Female sexual well-being: Flo’s latest research

In a survey-based study with over 2,000 of our app users, we found that women who were using our Trying to Conceive Mode and were logging sex more scored higher on a scientific index used to measure female sexual response. Age, body weight, and certain health conditions also played a role. 

We conducted this study in collaboration with Dr. Lubna Pal, a professor of obstetrics, gynecology, and reproductive sciences at Yale School of Medicine, US, and member of Flo’s scientific advisory board. The results are published in the journal npj Women’s Health. 

Read on to find out more about our latest research findings. 

What did we study?

Problems with sexual response are very common and include, for example, difficulties with arousal or experiencing pain during sex. 

Many factors can impact a person’s sexual response. This can include their physical and mental health, behaviors, as well as relationship factors. 

When scientists study female sexual response, they are looking to provide evidence that can inform the development of treatments for people with low sexual response. 

In our study, we wanted to understand if the following three things can impact sexual response:

• Frequency of different sexual activities
• Reproductive health conditions
• Sociodemographic factors like age and weight

For our study, 2,392 of our app users in the United States answered questions about themselves and their sexual response. 

We used a clinically validated measure called the Female Sexual Functioning Index (FSFI-6) to assess sexual response. The FSFI-6 includes questions about:

• Sexual desire
• Arousal
• Lubrication
• Orgasms
• Satisfaction with sex life
• Levels of discomfort or pain 

Higher FSFI-6 scores mean better sexual response. 

Having sex more often means better sexual response scores

We saw that our app users who logged vaginal sex events more frequently than average had higher FSFI-6 scores. The average number of logs for vaginal sex per year in our study was 23. 

The biggest drivers of better sexual response were high levels of logging orgasms, high sex drive, and sensual touch. Oral sex, masturbation, and use of sex toys were also linked with higher FSFI-6 scores. 

“These findings based on real-world data offer novel insights into sexual responses and experiences of reproductive-age females,” Dr. Pal commented. “At this point, it is unclear if the mere act of having sex more often means that someone has a higher level of sexual response or if it’s the other way around — i.e., that people with higher sexual response tend to have sex more often. These findings clearly identify a need for future research,” Dr. Pal added. 

What else impacts sexual response?

The Flo app has several modes that users can select, including Track, Trying to Conceive, Pregnancy, and Perimenopause. Participants using Flo’s Trying to Conceive Mode rather than our Track Mode had higher FSFI-6 scores. 

“We were a little bit surprised about this result. Other studies have shown that when couples are actively trying to conceive, the increased focus on timing sex around ovulation can be very stressful and linked with lower levels of sexual functioning. However, much of this research included women with fertility problems,” commented Liudmila Zhaunova, PhD, director of research at Flo. 

“Since we didn’t ask about fertility in our survey, our participants likely include women with and without fertility issues, which could explain the differences, and it’s possible that our app users in this mode are highly motivated to have sex as they are trying to get pregnant,” she continued. 

When it came to the impact of age on sexual response, the picture was mixed. Our participants who were 35 and older had higher scores for orgasms and reported less pain during sex than their counterparts who were under 35. Additionally, the scores for satisfaction were lower among those 35 and older. Yet, there was no difference in the overall FSFI-6 scores between the groups.   

“A decline in sexual function and deterioration in sexual satisfaction with advancing age is a common perception. Existing studies suggest that a decline in sexual function may be evident in some as early as late 30s,” Dr. Pal said. “The positive associations that we noted in this real-world study of sexually active females who are neither ‘patients’ nor seeking ‘care for a problem’ with being over 35 and aspects of sexual response are therefore highly reassuring. Aging is NOT necessarily all bad after all!” 

Having one of the included reproductive health conditions was linked with lower FSFI-6 scores, which was driven by experiencing more pain during sex. This finding was most pronounced among women with uterine fibroids, whereas there was no link between sexual response and those reporting other conditions, including endometriosis and polycystic ovary syndrome. 

“Thanks to our app users who so generously used their time to complete this survey, we’ve been able to explore female sexual response and some of the factors that can influence it,” Liudmila concluded. “In our study, we saw that over 4 in 10 women get their information about sexual health from mobile apps or the internet. This highlights the potential of apps like Flo in helping women better understand their bodies and providing them with medically accurate health information.”