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

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. We aimed to evaluate the feasibility (Aim 1) of a brain injury–tailored yoga program, and its impact on sexual function (Aim 2a) and mood correlates—depression, anxiety, PTSD (Aim 2b)—in women aged 18+. We also assessed sustainability (Aim 3) and acceptability/ participant satisfaction with the intervention (Aim 4). Methods Participants 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 additional 15 were assigned to a wait-list control condition. Participants received a self-report survey 1-week post- yoga intervention (week 7) and 5 weeks post-intervention (week 11). All participants were yoga novices, defined as practicing yoga once a 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 treatment effects, and the counterfactual means of the intervention group. We also used Glass’ Delta ( Δ ) to calculate effect sizes. Results (Aim 1) Fifty-seven eligible women expressed interest in the yoga program. Invitations were sent in two batches to limit sessions to 15 participants. For Group 1 (Yoga group), 27 women were invited; 16 (59%) confirmed interest, and 12 enrolled after exclusions due to scheduling constraints. Attendance varied, with 6/12 (50%) completing ≥3 sessions; 5 of these 6 (83%) completed both week-7 and week-11 follow-up surveys. For Group 2 (wait-list controls), 34 women were invited, including those unable to attend Group 1. 15 (44%) confirmed participation, and 11 (73%) completed both follow-up surveys. Outcomes were compared between the yoga and wait-list control groups. At 1-week post-yoga intervention (Aims 2a and 2b), participants reported substantial improvements in their sexual functioning and mood symptoms. 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 (Aim 3), scores declined slightly but stayed above baseline. Sexual function retained a medium effect size (−0.34). All other domains had small effect sizes. Acceptability was high, with mean satisfaction scores of 8.7/10 (Aim 4). Using open-ended text boxes, participants commented on the intervention’s impact on their mental health, physicality, social connection/isolation/belonging; and provided suggestions for improvement. Conclusion Yoga has the potential to improve women’s sexual functioning after concussion and offers a non-pharmacological alternative for treating mood and other important correlates of women’s sexual well-being. Larger randomized trials are needed.