Some women may subconsciously associate sex with submission, and the connection could wreak havoc on their ability to enjoy sex, research shows.

In a series of studies involving female college students, University of Michigan researchers found that the women who most strongly linked sex with submission reported the most difficulty becoming sexually aroused. The same association was not seen in young men.

"Women seem to internalize the female sexual role of submission," the researchers write. "In the process of fitting their sexual behavior and desires into this cultural mold, women may unwittingly undermine their sexual arousal."

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Empowerment = Satisfaction

Two well-known sex therapists who spoke to WebMD expressed differing opinions on the research.

"I just don't think this study is relevant for sexually mature, experienced women," says Sandra R. Leiblum, PhD.

Leiblum directs the Center for Sexual and Relationship Health at the UMDNJ-Robert Wood Johnson Medical School in New Jersey.

"It may be relevant to younger, less-sexually experienced women who tend to respond more to gender role stereotypes. But it would be hard to find too many 50-year-old women who feel submissive."

She adds that the most common complaint she hears from older women is a disinterest in sex.

Therapist, author, and researcher Laura Berman, PhD, agrees that college-aged women often lack a sense of sexual empowerment. But she adds that she sees the problem in women of all ages and social levels.

Berman and colleagues interviewed several thousand women for her book Secrets of the Sexually Satisfied Woman, which was published earlier this year.

She says the most sexually satisfied women were comfortable with their bodies, were able to communicate their sexual needs to their partner, and had a sense that their partner was receptive to their needs.

"Elements of empowerment are key to a woman's level of sexual satisfaction," she says. "So it makes sense that sexual response is not as good for women who don't feel this autonomy."

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The Research

The University of Michigan researchers used a subliminal association test to measure the degree to which women associated sex with submission. Thirty-six female undergraduates participated in the research.

The women were told that they would complete a simple word categorization task. They were instructed to sort nonwords from words by pressing keys marked "nonword" or "word" on the keyboard as quickly as possible.Following random prime words, target words were presented on a computer screen. It remained there until the participant pressed the "nonword" or "word" key, at which point a reaction time was recorded.

The women's responses tended to be faster when submissive words like comply, submit, slave, and weaken were preceded by sex prime words than neutral ones. This indicated that they associated sex with submission, study researcher Amy Kiefer, PhD, tells WebMD.

Those who had the quickest responses were also more likely to report engaging in submissive sexual behavior.

College-aged men recruited for the same test were much less likely to associate sex with submission, and the degree to which they did so did not predict submissive sexual behavior.

In a follow-up study, the researchers asked the female participants a series of questions to gauge the impact of submissive behavior on arousal. The more women reported engaging in submissive sexual behaviors the less arousal they reported from a range of sexual activities.

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"We showed that women tend to associate sex with submission without necessarily being aware of it," Kiefer tells WebMD.

She says women are probably not hardwired to be sexually submissive and that greater awareness of the issue may help them achieve more sexual satisfaction.

Berman says even though women's attitudes toward sex have changed in recent decades, most still don't feel comfortable discussing their sexual needs with their partners.

"Even though we had the women's movement and the sexual revolution and have made huge strides in terms of sexual empowerment, I work with women every day who are struggling with this," she says. "Even today there is this idea that nice girls can be sexually receptive and responsive, but if they are too sexually assertive it is off-putting."

By Salynn Boyles, reviewed by Brunilda Nazario, MD

SOURCES: Kiefer, A, University of Michigan study. Amy Kiefer, PhD, research fellow, University of California at San Francisco. Sandra R. Leiblum, PhD, professor of psychiatry; director, Center for Sexual and Relationship Health, University of Medicine and Dentistry New Jersey-Robert Wood Johnson Medical School, Newark, N.J. Laura Berman, PhD, sex therapist; director and president, Berman Center, Chicago.