Science of Sex: Vaginismus

September 15th, 2018

Welcome to this month’s edition of Science of Sex. This topic was suggested by one of my readers in my recent blog giveaway (thanks Courtney!). Vaginismus is a condition that you might never have heard of if you haven’t struggled with it (or known someone who has). And it seems like medical professionals don’t always take claims of pain as seriously as they should. It’s a shame because vaginismus is quite treatable as you’ll learn below.

Check out the rest of the Science of Sex posts here.

Vaginismus science of sex

Some people suffer from a condition known as vaginismus, which is characterized by involuntary contractions of the vagina that make sex painful or even impossible. It’s not uncommon for people who have this — or their partners — to describe it like hitting a wall.

There are two types of vaginismus: primary (lifelong) and secondary (developed).

A similar problem is dyspareunia or painful sex; although, vaginismus is a specific condition and patients with this condition have fewer issues with desire and self-lubrication than those whth dyspareunia.

Vaginismus is interested because it’s certainly tied to emotions, especially fear and anxiety. One survey found that people who suffer from vaginismus had a significantly higher phobia of sex while another found that over half of participants with vaginismus qualified as alexithymic (the inability to name their emotions).

While a past trauma such as sexual assault may potentially be one factor in vaginismus, people who have never engaged in any form of sexual activity can also suffer from this. And pain may be present in non-sexual situations like using a tampon or getting a Pap smear.

But there is doubt whether the emotional state causes vaginismus or whether pain leads to anxiety. Vaginismus is definitely a vicious cycle.

Researchers have looked for differences in brain and genital response in people with this condition. Interestingly, there are no differences in how the brain responds. Furthermore, while women with vaginismus report less mental arousal to erotic content, they don’t necessarily have decreased genital arousal. This is known as arousal non-concordance, and is a common theme of female sexual dysfunction.

Because of the emotional/mental aspects of vaginismus, many of the treatment options are psychological. Mindfulness, for example, can be an effective treatment.

Touching exercises are a common treatment for this condition. Patients are instructed to touch themselves progressively closer to their vagina until their can do so with less or no pain. Insertion begins with a single finger, then moves to devices (dilators) that become progressively larger.

Coping with vaginismus can be difficult for couples. Some professionals recommend erection-enabling medications if partners find it difficult to remain erect or to engage in penetration after dealing with vaginismus. Becoming accustomed to touch helps to desensitize people.

Treatment can allow for successful intercourse in as little as two weeks.

Medicine interventions have been explored, and botox may be one option for treating vaginismus. Surgery is also occasionally a solution. A hymenectomy (removal/reduction of the hymen) to make sex possible and pleasurable.

Although most people think of vaginismus in terms of sex, it can also affect childbirth and labor. Specifically, women with vaginismus are more likely to have C-sections and to suffer from perineal laceration (tears of the perineum, the skin between the anus an vagina) during vaginal deliveries. It stands to reason that fear of pain and muscle contractions or tension could make this area more vulnerable.

Further Reading

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Categories: Science of Sex

Science of Sex: Mindfulness as a Treatment for Sexual Dysfunction

July 14th, 2018

This month’s Science of Sex post is directly inspired by the book that I reviewed by Dr. Lori Brotto and, in fact, will draw from several of her studies. Mindfulness at first times to be new agey– more hype that hypothesis. But multiple studies have shown that mindfulness can have a positive impact on many facets of life, sex among them. So this month’s Science of Sex post focuses on that.

Check out previous Science of Sex posts here.

Mindfulness as a Treatment for Sexual Dysfunction

Dr. Brotto does a good job of explaining what mindfulness is in her book: it’s an awareness of your thoughts, feelings, and sensations, that allows you to create a distance with them, which can reduce the impact of pain, for example. But mindfulness also helps you remain more in the moment to focus on sensation. We’ll start with Brotto’s work since she’s done so much.

In one study, Brotto and her team found that while mindfulness didn’t necessarily increase arousal, it does increase women’s’ awareness of their physical/genital arousal, in turn increasing arousal concordance (symmetry between observed physical and genital arousal).

Another study by Brotto et al found that a group of 31 endometrial cancer survivors experienced improvements in multiple aspects of sexual functioning — desire, arousal, lubrication, orgasm,  and satisfaction — after participating in three sessions of mindfulness-based cognitive behavior therapy. And the improvements remained six months later.

Yet another study by Brotto found four sessions of a “mindfulness-based therapy significantly improved sexual desire, arousal, lubrication, satisfaction, and overall sexual functioning”. Continued sessions resulted in further improvements in genital and mental excitement. Any immediate improvements continued to a 6-month followup.

Finally, a 2008 study found similar improvements in women’s’ sexual function when exposed to mindfulness training. Furthermore, women who had previously experienced sexual abuse benefited the most from mindfulness compared to all participants.

Clearly, Dr. Brotto has done a lot of research on mindfulness and sexual function and talks about a 60% increase in sexual function after mindfulness in one of her studies. I think we can expect that to continue. But she’s not the only one. Time and again, studies suggest that mindfulness could be key to an improved sex life.

One such study compared how long it took men and women to register their physical arousal, finding that men did it significantly quicker than women. Mindfulness meditation enabled women to require less time to notice bodily responses, putting them on par with men. Additionally, women who practiced mindfulness were less judgmental toward themselves. Others found that mindfulness may be helpful to people who experienced sexual abuse as children.

Yet another study posited that people with more disproportional mindfulness would be less likely to engage in sexually compulsive behaviors or use drugs and found this to be true. Finally, a survey of women who completed mindfulness-based therapy online only found improvements in sexual function.

Studies on mindfulness have focuses on women, perhaps because they’re more likely to experience certain sorts of sexual dysfunction (low desire, difficulty with arousal, impaired pleasure, etc), but it’s reasonable that men could improve their sex lives by learning and practicing mindfulness, too. Some sources even state that mindfulness could help people with ED and at least one study focuses on sensate touch, a type of mindfulness program originally developed by Masters and Johnson, as a possible aid here. I’d like to see mindfulness applied to men. Otherwise, the science is promising.

Further Reading

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Categories: Science of Sex

Better Sex Through Mindfulness: How Women Can Cultivate Desire

July 12th, 2018

Better Sex Through Mindfulness: How Women Can Cultivate Desire
$13.86 from Amazon

Some of you may not read as many educational books about sex as I do, so you may not realize that this year has been pretty active with releases (this does not actually include my last book review, Becoming Cliterate, which was released last year). It’s why I’ve been reading about sex non-stop for the past several months. It’s been a few years since this has been the case; although, the break from reading about astrophysics certainly was welcome.

Check out all my book reviews before you leave.

Even though Better Sex Through Mindfulness was just published a couple months ago and I was able to get my hands on a digital copy immediately, the author came across my radar last year. You see, Lori Brotto, a psychologist, is one of the women I wrote about in my post about women who study sex.  Let me refresh with the description of her work because it leads us directly to the theme of Brotto’s book:

Lori Brotto has studied the disconnect that women often experience between mental and physical arousal. Brotto’s research suggests that the way that women multitask and tend to be detached from their bodies contributes to this. Brotto suggests mindfulness as one possible solution

So her work and research have led her to write a book directly about how mindfulness can help women overcome their sexual issues. Brotto is one of many who are adamant that the solution to low sexual desire cannot be fixed simply by a little pink pill (Emily Nagoski, who wrote the foreword, shares similar views). And while the tagline of this book focuses on desire. Better Sex Through Mindfulness goes beyond how mindfulness can be helpful with sex drive and focuses on topics such as heightening pleasure and reducing the impact from pain as well.

As a researcher, Brotto has worked with women to help them solve and alleviate the symptoms of their sexual issues, and she draws heavily from her own research when she makes conclusions in Better Sex Through Mindfulness. When she tells you that women have increased sex drive as well as pleasure from sex due to a something as small as mindfulness, you believe her and wonder if we’ve been treating sexual complications wrong all along. At one point, Brotto mentions how “mood, sense of well-being, body image, self-esteem, and how a woman feels about her partner turned out to be far stronger predictors of her level of sexual desire than a single hormone,” which really drives this point home (later she highlights how opinions about sexuality can also be more significant than hormones). Not only may some treatment options for sexual dysfunction be misguided, but the focus of hormones as cause and treatment for sexual dysfunction after menopause may also overestimate the function of hormones in sexual function.

But let me back up because by calling mindfulness ‘small,’ I am being quite reductionist. Really, mindfulness can be life-changing, and Dr. Brotto takes time to explore the definition and use of mindfulness as well as its history (the word wasn’t using when Masters and Johnson were teaching about sex, for example, but their sensate practices were certainly mindful!). She compares and contrasts mindfulness with cognitive behavioral therapy, with which I was familiar from my own experiences.

Furthermore, mindfulness can be difficult for some people, and Dr. Brotto emphasizes that willingness to try and practice mindfulness as key to its effectiveness. As someone who has struggled with meditation and mindfulness in the past, I think this is especially pertinent. It struck me that getting help to master mindfulness might be the catalyst to success in people who similarly struggle. Indeed, Dr. Brotto points out how trying to force yourself to relax is a misunderstanding of mindfulness and can be counterproductive.

Brotto often points to others’ research as well. In her book, she talks about studies that have highlighted differences in the brains of women who have healthy versus low sexual desire. One difference may be smaller amounts of grey matter in the brains of women who have low sexual desire. Brotto explains how women with low sexual desire spend more time monitoring their sexual performances rather than enjoying sex — and research backs it up!

Better Sex Through Mindfulness isn’t all about the argument that mindfulness can be helpful, however. Scattered through the books are practices that readers can use to (try to) improve their own sex lives. Admittedly, I am not currently struggling with sexual issues, but I found the reminder to be mindful during my everyday life useful. Of course, this book also offered something to sate my appetite for sexual science. Of particular note was how mindfulness can assist women who suffer from pain during sex due to various conditions. While mindfulness does not lessen the pain (and in some instances, medical professionals are not sure how to do this), it does enable women to enjoy sex and intimacy by reducing the intensity of their perception of pain and by encouraging a wider variety of intimacy.

I also highlighted a blurb regarding how sexual concordance differs between men and women. Women experience a lower level of +.26 than men’s level of +.66 (with 1.0 being perfect concordance between mental and physical arousal). This book was full of interesting tidbits like that.

In Better Sex Through Mindfulness, Brotto makes the case for her mindfulness programs by revealing the results of surveys filled out by the participants. She states that “sexual satisfaction increases by 60 percent” from prior to the program. She also illustrates how learning mindfulness can equate to long-term sexual improvement and not just improvement in the present. Even women who were dubious about the effects of mindfulness found it to be helpful. Certain groups of women (those who were the most distresses prior) even benefited the most.

In the end, Dr. Brotto’s book shows that not only is there hope when it comes to sexual dysfunctions such as low desire or pain but that the solution might be easier and more accessible than people realize, all without needing pharmaceutical intervention. Although geared toward women, I can imagine men would benefit from this book, too.

Better Sex Through Mindfulness ends with an appendix full of resources, either for women to get help to improve sexual function. This book is ideal for any woman (or man) who wants to get more out of her sex life, but some professionals might also benefit from reading it and incorporating mindfulness into their treatment and coping strategies.

If you think you might benefit, you can buy it at any number of retailers. A hard copy might be especially useful for partaking in activities, but I usually prefer Kindle versions for highlighting and taking notes. Get the digital version for less than $10. It’s only a couple bucks more for physical!

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