Benefits of Sexual Activity on Psychological, Relational, and Sexual Health During the COVID-19 Breakout

Abstract

Background The COVID-19 related lockdown has profoundly changed human behaviors and habits, impairing general and psychological well-being. Along with psychosocial consequences, it is possible that sexual behavior was also affected. Aims With the present study we evaluated the impact of the community-wide containment and consequent social distancing on the intrapsychic, relational, and sexual health through standardized psychometric tools. Methods A case-control study was performed through a web-based survey and comparing subjects of both genders with (Group A, N=2608) and without (Group B, N=4213) sexual activity during lockdown. The Welch and chi-square tests were used to assess differences between groups. Univariate analysis of covariance, logistic regression models and structural equation modeling (SEM) were performed to measure influence and mediation effects of sexual activity on psychological, relational, and sexual outcomes. Outcomes Main outcome measures were General Anxiety Disorder-7 for anxiety, Patient Health Questionnaire-9 for depression, Dyadic Adjustment Scale for quality of relationship and a set of well-validated sexological inventories (International Index of Erectile Function, Female Sexual Function Index, and male-female versions of the Orgasmometer). Results Anxiety and depression scores were significantly lower in subjects sexually active during lockdown. Analysis of covariance identified gender, sexual activity and living without partner during lockdown as significantly affecting anxiety and depression scores (p<0.0001). Logistic regression models showed that lack of sexual activity during lockdown was associated with a significantly higher risk of developing anxiety and depression (OR: 1.32 [95% CI: 1.12 - 1.57, p<0.001] and 1.34 [95% CI: 1.15 - 1.57, p<0.0001], respectively). SEM evidenced the protective role of sexual activity towards psychological distress (β males =-0.18 and β females =-0.14), relational health (β males =0.26 and β females =0.29) and sexual health, both directly (β males =0.43 and β females =0.31), and indirectly (β males =0.13 and β females =0.13). Clinical translation The demonstrated mutual influence of sexual health on psychological and relational health could direct the clinical community towards a re-interpretation of the relationship among these factors. Strengths and limitations Based on a large number of subjects and well-validated psychometric tools, this study elucidated the protective role of sexual activity for psychological distress, as well for relational and sexual health. Main limitations were the web-based characteristics of the protocol and the retros...

The disruptive impact of the COVID-19 pandemic on sexual behavior of a German-speaking population

“…One explanation for this decline might be mood-related effects on sexual behavior and sexual functioning due to uncertainty and fear, as previously described ( Bancroft et al, 2003 ). An association between mood and sexual activity was also reported by Mollaioli et al (2021) in a study population showing higher rates of symptoms of depression and anxiety in sexually inactive subjects in Italy. But as longitudinal data are missing it remains unclear if mood affects sexual activity or sexual inactivity has a negative effect on mood.…”

“…At the same time, research teams worldwide have gathered cross-sectional and prospective data to shed light on the question of the impact of physical distancing measures during the COVID-19 pandemic on sexual behavior based on scientific evidence. Changes in sexual behavior have been described by current studies collecting data during the first physical distancing measures in China ( Li et al, 2020 ), the United Kingdom ( Jacob et al, 2020 ), France ( Landry et al, 2020 ), Italy ( Mollaioli et al, 2021 ), Poland ( Fuchs et al, 2020 ), Turkey ( Yuksel and Ozgor, 2020 ) and by an internationally distributed online survey from the United States for English speaking participants ( Lehmiller et al, 2020 ).…”

“…A cross-sectional study from Italy was able to show ( Mollaioli et al, 2021 ) that sexual activity (e.g. sexual intercourse) during the pandemic was linked positively to factors regarding mental, relational and sexual health.…”

Physical and Psychological Effects of Gender-Affirming Hormonal Treatment Using Intramuscular Testosterone Enanthate in Japanese Transgender Men

“…As such, providers who encounter women presenting with sexual dysfunction may wish to screen for the presence of pandemic-related stressors. In light of recent evidence that demonstrates sexual activity can have a protective effect on the development quarantine-related anxiety and mood disorders, optimization of patients' sexual health and optimization of patients' mental health are reciprocal and synergistic goals [31].…”

Anosmia and ageusia: a piece of the puzzle in the etiology of COVID-19-related transitory erectile dysfunction

“…While being a trivial matter while admitted into ICU, ED represents a worrying phenomenon for a large part of affected patients. As such, it has been reported how sexual activity plays a protective effect on the quarantine-related plague of anxiety and mood disorders during the COVID-19 pandemic [ 2 ].…”