WHAT GETS WOMEN IN THE MOOD?; AFTER DECADES OF STUDIES FOCUSING ON MEN, SEX RESEARCHERS TURN ATTENTION TO WOMEN AND LEARN NEW THINGS ABOUT FEMALE AROUSAL.

Byline: Cecelia Goodnow Seattle Post-Intelligencer

Soft music, candlelight, a relaxing dinner. We know what that leads to.

Well, guess again.

In another setback for conventional wisdom, science has found that this time-honored route to romantic seduction can lead to a dead end.

Instead, jumping on an exercise bike shortly before hitting the sheets is far more likely to increase sexual arousal - at least for women.

``Don't sit and have a candlelight dinner and get relaxed - go do something,'' advises Dr. Eileen Palace, part of a small cadre of researchers working to unravel the surprisingly mysterious process of female sexual arousal.

Researchers are finding that exercise not only pumps up the heart rate and breathing but also primes women to respond to sexual stimulation.

``It somehow prepares you for sexual arousal, so then, when you're put into a sexual scenario, it gives you a jump-start,'' said Dr. Cindy Meston, a psychologist and researcher at the University of Washington's Human Sexual Psychophysiology Laboratory.

That's one of the most intriguing findings to emerge from this budding field, which studies how mind and body affect sexuality.

More than three decades after the sexual revolution, researchers say most treatment programs for sexually dysfunctional women are still based on studies of male arousal - and even those findings are being called into question. Typically, such programs focus on getting couples to relax and get ``in the mood,'' which researchers say may not be the best approach.

``There are many aspects of female sexuality that have never been examined before,'' Meston said. ``It's such an understudied area. Very little is known about it.''

While dozens of researchers have studied male sexual functioning, Meston said only three research centers in the world - in Seattle, Amsterdam and New Orleans - are researching arousal in women.

``Unfortunately, I'm afraid that's true,'' said Palace, founder and director of the Center for Sexual Health that opened recently at Tulane University Medical Center in New Orleans. ``We have a pretty good feel for what's happening with men's sexual dysfunction but not with women's.''

Palace, a psychologist, said the center will offer an unusual, interdisciplinary approach to treatment, education and research on a wide range of sexual issues. The scope of the clinic is reflected in Palace's title: associate professor of psychiatry and neurology, obstetrics and gynecology, urology and surgery.

Steamy science

Meston said the opportunity to do groundbreaking research is one of the attractions of the field.

Her lab consists of two small, adjoining office spaces in the UW outpatient psychiatry clinic. Subjects come in individually and settle back in a recliner while Meston sits next door monitoring equipment that measures their responses to stimuli, including brief erotic film clips.

Despite the common belief that women don't share men's interest in graphic depictions of sex, Meston laughed and said, ``I get very good responses (from my subjects) to erotic stimuli.''

Meston's ultimate goal is to map out the brain message centers that regulate female sexual response. She is completing a study of how early sexual abuse influences the way women process memories and attitudes toward sex.

``We're just really trying to get some insight into why and how early abuse experiences cause such deleterious effects in adulthood,'' she said. ``The hope is it will trigger new treatment methods.''

Meston and Palace, who earned their doctorates at the University of British Columbia in Vancouver, are studying complementary aspects of how mind and body work together to generate sexual arousal.

Their work stems from a new understanding of anxiety's role in sexual response. In 1970, sex researchers Masters and Johnson described anxiety as the greatest known deterrent to sexual arousal, and that has been the prevailing view of experts in the field.

More recently, however, researchers have found that anxiety actually heightens sexual arousal - at least in women, and possibly in men. More precisely, arousal is boosted by the physiological responses that accompany anxiety such as rapid heart rate, sweating, elevated blood pressure and dilated pupils.

Vigorous exercise creates the same kind of nervous-system arousal, according to a series of studies Meston conducted in Vancouver. She found that women who cycled for 20 minutes on an exercise bike at 70 percent of maximum heart rate had a stronger sexual response to a three-minute erotic film clip than women who hadn't exercised.

That result later held true for women diagnosed with low sex drive, although it didn't help women with orgasm problems.

Meston found, however, that exercise by itself wasn't enough to trigger women's arousal. Cyclists who viewed a film clip of Antarctica showed no elevated response to the naked expanse of ice. Only when an erotic stimulus was presented, in the form of an adult film, did arousal soar among women who had just exercised.

Exactly how to measure, or even define, women's sexual arousal is a hotly debated topic. With males, Meston said, ``an erection is an erection.'' But with women, the markers are more ambiguous and complex, and research results may vary depending on what's measured - lubrication, labial temperature or other physiological changes.

Meston, using a method that Dr. Juila Heiman of the UW Reproductive and Sexual Medicine Clinic helped pioneer, outfitted her subjects with a tampon-sized device that measures vaginal blood volume, a slow-building indicator of sexual response; and vaginal pulse amplitude, a quick, moment-to-moment reading that kicks in within 10 seconds of exposure to an erotic stimulus.

The device, called a vaginal photoplethysmograph, works indirectly by emitting light into the vagina and measuring the amount of light that's reflected back. With higher levels of arousal, the vagina becomes more engorged and less light can travel through. Meston also had women complete questionnaires rating their responses on a scale of 1 to 7.

In a study published in the July/August issue of the Journal of Psychosomatic Medicine, Meston cross-checked the effects of exercise by examining how sexual arousal is affected by the blood-pressure medicine clonidine. She assumed, correctly, that clonidine would dampen arousal because, she said, ``it does the opposite of exercise; it suppresses nervous-system arousal.''

In fact, she found the drug reduced sexual responsiveness by more than 50 percent in women who had just exercised, although it didn't affect arousal in the group that did not exercise.

``This is the first study that has ever been done examining the effects of any sort of drug on female physiological sexual arousal,'' said Meston, who carried out the study with Dr. James Wright, head of pharmacology at UBC, and Dr. Boris Gorzalka, a UBC specialist in rat sexuality.

``While drug-induced sexual dysfunction is well-known to occur with anti-hypertensive drugs in men,'' they reported, ``research on the effects of these drugs in women has been largely ignored.''

They said the lack of research is surprising, since hypertension is just as common in women as in men and has been estimated to cause sexual dysfunction in up to 23 percent of female patients.

Out of sight, out of mind 

Palace, who also heads Tulane University's Sexual Psychophysiology Clinic, is exploring how women's thoughts and beliefs affect their sexual responses.

Palace has found that women's inability to see how aroused they are - the way men can tell at a glance if they have an erection - may partly explain why some women report feeling less aroused than the vaginal measurements indicate. Palace said one researcher has found that when men sit with a board over their naked laps, they, too, lose the ability to gauge their arousal.

What's more, Palace said, sexually dysfunctional women tend to have sluggish physical responses in general. If startled, for instance, they show relatively little increase in heart rate.

Biofeedback can actually aggravate the problem because a barrage of discouraging feedback can lower a woman's expectations about her ability to respond sexually. Palace found she could change that equation by deceiving subjects into thinking their physiological responses were high.

``I told the women they were getting more aroused than they actually were,'' she said.

As a result, women not only raised their expectations, they showed higher levels of physiological arousal.

``They changed their actual physical response,'' Palace said. ``They made it happen.''

To avoid having to deceive women, Palace used biofeedback after the women had jump-started their nervous systems with vigorous exercise. When women saw that they really were more aroused, their expectations rose, creating a positive feedback loop.

This combination of mind and body techniques was more successful than either exercise or cognitive therapy alone, Palace said. When the techniques were combined, women reached normal levels of sexual arousal within three minutes.

``You have to have the two together,'' Palace said, adding that the benefits increased over time.

Similar techniques could be used to treat health problems such as cardiovascular disease, depression and anxiety, added Palace, who is editing a textbook called ``Women's Health: A Behavioral Medicine Approach.''

``I think it has broader implications beyond sex,'' she said.

CAPTION(S):

2 Photos

Photo: (1--Cover--Color) Sexercise?

Forget candlelight - vigorous activity may be best form of foreplay for women

(2) Exercise, rather than relaxation, primes women to respond to sexual stimulation, according to research done at the University of Washington's Human Sexual Psychophysiology Laboratory.