Is A Lack Of Sex Bad for Your Health? We Asked Experts

We know sex as many things. It's pleasure, it's bonding, it's romance, and it's erotic. It can be euphoric—even addictive—but in its purest form, it's the ultimate expression of love and the source of life itself. But what happens when sex goes away?

Most of us compare our romantic lives to what we see in our favorite hit TV series and films, and we start to believe that we, like the leading characters, should be having mind-blowing sex—all of the time. There's a significant disconnect between how sex is portrayed in entertainment and what unfolds in real life. And for about a quarter of Americans—coupled up or not—nothing has "unfolded" in quite some time.

While it's tough to say for certain how many people are or aren't having sex, the 2021 General Social Survey revealed that 26% of American adults hadn't had sex in the last 12 months. And of those who are sexually active, 50% reported having sex just once a month or less, which just barely surpasses what some intimacy experts consider "sexless" (having sex 10 times a year or less). 

"Any sex therapist will tell you that's probably the most common problem they see—sexless relationships and sex ruts," says Ian Kerner, Ph.D., LMFT, a psychotherapist, nationally recognized sex therapist, and bestselling author of She Comes First.

As for why some relationships become sexless, it often has to do with "a buildup of stressors, a buildup of turnoffs, and a lack of 'exciters' and turn-ons," explains Kerner. "Couples today find that their energy has to be distributed in so many different areas, whether it's work, parenting, maintaining a household, or other family matters, and that very little time gets allocated to the self-actualization of the relationship. Many couples are under the false illusion that sex is something that's just sort of natural and organic and not something that you need to tend to. It just sort of takes care of itself and should happen automatically. That's a myth." 

While many of us are familiar with the emotional and stress-relieving aspects of sex, ongoing research is uncovering various health benefits linked to sexual activity, including positive cardiovascular outcomes1, reduced risk of prostate cancer, enhanced immunity2, and a stronger pelvic floor3 (which is vital for urinary continence, sexual function, as well as posture and stability, as we age).

Regular sexual activity can help to empower women through the menopausal phase, a time when many tend to shy away due to lower levels of estrogen causing vaginal dryness. While low doses of estrogen therapy and vaginal moisturizers can help women maintain or regain moisture to continue enjoying sex after menopause, regular sexual activity can also help achieve that, according to the North American Menopause Society. 

On the mental and emotional side, a healthy sex life is associated with lower anxiety 4levels, fewer feelings of depression, and an elevated mood5.

It can also help build body confidence. Ali Novitsky, M.D., a triple-boarded physician and founder of The Fit Collective, explains that often, when confidence in our bodies is lacking for specific reasons, engaging in positive and frequent sexual encounters can serve as a confidence-builder. Meaning that a person doesn't necessarily need to feel 100% confident to engage in or initiate sex.

Almost counterintuitively, sex itself—and the response from your partner—can provide a confidence boost and evoke a sense of well-being and gratitude for one's body, which facilitates intimacy.

Given all of these potential benefits, it's no surprise that experts do think that a healthy sex life is a key aspect of well-being.

That said, "while sex can contribute to overall well-being in various ways, it's crucial to remember that not engaging in sexual activities does not inevitably lead to negative health implications," says Novitsky.

That's not to say a lack of sex won't threaten the health of relationships in some cases. If both partners in a relationship agree on voluntary abstinence and sex simply isn't important, that's one thing. But when it comes to involuntary celibacy in a partnership—or a sexless relationship—Kerner says, "Sex is a really important part of a relationship and being alive. So it's an existential issue when it's not occurring." 

Kerner also notes that couples who have sex on a regular, consistent basis have higher levels of relationship positivity and higher levels of relationship resilience. "They're able to put up with the hard stuff in a relationship better than couples who do not have sex. Sex is a kind of glue that helps us move through the life cycle together and hold on to the positivity that we need to surmount all of life's difficulties and complexities." 

Without the sexual intimacy that a partner desires, Kerner explains that one may start feeling deprived in the relationship, leading to potential emotions of sadness, depression, and a sense of neglect or rejection. Novitsky adds that if one partner wants sex and the other partner does not want sex, "there could be significant mental and emotional stress that could occur because of this mismatch."

While frequent sex may benefit several aspects of physical and mental health, abstaining from sex—whether by choice or circumstance—is not generally associated with adverse health effects.

That said, individuals who desire more sex than they are getting may find that this exacerbates stress, which could negatively harm health in the long run. And prioritizing a fulfilling sex life could be a major boon to couples who are in a rut.