Most women carry some private question about intimacy at one time or another. It rarely arrives as a crisis. More often it sits in the background for months or years, surfacing late at night or halfway through an ordinary conversation, then slipping away again because there never seems to be a right moment, or a right person, to ask.
“After years in a relationship, why I don't feel like myself?”
“My mind wants intimacy but why my body doesn't seem to respond?”
Sometimes the question has a clinical name. In a national study of Australian women aged 40 to 65, about one in three met the research definition of distressing low sexual desire, a recognised condition called hypoactive sexual desire disorder, or HSDD.¹ Many more women carry concerns that would never meet a diagnosis and weigh on them just as much.
The questions also change shape as life does. What a woman wonders about at twenty-eight is seldom what she wonders about at forty-five or sixty. This article puts some of them into plain words: what the research says about desire and women's health, when a concern becomes something to take to your doctor, what tends to help, and where Tantra bodywork in Newcastle fits into the picture.
How the questions shift from your twenties to your sixties
In her twenties or thirties, it might be a suspicion that she's supposed to want more than she does. Or it might be harder to name: an uncertainty about whether something she has done for years is genuinely enjoyable, or simply what she learned to go along with. Confidence on the outside doesn't settle that kind of question. A woman can be articulate and decisive in almost every part of her life and still realise that nobody, herself included, has ever really asked what she likes.
Pregnancy and the early years of motherhood change things in a different way. When her body has been needed by somebody almost every hour of the day (fed from, carried against, woken in the night), she can long for closeness and still stiffen at being touched. Some mothers call it being 'touched out'. There can be guilt in that, especially if a partner is being patient about it, and very little opportunity to talk about it when everyone assumes she's simply tired.
Through her forties, life often gets louder. Teenagers and ageing parents can be leaning on her at the same time, work asks a great deal, and her own needs drift towards the bottom of a very long list. She might love her partner dearly and find that desire has gone very quiet, without any single reason she can point to. Or perimenopause might bring a dryness and discomfort nobody warned her about, along with a body that responds differently from the one she knew. Because so few women are told to expect this, it's easy to assume she's the only one.
Later there may be menopause itself, a divorce, or the loss of a partner. There may be a body that looks different in the mirror, and the unfamiliar prospect of being seen by someone new after many years with the same person. For some women this stretch of life brings an unexpected sense of freedom. For others it feels as though intimacy quietly left the room some time ago and nobody mentioned it. Either experience deserves to be taken seriously.
And for some women, an old experience means touch has never felt entirely simple. That can be true at any age, and it can sit underneath the other questions for years without ever being named.
None of this happens in a tidy sequence, and many women never pass through some of these stages at all. Not every woman has a partner, has children or is attracted to men. The details vary enormously from one life to the next. What tends to stay the same is how private it all feels.
4 in 10 women, and far less talked about
Around four in ten women experience some kind of challenge in their sexual lives. In the landmark US survey behind that figure, 43 per cent of women reported at least one persistent sexual difficulty lasting several months over the previous year, compared with 31 per cent of men.²˒³ Those challenges take many forms. Some are about desire, arousal or physical comfort. Others sit around them: pressure to perform, strain in a relationship, taboos absorbed early, a family or culture where none of this was ever spoken about, and the long habit of putting up with it in silence.
Australian research shows the same picture at every age. In a study of more than 10,000 Australian women, just over half of those aged 25 to 39 reported distress about their sexual lives.⁴ In the largest study of its kind among Australian women aged 40 to 69, around half had poor sexual wellbeing: one in four had a sexual dysfunction, and another one in four were distressed about their sexual lives without meeting any diagnosis at all.⁵ And after childbirth, a British study found that 83 per cent of new mothers experienced some kind of sexual difficulty in the first three months, yet only 15 per cent of them had raised it with a health professional.⁶
That last figure is the telling one. Plenty of women grew up in families or cultures where intimacy simply wasn't discussed, and even as capable adults they find the words hard to reach, sometimes even with their doctor.⁷ Knowing a concern is common doesn't make it much easier to raise with five minutes left in a GP appointment. So the questions stay private. Women adjust, put up with things, and quietly decide this must be how it is now.
Why intimacy belongs in the conversation about your health
The research suggests intimacy deserves far more attention than that. In the US survey, sexual difficulties were strongly associated with poorer physical and emotional health, more negative experiences in relationships and lower overall wellbeing, which is why the researchers described them as an important public health concern.² Recognising and addressing sexual concerns is part of looking after a woman's health as a whole.
The other side of that picture is just as striking. A satisfying intimate life is associated with better mood and emotional wellbeing, lower stress, better sleep, healthier vaginal tissue, greater relationship satisfaction and more enjoyment of life, along with lower cardiovascular risk and even longer life.⁸ These are associations rather than promises, but they place intimacy firmly in the same conversation as the rest of your health. That is why maintaining it, or redefining it, through midlife and beyond matters so much for lasting wellbeing and happiness. Redefining is the important word. Intimacy at sixty doesn't need to resemble intimacy at thirty to be worth having.
Australian research is encouraging, too. In a national survey of 7,252 women and men, 84 per cent reported emotional satisfaction and 76 per cent physical pleasure in their relationships.⁹ Good physical health has also proved a stronger predictor of sexual wellbeing than age,¹⁰ which is worth remembering whenever someone implies that desire comes with a use-by date.
There's no ideal amount. It's normal for libido to rise and fall across a life, and researchers count many forms of consensual intimate contact, not one particular act. For anyone who has been quietly measuring herself against a standard she never chose, that's worth knowing.
When a concern becomes a condition: understanding HSDD
Most sexual concerns aren't a medical diagnosis, and they don't need to be to matter. Some are, though, and it helps to know the difference. Sexual dysfunction is the clinical term for sexual difficulties that cause personal distress,⁵ and low desire is the most common of them at midlife.¹ HSDD describes a loss of motivation for intimacy because spontaneous desire has faded, desire no longer responds to closeness and touch, or it can't be sustained, lasting at least six months and accompanied by real distress.¹¹ Largest study of its kind explores sexual dysfunction in women at midlife +2
Estimates of how many women it affects vary with how it's measured. International expert panels put it at around one in ten adult women,¹¹ while the Australian study mentioned earlier found about one in three among women aged 40 to 65. The same study found that low desire on its own was far more common, affecting almost seven in ten, and many of those women weren't distressed by it.¹ That distinction matters. Low desire that doesn't bother you isn't a disorder. Low desire that does bother you deserves attention, whether or not it ever meets a diagnosis.
HSDD sits within a wider group of sexual difficulties, usually described as concerns with desire, arousal, orgasm and pain.²˒⁵
Desire. A persistent, distressing lack of sexual desire. It can show up as sexual thoughts and fantasies fading away, desire that doesn't arrive even once intimacy has begun or fades partway through, or motivation for sex quietly disappearing.¹¹ Some women start avoiding physical closeness, or stop dating altogether. HSDD is linked with low mood and other difficult emotional states,¹² and it can travel with a dip in confidence and self-worth, along with a sense of disconnection from her own body or from a partner.
Arousal. The body doesn't respond with the warmth, lubrication and sensation she'd expect, or can't sustain them, even when she wants to be close.
Orgasm. Orgasm is difficult to reach, or has become much harder than it used to be, despite enough stimulation and arousal.
Pain. Pain with intimacy, often from conditions that need gynaecological care, such as vaginal atrophy, vulvar vestibulitis (now more often called provoked vestibulodynia) and vaginismus, where the muscles around the vagina tighten involuntarily.
These areas overlap, and plenty of women recognise something of themselves in more than one. The labels are useful to a doctor planning care. What matters more for everyone else is that each of these is recognised and has causes that can be looked into, and none of them says anything about a woman's worth.
What shapes desire: body, mind, culture and relationship
Desire doesn't live in one place, which is why clinical guidelines now assess it from several angles at once, looking at health, relationships and cultural expectations, and put particular weight on the factors that can be changed.¹²˒¹³ Those factors are usually grouped four ways.
Biological. Physical health, medical conditions and medications all play a part, as does hormonal change. Psychotropic medications, those that act on mood and the brain, have been linked with distressing low desire,¹ and early perimenopause has been found to double the likelihood of desire and arousal difficulties compared with the years before it.⁵
Psychological. Performance anxiety, depression, low self-esteem and a history of abuse can each dampen desire. In the Australian midlife study, poor sexual self-image was the difficulty most likely to come with distress.⁵
Sociocultural. Upbringing, cultural norms and the expectations placed on women, including early messages about whether a woman's pleasure was something to be spoken about at all.¹³
Interpersonal. The quality of current and past relationships, long stretches without intimacy, everyday stressors like money worries, and difficult experiences in past relationships or dating.¹³
Seen this way, low desire is seldom one thing. For one woman it might be mostly hormonal. For another it's the accumulated weight of caring for everyone, an old message about sex and a relationship that has drifted, in proportions nobody would guess from the outside. That's more hopeful than it might sound, because several of those threads can change.
Why desire often arrives second
Women engage in intimacy for all sorts of reasons, and physical urge is only one of them, way down the list. The Basson model of female sexual response describes how, for many women, intimacy is motivated as much by a wish for emotional closeness as by physical desire, and how sexual connection in turn strengthens that closeness.¹⁴ Desire doesn't always come first. It can begin with no particular motivation at all and emerge as arousal builds, provided the circumstances are right: feeling safe, unhurried, connected and at ease in her body.
It can help to think of it in terms of appetite. Spontaneous desire is like feeling hungry before anyone has mentioned dinner. Responsive desire is more like the appetite that turns up once the table is set and the company is good.
The spontaneous, urgent kind commonly fades over a long relationship. Responsive desire works differently. It grows out of emotional intimacy, adapts as both partners' needs change, and in turn deepens the bond it came from, which is why it can keep nurturing a relationship for decades.¹⁴
Satisfaction follows a similar pattern. It rests on much more than any single physical response: on closeness, pleasure and trust, on how she feels about her partner, and on where her mind is at the time.¹⁴ Anxiety, distraction or feeling unattractive can dull an experience that might otherwise have been lovely, while experiences that feel good make her more inclined to return to intimacy next time. Anyone who has caught herself running through tomorrow's to-do list, or worrying about how she looks, in the middle of what was meant to be a close moment will know how quickly the mind can take someone out of her own experience.
For a woman whose desire no longer appears out of nowhere, all of this can come as real relief. Nothing is broken. Her desire may simply be waiting for the right conditions.
Mismatched desire in a loving relationship
Responsive desire also helps explain one of the most common strains in long relationships. A woman can love her partner completely and still find that her desire no longer matches theirs. Mismatched desire is a common concern for couples, and one that can be addressed openly, well before it becomes a wedge.³
Without those conversations, a quiet pattern can settle in. One person stops reaching out so as not to be turned down again, while the other starts avoiding affection in case a hug is read as an invitation. Before long, neither is getting the closeness they both still want.
The conversations get easier the more often you have them. It helps to talk away from the bedroom, when neither of you is rushed, and to say honestly if the subject makes you anxious and you'd like some reassurance. Silence has its own cost: when concerns and the feelings around them go unspoken, a partner can end up shut out, and that distance can slowly wear a relationship down.
There's another reason desire can retreat, and it's rarely named. When a 'no' isn't respected, whether by a partner or by someone she dated in the past, something shifts. Even once or twice can be enough for desire to start pulling back, as if some part of her has learned that closeness might not stay on her terms. Affection can begin to feel like a negotiation, and keeping her distance can feel safer than risking the same thing again. For a woman without a steady partner, it can show up as a reluctance to date at all, with desire fading quietly in the background. This is far more common than most people realise. In a representative study of 9,134 Australian women, about one in five had been forced or frightened into unwanted sexual activity, and any such experience was linked with poorer psychological, physical and sexual health.²⁴ When desire pulls back after something like this, it's a sensible response to a boundary that should have been respected, and nothing about it is a flaw. If it's happening in a current relationship, 1800RESPECT (1800 737 732) offers confidential support, any time of day.
If you're not in a relationship, the rest of this still applies.
Where to start
If any of this feels familiar and it bothers you, your GP is a good first conversation, and there's now a clear framework for having it. International guidelines for HSDD set out the process: the doctor asks about sexual concerns, uses a short screening questionnaire or sexual history, then looks at the biological, psychological and relationship factors that could be changed before considering specific treatment.¹²
Two short tools are worth knowing about. The Decreased Sexual Desire Screener is a five-question tool that helps doctors identify HSDD; in its validation study of 263 women, it agreed with a specialist's diagnostic interview in 85 per cent of cases.¹⁵ The Brief Sexual Symptom Checklist for Women, created by the International Consultation on Sexual Medicine, asks four simple questions: how satisfied you are, what the difficulty is, how much it bothers you, and whether you'd like to talk it over with your doctor.¹⁶ Filling it in beforehand can make an awkward conversation much easier to start.
If you want to take a quick self-test, use the form below as a starting point. It’s not a substitute for a clinical assessment.
Some causes are physical and very treatable. Vaginal dryness is among the factors linked with distressing low desire in midlife, and it can be treated safely and effectively.¹ It also remains common well beyond menopause, yet in a study of Australian women aged 65 to 79, symptoms like it were mostly going untreated.¹⁷ Pain, dryness, irritation or any change that worries you is worth raising with your GP, a menopause specialist or a pelvic health physiotherapist. Where the concerns are more emotional or relational, a psychologist or sex therapist can help, and sex therapy has long been the standard approach for HSDD itself.¹¹
What helps: practical steps the research points to
The research on keeping intimacy healthy through midlife and beyond points to some practical steps, most of them simpler than people expect.³˒⁸
Look after the foundations. Regular activity, a healthy body weight, good eating patterns and quality sleep all support a healthy sex life, as does overall physical and mental wellbeing. Self-esteem and body image belong on this list too. Do some exercise, take some massage, meditate regularly.
Talk about it. Discussing the problem openly, being honest about your levels of interest and saying what you'd like are consistently recommended. Sex therapy and counselling can help individuals and couples develop more positive attitudes towards sexuality, particularly where old messages still carry weight.
Make time for connection and novelty. Time together that has nothing to do with sex, such as a regular date night, keeps the relationship itself in good shape. Novelty helps some couples too: a change of routine or setting, new positions, lingerie, sex toys or adult material, if any of those appeal. Tantra practices belong on this list as well, as a way of slowing down and exploring touch without a goal.
Strengthen the pelvic floor. Pelvic floor exercises, ideally guided by a pelvic health physiotherapist, are also recommended. Tantric breathwork often pairs the breath with awareness of the pelvic floor, which can be a helpful companion to that work.
Where Tantra bodywork fits
This is why intimacy has a place here. Sukh Tantra isn't a sexual service, and arousal or performance is never the aim of any session. But a woman's intimate wellbeing is part of her health, and the conditions the research keeps returning to are exactly what Tantra bodywork is built around: feeling safe, having time, trusting her own signals and being at ease in her body.
The link with desire is closer than it first appears. If desire for many women is responsive, it depends heavily on conditions, and conditions can be cultivated. Of the psychological approaches to HSDD, mindfulness-based therapy is the one with the clearest research support,¹¹ and mindfulness trains the same capacity that sits at the heart of Tantra: present-moment, non-judgemental awareness of what the body is actually feeling. Tantra bodywork works on that capacity through four elements (attention, breath, unhurried touch and stillness), alongside meditation and mindfulness practice.
Attention means noticing what is actually happening in the body, rather than what she thinks ought to be happening. For a woman who has spent years tuned to everybody else's needs, or whose body has changed through pregnancy or menopause, being asked to notice her own signals can feel unfamiliar at first. That unfamiliarity is often where the work begins. Getting to know how her body responds now, rather than how it responded at twenty-five, is part of what gives responsive desire somewhere to start. A 2025 meta-analysis of 29 randomised trials of mindfulness training, eight of which used body-based approaches incorporating elements like massage, found small-to-moderate improvements in this kind of internal body awareness, known as interoception.¹⁸
Breath is often the simplest place to begin slowing down. Deliberately slow breathing increases vagally mediated heart-rate variability, a marker of the body's rest-and-recover system, both during practice and afterwards.¹⁹ When the body isn't braced against the day, sensation has a chance to register. Tantric breathwork also carries attention down into the pelvis, an area that can go years without much attention at all. Meditation and mindfulness practices work on the same system and are easy to continue on your own.
Many body-based practitioners understand the fascia, the connective tissue that wraps every muscle, as one of the places the body holds on to tension from difficult times, and the slow, attentive massage of Tantra bodywork works through those layers so that what has been carried can be felt and allowed to ease. The research supports part of that picture: in the meta-analysis mentioned earlier, which included massage-based approaches, better body awareness went hand in hand with less psychological distress.¹⁸
Unhurried touch takes away the sense of heading somewhere. When touch isn't building towards anything and nothing is expected in return, it becomes easier to receive it without bracing for what comes next. For a mother who feels touched out, it can be the first touch in a long while that asks nothing of her. For a woman whose body looks different from how it once did, touch that attends to sensation rather than appearance can change how she relates to it. And for a woman returning to intimacy after a long gap or a divorce, it offers a chance to practise receiving well before a new relationship asks it of her.
Stillness is easy to overlook. The pauses give the body time to register what it has felt, and give her a moment to notice whether she'd like more of something, less of it, or nothing at all. In Tantra, stillness is the door where healing can enter.
Research on mindfulness and body awareness, which share Tantra's emphasis on attention and breath, has linked them with improvements in women's desire, arousal and satisfaction, including in women who had sought help for low desire.²⁰˒²¹˒²²
Nothing is assumed because the word Tantra is involved. The pace is hers, she can pause or stop at any point without explaining why, and there is no response she is expected to have.
When the past is part of it
For some women, low desire or unease with touch is tied to difficult experiences, sometimes recent, sometimes decades old. Tantra, like many body-based traditions, works from the understanding that the body carries the imprint of what we've lived through as well as the mind. In practice, emotion can surface during bodywork, occasionally connected to memories a woman hasn't thought about in years.
Tantra meets that with patience rather than pushing past it: slowing down, returning to the breath, and leaving every decision about what happens next with her. Being able to feel something difficult while staying in charge of the experience can be part of how touch starts to feel safer, and how some of what has been carried for a long time is finally released.
Research points in a similar direction. In a small pilot study of women with sexual distress and a history of childhood sexual abuse, both a brief mindfulness-based program and a cognitive behavioural one reduced sexual distress, and the mindfulness group also showed a closer match between what their bodies were doing and what they felt.²³ Where the past weighs heavily, working with a psychologist who specialises in trauma alongside bodywork gives a woman support from both directions.
Starting with a conversation
Whatever stage of life you're at, and whatever brought you to this page, you don't have to keep carrying these questions on your own. Sometimes it helps simply to ask them out loud, to someone who will answer plainly. If something here feels familiar, a discreet Discovery Call is an easy place to begin, with no expectation that it leads anywhere in particular.
Intimacy desire checklist
We don't ask for your name or any other personal details, so feel free to use it as often as you like. Nothing you enter here is stored on this site; submit button leads nowhere, so no need to click on it.
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This checklist is for self-reflection only. It isn't a clinical assessment or a diagnosis. Once you've worked through it, you can decide for yourself whether it would help to speak with your GP, a psychologist or another health professional.
If you feel Tantra bodywork could help you, you're welcome to book a discreet Discovery Call here.
If you're feeling distressed, Lifeline is available 24 hours a day on 13 11 14. If you're experiencing sexual, domestic or family violence, or feel unsafe in a relationship, call 1800RESPECT on 1800 737 732. In an emergency, call 000.
A note on this series: Tantra is broader than sexuality, though it touches many parts of intimate life, which is why topics like this one appear here. Most of what's discussed applies to people of any gender; women are named because they are who Sukh Tantra works with, not to single them out.
Tantra bodywork is a complementary practice and not a substitute for medical, psychological or gynaecological care. If you're experiencing any of the concerns described here, please speak with your GP or a psychologist.
Research notes
Notes 18–23 support individual components that overlap with contemporary Tantra, such as mindfulness, body awareness and slow breathing, rather than Tantra as a complete clinical intervention. The remaining notes relate to intimate wellbeing and sexual health generally.
Worsley R, Bell RJ, Gartoulla P, Davis SR. Journal of Sexual Medicine, 2017;14(5):675–686. In a nationally representative sample of 2,020 Australian women aged 40–65, 69.3% had low desire, 40.5% sexually related personal distress and 32.2% HSDD, including women without a partner; associated factors included psychotropic medication use and vaginal dryness, which are modifiable or treatable.
Laumann EO, Paik A, Rosen RC. JAMA, 1999;281(6):537–544. In a national sample of 1,749 US women and 1,410 men aged 18–59, 43% of women and 31% of men reported sexual dysfunction, which was associated with poorer physical and emotional health, negative experiences in sexual relationships and lower overall wellbeing.
McCarthy, Journal of Contemporary Psychotherapy, 2008;38:139–149. Around 43% of women experience sexual dysfunction; mismatched desire is a common concern for couples and can be addressed proactively through communication, counselling and lifestyle.
Zheng J, Islam RM, Bell RJ, et al. Journal of Sexual Medicine, 2020;17(10):1885–1895. In 10,554 Australian women aged 18–79, just over half of those aged 25–39 reported sexually related personal distress; low desire with associated distress was most prevalent at midlife.
Wang Y, Islam RM, Bond M, Skiba MA, Davis SR. The Lancet Obstetrics, Gynaecology & Women's Health, 2025;1(3):e198–e208. Among 5,468 Australian women aged 40–69, around half had poor sexual wellbeing: one in four had a sexual dysfunction and one in four sexually related distress without an identified dysfunction. Early perimenopause doubled the likelihood of desire and arousal dysfunction, and poor sexual self-image carried the greatest likelihood of distress.
Barrett G, et al. BJOG, 2000;107(2):186–195. Among 484 women, 83% experienced sexual problems in the first three months after childbirth (64% at six months), and only 15% had discussed them with a health professional.
Rutte, BMC Family Practice, 2015;16:69. Sexual concerns often go undiscussed, including in primary care.
Liss, Journal of Sexual Medicine, 2023;20:921–924. Smith, Sexual Behaviour and Health in Older Adults, Springer, 2023. Lusti-Narasimhan, Bulletin of the World Health Organization, 2013;91:707–709. A satisfying intimate life is associated with improved mood, emotional wellbeing, sleep, vaginal health, relationship satisfaction and enjoyment of life, lower cardiovascular risk and greater longevity; Smith also outlines practical steps for maintaining sexual health, from lifestyle and communication to lubricants, novelty and pelvic floor exercises.
Badcock, Sexual Health, 2014;11:427–438. A survey of 7,252 Australian women and men reported 84% emotional satisfaction and 76% physical pleasure in their relationships.
Lindau, New England Journal of Medicine, 2007;357(8):762–774. Hess, Journal of Sexual Medicine, 2009;6:1358–1368. Good physical health is a stronger predictor of sexual frequency and function than age.
Goldstein I, Kim NN, Clayton AH, et al. Mayo Clinic Proceedings, 2017. ISSWSH expert consensus review: HSDD affects approximately 10% of adult women; symptoms include loss of motivation due to decreased spontaneous or responsive desire, or inability to maintain desire, for at least six months with distress; sex therapy has been the standard treatment, with mindfulness-based cognitive behavioural therapy the approach with efficacy evidence.
Clayton AH, Goldstein I, Kim NN, et al. Mayo Clinic Proceedings, 2018;93(4):467–487. The ISSWSH Process of Care for HSDD begins with the clinician asking about sexual concerns, uses the Decreased Sexual Desire Screener or a sexual history, and emphasises biopsychosocial assessment and modification of changeable factors; HSDD is associated with negative emotional and psychological states, including depression.
Hatzichristou D, Kirana P-S, Banner L, et al. Journal of Sexual Medicine, 2016;13(8):1166–1182. Evaluation of sexual concerns should cover overall health and comorbidities, partner relationship and interpersonal factors, and cultural and personal expectations and attitudes.
Basson, Journal of Sex & Marital Therapy, 2001;27:33–43. Women's desire is often responsive, arising from emotional intimacy and receptivity rather than preceding it, and can emerge during arousal; satisfaction is shaped by closeness, trust and state of mind, and responsive desire strengthens emotional bonds as spontaneous desire declines in long-term relationships.
Clayton AH, Goldfischer ER, Goldstein I, et al. Journal of Sexual Medicine, 2009;6(3):730–738. The five-item Decreased Sexual Desire Screener agreed with an expert diagnostic interview in 85.2% of 263 women.
Hatzichristou D, Rosen RC, Derogatis LR, et al. Journal of Sexual Medicine, 2010;7(1 Pt 2):337–348. The International Consultation on Sexual Medicine endorsed the Brief Sexual Symptom Checklist for Women for screening.
Zeleke BM, Bell RJ, Billah B, Davis SR. Fertility and Sterility, 2016;105(1):149–155. Among 1,548 Australian women aged 65–79, 32.5% of partnered women reported vaginal dryness in the past month; such symptoms were predominantly untreated.
Treves IN, et al. Scientific Reports, 2025;15:38889. A meta-analysis of 29 randomised trials involving 2,191 participants, including body-based approaches that incorporated massage, found small-to-moderate improvements in self-reported interoceptive awareness.
Laborde S, et al. Neuroscience and Biobehavioral Reviews, 2022;138:104711. A systematic review and meta-analysis of voluntary slow breathing found increases in vagally mediated heart-rate variability during and following slow-breathing practice.
Seal BN, Meston CM. Sexual Medicine Reviews, 2020;8(2):242–255. A review of 29 studies found body awareness, particularly through mindfulness and sensate-focus approaches, to be relevant to female sexual response and wellbeing, including in women with low arousal and hypoactive desire, while noting limitations in determining which components produced the effects.
Brotto LA, Basson R. Behaviour Research and Therapy, 2014;57:43–54. In women seeking help for low sexual desire and arousal, a mindfulness-based intervention improved reported desire, arousal, lubrication, satisfaction and overall sexual functioning.
Brotto LA, et al. Journal of Consulting and Clinical Psychology, 2021;89(7):626–639. Randomised research found mindfulness-based cognitive therapy and structured sex education and support beneficial for women experiencing sexual interest and arousal difficulties.
Brotto LA, Seal BN, Rellini A. Journal of Sex & Marital Therapy, 2012;38(1):1–27. In a pilot study of 20 partnered women with sexual distress and a history of childhood sexual abuse, both brief mindfulness-based and cognitive behavioural group treatments reduced sexual distress; the mindfulness group showed greater concordance between subjective and physical arousal.
de Visser RO, Rissel CE, Richters J, Smith AMA. Archives of Sexual Behavior, 2007;36:676–686. In a representative sample of 9,134 Australian women aged 16–59, 21% had been sexually coerced, defined as being forced or frightened into unwanted sexual activity; any experience of sexual coercion was associated with poorer psychological, physical and sexual health.
