Autonomic imbalance and female sexual arousal disorder : the identification of heart rate variability level as a marker and treatment target

Heart rate variability (HRV) is widely considered to be a noninvasive marker of autonomic nervous system (ANS) function. Defined as the degree of variability in the interval lengths between consecutive heartbeats, HRV reflects the relative balance of the two branches of the ANS, the sympathetic nervous system (SNS) and the parasympathetic nervous system (PNS). Impaired autonomic function, indexed by HRV, has been associated with a number of pathophysiological conditions, including diabetes (Liao et al., 1995), atherosclerosis (Hayano et al., 1991), and hypertension (Chakko, Kessler, & Myerburg, 1993) as well as with a general risk of negative cardiac events (Yoo, Lee, Yi, Kim, & Kim, 2011). More recently, low resting HRV has also been associated with mental health conditions that are likely related to an imbalance in autonomic activity, including depression (Kemp et al., 2010), anxiety (Kemp, Quintana, Felmingham, Matthews, & Jelinek, 2012), and alcohol dependence (Quintana, Guastella, McGregor, Hickie, & Kemp, 2013). A large body of evidence indicates that autonomic balance plays a significant role in female sexual function. Moderate SNS dominance (relative to PNS activity) has been shown to facilitate women’s genital arousal in the laboratory (Lorenz, Harte, Hamilton, & Meston, 2012; Meston & Gorzalka, 1995, 1996a, 1996b). Based both on this established relationship between the SNS and female sexual function as well as a growing clinical literature indicating that impaired HRV is associated with negative health outcomes, my dissertation studies will investigate the relationship between HRV and female sexual arousal dysfunction. This line of research will help evaluate HRV as a marker of sexual arousal problems, advance our understanding of the mechanisms underlying the association between HRV and sexual arousal, and explore novel treatment strategies that focus specifically on HRV manipulation.