Arousal non-concordance … putting a name to the feeling
By Sara Twogood, MD
Note: sexual assault is mentioned briefly, under #1 below. Please scroll down to the How Common Is It? if you prefer to skip this part.
Arousal non-concordance is when the brain and the body do not respond the same to sexual stimuli. It’s super common! And knowing how common it is (plus other details) can answer so many questions and improve your sexual wellness.
Arousal non-concordance comes up in 2 ways:
#1 : Natural lubrication is amped up but the sexual brain is not feeling it. This is: “why is my body reacting this way?” Or a partner says “you’re so wet” and takes it as a sign they’re doing everything right … when they’re really not. There is also a more in depth, sensitive, gender neutral discussion about sexual assault and this type of non-concordance. For example: a perpetrator using a victim’s physical response to defend their behavior or “evidence” that the assault was actually consensual. I am not going to address this in more detail today but know there is medical literature diving into this topic if you’re inclined to read it.
#2 : The sexual brain is very turned on but the natural lubrication is not robust. This looks like: “why isn’t my body in sync with my sexual brain?” Or a partner commenting that you feel “dry” and wondering if you’re just not turned on (a very delicate thing to bring up because it has the potential to feel like a judgment on you, or a blow to their ego). This is the type of non-concordance we will discuss more in depth.
How common is it?
When arousal concordance / non-concordance has been studied in female sexual health, there is about a 10% overlap between what the body thinks is sex related and what the mind is sexually turned on by. Another way to say this is that the body responds different than the sexual brain up to 90% of the time. Wild, right?
This is why communication during sex is so important!
If you’re the quiet, non-communicative type when it comes to being turned on, your partner only has the physical changes - natural lubrication, engorgement and swelling of the genitals, and movements - to know if and when you are turned on.
You know what’s easier, clear, and more direct? Tell them! Tell them you’re turned on with your words and noises. They’ll get the message you are sexually aroused even if they aren’t noticing a lot of natural lubrication.
Lubrication feels nice with sex. So what can you do about not having enough natural lubrication even when the sexual brain is on fire? Are there ways to increase natural lubrication?
Maybe. Remember, not having enough natural lubrication when sexually aroused is very common and even expected. There is not a simple solution, and non-concordance does not mean something is wrong! But most people with significant non-concordance (the type where the body does not respond with natural lubrication to sexual thoughts) would improve it if they could.
Here are some techniques to try:
Topical vaginal treatments:
Vaginal estrogen. This topical medication helps if the body is in a low estrogen state. Low estrogen states includes perimenopause / menopause (the most obvious), using hormonal contraception, and breastfeeding.
Hyaluronic acid vaginal suppositories. Although vaginal estrogen is the gold standard for vaginal atrophy in low estrogen states, the use of vaginal hyaluronic acid has been shown to have a similar effect in the short term. If you want to try a non-prescription alternative to vaginal estrogen, this is a good option. If vaginal dryness or low natural lubrication is present but not a low estrogen state, a trial of these suppositories may help too.
Other vaginal products: CBD vaginal suppositories and other vaginal moisturizers may help rejuvenate the vaginal cells by increasing their water content or decrease inflammatory markers.
Vibrator use, masturbation, more sexual activity. The goal is to increase blood flow to the genitals. When there is an increase in blood flow to areas of the body, the cells adjust to optimize this blood flow. Over time that region receives blood flow quicker and more robustly, helping with a physical sexual response. This is where the “use it or lose it” concept is partially true – more sexual response helps with more sexual response!
Connecting the mind and body. This takes practice. When touching the genitals, think sexual thoughts. Focus and try not to get distracted. When you think a sexual thought, touch the genitals (Of course there are many social situations where this is just not appropriate! Use good judgment.). Make the physical connection. Hopefully, with time, the body’s response will become more automatic.
Use lube. This is not a way to boost natural lubrication but helps solve the problem of the bad kind of friction. Patients tell me they hesitate to bring this up with partners so let me give you some options. The conversation might be a simple statement of fact: I like things more slippery than my body usually supplies. Or: wetness does not equal how turned on I am – I want you to know that because I am very turned on right now. Or, if you want to get more clinical: I have arousal non-concordance so I want to use lube. Not sure how this one will go over but worth a try if you’re stuck!