Sexual Frequency and Heart Health: What the Research Shows
Key insights: 60-second read
- Sexual frequency is associated with heart health - A study of over 17,000 people found a U-shaped relationship between sexual frequency and cardiovascular disease risk.
- Too little or too much may be detrimental - The lowest risks were seen at 52-103 times per year (roughly 1-2 times per week). Both lower and higher frequencies were associated with increased risk.
- It's about association, not causation - Healthier people may simply be more sexually active. The relationship is complex and likely bidirectional.
- The "sweet spot" appears to be 1-2 times per week - This aligns with what many studies suggest is a healthy range for overall wellbeing.
Sexual activity is a normal, healthy part of human life. But does it have any connection to your heart health? A new study published in Scientific Reports (Teng et al., 2025) set out to explore this question.
The researchers analysed data from over 17,000 young and middle-aged adults in the United States. They looked at self-reported sexual frequency and tracked cardiovascular disease incidence and all-cause mortality over a median follow-up of nearly nine years.
What they found was a fascinating U-shaped relationship: both too little and too much sexual activity were associated with higher risks, with the sweet spot sitting around 52-103 times per year - roughly once or twice a week.
But before we jump to any conclusions, let's take a respectful, measured look at what this research actually tells us - and what it doesn't.
"Both excessive and infrequent sexual frequency may be detrimental to health." - Teng et al., 2025
On this page
What the Study Found
The researchers used data from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2016, including 17,243 adults aged 20 to 59. Participants self-reported their sexual frequency over the past 12 months and were followed for an average of 106 months (nearly nine years).
After adjusting for a wide range of confounders - including age, sex, race, education, income, BMI, smoking, drinking, exercise, depression, and existing health conditions - the researchers found:
Higher CVD Risk
Those with sexual frequency of less than 12 times per year had the highest risk of cardiovascular disease and all-cause mortality.
Lowest Risk
The lowest risks were seen in the 52-103 times per year group (roughly 1-2 times per week).
Increased Risk at High Frequency
Those with sexual frequency of 365 times or more per year (daily or more) also showed increased risk.
Mortality
Those with 0 sexual frequency had a 2.36 times higher mortality risk compared to the reference group.
The U-Shaped Relationship
One of the most interesting findings was the clear U-shaped pattern. As sexual frequency increased from very low levels, the risk of CVD and mortality decreased. It reached its lowest point at around 52-103 times per year. Beyond that, as frequency increased further, the risk started to rise again.
The researchers summarised it well: "Both excessive and infrequent sexual frequency may be detrimental to health."
The Numbers at a Glance
- 0 times/year: CVD HR 1.61 (1.06, 2.37); Mortality HR 2.36 (1.48, 3.78)
- 52-103 times/year: Reference group (lowest risk)
- 365+ times/year: CVD HR 2.35 (1.03, 5.39); Mortality HR 2.82 (1.28, 6.23)
Correlation vs Causation: What Does This Actually Mean?
An Important Distinction
This is where we need to be careful. The study shows an association between sexual frequency and health outcomes - but it does not prove that sexual frequency causes better or worse heart health.
There are several alternative explanations to consider:
- Reverse causation: People who are already healthier may simply be more likely to be sexually active. Poor health, fatigue, and chronic conditions can reduce sexual desire and frequency.
- Confounding: People with healthier lifestyles (more exercise, better diet, lower stress) may also have healthier sex lives. The study tried to adjust for many of these factors, but it's impossible to account for everything.
- Erectile dysfunction as an early warning sign: The researchers note that erectile dysfunction can be an early marker of cardiovascular disease. Men with undiagnosed heart problems may have reduced sexual function, which could explain the link.
- Mental health: Depression and anxiety can affect both sexual desire and cardiovascular health. The study did adjust for depression using the PHQ-9, but it's a complex relationship.
As the authors themselves acknowledge: "The presence of observational and unmeasured confounding factors in the study design hinders the determination of causality."
So, does this mean that having sex 1-2 times per week will protect your heart? Not necessarily. It means that, on average, people who report this frequency tend to have better health outcomes. The reasons are likely complex and involve multiple factors.
I can imagine many will light-heartedly send the results of a study like this to their partners in the hope of nudging them towards a higher frequency of intimacy, but it is important to reinforce the idea that these results aren't definitive.
Possible Explanations
The researchers explored several biological and psychological mechanisms that might explain the observed association:
For Low Sexual Frequency
- Erectile dysfunction as a warning sign: ED can be an early indicator of atherosclerosis and cardiovascular disease. The penile artery is smaller (1-2mm) than the coronary artery (3-4mm), so problems may show up here first.
- Low testosterone: Low testosterone levels are associated with higher cholesterol, increased inflammation, and a higher risk of cardiovascular disease.
- Depression and anxiety: Mental health conditions can reduce libido and also increase cardiovascular risk through stress pathways.
For High Sexual Frequency
- Sympathetic overexcitement: Intense sexual activity can trigger excessive sympathetic nervous system activation, which may contribute to endothelial damage and accelerated atherosclerosis.
- Sexual addiction: The researchers note that very high frequency (365+ times per year) may indicate problematic hypersexuality, which can be associated with mental stress and health risks.
- Diminishing returns: Just as excessive aerobic exercise may have negative effects, very high levels of sexual activity may reach a point of diminishing returns.
Study Limitations
The researchers openly acknowledge several limitations that are important to consider:
- Self-reported data: Sexual frequency was self-reported, which is subject to recall bias and social desirability bias.
- No data on other sexual behaviours: The study did not include data on masturbation, oral sex, or the duration of sexual activity.
- Limited age range: Participants were aged 20-59. The findings may not apply to older adults.
- Observational design: Causality cannot be determined from this type of study.
Practical Takeaways
So, what can we reasonably take from this research?
Key Takeaways
- Sexual activity is a normal part of a healthy life. There's no need to worry if your personal frequency doesn't match the "sweet spot" - everyone is different.
- Low sexual frequency may be a marker for underlying health issues. If you're experiencing a sudden or unexplained drop in sexual desire, it's worth discussing with your healthcare provider.
- Erectile dysfunction is worth taking seriously. It can be an early warning sign of cardiovascular problems.
- Mental health matters. Depression, anxiety, and stress can affect both sexual function and heart health.
- Balance is key. The U-shaped curve suggests that extremes in either direction may not be optimal - but this is likely just one of many factors that influence health.
The Bottom Line
This study adds to a growing body of evidence suggesting that sexual frequency is associated with health outcomes - but it's not a simple "more is better" or "less is better" story. The relationship appears to be U-shaped, with the lowest risks at around 1-2 times per week.
However, it's crucial to understand that this is a correlation, not causation. Healthier people may simply be more sexually active, and many underlying factors - physical, psychological, and social - likely play a role.
Rather than obsessing over a target number, focus on overall health and wellbeing. If you have concerns about your sexual health, cardiovascular health, or both, discuss them with your healthcare provider.
Reference
Teng, T. Q., Liu, J., Wang, M. M., et al. (2025). The association of sexual frequency with cardiovascular diseases incidence and all-cause mortality. Scientific Reports, 15, 1234. doi:10.1038/s41598-024-83414-3
Frequently Asked Questions
Does this mean I need to have sex 1-2 times per week for my heart health?
No. The study found an association, not causation. There are many factors that influence both sexual frequency and heart health. The finding is interesting from a population health perspective, but it doesn't translate into a prescription for individuals.
Is too much sex actually bad for you?
The study suggested that very high frequency (365+ times per year) was associated with increased risk. However, this was a relatively small group and may reflect other factors like sexual addiction or underlying health issues. For most people, the "too much" threshold is likely not a concern.
What if my sexual frequency is lower than the "sweet spot"?
That's perfectly normal. Everyone is different. If you have concerns about a sudden or unexplained drop in sexual desire, it's worth discussing with your healthcare provider, as it could be a marker for underlying health issues.
Should I be worried about erectile dysfunction?
ED can be an early warning sign of cardiovascular problems. If you're experiencing ED, it's a good idea to discuss it with your healthcare provider, not just for sexual health but for overall cardiovascular assessment.
Does this study apply to everyone?
The study included adults aged 20-59 from the United States. The findings may not apply to older adults, people with specific health conditions, or those from different cultural backgrounds. More research is needed.
One key insight
"A study of over 17,000 people found a U-shaped relationship between sexual frequency and heart health. The lowest risks were around 52-103 times per year (1-2 times per week). However, this is an association, not causation - healthier people may simply be more sexually active."
Living With Persistent Pain or Health Concerns?
If you're dealing with persistent pain or health issues that affect your quality of life, a comprehensive approach can help. Learn more about our physiotherapy services in Port Macquarie.
Want personalised guidance?
If you'd like help making sense of your health concerns, you can book with Grant either in Port Macquarie or via an online telehealth consultation.
