Sex Hormones and the Big "O"by Sheila Kirk, M.D.
n my last article I discussed in general thoughts about orgasm, telling of some of the dynamics of that pleasurable experience from a physiologic and psychologic standpoint. There's another area about orgasm worthy of discussion that we can examine together. As I have mentioned, many things influence orgasm- it's existence, intensity and depth. For example, many of the things we ingest in both diet and medications are some of those things that affect orgasm. And to be more specific about medications - hormones can influence sexual gratification quite considerably. I refer to the sex hormones estrogen and testosterone. Testosterone whether present or lacking is the first one to focus on. Adequate testosterone levels influence sexual appetite or libido and therefore that hormone could be considered as the initiator of sexual desire and eventual anatomic changes leading to orgasm. The genetic male making testosterone and the genetic female using testosterone both will have active libido because of it and in addition the genetic male has erectile function and production of seminal fluid and sperm because of it. Genetic females using small amounts of it particularly in their menopausal years will have an awakening of their sexual drive and the genetic female using much larger amounts to masculinize will be interested in sex just as much and as often as a sixteen year old male. So testosterone serves a function that leads to orgasm in the male and those females who want to masculinize or to increase their sexual desire in their menopausal years. There are medical disorders wherein there is a diminished amount of testosterone. In the genetic male with lowered levels or loss altogether of testosterone in the blood, the drive to have sex is lessened greatly, adequate erectile function and performance are adversely affected and the quality of orgasm or even the presence of it is seriously hampered. Let's look at estrogen as an influence in orgasm. Because of the loss of testosterone production to below appropriate levels with the use of estrogen to feminize genetic males, libido will fall, erectile function and performance will diminish and orgasm can be altered quite seriously for many. But it may not always be so. The estrogen-using genetic male can have very gratifying and orgasmic sex even with loss of former sexual prowess. The feelings and responsiveness akin to , if not the very same as estrogen producing genetic females, can be overwhelmingly satisfying - even though more passive and vastly different from the experiences of the testosterone-producing male. PredictabilityIs any of this predictable? Yes, it is somewhat, but even predictable occurrences can change and over time they can be just the opposite. What we can say with almost complete assurance is that the person using testosterone will likely always be orgasmic. The person using estrogen will need time and the right circumstances and techniques to be orgasmic. In situations where there is genuine role reversal with or without anatomic change but with activated and nurtured psychologic reversal, orgasm can be as fulfilling if not more so and more gratifying than ever before. Orgasm is a complex physical and psychologic phenomena. Some will accomplish it almost always. Some, almost never. With the right person, under the right circumstances with intimacy and passion in a healthy mix, you can be asked..."Was it good for you?" and you can mean it when you say - "Yes!"
Sheila Kirk, MD is a Transgender Medicine Specialist, board-certified in Obstetrics and Gynecology and in practice in Pittsburgh, PA. She is a well-known author and leading authority on transgendered medical care and research. Dr. Kirk provides international and national consultations and referrals to the TG community and health care professionals who assist in their care. She can be reached the following ways:
Phone: (412) 781-1092 Fax: (412) 781-1096 mailing address: Sheila Kirk, P.O. Box 38114, Blawnox, Pa 15238-8114 |