If Having Sex is Healthy, is Not Having Sex Unhealthy?

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Woman sitting alone on edge of bed.

A reader submitted the following question:

“It is known that having sex has positive effects on both our mental and physical health. But what do we know about the consequences of sexual inactivity? If having sex is ‘healthy’ is there any evidence to claim that not having sex is ‘unhealthy?’”

Thanks for this great question! As you mentioned—and as I’ve written about on the blog many times in the past—sexual activity is associated with a wide range of health benefits. For example, research has found that sexually active men have lower odds of developing prostate cancer, they’re less likely to have heart attacks, and they tend to live longer. Also, for men and women alike, being sexually active in later life is linked to better cognitive function. Plus, across genders, sex tends to provide a temporary mood boost, while also increasing meaning in life (for a summary of the health benefits linked to sex, see here).

This pattern of findings would seem to suggest that people who are sexually active are healthier on average than those who are sexually inactive. However, it would be problematic to use these results to leap to the conclusion that sexual inactivity in and of itself is inherently unhealthy or always linked to worse health outcomes. Here’s why: 

First, most of the research linking sexual activity to health benefits is correlational, meaning we cannot infer cause-and-effect. It’s probably true that people who are healthier to begin with—physically and mentally—are more likely to have sex in the first place. But is sex necessarily making them healthier, or is it just that they’re more physically capable of sex and/or more likely to be in the mood for sex? I suspect that both explanations are true to some extent, but we really need more research to draw firm conclusions.

Second, in understanding how sexual inactivity relates to health, it’s important to consider people’s reasons for not having sex. There are a lot of different reasons why a given person might not be having sex at all (or very infrequently). Here are a few:

·  You are asexual and do not have the desire for partnered sex. 

·  You once had the desire for sex, but your desire decreased or disappeared over time. 

·  You desire sex, but have voluntarily chosen to be celibate for a period of time.

·  You desire sex, but cannot find a partner or do not have access to partners.

·  You desire sex, but your partner does not (i.e., you’re in a sexless relationship or have a sexual desire discrepancy).

This is not a comprehensive list by any stretch of the imagination, but as you can see from the reasons listed above, there are a lot of different factors that could potentially play a role in sexual inactivity—and the implications of each for one’s health are likely to be quite different.  

For example, if someone does not have the desire for sex or has voluntarily decided not to have sex, that’s a very different situation compared to one in which a person wants to have sex but is unable to do so. The latter circumstances could lead to frustration, depression, anxiety, and other negative mental health outcomes (which, in turn, could lead to negative physical health outcomes, such as fluctuations in weight and/or effects from chronic stress). 

As a result, even though research suggests that sexual inactivity is linked to worse health overall, this doesn’t mean that everyone in the inactive category is necessarily worse off. We need to step back and look at people’s reasons for not having sex in in the first place because that’s likely to play an important role in how the absence of sex impacts people’s health.

At the same time, it’s worth recognizing that being sexually active does not necessarily mean that one is healthier. Just as there are different reasons for not having sex, there are also a wide range of reasons for having sex (at least 237!)—and some of those reasons may be linked to worse health, such as those who are in a relationship where they feel pressured or coerced to have sex that they don’t want, or those who use sex as a form of self-injury (i.e., those who have sex as a means of intentionally harming the self).

In short, yes, there are health differences on average between sexually active an inactive persons, but we need to be mindful of the fact that there are limitations of this research (correlational data) and that people’s reasons for having or not having sex probably influence the link between sex and health. 

For more Q&A’s on Sex and Psychology, click here. To send in a question, click here.

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Image Source: 123RF/Yupa Watchanakit

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