Mindfulness in Sex

                We all know that sex can be pleasurable, and most of us seek it as a core aspect of a fulfilled life. We do this instinctively, like the desire to eat good food or have a nice restful sleep. Yet, we rarely discuss how sex is potentially a very important aspect of our mental and physical health. Most don’t even know if it is, and we have a culture that often treats sex as a taboo. Here, the physical and mental health benefits of sex will be explored. Additionally, I will make an argument that sex is potentially a core aspect of holistic health that is improved when other aspects of health are maintained.

                In a previous blog post discussing how mindfulness was a core aspect of ancient hunter gather life, I began to formulate an idea: perhaps all core aspects on ancient human life can be seen as sure ways to promote physical and mental health. As of now, I have identified “Six Pillars” of life, which could be said to be: exercise, meditation (mindfulness), diet, sleep, social relationships and sex. We all take for granted the important effect exercise, diet, and sleep have on health. One of the main purposes of this blog is to discuss how meditation belongs in this list as well. What about sex? I had a question, so I began researching.

Sex and a Longer Life

                What became immediately identifiable was a weird bias within the scientific community in regards to sex research. Despite the fact that it is very difficult to find any scientist that disagrees with the notion that sex is fundamental to health1, most research focuses on the negative aspects of sex2. Most research focuses on the occurrence of sexually transmitted infections, abuses and assaults, unplanned pregnancies, and so forth2. Rarely, is there investigation into what happens in the body that makes sex so healthy. This is an incredible shame, because the research that we do have, reveals an incredible observation: people who have more sex (more orgasms) live longer lives 3,4. We aren’t sure how, but we commonly observe this trend. There was a similar observation observed during the COVID-19 lock down, where the more sex someone had during that time, the less anxiety and depression they had5. Does sex improve mental health, physical health, or both? Again, we certainly do not have a full understanding given the lack of research, but there are some clues to say that both are benefited.

                As previously stated, sex may improve mental health in regards to stress. This seems fairly intuitive. Additionally, similar to the benefits of meditation, people who more frequently have sexual intercourse show greater resilience to incoming stressors, while also showing healthier blood pressure levels (the same was not true in masturbators)6. Of course, mental health also leads to physical health.

Nonetheless, the benefits of sex are not purely mentally induced. A lot of attention has also been directed towards the direct physical benefits of sex. For example, there is increasing evidence that sexual activity decreases the risk of prostate cancer7,8. Additionally, sexual activity seems to create changes in hormone production that not only benefit health, but it also generates a positive feedback loop creating more sexual desire. Further incentivizing more sexual activity. Sexual activity affects testosterone levels, and low testosterone is common in erectile dysfunction1. So just like our neurons that have the “use it or lose it” principle, perhaps the penis does too. This trend doesn’t only apply to men either. Other research has shown that the more sex a woman has, the more lubricated their vaginas become9. Similarly, more sexually active woman has less vaginal atrophy and higher levels of hormones (androstenedione, testosterone and gonadotropins). Indicating that more sex generates more sexual function and desire. This generates a positive feedback loop that potentially drives further healthy lifestyle practices in regards to sexual activity.

Mindfulness and Sex

                It is evident that sex improves sex at a physiologic level. It may also be obvious that physical fitness can improve sex as well. So how does mindfulness meditation relate to sex?

Firstly, it should be noted that there is a large population of people that suffers from sexual dysfunction. Women are the most affected. Sexual desire is strongly related to relationship satisfaction, mood, self-esteem, body image, psychiatric symptoms, and age10. 24% of woman have either always suffered from a reduced orgasmic sensation by 75-100% or have developed this disorder over time11. Female sexual interest/arousal disorder (SIAD) is defined by low level of sexual desire, infrequent sexual thoughts/fantasies, low receptivity to sexual activity, low sexual pleasure, low desire triggered by sexual stimuli, and low genital and non-genital sensations12. Therefore, it is highly apparent that mental health, especially as it related to the perception of the self, can have dramatic effects in not only sexual desire, but sexual pleasure as well. However, this problem is not specific to woman at all. Emotions related to depression are highly related to sexual dysfunction in both men and woman13. Most notably, performance anxiety influences the occurrence of erectile dysfunction10. Given the relationship between sex and health, resolving such sexual dysfunction is crucial to improving general health and well-being.

Given the fact that mental state in various ways contributes to sexual dysfunction, meditation is a strong candidate for a useful therapy. As previously discussed in this blog, mindfulness meditation is a practice of generating a non-judgmental, open, and curious orientation towards all incoming thoughts and stimuli of the present moment14. For this reason, I have written about how the practice has been shown to be highly capable of decreasing symptoms of anxiety and depression. These symptoms of ruminative thoughts that burden the mind during sex, are alleviated through meditation. So, it is unsurprising that mindfulness-based cognitive therapy (MBCT) has been shown to be helpful in improving sexual function11. Additionally, a new form of therapy called Mindfulness-Based Sex therapy (MBST) has been developed for these very reasons15. Mindfulness is recommended as a therapy for sexual dysfunction16, but why?

How it works

As previously discussed, one way mindfulness meditation improves sexual function is through the changes it generates within the mind. Multiple studies have shown that through mindfulness, not only are the traits of depression and sex-related distress decreased, but woman subsequently experience greater sexual desire and improved sexual function10–12. Women who were previously low on sexual desire, have improved sexual desire through mindfulness15. This is likely because the mental schemas that negatively affected their sex life are diminished through a practice of mindfulness meditation. Research using MBST has suggested that enhancing concentration and compassionate self-acceptance may lead to greater integration of physical and mental sexual response to erotic stimuli15.

Even though the psychological arguments for how meditation improves sexual function are convincing, I personally require more evidence. The mind is a window into the body, and therefore analyzing human health through the lenses of the thoughts of the mind only is not substantial evidence for me to be convinced. There are of course more complex physiologic processes that may go to explain these observed effects.

  In a previous post, I argue that meditation can influence our conscious experience by quieting the mind, allowing, for the brain to more accurately and efficiently process incoming stimuli. This allows us to have healthier and more informative understanding of ourselves (our body) and the world around us (our environment). If this is indeed the case, then we would expect to see mindfulness result in improves processing of physical stimuli. In the case of sexual performance, this certainly seems to be the case. Studies have shown a mindfulness meditation practice increases reaction time for sexual stimuli17. This is a strong indicator that through mindfulness, individuals will have a more accurate and clear experience generated from sexual stimuli, allowing for greater pleasure and performance. Additionally, it was noted in the study that woman take longer to respond to sexual stimuli compared to men, and the impaired ability to do so leads to self-judgment17. So, if mindfulness can alleviate this impairment, and improve self-perception, then it creates a positive feedback loop of mental health improving sexual function which in turn improves mental health.

Since improved interoception (ability to sense inside the body) is suspected to be involved in this process, the insula of the brain, which has been implicated to play a major role in interoception18, likely plays a role in the physiologic change that occurs. For reasons like the ones in my previous post, the insula is also regarded as a possible neuronal area related to consciousness19. As it relates to sexual function, it is possible that improved insula-mediated increase in interoceptive ability from various mindfulness exercises contributed to the observed improved concordance between genital and subjective arousal after MBST15. This theory is reinforced by the observation that the insula increases in size following mindfulness meditation practices20,21. Indicating that because mindfulness meditation is oriented around the attentive observation of internal stimuli, the brain area involved is strengthened and grows. This allows for greater interoception in all cases, including sexual stimuli, thereby improving sexual function.

Conclusion

                Exercise, social relationships, meditation, diet, sleep, and sex are fundamental aspects of human life. When looking back onto ancient human life, all of these aspects were fundamental to our health and prosperity. What was true then is still true now. Unsurprisingly, scientist commonly agree that safe sexual activity is an important aspect of maintaining general well-being and health. There have been studies that suggested that the more sex you have, the longer you may live. Unfortunately, the stresses of modern-day life, and the associated manifestations of self-judgment, lack of perceived self-worth, and unrealistic standards of beauty and sexual appeal have hindered some in being able to fully experience and practice a healthy sex life. Therefore, it is important to consider how other healthy life practices, such as meditation, are not only important in their own right, but are important because they may foster other healthy life habits in other areas, such as sexual activity.  To calm the mind and rid it of our unconstructive ruminative thoughts once again is shown to be crucial to achieving a life of mental and physical well-being and health. Let us free our minds, free our hearts, and enjoy the present and our lives for all of its worth and beauty.

References

1.          Jannini EA, Fisher WA, Bitzer J, McMahon CG. Is sex just fun? How sexual activity improves health. Journal of Sexual Medicine. 2009;6(10):2640-2648. doi:10.1111/j.1743-6109.2009.01477.x

2.          Diamond LM, Huebner DM. Is good sex good for you? Rethinking sexuality and health. Social and Personality Psychology Compass. 2012;6(1):54-69. doi:10.1111/j.1751-9004.2011.00408.x

3.          Lindau ST, Gavrilova N. Sex, health, and years of sexually active life gained due to good health: Evidence from two US population based cross sectional surveys of ageing. BMJ (Online). 2010;340(7746):580. doi:10.1136/bmj.c810

4.          Smith GD, Frankel S, Yarnell J. Sex and death: Are they related? Findings from the Caerphilly cohort study. BMJ. 1997;315(7123):1641-1644. doi:10.1136/bmj.315.7123.1641

5.          Mollaioli D, Sansone A, Ciocca G, et al. Benefits of Sexual Activity on Psychological, Relational, and Sexual Health During the COVID-19 Breakout. Journal of Sexual Medicine. 2021;18(1):35-49. doi:10.1016/j.jsxm.2020.10.008

6.          Brody S. Blood pressure reactivity to stress is better for people who recently had penile-vaginal intercourse than for people who had other or no sexual activity. Biological Psychology. 2006;71(2):214-222. doi:10.1016/j.biopsycho.2005.03.005

7.          Leitzmann MF, Platz EA, Stampfer MJ, Willett WC, Giovannucci E. Ejaculation Frequency and Subsequent Risk of Prostate Cancer. Journal of the American Medical Association. 2004;291(13):1578-1586. doi:10.1001/jama.291.13.1578

8.          Giles GG, Severi G, English DR, et al. Sexual factors and prostate cancer. BJU International. 2003;92(3):211-216. doi:10.1046/j.1464-410X.2003.04319.x

9.          Leiblum S. Vaginal Atrophy in the Postmenopausal Woman. Jama. 1983;249(16):2195. doi:10.1001/jama.1983.03330400041022

10.        Brotto LA, Basson R. Group mindfulness-based therapy significantly improves sexual desire in women. Behaviour Research and Therapy. 2014;57(1):43-54. doi:10.1016/j.brat.2014.04.001

11.        Adam F, de Sutter P, Day J, Grimm E. A Randomized Study Comparing Video-Based Mindfulness-Based Cognitive Therapy With Video-Based Traditional Cognitive Behavioral Therapy in a Sample of Women Struggling to Achieve Orgasm. Journal of Sexual Medicine. 2020;17(2):312-324. doi:10.1016/j.jsxm.2019.10.022

12.        Paterson LQP, Handy AB, Brotto LA. A Pilot Study of Eight-Session Mindfulness-Based Cognitive Therapy Adapted for Women’s Sexual Interest/Arousal Disorder. Journal of Sex Research. 2017;54(7):850-861. doi:10.1080/00224499.2016.1208800

13.        Nobre PJ, Pinto-Gouveia J. Emotions during sexual activity: Differences between sexually functional and dysfunctional men and women. Archives of Sexual Behavior. 2006;35(4):491-499. doi:10.1007/s10508-006-9047-1

14.        Bishop SR, Lau M, Shapiro S, et al. Mindfulness: A Proposed Operational Definition. Clinical Psychology: Science and Practice. 2006;11(3):230-241. doi:10.1093/clipsy.bph077

15.        Brotto LA, Chivers ML, Millman RD, Albert A. Mindfulness-Based Sex Therapy Improves Genital-Subjective Arousal Concordance in Women With Sexual Desire/Arousal Difficulties. Archives of Sexual Behavior. 2016;45(8):1907-1921. doi:10.1007/s10508-015-0689-8

16.        Brotto LA, Goldmeier D. Mindfulness Interventions for Treating Sexual Dysfunctions: The Gentle Science of Finding Focus in a Multitask World. Journal of Sexual Medicine. 2015;12(8):1687-1689. doi:10.1111/jsm.12941

17.        R. Gina Silverstein, BA, Anne-Catharine H. Brown, Harold D. Roth, PhD, and Willoughby B. Britton P. Effects of Mindfulness Training on Body Awareness to Sexual Stimuli: Implications for Female Sexual Dysfunction. Psychosom Med. 2011;23(1):1-7. doi:10.1097/PSY.0b013e318234e628.Effects

18.        Giuliani NR, Drabant EM, Bhatnagar R, Gross JJ. Emotion regulation and brain plasticity: Expressive suppression use predicts anterior insula volume. NeuroImage. 2011;58(1):10-15. doi:10.1016/J.NEUROIMAGE.2011.06.028

19.        Craig ADB. How do you feel — now? The anterior insula and human awareness. 2009;10(January).

20.        Lazar SW, Kerr CE, Wasserman RH, et al. Meditation experience is associated with increased cortical thickness. Neuroreport. 2005;16(17):1893-1897. doi:10.1097/01.wnr.0000186598.66243.19

21.        Hölzel BK, Lazar SW, Gard T, Schuman-Olivier Z, Vago DR, Ott U. How Does Mindfulness Meditation Work? Proposing Mechanisms of Action From a Conceptual and Neural Perspective. Perspectives on Psychological Science. 2011;6(6):537-559. doi:10.1177/1745691611419671

Published by Sydney Bright

Sydney is a educator and consultant at Bright Minds Consulting. He is passionate about holistic practices and mindfulness techniques that cultivate inner peace and understanding of the self. Additionally, he is dedicated to educating people about the technological innovation of Bitcoin, and helping people understand how they can securely own and protect this society-changing asset.

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