People in Britain are having sex less often than they used to a decade ago and less often than they want to, especially those in early middle age and who are married or cohabiting, new research has revealed. The authors of the study,* published in The BMJ, warned that this ‘disquieting trend’ needs further investigation – and an expert urged healthcare professionals to be alert to the possibility of sexual problems when talking with patients.
Researchers from the London School of Hygiene and Tropical Medicine pointed out that several high-income countries have recently reported a decline in the frequency with which men and women have sex. Little was known about these trends in Britain, and the lifestyle factors associated with sexual frequency, so to remedy this they analysed data from the National Surveys of Sexual Attitudes and Lifestyles (Natsal-1, Natsal-2, and Natsal-3).
These surveys covered 18,876 men and women aged 16-59 and resident in Britain who were interviewed in Natsal-1, completed in 1991; 11,161 aged 16-44 years in Natsal-2, completed in 2001; and 15,162 aged 16-74 years in Natsal-3, completed in 2012. Main outcome measures were sexual activity in the past month; frequency of sex in the past month; and preferred frequency of sex.
They found that the median number of occasions of sex in the past month was four in Natsal-1 and Natsal-2 and three in Natsal-3 among women; and three in Natsal-1, Natsal-2, and Natsal-3 among men. The proportion of interviewees reporting no sex in the past month fell between Natsal-1 and Natsal-2 (from 28.5% to 23.0% in women and from 30.9% to 26.0% in men) but increased significantly in Natsal-3 (to 29.3% in women and 29.2% in men).
Declines in frequency of sexual activity were largest among those aged 25 and over. Between the Natsal-2 and Natsal-3 surveys, median number of occasions of sex in the past month fell from four to two among 35-44-year-old women and from four to three among men in this age group. Frequency of sexual activity was higher among participants who were currently married/cohabiting across all three surveys – but the decline over time was significantly greater in this group.
The proportion of people who said they’d had sex at least 10 times in the past month increased between Natsal-1 and Natsal-2, from 18.4% to 20.6% in women and from 19.9% to 20.2% in men, but fell steeply in Natsal-3, to 13.2% in women and 14.4% in men. Participants aged 25 and over, and those married or cohabiting, experienced the steepest declines in sexual frequency.
The researchers added that men and women in better physical and mental health had sex more frequently, as did those who were fully employed and those with higher earnings.
They also found that the proportion of participants who expressed a preference for more frequent sex increased significantly between Natsal-2 (39.1% of women and 51.2% of men) and Natsal-3 (50.6% of women and 64.3% of men). This increase occurred in all age groups and both marital status categories, but with evidence of a steeper increase among those married or cohabiting.
They concluded: “[Our finding] that close to half of women and almost two thirds of men report wanting to have sex more often-merits concern, as does – notwithstanding the possibility of reverse causality – the strong relationship between lower sexual frequency and depression and self-related health. The wider implications of the decline in sexual frequency are perhaps more worrying. Should frequency of sexual contact serve as a barometer for more general human connectedness, then the decline might be signalling a disquieting trend. The decrease in sexual activity is interesting, unexplained, and warrants further exploration.”
The author of an accompanying editorial** argued that the findings should be interpreted with caution as not all sexual activity was measured; quantity and quality of sexual activity are not necessarily connected; and added that the decline in sexual frequency might reflect a sexual agenda set by women rather than men. But he noted that personal needs are not being fully met, given that a substantial proportion of both men and women indicated that they were not satisfied with the frequency of sexual activity.
He concluded: “Healthcare professionals should be aware of the links between sexual health, general health, and social factors and should be alert to the possibility of sexual problems during discussions with patients. [These] findings should encourage both researchers and clinicians to start talking about sex.”
* Wellings K, Palmer MJ, Machiyama K, et al. Changes in, and factors associated with, frequency of sex in Britain: evidence from three National Surveys of Sexual Attitudes and Lifestyles (Natsal). BMJ 2019; 365: l1525 doi: 10.1136/bmj.l1525
** Leusink P. Editorial: Surveys indicate a decline in sex among young adults in Britain. BMJ 2019; 365: l1961 doi: 10.1136/bmj.l1961