Associations between health and sexual lifestyles in Britain: findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3)

Field, N; Mercer, CH; Sonnenberg, P; Tanton, C; Clifton, S; Mitchell, KR; Erens, B; MacDowall, W; Wu, F; Datta, J; Stevens, A; Prah, P; Copas, AJ; Phelps, A; Wellings, K; Johnson, AM; (2013) Associations between health and sexual lifestyles in Britain: findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). Lancet. ISSN 0140-6736 DOI:

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Background: Physical and mental health impact on sexual lifestyles, formation and maintenance of relationships, and sexual fulfilment, but the nature and extent of these effects at a population level are poorly understood. Methods: During 2010-2012, we undertook a probability sample survey of 15,162 men and women aged 16-74, resident in Britain, collecting data on self-reported sexual behaviours, lifestyles and general health. The third British National Survey of Sexual Attitudes and Lifestyles (Natsal-3) explored the independent associations between health status, age, and three parameters of sexual wellbeing: recent sexual activity, satisfaction, and physiological responses. Findings: Reporting of sexual activity (opposite- and same-sex) in the past four weeks declined sharply with age, from 79.4% to 39.3% in men and from 80.0% to 22.7% in women aged 25-34 and 65-74 respectively. Sexual activity, adjusted for age and relationship status, was significantly less common in those with poorest self-assessed general health (AORs: 0.29 (95%CI 0.19-0.44) in men and 0.43 (0.31-0.61) in women), and in those with specific conditions (cardiovascular disease, diabetes, chronic airways disease, arthritis and depressive symptoms in men and women, hypertension in men, and menopause). Sexual satisfaction varied less with advancing age and was strongly associated with recent sexual activity. Lack of satisfaction was associated with poor general health and depression and, for women only, diabetes and musculoskeletal conditions. Two physiological responses were assessed: erectile difficulties were strongly associated with cardiovascular conditions, diabetes, depression and prostate disease, and vaginal dryness was associated with depression, menopause and backache. Interpretation: Poor health was strongly and independently associated with diminished sexual wellbeing. Significant declines occurred with ageing, but many older people remained sexually active, and sexual inactivity was associated with dissatisfaction. Sexual well-being should be considered a vital component of health across the life-course in clinical practice and policy.

Item Type: Article
Faculty and Department: Faculty of Public Health and Policy > Dept of Social and Environmental Health Research
Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Faculty of Public Health and Policy > Dept of Health Services Research and Policy
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PubMed ID: 24286788
Web of Science ID: 327540700027


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