The ethics of studying sex

With innovation comes risk — and nobody knows this better than Stuart McGill, a professor of kinesiology at the University of Waterloo.  The leading spine biomechanics expert is overseeing the world’s first study on back pain during sex, a topic he says, could not be researched at just any university.

“Sex is still a universal taboo. Very few universities have the right academic climate for a study like this. But at Waterloo we pride ourselves on innovation, and we don’t shy away from topics if they can help improve people’s health and well-being," says McGill.

The pioneering study received ethical clearance from the University’s Office of Research Ethics and followed strict privacy regulations. Participants were recruited only by a verbal invitation from McGill or PhD candidate Natalie Sidorkewicz, who was lead investigator on the project. Eligibility for participation was limited to couples who had been in a monogamous relationship for a minimum of one year, and had no affiliation with the University.

Recruitment challenge

“As you can imagine, participant recruitment was challenging. The sensitivities around a study like this are substantial, and our first priority was that all parties willing to participate in this pioneering study were treated respectfully and were absolutely comfortable with the situation," says McGill.

Prior to participation, couples were interviewed by the researchers and given a tour of the lab. On the day of the study, couples were outfitted with remote sensors to track how their spines moved, and electrodes to measure muscle activity.

Although in the same room, researchers could not see the participants as they engaged in five pre-selected sex positions (two variations of missionary, two variations of doggy-style and spooning).

Award-winning work

The data gathered from the sensors was used to create animated 3D models of the human skeleton, allowing researchers to  measure spine motion in each sex position. The findings, which have already garnered Sidorkewicz academic accolades including the prestigious Best Paper Award at the 40th Annual Meeting of the International Society for the Study of the Lumbar Spine, are part of new clinical guidelines outlining the best sex positions for low back pain patients.

“As a student at Waterloo, I had heard the theme, the spirit of ‘why not?’, countless times. Yet I never truly appreciated the meaning behind it or why I was so fortunate to be a student at the University of Waterloo until I received full ethics clearance to begin my groundbreaking research,” says Sidorkewicz. “I often think back to something David Johnston, Governor General of Canada and former president of the University of Waterloo once said: ‘What we have accomplished to date — and stand to accomplish over the next decade — is very much the result of daring to dream the impossible and of ignoring conventional wisdom when it says something can’t be done. Our first question is always, why not?’”

Life-changing potential

The findings — the first on spine motion during sex — are expected to change the type of advice clinicians give their patients struggling with low back pain.

“For the first time ever, health care practitioners have the tools to make scientifically-sound recommendations to couples who avoid or reduce sexual activity because of back pain. It has the potential to improve quality of life — and love life — for many couples...  We’re hoping to help facilitate conversations between the patient and practitioner and also between partners who live with this debilitating pain every day," says Sidorkewicz.