Heart Rate Variability Biofeedback for Female Sexual Arousal Disorder


Low resting heart rate variability (HRV) has been associated with sexual arousal problems and overall sexual dysfunction in women. Research has indicated that HRV biofeedback leads to increases in HRV as well as improvements in symptoms associated with several psychological disorders, some of which are comorbid with sexual arousal problems in women. Autogenic training also facilitates increases in HRV and was recently associated with acute increases in sexual arousal among sexually healthy women. The primary aim of the current study is to examine the efficacy of HRV biofeedback, with and without autogenic training, for the treatment of female sexual arousal disorder (FSAD).

Full Title of Study: “Autonomic Imbalance and Female Sexual Arousal Disorder: The Identification of Heart Rate Variability Level as a Risk Factor and Treatment Target”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Treatment
    • Masking: Single (Participant)
  • Study Primary Completion Date: January 2018

Detailed Description

Women who meet ICD-10-CM diagnostic criteria for FSAD will be recruited and randomized into one of three conditions, HRV biofeedback (n = 25), HRV biofeedback plus autogenic training (n = 25), or wait-list control (n = 15). All participants will complete a baseline assessment, during which their resting state HRV and vaginal pulse amplitude (VPA) will be measured. The participants in the two biofeedback conditions will receive training in HRV biofeedback from the experimenter, and they will be provided with the materials necessary to guide self-practice in HRV biofeedback at home. Participants in these two conditions will be instructed to engage in at-home HRV biofeedback (with or without autogenic training) at least 5 times over a period of two weeks, during which they will report levels of arousal in a sexual activity diary. Participants in the wait-list control condition will report levels of arousal in a sexual activity diary. After two weeks, participants in all three conditions will return to the laboratory, where their physiological and psychological sexual arousal will be measured. Over the next two weeks, participants in the two biofeedback conditions will be asked to complete 5 more self-guided biofeedback sessions along with the sexual activity diary. Participants in all three conditions will return to the lab for a final assessment to measure post-treatment HRV and VPA levels as well as psychological sexual arousal. To our knowledge, this study will be the first randomized controlled trial of HRV biofeedback in women with sexual arousal problems. If the intervention increases arousal in this population, this study may offer a promising cost-effective psychosocial treatment for women with sexual arousal problems.


  • Behavioral: HRV Biofeedback
    • At-home heart rate variability biofeedback using Elite HRV app and Polar H7 chest strap
  • Behavioral: Autogenic Training
    • Autogenic training recording provided on a CD

Arms, Groups and Cohorts

  • Experimental: HRV Biofeedback
    • At home HRV biofeedback using mobile device
  • Experimental: HRV Biofeedback with Autogenic Training
    • At home HRV biofeedback using mobile device plus autogenic training recording
  • No Intervention: Wait List
    • Wait list control

Clinical Trial Outcome Measures

Primary Measures

  • Physiological sexual arousal assessed by vaginal photoplethysmography
    • Time Frame: One month
  • Subjective sexual arousal assessed by Film Scale (Heiman & Rowland, 1983)
    • Time Frame: One month
  • Sexual function assessed by Female Sexual Function Index (Rosen et al., 2000)
    • Time Frame: Two months

Secondary Measures

  • Depression symptoms assessed by Beck Depression Inventory-II (Beck, Brown, & Steer, 1996)
    • Time Frame: Two months
  • Anxiety symptoms assessed by Beck Anxiety Inventory (Beck et al., 1988)
    • Time Frame: Two months
  • Interoceptive awareness assessed by the Multidimensional Assessment of Interoceptive Awareness (Mehling et al., 2012)
    • Time Frame: Two months

Participating in This Clinical Trial

Inclusion Criteria

  • Premenopausal (18-40 years)
  • Fluent in English
  • Heterosexual or bisexual
  • Score of 26.55 or less on the Female Sexual Function Index (FSFI)
  • Current sexual arousal dysfunction
  • Ownership of an Elite HRV compatible device (recent iPhone, iPad, or Android)

Exclusion Criteria

  • Pregnant or breastfeeding
  • History of or current sexually transmitted infections
  • History of major pelvic surgery
  • History of childhood sexual abuse
  • Currently taking androgens, estrogens, or other medical treatments to enhance sexual arousal
  • Current psychosis
  • If on antidepressants or antihypertensives, must be stabilized for at least 3 months

Gender Eligibility: Female

Minimum Age: 18 Years

Maximum Age: 40 Years

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • University of Texas at Austin
  • Provider of Information About this Clinical Study
    • Sponsor
  • Overall Official(s)
    • Cindy M Meston, Principal Investigator, The University of Texas at Austin

Clinical trials entries are delivered from the US National Institutes of Health and are not reviewed separately by this site. Please see the identifier information above for retrieving further details from the government database.

At TrialBulletin.com, we keep tabs on over 200,000 clinical trials in the US and abroad, using medical data supplied directly by the US National Institutes of Health. Please see the About and Contact page for details.