New research suggests women find it harder to orgasm after having botulinum treatment – but not everyone is convinced this means facial expressions are key to feeling pleasure

Most people dread the idea of anyone seeing their sex face, but it may be saving their sex life.

According to research by Cardiff University, women experience less satisfying orgasms and find it harder to orgasm after having botulinum toxin treatment (Botox). Because the muscles often targeted by botulinum are associated with orgasm and sexual excitement, the researchers wanted to test whether restricting them affected the ability to feel sexual pleasure. They followed a small sample of women – 24 before and after botox, compared with 12 women who had had non-muscle restricting work done (such as skin peels). They found a significant drop in sexual satisfaction for the 13 women whose frown lines had been altered and a “near significant” drop for women who had had injections for crow’s feet and frown lines.

Previous research has shown that people feel happier after botulinum treatment because of the resulting inability to frown. Dr Michael Lewis, who led the research, says: “It’s an example of how facial muscles have a feedback effect on the way that we feel, rather than just depicting what we feel inside ourselves.”

It is not just botulinum that has this effect. Studies show that you can trick your body into feeling happier – even healthier – by putting on a smile, as this causes chemical reactions in the brain, such as the production of serotonin or dopamine, that result in positive feelings.

Other academics argue that facial expressions are a social tool, used to influence others around us, rather than an indicator of how we actually feel. Across the world, people use different facial expressions for different reasons.

The neuroscientist Dr Lisa Feldman Barrett, the author of How Emotions Are Made, describes the effect of mimicking the feeling that you want to feel: “When you’re not having a day filled with disaster, that nudge might be enough to shift you from having a neutral day to a slightly pleasant day ... but the findings are inconsistent and slight.”

The brain is constantly making predictions and correcting them. If you think you are about to climax, then try to produce the relevant facial expression but don’t, it makes sense that your brain may deduce that you are not having that much fun. But Barrett argues that some studies fail to consider alternative explanations for the change in emotion – such as whether a lack of facial communication led to a sexual partner being unable to perform as well or distracted the woman.

So, can dropping our jaws and rolling back our eyes really help us to orgasm more? Lewis thinks not: “You can certainly make yourself feel better by smiling and laughing … but could you move yourself to ecstasy by producing the [associated facial expressions]? I think that’s probably less likely.”