A new perspective on sexual health: Using biofeedback to enhance physical and mental awareness, taking women as an example

Intimacy is a crucial part of relationships between couples. Sexual activity is not just physical contact; it’s also a way to connect, build trust, and foster a sense of security. However, for some women, sex isn’t always a positive experience. It can be painful or difficult to arouse. They worry their true feelings won’t be understood by their partners or others, and they may feel embarrassed and unable to share their feelings. Instead, they choose to endure in silence, or even feel pressured to have sex, leading to avoidance of intimacy. This not only impacts their quality of life but also their relationship satisfaction.

  In the past, many methods have been used to alleviate sexual pain in women, including surgery, cognitive behavioral therapy, and medication. Among them, biofeedback from pelvic floor muscle potentials is often used to help alleviate sexual pain. By stretching and relaxing the pelvic floor muscles and practicing awareness of changes in body sensations, it can increase muscle tension, improve blood circulation, and promote hypersensitivity in the vaginal area, thereby alleviating long-term sexual pain (Stanton & Kirakosian, 2020).

  Researchers Brotto (2015) and others invited women experiencing sexual pain to participate in a 10-12 week group therapy program. The therapy included mindfulness-based cognitive behavioral techniques (such as abdominal breathing and progressive muscle relaxation) and pelvic floor muscle potential biofeedback, allowing participants to learn to control their pelvic floor muscles while also using mindfulness strategies to improve awareness of physiological pleasure and promote a relaxation response. The study found that after completing the treatment, these women were able to effectively reduce sex-related stress and sexual pain, and also showed improvements in sexual arousal. These treatment effects were sustained during the three-month follow-up period.

  The issue of women’s sexual arousal is related to their genitals and subjective feelings, and there is an interaction between the two. For some women, genital contact and sensation are considered the most important part of sexual arousal; however, others consider specific emotional feelings or contextual cues as central to the overall experience of sexual arousal (Stanton & Kirakosian, 2020). Stanton et al. (2019) noted that heart rate variability (HRV) plays a role in regulating physiological and emotional responses. Previous research has shown that women with sexual arousal difficulties have lower HRV, sympathetic nervous system overactivation, and autonomic imbalance. One study found that women with high trait anxiety had lower genital arousal responses after watching videos related to sexual activity, compared to women with moderate trait anxiety (Bradford & Meston, 2006).

  To address the issue of autonomic imbalance, researchers Stanton et al. (2019) recruited 78 women with low sexual arousal and randomly assigned them to three groups. The first group received HRV biofeedback training and performed 20-minute breathing exercises at home using an HRV training app two to three times a week. The second group followed the same protocol, but each session included 14 minutes of auto-suggestive relaxation training. The third group served as a control group and did not receive biofeedback training. After one month, the study found that participants in both the first and second groups (who underwent biofeedback training) showed significant improvements in genital and subjective arousal, as well as awareness of genital arousal, compared to the control group.

  The studies above reveal that sexual difficulties may involve a complex interplay of physiological and psychological factors. Furthermore, factors such as hormonal changes, chronic illness, medication effects, lifestyle habits, stress, anxiety, body image, past traumatic experiences, or emotional disconnection and communication issues with one’s partner may all affect the experience of sexual intercourse. If you encounter these difficulties, you can try the following methods to help yourself or your partner:

1. Try to clarify the possible reasons, communicate with your partner with an open mind, or seek professional help.
2. Through the awareness and practice of physiological feedback, adjust muscle contraction and control, practice slow and regular breathing to train heart rate variability, and help yourself regain the balance of the autonomic nervous system.
3. At the same time, combine it with other psychotherapy techniques or relaxation exercises to gradually improve these physical and mental symptoms.

  If you or your partner encounters these problems, please share the above tips with your significant other. By helping women regain a sense of control over their own bodies and positive connections, you can build a more harmonious intimate relationship.

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