White Paper Published by the Katharine Dexter McCormick Library Planned Parenthood Federation of America 434 W est 33rd Street New York, NY 10001 212-261-4779 www.plannedparenthood.org www.teenwire.com Current as of July 2007 The Health Benefits of Sexual Expression Published in Cooperation with the Society for the Scientific Study of Sexuality In 1994, the 14th World Congress of Sexology with the vast sexological literature on dysfunction, adopted the Declaration of Sexual Rights. This disease, and unwanted pregnancy, we are document of “fundamental and universal human accumulating data to begin to answer many rights” included the right to sexual pleasure. This questions about the potential benefits of sexual international gathering of sexuality scientists expression, including declared, “Sexual pleasure, including autoeroticism, • What are the ways in which sexual is a source of physical, psychological, intellectual expression benefits us physically? and spiritual well-being” (WAS, 1994). • How do various forms of sexual expression benefit us emotionally? Despite this scientific view, the belief that sex has a • Are there connections between sexual negative effect upon the individual has been more activity and spirituality? common in many historical and most contemporary • Are there positive ways that early sex play cultures. In fact, Western civilization has a affects personal growth? millennia-long tradition of sex-negative attitudes and • How does sexual expression positively biases. In the United States, this heritage was affect the lives of the disabled? relieved briefly by the “joy-of-sex” revolution of the • How does sexual expression positively ‘60s and ‘70s, but alarmist sexual viewpoints affect the lives of older women and men? retrenched and solidified with the advent of the HIV • Do non-procreative sexual activities have pandemic. Today’s public discourse about sexuality benefits for society? is almost exclusively about risks and dangers: • Is recreational sex good for people? abuse, addiction, dysfunction, infection, pedophilia, • Can having sex be therapeutic? teen pregnancy, and the struggle of sexual minorities for their civil rights. Public discourse • Are there psychosocial benefits in sexual about the physiological and psychosocial health abstinence until marriage? benefits of sexual expression has been almost • Are there differences in the health of the entirely absent (Davey Smith et al., 1997; Reiss, sexually active and the sexually abstinent? 1990). The studies cited in this paper provide suggestive insights to these and other important questions However, pioneering researchers have about the various potential health benefits of sexual demonstrated many of the various health benefits of expression. This paper is neither a meta-analysis sexual expression, including its positive physical, nor a critique of the research — it presents some of intellectual, emotional, and social dimensions the published findings that suggest the positive (Ogden, 2001). Although this body of research is benefits that sexual expression may have for limited and often only suggestive when compared physical and emotional health. The following studies, while often not definitive, are suggestive, 2 intriguing, and point to the need for more rigorous intercourse was not correlated with longevity for research in this important area. either women or men. Even though causation cannot be determined from this study, it suggests a positive association between sexual PHYSICAL HEALTH intercourse and pleasure and longevity (Palmore, 1982). Many studies have been conducted to examine the relationship between sexual activity and physical • A Swedish study also found an association health. The potential negative impacts of sexual between sexual intercourse and longevity. One activity on physical health — including sexually hundred and sixty-six 70-year-old men and 226 transmitted infections and unplanned pregnancy — women were surveyed. Five years later records have been widely reported. Less publicized studies were checked to see which participants had died suggest that both masturbation and partnered before their 75th birthday. Mortality was higher sexual activity may enhance our well-being in many among men who had ceased having sexual ways: fostering happiness, immunity, longevity, pain intercourse at earlier ages. No association was management, and sexual and reproductive health found between sexual intercourse and mortality (Trudel et al., 2000). Some studies even suggest for women (Persson, 1981). that sexual activity may be associated with reducing the risk of the two leading causes of death in the • In the early 1980s, survey results were U.S. — heart disease and cancer (Ebrahim et al., published that examined the sexuality and 2002; Petridou et al., 2000). behavior of America’s “senior” population. Of the more than 800 adults over the age of 60 who Longevity were questioned, 92.7 percent of the men and • A study with a 10-year follow-up was conducted 70.4 percent of the women were still sexually in Caerphilly, South Wales, to examine the active. Seventy-five percent of the respondents relationship between frequency of orgasm and believed that sex contributed positively to their mortality. From 1979 to 1983, 918 men aged current health status (Starr & Weiner, 1981). 45–59 were recruited to the study. The men were given a physical examination, including a Heart Disease, Stroke, and Type-2 Diabetes medical history, and blood pressure, • Further analysis of the Caerphilly study (see electrocardiogram, and cholesterol screenings. “Longevity” above) examined the relationship They were also asked about their frequency of between engaging in sexual intercourse and orgasm. At the 10-year follow-up, it was found experiencing heart disease and stroke. that the mortality risk was 50 percent lower Researchers found that even when adjusting for among men who had frequent orgasms (defined age and other risk factors, frequent sexual in this study as two or more per week) than intercourse — twice or more a week — was among men who had orgasms less than once a correlated with lower incidence of fatal coronary month. Even when controlling for other factors events. Upon a 10-year follow-up, those who such as age, social class, and smoking status, a reported an intermediate or low frequency of strong and statistically significant inverse sexual intercourse — less than once a month — relationship was found between orgasm had rates of fatal coronary incidences twice that frequency and risk of death. The authors of this of those who had reported high frequency of study conclude that “[s]exual activity seems to sexual intercourse. Using similar methods, have a protective effect on men’s health” (Davey researchers found that frequent sexual Smith et al., 1997). intercourse did not result in an increased risk of stroke. This finding is particularly important, • A longitudinal study followed 252 racially diverse given a prevailing belief that frequent sexual people in North Carolina over the course of 25 intercourse may cause strokes (Ebrahim et al., years to determine what factors were important 2002). in determining lifespan. Three of the factors studied were frequency of intercourse, past • Additional research with middle-aged men enjoyment of intercourse, and present suggests a relationship between the levels of the enjoyment of intercourse. For men, frequency of hormone dehydroepiandrostone (DHEA), which intercourse was a significant predictor of is released with orgasm, and a reduction in the longevity. While frequency of intercourse was risk of heart disease (Feldman et al., 1998). not predictive of longevity for women, women Testosterone, the hormone important to the sex who reported past enjoyment of intercourse had drive in women and men, has also been shown greater longevity. Current enjoyment of to help reduce the risk of heart attack and to 3 reduce harm to the coronary muscles when matched with 95 controls. A higher risk of heart attack does occur (Booth et al., 1999; breast cancer was correlated with a lack of a sex Fogari et al., 2002). partner and rare sexual intercourse — defined as less than once a month (Lê et al., 1989). • An earlier study, conducted from 1972 to 1975, examined the sex lives of 100 Israeli women • A recent case-control study of the endocrine hospitalized with myocardial infarction in correlates of breast cancer examined the comparison to a control group of 100 women incidence of male breast cancer among 23 men who were hospitalized for other reasons. The in Greece. The study found an inverse control group was matched for age. Patients relationship between frequency of orgasm were given a 57-item interview about their sex during adulthood and the incidence of breast lives, including the incidence of “frigidity” and the cancer (Petridou et al., 2000). onset of menopause. “Frigidity” was indicated by a lack of enjoyment of sexual intercourse, an • Pregnancy and, possibly, exposure to sperm are inability to achieve orgasm during coitus that led believed to provide a protective effect against to emotional distress, and/or a lack of orgasm, breast cancer. A fetal antigen hypothesis sexual enjoyment, and/or sexual intercourse due proposes that a fetus inherits breast cancer to a partner’s illness or impotence. The study genes from the male partner. These genes found a statistically significant positive indirectly provide a protective effect to the correlation between sexual “frigidity,” sexual mother via immune response