Genital vibration for sexual function and enhancement: a review of evidence

Let's talk about sex: consensus guidelines of the GINECOR working group of the Spanish Society of Radiation Oncology: clinical recommendations after pelvic radiotherapy

PURPOSE

The present consensus statement was developed by the GINECOR working group on behalf of the Spanish Society of Radiation Oncology (SEOR). This document addresses sexual health management in patients with gynaecological cancer after pelvic radiotherapy.

METHODS

A modified two-round online Delphi study was conducted, where GINECOR members were surveyed on the diagnosis, treatment, and follow-up of sexual health problems. An expert panel of radiation oncologists, nurses and a gynaecologist participated in the Delphi study to reach a consensus, applying GRADE criteria to establish the level of agreement.

RESULTS

The consensus recommendations cover both diagnosis and treatment, with an emphasis on patient-reported outcome measures (PROMs). They highlight recommendations such as the systematic assessment of genitourinary, gastrointestinal, and sexual symptoms, and the use of several treatments after radiotherapy. Recommendations include pharmacological options like vaginal lubricants and hormone therapy, and mechanical interventions such as vaginal dilators and vibrators. These suggestions stem from both scientific evidence and clinical expertise.

CONCLUSION

This consensus statement describes a comprehensive, multidisciplinary approach developed to address the sexual needs and enhance the quality of life of patients with gynaecological tumours after pelvic radiotherapy. It offers specific recommendations for managing sexual issues, emphasizing the importance of specialized care and regular assessment. The document underscores the significance of proactive, patient-centered sexual health management in gynaecological cancer patients.

The sextech industry and innovative devices for treating sexual dysfunction

Since the digital revolution, there has been a notable increase in the use and popularity of sex toys and innovative sexual devices, which can be attributed to advancements in technology. The sex toys industry strives to improve sexual experience, pleasure and sexual health, and to address sexual dysfunction through devices and technology. With the growth of this industry, new products that are considered "smart sexual devices" have gradually entered the market. Smart sexual devices feature wireless connectivity to a smartphone application that allows the user to control the device's features and provide personal or sexual data about their sexual experiences. Other smart devices have sensors and are able to collect physical data during usage. With the aid of this data, individuals may be able to understand their sexual behavior and arousal better, resulting in improved sexual experience or the overcoming of sexual dysfunction. The present article aims to explore the potential applications of technology-based devices, and smart sexual devices, in the treatment of male sexual dysfunctions, including premature ejaculation (PE), and delayed ejaculation (DE), as well as female sexual dysfunction (FSD), such as sexual arousal disorder and female orgasmic disorder. Furthermore, we examine the advantages and disadvantages of these devices. Given the limited literature available on this subject and the absence of controlled studies, we conduct a narrative review of the existing scientific research on technological and smart sexual devices.

Development of a Sexological Ontology

This study aimed to show what role biomedical engineering can play in sexual health. A new concept of sexological ontology, an essential tool for building evidence-based models of sexual health, is proposed. This ontology should be based on properly validated mathematical models of sexual reactions identified using reliable measurements of physiological signals. This paper presents a review of the recommended measurement methods. Moreover, a general human sexual reaction model based on dynamic systems built at different levels of time × space × detail is presented, and the actual used modeling approaches are reviewed, referring to the introduced model. Lastly, examples of devices and computer programs designed for sexual therapy are described, indicating the need for legal regulation of their manufacturing, similar to that for other medical devices.

Global web trends analysis of sex toys

Background

Individuals from all over the world are increasingly using the internet to purchase sex toys and gadgets to enhance their sexual experience and provide variety and excitement to their sexual encounters.

Aim

This study examined the trends about the most popular preferred sex toys by nation/region from 2009 using data from Google Trends (GT).

Methods

GT was used to generate a "line-graph" that displays how interest in a topic in certain places has risen or diminished over time. Search terms were generated for vibrator, dildo, anal plug, strap-on, and masturbator. The data were included "globally" from January 1, 2009 to June 30, 2023.

Outcomes

The search values for certain terms were indexed using the relative search volume (RSV), which is shown on a scale of 0-100.

Results

In the linear regression analysis, the trends by strength were sorted as follows: dildo, vibrator, strap-on, anal plug, and masturbator. In 2018, vibrator surpassed strap-on and came in second, while the regression analysis showed a positive trend for dildo between 2009 and 2016 (P = .014). It had a negative trend after 2016. Strap-on was the only one to have a downward trend (P = .029). Regression analysis revealed positive trends for vibrator and masturbator (P = .030, P = .045). The upward trends have continued uninterruptedly since 2009.

Clinical implications

According to our research, interest in online trends relating to sex toys has increased along with advancements in technology and clinical applications. This rise is linked to the worldwide sex toy industry's development in response to consumer demand and ease of accessibility.

Strengths and limitations

This is the first research of this sort, looking into the interests of internet users about sex toys by country over time using GT. GT data is anonymous, and analysis of subpopulation groups is not possible.

Conclusion

Individual preferences for sex toys have different trends on different continents around the world. The compatibility of sex toys with technology over time, their clinical use, and sex toy-related injuries play an important role in the selection process. Web trends seem appropriate to reflect how the demand for sex toys has changed over time.

The Role of Vibrators in Women's Pelvic Health: An Alluring Tool to Improve Physical, Sexual, and Mental Health

INTRODUCTION AND HYPOTHESIS

In limited studies vibrators have been shown to improve sexual function and pelvic floor health; however, there are even fewer studies on the effect of vibrator use on overall genitourinary and mental health. To investigate the effect of regular vibrator use on sexual, genitourinary, and mental health in addition to quality of life.

METHODS

We performed a prospective pilot study of women aged 18 to 80 years recruited from a urogynecology clinic. Study participants were instructed to use a vibrator according to the protocol. Sexual function, pelvic floor function, mental health, and pelvic examination were assessed at the initial visit and at 3 months' follow-up using validated questionnaires.

RESULTS

Of the 79 participants enrolled in the study, 53 women (66%) completed the study. The mean age of the participants was 54.7 years (range 19-80 years), and the majority of participants were white (n = 59, 74.7%), post-menopausal (n = 48, 60.8%), and not receiving systemic (n = 63, 79.7%) or local (n = 63, 79.7%) hormone therapy. Sexual function significantly improved over time (p = 0.002), whereas the rate of bothersome pelvic organ prolapse symptoms and pain scores significantly decreased (p = 0.034 and 0.0008 respectively). Rates of urge urinary incontinence decreased although this was not statistically significant (p = 0.059). There was a significant improvement in the gross appearance of lichen sclerosus lesions (p = 0.025) and in the severity of vaginal atrophy (p = 0.018). Rates of depression were significantly decreased (p = 0.011).

CONCLUSIONS

Vibrator use was associated with improved sexual, genitourinary, and mental health.

Sexual Self Discrepancies, Sexual Satisfaction, and Relationship Satisfaction in a Cross-Sectional Sample of Women Who Experience Chronic Vaginal Pain during Sexual Intercourse

One out of three women may suffer from chronic vaginal pain during intercourse, a complex health issue that leads to lasting psychological, sexual, emotional, and relational difficulties even after initial relief. Women who experience this pain condition may compare their sexual selves to the societal norm of being pain-free. Comparisons that do not align with one's actual sexual self result in sexual self-discrepancies and may cause emotional distress. Sexual self-discrepancies may hinder sexual and relationship satisfaction for women who experience chronic vaginal pain during sexual intercourse. This mixed-method study examined the sexual self-discrepancies women reported and the degree to which their sexual self-discrepancies were related to their sexual and relationship satisfaction. Results from this cross-sectional study showed that the majority of participants experienced sexual self-discrepancies and that they experienced a significant inverse correlation between sexual self-discrepancies and sexual satisfaction. In multivariate models, sex frequency was the strongest predictor of sexual satisfaction. There were no correlations between sexual self-discrepancies and relationship satisfaction. Future measurement research should examine the role of sex frequency in the experience of sexual satisfaction. Education on maximizing pleasure and minimizing pain may aid women to cope with the negative impact of pain.

Sexual Dysfunction and Dyspareunia in the Setting of the Genitourinary Syndrome of Menopause

Sexual dysfunction is a common consequence of the genitourinary syndrome of menopause (GSM). In this book chapter, we discuss the pathophysiology, prevalence, evaluation, and evidence-based management of sexual dysfunction in patients affected by GSM. Additionally, we present an algorithm to guide clinicians in the management and treatment of sexual dysfunction in this setting based on available evidence and best practices.

Masturbation, sexual function, and genital self-image of undergraduate women: a cross-sectional study

BACKGROUND

The relationship between factors related to masturbation, sexual function, and genital self-image among women has not been fully explored in the literature.

AIM

The study sought to investigate the association between masturbation frequency, feelings, and behaviors with sexual function and genital self-image in young women.

METHODS

A cross-sectional survey among 110 undergraduate female students was conducted. Online self-administered questionnaires to assess sociodemographic characteristics, masturbatory frequency, feelings, and behavior were completed. Participants also answered the Brazilian version of the Female Sexual Function Index (FSFI) and the Female Genital Self-Image Scale (FGSIS).

OUTCOMES

The outcome includes masturbation frequency and behaviors associated, as well as scores on the FSFI and FGSIS.

RESULTS

Women showed higher scores in FSFI subdomains when masturbation was considered important for them, along with reported feelings of empowerment and satisfaction during this activity. However, those who experienced negative emotions during masturbation, such as shame or guilt, demonstrated a significant association with lower scores in both FSFI and FGSIS. Masturbation frequency was found to correlate with better sexual function specifically in the desire domain among women who engaged in daily masturbation. Additionally, an association was observed between higher scores in the FGSIS and increased scores in the domains of satisfaction, arousal, and orgasm within the FSFI. There was an association in the domain's satisfaction, arousal, and orgasm of the FSFI with greater scores in FGSIS.

CLINICAL IMPLICATIONS

The clinical implications encompass the augmentation of understanding pertaining to female sexual function.

STRENGTHS AND LIMITATIONS

The study provides valuable insights into the sexual behavior of undergraduate female students, and its methodology improves openness in responses, as it provides anonymity given the sensitive nature of the topic studied. Study limitations include the unsuitability of the FSFI questionnaire for sexually inactive women in the past 4 weeks; the participation bias and reporting bias in sexuality searches; and the unknown validity of the investigator-derived questionnaire about masturbation, as it has not been previously validated.

CONCLUSION

Masturbation frequency has minimal to no impact on female sexual function, whereas harboring positive feelings toward it and maintaining a positive genital self-image may exert a positive influence on sexual function.

Relationship between Solitary Masturbation and Sexual Satisfaction: A Systematic Review

Masturbation is a healthy sexual behavior associated with different sexual functioning dimensions, which highlights sexual satisfaction as an important manifestation of sexual wellbeing. This review aims to systematically examine studies that have associated masturbation with sexual satisfaction, both in individuals with and without a partner. Following the PRISMA statement, searches were made in the APA PsycInfo, Medline, Scopus, and Web of Science databases. The search yielded 851 records, and twenty-two articles that examined the relation between solitary masturbation and sexual satisfaction were selected. In men, a negative relation between masturbation and sexual satisfaction was observed in 71.4% of the studies, 21.4% found no such relation, and 7.2% observed a positive association. In women, 40% reported no relation, 33.3% a negative relation, and 26.7% a positive one. The negative association between solitary masturbation and sexual satisfaction is consistent with the previously proposed compensatory role of masturbation, especially for men. In women, compared to men, the complementary role of masturbation in relation to sexual relationships is observed to a greater extent and is associated more closely with sexual health. The importance of including different parameters beyond the masturbation frequency in future studies to explore its relation with sexual satisfaction is emphasized. This systematic review is registered in PROSPERO (CRD42023416688).

Masturbation Prevalence, Frequency, Reasons, and Associations with Partnered Sex in the Midst of the COVID-19 Pandemic: Findings from a U.S. Nationally Representative Survey

Despite well-documented individual, relational, and health benefits, masturbation has been stigmatized and is understudied compared to partnered sex. In a US nationally representative survey of adults, we aimed to: (1) assess the prevalence and frequency of participants' prior-year masturbation, (2) describe reasons people give for not masturbating, (3) describe reasons people give for masturbating, and (4) examine the association between masturbation frequency and actual/desired partnered sex frequency in the prior year. Significantly more men than women reported lifetime masturbation, past month masturbation, and greater masturbation frequency. The most frequently endorsed reasons for masturbating related to pleasure, feeling "horny," stress relief, and relaxation. The most frequently endorsed reasons for not masturbating were lack of interest, being in a committed relationship, conflict with morals or values, or being against one's religion. Among women, those who desired partnered sex much more often and a little more often were 3.89 times (95% CI: 2.98, 5.08) and 2.07 times (95% CI: 1.63, 2.62), respectively, more likely to report higher frequencies of past-year masturbation than those who desired no change in their partnered sex frequency. Among men, those who desired partnered sex much more often and a little more often were 4.40 times (95% CI: 3.41, 5.68) and 2.37 times (95% CI: 1.84, 3.06), respectively, more likely to report higher frequencies of past-year masturbation activity than those who reported that they desired no change in their current partnered sex frequency. Findings provide contemporary U.S. population-level data on patterns of adult masturbation.

Is it time for doctors to Rx vibrators? A systematic review of pelvic floor outcomes

Introduction

Vibrators and similar devices are an underutilized treatment modality in pelvic and sexual medicine, likely because of the limited knowledge on the health benefits of their use.

Objectives

The aim of this study was to review available data regarding the effect of vibrator use on sexual function, pelvic floor function, and chronic unexplained vulvar pain.

Methods

We performed a systematic literature review of PubMed, Embase, and MEDLINE from inception to March 2021 per the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-analyses). The search was based on the following keywords: sex toy woman, pelvic vibrator, sexual stimulation vibrator, vaginal vibrator, vibrator pelvic floor, vibrator incontinence, and vulvar pain vibrator. An overall 586 articles were identified. Studies that met inclusion criteria were reviewed: original research, sample of women, vibrator use, and application to the pelvic/genital area. Exclusion criteria included case reports, unrelated content, vibrator not applied to the pelvic/genital area, male participants, or conditions of interest not addressed. A total of 17 original studies met the criteria and were reviewed in depth.

Results

After review of the literature and identification of articles appropriate for the study, there were 8 studies surrounding sexual function, 8 on pelvic floor function (muscle strength/urinary incontinence), and 1 on vulvar pain. Among the identified studies, vibrators were considered an accepted modality to enhance a woman’s sexual experience, improve pelvic floor muscle function, and facilitate treatment of vulvar pain.

Conclusions

Vibrators are not well studied, and given the promising benefits demonstrated in the articles identified, future research efforts should be directed toward investigating their utility. Considering the potential pelvic health benefits of vibrators, their recommendation to women could be included in our pelvic floor disorder treatment armamentarium.

Living Your Best Life: Lifestyle Medicine for All Women

In an era of ever-increasing healthcare expenditures, yet simultaneously worsening outcomes, many of our patients choose between traditional medical care or often unproven alternative therapies. While the recognition of lifestyle change in addressing cardiovascular and metabolic disease grows, there is less understanding of the impact of lifestyle change on issues facing women every day. Millions of women around the globe struggle with infertility, cancer, sexual dysfunction, and dermatologic needs. Yet, research on the benefits of lifestyle change on these conditions is scarce, and gaps exist both in our understanding of evidence-based approaches to address these issues, as well as adequate provider education when evidence exists. The Women’s Health Member Interest Group convened medical experts in these areas that affect women’s lives to provide insights and meaningful education applicable not only for our patients, but also in our own lives.

Vibration or Transcutaneous Tibial Nerve Stimulation as a Treatment for Sexual Dysfunction in Women with Spinal Cord Injury: Study Protocol for a Randomized Clinical Trial

BACKGROUND

Women with spinal cord injuries usually suffer from sexual dysfunction, such as alterations during arousal and an increase in the time to reach orgasm. However, little evidence has been found on its physiotherapeutic approach, as well as poor adherence to the latter. The aim of this study is to determine the effectiveness of two interventions to improve sexual dysfunction: the application of genital vibration and transcutaneous tibial nerve stimulation.

METHODS

This is a randomized clinical trial that will recruit 54 women who, one year after a spinal cord injury, suffer from sexual dysfunction associated with the latter. The participants will be randomized to three groups: (a) intervention group 1 treated with transcutaneous tibial nerve electrostimulation (n = 18), (b) intervention group 2 treated with genital vibration (n = 18), and (c) a control group (n = 18). The treatment time will be 12 weeks. Adherence to the treatment will be evaluated, as well as the effectiveness of the treatment, through the Female Sexual Function Index, the Sexual Quality of Life-Female questionnaire, quantitative sensory tests, and the improvement reported by the patient in terms of arousal and orgasm. The evaluations will be carried out before the treatment, at the end of the treatment and 3, 6 and 12 months after the end of the treatment.

Clinical use and implications of sexual devices and sexually explicit media

Given that sexual pleasure is a core component of sexual health, devices that are designed to enhance and diversify sexual pleasure are particularly useful in clinical practice. Despite their growing popularity and widespread use in various biopsychosocial circumstances, many taboos still seem to exist, as indicated by the paucity of scientific literature on the prevalence, application and effectiveness of sexual devices for therapeutic use. However, sex toys and sexual devices are commonly used and have a variety of indications to expand individual and partnered sexuality and to treat sexual difficulties. Different devices are associated with specific advantages and potential risks, opportunities, barriers and ethical challenges when used in a clinical context. Increased knowledge about the aim and functional possibilities of sexual devices might help health-care professionals overcome potential embarrassment, preconceptions and other barriers, learn which patients might benefit from which products, consider their use in treatment programmes, educate about correct use and safety issues, and facilitate open communication about sexual pleasure with their patients.

Sexual function after cancer: paying the price of survivorship

Sexual dysfunction is one of the most prevalent and distressing treatment side effects for millions of female cancer survivors, yet the majority of survivors do not receive necessary information, support, or treatment for these sexual consequences. Cancer can devastate the body and impair sexual function and body image. Furthermore, all primary modalities of cancer treatment (surgery, radiotherapy, chemotherapy, and hormonal therapy) have the potential to negatively impact sexual function. Assessment and identification by clinicians can be done efficiently and easily with short validated tools using a style of inquiry which starts by acknowledging how common sexual dysfunction is amongst cancer survivors rather than asking direct questions. Sexual concerns are impacted by psychological, biological, and interpersonal factors, and a multidisciplinary approach to treatment allows clinicians to comfortably inquire, assess, and refer if treatment is beyond their comfort or expertise.