(023) The Acute Effect of Caffeine on Genital Arousal in Women: A Pilot Study

Abstract

Abstract Introduction Genital sexual arousal, a process characterized by increased vaginal lubrication and vasocongestion in females, is facilitated by moderate activation of the sympathetic nervous system (SNS) (for review, see Stanton, Handy, & Meston, 2018). Among the range of factors that impede the female genital arousal response (e.g., disrupted endocrine functioning and vascular and neurological problems), antidepressants have strikingly deleterious effects on genital arousal function that hinder quality of life (Nappi et al., 2016) and jeopardize medication adherence. When patients present with antidepressant-induced sexual side effects, physicians may switch their antidepressant or tack on an additional medication (e.g., bupropion) to counter them. While sometimes effective, this increases patients’ financial burden and often introduces a host of new side effects. Moderate activation of the SNS through exercise has shown promising results for ameliorating antidepressant-induced genital arousal dysfunction (Lorenz & Meston, 2012; 2014). Given that SNS activation prior to sex counteracts the inhibitory effect of antidepressants on genital blood flow, it is feasible that caffeine – an SNS stimulant (Biaggioni et al., 1991; Zahn et al., 1987) – could improve antidepressant-induced genital arousal difficulties if ingested prior to sex. Caffeine could serve as a low-cost, widely accessible intervention with minimal side effects if efficacy is shown. Objective The goal of the present pilot study is to examine whether the acute administration of 300mg of caffeine increases genital arousal (i.e., vaginal pulse amplitude) in women experiencing antidepressant-induced genital arousal difficulties. Methods Women attended two counterbalanced in-laboratory sessions in which they ingested either 300mg caffeine or placebo. Fifteen minutes post-ingestion, they viewed an erotic film while their heart rate and genital sexual arousal were measured. Caffeine consumption was controlled for. Results Preliminary data analyses suggest that compared to placebo, 300mg of caffeine increases vaginal pulse amplitude fifteen minutes post-ingestion among women experiencing antidepressant-induced genital arousal difficulties. Additional pilot subjects are currently being tested; results will be updated with an addendum upon completion. Conclusions If efficacy is demonstrated in our sample, caffeine may serve as a low-cost, widely accessible treatment for women experiencing antidepressant-induced genital arousal dysfunction. While we aim to target genital arousal concerns with caffeine, improvements in genital arousal are likely to positively impact other stages of women’s sexual response given the high degree of overlap between these stages. Disclosure No