Your STYLE: I passed one of your female patients in the office doorway. She was well-groomed and attractive. Do women come to see you more often than men?
Zbigniew Lew-Starowicz: Actually, they make up more than half of my patients. I’m convinced they’d come even more often if treatment with a sexologist were free. For half a century, I worked at a clinic in downtown Warsaw, and back then, women from nearby office buildings would drop by on their way through because they could—the visit cost nothing. Out of 100 women, only 20 don’t need a sexologist’s help at all. And that hasn’t changed in decades. The rest either don’t have orgasms, or experience pain during intercourse, don’t want to make love, or don’t feel the need to. The list of disorders is long.
TS:I didn’t know that so many Polish women need a sexologist’s help!
ZLS: Indeed, quite a few. These women should seek treatment. But often they don’t come at all. There are probably about two hundred of us sexologists in the country, and only a fraction of us see patients in public clinics. And when a woman has to pay 200 zł for a visit, she starts thinking: maybe it’s better to buy shoes for the child, or theater tickets. And she gives up.
TS:Doesn’t the modern Polish woman feel that she simply deserves an orgasm?
ZLS: Rarely. For many women, orgasm is important; without it, they don’t feel fulfilled not only as lovers, but as women. But some Polish women don’t think in those terms about their orgasm, libido, or even comfort during intercourse. If sex doesn’t bring pleasure, or even causes pain, they often decide to just wait it out. No orgasm? There’s nothing you can do about it. Does it hurt? It’ll hurt for a bit and then stop. That’s how many of them approach it. Even though—as my latest research shows—eroticism is playing an increasingly important role in the lives of Polish women. The group of those who believe sex is unnecessary is shrinking. So awareness has changed. Women want more, and they want it better—in the bedroom as well.
TS:All of them? I was surprised to learn in *Women’s Sexuality: 2016 Report* that 30-year-olds and 60-year-olds have sex just as often. Do the former do it less often than they used to, or the latter more often?
ZLS: Today’s 30-year-olds don’t have time for sex. They come home late from work, and there’s so much entertainment: parties, the Internet! Sex somehow pales in comparison. And on the weekend: graduate studies, activities with the kids, sports. There’s no time for lovemaking. It’s different for a 60-year-old: she’s gone through menopause, she’s not at risk of pregnancy. She no longer has to prove herself at work, or she’s retired. Active, well-groomed, athletic. Her children are grown. She’s discovering a zest for life, for all its pleasures.
TS:Only now?
ZLS: Better late than never! I’ve noticed an interesting phenomenon: 60-year-olds are waking up from a long slumber. Their youth coincided with a time of crisis. The 1980s in Poland were gray and hopeless; even sex was crude. There was a lack of knowledge and sexual awareness. Young women didn’t have the opportunities they have today. No wonder they want to take advantage of them now. They long to experience the pleasures and ecstasies they were previously deprived of. For some reason, however, these women’s partners—their peers—are still asleep. Patients complain that they have no one with whom to experience a second youth. Some find themselves a lover. This is made easier by the fact that social acceptance of infidelity has grown: celebrities constantly change partners, and this serves as a model for others. Cheating is also easier today: you can start an affair with a single text message and arrange meetings that way. It used to be more complicated; the risk of getting caught was enormous.
TS:Am I to understand that for older women, cheating is just a way to satisfy sexual needs? Is there no emotion involved?
ZLS: “I’ve got a hunk,” says a 60-year-old friend of mine about her younger companion. She doesn’t love him, she doesn’t want to leave her husband and commit to the “hunk.” She knows how to separate sex and feelings. However, for other women her age, cheating is out of the question. Nor is giving up pleasure. They choose solo love. Twice as often as 30 years ago. This is where the biggest change has occurred: over half of Polish women today openly admit to masturbating. They do it more often on their own and talk about it more often to researchers, they are no longer ashamed.
TS: Do we choose masturbation only because our partner has lower sexual needs?
ZLS: Not only that. Among the growing group of women who admit to masturbating, there are many singles. Many women choose not to be in a committed relationship or enter one later in life. And they need orgasms and the release of sexual tension. Polish women are experienced; they already know what they want. They have no qualms about taking care of their own pleasure. For them, masturbation is a neutral topic. So much is written about it that few women associate it in their minds with “guilt” or “sin.”
TS: Maybe we no longer need men?
ZLS: Like in Juliusz Machulski’s *Seksmisja*? In that film, women longed for men even though they didn’t know them. Polish women aren’t quite that modern, but fortunately for them, sex is not just about pleasure—it’s also about a relationship with someone. Even while masturbating, they fantasize about a partner, real or imagined. I know women who satisfy themselves, sometimes using sex toys, and are also in a relationship—for example, a platonic one. Or one in which the partner, the lover, isn’t the “provider” of orgasm. There’s sex, which is pleasant because it’s intimacy with a man she likes and admires. And then, after intercourse, she goes to the bathroom and brings herself to ecstasy. Because it’s faster that way, and in her opinion, better. The man usually has no idea: that his partner has left to give herself pleasure.
TS: So Polish women don’t always get what they want in bed. What kinds of issues do women of different ages bring to you?
ZLS: The youngest ones mainly complain about relationship problems. They have specific expectations, are assertive and self-confident, and often hold managerial positions at work. They don’t want to give up that role in the bedroom. So the power struggle begins right at the start of a romantic relationship. Who decides how often we make love, and in what positions? This is a new phenomenon. Now it’s the woman who complains that her partner wants it too rarely, making excuses like a headache; 30 years ago, only one in three Polish women wanted to have sex once a week or more often. Today, most of them want it! A huge transformation. Young Polish women have trouble fulfilling these desires. Women in their 30s and 40s come to my office complaining of pain during intercourse.
TS: And it seemed that sex only became painful later in life, after menopause.
ZLS: This finding from the report surprised me. For 20 percent of women across all age groups, sex is associated with pain. That’s really a lot! The list of possible causes is long. There are physiological reasons—for example, endometriosis, excessive vaginal dryness—but also psychological ones: muscle spasms caused by stress can make intercourse painful or even impossible. The longer a woman endures the pain, the more these causes compound. It starts with vaginal dryness, compounded by a fear of pain, which causes excessive muscle spasms. And indeed, because of the stress, it hurts even more. A snowball effect. Women are aware that this shouldn’t be the case, so they often seek help from their gynecologists. And they, unfortunately, dismiss it.
TS: How so?
ZLS:“I don’t see anything here,” they tell a patient who complains of pain. And the issue is often trivial, solvable in just a few visits. Sometimes well-chosen hormonal medications or an ointment are enough. It pains me that many women who haven’t received support withdraw from sexual contact. Some will learn to endure the pain somehow, especially if it isn’t very severe, because they’ll know that afterward it’s still fun and enjoyable. Others give up on sex altogether.
TS: What can be done?
ZLS: The first step, however, is to talk to a gynecologist. If they can’t identify the cause of the pain during intercourse, it’s a good idea to ask for a written opinion and take it to a sexologist, even if it’s a private practice. It’s worth it, because the cost might be limited to a few hundred zlotys. And the benefit will be enormous. It shocks me when patients, when asked what they associate with the words “intercourse” and “vagina,” answer: “distress,” “suffering.” Pain-free sex is something worth fighting for.
TS: You said that it’s women in their 30s and 40s who come in complaining of painful intercourse. Doesn’t this bother older, sexually active Polish women who are experiencing a second youth in sex?
ZLS: Of course it does. But the active ones, for whom sex is very important, try to remedy it. However, not all Polish women are “hey, let’s go for it.” After all, there is a group of women who say they are willing to give up sex. Especially when their partner, a peer, has diabetes, high blood pressure, or erectile dysfunction. Sometimes it’s not a matter of illness, but of obesity or years of smoking and alcohol abuse. I’ve had patients—among the active, orgasm-oriented group—who tried to solve this problem on their own by sneaking various potency-boosting substances into their husband’s food. I don’t recommend this; the consequences can be dire.
TS: Because…
ZLS: …because we don’t know what interactions the new medication will have with the drugs the man is already taking. What will happen? It’s better not to find out. Besides, let’s remember that all “blue pills” and their derivatives only work for a man who wants to, but can’t. That is, he feels aroused at the sight of a woman, but technically is unable to achieve an erection. Patients cry in my office: “Doctor, I don’t turn him on!” To be honest, I know of very few cases where the woman a man lives with doesn’t turn him on. Maybe he’s taking medication that drastically reduces his libido? Poles are popping all kinds of pills like there’s no tomorrow, and yet they all have side effects. Or maybe the partner is simply depressed—if he doesn’t feel like living, he probably doesn’t feel like making love either.
TS: Or maybe he just doesn’t feel like making love to this particular woman, his own wife?
ZLS: I would rule out that possibility, though. I assure all female readers that each of you has the potential to “turn on” your partner. Believe me: a healthy man always has sex on his mind. And he suffers when he can’t fulfill himself as a lover. I urge you ladies: don’t worry that “I don’t turn him on,” absolutely don’t give up on sex, but also don’t believe TV ads for potency drugs. Go see a doctor. Get your testosterone levels checked right away; they’re probably too low—it’s a disease of modern society, and men have less and less of this hormone. And sex is, after all, necessary and can be enjoyable. It’s good that Polish women are increasingly seeing it this way and are more willing to enjoy it. And if that means I lose some patients… There will be more happiness in the nation instead. I can make the sacrifice and retire to a well-deserved rest.
Interviewed by: Jagna Kaczanowska, “Twój Styl,” March 2017, No. 3 (pp. 54–56)
