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Your Heart and Sex

Updated: Oct 8, 2022

Did you think this post was about romance? If so, sorry to disappoint! It wasn't a figure of speech, but the actual work of your heart and how it relates to sexual function, pleasure, and satisfaction. We all know the basics of the heart’s work: it pumps blood throughout our body. Until not too long ago, I thought our hearts just kept pumping in certain rhythms, going faster if you are aroused and need more energy, like when exercising, which might vary how much it needs to change according to your physical condition and the duration of the activity and going slower when relaxed or resting. For someone who regularly exercises, their heart might not need to accelerate as much when going up three floors using the stairs because they are pretty used to it; but if you are sedentary and suddenly must go up three floors, at the top you’ll feel your heart beating noticeable faster (you may also struggle a bit to catch your breath).

We might also feel changes in our hearts on other occasions, such as when you get startled and feel as if your heart stopped (even for just a microsecond) or ‘dropped’, you might have felt a pain in your chest, followed by a faster beat… If you take a bath or shower with warm water, get a massage or anything else that helps you relax, you might notice your heart is going slower than in normal activity. We are all acquainted with these changes, right?

But our hearts do not always beat at the same rate every time. There is a difference -a very small, but important, difference- in the time between each beat. This is known as Heart Rate Variability (HRV), it is a beat-to-beat change in your heart rate that happens all the time. It indicates the frequency with which your heart accelerates and decelerates in response to stimuli in the environment and other interior systems (such as your breath, hormones, thoughts, emotions, etcetera, that may influence your heart rate). The capacity of our heart to vary the pace of its beats indicates the ability of our autonomic nervous system to adapt to daily changes and challenges in our lives. High Heart Rate Variability is associated with higher levels of energy, better physical and mental health, resilience, and better physical and mental performance; the same is true vice-versa, with low HRV being associated with poor health, low energy, and higher incidence of disease.

We are very complex organisms, living in systems that interact with one another. There is a lot that goes into physiological, and psychological, arousal. For the purpose of this post, I will focus on the cardiovascular system in relation to sexual function and how you can use breath to improve your sexual experience. Our nerves run from our brains through the body, sending signals up and down the spinal cord. Afferent neurons carry information from sensory receptors in the organs (including the skin) to the brain and efferent neurons carry motor information from the Central Nervous System to muscles and glands in the body. When there is a sensory stimulus (such as touch, smell, vision, or something in our imagination), that sensory information is sent to the brain. Once the brain receives that information, it sorts out the ‘meaning’ of it and decides what to do with that. Then, the brain sends signals back to the glands and muscles (which stimulates the production of hormones and the relaxation and contraction of muscles).

Our Autonomous Nervous System has two branches that work together to adapt to physiological and environmental changes by regulating different systems. These are the Sympathetic Nervous System (SNS) and the Parasympathetic Nervous System (PNS). You might have heard of them as opposing forces that either place us in fight or flight (SNS) or rest and digest (PNS). The reality is that these systems are a lot more complex than that and they need to work together for optimal functioning. As we breathe in, our SNS is more dominant and our heart accelerates, as we breathe out, our PNS is more dominant and our heart slows down; this has a great impact on the rest of our body. Ideally, these systems work in a beautiful dance, taking turns in leading the body; sometimes increasing the energy available (SNS), while at others taking the body to rest, digest, and regenerate (PNS). HRV measures the ability of our body to switch between sympathetic and parasympathetic activation.

So, what does it have to do with sex?

There are a lot of factors that play a role in our sexuality, can you think of some? Psychological, physiological, and sociological factors all influence how we experience, perceive and interpret our sexual experiences. Do you remember that time they spoke about cardiovascular health in sexual education class? Yeah, me neither… Chances are, it might have sliped out of your cardiologist or primary care physician mind during your last visits. The heart is often left out of sex education even though it plays a very important role in sexual arousal. A lot of the physical changes we can feel and observe in our bodies when we are physically aroused are brought on by changes in blood flow. Examples of such changes are lubrication, erection (of the penis, clitoris, and/or nipples), increase in temperature, and flushing of the skin.

In a beautiful interplay of hormones and electrochemical signals, the heart gradually increases the volume of blood in each heart stroke, as we start breathing more deeply, also more oxygenated blood throughout the body, which increases sensations. However, when the SNS is activated as a threat response, it will prioritize areas of the body that are needed to fight the threat or run away (and that definitely does not include your penis, vagina, or breasts). Our system needs to have the ability to bring in, you guessed it, the PNS activation. The activation of the PNS allows the walls of the smooth muscle cells in the walls of arteries to relax, causing vasodilation; thus, there is now more blood in the tissues. This change in blood pleasure is what causes engorgement (an erect penis or clitoris, engorged vestibular bulbs in the vagina, etcetera). What a way to keep it sexy, huh?

As you can see, our body needs to be able to switch between each system. Even if we see it from a purely physiological stance (not adding the layers of complexity psychological, social, and interpersonal issues bring to the mix), it is quite a piece of work! All just in a few seconds or minutes and seemingly totally out of our control... Remember heart rate variability can be used as an indicator of our capacity to switch between systems? This is where I tell you how to use this to your advantage!

Taking care of your cardiovascular system is surely critical for your health, longevity, and quality of life. Do consult with your primary care physician for more directions on lifestyle changes you can make to improve your health. Heart Rate Variability training, a type of biofeedback therapy, is one of the ways you can improve your health and sex! Various studies have shown that HRV training methods, such as Autogenic Training and Resonance Frequency Breathing, can increase heart rate variability. Furthermore, it has been shown that it can improve both genital (physiological) and subjective (psychological) arousal.

While it is always good to consult with a trained professional, you can also do HRV training by yourself. You do not necessarily need to buy anything, just by practicing Resonance Frequency Breathing-for example- with a general guideline for a few minutes every day you can improve your HRV (this is one of the many videos available to practice: click here). There are also many measurement equipment in the market, some are more accurate than others, that you can use to measure your HRV, and some offer suggestions that are specifically tailored to you. Some watches can measure it, other sellers might include pulse sensors and apps where you'd see the information and recommendations, and there are some that include virtual reality programs where you'd see visuals as you work through your training.

Thaina Cordero is a Certified Sexologist and Care Coordinator at Cypress Wellness Center. She has an MS in Educational Psychology, is a trauma-informed yoga teacher, and doctoral student of Clinical Sexology at Modern Sex Therapy Institute. She has completed Levels 1 and 2 of Clinical Foundations in Gottman Method Couples Therapy. She helps individuals and couples explore their sexual expression, needs, fantasies, preferences, curiosities, and difficulties as they create more pleasurable, satisfying, and fulfilling sex life and relationships. Click here to request an appointment.


Bouchard KN, Dawson SJ, Shelley AJ, Pukall CF. Concurrent measurement of genital lubrication and blood flow during sexual arousal. Biol Psychol. 2019 Jul;145:159-166. doi: 10.1016/j.biopsycho.2019.05.003. Epub 2019 May 8. PMID: 31075363.

Menston, Cindy (n.d.) Heart Rate Variability and Sexual Arousal. The Sexual Psychophysiology Laboratory. Department of Psychology. The University of Texas at Austin. Web.

Meston CM, Stanton AM. Understanding sexual arousal and subjective-genital arousal desynchrony in women. Nat Rev Urol. 2019 Feb;16(2):107-120. doi: 10.1038/s41585-018-0142-6. PMID: 30664743.

Stanton, A. M., Lorenz, T. A., Pulverman, C. S., & Meston, C. M. (2015). Heart Rate Variability: A Risk Factor for Female Sexual Dysfunction. Applied psychophysiology and biofeedback, 40(3), 229–237.

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