Are you femme presenting? Do you sometimes wish more people would have more of an opinion on how you have sex? How often you have sex? How you should behave when you don’t want to have sex? How often you should want sex? How your body behaves when you do/don’t have sex? Whether your experience of sex is real? What ‘real’ sex is and who ‘real’ sex happens with?

Well, you’re in luck! Because over the last year and a half the British media have been telling us all about a “study” which says if you’re not having “enough” sex, your vagina (if you have one) will get depressed and “atrophy”.

As far as I can tell, this all started a little over a year ago when The Sun wrote this headline:

“SORE POINT Do you have a ‘depressed’ vagina? This could be why sex is SO painful (and it’s nothing to do with an STI)”. The story resurfaced just a few weeks ago when Higher Perspectives said “New Research Says Lack Of Sex Makes Your Vagina Depressed”

The Higher Perspectives article begins “We all know that a healthy sex life keeps our immune system humming, lessens pain and relieves stress. It makes for a happier life. But what happens when we don’t have a sex?”. The article goes on to explain that “research” shows that “Sexual abstinence can make our vagina depressed and this can also lead to vaginal atrophy.”

Do they link to this research? Well, no. And having a look on Pubmed shows no sign of any such research in existence. But they said their claims were “backed in science” it so it must be true, right?

Digging a little deeper, it becomes clear that the media – including The Sun, Maxim, The New York Post and Women’s Health Magazine seem to think a diagnosis of vulvodynia is a synonym for vaginal depression. The Sun even claims that vaginal atrophy is “The horrifying thing that can happen to your vagina if you don’t have enough sex” – again, this begs the question of where they get this claim that a lack of sex can cause vaginal atrophy – and again, this news outlet does not link a reliable source to support the claim.

They do however, mention that Louise Mazanti, a “sex therapist” from London, has just released a book…More on Louise Mazanti later.

Vulvodynia ≠ vaginal depression

The idea that vulvodynia and vaginal depression are equivalent terms, seems to come from an episode of Sex and the City where Charlotte is diagnosed with the condition (the real one, not the media hyperbole one). She remarks that her doctor prescribed her antidepressants and it’s “hilariously” questioned if her vagina is depressed.

Nearly ten years after Sex and the City finished broadcasting, we collectively know so little about vulvodynia that this misnomer seems to have stuck.

And yet vulvodynia is a significant diagnosis that affects a huge proportion of people with vaginas at some point in their lives.

Simply put, vulvodynia is chronic pain (lasting 3 months or more) of the vulvar area. Vulvodynia is a tricky condition to treat, as with many chronic pain conditions, and requires collaboration between doctor and patient to find the right treatment.

One treatment option is a tricyclic antidepressant.

This is where the confusion starts – but antidepressants used in this way are prescribed in far lower doses than required for an antidepressant effect. These drugs are actually used because in low doses they act as pain modifiers. The comparison of vulvodynia to depression is completely inaccurate.

Having “enough” sex?

For some people with vulvodynia, penetrative sex is not possible. Suggesting women have more sex to solve all their medical problems, can actually cause harm far more than it helps. We know that our society tends to view penis in vagina sex as the only “real” sex. The consequences of this are significant – sex between two women is dismissed, oral and digital forms of sex are considered “foreplay” and there is a huge pressure placed onto the idea of “virginity”. And for people with the forms of vulvodynia that make penetration very difficult, this idea can have a damaging effect on their mental health. Across our society “women” are expected to “provide” for their “men” and this includes having sex frequently (but not too frequently). It is easy for people with vulval pain to feel dysfunctional and that can be damaging to their mental wellbeing – not helped when a lack of libido is often termed “female sexual dysfunction” but that’s a rant for another day.

Vaginal atrophy

These latest stories are particularly keen to mention frequency of (penetrative) sex being a preventative for vaginal atrophy (a thinning of the vaginal walls which the NHS website refers to as vaginal dryness). They claim this is founded in science but give no supporting evidence of this. Vaginal atrophy does happen – but it is scientifically understood to be a response to changes in hormone levels, and therefore is most common during and after the menopause. There is very little a person can do to control it and it is not as “horrifying” as The Sun claims – sexual frequency might enhance blood flow to the area to help delay or prevent this but that is not dependent on penis in vagina penetration. Using dilators, dildos, vibrators or manual penetration and stimulation will help just as well.

Louise Mazanti

So, if there’s no obvious “new” study which triggers this year’s media interest in our sexual habits, why else might this be “newsworthy”?

Perhaps it’s all to do with a new book that Louise Mazanti published earlier this year titled “Real Sex: Why Everything you Learned about Sex is Wrong” alongside her husband Mike Lousada.

Mike was an investment banker before his spiritual awakening led him to retrain as a counsellor and “sexologist” while Louise was a Professor in art and design before her own spiritual awakening and retraining in sex therapy. They both see clients in London and give talks and write books together and separately.

Louise is touted as an expert sex therapist in a number of articles discussing vulvodynia. On her webpage about her “expertise” is the claim that “Louise holds a strong energetic field for you to start exploring your own inner truth, and she can guide you into states of expansion that will give you a new direction in life.”. Louise is “trained in energy psychology [and] esoteric wisdom”.

And apparently that’s good enough to be an expert on the medical health of the vagina, or at least that seems to be the opinion of the media who think vaginal depression is a synonym for vulvodynia.

Read more about vulvodynia:

• NHS
• Wikipedia
• Vulval Pain Society

Dr Alice Howarth, PhD

Alice is a cell biologist and cancer researcher who works in the Institute of Translational Medicine at the University of Liverpool. She is the Treasurer of the Merseyside Skeptics Society and co-hosts the popular sceptical podcast Skeptics with a K. In her free time she Instagrams photos of her ridiculous dog, Lupin and watches Buffy the Vampire Slayer ad infinitum. Find her at DrAlice.blog or @AliceEmmaLouise on social media.