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

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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Categories: Books, Reviews

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Science of Sex: Female Sexual Dysfunction

May 19th, 2018

Welcome to my latest installment of Science of Sex. I’ve officially be doing these for more than a year and have more planned! If you want to check out my archives, click here. Otherwise, enjoy this month’s post!science of sex - female sexual dysfunction

Today we’re venturing into the realm of female sexual dysfunction, just what it is, and why that title might not actually be helpful.

At its heart, female sexual dysfunction is an issue with sexual functioning in a woman. This can include a number of conditions and concerns, but four of the main ones are:

  • Desire : Many women and sometimes their partners describe their lack of spontaneous desire as a dysfunction. However, studies show that women are more likely to have responsive desire than men. This is not a dysfunction as much as it is a difference in sexual function. Furthermore, some have suggested that the traditional stages of arousal may not apply as well to women whose arousal process is more cyclical. It’s also important to understand that a woman’s sexual brakes are often quite touchy (learn more about this). Finally, low desire often corresponds to relationship issues, so it’s not so much a sign of sexual dysfunction as it is one of relationship dysfunction.
  • Arousal: Female sexual dysfunction can also present as a lack of physical arousal. This highlights further incorrect assumptions or beliefs about female sexuality. First, it doesn’t take into consideration that women are much less likely to experience concordance – an alignment between mental desire and physical arousal – than men and, secondly, it ignores the variance in a woman’s natural lubrication.
  • Orgasm: Some women may describe their inability to orgasm through sexual intercourse as dysfunction, but multiple surveys have found that the majority of women need clitoral stimulation to orgasm and very few achieving orgasm solely through penetration. At least one study reports a group of women who prefer penetration/sex with their clit stim as a way to get off.
  • Pain: Too many women experience pain during intercourse (in fact, at least one study has found that the bar for good sex for women is so low that they simply describe it as sex that is not painful). This is often remedied by increasing foreplay to encourage arousal, using lube and improved sexual communication. While conditions such as vaginismus and endometriosis can lead to pain during sex, painful sex can also be a symptom of poor technique and can often be ameliorated by changing the script.

Of course, there are other types of dysfunction, including those that center on physical issues and are not rooted in psychological or romantic distress. But the solution or treatment to any one of these “dysfunctions” may not be at all alike to the treatment for any other dysfunction.

The problem is that the term sexual dysfunction itself is not well-defined, and female sexual dysfunction is even more poorly defined because the umbrella term lumps together so many potential issues, including those that may be easily rectified by a better understanding of female sexuality. Furthermore, having a stronger grasp on female sexuality would show that some so-called dysfunctions are simply functions of sexuality in women that do not need to be pathologized. Of course, it’s not like men don’t suffer from this. It’s not a dysfunction if men ejaculate within ten minutes — it’s the norm — but the deep-seated misunderstanding of female sexual function had led to a lot of suffering.

Fortunately, doctors have devised questionnaires such as the aptly-named Sexual Function Questionnaire, and other tools to more readily diagnose sexual dysfunctions and focus on the root of the problem, whether it may be physical, relational, or a combination of factors. Sex therapists and educators are also making great strides in adjusting public and personal views of normal and healthy sexual function. For example, Dr. Emily Nagoski has written about desire and arousal in her book Come As You Are, Dr. Laurie Mintz shed light on clitoral stimulation in her own book Becoming Cliterate, and Dr. Lori Brotto helps women experience greater sexual function in her recently-released book Better Sex Through Mindfulness.

It should come as no surprise that women working on sexual research and providing sex therapy offer unique insight into female sexuality and what truly is dysfunction. If you’re interested in that topic, check out my post on  about the Women of Sexology

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Categories: Science of Sex

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