Sunday, June 09, 2013

How to Measure Female Desire

A Sexual Laboratory of One's Own, 
aka A Clean Well-Lighted Place for Sex

Psychophysiologic studies of sexual response should be done in a comfortable, well-designed laboratory to minimize subject anxiety and discomfort (Woodard & Diamond, 2009, Fig. 5).



How do scientists measure the physiological aspects of sexual arousal in women? A 2009 paper by Woodard and Diamond reviewed 45 years of research using instruments that measure female sexual function. These devices include the vaginal photoplethysmograph (right), vaginal and labial thermistors, pressure/compliance balloons, clitoral electromyography, and the electrovaginogram. For a full list, see Table 1 at the bottom of this post.

The authors note that these physiological measures do not correlate very well with subjective ratings of sexual arousal. Furthermore, clinicians who treat women with sexual dysfunctions are of two minds. Some say the distinction between female desire and arousal may be artificial (see DSM-5 changes, p. 13), while others maintain that the merger of female sexual arousal disorder (FSAD) with Hypoactive Sexual Desire Disorder (HSDD) will be disastrous (Clayton et al., 2012).

The previous post about Lybrido and Lybridos, the drugs in clinical trials for HSDD, talked briefly about Emotional Brain, the Dutch drug company that is developing them. Putting aside the many objections to the HSDD diagnosis for now, and the fact that the trials pathologize sexual boredom within marriage, the company has conducted some interesting studies1 to assess sexual desire.

Foremost among these is the development of an at-home testing environment, or ambulatory lab, to conduct studies of sexual function (Bloemers et al., 2010).


Fig. 1 (Bloemers et al., 2010). Schematic overview of the ambulatory measurement setting. (1) Generic laptop, (2) genital probe, (3) wireless sensor system, (4) handheld computer, and (5) secure central database.


The participants must be so much more comfortable watching hardcore porn and measuring their own vaginal pulse amplitude and clitoral blood volume in the privacy of their homes, without the prying eyes of hoards of scientists in white lab coats (although some people might be into that).

And that's what was found, for the most part (Bloemers et al., 2010):
The results of this study support our hypothesis that in healthy controls, clitoral and subjective laboratory measures of sexual arousal show stronger increases to erotic stimuli in the home environment than in the environment of the institutional laboratory. This effect was apparent in response to hardcore stimuli, but not to erotic fantasy. ... To our knowledge, this is the first study that investigates ecological validity of sexual psychophysiological measures by comparing those assessed in the institutional laboratory to those assessed at home with an ambulatory laboratory.


Footnote

1 Albeit flawed studies, from a cognitive perspective (especially their implementation of an 'Emotional Stroop' task). I am not particularly qualified to comment on other aspects of this research.


References

Bloemers, J., Gerritsen, J., Bults, R., Koppeschaar, H., Everaerd, W., Olivier, B., & Tuiten, A. (2010). Induction of Sexual Arousal in Women Under Conditions of Institutional and Ambulatory Laboratory Circumstances: A Comparative Study Journal of Sexual Medicine, 7 (3), 1160-1176 DOI: 10.1111/j.1743-6109.2009.01660.x

Woodard, T., & Diamond, M. (2009). Physiologic measures of sexual function in women: a review Fertility and Sterility, 92 (1), 19-34 DOI: 10.1016/j.fertnstert.2008.04.041


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2 Comments:

At June 11, 2013 9:33 AM, Anonymous Matthew Stief said...

I'm curious what you think was wrong with their Stroop task?

 
At June 11, 2013 11:18 PM, Blogger The Neurocritic said...

I'm not sure why they decided to use a masked version of the task, other than saying, "A masked version of this task turned out to be a more reliable measurement of (preconscious) attentional bias for emotional cues." OK then, but it doesn't look like they did an awareness check afterwards to see if any participants were able to identify the masked words.

Further, they actually used results from the emotional Stroop to identify groups of women who show "high" and "low" sensitivity to sexual cues. And the way they interpreted the interference effect, and how it was affected by Lybrido, was problematic, to say the least. In one of their papers (Poels et al.):

"Figure 3. Preconscious attentional bias for sexual cues. Treatment with T+PDE5i relative to placebo produced an increase in the preconscious attentional bias (the differences between the mean reaction times of erotic and neutral words) for sexual cues in women with a relative insensitivity for sexual cues."

The "increase in preconscious attentional bias" in low sensitive women went from an interference effect of about -22 ms (faster for neutral) to -4 ms (not different from zero), i.e. the time to name the color of masks preceded by "coitus" vs. "chair" was identical. The drug didn't result in greater allocation of attention to masked sexual words.

And who knows what happened in any previous unmasked versions, and in the "high sensitive" women. If you're going to use a cognitive task to define clinical groups, you'd better be pretty rigorous about it.

 

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