Good Vibrations: The Transition from Sex Toy to Medical Device

NEW ORLEANS — Formal medical studies of vibrators have revealed positive effects on multiple sexual and urinary outcomes in women, a review of published literature showed.

Though limited in number, the studies induced favorable changes in blood flow and muscle tone of genital tissues, improved multiple aspects of sexual arousal and satisfaction, increased orgasmic response, and decreased sexual distress. In women with pelvic floor dysfunction, use of vibrators was associated with decreased urine leakage and urinary symptoms and significantly improved pelvic muscle strength. Other studies showed that vibrators decreased pain and improved sexual enjoyment in women with vulvodynia.

“Medical providers, especially gynecologists, urologists, and FPMRS [female pelvic medicine and reconstructive surgery specialists] need more education on women’s sexual health and vibrators,” said Alexandra Dubinskaya, MD, of Cedars-Sinai Medical Center in Los Angeles, at the American Urological Association annual meeting. “We need to remove the stigma from vibrators and I do believe this soon will be possible as we are now normalizing discussion about women’s sexual health.”

“In our practice, we usually tell our patients to eat healthy, exercise, get enough sleep, and please use your vibrator,” she added.

Vibrators should be viewed as another form of technology that can be applied to benefit patients in clinical practice, said Rachel S. Rubin, MD, of Georgetown University in Washington.

“I believe we use technology to make our lives better in almost every way … and the bedroom should not be absent of technology,” she said. “Sex tech is incredible now, from what it used to be. It’s no longer just the seedy stores with newspaper over the windows, but really high-end wonderful devices for couples for all genders. There are so many health benefits to these devices.”

“I believe that if we get male partners interested in devices in the bedroom, everyone’s sexual health will improve,” she stated. “[Dubinskaya’s] work and the work we’re doing in terms of the science behind it, it takes the shame away and the guilt away. We know that women take longer to orgasm than their male partners, and that’s because the clitoris is all internal. Teaching people basic science and physiology will make sex more fun, more enjoyable, and help everyone have better quality of life [QoL].”

Therapeutic vibratory stimulation has its origin in the historical condition known as female hysteria, associated with excessive emotions and thought to be related to marital relationships, orgasm, and pregnancy, said Dubinskaya. Early practitioners who treated the condition used manual pelvic massage to bring women to orgasm, which was thought to reduce the emotionality.

“Because doctors’ hands were getting tired while providing pelvic massage to women who had female hysteria, they kept looking for methods to free their hands,” she said.

The search took practitioners to hydrotherapy with pelvic douches, a coal-powered flat surface with a rotating sphere in the middle for women to sit on, and finally to the first hand-held electric vibrators, which were also used to treat constipation, arthritis, muscle fatigue, and “pelvic congestion.”

Over the years, the association with potential health benefits became overshadowed by vibrators’ reputation as sex toys, supported by the devices’ use in early pornographic movies, said Dubinskaya. Traditionally associated with female sexual pleasure and having a phallic shape, modern vibrators have a high-tech appearance. Surveys conducted more than a decade ago showed that a majority of women and more than 40% of men reported using vibrators at some point in their lives.

Dubinskaya and colleagues sought to assess the evidence supporting vibrators’ medical benefits in women. They conducted a systematic literature review, focusing on studies related to sexual health, pelvic floor function, and vulvar health. Of 558 abstracts of potential interest, 21 met all the inclusion criteria, consisting of 11 studies of female sexual dysfunction, nine on pelvic floor dysfunction, and one on vulvodynia.

From a science perspective, the studies of sexual dysfunction showed that vibratory stimulation facilitated vasodilation and blood flow, improved tissue perfusion and metabolism, decreased muscle tone, and increased relaxation. Clinically, use of vibrators was associated with significant improvement in the Female Sexual Function Index score (P<0.001), as well as increased arousal, orgasm, and genital sensation.

Patients who used vibrators reported increased sexual desire, satisfaction, and overall sexual function, as well as reduced time to orgasm, achievement of multiple orgasms, and reduced distress.

The studies of pelvic floor dysfunction showed that vibratory stimulation was associated with a significant (P<0.001) reduction in use of hygienic pads among women with stress urinary incontinence and urine leakage, as well as a reduction in urinary symptoms. Pelvic-floor muscle tone improved significantly (P<0.001), QoL improved as assessed by multiple scales, as did patient satisfaction with the treatment.

The single study of vulvodynia focused on vibratory stimulation for relief of pain and associated symptoms. Dubinskaya said that after 4 to 6 weeks of vibrator use, women reported antinociceptive and desensitizing effects, reduced pain, and increased sexual enjoyment. More than 80% of the study participants expressed satisfaction with the treatment, and 90% said they were comfortable with their doctor offering a vibrator as a form of therapy.

Enrollment has begun in a clinical trial to identify which conditions and which characteristics of sexual dysfunction benefit most from use of vibrators. Accrual will continue until the end of the year, and Dubinskaya encouraged patients and clinicians to contact her for more information about the study.