It’s not necessarily a full workout, but it can be as good for you as moderate exercise. It raises your heart rate about the same as a brisk walk or a slow bike ride.
Good for a Woman’s Heart
2/14
Women who have sex a couple of times a week are less likely to get heart disease than those who have it once a month. Whether that’s because healthier women enjoy it more often, or because it helps protect a woman’s heart is unclear.
May Cure Your Headache
3/14
Say goodbye to the old standby “Not tonight, Dear. I have a headache.” It turns out sex can help with pain, and that includes some kinds of headaches, such as migraines. Not feeling frisky? Try: “Not tonight, Honey. I have a highly contagious stomach bug.” Works every time.
Lowers Stress
4/14
People who have more sex are less anxious when they’re faced with stressful tasks like public speaking or arithmetic. But according to the study, it only works when you have a partner — masturbation doesn’t count.
You May Live Longer
5/14
One study suggested that married women who climaxed more often had a slight tendency to live longer. Researchers aren’t sure if the sex actually lengthens your life or if having sex is a sign of a healthier person. But why take any chances?
Sharpens Your Mind
6/14
Sex has been linked to the making of new brain cells, and that’s a good thing. People over 50 who had more sex were better able to recall numbers and do basic math, and the difference was pretty big. It seemed to help men more than women, but both did better than those who had less sex.
Makes You Happy
7/14
You don’t have to overdo it — once a week is plenty. More than that, and the effect fades. But scientists only studied couples in committed relationships, so if you’re trying to meet your quota by picking up strangers at your local bar, all bets are off.
Bonds You to Your Partner
8/14
The hormone oxytocin is released during sex, and it sparks feelings of intimacy, affection, and closeness with your partner. That helps build a strong, stable relationship, which is good for everyone.
Keeps You Lean
9/14
The more sex you have, the slimmer you’re likely to be. Is that because more sex keeps you trim? Or because lean people have more sex? Scientists don’t really know, but all you need is a partner and a bathroom scale to try to find out.
Good for Mental Health
10/14
Adults in committed relationships who have more sex are less likely to be depressed or take medication for mental health issues.
Helps Fight off the Common Cold
11/14
Move over, vitamin C. College students who had sex twice a week had more cold-fighting antibodies in their saliva than those who had sex less often.
Helps You Sleep
12/14
Orgasm triggers a surge of endorphins and oxytocin in both men and women, and that dulls pain and relaxes you. Both of those can help you sleep more easily, though according to scientists — and many women — the effect is more pronounced in men.
You Could Make a Baby
13/14
If you’re trying to have a baby, the more sex you have, the more likely you are to hit the right time of the month. But more sex may also prime women for pregnancy and improve sperm quality in men, which can speed things along.
Helps Your Future Self
14/14
People who have more sex may have better quality of life — and not just now, but in the future, too. If you have an active sex life in middle age, you’re more likely to keep it up as you get older, which is linked to better health and happiness.
Summary: Researchers developed the first comprehensive brain map showing activity in prairie voles during mating and bonding, uncovering 68 brain regions involved in forming enduring monogamous relationships. This study challenges previous assumptions that male and female brains operate differently during these processes, revealing nearly identical patterns of brain activity in both sexes.
Surprisingly, the most significant predictor of bonding-related brain activity was found to be male ejaculation, suggesting a profound emotional state that facilitates pair bonding. This groundbreaking research not only offers insights into the neurobiological basis of monogamy but also hints at potential parallels in human relationship formation and maintenance.
Key Facts:
Comprehensive Brain Activity Mapping: The study identified 68 distinct brain regions involved in the stages of mating, bonding, and the development of stable relationships in prairie voles.
Gender Similarities in Brain Patterns: Contrary to previous beliefs, the research found nearly identical patterns of brain activity in both male and female voles during bonding processes.
Emotional State Tied to Male Ejaculation: The strongest predictor of bonding-related brain activity was male ejaculation, indicating its significant role in facilitating pair bonding and potentially suggesting orgasm-like responses in both sexes.
Source: UT Austin
How does sex relate to lasting love?
To answer that question, scientists have long studied a small Midwestern rodent called the prairie vole, one of the few mammals known to form long-term, monogamous relationships.
A team of researchers including Steven Phelps at The University of Texas at Austin has created the first brain-wide map of regions that are active in prairie voles during mating and pair bonding.
The researchers found that bonding voles experience a storm of brain activity distributed across 68 distinct brain regions that make up seven brain-wide circuits. The brain activity correlates with three stages of behavior: mating, bonding and the emergence of a stable, enduring bond.
Most of these brain regions the researchers identified were not previously associated with bonding, so the map reveals new places to look in the human brain to understand how we form and maintain close relationships.
Earlier studies concluded that male and female brains often use fundamentally different mechanisms to produce the same behaviors, such as mating and nurturing offspring. But in this study, bonding males and females had nearly identical patterns of brain activity.
“That was a surprise,” said Phelps, a professor of integrative biology at UT Austin and senior author of the new study in the journal eLife.
“Sex hormones like testosterone, estrogen and progesterone are important for sexual, aggressive and parental behaviors, so the prevailing hypothesis was that brain activity during mating and bonding would also be different between the sexes.”
Compared with humans, prairie voles have whirlwind courtships. Within half an hour of being together, a male and female begin to have sex, and they will do so repeatedly, often many times an hour.
Within a day, their amorousness will lead the pair to form a bond that can last a lifetime. Bonded pairs will groom each other, console each other when stressed, defend their shared territory and rear their young together.
The researchers were able to pinpoint with high resolution which brain cells were active in vole brains at various points over the course of the process that leads to and includes bonding.
This is the first time such a method has been applied to prairie voles. By studying more than 200 prairie voles across multiple times during mating and bonding, the researchers produced an unprecedented and foundational data set.
The strongest predictor of activity across the 68 brain regions that the researchers identified surprised them. It was male ejaculation, suggesting the experience elicits a profound emotional state—and not only in the affected males. Females, too, had more bonding-related brain activity with males who reached that milestone.
“The brain and behavior data suggest that both sexes may be having orgasm-like responses, and these ‘orgasms’ coordinate the formation of a bond,” Phelps said. “If true, it would imply that orgasms can serve as a means to promote connection, as has long been suggested in humans.”
Phelps cautioned that it’s impossible to know whether a female prairie vole is having an orgasm simply by watching its sexual behavior, though previous research has found that some female animals such as monkeys have these physiological responses.
Summary: Researchers developed an artificial intelligence model that accurately determines the sex of individuals based on brain scans, with over 90% success. This breakthrough supports the theory that significant sex differences in brain organization exist, challenging long-standing controversies.
The AI model focused on dynamic MRI scans, identifying specific brain networks—such as the default mode, striatum, and limbic networks—as critical in distinguishing male from female brains.
This research not only deepens our understanding of brain development and aging but also opens new avenues for addressing sex-specific vulnerabilities in psychiatric and neurological disorders.
Key Facts:
High Accuracy in Sex Determination: The AI model’s ability to distinguish between male and female brain scans with more than 90% accuracy highlights intrinsic sex differences in brain organization.
Key Brain Networks Identified: Explainable AI tools identified the default mode network, striatum, and limbic network as crucial areas the model analyzed to determine the sex of the brain scans, underscoring their roles in cognitive functions and behaviors.
Potential for Personalized Medicine: The findings suggest that acknowledging sex differences in brain organization is vital for developing targeted treatments for neuropsychiatric conditions, paving the way for personalized medicine approaches.
Source: Stanford
A new study by Stanford Medicine investigators unveils a new artificial intelligence model that was more than 90% successful at determining whether scans of brain activity came from a woman or a man.
The findings, to be published Feb. 19 in the Proceedings of the National Academy of Sciences, help resolve a long-term controversy about whether reliable sex differences exist in the human brain and suggest that understanding these differences may be critical to addressing neuropsychiatric conditions that affect women and men differently.
The team then wondered if they could create another model that could predict how well participants would do on certain cognitive tasks based on functional brain features that differ between women and men.
“A key motivation for this study is that sex plays a crucial role in human brain development, in aging, and in the manifestation of psychiatric and neurological disorders,” said Vinod Menon, PhD, professor of psychiatry and behavioral sciences and director of the Stanford Cognitive and Systems Neuroscience Laboratory.
“Identifying consistent and replicable sex differences in the healthy adult brain is a critical step toward a deeper understanding of sex-specific vulnerabilities in psychiatric and neurological disorders.”
Menon is the study’s senior author. The lead authors are senior research scientist Srikanth Ryali, PhD, and academic staff researcher Yuan Zhang, PhD.
“Hotspots” that most helped the model distinguish male brains from female ones include the default mode network, a brain system that helps us process self-referential information, and the striatum and limbic network, which are involved in learning and how we respond to rewards.
The investigators noted that this work does notweigh in on whether sex-related differences arise early in life or may be driven by hormonal differences or the different societal circumstances that men and women may be more likely to encounter.
Uncovering brain differences
The extent to which a person’s sex affects how their brain is organized and operates has long been a point of dispute among scientists. While we know the sex chromosomes we are born with help determine the cocktail of hormones our brains are exposed to — particularly during early development, puberty and aging — researchers have long struggled to connect sex to concrete differences in the human brain.
Brain structures tend to look much the same in men and women, and previous research examining how brain regions work together has also largely failed to turn up consistent brain indicators of sex.
In their current study, Menon and his team took advantage of recent advances in artificial intelligence, as well as access to multiple large datasets, to pursue a more powerful analysis than has previously been employed.
First, they created a deep neural network model, which learns to classify brain imaging data: As the researchers showed brain scans to the model and told it that it was looking at a male or female brain, the model started to “notice” what subtle patterns could help it tell the difference.
This model demonstrated superior performance compared with those in previous studies, in part because it used a deep neural network that analyzes dynamic MRI scans. This approach captures the intricate interplay among different brain regions. When the researchers tested the model on around 1,500 brain scans, it could almost always tell if the scan came from a woman or a man.
The model’s success suggests that detectable sex differences do exist in the brain but just haven’t been picked up reliably before. The fact that it worked so well in different datasets, including brain scans from multiple sites in the U.S. and Europe, make the findings especially convincing as it controls for many confounds that can plague studies of this kind.
“This is a very strong piece of evidence that sex is a robust determinant of human brain organization,” Menon said.
Making predictions
Until recently, a model like the one Menon’s team employed would help researchers sort brains into different groups but wouldn’t provide information about how the sorting happened. Today, however, researchers have access to a tool called “explainable AI,” which can sift through vast amounts of data to explain how a model’s decisions are made.
Using explainable AI, Menon and his team identified the brain networks that were most important to the model’s judgment of whether a brain scan came from a man or a woman. They found the model was most often looking to the default mode network, striatum, and the limbic network to make the call.
The team then wondered if they could create another model that could predict how well participants would do on certain cognitive tasks based on functional brain features that differ between women and men.
They developed sex-specific models of cognitive abilities: One model effectively predicted cognitive performance in men but not women, and another in women but not men. The findings indicate that functional brain characteristics varying between sexes have significant behavioral implications.
“These models worked really well because we successfully separated brain patterns between sexes,” Menon said. “That tells me that overlooking sex differences in brain organization could lead us to miss key factors underlying neuropsychiatric disorders.”
While the team applied their deep neural network model to questions about sex differences, Menon says the model can be applied to answer questions regarding how just about any aspect of brain connectivity might relate to any kind of cognitive ability or behavior. He and his team plan to make their model publicly available for any researcher to use.
“Our AI models have very broad applicability,” Menon said. “A researcher could use our models to look for brain differences linked to learning impairments or social functioning differences, for instance — aspects we are keen to understand better to aid individuals in adapting to and surmounting these challenges.”
From work to school to socializing, COVID-19 has impacted just about every part of our lives—and now Boston University research has shown that also includes what happens in the bedroom. A study of more than 2,000 cisgender women found the coronavirus disease can impair sexual function, with long COVID having an especially detrimental effect.
“If you’re sick with COVID, you’re probably less interested in sex and maybe your body is less prepared to have sex,” says Amelia M. Stanton, a BU College of Arts & Sciences assistant professor of psychological and brain sciences. “But what might be surprising to some folks is that long COVID symptoms really may have a physiological and psychological impact on sexual well-being for women.”
Although previous research has investigated the effect of the pandemic on peoples’ sex lives—particularly in men—Stanton says this is the first study to highlight long COVID’s fallout on sexual health in women. An expert on sexual and mental health, she helped lead the study with researchers from Middlebury College, McLean Hospital, and the University of Vermont. The findings were recently published in the Journal of Sexual Medicine.
Long COVID and sexual dysfunction
To figure out COVID’s impact on intimacy, Stanton and her colleagues conducted an online survey. Roughly half of the women taking part had reported never having had COVID, the rest said they’d tested positive. Participants were quizzed using the Female Sexual Function Index (FSFI), an established tool that measures factors like arousal and satisfaction with questions such as, “Over the past 4 weeks, how often did you feel sexual desire?” Only women who’d had sex in the previous month were included in the results.
Among those who’d had COVID, levels of desire, arousal, lubrication, and satisfaction were all lower than in those who hadn’t; orgasm and pain scores weren’t significantly different between the two groups. But while women in the COVID group were still classed within the index’s functional range, participants with long COVID had “an average FSFI full scale score in the dysfunctional range,” according to the researchers. They found women with long COVID—a broad condition with cognitive and physical symptoms that linger for weeks, sometimes months, after an initial infection—had markedly worse arousal, lubrication, orgasm, and pain scores.
“I hope it’s validating. If women type in ‘sex long COVID,’ something will come up now,” says Stanton, who is also a clinical health psychologist at The Fenway Institute, a Boston clinic focused on the health of sexual and gender minorities. “Sex, sexuality, and sexual function are still relatively taboo subjects. But this offers something patients can bring to their providers and say, ‘This is going on for me,’ and maybe create an open dialogue around sex.”
In their paper, Stanton and her colleagues say the results suggest “that COVID-19 infection may be associated with impairment of both cognitive and physiological aspects of sexual function.” Just as the body and mind might take some time to get back to firing on all cylinders when it comes to work, study, and exercise, the same may apply to sex. They also speculate that wider societal changes caused by the pandemic may be a factor, with fewer social events and kids hanging around at home more reducing opportunities for shared or solo sexual activities.
Talking about sex
While a COVID infection might impact women’s sexual health, previous BU research has found vaccination does not cause infertility, reduce pregnancy chances, or have a significant impact on menstruation.
“COVID-19 vaccination in either partner is unrelated to fertility among couples trying to conceive through intercourse,” Amelia Wesselink, an SPH research assistant professor of epidemiology, told The Brink in 2022 when discussing her study on vaccines and fertility. That same research did, however, find that men who’d tested positive for COVID within the past 60 days had reduced fertility.
Stanton is the principal investigator of BU’s Sexual, Reproductive, and Mental Health Disparities Program—an effort to explore sexual and mental health in minoritized and marginalized populations—and says possible future routes for the latest project would be to expand the study’s sexual and gender minority diversity, talk to women for their qualitative experiences, and design tools to help providers better support their patients.
“I’m an interventionist, so I always think about intervention design as a next step,” says Stanton. In other research, she’s working to develop new approaches clinicians can use to talk about sex with their patients, as well as studying how to improve sexual well-being and mental health in low-resource communities.
“I always encourage providers to initiate conversations about sex,” says Stanton. “If they have someone who’s coming in for long COVID, maybe ask, ‘How are you doing sexually?’ Asking that one question could open the door for people to say, ‘You know, I’ve been ashamed to say that this is going on, and I really need help.’ Any way we can iterate to folks that there is hope and there are strategies—your symptoms are meaningful and relevant, and they’re important to talk about.”
A new hormone injection could treat low sex drive in both women and men, according to researchers in the United Kingdom. A team from Imperial College London says kisspeptin can boost sexual responses in men and women suffering distress as a result of their low libido.
Two studies, both published in JAMA Network Open, show that giving patients kisspeptin can boost sexual responses in people who have hypoactive sexual desire disorder (HSDD) – a condition where patients experience psychological distress due to their low sexual desire. Women taking part in the trial reported feeling “more sexy” during the kisspeptin treatment.
HSDD affects up 10 percent of women and roughly one in 12 men worldwide. It can have “devastating” psychological and social impacts. Study authors explain that kisspeptin is a naturally-occurring hormone which stimulates the release of other reproductive hormones in the body. The team previously demonstrated that kisspeptin can enhance responses to sexual stimuli and boost attraction brain pathways independent of other reproductive hormones like testosterone in men with intact sexual desire. Now, they’re investigating the effects in women and men with low sexual desire for the first time.
The two clinical trials involved 32 pre-menopausal women between the ages of 19 and 48, and 32 men with HSDD. In both studies, researchers scanned participants using brain MRI imaging, as well as blood and behavioral tests. Taking kisspeptin improved sexual brain processing in both women and men. This resulted in positive boosts in each person’s sexual behavior compared to those who did not receive the injections.
The clinical trials are the first to explore the ability of kisspeptin to boost sexual pathways in people suffering distress from low libido. The researchers believe that the results provide the groundwork for kisspeptin-based therapies for people with HSDD.
“Low sexual desire can be distressing and so result in HSDD. This can have a major detrimental impact on relationships, mental health, and fertility. Even though it is relatively common, treatment options in women are limited, carry significant side-effects and in some cases can be harmful to even try. And unfortunately, these treatments have limited effectiveness. In men there are currently no licensed treatments and none on the horizon. Therefore, there is a real unmet need to find new, safer and more effective therapies for this distressing condition for both women and men seeking treatment,” says Dr. Alexander Comninos from the Department of Metabolism, Digestion and Reproduction at Imperial College London in a media release.
“Our two studies provide proof-of-concept for the development of kisspeptin treatments, as we provide the first evidence that kisspeptin is a potentially safe and effective therapy for both women and men with distressing low sexual desire,” Dr. Comninos continues.
“Additionally in men, we demonstrate that kisspeptin can have positive effects not only in the brain but also in the penis by increasing rigidity. Furthermore, kisspeptin was well-tolerated by both women and men with no side-effects reported, which is crucial from a drug development point of view. We now plan to take things forward to hopefully realize the potential of kisspeptin therapeutics in psychosexual disorders – sexual problems which are psychological in origin, such as unexplained low libido.”
“Our studies build on our previous work to assess the effectiveness of kisspeptin and its boosting effects in terms of arousal and attraction. It is highly encouraging to see the same boosting effect in both women and men, although the precise brain pathways were slightly different as might be expected,” adds Professor Waljit Dhillo, an NIHR Senior Investigator and co-senior study author.
“Collectively, the results suggest that kisspeptin may offer a safe and much-needed treatment for HSDD that affects millions of people around the world and we look forward to taking this forward in future larger studies and in other patient groups.”
The treatment creates more ‘happiness about sex’
During kisspeptin or placebo treatments, female participants underwent functional MRI scans while watching erotic videos and viewing male faces to see how these videos affected brain activity. Non-erotic exercise videos served as a control in the experiment. The team found that kisspeptin improved sexual and attraction brain activity in key brain areas in women.
Results also show that women suffering from distress due to low sexual function had greater kisspeptin-enhanced brain activity in the hippocampus — a key structure that scientists say plays a role in female sexual desire. Researchers found that the more kisspeptin activated the posterior cingulate cortex — another key behavioral brain area — when participants saw attractive male faces, the less sexual aversion the women had.
In the second study, 32 heterosexual men between 21 and 52 with HSDD underwent a similar study. However, the team also measured penile rigidity between January and September 2021. The study demonstrated that kisspeptin significantly boosted brain activity in the “sexual brain network,” while also increasing penile rigidity by up to 56 percent in comparison to taking a placebo.
Similar to the study with women, kisspeptin had greater effects in key brain regions in men who were more distressed by their low sexual desire. Psychometric analyses reveal that kisspeptin improved “happiness about sex” among men.
What do the patients say about the treatment?
“I got involved in the trial because I had previous problems with my sexual appetite and performance,” says a 44-year-old man named “Peter,” who took part in the trails.
“The issue had always been detrimental to sustaining relationships. I would often make excuses as to why my sexual appetite was low. For example, I would blame stress at work or tiredness as a reason instead of being honest. I had tried other performance supporting medication like Viagra. However, this proved ineffective as the issue was simply one of low desire. It was highly embarrassing and not something I felt able to talk to my previous partners about. I feared they would confuse it with lack of attraction to them,” the trial participant continues.
“I was keen to learn whether there was a solution to my problem and learn more about my condition.”
“I received the kisspeptin infusion in June 2021 and I noticed a difference in terms of my sexual desire. The week I had the kisspeptin infusion we conceived our son, who was born in March 2022. I had the best possible outcome as a result of the trial.”
“I also learnt a lot more about myself and my condition. I am really pleased to have contributed to this trial, which has been life-changing for me. I’m glad that others in a similar position could benefit from the treatment.”
“I took part in the trial as I was experiencing low sexual libido. Initially, I put it down to having small children and being exhausted as a result. However, this continued and started to impact my wellbeing. I wanted to see whether there was another reason for why I was feeling this way,” adds another trial participant and 43-year-old mom named “Eve.”
“I had two study visits in 2020 where I received the placebo and the kisspeptin infusions without knowing which one I was getting at the time. I did notice a bit of a difference once I received the kisspeptin infusion and it was fascinating to be part of the process,” Eve adds.
“I am glad that I took part in the study as many women wouldn’t like to admit they are experiencing this and may not seek help. I’m glad to know that kisspeptin could be a treatment option for other women.”
Dr. Comninos and Prof. Dhillo now plan larger studies in order to develop kisspeptin as a realistic treatment for both men and women dealing with sexual disorders.
Though certain sexual disorders are well-understood in men with diabetes, we know a lot less about the prevalence, impact, and management of sexual dysfunction in women with diabetes. At the ADA Scientific Sessions, Dr. Sharon Parish gave a broad overview of what we do know about this topic.
Dr. Sharon Parish, professor of medicine, clinical psychology and professor of clinical medicine at Weill Cornell Medicine, delivered a fascinating presentation on the third day of the 82nd ADA Scientific Sessions that included a broad overview of sexual disorders and dysfunction in women with diabetes.
What sexual disorders do women with diabetes face?
There are a number of sexual disorders that can affect women and women with diabetes specifically. These include hypoactive sexual desire disorder (HSDD) (reduced sexual desire and motivation), female sexual arousal disorder (reduced sexual arousal), and female orgasm disorder (reduced frequency, intensity, or pleasure of orgasms, and/or delayed, spontaneous, or premature orgasms), among many others.
How common is sexual dysfunction?
The prevalence of these conditions is disheartening. Research shows that in sexually active women with type 2 diabetes, as many as:
50% experience desire problems
34% experience arousal problems
36% experience lubrication problems
36% experience orgasm problems
More recent data shows these rates may actually be slightly lower, and there are differences with type 1 vs. type 2 diabetes. Women with type 1 diabetes having a greater prevalence of sexual dysfunction, including decreased desire, lubrication, and arousal. In women who do have sexual dysfunction, there are also higher rates of diabetes distress, impaired emotional well-being, and anxiety.
The reasons these conditions show up more prominently in women with diabetes could include hormonal reasons, infections, hyperglycemia that affects vaginal lubrication, neurological damage, and increased rates of mental health conditions like depression.
What are the risk factors?
Risk factors for these sexual dysfunctions include older age, obesity, smoking, higher A1C, and longer duration of diabetes. Interestingly, depression and marital status are significant predictors of sexual dysfunction in women.
The importance of screening for sexual dysfucntion and reducing stigma
Parish stressed that screening is key, but that these conversations should be initiated by healthcare providers by asking open-ended questions. “Have them tell you a story, ask follow-up questions,” she said.
And as a person with diabetes, being honest with your healthcare provider about how diabetes affects your sex life can help them help you. If they don’t bring the topic up, and you are comfortable, initiate the conversation yourself. This can help normalize talking about sex and reduce the stigma associated with these conversations – all people deserve to have a healthy and fulfilling sex life.
Treatment options for some sexual disorders in women with diabetes
For women with HSDD, Parish broke down three treatment options. If you have this condition, ask your healthcare provider if any of these may be available to you.
For pre-menopausal women, Flibanserin could elevate hormones in your brain that lead to sexual desire and Bremelanotide (an injection taken on-demand) can increase desire and decrease distress. Though there is less research in the area, there is some evidence that testosterone injections given off-label could moderately improve desire in post-menopausal women.
In addition, if the root cause of HSDD is determined to be tied to a psychological or relationship/lifestyle issue, counseling, cognitive behavioral therapy, or psychotherapy could also be good options for treatment.
Finally, Parish explained some signs and symptoms of vulvovaginal atrophy (VVA) and genitourinary syndrome of menopause (GSM) and treatment options. These conditions, which occur post-menopause, can lead to loss of elasticity, soreness, dryness, irritation, and burning. They may be able to be treated with lubricants and moisturizers or low-dose vaginal estrogen.
Why is sexual health important?
Sexual health is an important part of your overall health. Talking to your healthcare team about how diabetes affects your sex life, and finding ways to address the root causes of any issues you notice, could improve not only this area of your life but also your emotional and mental well-being. It’s also important for healthcare providers to help initiate these conversations in their clinics.
If you’re a woman with diabetes, you may be at greater risk for certain sexual issues. Here’s more on how to manage it.
Your sexual life is an important part of your well-being, but if you’re a woman with diabetes, you may be at greater risk for sexual problems like low libido, less sexual stimulation, and yeast infections.
It’s not always easy to talk about sexual problems with your clinician, but it’s a good first step toward finding the right treatment. It’s important to prioritize women’s sexual health and for both healthcare professionals and patients to bring up these issues.
Impact on women with diabetes
“The risk of sexual dysfunction is very high in diabetes, but we have a number of solutions if the issue is carefully addressed by doctors,” said Dr. Emmanuele Jannini, researcher and professor of endocrinology and sexual medicine at the University of Rome Tor Vergata.
In a 2023 review, researchers looked at sexual dysfunction in premenopausal women with type 1 diabetes. Among them, 36% experienced some type of sexual problem. The study also found that women with type 1 diabetes are three times more likely to experience sexual issues compared to those without diabetes.
For women with type 2 diabetes, the numbers are even higher. A 2019 meta analysis found that roughly 67% of women with type 2 diabetes experienced sexual dysfunction.
Reasons for sexual dysfunction
There are several reasons why women with diabetes may be at greater risk for sexual problems, including:
Lubrication issues. When your blood sugar is consistently high, this can cause damage to your blood vessels, including those in your vagina. When this happens, your vagina may not be able to properly lubricate itself, leading to dryness.
Less stimulation. High blood sugar can also lead to nerve damage. When the nerves in your vagina and vulva are damaged, you may not be able to feel as much sexual stimulation.
Difficulty feeling aroused. Sexual arousal triggers increased blood flow to your vagina and vulva. If your blood vessels are damaged by diabetes, you may have restricted blood flow to these areas.
Urinary tract infections (UTIs). If you have diabetes, you’re at a greater risk for developing a UTI due to extra sugars present in the tissues of your urinary tract. This creates an environment that’s easier for bacteria to grow and cause an infection. Having a UTI can also seriously affect your sex life. Having sex may put extra pressure on your bladder, which can trigger intense pain or discomfort.
Yeast infections. People with diabetes are more likely to get yeast infections because yeast grows more easily in urine that’s high in sugar. Yeast infections are also a side effect of SGLT-2 inhibitors, which are used to manage blood sugar in people with diabetes. Yeast infections can cause pain and itching in your vulva, and make sex extremely uncomfortable.
Low libido. Diabetes can disrupt the normal balance of sex hormones like estrogen and testosterone. Changes in these hormones can reduce your sex drive and make it harder to become aroused.
The importance of women’s sexual health in clinical care
According to some experts, most of the research on sexual problems focuses on men with diabetes – not women.
There is early research on medications that may help for sexual dysfunction in women, including testosterone therapy and Cialis (tadalafil). However, more studies are needed to prove these treatments work effectively for females.
Due to the general lack of research regarding women’s sexual health, healthcare providers don’t have a way to accurately measure sexual dysfunction in women. Developing this kind of assessment would help determine which women need treatment and shine a light on how common the problem truly is.
As a starting point, clinicians should directly ask patients if they’re having any sexual issues, as many may be uncomfortable bringing up the subject on their own. Along with testing, researchers and healthcare experts need to focus on developing treatment methods that specifically target women’s sexual health issues.
Education for doctors is also important. Many clinicians who specialize in endocrinology may not have education in sexual medicine, Jannini said, and this needs to change.
Treatment options
Despite the challenges around sexual dysfunction in women with diabetes, there are treatment options available. For those experiencing sexual pain or discomfort, hormone therapy, physiotherapy, and certain medications may help. There are tons of varieties of lubricants found at your local pharmacy or sex shop to help with vaginal dryness.
For issues with stimulation and sexual arousal, sex therapy or counselling can teach you more about ways to increase intimacy and learn more about your body’s sexual responses. While more research is needed, medications including sildenafil (Viagra) and buproprion (an antidepressant) have shown positive results in improving and even reversing sexual dysfunction in women.
The bottom line
Many women with diabetes experience sexual issues; getting the right testing and treatment can make a big difference. Doctors and medical policymakers need to prioritize this issue by developing better testing measures and treatments that specifically target women’s needs.
It’s not necessarily a full workout, but it can be as good for you as moderate exercise. It raises your heart rate about the same as a brisk walk or a slow bike ride.
Good for a Woman’s Heart
2/14
Women who have sex a couple of times a week are less likely to get heart disease than those who have it once a month. Whether that’s because healthier women enjoy it more often, or because it helps protect a woman’s heart is unclear.
May Cure Your Headache
3/14
Say goodbye to the old standby “Not tonight, Dear. I have a headache.” It turns out sex can help with pain, and that includes some kinds of headaches, such as migraines. Not feeling frisky? Try: “Not tonight, Honey. I have a highly contagious stomach bug.” Works every time.
Lowers Stress
4/14
People who have more sex are less anxious when they’re faced with stressful tasks like public speaking or arithmetic. But according to the study, it only works when you have a partner — masturbation doesn’t count.
You May Live Longer
5/14
One study suggested that married women who climaxed more often had a slight tendency to live longer. Researchers aren’t sure if the sex actually lengthens your life or if having sex is a sign of a healthier person. But why take any chances?
Sharpens Your Mind
6/14
Sex has been linked to the making of new brain cells, and that’s a good thing. People over 50 who had more sex were better able to recall numbers and do basic math, and the difference was pretty big. It seemed to help men more than women, but both did better than those who had less sex.
Makes You Happy
7/14
You don’t have to overdo it — once a week is plenty. More than that, and the effect fades. But scientists only studied couples in committed relationships, so if you’re trying to meet your quota by picking up strangers at your local bar, all bets are off.
Bonds You to Your Partner
8/14
The hormone oxytocin is released during sex, and it sparks feelings of intimacy, affection, and closeness with your partner. That helps build a strong, stable relationship, which is good for everyone.
Keeps You Lean
9/14
The more sex you have, the slimmer you’re likely to be. Is that because more sex keeps you trim? Or because lean people have more sex? Scientists don’t really know, but all you need is a partner and a bathroom scale to try to find out.
Good for Mental Health
10/14
Adults in committed relationships who have more sex are less likely to be depressed or take medication for mental health issues.
Helps Fight off the Common Cold
11/14
Move over, vitamin C. College students who had sex twice a week had more cold-fighting antibodies in their saliva than those who had sex less often.
Helps You Sleep
12/14
Orgasm triggers a surge of endorphins and oxytocin in both men and women, and that dulls pain and relaxes you. Both of those can help you sleep more easily, though according to scientists — and many women — the effect is more pronounced in men.
You Could Make a Baby
13/14
If you’re trying to have a baby, the more sex you have, the more likely you are to hit the right time of the month. But more sex may also prime women for pregnancy and improve sperm quality in men, which can speed things along.
Helps Your Future Self
14/14
People who have more sex may have better quality of life — and not just now, but in the future, too. If you have an active sex life in middle age, you’re more likely to keep it up as you get older, which is linked to better health and happiness.
Takotsubo syndrome (TTS) is a condition characterized by acute heart failure and transient ventricular contractile dysfunction that is frequently precipitated by acute emotional or physical stress. Although the precise pathophysiologic mechanism underlying this syndrome remains unknown, enhanced sympathetic stimulation resulting in microvascular dysfunction and/or direct myocyte injury is believed to be central to the syndrome’s pathogenesis.1 Since its original description in the early 1990s, a consistent observation in all series of TTS has been the marked preponderance of older postmenopausal women. Women comprise approximately 90% of the cases reported in the literature with a mean age of 65-75 years in most series, and the risk of developing TTS increases 5-fold in women after the age of 55 years.2 The precise reason that older women are so disproportionately affected remains unknown, but it is believed that the declining beneficial effects of estrogen on cardiac microvascular function as women age make postmenopausal women particularly susceptible to microvascular ischemia and TTS during episodes of excessive sympathetic stimulation. Given the marked female predisposition to TTS, it is not surprising that most of the literature over the past 20 years has focused primarily on women with this disorder, and far less has been written about the clinical features and outcomes of men with TTS. Although men clearly make up the minority of reported cases, the available literature suggests that males with TTS may represent a particularly vulnerable population with increased rates of arrhythmia, cardiogenic shock, and mortality compared with females with the syndrome.3-5
In this issue of the Journal of the American College of Cardiology, Arcari et al6 provide much needed insight into the influence of sex on TTS by presenting a large population of both men and women with TTS enrolled in the GEIST (GErman Italian Spanish Takotsubo) registry. The investigators looked at 2,492 patients enrolled in this registry and compared the clinical features and short- and long-term outcomes between men and women with TTS. After examining sex differences in this large population, they then performed a propensity score analysis by matching men and women 1:1 based on several variables that included age, presence of diabetes, current smoking status, history of malignancy, and the type of trigger precipitating the syndrome (emotional vs physical). Several important observations were made in this study: 1) men comprised 11% of the total TTS population, a prevalence similar to what has been reported in other studies and registries; 2) physical triggers were more frequently reported in male patients, whereas emotional triggers were more common in female patients; 3) men were significantly sicker at the time of initial presentation and were more likely to have cardiogenic shock, to require catecholamine administration, and to require intubation both in the total population and after propensity score matching; 4) in-hospital mortality was significantly higher in men, both in the overall and matched cohorts; and 5) long-term mortality was higher in men in the overall population but was not different between men and women in the matched cohort. Some of these observations can be readily explained by looking at the demographics of the overall GEIST population. Men had a significantly higher prevalence of diabetes mellitus, tobacco use, pulmonary disease, malignancies, and coronary artery disease, comorbidities that one would expect to have an impact on in-hospital complications as well as short- and long-term survival. Men in the overall population were also more likely to develop TTS following physical triggers, which has been previously shown to be associated with worse outcomes compared with emotional triggers.7 Men were also less likely to be discharged from the hospital on beta-blockers and angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, which may have also had an impact on long-term outcomes. Although there were significant demographic differences between men and women in the overall population, the study by Arcari et al6 is novel in that the relatively large size of the GEIST registry made it possible for the investigators to account for many of these confounding variables by performing a propensity score matching analysis. Interestingly, even after matching for age, comorbidities, and type of precipitating trigger, men with TTS remained much sicker than women with a higher incidence of cardiogenic shock, in-hospital death, and death at 60 days. Men also had a lower ejection fraction and a higher prevalence of the apical ballooning variant compared with women, echocardiographic features known to be associated with worse short-term outcomes.8 By contrast, long-term mortality was not affected by sex in the matched cohort. This last observation suggests that once left ventricular systolic function recovers, which typically occurs within days to weeks of initial presentation, long-term mortality in TTS is driven primarily by non-cardiac comorbidities and events.
The study by Arcari et al6 shows convincingly that although men are far less likely to develop TTS than women, they have more serious complications and are more likely to die than women presenting with the syndrome. Although these observations may seem paradoxical at first, they may actually provide important clues about the pathophysiologic mechanisms of this disorder. There is increasing evidence that the transient myocardial dysfunction observed in TTS is the result of sympathetically mediated microvascular ischemia.1Figure 1 illustrates how TTS susceptibility may be dependent on the delicate balance between resting sympathetic tone and microvascular function. In this paradigm, individuals with normal basal sympathetic tone and normal microvascular function may be at low risk for developing TTS, whereas individuals with elevated resting sympathetic tone and significant microvascular dysfunction may be highly vulnerable. This paradigm helps to explain why older women are particularly susceptible to TTS. Resting sympathetic tone appears to be particularly elevated in older women,9 and as women age, there are significant decreases in cardiac vagal tone and baroreflex sensitivity with an associated increase in sympathetic activation.10 Estrogen is also an important regulator of endothelial function and vasomotor tone, and can attenuate catecholamine-mediated vasoconstriction, making older postmenopausal women potentially more susceptible than men to stress-related microvascular ischemia.11Figure 1 further illustrates that the sympathetic stimulus required to precipitate TTS is inversely related to susceptibility. Only mild sympathetic stimulation may be needed to precipitate TTS in highly susceptible individuals such as older women, and whereas older women may be more likely to develop the syndrome following acute stress, the smaller sympathetic stimulus may result in less myocardial injury and fewer cardiac complications. By contrast, significant noradrenergic stimulation may be necessary to precipitate TTS in men who have lower resting sympathetic tone and less microvascular dysfunction, thus resulting in more myocardial injury (eg, higher troponin, more contraction band necrosis, lower ejection fraction) and a higher incidence of cardiovascular complications and death in the acute period.
Download FigureDownload PowerPointFigure 1Proposed Inverse Relationship Between Stimulus Needed to Precipitate TTS and Syndrome SusceptibilityProposed paradigm illustrating the inverse relationship between takotsubo syndrome (TTS) susceptibility and the degree of sympathetic stimulation needed to precipitate the syndrome. Individuals with normal microvascular function and basal sympathetic tone (eg, young healthy individuals) have low susceptibility to TTS and will therefore require a large sympathetic stimulus to precipitate the syndrome. Individuals with mild-to-moderate abnormalities in microvascular function and basal sympathetic tone (eg, middle-aged men) will require at least a moderate amount of sympathetic stimulation to precipitate TTS. The people most susceptible to TTS are those with high resting sympathetic tone and significant microvascular dysfunction (eg, older women) and even mild sympathetic stimulation can precipitate the syndrome in these individuals.
The proposed paradigm in Figure 1 helps to explain an interesting and recurrent theme that has emerged in the Takotsubo literature, and that is that groups with the lowest prevalence of TTS appear to be the sickest at the time of presentation. African Americans made up <10% of the reported cases of TTS in one series but had a greater number of in-hospital complications compared with Caucasians.12 Young individuals (aged <50 years) comprised only 11% of the InterTAK (International Takotsubo) registry but were more likely to have cardiogenic shock and to require inotrope and ventilator support than older patients.13,14 Once again in the current study, men accounted for only 11% of the total GEIST registry but were significantly sicker than their female counterparts. These observations not only shed light on possible pathophysiologic mechanisms of this disorder, but also serve as an important reminder to clinicians that the patients least likely to get TTS are perhaps the most likely to die from it.
From skinny dippers to people who have actual intercourse with nature, ecosexuality is a growing movement taking a new approach to combatting climate change.
If you happen to find yourself in Sydney this week, you have the unique opportunity to have sex with the earth. You just need to stop by the “ecosexual bathhouse,” which is currently part of the Syndey LiveWorks Festival of experimental art. The bathhouse is an interactive installation created by artists Loren Kronemyer and Ian Sinclair of Pony Express, who described the work to me as a “no-holds-barred extravaganza meant to dissolve the barriers between species as we descend into oblivion” as the result of our global environmental crisis. But they also see their piece as a part of a much larger ecosexual movement, which they say is gathering momentum around the world.
And they may be right. Jennifer Reed, a PhD candidate in sociology at the University of Nevada, Las Vegas, is writing a dissertation on ecosexuality, and says that the number of people who identify as ecosexuals has increased markedly in the past two years. And Google search data confirms that interest in the term has spiked dramatically over the past year. We may look back on 2016 as the year ecosexuality hit the mainstream.
Ecosexuality is a term with wide-ranging definitions, which vary depending on who you ask.
A participant at the Ecosexual Bathhouse by the art group Pony Express. Photo by Matt Sav
Amanda Morgan, a faculty member at the UNLV School of Community Health Sciences who is involved in the ecosexual movement, says that ecosexuality could be measured in a sense not unlike the Kinsey Scale: On one end, it encompasses people who try to use sustainable sex products, or who enjoy skinny dipping and naked hiking. On the other are “people who roll around in the dirt having an orgasm covered in potting soil,” she said. “There are people who fuck trees, or masturbate under a waterfall.”
Sprinkle and Stephens talk openly about ecosexuality as a new form of sexual identity. At last year’s San Francisco Pride Parade, they led a contingent of over a hundred ecosexuals in a ribbon-cutting ceremony to “officially” add an E to the LGBTQI acronym; Stephens told Outsidethat they believe there are now at least 100,000 people around the world who openly identify as ecosexuals.
According to Reed’s research, the term “ecosexuality” has existed since the early 2000s, when it started appearing as a self-description on online dating profiles. It wasn’t until 2008 that it began its evolution toward a fully fledged social movement, when Sprinkle and Stephens began officiating ecosexual weddings. The two artists had been active in the marriage equality movement, and they wanted to harness that energy for environmental causes. Stephens has said that their aim was to reconceptualize the way we look at the earth, from seeing the planet as a mother to seeing it as a lover.
Also in 2008, Stefanie Iris Weiss, a writer and activist based in New York, began researching her book Eco-sex: Go Green Between the Sheets and Make Your Love Life Sustainable, published in 2010. Weiss, who was at that time unaware of Sprinkle and Stephens’s work, initially lent the idea a more practical, literal focus, with research revealing the harmful environmental impact of materials used in condoms, lubes, and other sex products upon both our bodies and the planet. She said that she wrote the book to help people make their sex lives “more carbon neutral and sustainable,” and to help us avoid polluting our bodies when we have sex.
The desire for safer and more sustainable sex products remains an important part of the ecosexual movement, and Weiss said that green options for consumers when it comes to sex products have increased dramatically since she wrote her book. But she has also happily embraced Sprinkle and Stephens’s more holistic take on ecosexuality, immediately recognizing in their efforts a shared goal: to help people reconnect with nature, and with their own bodies.
Reed said that ecosexuality is different from other social movements in that it focuses on personal behavior and pleasure rather than protests or politics. She said that some people within the environmental movement have kept their distance from it for this reason. But ecosexual activists interviewed for this story all insist they have a serious goal at heart. As Morgan said, thinking about the earth as a lover is the first step toward taking the environmental crisis seriously. “If you piss off your mother, she’s probably going to forgive you. If you treat your lover badly, she’s going to break up with you.”
At the same time, the sense of levity that characterizes works such as the bathhouse or Sprinkle and Stephens’s performances is an integral part of the movement. Morgan describes ecosexuality as a means of moving beyond the “depressing Al Gore stuff” that people often associate with environmentalism. Her hope, and that of other ecosexuals such as Weiss and Kronemyer, is that it can gives the average person a way of engaging with the issue that is accessible and fun, and that creates a sense of hopefulness.
Morgan and Weiss both say that they also see sex as a potentially powerful tool for motivating people to make the environment a priority. As Weiss put it: “If you’re running from floods, you won’t have any time for sex.”
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