Reviewed by Vern L. Bullough, R.N., Ph. D.
Distinguished Professor Emeritus, State University of New York
Outstanding Professor Emeritus, California State University, Northridge
Currently Visiting Professor, Nursing, University of Southern California
 

         This is a delightful and informative read.  Groneman traces the history, primarily in the United States, of nymphomania, a concept that first appeared in the medical literature of the nineteenth century, and  following her title of the mania about nymphos.  Although there is a long history of medical concern about female sexuality going back as far as Galen's belief in the necessity of women having periodic orgasms, even self induced ones, or otherwise hysteria would result, the fear of "excessive" female sexuality seemed to have peaked in the nineteenth century.  In a period in which a large segments of the medical community believed that masturbation and sexual excess caused insanity and disease, it probably seemed logical to many of them to label women with "excessive sexual desires," as nymphomaniacs, although it was never clear what excessive meant.  Men with similar excessive desires were said to be have satyriasis, but it was women who came in for the most pointed comments in the medical literature, dominated by the writings of male physicians.
         Nymphomaniacs did not have to have a partner to be labeled as such, and much of the nineteenth century history of nymphomania is concerned with masturbation. In fact, not all the cases reported in this book were labeled as cases of nymphomania at the time, but simply used as examples of the dangers of excessive female sexuality.  This means that the
book is at heart a study of medical ideas about female sexuality and their effect on the general population and professionals in other fields. The most extreme forms, fitting in with the theory of masturbatory insanity, were reported in asylums where women used lewd and obscene language, engaged in violent tearing of their clothes, and incessant, public masturbation. Many in the medical communty fervently believed that unless they could intervene effectively in curtailing female sexuality, their patients would end up in mental institutions. The medical community, however,  was divided over whether nymphomania was a problem of the genitals or of the brain. Autopsies gave them no guidance, but the fear of dangers of nymphomania and masturbation inculcated into the public mind was so great that many women desperately sought help with their sexual problems in order to avoid going insane.
         Even though many of the ideas about masturbation  were challenged and even modified by individuals such as Havelock Ellis and Sigmund Freud, it was still believed that women who refused to accept their innate feminine psyches which programmed them to be modest, maternal, and passive, were oversexed, potentially pathological, and sexually deviant.  Excessive sexuality in women, for example, might lead to lesbianism.   A contrasting current theory had a different explanation, namely that nymphomaniacs were  frigid and it was lack of sexual satisfaction which led women to be oversexed. Tied in with this was a belief that women made up charges of rape since fantasies of rape were common to most women and it was the
unsatisfied sexual drive of females which led them to make such claims.
        Almost any women who seemed to enjoy sex could be called a nymphomaniac by some medical specialist or other and especially if she had a sex drive stronger than that of her male companion. Nymphomania made its appearance as a sexual deviation  in the first DSM which appeared in 1951, and this was changed to a psychosexual disorder in the DSM III in 1980. The diagnostic category in both cases was ambiguous and not helpful since there were no specific diagnostic criteria and no instructions to the mental health practitioners on how to recognize it. The DSM IIIR labeled it a sexual addiction, but this was dropped in  DSM IV.  At the beginning of the twenty first century nymphomania had finally disappeared as a medical diagnosis, although a popular image of such a woman still is retained.
        In sum, this is an important study of the changing concepts of female sexuality, and ranges far beyond the medical literature to include illustrative material from women's magazines and pornography.  While it is now neither regarded as an organic disease nor a specific mental disorder, it lives on in popular culture both in the image of the happy nympho, and conversely in the victimized child who grows up to be a sex addict.  What the author concludes is that as far as women are concerned there is no satisfactory answer to how much is too much and how much is enough.  The obvious answer is that this varies among women just as it does among  men, something that many cannot yet accept.