Physiological Synchrony During Partnered Sexual Activity.

Physiological synchrony (PS) refers to the coordination of bodily responses in close relationships. It seems to be linked to relational well-being, satisfaction, closeness, and empathy. Recent research extends these findings to sexual relationships as well, with evidence suggesting that PS may predict attraction and sexual satisfaction. The current study focuses on PS during sexual activity within established couples. Results suggest that PS develops during sexual activity, in certain contexts, and tends to be greater in magnitude during sexual encounters than during non-sexual interactions. Results may shed light on the dyadic psychophysiological factors relevant to sexual experiences.

Psychometric Evaluation and Adaptation of the Five-Factor Sexual Satisfaction Scale (SSS-W) for Use in Men: The Sexual Satisfaction Scale (SSS).

The Sexual Satisfaction Scale for Women (SSS-W) is a psychometrically sound, widely used instrument for assessing sexual satisfaction and distress in women. Because the majority of scale items are gender nonspecific, numerous researchers have adapted this scale for use in male samples. The goal of the current study was to assess the reliability and validity of a slightly modified version of the SSS-W in a male sample (N = 268). A Confirmatory Factor Analysis of five previously established factors provided evidence for consistency of internal structure in men. The adapted scale (SSS) exhibited acceptable test-retest reliability, as well as evidence for validity based on relationships with theoretically predicted variables. Taken together, there is evidence to suggest that the SSS may be a reliable and valid psychometric tool for the measurement of sexual satisfaction and distress in both men and women.

Reduction in genital sexual arousal varies by type of oral contraceptive pill.

BACKGROUND: Although oral contraceptive pills (OCPs) have been associated with decrements in self-reported genital arousal and vaginal lubrication, 1,2 little is known about how these outcomes vary across types of OCPs. AIM: The present study examined differences in physiological lubrication and vaginal blood flow, as well as rates of self-reported vulvovaginal atrophy and female sexual arousal disorder, among women using OCPs with varying androgenic properties. METHODS: Participants in this study were 130 women: 59 naturally cycling control women, 50 women taking androgenic OCPs, and 21 women taking antiandrogenic OCPs. Participants watched sexual films while their sexual arousal responses were measured, completed questionnaires, and participated in a clinical interview. OUTCOMES: Vaginal blood flow, vaginal lubrication, self-reported vulvovaginal atrophy, and female sexual arousal disorder were assessed. RESULTS: Results indicated deficits in vaginal pulse amplitude and lubrication for women taking either form of OCP, with marked inhibitory effects found in women taking antiandrogenic OCPs. Rates of self-reported vulvovaginal atrophy and female sexual arousal disorder were also significantly greater in the antiandrogenic group compared with the control group. CLINICAL IMPLICATIONS: It is recommended that prescribing clinicians consult patients on such physiological effects of OCPs. STRENGTHS AND LIMITATIONS: To our knowledge, this was the first study to compare multiple measures of physiological sexual arousal across groups of women taking OCPs with varying hormonal profiles. Because all OCPs included in this study contained low doses of ethinylestradiol, we were able to identify the specific effects of the androgenic properties on women's sexual arousal responses. However, the self-administered lubrication test strip was subject to user error. Additionally, the generalizability of findings is limited by the largely heterosexual and college-aged sample. CONCLUSION: Compared with naturally cycling women, women taking OCPs that contain antiandrogenic progestins experienced decreased vaginal blood flow and lubrication as well as higher rates of self-reported vaginal bleeding and female sexual arousal disorder.

Why Hungarians Have Sex: Development and Validation of a Brief 15-Item Instrument (YSEX?-15H).

The present study developed a brief version of the Hungarian Why Sex? questionnaire (Meskó et al., 2022). The study was in part based on previously reported data obtained from several samples (N = 6193; 1976 men, 4217 women). Using Mokken Scaling Procedure, Item Response Model and redundancy analysis indicated that retaining three summary scales comprising five items each was the optimal solution for the brief version. The validity of the brief scale was tested with the Sexual System Functioning Scale (SSFS), the Experiences in Close Relationships Scale-Short Form (ECR-S) and, the Hungarian version of the Attachment Style Questionnaire (ASQ-H; n = 297, 127 men, 170 women). In addition, correlations between the long and brief versions of YSEX? with sociosexual orientation (SOI-R) and the five-factor personality construct (BFI-S) were compared (n = 1024, 578 women, 446 men). The results suggest that the three summary scales of the Hungarian 15-item Form of the Why Sex Questionnaire (YSEX?-15H) provide reliable and valid measures of the previously affirmed three broad sexual motives (Personal Goal Attainment, Relational Reasons, Sex as Coping). The Relational Reasons summary scale was associated with secure emotional and sexual attachment. The Personal Goal Attainment and Sex as Coping summary scales showed coherent patterns of associations with the emotional and sexual aspects of secondary attachment strategies (over- and under-functioning). The YSEX?-15H offers both researchers and practitioners a concise and useful instrument for the assessment of sexual motivation.

A Review of Undergraduate Student Disclosures of Sexual Violence.

INTRODUCTION: Sexual violence (SV) has been a prevalent issue on college campuses for decades. Researchers, universities, and legislators have tried to understand and prevent it. Despite these efforts, 25% of female and 6% of male undergraduate students will experience a nonconsensual sexual experience (NSE) as a student. An immense amount of research has been conducted on the prevalence, effects, resources for, and outcomes of SV over the last few decades. OBJECTIVES: The current paper aims to compile and summarize the extant literature on undergraduate student disclosures of sexual violence. The objective is to provide a comprehensive review of the research. METHODS: A literature search was performed using the terms sexual violence, NSE, undergraduate students, informal and formal reporting, and disclosure. RESULTS: Disclosure patterns and outcomes for survivors vary widely based on individual factors including type of disclosure source (ie, informal or formal reporting), disclosure recipient response, previous history of NSEs, and personal identity (ie, gender identity, sexual orientation, race/ethnicity). Though there are many formal resources (ie, police, Title IX), the majority of survivors report to informal sources (ie, family or friends). In addition to researching survivors' experiences and rates of disclosures, research also evaluates how disclosure recipients perceive their response to a survivor's disclosure, their likelihood of receiving a disclosure based on their own individual identities, and how the disclosure impacts the recipient and their relationship with the survivor. CONCLUSION: The individualized response and decision to report SV has made prevention and the creation of effective resources difficult. As there are so many individual factors to consider when evaluating how or whether a NSE will be disclosed, future research should consider these individual differences and use them to create more effective reporting sources and resources. Sears-Greer MA, Friehart BK, Meston CM. A Review of Undergraduate Student Disclosures of Sexual Violence. Sex Med Rev 2022;10:543-553.

Why Hungarians Have Sex (YSEX?-HSF).

Using the same methodology as Meston and Buss (2007), three studies were conducted on a Hungarian sample (total N = 4913) which corroborate previous findings on the universal diversity of sexual motivation. Study 1 (N = 2728; 1069 women and 1659 men) identified 197 reasons for having sex based on participants' free responses. In Study 2 (N = 1161; 820 women and 341 men), participants indicated the extent to which each of the 197 reasons had led them to have sexual intercourse. Factor analyses yielded three factors and 24 subfactors. This differed from the original YSEX? four-factor questionnaire. In Study 3 (N = 1024; 578 women and 446 men), a reliable and valid 73-item short form version of the YSEX? questionnaire was developed in a Hungarian sample (YSEX?-HSF). In addition to similarities and differences in the factor structure, we found important links between reasons for having sex and age, gender, personality, and mating strategy. For example, number of reasons for having sex tended be higher in younger compared to older participants. Men exceeded women on having sex for novelty-seeking and infidelity opportunities, whereas women exceeded men on having sex for relationship commitment and mate retention. Extraversion and neuroticism were linked with reasons for having sex, and those who pursued a short-term mating strategy reported having sex for a larger variety of reasons.

A Review of Undergraduate Student Disclosures of Sexual Violence.

INTRODUCTION: Sexual violence (SV) has been a prevalent issue on college campuses for decades. Researchers, universities, and legislators have tried to understand and prevent it. Despite these efforts, 25% of female and 6% of male undergraduate students will experience a nonconsensual sexual experience (NSE) as a student. An immense amount of research has been conducted on the prevalence, effects, resources for, and outcomes of SV over the last few decades. OBJECTIVES: The current paper aims to compile and summarize the extant literature on undergraduate student disclosures of sexual violence. The objective is to provide a comprehensive review of the research. METHODS: A literature search was performed using the terms sexual violence, NSE, undergraduate students, informal and formal reporting, and disclosure. RESULTS: Disclosure patterns and outcomes for survivors vary widely based on individual factors including type of disclosure source (ie, informal or formal reporting), disclosure recipient response, previous history of NSEs, and personal identity (ie, gender identity, sexual orientation, race/ethnicity). Though there are many formal resources (ie, police, Title IX), the majority of survivors report to informal sources (ie, family or friends). In addition to researching survivors' experiences and rates of disclosures, research also evaluates how disclosure recipients perceive their response to a survivor's disclosure, their likelihood of receiving a disclosure based on their own individual identities, and how the disclosure impacts the recipient and their relationship with the survivor. CONCLUSION: The individualized response and decision to report SV has made prevention and the creation of effective resources difficult. As there are so many individual factors to consider when evaluating how or whether a NSE will be disclosed, future research should consider these individual differences and use them to create more effective reporting sources and resources.

An Objective Measure of Vaginal Lubrication in Women With and Without Sexual Arousal Concerns.

Changes in vaginal blood flow and lubrication are primary components of physiological sexual arousal in women. Despite the existence of well-established tools for measuring vaginal blood flow, there is not yet a consistently implemented measure of physiological lubrication. To address this methodological gap, researchers have begun examining the utility of litmus test strips, primarily in sexually healthy women. The present study builds on this work by examining the utility of an alternative tool, the Schirmer Tear Test strips, in women with (n = 32) and without (n = 32) sexual arousal concerns. Significant increases in physiological lubrication were found in response to a sexual film, and these changes were moderately correlated with self-reported genital arousal (r = .41) and lubrication (r = .30). No between-group differences in lubrication were observed. These results indicate the Schirmer Tear Test strips are sensitive enough to detect increases in lubrication and may be valuable in clinical and research assessments of female sexual arousal.

Sexual Shame in the Sexual Excitation and Inhibition Propensities of Men With and Without Nonconsensual Sexual Experiences.

For men with nonconsensual sexual experience (NSEs) histories, sexual shame may play a critical role in their sexual responses. Through online surveys, the current study examined sexual shame in the sexual excitation and inhibition responses of men with NSE histories who both do (identifiers; n = 255) and do not identify (non-identifiers; n = 239) their NSEs with sexual violence labels (e.g., rape) and men with no NSEs (n = 289). Regardless of identification, men with NSEs reported greater sexual shame than men with no NSEs and higher levels of excitatory (e.g., arousability) and inhibitory (e.g., inhibitory cognitions) domains of sexual response propensities. Sexual shame predicted inhibitory domains of sexual response for all of the men. NSE history and identification moderated the relationship between sexual shame and arousability. Sexual shame had a stronger positive association with arousability for both identifiers and those with no NSEs than non-identifiers. The results provide support for the role of sexual shame in men's sexual response and suggest sexual shame is an important target for interventions with men with NSEs.

The Relationship between Subjective and Physiological Sexual Arousal in Women with and without Arousal Concerns.

Whereas laboratory studies frequently report low correlations between women's physiological and subjective sexual arousal (i.e., concordance), research employing advanced statistical techniques reveals striking between-person variability in this relationship. Moreover, previous research has shown that interoception (i.e., the awareness of changes within the body) influences concordance in women, though how this effect varies by sexual function is yet unknown. The present study used multilevel modeling to examine concordance in women with (n = 27) and without (n = 28) sexual arousal concerns and explored how concordance varies as a function of interoception. Women viewed a sexual film while their arousal responses were measured and then completed a self-report measure of interoception. A significant relationship emerged between physiological and subjective sexual arousal, in addition to tremendous between-person variability across both groups. Several aspects of interoception moderated concordance (p's between 0.0008 and 0.03), and this pattern varied across groups. Given this variability even in absence of sexual arousal concerns, these findings question the utility of using concordance as a clinical outcome in treatment research. Individual differences in interoception may have implications for treatment matching.

Sexual dysfunction in women with a history of childhood sexual abuse: The role of sexual shame.

OBJECTIVE: Women with histories of childhood sexual abuse (CSA) are at a higher risk for sexual dysfunction, and show a differential response to sex therapy, than women without abuse histories. The factors underlying those differences have yet to be clearly articulated by the literature. This study examined potential mechanisms of action to account for the relationship between CSA and sexual function. METHOD: Participants were 120 adult women recruited from the local community. Women completed a single laboratory session in which they viewed a short erotic film and completed a battery of questionnaires on sexual health. Data were analyzed with structural equation modeling mediation, an approach that enables comparison between groups of women. RESULTS: Sexual shame completely mediated the relationship between history of CSA and sexual function, and explained this relationship better than any of the other candidate mechanisms. CONCLUSIONS: Several differences have been noted between the sexual function of women with and without histories of CSA. Results suggest that differences in sexual shame may contribute to differences in sexual function between these groups. For women with CSA histories treatments that aim to reduce sexual shame may improve sexual function. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Why Humans Have Sex: Development and Psychometric Assessment of a Short-Form Version of the YSEX? Instrument.

Research has documented 237 distinct reasons for engaging in sex, which have been clustered into the 141-item, 13 subscale YSEX? instrument. Although the YSEX? has impressive psychometric properties, the required completion time is a barrier to its use in time-constrained contexts. The current studies develop and validate a short-form version of the instrument. The new 28-item, 14 subscale YSEX?-SF demonstrates acceptable model fit and good internal-reliability, with evidence for cross-form and construct validity. The YSEX?-SF maintains the original instrument's sound psychometric properties with a significantly shorter completion time, which may facilitate the study of sexual motivation.

The Impact of Body Awareness on Women's Sexual Health: A Comprehensive Review.

INTRODUCTION: Body awareness has been linked to female sexual response in laboratory manipulation studies and is used in clinical settings to ameliorate sexual difficulties. AIM: To evaluate and review the literature on body awareness and female sexual function. METHODS: A literature review was conducted through PsycInfo, PsycARTICLES, and PubMed using terms such as body awareness and sexual function. A manual search also was conducted using reference lists. MAIN OUTCOME MEASURES: Studies were included if manipulated body awareness was a main variable of interest and if outcome variables included female sexual functioning or sexual response. RESULTS: 29 studies were included in this review and grouped into 3 categories: sensate focus (n = 7), mindfulness (n = 13), and laboratory manipulations of body awareness (n = 9). Body awareness is identified as an area of importance for female sexuality. Explicit instructions aimed at increasing body awareness, including those used in the clinical techniques of sensate focus and mindfulness, appear to enhance sexual response for many women, including women with low sexual arousal, hypoactive desire, anorgasmia, and sexual pain and in non-clinical samples. Induction of implicit body awareness also resulted in increased arousal in 1 study. CONCLUSION: Body awareness appears to enhance sexual well-being for some women. This is supported by laboratory manipulation studies conducted on women with and without sexual difficulties and by intervention studies using sensate focus and mindfulness for women with a range of sexual problems. The extent to which enhanced body awareness accounts for results in intervention studies is often unclear because of other features of the interventions and/or study design. This review provides the field with a summary of intervention and laboratory studies on body awareness, with results pointing toward body awareness as an integral component of treatment for sexual dysfunction. Seal BN, Meston CM. The Impact of Body Awareness on Women's Sexual Health: A Comprehensive Review. Sex Med Rev 2020;8:242-255.

Scoring and Interpretation of the FSFI: What can be Learned From 20 Years of use?

INTRODUCTION: Over the past 20 years, the Female Sexual Function Index (FSFI) has been considered the gold standard for the measurement of sexual function in women, with over 1,000 published manuscripts citing the article. Despite the measure's widespread usage and excellent psychometric properties, there has been some confusion over how to best implement and score the measure and interpret corresponding findings. AIM: The aim of the current article is to provide guidance, drawing from 20 years of use, on how to best implement the FSFI in research settings and interpret results based on the validation studies that have been conducted to date. METHODS: The overview of scoring and interpretation procedures found in this article is drawn from a review of the published literature on the psychometric properties of the FSFI. MAIN OUTCOME MEASURE: The measure of interest for the present review is the FSFI. RESULTS: This review article provides information about implementing, scoring, and interpreting the full-scale FSFI. Domain-level scoring and interpretation procedures are also discussed across the 5 domains of the FSFI: arousal, satisfaction, desire, pain, and lubrication. Additionally, guidance is provided for evaluating translated versions of the FSFI and using the measure to examine sexual function in culturally diverse populations. CLINICAL IMPLICATIONS: Guidance on appropriately scoring and interpretating the FSFI has the potential to strengthen our empirical understanding of sexual function, and consequently, to guide theory-driven treatment development and clinical practice. STRENGTH & LIMITATIONS: The present review provides applied guidance for the appropriate use of the FSFI specifically, but does not cover other common measures of sexual function or adaptations of the original measure. CONCLUSION: It is our hope that the guidance found in this review will ultimately lead to more rigorous and appropriate usage of the FSFI in research settings. Meston CM, Freihart BK, Handy AB, et al. Scoring and Interpretation of the FSFI: What can be Learned From 20 Years of use? J Sex Med 2020;17:17-25.

Preliminary Evidence for a Relationship Between Physiological Synchrony and Sexual Satisfaction in Opposite-Sex Couples.

INTRODUCTION: Over the past 3 decades, our understanding of physiological synchrony (PS) has increased substantially. Research has shown that interpersonal PS is stronger in relationships characterized by emotional closeness and intimacy and that the magnitude of PS is moderated by relational satisfaction. Despite growing momentum for this area of study, no research to date has examined the relationship between PS and sexual satisfaction. AIM: The current study seeks to elucidate the relationship between PS and sexual satisfaction using study tasks that have been used in previous research to assess PS. METHODS: Heterosexual couples completed several survey measures in a laboratory setting. They were then connected to an electrocardiogram and instructed to complete baseline, gazing, and mirroring tasks. Subsequently, heart rate (HR) data for each dyad were analyzed for PS using a moderated multilevel modeling approach. MAIN OUTCOME MEASURE: Scores on the Sexual Satisfaction Scale were used to moderate dyadic coherence between male and female partner HRs over time. RESULTS: PS was detected in our sample, with both men reliably predicting the HR of their female partners, and women reliably predicting the HR of their male partners. Akaike information criterion values indicate the better fitting model for each task was for men predicting the women's HRs. A significant interaction effect was found between observed PS during the mirroring task (with male HR predicting female HR) and overall sexual satisfaction scores. There was no relationship between PS during baseline or gazing and overall sexual satisfaction. CLINICAL IMPLICATIONS: Results provide initial evidence for the relevance of PS in sexual dyanmics. STRENGTHS & LIMITATIONS: The current analysis used a dyadic psychophysiological approach to extend the growing body of literature on PS into the theoretically linked field of sexuality. Because of the small sample size and nondirectional nature of the study design, future research is needed to replicate and extend findings. CONCLUSION: The ability of couples to co-regulate while attempting actively to synchronize (as in the mirroring task) may be connected to how they perceive and experience their sexual relationship. Conversely, more sexually satisfied couples may be more likely to synchronize physiologically. Taken together, these findings reflect the first evidence that PS and sexual satisfaction may be associated at the couple-level. Freihart BK, Meston CM. Preliminary Evidence for a Relationship Between Physiological Synchrony and Sexual Satisfaction in Opposite-Sex Couples. J Sex Med 2019;16:2000-2010.

Toward a More Evidence-Based Nosology and Nomenclature for Female Sexual Dysfunctions-Part III.

INTRODUCTION: In 2016 the International Society for the Study of Women's Sexual Health (ISSWSH) published an expert consensus report on new nomenclature that addressed the need for comprehensive, evidence-based criteria for new diagnoses in desire, arousal, and orgasm, with the definition on arousal focusing exclusively on female genital arousal disorder (FGAD). AIM: A new expert panel solely focused on mechanisms of arousal disorders convened to revise the nomenclature to include female cognitive arousal disorder (FCAD) and FGAD. METHODS: The ISSWSH co-chairs identified experts on arousal disorders in women. The 10 participants included clinicians, researchers, and educators, representing a diverse, multidisciplinary group. Pre-meeting preparation included evidence-based literature review as the basis of presentations panelists made at the meeting on the current knowledge in cognitive arousal. Consensus was reached using a modified Delphi method. Writing assignments were made as a basis of manuscript development. MAIN OUTCOME MEASURES: The new definition of FCAD is characterized by distressing difficulty or inability to attain or maintain adequate mental excitement associated with sexual activity, as manifested by problems with feeling engaged and mentally turned on or sexually aroused for a minimum of 6 months. RESULTS: Female sexual arousal disorder encompasses both FGAD (revised definition) and FCAD (new definition). Recommendations regarding diagnosis include a clinical interview to assess for FCAD using targeted questions. Patient-reported outcomes that contain questions to assess FCAD are described, including limitations for differentiating between cognitive arousal, genital arousal, and sexual desire. Laboratory measures of cognitive and genital arousal are discussed, including the relationships between genital and cognitive arousal patterns. Biopsychosocial risk factors for FCAD and FGAD, as well as exclusionary conditions, are presented. CLINICAL IMPLICATIONS: The revision of the ISSWSH nomenclature regarding the criteria for the 2 arousal categories, FCAD and FGAD, and the recommended diagnostic strategies offers a framework for management of women with arousal disorders. STRENGTHS & LIMITATIONS: This nomenclature allows for basic science and clinical research in subtypes of arousal in order to develop better diagnostic and treatment options for use by clinicians, scientists, and regulatory agencies. There are limited validated measures of cognitive arousal, including the Female Sexual Function Index, the most commonly used measure, which does not effectively distinguish between cognitive excitement, genital sensations, and event-related desire. CONCLUSION: Future directions include the refinement of FCAD and FGAD and development and validation of patient-reported outcomes that distinguish between the cognitive processes and genital responses to enhance clinical care and research in this area. Parish SJ, Meston CM, Althof SE, et al. Toward a More Evidence-Based Nosology and Nomenclature for Female Sexual Dysfunctions-Part III. J Sex Med 2019;16:452-462.

Understanding sexual arousal and subjective-genital arousal desynchrony in women.

Sexual arousal in women comprises two components: genital arousal and subjective arousal. Genital arousal is characterized by genital vasocongestion and other physiological changes that occur in response to sexual stimuli, whereas subjective arousal refers to mental engagement during sexual activity. For some women, genital arousal enhances subjective arousal; for others, the two types of arousal are desynchronous. However, the relationship between genital and subjective arousal might not be relevant to the diagnosis and treatment of sexual arousal dysfunction. Studies have shown that not all women who report sexual arousal problems have decreased genital arousal, and only some women with decreased genital arousal have low subjective arousal. To develop efficacious treatments for female sexual arousal dysfunction, researchers need to differentiate the women for whom genital sensations have a critical role in their subjective arousal from those who are not mentally aroused by genital cues. The mechanisms by which women become aroused and the inputs into arousal have considerable implications for treatment outcomes.

The Sexual Satisfaction Scale for Women (SSS-W): Adaptation and Validation of a Traditional Chinese Version in Taiwan.

Sexual satisfaction is a key factor in an individual's sexual health and overall well-being. The aim of this study was to validate the most comprehensive index of sexual satisfaction-the SSS-W-for use among Chinese-speaking individuals. A total of 103 women (20-65 years old) participated in this survey study. An SSS-W traditional Chinese version (SSS-W-TC) was developed following the guidelines for cross-cultural translation and adaptation. The translated version, the SSS-W-TC, demonstrates psychometric properties within the satisfactory range, suggesting the feasibility of the SSS-W-TC for use in Taiwan. In terms of internal consistency, the reliability of the SSS-W-TC and its subscales is excellent. High test-retest reliability coefficients were obtained for all subscales of the translated version, demonstrating acceptable stability of the SSS-W-TC across measurement intervals. The ability of the SSS-W-TC to discriminate sexually functional and dysfunctional women shows evidence of concurrent validity. Low to modest correlations between the total and domain scores of the SSS-W and the Female Sexual Function Index Satisfaction domain echo the need for a multidimensional measure of sexual satisfaction in this population. The development of the SSS-W-TC lays the groundwork for future researchers who wish to conduct cross-cultural work in sexual satisfaction using Chinese-speaking samples.

What Does Sexual Arousal Mean to You? Women With and Without Sexual Arousal Concerns Describe Their Experiences.

Sexual arousal is frequently characterized by both subjective (i.e., mental) and physiological (e.g., genital) components. The nuances of these components, however, are difficult to capture via self-report instruments. Asking women to describe sexual arousal in their own words may therefore enhance our understanding of this construct. In the present study, women with (n = 190) and without (n = 610) arousal concerns were recruited online and wrote about their experience of sexual arousal. Seven clusters of words were extracted using automated text analysis, and the prominence of these clusters was compared between groups of women. The autonomic arousal cluster differed between groups such that women with arousal concerns invoked this cluster significantly less than did women with no such concerns. Furthermore, the context cluster significantly predicted group membership (odds ratio [OR] = 1.063); greater scores on this cluster were associated with arousal concerns. Results suggest that autonomic arousal and relationship factors may play important roles in arousal concerns. It is suggested that clinicians assess for aspects of the sexual relationship that may facilitate or hinder sexual arousal. Clinicians may also consider inquiring about the presence or appraisal of autonomic arousal (e.g., one's interpretation of an increase in heart rate or respiration) during sexual activity.

Heart rate variability biofeedback increases sexual arousal among women with female sexual arousal disorder: Results from a randomized-controlled trial.

Low resting heart rate variability (HRV) has been associated with poor sexual arousal function in women. In a recent study, a single session of autogenic training increased HRV and facilitated improvements in both sexual arousal and perceived genital sensations among women experiencing decreased arousal. The current study expands upon these findings by examining the efficacy of HRV biofeedback, with and without autogenic training, as a treatment for sexual arousal dysfunction in an at-home setting. Participants (N = 78) were randomized into one of three conditions: HRV biofeedback, HRV biofeedback + autogenic training, or waitlist control. Each condition included three laboratory sessions; participants in the two active conditions completed 4-6 biofeedback sessions at home, and participants in the HRVB + A condition listened to a 14-min autogenic training recording before completing the biofeedback. Across the three laboratory visits, participants in the three conditions singficnatly differed in their genital arousal, subjective sexual arousal, and their perceived genital sensations. Compared to women in the control group, women who engaged in HRV biofeedback at home, with and without additional autogenic training, experienced increases in genital arousal, subjective sexual arousal, and perceived genital sensations. These results provide preliminary support for the contribution of heart rate variability level to female sexual arousal function and for the use of either of these interventions in the treatment of sexual arousal concerns.