Heart Rate Variability Biofeedback for Women with Female Sexual Arousal Disorder

Low resting heart rate variability (HRV) has been associated with poor sexual arousal function in women (Stanton, Lorenz, Pulverman, & Meston, 2015). In a series of studies, we found autogenic training increased HRV and increased both genital and subjective sexual arousal in sexually functional women (Stanton, Pulverman, & Meston, 2016) and enhanced both sexual arousal and perceived genital sensations among women experiencing decreased arousal (Stanton, Hixon, Nichols, & Meston, 2018). The results of these studies revealed that, in small samples of women, autogenic training effectively increased HRV, subjective sexual arousal, and genital sexual arousal.

In a follow-up study, we (Stanton, Boyd, Foggarty, & Meston, 2019) examined the effectiveness of HRV biofeedback and a combination of HRV biofeedback with autogenic training on sexual arousal in women with arousal dysfunction. HRV biofeedback is a method of training participants to control their breathing to the resonant frequency of about five to six breaths per minute, via providing them with beat-by-beat heart rate data.  HRV biofeedback has previously shown promise in the treatment of several disorders that are specifically associated with autonomic imbalance, including depression, anxiety, and PTSD. In our study, 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. Our findings showed that, across the three laboratory visits, participants in the three conditions signficantly 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.

Recommended papers:

Stanton, A. M., Boyd, R. L., Fogarty, J. J., & Meston, C. M. (2019). Heart rate variability biofeedback increases sexual arousal among women with female sexual arousal disorder: Results from a randomized-controlled trial. Behaviour Research and Therapy115: 90-102. PDF (1 MB)

Stanton, A. M., Hixon, J. G., Nichols, L. M., & Meston, C. M. (2018). One session of autogenic training increases acute subjective sexual arousal in pre-menopausal women with sexual arousal problems. Journal of Sexual Medicine, 15(1), 64-76. PDF (462 KB)

Stanton, A. M., Pulverman, C.S., & Meston, C.M. (2016). Vagal activity during physiological sexual arousal in women with and without sexual dysfunction. Journal of Sex & Marital Therapy, 43(1), 78-89PDF (317 KB)

Stanton, A.M., Lorenz, T.A., Pulverman, C.S., & Meston, C.M. (2015). Heart rate variability: A risk factor for female sexual dysfunction. Applied Psychophysiology and Biofeedback, 40(3), 229-237. PDF (502 KB)