"Sexy Times Call For Sexy Measure" | CAS Inquire

CAS MarComm Author

03/04/2022 Added

67 Plays

Description

Tierney Lorenz of the Department of Psychology gave the talk for CAS Inquire Feb. 22.

Searchable Transcript

Search:

[00:00:02.240]Good evening, I'm Dr.
[00:00:03.800]Taylor Livingston,
[00:00:04.840]the director of the College of Arts and Sciences Inquire program.
[00:00:08.960]Thank you all for joining us tonight.
[00:00:12.080]We had the cozy comfort of Zoom or joining us in person
[00:00:16.840]and braving the blistering cold outside.
[00:00:21.080]Tonight's installment of the spring semester CAS Inquire
[00:00:24.560]lecture series is based upon the theme Pain and Pleasure.
[00:00:29.000]Although the topic for the series was chosen before the global pandemic,
[00:00:33.400]it's particularly apt given our current cultural moment
[00:00:37.400]and celebrating recently the anniversary of the second year of a global pandemic.
[00:00:44.160]The entire series is structured around these lectures,
[00:00:47.760]allowing students, faculty, staff and the wider public
[00:00:52.160]the opportunity to investigate how we, as individuals and society
[00:00:57.760]understand the concepts of pain and pleasure
[00:01:00.880]and how their perceptions shape and are reflected by human behavior.
[00:01:07.360]Additionally, it creates the opportunity to learn about the fascinating research
[00:01:12.280]the faculty members in the College of Arts and Sciences are conducting
[00:01:16.360]and enable students to see the necessity of multi trans
[00:01:21.160]and interdisciplinary insights to understand human phenomena and actions.
[00:01:27.600]Tonight's lecture by Dr.
[00:01:29.280]Tierney Lorenz, assistant professor of psychology
[00:01:32.280]in the Department of Psychology and also in the Center for Brain
[00:01:37.240]Biology and Behavior, explores the discom, the aspects of pleasure,
[00:01:43.440]sexual arousal and, while perhaps not openly discussed,
[00:01:48.520]is a vital aspect of women's, mental and physical health.
[00:01:53.520]Dr. Lorenz was a postdoctoral fellow at the Kinsey Institute
[00:01:58.120]for Research in Sex, Gender and Reproduction
[00:02:01.560]and here at Nebraska.
[00:02:04.360]She is the director of the Women Immunity and Sexual Health Lab, which investigates
[00:02:09.720]the connection between sexual behavior, women's immune system and hormone levels.
[00:02:16.240]In addition to this research, the lab also helps women with mental
[00:02:20.560]and physical health conditions lead sexually fulfilling lives.
[00:02:25.000]Please join me in welcoming Dr. Lorenz.
[00:02:51.120]OK, they told me that
[00:02:54.360]I still have to use a mic, even though I'm a New Yorker.
[00:02:58.360]OK, well, thank you all for braving the cold to be with us today.
[00:03:02.720]I'm absolutely thrilled to be here to get to close out
[00:03:04.920]what has been a really amazing lecture series on pleasure and pain.
[00:03:10.320]And thank you, Dr.
[00:03:11.080]Livingston, for that lovely introduction.
[00:03:13.920]As you mentioned, I am an assistant professor in the Department of Psychology
[00:03:17.280]and the Center for Brain Biology and Behavior, CB three
[00:03:20.280]and the Women Immunity and Sexual Health Lab,
[00:03:22.880]which has a couple of representatives here in the front row. Thanks for coming!
[00:03:26.880]Is within the clinical psychology and neuroscience and behavior areas.
[00:03:31.120]Today, I'm going to be talking a little bit about some of our recent work
[00:03:34.120]on sexual arousal, desire, pleasure
[00:03:36.920]and how that might influence women's, mental and physical health.
[00:03:41.280]So as a quick heads up, I'm guessing that if you are listening today
[00:03:47.400]that you know that we're going to be talking about sexuality.
[00:03:51.080]But I do want to warn folks that I am going to be using scientifically accurate
[00:03:55.720]but explicit language to describe sexual anatomy and sexual processes.
[00:04:00.760]So if you're listening at home
[00:04:02.000]and you have some little ones
[00:04:03.080]in the background, now's a great time to get those headphones.
[00:04:07.120]I also want to mention that I'm going to be talking
[00:04:09.720]about some of our work with survivors of sexual trauma
[00:04:12.840]and how their minds and bodies respond to sexual stimuli post assault.
[00:04:17.040]I recognize that that can be a really sensitive topic
[00:04:19.280]for some people, so I will give a heads up before we get into those sections.
[00:04:22.720]There will be two of them
[00:04:24.000]and each one is going to take about two, two and a half minutes or so.
[00:04:26.800]So if you want to tap out during the sessions, you will get fair warning.
[00:04:31.200]So let's start with the very broadest question, which is why study sex at all?
[00:04:37.200]Why study sexual pleasure and why specifically are we interested in the fun
[00:04:41.840]bits? I get this question a lot, usually right after the loading screen fail face.
[00:04:49.120]A you study what
[00:04:52.520]because people have a really hard time wrapping their heads around the idea
[00:04:57.080]that a scientist would want to take something
[00:04:59.880]that's so taboo and so personal and quantify and analyze it.
[00:05:04.240]But it's that tension that makes sexual pleasure so interesting to study.
[00:05:08.640]Some of the other talks in this series of really nicely
[00:05:11.200]highlighted the ways in which we think about pleasure and pain
[00:05:15.360]and how that in turn helps us to understand who we are as people
[00:05:20.520]and as a society now as a neuroscientist.
[00:05:23.800]I would argue that sexual pleasure is one of the most important aspects
[00:05:28.320]of pleasure to understand because it shaped the evolution
[00:05:33.040]of our sexual reward systems or of our reward processing systems more broadly.
[00:05:37.680]Sexual pleasure is considered one of the primary rewards, meaning that it's innate.
[00:05:41.880]It's sort of built into how our reward processing centers work.
[00:05:46.800]Primary rewards refer back to those rewards
[00:05:50.280]that we experience when engaging with our most basic needs, right?
[00:05:53.320]So the pleasure that we get from eating or from relief, from physical discomfort.
[00:05:58.480]But sex is really special among the primary rewards because
[00:06:04.240]although reproduction is necessary for the survival of the species,
[00:06:08.640]it's not necessary for the survival of any individual
[00:06:12.080]and in fact can come at really great cost.
[00:06:15.120]And so evolution has favored those individuals
[00:06:19.200]whose sexual motivation and reward processing is sensitive
[00:06:24.040]to the environmental context is sensitive to those times
[00:06:28.480]when resources are good and you can afford to invest
[00:06:32.320]in reproduction and in humans who are an incredibly social animal.
[00:06:38.160]That environment, when we talk about being sensitive
[00:06:41.000]to the environment, that environment includes the social environment.
[00:06:44.800]So understanding sexual pleasure
[00:06:48.680]gives us a really important key to understanding
[00:06:52.040]some of these evolutionary tradeoffs that we make between
[00:06:56.320]investing now in a current reproduction versus delaying later.
[00:07:00.760]And that, in turn, tells us a great deal about the mechanisms
[00:07:05.560]by which our minds, our bodies and our relationships
[00:07:09.960]are responsive to each other and to the environment .
[00:07:13.040]It provides a really excellent model of those broader systems.
[00:07:16.960]So for example, as we're going to see throughout the talk today,
[00:07:20.320]our bodies pay attention to our sexual activity
[00:07:23.440]and our sexual arousal levels in order to regulate the action of our hormones,
[00:07:28.200]of our autonomic nervous system and on of our immune system.
[00:07:33.480]And moreover, the ways that we experience sexual pleasure
[00:07:37.600]have also shaped the evolution
[00:07:39.160]of how we relate to each other in our most intimate relationships.
[00:07:43.440]There's been a lot of really great work that suggests that when it is shared,
[00:07:47.120]sexual pleasure is one of the most
[00:07:49.920]tight bonds that people can experience
[00:07:52.080]one of the strongest binding forces within a relationship.
[00:07:55.360]And evolution knows this and has used this to kind of shape the incredible
[00:07:59.680]diversity of different social systems that we see across the globe, right?
[00:08:05.640]Many different kinds of intimate relationships that vary in their structure
[00:08:10.240]and their form, but always come back to this sort of foundational
[00:08:15.120]framework of shared sexual pleasure.
[00:08:17.280]So if we don't understand how we experience sexual pleasure,
[00:08:21.280]why we experience that, the ways that people use it
[00:08:23.520]in their sexual relationships, then we're really missing out on this kind
[00:08:26.640]of key foundational piece to understanding the diversity of human relationships
[00:08:31.000]and the very nature of intimacy itself.
[00:08:34.480]As a real quick aside, here I do want to be mindful
[00:08:37.800]of the ace and Arrow folks who are listening in.
[00:08:41.080]I realize that it could sound like I'm dismissing people who don't experience
[00:08:45.360]sexual pleasure and don't particularly want to is somehow being unnatural.
[00:08:48.880]And I do recognize that historically there's been a lot of marginalization
[00:08:52.600]from science that has generally either excluded asexual folks or
[00:08:58.760]treated asexuality as some sort of pathology.
[00:09:01.720]But I think that there is incredible value in understanding
[00:09:04.760]your experiences, too, because it's a sexuality.
[00:09:09.040]And although sexuality evolved together and understanding both of these
[00:09:13.680]gives us a much better understanding of the broad range and spectrum
[00:09:17.640]of human sexual experience,
[00:09:20.080]and it helps us to understand these complex ways that sexual pleasure
[00:09:23.320]shapes our minds, bodies and relationships.
[00:09:26.560]So all of this is my pitch to you about why
[00:09:28.760]sexual pleasure is interesting from the perspective of a neuroscientist.
[00:09:31.840]But I'm also a clinical health psychologist, and from that perspective,
[00:09:36.000]I'm really interested in sexual pleasure and the ways in
[00:09:38.760]it's rooted in promoting well-being.
[00:09:41.840]So when we have good models of how the mind, the body and relationships work
[00:09:45.360]together, then we can act on those systems to promote. Well-Being.
[00:09:50.080]And when I talk about this, people are usually quick
[00:09:52.360]to think about reproductive health, and certainly sex
[00:09:56.040]is really important for understanding reproductive health.
[00:09:59.200]So for example, if we're really serious about understanding
[00:10:02.040]sexually transmitted infections,
[00:10:03.800]we have to understand the context in which people get
[00:10:07.200]sexually transmitted infections, which are sexual context, right?
[00:10:10.960]People don't engage in sex in order to expose themselves to risk.
[00:10:14.920]They engage in sex because it's fun.
[00:10:16.800]And so if we don't understand that fun, then we're really missing a key
[00:10:20.280]part of being able to help people to reduce their risks in a meaningful way.
[00:10:26.080]So if we're not serious about sexual pleasure,
[00:10:28.560]we're really not going to get very far when it comes to reproductive health.
[00:10:32.480]But as I just argued, sexual pleasure is really foundational
[00:10:36.480]to understanding how our minds and bodies work.
[00:10:39.720]So a lot of the work from my lab looks at sexual
[00:10:42.840]wellbeing in folks with mental or physical health conditions, as Dr.
[00:10:46.320]Livingston mentioned.
[00:10:47.840]But that's not just because we want to promote health
[00:10:50.600]in these populations, although we certainly do,
[00:10:53.120]but also because we see sex as a health behavior
[00:10:56.480]that can be used to promote well-being and reduce the risk of disease.
[00:11:01.200]So for example, today we're going to be talking
[00:11:03.640]about how sexual activity interacts with inflammation
[00:11:07.360]and how that in turn, could potentially influence people's risk for inflammatory
[00:11:11.880]inflammation related conditions such as depression or heart disease.
[00:11:17.280]And then finally, as a teacher and a mentor to the next generation
[00:11:21.520]of scientists and clinicians, I'm committed to training folks in the bio.
[00:11:25.320]Psychosocial model of health and sexual science is a really great way
[00:11:28.840]to get at this because sex is inherently a biological phenomenon,
[00:11:33.440]a psychological experience and a social context.
[00:11:37.480]So the science of sexuality really helps us to be able to train that mindset
[00:11:41.120]in the next generation, and I'm excited to see some of that next generation here.
[00:11:45.600]So that's my pitch for why we need to study
[00:11:49.320]sexual pleasure in the first place.
[00:11:51.240]But given that importance, how do we go about quantifying
[00:11:55.360]such a nebulous variable?
[00:11:57.880]So generally speaking, psychologists psychological scientists
[00:12:01.320]are interested in people's thoughts, feelings and behaviors.
[00:12:04.960]So this means that in the context of sexuality,
[00:12:07.200]we might be interested in studying people's behavior, such as their patterns
[00:12:10.840]of sexual activity, both partners and solitary.
[00:12:14.760]We might be interested in their sexual feelings, their subjective experiences
[00:12:18.280]of their own desire and pleasure, as well as their positive and negative emotions.
[00:12:23.160]When it comes to cognition, we might be interested in people's patterns
[00:12:26.560]of sexual motivation and interest, but also their attention to sexual cues
[00:12:31.440]or conversely, their distraction or dissociation from those cues,
[00:12:35.520]as well as the way that we think
[00:12:37.240]about our own sexuality that is our sexual self schema.
[00:12:41.280]Now, none of these broad categories are things that are particularly unique
[00:12:45.400]to sexuality scientists.
[00:12:46.640]There's lots of tools that psychologists use to measure schemas or attitudes or
[00:12:51.280]people's health behaviors.
[00:12:53.440]And certainly, we use all of these tools in my lab.
[00:12:55.640]But something that's unique to our lab and to sexual psycho physiology
[00:12:59.440]is also looking at the ways that people's minds influence
[00:13:02.880]what their bodies do during the sexual response and vice versa.
[00:13:06.240]That is what we call sexual arousal and orgasm psycho physiology.
[00:13:11.800]So thinking about what are the different aspects,
[00:13:16.440]what are the ways in which our minds influence what our bodies do during sex?
[00:13:21.080]first and foremost, we have to think about sexual arousal as an emotional response.
[00:13:27.040]So like all emotional responses,
[00:13:30.400]arousal is going to activate certain parts of the autonomic nervous system.
[00:13:35.440]So I'm going to take
[00:13:36.000]a little step back here and do some kind of psych 101 refreshing
[00:13:40.360]in our nervous system, right?
[00:13:42.120]We have different parts of the nervous system.
[00:13:43.720]We have the central nervous system. That's your brain, your spinal cord.
[00:13:46.840]And that's what most people think of when they think of the nervous system.
[00:13:49.360]But there's this whole other branch
[00:13:50.960]called the autonomic nervous system, and this is the part of your nervous system
[00:13:55.240]that helps to kind of coordinate action across different organ systems
[00:14:00.160]and communicate with your central nervous system in response to particular stimuli
[00:14:04.560]that you need to either activate or rest and relax.
[00:14:07.440]So the autonomic nervous system has the parasympathetic nervous system
[00:14:10.840]and the sympathetic nervous system as kind of buddies that operate together
[00:14:15.200]the parasympathetic nervous system. This is your rest and relax system.
[00:14:18.440]This is the system that's predominantly active
[00:14:20.360]most of the time when you're a healthy person, and the sympathetic
[00:14:23.400]nervous system is sometimes called the fight or flight system.
[00:14:27.200]It's a little bit of a misnomer, though, because it would be more accurate to say
[00:14:30.120]it's your activate
[00:14:31.320]and get energized system because with the sympathetic nervous system does is , it
[00:14:35.080]constantly scans the environment for cues that you need
[00:14:38.560]to react to a particular stimulus you need to activate.
[00:14:42.360]And when it notices those cues, it activates
[00:14:44.640]a whole bunch of different systems all across the body in.
[00:14:48.360]Order to be able to mobilize energy resources
[00:14:51.480]and get you ready to do something in response to that stimulus.
[00:14:55.120]So all emotions are going to generate some sympathetic activation.
[00:15:01.080]That's part of what makes
[00:15:03.600]emotional responses feel activating fuel energizing right now.
[00:15:08.960]That's true if you get turned on or if you're happy or you're angry, right
[00:15:12.960]that you're sympathetic, nervous system
[00:15:14.200]is going to kick on a little bit for any kind of emotional response.
[00:15:18.680]What's really interesting and unique about sexual arousal
[00:15:22.360]as an emotional response is the relationship that we have between
[00:15:27.800]this autonomic nervous system activation and the stress response.
[00:15:32.720]So when your sympathetic nervous system kicks in, right when that fight
[00:15:36.440]or flight system kicks in, when it gets to the higher levels
[00:15:39.440]of its activation, it can trigger a broader stress response.
[00:15:44.000]When we think about stress, we often think about the responsiveness
[00:15:46.920]of our hormonal stress responses like cortisol, right?
[00:15:50.680]And so when you feel really, really strong emotional responses,
[00:15:55.200]whether they're happy or not happy, whether they're good or bad,
[00:15:59.520]if they get to very high levels of sympathetic activation
[00:16:02.200]that can generate a stress response, that's part of why it feels so draining
[00:16:06.120]to have really strong emotions, even if those strong emotions are positive.
[00:16:11.560]But this is what's really unique about sexual response
[00:16:16.000]is that when sympathetic activation happens in the context of sexual arousal,
[00:16:21.240]we don't see that stress triggering
[00:16:23.720]right at very high levels of arousal and particularly at orgasm
[00:16:27.760]when we see really high levels of sympathetic activation.
[00:16:31.360]We see a significant drop in cortisol levels.
[00:16:35.000]Now, from a scientific perspective, this is really fascinating
[00:16:38.000]because it says that there's something unique about sexual arousal
[00:16:42.080]that allows the body to decouple this activation
[00:16:46.080]of the autonomic nervous system with a broader stress response.
[00:16:49.720]And if we can just understand that decoupling system,
[00:16:53.880]we might be able to harness that to be able to help
[00:16:57.320]to retrain the stress system in people whose bodies are particularly responsive
[00:17:02.720]to autonomic arousal, such as people with anxiety disorders.
[00:17:06.680]So as one example of this line of research
[00:17:10.320]from my lab, we've looked at sympathetic
[00:17:14.240]activation and various different measures of genital arousal.
[00:17:18.040]And here we're talking about vaginal genital arousal.
[00:17:20.720]So this vigorous from a large meta analysis that we conducted
[00:17:24.400]a meta analysis is when you take data from a bunch of different studies
[00:17:27.880]that study something similar and you put them all together
[00:17:30.040]into one big data set to try to come up with some stronger conclusions.
[00:17:33.720]So in this study, we looked at changes in heart rate variability,
[00:17:36.840]which is a measure of this autonomic balance, right?
[00:17:39.840]So in the kind of more blue side of the screen here,
[00:17:42.840]we're seeing more increasing parasympathetic activation.
[00:17:46.160]That means lower sympathetic activation.
[00:17:48.640]And on the red side of the screen, here
[00:17:50.240]we're seeing increasing sympathetic activation.
[00:17:52.920]This is in response to a sexual fell
[00:17:56.400]on the y axis. We have changes in genital arousal and in this particular case,
[00:18:00.280]we're looking at changes in vaginal blood flow in response to a sexual thing.
[00:18:03.760]I'll get into how we measure that in just a moment.
[00:18:06.440]But as you can see, there's this really interesting curvilinear
[00:18:09.080]response between autonomic arousal and subsequent genital arousal. Right?
[00:18:14.800]What's even more interesting is that when we get to these
[00:18:17.400]really high levels of sympathetic activation, even though
[00:18:21.200]there's maybe lower levels of absolute genital arousal,
[00:18:25.800]we're not seeing that same stress cascade.
[00:18:29.560]So really kind of interesting
[00:18:32.560]decoupling happening here and something that would be very difficult
[00:18:36.520]to look at if we weren't measuring genital arousal directly
[00:18:40.520]. As a heads up, I had mentioned that there were going to be a couple of moments
[00:18:43.600]when I was going to talk about sexual trauma, and this is one of those.
[00:18:46.160]So again, if you need to step out, now's the time to step out.
[00:18:48.680]We'll see you in about two and a half minutes.
[00:18:52.840]So one of the reasons that we're really interested
[00:18:54.840]in this kind of decoupling response is because we're really interested
[00:18:58.520]in the ways that this plays out in sexual trauma survivors.
[00:19:01.920]So in folks who have experienced sexual trauma, a sexual stimulus is
[00:19:08.120]has a kind of a push pull to it
[00:19:10.600]because on the one hand, a sexual stimulus still signals the possibility of reward.
[00:19:15.280]Right. Sex can still be quite pleasurable and fun for folks, even post assault.
[00:19:20.800]But at the same time, that exact same stimulus is now
[00:19:24.400]also being coded as a stressor.
[00:19:27.560]So you have this really interesting simultaneous activation
[00:19:31.160]of the sexual response and the stress response system at the same time.
[00:19:35.160]In parallel, that decoupling sort of breaks
[00:19:38.160]down in the context of sexual trauma survivorship.
[00:19:41.440]And that's also really interesting because it tells us a great deal more
[00:19:45.160]about the potential after effects of sexual trauma and the ways
[00:19:49.280]in which sexual trauma really uniquely activates the stress response system,
[00:19:53.720]even in the face of what would otherwise be a very pleasant, rewarding you.
[00:19:59.280]And so understanding that, too has some really powerful implications for therapy
[00:20:04.880]and for treating sexual trauma survivors
[00:20:07.160]and helping them to be able to experience reward again.
[00:20:10.800]So in a set of studies, we've looked at
[00:20:14.280]sexual trauma survivors and folks who don't have a trauma history.
[00:20:18.080]And what we found is that among women who have a sexual trauma history,
[00:20:22.400]particularly a history of childhood sexual abuse, we see
[00:20:25.840]we tend to see higher sympathetic activation.
[00:20:28.640]And it gets up to that level where we start to see the triggering
[00:20:31.440]of the stress response that we don't see in folks who don't have a trauma history .
[00:20:36.040]In fact, folks without a trauma history,
[00:20:38.040]we tend to see relatively lower sympathetic activation,
[00:20:41.200]but that's actually associated with higher arousal levels simply because it kind of
[00:20:44.800]puts them into this more moderate level of sympathetic activation.
[00:20:48.160]And then in folks
[00:20:48.880]who don't have a trauma history but who say that they have sexual problems,
[00:20:53.600]we actually see really low activation of sympathetic activity.
[00:20:57.640]And this kind of reflects the sort of broader issue
[00:21:00.800]with not feeling activated, not feeling energized, not feeling excited
[00:21:04.960]and engaged during sex.
[00:21:07.080]So it kind of nicely reflects that across the board. OK.
[00:21:10.960]Those of you who tapped out for the sexual trauma piece, welcome back.
[00:21:16.000]So coming back to that broader picture, right?
[00:21:18.000]So going beyond the idea that sexual arousal is an emotional response,
[00:21:23.240]there's 1,000,000 other things that happen to the body during sex that we could
[00:21:28.040]potentially measure and do measure in sexual psycho physiology.
[00:21:31.840]And I will note, not everything on this list
[00:21:33.520]I'm about to present is stuff that we do necessarily in our lab.
[00:21:37.040]But it is definitely things that we collaborate with, with other labs
[00:21:40.200]and is used in the broader field of sexual psycho physiology.
[00:21:43.840]So like I mentioned, we're really interested in autonomic arousal.
[00:21:48.400]At its core, sexual arousal is a
[00:21:51.280]a process of blood flow rate is a shift of blood flow
[00:21:55.160]to the genitals in response to a particular cue
[00:21:58.040]that the brain identifies as sexual or erotic.
[00:22:01.680]And so when we're studying blood flow,
[00:22:03.640]there's all different pieces to this that we can study.
[00:22:05.480]We can look at the direction of blood flow into the genitals,
[00:22:09.680]which we can measure directly using ultrasound or Photoshop.
[00:22:12.920]This mammography, both of which are tools that are going to measure the movement
[00:22:16.080]of blood flow or volume of of blood that pools into a tissue.
[00:22:22.240]So we can look at this
[00:22:23.080]directly, but we can also look at the after effects of that process.
[00:22:26.840]So if you think about the last time that you blushed,
[00:22:30.160]I'm going to call you out here
[00:22:31.120]because you were talking about how every time I talk,
[00:22:33.280]every time I give a talk, you always blush.
[00:22:35.000]So right now in Rick's cheeks, probably there's a little bit of blood
[00:22:39.280]that was circulating close to his core and is now coming up into his cheeks, right?
[00:22:45.680]And it's causing some change in color
[00:22:47.440]and it's causing some change, and he is giving me a thumbs up.
[00:22:50.000]That's what's happening. So, right,
[00:22:52.080]so when we move blood from the central part of the body
[00:22:56.320]into the periphery, it changes the heat and the color of those tissues.
[00:23:00.680]And those two we can measure directly using thermal graphic measurements.
[00:23:06.080]There is, of course, erection, which is probably
[00:23:08.200]what popped into most people's heads when I said measuring sexual arousal.
[00:23:12.240]So we can measure the physical firmness of the tissues.
[00:23:14.800]But more often we're changing.
[00:23:16.120]We're looking at changes in size or the rigidity of the tissue,
[00:23:20.320]and that's measured using this placement so we can put a displacement chamber
[00:23:23.680]over a tissue bed and that chamber will be filled with air.
[00:23:28.360]And as the tissue changes in shape or size
[00:23:31.640]that will push the air out of that chamber,
[00:23:33.640]and we can look at the amount of air
[00:23:34.920]that is being pushed out as a reflection of the degree of the erection,
[00:23:38.760]where similarly there are soft rings that are filled
[00:23:41.520]with liquid that you can place over or around a tissue.
[00:23:44.680]And again, as it becomes as it changes in shape, as it becomes more rigid,
[00:23:48.400]it will push against that soft ring and it will pull some of the liquid.
[00:23:52.280]Out of that ring, and we can measure just the amount of change in liquid
[00:23:56.040]in order to be a reflection of the degree of erection of that tissue.
[00:24:01.800]So in the uterus and vagina, during arousal,
[00:24:05.440]there are some really interesting protective mechanisms that occur
[00:24:09.600]to help protect the cervix and the internal organs from penetration.
[00:24:14.320]And so during arousal, as the body becomes more aroused,
[00:24:17.720]the vagina will actually stretch long and the uterus will kind of retreat up
[00:24:21.520]into the abdomen,
[00:24:22.800]and that both of those responses will increase the pressure
[00:24:25.640]within the vaginal canal.
[00:24:27.240]And so we're able to measure the change in the amount of pressure
[00:24:30.560]within the vaginal canal, either by using force plates
[00:24:34.760]or by looking at things in MRI.
[00:24:36.880]So by doing direct imaging, they're
[00:24:40.080]in a manner similar to how the uterus and vagina
[00:24:43.520]change their shape in order as a protective response for penetration.
[00:24:49.000]Similarly, the scrotum will also change its shape.
[00:24:52.440]And so this is essentially to kind of protect it from harm
[00:24:57.280]if it's being moved about or if it's being pressed up another body.
[00:25:01.320]So we can look at the changes in skin tension or elasticity
[00:25:05.080]as a function of the degree of arousal.
[00:25:10.080]Excuse me, something that we're really interested in in my lab is
[00:25:13.760]the way that arousal changes lubrication, vaginal lubrication in particular.
[00:25:18.400]So there's lubrication that occurs across genital types, not just in vaginas, but
[00:25:24.160]we can look at the amount of lubrication that's actually produced during arousal.
[00:25:29.120]So just the sheer amount of moisture.
[00:25:30.640]But what's even more interesting is that there are some
[00:25:32.480]pretty significant changes in the composition of that lubrication
[00:25:36.360]in terms of its acidity, its protein content, the presence of certain
[00:25:40.040]immune parameters or endocrine factors, hormones.
[00:25:43.880]So, for example, at baseline at rest,
[00:25:47.840]a healthy vagina is going to have a moderately acidic p h.
[00:25:52.400]It is precisely the age of a pinot noir wine.
[00:25:57.240]Good luck with trying to get that packed out of your mind
[00:26:00.040]the next time that you go to a wine bar. You're welcome.
[00:26:03.560]And as the process of arousal unfolds,
[00:26:06.920]that or that lubrication is going to become very slightly more basic.
[00:26:10.960]And so we're able to actually measure the changes in p h by
[00:26:14.000]just handing off a P H testing strip to be able to observe the ways
[00:26:18.880]in which arousal is changing that lubrication dynamic.
[00:26:23.400]So in addition to the changes in muscles and blood
[00:26:25.960]vessels and glands in the genitals,
[00:26:27.560]there's also changes in the nerve beds that generate sexual sensation.
[00:26:31.720]And we can measure this as well.
[00:26:33.440]So there's a really strong increase in sensitivity to fine touch and pressure.
[00:26:39.040]And at the same time, there's a significant decrease
[00:26:41.880]in pain sensitivity that is an increase in pain tolerance.
[00:26:45.760]What's really amazing is that the pain tolerance that we see in these nerve beds
[00:26:52.280]during orgasm is actually
[00:26:54.200]among the highest unmedicated pain tolerances that have been recorded.
[00:26:58.880]Now, from an evolutionary perspective, this makes a ton of sense because we are
[00:27:03.200]subjecting those tissues to extraordinary forces during sexual arousal, right?
[00:27:08.600]They are changing their shape, they're changing their structure,
[00:27:12.000]they're being moved about with great vigor.
[00:27:14.280]And so it would make a lot of sense that we would have evolved and adapted
[00:27:18.320]to have increased pain tolerance in those tissues during this time.
[00:27:22.720]But from a scientific perspective, this is really fascinating
[00:27:25.640]for understanding pain perception itself, right?
[00:27:28.920]Understanding the way that the brain processes pain
[00:27:31.760]and and interacts with other emotional sensations
[00:27:34.800]to be able to either increase or decrease our pain tolerance.
[00:27:38.360]So, for example, there's some really amazing work that's happening
[00:27:41.560]right now looking at people with chronic pain conditions
[00:27:46.160]and using orgasm therapies to retrain how the brain perceives pain
[00:27:51.840]in order to be able to help treat that chronic pain.
[00:27:55.160]I don't want to oversell that work.
[00:27:56.400]It is still definitely it's in its infancy,
[00:27:58.920]but I think it's really fascinating and kind of underscores
[00:28:01.240]the fact that understanding
[00:28:02.560]these processes tells us a great deal about how the brain works
[00:28:07.320]when it comes to orgasm.
[00:28:09.320]one of the things we're interested in is the not just the rhythmic contractions of
[00:28:15.840]that happen during orgasm,
[00:28:17.880]but the specific patterns of those rhythms, right?
[00:28:20.920]So during orgasm, there are contractions that occur within
[00:28:25.120]the genitals that kind of spread out into the pelvic floor.
[00:28:28.040]And there's some evidence that in people who are pregnant
[00:28:32.160]as they get closer and closer to their delivery date,
[00:28:36.760]that the pattern of rhythm that we see in during
[00:28:41.080]orgasm gets closer and closer to that which is coordinated during delivery.
[00:28:45.680]So there's this hypothesis that the body is using orgasm
[00:28:50.400]to train the pelvic floor not only in the extraordinary strength,
[00:28:54.560]but also the specific rhythms that are going to be necessary
[00:28:57.480]for a successful delivery. Really fascinating stuff.
[00:29:01.160]And then finally, there are these specific brain activation patterns
[00:29:05.160]that are associated with our subjective experience of our own sexual response
[00:29:09.920]and perhaps not surprisingly, sexual arousal and orgasm are associated
[00:29:13.800]with a significant decrease in brain activity,
[00:29:17.080]particularly in the higher order areas of the brain.
[00:29:20.920]This is often why I joke that I am a below the neck neuroscientist because if the
[00:29:24.960]brain's doing its job during orgasm, not a lot going on above the neck.
[00:29:31.920]So that was a lot.
[00:29:34.720]But hopefully it gives you an idea of some of the complexity of these measurements
[00:29:37.720]and the wealth of information that we can gather if we actively look
[00:29:41.480]for what happens during the sexual response.
[00:29:47.000]So what does that all get us?
[00:29:48.360]Let's dove into a little bit
[00:29:49.640]of our research on inflammation and women's sexual response.
[00:29:54.560]So a shout out here to my graduate student on a list
[00:29:58.080]who is in this picture showing off her amazing technical skills in the wet lab.
[00:30:01.440]But she's also a very talented graphic designer,
[00:30:03.640]and she designed this figure for one of our recent reviews.
[00:30:06.920]So in the whish lab, we're really interested in the ways
[00:30:09.600]that the immune system and in particular the inflammatory system
[00:30:12.800]interacts with women sexual desire, arousal pleasure.
[00:30:16.320]Inflammation is a really significant contributor to a lot of different
[00:30:20.000]chronic health conditions because it has interactions
[00:30:24.040]with a lot of different systems throughout the body.
[00:30:26.920]So, for example, the inflammatory system has communication
[00:30:30.160]with the endocrine system with hormones, and it regulates and is regulated
[00:30:35.120]by the expression of reproductive hormones and stress hormones.
[00:30:38.160]two things we're really interested in.
[00:30:40.080]It's also responsible for coordinating
[00:30:43.520]certain certain aspects of cardiovascular function, such as and can
[00:30:47.160]contribute to cardiovascular pathologies such as heart disease.
[00:30:51.280]So insofar as we're interested in arousal, right,
[00:30:54.560]we're really interested in blood flow.
[00:30:56.040]And so understanding inflammation is important there, too.
[00:30:59.200]And then there's also direct effects of inflammation on the brain,
[00:31:03.040]on the central nervous system, changing the way that the brain processes reward.
[00:31:07.880]So all of these things not surprisingly contribute to women's
[00:31:11.000]sexual arousal, desire and pleasure, and potentially vice versa.
[00:31:15.760]So I first got interested in this question of the interaction
[00:31:19.080]between sexuality and inflammation
[00:31:21.400]when I saw the results from the biological study about ten years ago.
[00:31:25.040]Now, it seems like yesterday.
[00:31:27.160]So this was a study that was conducted by the National Institutes of Child
[00:31:30.400]Health and Human Development.
[00:31:32.160]And in this study, they followed 259 women over the course
[00:31:36.520]of several menstrual cycles and measured multiple times throughout their menstrual
[00:31:40.600]cycles, a variety of different hormones and immune factors.
[00:31:44.240]And in this particular aspect of the study, they were really interested
[00:31:47.320]in this particular marker of inflammation called C-reactive protein, or CRP.
[00:31:52.280]A CRP is a really useful marker of the aspects of inflammation
[00:31:57.000]that can contribute to vascular pathology,
[00:32:00.080]which in turn can contribute to the risk for heart disease.
[00:32:03.280]So this is actually a test that your doctor can order
[00:32:06.520]to assess your risk for getting heart disease later on. Right?
[00:32:11.240]But the researchers were really interested in understanding
[00:32:14.800]how that measure might change over the course of the menstrual cycle.
[00:32:18.800]So here is being depicted in the dark circles that are filled in.
[00:32:23.960]And as you can see, there is a significant change in CRP
[00:32:27.520]over the course of the menstrual cycle in these healthy women.
[00:32:31.040]So we have the highest levels of CRP or highest levels
[00:32:33.960]of inflammation around menses.
[00:32:36.240]And then the lowest levels around the time of ovulation right around mid-cycle.
[00:32:40.840]What's more, these researchers found that if you took exactly the same woman
[00:32:45.880]and you took her values of CRP at menses,
[00:32:50.000]the same exact woman might be
[00:32:52.760]misdiagnosed as having heart disease if you measured her during menses.
[00:32:57.320]Then if you measured her two weeks later during her ovulation.
[00:33:01.480]So this has really profound implications for understanding
[00:33:04.760]the clinical utility of CRP as a marker of heart disease.
[00:33:08.640]But what intrigued me about this was the rationale that these authors offered
[00:33:12.560]for why there might be changes in CRP over the course of the cycle
[00:33:16.720]in the first place.
[00:33:17.960]So they hinted that it might be part of an evolutionary adaptation
[00:33:22.160]that by reducing the level of inflammation around mid-cycle,
[00:33:26.680]that is around the time of peak fertility that the body might be reducing
[00:33:31.640]the risk of interference of inflammation with the chance of conception.
[00:33:37.040]So this explanation struck me as logical, but a little bit incomplete,
[00:33:42.560]because if the body evolved to shift its immune function
[00:33:46.840]priorities over the course of a menstrual cycle
[00:33:49.880]in order to balance these offs between conception and
[00:33:55.360]defending against disease,
[00:33:57.200]then it would follow that those trade offs would only be relevant
[00:34:00.960]for people who could be reproducing that cycle. Right.
[00:34:04.320]So if a person is sexually active, then their chance of conceiving that cycle
[00:34:10.600]is it's possible they might get pregnant because they have been sexually active.
[00:34:14.800]And so it would make sense that for these people
[00:34:17.120]that you would see this shift in immune function over the course of the cycle.
[00:34:21.200]But in people who are sexually abstinent,
[00:34:23.600]then the chances of getting pregnant that cycle are.
[00:34:27.480]I mean, the pretty low rate, like the Virgin Mary is pretty much
[00:34:29.960]the only instance I can think of in which an absent person got pregnant.
[00:34:34.600]So barring that, it's real, pretty low.
[00:34:37.480]And so it really wouldn't make sense to be engaging with this tradeoff
[00:34:41.280]if somebody is sexually abstinent.
[00:34:44.200]So we first started to look at this hypothesis.
[00:34:47.600]We first tested this hypothesis in a sample of about
[00:34:51.480]30 healthy young college students here in the US.
[00:34:55.360]So women provided saliva samples at four time points throughout their cycle.
[00:34:59.680]So within the first three day of their menstrual cycle,
[00:35:02.720]about a week later during their follicular phase within 36 hours
[00:35:07.200]of their ovulation, which is what we call the Perry ovulatory phase.
[00:35:11.120]And then one week later, during their luteal phase,
[00:35:15.120]women collected their samples, their saliva samples at home,
[00:35:17.840]and they tested for ovulation using urine test strips for luteinizing hormone.
[00:35:21.960]So we were able to accurately pinpoint where within the cycle
[00:35:25.520]they actually ovulating so that we could match their saliva samples up to that.
[00:35:29.920]So about half of the sample was sexually abstinent,
[00:35:32.720]although I will note that this meant that they were not sexually partnered.
[00:35:36.400]This did not necessarily mean that they didn't engage in masturbation, because
[00:35:40.400]if you exclude women who masturbate from a young, healthy college sample
[00:35:45.200]pretty soon, you have no one left to study.
[00:35:47.280]So about half of the other women were sexually partnered, and of them,
[00:35:53.360]about half reported having partnered sexual activity once a week or less.
[00:35:57.640]That's our low frequency group, or twice a week or more.
[00:36:00.360]That's our high frequency group.
[00:36:02.680]These are not value judgments.
[00:36:04.120]These are just the median split of the data.
[00:36:07.560]So as predicted, the abstinent group
[00:36:10.040]showed very little change in inflammation over the course of the cycle.
[00:36:14.040]And similarly, the low
[00:36:15.640]frequency of sexual activity group also showed very little change.
[00:36:19.560]But among our folks who said that they had the most sexual activity,
[00:36:24.520]we saw really significant differences in inflammation over the course of the cycle.
[00:36:28.120]And this fits with our broader theory that this should only really matter
[00:36:31.320]for people who are more likely to potentially conceive.
[00:36:34.440]Right. So we saw much higher levels of inflammation in the in the menstrual phase
[00:36:39.400]and then a considerable decrease around the mid-cycle.
[00:36:43.120]So this is nice initial support for our evolutionary adaptation theory.
[00:36:47.680]But if this truly is an evolutionary adaptation,
[00:36:51.560]we should expect to see similar patterns across cultures and environments.
[00:36:57.640]And so we then sought to replicate these findings in a different population.
[00:37:02.360]And luckily, around this time I was working with an anthropologist colleague
[00:37:07.160]who was doing some research in Bolivia looking at rural Bolivian farmworkers,
[00:37:12.080]and she was really interested
[00:37:12.880]in understanding the dynamics of inflammation in that population
[00:37:15.880]so radically different from our UC College students.
[00:37:19.680]So here's what we found there.
[00:37:22.040]So in the graph that I'm about to show in a moment, the dotted lines reflect
[00:37:27.080]women who were sexually abstinent, were not sexually partnered, and then the
[00:37:30.280]solid lines are going to reflect the women who were sexually partners.
[00:37:34.200]And you can immediately see the extraordinary similarity
[00:37:37.280]to the findings that we had in the US population.
[00:37:40.640]So among the abstinent women,
[00:37:43.200]there's very little change in inflammation over the course of the cycle.
[00:37:47.000]And in the partnered women who are sexually active,
[00:37:50.120]we saw significantly elevated inflammation at the premenstrual menstrual
[00:37:56.360]luteal phase and a significant decrease around the time of population.
[00:37:59.600]So the fact that we saw such
[00:38:01.280]similar results across these two radically different populations of women
[00:38:05.200]really provides some additional support that this is an evolutionary adaptation.
[00:38:10.360]And what these studies suggest is that the body is using information
[00:38:14.320]about one's sexual behavior to direct the activity
[00:38:18.800]of the inflammatory system in really subtle but consistent ways.
[00:38:23.480]And that, in turn, got us thinking about some of the other ways
[00:38:26.640]that sexual activity both regulates and is regulated by the inflammatory system.
[00:38:32.520]So we were interested in understanding how the immune system might moderate
[00:38:35.840]inflammation to regulate reproductive investment, and that
[00:38:41.200]how this in turn could extend to sexual arousal to desire to pleasure.
[00:38:46.000]So in other words, the immune system in the reproductive system are coordinating
[00:38:50.080]their function in order to make sure that if sexual activity leads
[00:38:53.920]to an offspring, that that investment is really well spent,
[00:38:56.960]that conception is going to happen when the body is in this
[00:39:00.080]maximally receptive state a state of low, relatively low inflammation.
[00:39:07.600]Excuse me. So, for example, if a woman is really currently ill
[00:39:12.560]or engaging in a recovery response from an infection or an injury,
[00:39:17.760]and she's in a state of acutely inflamed and acutely inflamed state,
[00:39:22.880]that's not a great time for her to be investing a lot of energy
[00:39:26.400]in reproducing in producing an offspring.
[00:39:29.960]It would be better to delay her reproduction to when times are better,
[00:39:33.600]when resources are better and when her physical body
[00:39:35.520]is in a better condition to do so.
[00:39:37.400]And we certainly see this play out in the form of early
[00:39:40.240]pregnancy loss in folks who are experiencing acute illness.
[00:39:43.680]But as I mentioned at the beginning of the talk, evolution really favors
[00:39:46.840]these kind of subtle behavioral and psychological strategies
[00:39:50.320]because they allow us
[00:39:51.920]to dynamically respond to our environment in a much more flexible way.
[00:39:55.960]And so we started thinking of the ways that exposure to inflammation
[00:40:00.320]might also subtly change women's perceptions
[00:40:03.280]of their own desire and pleasure and their sexual reward.
[00:40:07.400]So in other words, inflammation might decrease a woman's sexual interest
[00:40:12.880]and decrease the amount of reward and pleasure that she experiences
[00:40:16.880]when she does engage in sex, and that if that happens on the balance,
[00:40:22.000]it's going to decrease her sexual frequency and delay her chance
[00:40:25.200]of conception to a time when her body is not in the state of active inflammation.
[00:40:30.440]And this would be a highly adaptive response in our evolutionary past.
[00:40:34.840]So we set out to investigate this new question by taking another
[00:40:38.480]look at the data from the study that I mentioned a moment ago
[00:40:40.680]where we were following women over the course of their cycle.
[00:40:43.400]So over that month, women reported on
[00:40:46.400]they did a daily diary measure
[00:40:48.120]on whether or not they had engaged in any kind of sexual activity that day,
[00:40:51.520]and if so, how aroused they became, how much pleasure they experienced and so on.
[00:40:56.520]And we also measured their CRP levels and kind of looked at how that mapped
[00:41:01.680]onto their self-reported sexual pleasure at different phases throughout the cycle.
[00:41:08.040]So indeed, we did see some significant effects here,
[00:41:11.200]so inflammation was not significantly related to women's self-reported
[00:41:15.480]sexual pleasure, either at menses or in the luteal phase, we didn't expect
[00:41:19.040]that those are not times when there's a very high chance of conception.
[00:41:23.120]It's not zero, but it's very unlikely.
[00:41:26.200]Surprisingly, there was actually a small but significant positive association
[00:41:30.600]between sirup and pleasure during the follicular phase,
[00:41:33.880]which is a little bit of a head scratcher, but might make sense in the context
[00:41:37.040]of the hormonal responses that are happening
[00:41:38.760]during this time as the body ramps up its estrogen
[00:41:42.840]during the follicular phase towards the ovulatory phase.
[00:41:46.640]It can actually have a slightly pro-inflammatory effect
[00:41:50.800]at the same time that other things are also driving sexual desire.
[00:41:55.760]But what was really kind of the kicker here is that we saw this
[00:41:58.320]really significant negative relationship between inflammation and pleasure
[00:42:03.760]during the ovulatory phase that is during the time of peak fertility.
[00:42:07.640]So in other words, if a woman experienced a higher level of inflammation,
[00:42:12.400]she reported much lower sexual pleasure for the sexual activity
[00:42:16.760]that happened during that ambulatory phase. Excuse me.
[00:42:22.800]So this fits this this fits really nicely with our original hypothesis
[00:42:27.360]that at the times when women were at peak fertility,
[00:42:30.080]that the negative effects of information on sexual reward were really amplified.
[00:42:35.080]But this analysis was limited by the fact that it's a really small group of women.
[00:42:39.040]It's only 30 women.
[00:42:40.760]So we thought to replicate these findings in a much larger, more diverse
[00:42:43.840]group of women and to examine a variety of different measures of inflammation
[00:42:47.400]and a variety of different ways of looking at sexual pleasure and desire.
[00:42:51.080]So for this next study, we recruited 91 women to come into the lab, and there
[00:42:55.480]they completed a really comprehensive battery of sexual functioning measures,
[00:43:00.360]as well as a comprehensive battery of measures of their inflammatory response.
[00:43:05.560]So we also measured their vaginal sexual
[00:43:07.600]arousal using about vaginal photocopies mcgruff, which indexes
[00:43:11.480]these really my new changes in blood flow in response to a sexual film.
[00:43:15.520]And they completed samples of saliva and blood and vaginal fluid.
[00:43:19.360]But to stay consistent here, I'm just going to be reporting
[00:43:22.600]on our findings with your so drumroll, please.
[00:43:26.200]We found a whole lot of nothing
[00:43:30.880]like seriously like impressively null results,
[00:43:34.000]and this was true if we looked at different measures of desire.
[00:43:37.720]So here I'm just showing off our results with our clinical index of desire,
[00:43:42.200]which comes from a really well validated clinical screener.
[00:43:45.080]But that was also true if we looked at self-reported desire
[00:43:48.040]to the sexual film or their desire that week.
[00:43:51.720]This was true. If we looked at zero p or we looked at other
[00:43:54.440]measures of inflammation like different kinds of cytokines.
[00:43:58.480]It was like really impressively null.
[00:44:00.600]And then we were talking about this with a group of researchers from Canada
[00:44:04.640]who had done a similar set of studies and we were like, we found all results.
[00:44:08.120]What did you find? And they said, Good question. Let's go look.
[00:44:10.720]And these sliced and diced their data 8 million ways.
[00:44:12.720]And they also found no results.
[00:44:15.280]So at least we were confident in the null myths of these results.
[00:44:21.120]Now, given the fact that this wasn't in lab study,
[00:44:25.480]it would be tremendously difficult
[00:44:27.240]to try to capture people during their ovulatory phase.
[00:44:30.040]It's a really narrow window of time.
[00:44:32.320]And so we were not actually in this study.
[00:44:34.440]We were not looking at people just within that narrow ovulation window.
[00:44:39.160]And so taken together, the results from our first study and the results
[00:44:42.880]from this impressively male study, what it suggests is that if there is an
[00:44:46.840]effect of inflammation on sexual desire, then it's really specific
[00:44:51.840]to the cycle phase, really specific to that ambulatory phase.
[00:44:56.760]But where we did see some significant effects
[00:44:59.400]of inflammation in this healthy sample is in sexual arousal
[00:45:03.880]and in particular with vaginal blood flow in response to sexual arousal.
[00:45:07.880]So our measure of national arousal is derived from the national photo.
[00:45:11.200]Put this in a graph I mentioned a moment ago.
[00:45:13.040]So here's a picture of the photo Put this in a graph.
[00:45:15.240]It's a small, tampon shaped device that participants
[00:45:18.360]insert themselves into their vagina in the privacy of a locked room,
[00:45:22.680]and it measures these really tiny minute changes in vaginal blood flow.
[00:45:26.640]The science writer Mary Roach once called this Cinderella's tampon,
[00:45:30.000]which I will treasure forever.
[00:45:32.960]So here I'm presenting on the
[00:45:34.320]degree of change in the amount of blood flow.
[00:45:38.120]But it's our findings are pretty similar here.
[00:45:40.080]If we look at how quickly the arousal response happened
[00:45:43.240]or how long women spent
[00:45:45.080]in their highest phase of arousal, that is the plateau phase.
[00:45:49.040]So following some of our prior work
[00:45:52.120]showing differences between women who are infrequently versus frequently
[00:45:55.600]sexually active, we looked at this interaction
[00:45:57.400]between degree of sexual activity and the effects of inflammation.
[00:46:02.120]So women who were regularly sexually active two or more times a week
[00:46:06.800]showed a really significant negative association between inflammation levels
[00:46:11.040]and the degree to which
[00:46:12.160]their vaginal blood flow increased in response to the sexual act.
[00:46:15.200]So nicely fitting in with our original theory.
[00:46:18.600]Surprisingly, we saw actually the opposite
[00:46:21.040]response in women who were more infrequently sexually active.
[00:46:24.480]Another head scratcher
[00:46:25.520]We don't have a great explanation for this,
[00:46:27.240]but one possibility is that women who are more infrequently sexually active
[00:46:31.400]have more variable patterns of sexual arousal,
[00:46:34.240]especially when they come into the lab.
[00:46:36.200]And so that may have kind of changed the way that we are able
[00:46:40.000]to detect these effects in the lab.
[00:46:43.120]So everything that I've been talking about up until this point has really kind
[00:46:47.200]of looked at inflammation and immune response across the whole body, right?
[00:46:51.200]Systemic levels.
[00:46:52.640]But we're also really interested in understanding the local effects
[00:46:56.360]within the reproductive tract because the effects of the immune system
[00:47:00.600]can be very different if you're looking in the general circulation
[00:47:04.120]versus if you're looking locally within a particular tissue bed.
[00:47:08.320]So here I'm going to do a
[00:47:11.080]little shout out to my graduate student, Kristen, who's also here in the front row,
[00:47:15.320]who is leading the next few set of studies that I'm going to be talking about here.
[00:47:19.680]So. In the same study that I described a moment ago, we also had
[00:47:22.520]women insert a menstrual cup into their vagina
[00:47:25.840]for ten minutes before and after the sexual film,
[00:47:29.080]and this collected samples of their vaginal and cervical fluid.
[00:47:31.800]So it allows us to be able to look at the composition
[00:47:33.920]of the lubrication that their body produced during sexual arousal.
[00:47:37.720]And not surprisingly, women had a greater expression of lubrication post arousal.
[00:47:43.280]So everything that I present here takes into account the difference
[00:47:46.280]in the total sample volume collected in the concentration
[00:47:49.360]of these findings are of these samples.
[00:47:52.880]So I'll also note here that I have shifted away from talking about inflammation,
[00:47:57.480]and here I'm looking at immunoglobulin
[00:48:00.400]A, which is a very important mucosal
[00:48:04.360]antibody that exists at the boundary points
[00:48:08.960]and is our first line of
[00:48:10.680]defense against diseases that occur within this mucosal environment.
[00:48:14.040]So is our first line of defense against sexually transmitted infections.
[00:48:18.240]We're really interested in kind of understanding the dynamics there.
[00:48:22.520]So we found no difference
[00:48:24.520]in the antibody production in women who had relatively low levels
[00:48:29.480]of vaginal sexual arousal from their pre to post arousal samples.
[00:48:34.400]There was really not a big difference.
[00:48:35.840]There was a slight decrease, but this was not significant.
[00:48:39.080]However, among women who had really high levels of national arousal,
[00:48:43.320]there was a significant increase in the production of these vaginal anti
[00:48:49.000]anti sexually transmitted infection antibodies.
[00:48:52.440]And because these antibodies are so important to the resistance
[00:48:55.360]disease, it's possible that this effect is part of a coordinated response
[00:49:00.320]of the body to use information about sexual arousal
[00:49:05.080]to predict the kinds of infection
[00:49:07.960]that it might encounter in the subsequent minutes,
[00:49:11.640]and to shift immune resources
[00:49:14.520]towards the kinds of immune resources, the kinds of antibodies
[00:49:18.320]that are going to be most important to reduce the possibility
[00:49:22.760]of having a transmitted infection in that context.
[00:49:27.560]So if that's the case, then it's another instance in which our body
[00:49:30.320]is using information about sexual arousal, about sexual pleasure
[00:49:34.560]in order to cue the activity of the immune system.
[00:49:39.040]This is heads up
[00:49:39.760]number two that I'm going to talk about sexual trauma for another moment.
[00:49:42.800]So again, those of you who are tapping out come back in about two minutes.
[00:49:47.640]So we're also really interested in the ways that sexual trauma,
[00:49:50.560]particularly childhood sexual abuse, or KASEI, can influence
[00:49:54.720]how a woman's immune response to sexual arousal might play out.
[00:49:58.800]Sadly, these experiences are incredibly common, and so a fair number of women
[00:50:03.600]in our sample reported having experienced childhood sexual abuse.
[00:50:07.960]So we saw a significantly increased concentration in vaginal IGA
[00:50:13.520]in the post arousal samples among women who did not have trauma histories.
[00:50:17.960]Unfortunately, in the women with the history of childhood sexual
[00:50:21.160]abuse, the level of vaginal antibodies significantly decreased.
[00:50:26.000]Now you're probably thinking as we were.
[00:50:28.240]Well, this is surely related to what
[00:50:29.720]you just showed me in the previous slide, right?
[00:50:31.400]Like this has to do with surely the women who have a history of childhood
[00:50:35.080]sexual abuse have lower levels of arousal and that that in turn,
[00:50:38.760]is explaining this decrease in their rational antibodies.
[00:50:42.600]But in this particular sample, that's actually not the case.
[00:50:45.520]There was no relationship between the history
[00:50:48.880]of childhood sexual assault and the degree of arousal.
[00:50:52.520]Some women had low arousal.
[00:50:53.920]Some women had high arousal in both groups.
[00:50:56.880]But the same kind of arousal, the same level of arousal,
[00:51:00.320]had very different outcomes, depending on the history of sexual trauma.
[00:51:05.080]And this, in turn, might start to explain why we see such
[00:51:08.240]dramatically different rates of sexually transmitted infections
[00:51:11.840]in survivors of childhood sexual abuse, even when we account for differences
[00:51:16.320]in sexual activity patterns and contraceptive barrier use.
[00:51:20.320]And again, a little
[00:51:21.400]shout out to sexuality science here, because I'll note that the pre
[00:51:25.240]arousal levels are pretty similar in women with and without trauma histories.
[00:51:29.920]And so we would not see this difference unless we studied women
[00:51:33.760]in the context of sexual arousal, right?
[00:51:36.560]And given that sexually transmitted infections happen,
[00:51:40.720]that they are transmitted during sex, it would seem really important for us
[00:51:45.400]to understand the dynamics of how the body responds during sex and how that in
[00:51:49.720]turn, might influence our risk for sexually transmitted infections.
[00:51:55.640]So welcome back to those of you who stepped out
[00:52:00.280]kind of transitioning again here.
[00:52:01.800]So our next direction for this line of work is trying
[00:52:06.400]to replicate the effects in a larger, more diverse sample
[00:52:09.560]and really digging into the mechanism of these effects.
[00:52:12.560]So does it change with people have different kinds of partnerships?
[00:52:15.240]Does it work in trans people? Does it?
[00:52:17.520]Do we have the same effect in?
[00:52:18.880]Queer relationships and people with multiple partnerships.
[00:52:21.800]Do we see it in older folks, do we see it in people
[00:52:23.680]using different kinds of contraception?
[00:52:25.200]These are all unanswered questions,
[00:52:26.640]and we're really excited to kind of delve into that.
[00:52:29.520]Another avenue that I'm really excited to follow up is applying these findings
[00:52:33.720]to understanding premenstrual dysphoric mood disorder or key MDT.
[00:52:38.520]So there's increasing evidence that inflammation and in particular
[00:52:42.080]the kind of chronic inflammation that we see in the modern western world
[00:52:46.520]is associated with depression and other mood symptoms
[00:52:51.480]like fatigue and loss of pleasure, which we call anhedonia.
[00:52:55.680]So some folks have suggested that premenstrual dysphoric mood disorder
[00:52:59.760]might reflect an increase in inflammation around the time of menses.
[00:53:05.920]But one of the things that makes this hypothesis really difficult to test
[00:53:10.360]is that there's extraordinary variability in individual relationships
[00:53:15.240]to their own menstrual cycle and individual differences
[00:53:19.720]in how the mood shifts over the course of the menstrual cycle.
[00:53:24.280]So just for example, in one study, we followed women for six months
[00:53:28.600]and we had them give us daily reports of their mood and other
[00:53:31.680]depressive symptoms for a total of 2534 daily reports.
[00:53:37.200]The study was a beast.
[00:53:39.520]And then we measured and modeled each person's
[00:53:42.120]individual level of variability, as well as cycle effects of variability.
[00:53:46.760]And this is a picture of the absolute mess that happens when you do that.
[00:53:51.800]So individual variation is absolutely overshadowing
[00:53:56.000]any of cycle that we can detect in a sample like this.
[00:54:00.280]But given what we now know about how sexual activity may interact
[00:54:05.280]with how inflammation changes over the course of the cycle and how
[00:54:09.080]sexual trauma in turn may further amplify these effects, it's possible
[00:54:13.600]that we may be able to better track mood changes that could lead to MDD
[00:54:18.640]if we account for sexual activity and trauma history.
[00:54:22.120]So we're currently conducting a follow up study that's measuring
[00:54:24.680]changes in cytokines and hormones over the course of the menstrual cycle
[00:54:28.720]in sexually active and abstinent women and women with and without a trauma history.
[00:54:32.240]So stay tuned for more results there.
[00:54:35.120]A great big shout out to the many people who make this work possible.
[00:54:38.880]first and foremost, a huge shout out to my graduate students
[00:54:42.600]without whom this work would simply not be possible.
[00:54:45.480]So right to left here we've got Katie and Alison.
[00:54:48.760]Tom Carper, Jones, Kirsten Clifton and Sophie Sanchez.
[00:54:51.520]Thank you guys so much for your work.
[00:54:53.800]It really would not be possible without you.
[00:54:55.440]Also, big thanks to our funders, without whose generous support.
[00:54:59.200]Again, this work would not be possible.
[00:55:01.920]And also a special little shout out
[00:55:04.200]thanks to the era of Zoom and the Zoom livestream.
[00:55:07.320]My parents are listening from the East Coast,
[00:55:12.040]so mom and dad, big shout out to you.
[00:55:14.680]Thank you for supporting me over the years, even when my crazy
[00:55:18.600]interests led to some pretty awkward dinner conversations.
[00:55:22.920]You've always been my biggest supporters, and I can't tell you how much
[00:55:25.920]that's meant to me over the years.
[00:55:27.840]So thank you all for your attention and I welcome any questions.
[00:55:37.840]Thank you so much to learn so much.
[00:55:40.440]It's wonderful if you have any questions
[00:55:44.040]and you were here in person, you're welcome to step up to the mikes.
[00:55:47.680]If you are via Zoom, you can put them in the chat.
[00:55:51.640]We do have one question. We have Zoom.
[00:55:55.960]There's a question about quantifying.
[00:56:00.360]Active and sexually active, so how active is sexually active?
[00:56:05.400]This is such a great question and I think really gets to the heart of
[00:56:09.680]the need for replication of these findings and really diving
[00:56:12.600]into the mechanisms of the effect because sexual activity
[00:56:17.040]has an enormous range of diversity of expression, right?
[00:56:20.920]And it's very difficult for us to even start to define what is sex like,
[00:56:26.880]what counts of sexual activity because of that immense diversity.
[00:56:31.000]And so one of the things that we really need to be doing
[00:56:33.920]moving forward with
[00:56:34.640]this work is kind of opening up and kind of looking at our right.
[00:56:37.680]Do we see this effect in queer folks?
[00:56:39.960]Do we see this in folks who are
[00:56:43.360]engaging in sex but with different kinds of contraception?
[00:56:47.320]Because that will help us to sort of tease apart
[00:56:49.680]what are the specific pieces of this that really that really matter?
[00:56:53.840]one of the things that we've sort of taken away from this,
[00:56:56.040]not from from the work that we've done, but from some other researchers
[00:56:59.680]who have looked at
[00:57:01.720]women who are in lesbian relationships versus women
[00:57:04.600]who are in hetero relationships versus abstinent women
[00:57:07.880]is that we do see very similar effects
[00:57:10.400]among queer and hetero folks, which suggests the possibility
[00:57:16.080]that it has to do more with some of the partnered aspects of sex
[00:57:20.560]or potentially the sexual arousal aspects of sex than it does
[00:57:24.960]the the pure kind of penetrative components.
[00:57:28.800]That said, queer women also engage in penetrative sex.
[00:57:31.520]That's not necessarily the case, and also
[00:57:33.720]we tend to see some of these effects in arousal to masturbation.
[00:57:37.720]So again, the broad answer to that question is, I don't know, and I'm
[00:57:41.480]excited to find out.
[00:57:53.120]I had a question about when your side that was talking about low grade
[00:57:57.000]chronic inflammation and how that relates to
[00:58:00.760]like lower vaginal arousal women who are sexually active.
[00:58:03.280]What is that inflammation that you're measuring and like?
[00:58:06.880]Like how does that how does that inflammation like present in the body?
[00:58:10.200]Great question. So there's a lot
[00:58:11.480]of different ways that you can measure inflammation.
[00:58:13.200]It's a it's a whole system.
[00:58:15.480]one of the ones that we typically measure is this protein called
[00:58:18.840]C-reactive protein, which is a it's a hepatic protein that is made on demand
[00:58:25.280]in response to a whole lot of different inflammatory systems across the body.
[00:58:29.480]So that is reflected in the general circulation.
[00:58:33.960]And then we can measure that either in the blood or in saliva.
[00:58:36.800]It's just a little bit easier to get in saliva because then
[00:58:38.600]we don't have to take blood from people and that can be a little stressful.
[00:58:42.360]But there's also different ways that we can look at
[00:58:45.520]the way that the immune system actually communicates with itself
[00:58:48.800]using particular signaling molecules called cytokines.
[00:58:51.960]And so one of the things that we're really interested in
[00:58:53.520]is understanding not just the byproducts of the inflammatory system, but
[00:58:58.080]also the signals that it sends to itself and also to other systems.
[00:59:02.960]There's also kind of functional ways that you can look at inflammation
[00:59:06.240]so you can look at things like wound healing
[00:59:09.040]or the ways that the inflammatory system actually changes the tissue.
[00:59:13.120]So things like actually causing
[00:59:15.920]changes in the vascular dynamics that's usually a little bit more of a
[00:59:19.960]kind of fine grained than what we get to in this research, just simply because
[00:59:24.960]we try to be as minimally invasive as possible with our work
[00:59:29.440]because we kind of recognize it's already asking a lot of the people to come
[00:59:32.280]into the lab and share their most intimate parts of themselves with us.
[00:59:36.240]But I think if we were to move forward, kind of that would be the next step
[00:59:39.480]of looking at some of those functional measures,
[00:59:41.280]because that's your question. Awesome.
[00:59:55.160]A great talk, thanks, Kim.
[00:59:57.520]Follow up on that just a little bit, so a lot.
[00:59:59.800]I mean, I guess I'm still trying to process how much the
[01:00:03.240]level of information reflected by the C-reactive protein,
[01:00:06.040]a sort of cause or which running in parallel.
[01:00:09.320]But we take we take lots of anti-inflammatories on a regular basis.
[01:00:15.000]Does that come in here?
[01:00:16.480]Is it does that influence your studies and does that influence
[01:00:20.040]how people feel arousal and when people have taken the toxin
[01:00:23.720]or ibuprofen or something like that that are really over-the-counter,
[01:00:28.000]pretty powerful, any
[01:00:28.720]inflammatory statement for the hundreds of milligram amounts? Yeah.
[01:00:31.960]So when we conduct these studies, we generally exclude people who are taking
[01:00:37.320]anti-inflammatory medications on a regular basis,
[01:00:40.920]and we ask people to avoid using those kinds
[01:00:43.960]of over-the-counter medications on the day that they come in.
[01:00:47.160]Essentially cause we want kind of a blank slate in that reflect.
[01:00:50.560]But I will say that is an active interest of mine
[01:00:54.160]because as I mentioned, some of the things that we're looking at in terms of
[01:00:58.480]understanding the interactions between inflammation
[01:01:01.080]and mood, particularly around this premenstrual dysphoric disorder.
[01:01:04.720]one of the implications of the findings of that study know, assuming that
[01:01:08.280]we find what we think we're going to find is that some of the prophylactic effect
[01:01:13.840]that people experience by taking these NSAIDs
[01:01:18.160]in that premenstrual phase could potentially extend beyond just
[01:01:23.320]regulating pain or regulating cramps, but
[01:01:26.640]potentially could also have an effect on mood as well.
[01:01:30.480]And if that's the case, that would be an immensely powerful tool
[01:01:33.600]for us to have as clinicians. OK, thanks.
[01:01:46.040]During lockdown,
[01:01:49.920]first, Tierney, thank you so much for a very thoughtful,
[01:01:53.800]interesting and inclusive talk, I really appreciated that tons.
[01:01:58.560]I'm going to ask you a question about the data you didn't
[01:02:00.680]talk about in your slide because it was just really interesting.
[01:02:03.720]I started scratching down notes because I was going to forget otherwise.
[01:02:06.920]So when you were showing the slide
[01:02:10.040]of the Bolivian women and the CERP measures,
[01:02:14.600]you replicated your effect, but you had another variable in there.
[01:02:17.280]You didn't talk about which was the poorer or better off.
[01:02:21.560]Yeah. Would you be willing to talk a little bit about that
[01:02:23.840]because you replicated the pattern in both?
[01:02:25.880]But just to remind people or no relationship was higher
[01:02:29.680]in both cases or the better off? Hmm.
[01:02:33.200]Yeah. And I I would love to unpack that further.
[01:02:36.120]So that piece of the project
[01:02:39.680]came out of trying to start to get at some of these mechanisms.
[01:02:44.080]And one of the things
[01:02:46.720]that I have a hunch about
[01:02:50.600]is that part of this effect of the way that sexual activity
[01:02:55.480]is having an effect on inflammation is through the stress system
[01:03:00.440]because of some of the things that we found around
[01:03:02.560]how sexual arousal kind of causes that decoupling with the stress
[01:03:06.280]response system, in particular with cortisol.
[01:03:09.440]So one of the things we were interested in, we had some women in that study
[01:03:14.080]who were really living under extreme
[01:03:18.000]conditions, extreme financial hardship.
[01:03:21.280]They were physically just moving their bodies all day,
[01:03:25.040]going through really difficult arm work, know low resource availability.
[01:03:31.520]And then some of the women lived kind of a little bit closer to town.
[01:03:35.240]They had a little bit more eat.
[01:03:36.600]They just had lighter, less stress overall.
[01:03:39.080]And so we were really interested in understanding the interaction between
[01:03:42.320]chronic stress that comes from socioeconomic status
[01:03:47.400]and its relationship to these kind of broader system of effects.
[01:03:51.800]Because we would expect that if it is really about stress,
[01:03:56.600]then we would see that amplified in the folks
[01:03:59.600]who are experiencing more chronic daily stressors.
[01:04:03.400]But what was kind of interesting is that we did see an ordinal effect
[01:04:08.120]like an intercept shift, but we didn't necessarily see the the interaction
[01:04:11.680]of the shape of the effects, the way that we had anticipated.
[01:04:23.800]I don't see any other questions,
[01:04:26.440]let's call it quickly.
[01:04:32.720]Thank you so much again,
[01:04:33.800]and I hope you all will join us on March 29th, which when
[01:04:37.600]all our speakers come back together and have a panel discussion.
[01:04:42.840]And thank you again to Dr. Lorenz.

The screen size you are trying to search captions on is too small!

You can always jump over to MediaHub and check it out there.

Comments

0 Comments

"Sexy Times Call For Sexy Measure" | CAS Inquire

Description

Searchable Transcript

Comments icon comment

Related Channels

Comments