"Am I pretty enough? Am I doing this right? Should I be going to yoga?"
These kinds of anxious, self-judgmental thoughts often run through some women's minds as they have sex, experts say. But a new study says "mindfulness meditation" training — which teaches how to bring one's thoughts into the present moment — can quiet the mental chatter that prevents these women from fully feeling sexual stimuli.
"Rather than feeling it, they get caught up in their heads," said the study's lead author, Gina Silverstein, who was a student at Brown University in Rhode Island at the time of the study. "It's impressive how mindful meditation can increase self-compassion, decrease anxiety and improve attention."
Silverstein and her colleagues studied 44 college students, 30 of whom were women, and about half of whom took a 12-week meditation course. All participants were shown a series of photos, some of them erotic, to gauge their reaction time in feeling "calm," "excited" or "aroused." The participants also completed questionnaires that reported aspects such as such as self-acceptance and psychological well-being.
At the study's start, women in both groups took longer to report how sexual slides made them feel, compared with how long it took men. But women who took the mindful meditation course became significantly faster at registering their body's responses — called "interoceptive awareness" — to sexual stimuli.
This increase in interoceptive awareness was also linked to improvements in self-reported measures of attention, self-judgment, anxiety and depression.
"It's interesting, the women who took longer (to register feelings of sexual arousal) at baseline were also the ones who were the harshest self-judgers," Silverstein said. "So it's definitely a correlated effect."
What's on women's minds?
While scant research data exists on the mental chatter that seems to occupy many women's brains during sex, Dr. Elizabeth Kavaler, a urologist at Lenox Hill Hospital in New York, said anecdotal evidence is abundant.
"The best part of this study is that it validates that the biggest part of sexuality in women is emotional and mental," Kavaler said. "The vagina is like the least important part of a woman's sexuality. It's true that sex for women is not necessarily the same as sex for men."
But the study's weakness was its exclusive use of college students, ages 18 to 22, most of whom hadn't experienced sexual dysfunction, said Jennifer Fariello, a certified nurse practitioner in women's health at the University of Pennsylvania.
"Arousal disorder is really hard to define," said Fariello, who also specializes in sexual health and urogynecology at the Pelvic and Sexual Health Institute at Graduate Hospital in Philadelphia. "So many factors go into female sexual dysfunction — is it because of depression and anxiety, or low libido because they don't feel good about themselves, or are they not be aroused [physically]? And who knows what's going on relationally."
Distractions and judgment
As for mental chatter during sex, Silverstein said "a huge range" exists, from women who think of other things during sex without it impeding their arousal, to others who can't function sexually if a stray thought crosses their mind.
She recommended meditation classes, which are available across the country, to anyone who feels their sex life may benefit from a greater focus on the here and now.
"We need to let go of so much of the self-judgment we have in our daily lives," Silverstein said. "There are so many people who are so hard on [themselves], or are dealing with depression. It's great how introducing mindfulness meditation can help with so many issues across the board."
The study is published in the November/December issue of the journal Psychosomatic Medicine.