our natural bodies – the biological bodies that have the potential to sustain multiple orgasms in quick succession. I challenge us to do this not only for the sake of a quick high between the sheets… but more importantly for the sake of consideration, empathy, and respect, and equality between the sexes.



For my favorite books on the subject, check out (all amazon links):

Sex at Dawn: How We Mate, Why We Stray, and What It Means for Modern Relationships

The Guide to Getting it On: A Book about the Wonders of Sex

The Red Queen: Sex and the Evolution of Human Nature

She Comes First: The Thinking Man’s Guide to Pleasuring a Woman

Passionista: The Empowered Woman’s Guide to Pleasuring a Man

The Male Brain: A Breakthrough Understanding of How Men and Boys Think

And of course, don’t forget my own book Sexy By Nature that covers all things women’s health!

 The Real Reason Women Orgasm Less Often Than Men - Paleo for Women

6 psychological hangups preventing you from having good sex

6 psychological hangups preventing you from having good sex


Somewhere in the neighborhood of 40 percent of women report having “sexual dysfunction.”

This was, for me, on first encounter, an astounding statistic. That’s practically half of us women!


Upon further reflection, however, the statistic makes perfect sense to me. To be honest, I’m surprised the number isn’t higher. With such high rates of negative body image, obesity, eating disorders, depression, anxiety, and stress in female lives in America, not to mention all the sexual objectification and denigration that happens in culture at large… it seems as though almost none of us should be getting by unscathed.

There are plenty of physiological reasons libido can be off, and plenty of ways to troubleshoot that with diet and lifestyle changes .  You can also read my book “Sexy by Nature”which addresses all of this and my thoughts on it here.

Perhaps even more important than that, however, are psychological problems. Psychological problems, ranging from doubts about your body’s appearance to lack of trust in your partner, cause undue worry in the female brain during sex. If your brain is anything other than 100 percent relaxed and “in the moment,” it’s going to be much harder to enjoy yourself and orgasm is going to be approximately 1500000% harder to achieve than otherwise. This is a simple fact of female physiology.

These are these psychological roadblocks to satisfying sexual activity I see most often in my friends and clients (and please note, before reading ahead, that I use explicit language and talk about explicit sexual things, so if that isn’t your cup of tea, feel free to stop now, no hard feelings. 🙂 ):

1) Thinking your lady parts are “gross”

I remember being twelve years old on the way to dance practice in the back of my mother’s SUV being told by my “cool” friend that I needed to shave my pubic hair if I wanted to be sexy.

I also remember experiencing feelings of disdain for this friend, since I obviously already knew that. 

I also remember making jokes about vaginas smelling badly, and tasting badly, and being all around just horribly unpleasant.

This made me never want to inflict my body on anyone. If my vulva were so gross, how could I possibly expect any man or woman to enjoy it?  If they insisted on pleasuring me anyway, how could I be sure it was because they really wanted to? What if they were grossed out the whole time?

Okay, ladies. This is the most important lesson about our sexual selves I think we could ever learn:

There is no valuative difference between a penis and a vulva. No smell, taste, sight, or feel of one is better than the other. Neither are “gross.” Any person or any media like a movie (or porn) that leads you to believe so is not just wrong but possibly evil.

If you want to read what our partners (and men in particular) REALLY think about the vulva, its taste, its smell, and what they are really thinking, you’ve got to read “She Comes First” by Ian Kerner.  It will open your eyes!

And if your partner is one of those evil doers, it’s time to have a conversation about what’s going on, or to show them the door. This is not a joke. Your body is straight up awesome. It has the ability to give both you and your partners pleasure (here for male pleasure, here for female!). It is a wonderland. No one has the right to take that away from you.

You are not gross. Society’s double standards about the impurity of female bodies has only made you feel that way.

2) Feeling self-conscious about the way your body looks

If you’re laying in bed and trying to think of sex positions that can hide your rolls rather than enjoying the ride, that’s a giant road block to both connection with your partner and also physical pleasure.

Nothing kills a libido like self-doubt.

Fortunately, there’s a fantastic remedy to this problem. It’s remembering three simple facts:

1) The sexiest woman alive to any person having sex is the one right there in the bedroom with them. Sure, Jennifer Lawrence may be a physical specimen, and Giselle Bundchen may have “perfect” proportions, but neither of them are a real person with your real partner in a real room.

2) Nobody will get into bed with you if they find you unattractive. Period. Initiating or consenting to the sexual act means that this person wants to be there. So get out of your own head. Stop worrying about the way that you look. This person finds you sexually appealing for one reason or another – there’s absolutely no way to ignore this fact.

3) The last thing any person you’re sleeping with wants you to be doing is worrying. That’s ridiculous. What they want is for you to be thinking about them and having a good time. So do those things. Don’t disrespect yourself or your partner by being self-conscious. Trust your partner’s desire, own every inch if who you are, and let yourself move comfortably in your own skin.

I know letting go of self-consciousness in the bedroom is easier said than done, but it’s incredibly empowering. Plus, once you begin doing it, you can’t stop. Self-love is powerful, and infectious.

3) Feeling ashamed of sexual desire and activity

As women in American society, we are taught (if subconsciously) that we are dirty and immoral if we have sexual desires. We are told that our bodies are primarily objects of sexual desire. Men want us, but we don’t want them. Men lust for us, but we don’t lust for them. Men always have orgasms, women sometimes do. Men’s sexual desires are supposed to be robust and lusty – marking them as strong “men.” Women’s sexual desires are supposed to be shrouded in burkas and locked away beneath chastity belts.

Mark my words, however:

this is bullshit.

Women have every right to be sexual, just as much as a man. Women are free to have desires – even non-monogamous ones! – and to have them be pleased. (My FAVORITE book on that topic is this one, you’ve got to read it!)

I cannot tell you how many women I’ve spoken to who have never had an orgasm in bed because it just “wasn’t her place.” So many women are focused on pleasing their partners, and keep quiet about their own needs.

In American culture as a whole, we tend to radically favor the male orgasm in bed, and to deny the importance of female pleasure.

But this is wrong. Your needs are normal. They should be met as equally – whatever they are! – as your partners are. You should be in the bedroom to take care of and entertain each other, not for you to be a subservient, unfulfilled sex toy.

So – if your sex life is unbalanced, consider if that’s because of your partner’s attitude, or your own. Consider why you neglect your own pleasure. Challenge yourself to accept this part of yourself. Challenge yourself to be in conversation with your partners about this. You will never get to experience pleasure if you do not welcome it into your heart.

4) Not having a safe space in which and partner with which to be sexual

This almost goes without saying. If you don’t trust your partner, like your partner, or have pleasant sexual experiences with your partner, you will never feel comfortable in bed with your partner.

If you do not feel comfortable, you will not have an easy time experiencing physical or psychological pleasure.

The solution to this problem is entirely contingent on your own particular situation. Perhaps you need couple’s therapy. Perhaps you need to have a conversation about each other’s doubts and desires. Perhaps you’re in an irredeemable relationship that you need to get out of. Perhaps you pick up random strangers who don’t always treat you very well. Perhaps you and your partner simply need to remember how to laugh with and love each other.

5) Worry about your sexual skills

Lots of people spend all of their time in bed worried that they’re not doing it “right.”

The only way to know if you are or not, however, is to ask. Every person is different, and every person has different tastes and desires. You’ll never know if what you’re up to is good for your partner if you do not communicate about it.

Moreover – the most important aspect of “skill” in the bedroom is the willingness to experiment, to listen, and to give and receive feedback. It’s not about how many partners you’ve had or how many sutras you’ve practiced. It’s about your desire to give pleasure and experience connection, and to communicate. Don’t worry about your performance. Simply be, and talk, and ask questions if you want answers.

There are two books that I really like that can also help with the concrete skills of sexual performance as well.  Find them here and here.

6) Being too stressed to think about sex

 Any thought that takes you away from your partner is going to diminish the quality of your sexual experience. This is true for all people, but it is especially true for women. Your body craves sexual activity only if it perceives a great enough state of safety in your life to enjoy it.

Stress makes you dwell on problems and prevents you from delighting in the blessings in your life.

The best way to mitigate this problem is to reduce the amount of stress in your life. This liberates your day dreams to wander into the realm of the explicit and the naughty, and it makes your heart free to reflect on love. If you absolutely cannot eliminate certain stressors, do your best to set aside time for sexual activity. When you do so, check your worries at the door.

Give yourself the time and space you need to be fully present – not locked in the past nor anxious about the future – and the depth of connection and pleasure you and your partner both experience will skyrocket.

But what does any of this have to do with paleo?

As I’ve argued many times before, there is the paleo diet, on one hand, and then the paleo perspective on the other.

Paleo provides us with a lens with which we can examine our lives. At least this is how I like to look at it. Paleo asks us to question social norms, and to think deeply about where our beliefs and habits come from. Just about everything we think, say, and do is cultured by the world in which we grow up. It is helpful for us to analyze those things (I do a lot of that in my book!), so that we can do away with the unhealthy ones.

Thinking a woman’s body “gross,” for example, is one of those things.

Paleo also asks us to think about what is “natural.” Is it natural to have sexual desire? Natural to have an imperfect body? Natural to receive pleasure without feeling guilty? The answer is yes to all of these things. Thinking about humanity in evolutionary terms helps us see that. Many groups – such as the evangelical Christian sects that promote purity vows in young girls – don’t think much of evolution, and this ends up being a significant hindrance to healthy and happy sexual activity.

(My favorite book on the naturalness of sexuality and questioning social norms [not my own!] is this one.)

Sexuality is an important part of relationships and life. There are physical aspects of that – which the paleo diet certainly helps, as I’ve discussed at length here – and there are psychological aspects of that which are also fun and important to look at with an evolutionary lens.


I cut out my gallbladder, then wanted to die.

I cut out my gallbladder, then wanted to die.

Hola ladies.

What follows today is a hell of a monster of a behemoth of a post. It’s nine single-spaced pages in Microsoft word. This bulk amounts to around 5000 words. This is not a number to sneeze at. In fact, it is regarded as a number that screams “don’t go there! You’ll lose all your readers!” to any blogger who knows just about anything about just about anything.

Nonetheless it is one of the best blog posts I have ever read (because I certainly did not write it). I thought I’d roll my eyes a paragraph in, click the little red X in the corner, and be on my happily scheduled productive way. Instead I was sucked in by line 2 and read every single word, a torrent of emotion and insight and stunningly beautiful prose.

I could go on, but I’ll let you see for yourself.

This is the story of Elissa Washuta and her body. It is full of so much love and hate and love and hate and fear and hope. Few stories can show us better (and have shown me better) the visceral truth of what it means to be a human animal in a concrete word.



Stab Wounds: Killing My Gallbladder, Wounding My Brain

An Essay by Elissa Washuta


I was twenty when the nausea came to stay. The feeling coiled around my stomach one morning when I woke up beside my boyfriend, picked my way across our fallen textbooks, and dry-heaved in his moldy bathroom.  Every week, as directed, I had pressed a fresh birth control patch onto a blank expanse of skin. We wanted so badly to draw on the patch, but the prescribing instructions had forbidden it, so we sharpied beside it, around it, and all over each other’s torsos. No fetuses, he wrote on me,  and drew a tadpole with a line through it. Ever since I was old enough to cover my scrapbooks in stickers of Mr. Yuk and unicorns, I was compelled to coat my life in adhesive badges.


As I sat on the grimy toilet and a phantom python tried to force all intruders out of my empty gut, I worried, transdermal ethinyl estradiol and norelgestromin notwithstanding, that the linty-edged sticker on my ass was no more magical than the neon Lisa Frank teddy bears that covered my fifth grade diary.


Hours before the roommates woke to shuffle off to class, my boyfriend drove me to the pharmacy. I bought three pregnancy tests for good measure. I peed out a negative. The attacks of nausea persisted, soon leading to pains that would break open my right side with an invisible shiv, then swiftly retreat. Over the following weeks, I lost my ability to stomach frozen pizza and box-mix brownies, and my diet moved toward hard liquor and liquid sugar. I was not pregnant, but I felt something inside me alive and howling.




This was 2005, and as a college sophomore and a hypochondriac since puberty, I learned to take my visits to Dr. Google to the next level. Swinging between starving and nauseated, I haunted WebMd and PubMed until my symptoms and family history locked into perfect alignment. Nothing sounded more elegant than porcelain gallbladder. I said cholecystitis over and over, as though a hidden door would slide open and show me a new world of hurt that was a cold, clinical alternate dimension. My own world had flipped from bright to hostile halfway through sophomore year, when my campus turned from brochure-bright to haunted. My bones felt rocked by the constant thuds of big university life: basketball-inspired couch-burning, rabid chants of obscenities upon every Maryland win or loss to Duke, and rows of Mid-Atlantic brick behind unwelcoming white columns. Rage, joy, and thirst seemed to have been written into the college’s charter. There was a time when I saw none of that—when my school was a place for learning.




My mother, a nurse at the county hospital back home, made the arrangements I requested while I kept my focus, as usual, on my grade point average. I traveled home to New Jersey to visit a surgeon. I told him my guts were tangled. By his order, a radiologist shot me up. When I asked about what I was going to feel, she told me, you may experience the same discomfort that brought you to your physician.


Cholecystokinin, meant to send my gallbladder into a panic, spread everywhere, from the crook of my elbow to my eyeballs. A radioactive tracer chemical collected in my liver to light up my hepatobiliary system under the gaze of the gamma camera. Will this stuff make me a superhero? I wanted to know. I needed protective powers of all kinds—self-defense and then some. She wouldn’t answer. Soon enough, I only wanted to save my own gut, empty my veins onto the gray floor. As my gallbladder seized, wrapped by the atomic-radiated python, clenching with ten times its normal strength, I implored the snake, Kill me, kill me here.




I knew the flesh was dead inside me before I had to be told. The surgeon summoned me back to his den. He said that I had no stones, but the organ had ceased to function. He gave it to me in brief, wasting no words: the gallbladder’s job was to release bile into the duodenum as food passed by, emulsifying lipids, but it had gone kaput. He could take it out, the liver’s bile ducts would enlarge, the liver would take over the gallbladder’s job, and everything would be beautiful. There was almost no chance that open surgery would be needed, as the whole shebang would be laparoscopic. There was a ten percent chance it wouldn’t work out. Meaning, what?—my mom wanted to know. I don’t remember what he said—something abstract, I think, about the bile ducts being unable to enlarge to compensate for the loss. I only know that his words weren’t gruesome enough to stop me from telling him that I needed him to cut it out of me.


The knife.

The knife.





While I waited to be opened at the end of 2005, some of my college friends mused that nobody really needs a gallbladder anyway.  Others asked if I could get a transplant.


Things I don’t need: my kitchen; my eyeglasses; my hands; my lips. I puked thin green chemical spills. I convinced myself that I could live like the saints I venerated throughout my Catholic upbringing: the self-flagellators, the hairshirt enthusiasts, the starvation devotees. I ate nothing but Cheerios and soy milk, read every food label, consumed no fat for weeks. Kill me, kill me here.


As finals week approached, students began leaving their customary offerings to Testudo the terrapin, the bronze idol of our mascot that lives on a pedestal outside the library. The gifts have become more elaborate in recent years, but back then, standard offerings were coins, flowers,  votive candles, pints of booze, to-go coffee. I left nothing. I wouldn’t even rub his nose for luck when I passed, the standard turtle greeting. I didn’t want luck, a purposeless force shaping my life without my control. I wanted to put my hands into my own works, broken by the unknown forces of illness and the known force of another person’s venom, and finally set myself right.




The person close to me who had no gallbladder told me not to go through with the surgery. “If I had to do it all over again, I don’t know if I would,” he said. I don’t even remember what else he said, because I couldn’t listen: all I wanted was to be sliced open so that the thing rotting deep inside me could be snipped out. I wanted my innards to be scrubbed clean with antimicrobials. I wanted the team to give me a brand new body. I wanted to tear open the cellophane and start over on my life. I must have told him that I was going to go through with it, because I did.


Right after Christmas, at age twenty-one, I put on a gown, asked for an IV in the back of my fist instead of my perpetually bruised fencing arm, and faced the knife. Nobody told me, in dramatic cinematic fashion, that I could back out anytime. I was Hibiclens-clean, properly foodless, and eager. The dream team was ready for the minor abdominal surgery that would be easier to my surgeon than an application of eyeliner was for me. Right before I went out, as I entered the bright operating theater, I thought, They will take off these clothes they gave me, and then they will open me, and I won’t even know if I die naked.




The women watching over me in the post-op recovery room wanted numbers. Seven, I yelled. Seven, again. I’m sorry, I cried. Seven. They said they’d hit the morphine ceiling. I had no eyeglasses. They silenced me with Demerol. Finally, my frontal lobe had been overtaken.


In the bed they said was mine, I was more nauseous than I knew I could be. My gut looked like an alien pregnancy, big but not happy, marked by four tiny cuts. The nurse called them stab wounds: a hole for the camera, a hole for inflation, a hole for snipping, a hole for yanking out the thing. She said that when they were trying to get the gallbladder out of that tiny hole, my belly would have been stretched so far away from my body it was like a cartoon.


The nurse said I could only leave after peeing, which took half the day. My mom sat with me in the bathroom while I tried to get empty. I went two drops and Mom made the announcement.


I was told not to fence for a month. While the morphine nausea persisted, Mom read me short stories and I hid from the light; after the drug wore off and I beat at the throbbing with vicodin, I busted the stitches on one of my stab wounds as I slipped off the couch after a fallen saltine while watching a 24-hour marathon of 24.


I thought about the flaws in my fencing game, picturing my broken body vertical, functional, flexible. I thought about my sweet boyfriend back in College Park, waiting for me to come back and play house. I spent a lot of time with my laptop sitting hot on my stab wounds as I Googled words I’d been afraid to look at for a year: post traumatic stress rape trauma date rape acquaintance rape college rape statistics denial. My stab wounds began closing over, starting with the smallest one, while the two longer lines refused to swallow their stitches. I couldn’t eat without feeling my insides sloughing off. Was it normal to hand in nausea and receive the runs in return? The photocopies from the hospital said nothing about it—I had been instructed not to make any important business or personal decisions for 24 hours following surgery, not to engage in sports until my physician gave permission. In bold capital letters, I had been told to make arrangements for someone to stay with me for the first night. I had not been told about the achy sojourns between toilet and couch, my incisions screaming. Creeping my way up the stairs, I worried that wide gashes would be torn across my punctured abdominals. At my destination, I’d remember that my wounds were buried deep: my liver sobbed over its loss.


My surgeon was inaccessible during an extended European vacation, so I saw the primary care doctor who had told me, before I left for college, to be careful with my virginity—what would my future children think about a mom who had slept with a bunch of guys? Now, she told me my only recourse was Imodium AD.  Until when? I wanted to know. This wasn’t a cure, she told me. This was a treatment: two with food, as long as symptoms persist. How long would symptoms persist? Well—how long did I expect to be gallbladderless?


What’s worse: nausea or the shits? Going to work or being bedridden? Having an organ never work again or never getting it back? A heart full of fear of the imagined first time having sex or a head wracked by memory of the known experience?



Here comes the Ow.


After three weeks on the couch, I went back to school. No surgeon was around to tell me not to fence, so I took up my epee a month after surgery; I traveled to a regional tournament, got wasted on Smirnoff Ice in the hotel room, woke up still drunk, stuffed my bloated body into my stiff white knickers and jacket, and fenced all day. By evening, I had my first fencing medal, and my topmost stab wound was losing the ends of its stitches as my overworked abdominals groaned. I accepted my shiny disc, dosed myself with vicodin, and curled up among the gear against the wall. During the dark bus ride back to Maryland, my teammates played “Never have I ever,” increasingly scandalous secrets about sexual dalliances coming out at every turn, while I sanded down my brain with pills and told them nothing.







I didn’t notice that my brain was spoiling. It just started getting mean.


I was standing on the subway platform one day, commuting home from work, when I realized that I had been raped that year before, by that boy who had first penetrated me. My heart was a train and it plowed through my head.


I called the campus peer counseling and crisis line and a grown man answered. I told him I thought I had been raped approximately one year ago, by a boy I was just beginning to date, and he said that in his professional experience, women who are raped or sexually assaulted are usually beaten within an inch of their lives, usually have their clothes torn off, usually they’re in pretty bad and bloody shape. I hung up and tried to eat my own mouth so it wouldn’t tell anyone else what I’d divulged.




I began showering at least twice a day. I showered whenever my insides shed while I cried on porcelain, begging kill me, kill me now, a secret held more deeply than any other, because no college student can ever tell the authorities that she wants to die, even if it’s not a true wish to die, but a wish to be physically reborn with new guts, new skin, new hymen stretched like a tarp, like a whip.



I don’t know what lobe of my brain said it, but someone inside my head told my boyfriend, “I need to know what it’s like to be with other people,” and he said he didn’t want to lose me. At the moment of crisis, my boyfriend coming in through the window and my heart flaccid, I knew that, despite the sad scene I had set up so I might rewrite my memory, another boy’s small hand was not the body part I was missing.





I developed a fixation upon a slightly younger boy who had no intention of dating me, preferred World of Warcraft over sex, and hadn’t dropped his baby fat. I left the boyfriend with whom I had psychic conversations and built love forts. I still didn’t eat. My back was the back of my bony fist and I wanted to curl up and bloody the face of the world.




I sat down with my surgeon and told him about the runs. He told me he wished I would’ve come in sooner. This thing had a name, postcholecystectomy syndrome, and if he could name it, he could smite it. He prescribed packets of Questran, a bile acid sequestrant once used to treat hypercholesterolemia, for my bile acid malabsoroption. How long will I have to take this? I asked. It’s cheap, he said. Mixed in some water, you can barely taste it.




Postcholecystectomy syndrome is the name for a bundle of symptoms after surgery, either a continuation of the pre-operative symptoms or the development of new ones. The problems are caused by changes in bile flow into the GI tract.


PCS is found in 5-30% of patients, with 10-15% being the most reasonable range. [. . .]


If the procedure is performed for stones, 10-25% of patients develop PCS. If no stones are present, 29% of patients develop PCS. [. . .]


Freud found age and sex differences.Patients aged 20-29 years had an incidence of 43%; those aged 30-39 years, 27%; 40-49 years, 21%; 50-59 years, 26%; and, 60-69 years, 31%. Patients older than 70 years did not develop PCS. Females had a 28% incidence of PCS, and males had a 15% incidence. [. . .]


Note that half of patients with a preoperative psychiatric disorder have an organic cause of PCS, whereas only 23% of patients without a psychiatric disorder have an organic cause. [SOURCE]




I became certain that I was addicted to love, or romance, or attention, or crushes, or being around magnetic people, or not going to work. My boss at my part-time federal government job said, “You had a major organ taken out. That’s a big adjustment for your brain.” I used all my sick days. I quit the job. I started working all night at the 24-hour service desk in the apartment lobby and then went home and drank alone.


One day, walking in my high heels to the liquor store in the suspended sweat of a Maryland summer, I realized that I might be one of those girls in the glossy magazines—not the ones with concave bellies and hips like dolphin backs, but the ones whose brains are horror stories, cautionary tales about the brinkwomanship of pressing against the edge of institutionalization.


I cut off all my hair. Then I did it again and again and again, daring someone to want me without it.



Until my boss mentioned the connection between my gallbladder and brain, I hadn’t thought they were related. Bipolar disorder may be associated with immune system dysfunction and pro-inflammatory cytokines, though results in individual studies are conflicted, according to a recent meta-analysis. Cholecystectomy has been found to result in cytokine release. I’m not a scientist; I’m a writer. I can’t prove that, when my surgeon cut into my gut, a phantom twin scalpel scored my brain. But the connection between the gut and the brain is coming into clear focus, and I know that when the surgeon took my gallbladder, he performed a lobotomy of the belly.




At the beginning of senior year, in 2006, I saw a psychiatrist at the university health center. According to my questionnaire responses, he found me depressed and prescribed Lexapro. Over the next few months, I would get all the drugs whose names had titillated me as a straight-edge kid in New Jersey: Wellbutrin, Ritalin, Ativan, lithium, and others I’d never heard of. I would break out in a rash signaling a potentially fatal reaction. I would get so depressed my doctor would write notes requesting assignment extensions. I would get so manic I would leap on my bed and think my ribs were god’s xylophone. Almost every day, I drank beer or Grey Goose screwdrivers. When the scale reported the number that was, by BMI, underweight for my height, I jumped up and down.


I gained forty pounds after moving to Seattle and going on a new antipsychotic drug. I would’ve tried to yank all my flesh off my body if the mania hadn’t been sanded down by the Seroquel and the depression by the intense endorphins of all the avocado-hummus-provolone sandwiches I was eating. Seroquel is thought to cause insulin resistance. My new doctor didn’t tell me that; she told me it would be a good drug, and it has been. Years later, she added Topamax, and twenty pounds dropped off. I figured out, through paleo—thank you, Level 4 CrossFit Seattle and Dave Werner—that I had celiac disease, and once I cut out gluten, the diarrhea stopped. Just like that.



The crazy never stopped. I found the right medication cocktail and got better at letting my hair grow out, but I’ll always be bipolar. I’ve seen practitioners who suggest I consider going off my meds. I think about the old days when I’d sit on a pile of high heels in my closet, wondering if I could get away with never coming out again, hoping if I starved for long enough my exhausted hepatobiliary system might reset and sprout new buds, wishing I could tweeze the pain from my skull. None of that happened. I spent seven medicated years writing a book about my body and my brain, and the regular wringing-out mechanism wore out every nerve until the shock of my brain’s tangle had worn off. I wrote the word rape, once as off-limits as a secret password, until it didn’t look like a word anymore, and rebuilt it as something I could begin to understand.


The only thing to do is find the wound and rub in the salve.




There’s a lot of talk in the paleo community about the over-prescription of psych drugs, but my meds keep me functional. Maybe I wasn’t born broken, but I’ve been broken into, and someone walked away with my treasures. There is too much at stake to try to disavow the chemicals that have patched my world back together. I hear, too often, that we should all be able to mend ourselves with the right food, the right movement, and sunshine. It’s easy to tell people they don’t need drugs when you don’t know what it’s like to need drugs, to wander around all night hoping you’ll find the end of the earth, to pummel the floor with another panic attack, to self-medicate with another handle of vodka because the right medication still hasn’t appeared. Maybe I could find the right combination of foods and movements that could replace the meds, but I could lose my mind while searching. This much is irreversible: I needed to get some dense nodule of hurt out of me, and so I agreed to that surgeon’s swift medicine and made wreckage of myself. I am no longer the intact human who arrived on this earth in 1984. I will do what I need to keep my brain from taking me down.




My moods are fairly stable now, the bipolar peaks and valleys having been evened out by medication and good practices. I still have a fat gut on my skinny, flamingo-legged frame. I still have keratosis pilaris—chicken skin—on my upper arms and thighs, signaling possible nutrient absorption problems. A couple of years into paleo, I developed dramatic cystic acne that comes and goes, seemingly related to a mysterious family of food intolerances (possibly, it seems, as broad as all salicylates). I have other symptoms. I still have a gut feeling that I am a destruction site, and now, it’s informed by too much knowledge: bad choices, genetic mutations. Regularly, I take 5-MTHF, fermented cod liver oil, offal, chicken foot broth, gelatin, butyrate, l-glutamine, ox bile, and so many other talismans to charm the snakes inside me. The most terrifying part is that nobody really seems to know how to make my snakes sleep—I try and I err and I eliminate foods until almost nothing remains. Humans are resilient, but we are not unbreakable, and the mending process is consuming me.




Almost ten years have passed since I was raped in my campus apartment by a boy who had my consent for kissing, for more than kissing, but not for the breaking of an emotional seal I feared more than anything: first-time sex. I suppose I could say I have “healed” in that I no longer act out in direct response to my tangled emotions. But it’s hard to say I’ll ever really get over being raped when I know I had my gut mutilated because I wanted to scalpel out my own crawling brain, my own dark heart. I thought I loved my illness, once it arrived. But in truth, I loved that it gave me the power to point to a part of myself and order its execution.





Last week, my friends and I went to the mystical bookstore. I don’t usually go for the new age stuff, being an actual Native person, but I like a good field trip. I went right for the table covered in stones: pink stones, green stones, crystals, stones with high polish. While Claire examined the pendulums, Catherine read from a book about the stones that could give me power, the stones that could heal me. I found a strand for my left wrist, a strand for my right, and a ring. This stone provides energy and protects from bad vibrations; this stone makes one invincible in battle. I know, in truth, as I put my hands into these stones, that they move nothing but my mind. Maybe, now, I need to stop shunning luck, start rubbing the terrapin’s nose and asking for intercession. I am tired. Keep my tissues untouched. Give me no other cure.






Elissa Washuta is a member of the Cowlitz Indian Tribe.
Her first book, My Body Is a Book of Rules, is now available on Amazon. 
Learn more about Elissa:
For more from me, check out my bestseller, Sexy By Nature, PCOS:Unlocked, and Weight Loss Unlocked.

“Rev Up Your Sex Drive with Stefani Ruper” the Podcast…or, Stefani Talks Hormones, the Clitoris, and the Best Positions for Women (Yes, the Sex Kind)

Last week I had the enormous pleasure of chatting with Caitlin and Mary of the Health Nuts podcast. The topic? Libido. The question? How to enhance it. The answers? Many:

Balance your hormones (often, though not always, easier said than done.) De-stress. Quite chronic exercise. Lift weights. Lose weight if you need to. Gain weight if you need to.

Think about your body better.

Think about sex better.

Love your skin.

Love your vulva.

Demand that your partners love your skin and your vulva, too.

And you can ditch the upside down wheelbarrow, but never let a good old fashion cowgirl or reverse missionary.

Listen for the smart and uproarious time @ The Health Nuts site  or get it straight on iTunes.

(Warning: to be clear, I say the words clitoris and vagina several times and do in fact talk sexual positions, so this podcast is not for the sexually prim or skittish. But we don’t get explicit in that way until the final 20 minutes or so, so you can listen about hormone balance for the first 45 minutes of the podcast if you like.)

Find more information on how to improve your libido in my best selling book, available here!