Yoga, sexual dysfunction, and female concussions: a mind-body pilot intervention

Abstract

Introduction: Sexual wellbeing is a key part of health and should be included in concussion recovery. While yoga can improve concussion outcomes, its effects on sexual wellbeing in women with post-concussion symptoms are unclear. To evaluate a brain injury–tailored yoga program's impact on sexual function (Aim 1a) and mood correlates—depression, anxiety, PTSD (Aim 1b)—in women aged 18+. We also assessed sustainability (Aim 2) and satisfaction (Aim 3). Methods: Partcipants were recruited from PINK Concussions, a social media support network for female concussion patients with symptoms lasting at least 1 month. Twelve participants were enrolled in a 6-week yoga program, and an additonal 15 were assigned to a wait-list control condition. Participants received a self-report survey 1-week post-yoga intervention (week 7 and week 5 weeks post-intervention (week 11). All participants were yoga novices, defined as practicing yoga once or month or less. Sessions were held over Zoom and led by a certified yoga instructor. The Female Sexual Functioning Index-6 (FSFI-6) was used to assess sexual dysfunction. Participants also completed measures of depression (PHQ-9), anxiety (GAD-7), and PTSD (PCL-5). We used difference in differences estimates to calculate the average 14 treatment effects, and the counterfactual means of the intervention group. We also used Glass' Delta (Δ) to calculate 15 effect sizes. Results: Of the 12 enrolled in the program, 6 completed at least 3 sessions and were sent the follow-up survey. At 1-week post-yoga intervention (Aims 1a and 1b), participants reported substantial improvements in their sexual functioning and mood symptoms. At 1 week post-yoga, participants improved in sexual function and mood. Effect sizes: large for sexual function (Δ = -0.50), medium for anxiety (-0.30), small for PTSD (-0.15) and depression (0.05). At 5 weeks, scores declined slightly but stayed above baseline. Sexual function retained a medium effect size (-0.34). Satisfaction was high (mean: 22 8.7/10). Conclusion: Yoga has the potential to improve women's sexual functioning after concussion and also offers a non-pharmacological alternative for treating mood and other important correlates of women's sexual well-being. Larger randomized trials are needed.