This is how not having sex impacts your health

By Alpana Mohta, MD, DNB, FEADV, FIADVL, IFAAD | Fact-checked by Barbara Bekiesz
Published April 9, 2024

Key Takeaways

  • Engaging in sexual activity can reduce stress, bolster immunity, improve sleep, and even improve cardiovascular fitness.

  • Reduced sexual activity can lead to an increased risk of chronic illnesses and self-rated health decline in both men and women, with specific risks like stroke in women.

  • Talk with your patients about how sexual health is closely tied to mental well-being and can influence conditions like anxiety and insomnia. While its absence doesn't directly cause these issues, it does mean losing a natural coping mechanism.

Several studies suggest that a healthy and active sex life correlates with a lower risk of health issues. In one of the largest studies from the US, including 1,046 men and 1,158 women followed over 5 years, regular and satisfying sexual activity was associated with a reduced risk of cardiovascular disease (CVD) in later life.[]

Frequent sexual activity is also linked to a decreased risk of fatal heart events, breast cancer, and prostate cancer, most likely due to the increased release of endorphins during intercourse.[][]

But is the opposite true? Can going without sex—whether voluntarily or involuntarily—harm your health?

Physical health implications

Regular sexual activity benefits cardiovascular and neurological health, while its absence may indirectly affect heart health. Notably:

  • Researchers publishing in the Journal of Sexual Medicine observed that cardiovascular risk factors like diabetes, high cholesterol, and hypertension were associated with sexual inactivity in older men and women.[]

  • A 2023 Italian study found that sexual dissatisfaction in CVD patients correlated with poor physical well-being.[]

  • NHANES data on young and middle-aged patients with hypertension indicated that married patients having sex less than 12 times a year had higher all-cause mortality rates.[]

  • A longitudinal study from the Archives of Sexual Behavior observed that men with decreased sexual desire at baseline were 41% more likely to develop long-term illnesses and 63% more likely to get cancer at 4-year follow-up.[]

  • In the above study, reduced sexual activity was associated with a higher likelihood of worse self-rated health in 47% of men and 64% of women.

  • For women, decreased sexual arousal was associated with a 136% higher risk of stroke.

Immune function

Sexual activity is linked to a boosted immune system. A 2021 report showed that more frequent sexual activity correlates with better immunity against COVID-19. On the flip side, those having sex less than three times a month had a higher risk of viral infection.[]

Sexual arousal and orgasm trigger a reaction similar to acute stress, by inducing higher adrenaline, noradrenaline, and prolactin levels. This enhances immunity by boosting leukocytes, including natural killer cells and cytotoxic/suppressor T lymphocytes.[] 

Psychological health implications

Stress and mental health

Sexual activity is a known stress reliever and has a bidirectional relationship with psychological health. While abstinence doesn't directly cause stress, it can result in the loss of a natural coping mechanism. 

For instance, in a 2023 study in the US, subjects who had recent sexual activity slept better, felt less anxious, and showed fewer signs of post-traumatic stress disorder.

Insomnia was significantly linked to sexual dysfunction: 53.8% of women with insomnia and 22.7% of men reported sexual issues.[] Additionally, anxiety (but not depression) was inversely linked with sexual satisfaction in patients with CVD, according to the aforementioned Italian study.

Self-esteem and body image

Sexual activity can boost self-esteem and body image. However, the impact of abstinence on these aspects can vary, depending on the individual and the situation. 

Research suggests a positive relationship between increased sexual activity and improved body image.[] This trend is consistent across different sexual orientations.

For instance, a study comparing transgender and cisgender individuals using daily diaries found that sexual intimacy was associated with higher sexual esteem and better body image in both groups.[]

Myths about health impacts

But sex is not a panacea for all illnesses. Common claims, like sexual activity burning 100 to 300 kcal, are exaggerated.

In reality, a 6-minute encounter typically burns just 21 kcal for a man in his 30s—only 14 kcal more than watching TV.[]

On the flip side, abstinence is often touted as beneficial for athletic performance, but scientific evidence doesn't support this claim. As noted in a recent meta-analysis, engaging in sexual activity shortly before exercise, within 30 minutes to 24 hours, doesn't notably affect “aerobic fitness, musculoskeletal endurance, or strength/power.”[]

And lastly, concerns about protein loss through ejaculation, particularly among bodybuilders, are also largely unfounded. Ejaculation releases about 250 mg of protein, easily replenished through diet and minimally impacting protein balance.[]

What this means for you

Health professionals should be aware that a decrease in sexual activity, desire, or function, especially in older age, might indicate future health problems. Conversely, the correlation might also reflect that individuals in good health are more inclined to participate in sexual activities compared to those with health challenges.

Read Next: 6 sexual health myths busted
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