Department of Psychology, University of Toronto Mississauga, Mississauga, Ontario, Canada.
Child and Youth Psychiatry, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
J Sex Med. 2022 Sep;19(9):1343-1358. doi: 10.1016/j.jsxm.2022.06.005. Epub 2022 Jul 17.
A younger age at sexual intercourse has frequently been linked to adverse sexual health outcomes. Yet, little is known about its associations with healthy sexual function, and less still about the timing of pre-coital sexual debuts and adult sexual health.
We examined associations between an earlier sexual debut and subsequent sexual health, using broad operationalizations of each that capture pre-coital experiences and positive outcomes. Connections to sexual health risk and healthy sexual function were assessed through the lens of the dual-control model of sexual response.
Data on age at first sexual intercourse, first sexual contact, first sexual stimulation, and first orgasm, as well as sexual health risk and healthy sexual function were gathered from 3,139 adults.
Adverse sexual events (reproductive illness, infection, or injury affecting sexual activity; pregnancy termination and/or loss; non-volitional sex) and current sexual difficulties (Female [FSFI] and/or Male Sexual Function Index [MSFI] scores; Sexual Excitation and/or Sexual Inhibition Inventory for Women and Men [SESII-W/M] scores).
When defined narrowly as first sexual intercourse, earlier sexual debut was associated with adverse sexual events, including non-volitional sex, pregnancy termination and/or loss, and reproductive illness, infection, or injury affecting sexual activity. However, it was also related to healthier sexual function, including less pain during vaginal penetration, better orgasmic functioning, and lower sexual inhibition. When sexual debut was broadened to include pre-coital experiences, earlier sexual contact, like earlier sexual intercourse, was associated with non-volitional sex. However, earlier sexual stimulation and orgasm were unrelated to adverse outcomes. Rather, these related to fewer sexual desire difficulties, and greater sexual excitation. Exploratory mediation analyses revealed later sexual intercourse and orgasm were connected to sexual difficulties through higher sexual inhibition and lower sexual excitation, respectively.
When sexual functioning is impaired, delay of both coital and noncoital debuts may warrant assessment, and sexual excitation and inhibition may be targets for intervention. To facilitate healthy sexual development of young people, non-coital debuts with and without a partner may warrant inclusion in risk management and health promotion strategies, respectively.
STRENGTHS & LIMITATIONS: Although this research operationalized sexual debut and sexual health broadly, and examined associations between them, it is limited by its cross-sectional retrospective design and non-clinical convenience sample.
From a risk-based perspective, earlier sexual intercourse is adversely related to sexual health. Yet, it is also associated with healthy sexual function. Indeed, earlier sexual initiation may confer more benefits than risks when sexual debuts beyond intercourse are considered. Peragine DE, Skorska MN, Maxwell JA, et al. The Risks and Benefits of Being "Early to Bed": Toward a Broader Understanding of Age at Sexual Debut and Sexual Health in Adulthood. J Sex Med 2022;19:1343-1358.
性交年龄较小与不良的性健康结果密切相关。然而，人们对其与健康的性行为之间的关系知之甚少，对婚前性行为和成人性行为的时机了解得更少。
我们使用广泛的性行为和积极结果的操作性定义，来检验性初潮与后续性健康之间的关联。通过性反应的双重控制模型，评估与性健康风险和健康性功能的联系。
从 3139 名成年人那里收集了初次性交、初次性接触、初次性刺激和初次性高潮的年龄，以及性健康风险和健康性功能的数据。
当狭义地定义为初次性交时，较早的性初潮与不良的性事件有关，包括非自愿性行为、妊娠终止和/或流产以及影响性行为的生殖疾病、感染或损伤。然而，它也与更健康的性功能有关，包括阴道插入时疼痛减轻、更好的性功能和更低的性抑制。当性行为初潮扩大到包括婚前经历时，像初次性交一样，较早的性接触也与非自愿性行为有关。然而，较早的性刺激和性高潮与不良后果无关。相反，这些与较少的性欲望困难和更大的性兴奋有关。探索性中介分析显示，较晚的性交和性高潮与性困难有关，分别是通过更高的性抑制和更低的性兴奋。
当性功能受损时，推迟性交和非性交初潮都需要评估，性兴奋和抑制可能是干预的目标。为了促进年轻人的健康性行为发展，有伴侣和无伴侣的非性交初潮都可能需要纳入风险管理和健康促进策略。
尽管这项研究广泛地对性行为初潮和性健康进行了操作性定义，并对它们之间的关系进行了检验，但它受到其横断面回顾性设计和非临床便利样本的限制。
从风险的角度来看，较早的性交与性健康有关。然而，它也与健康的性功能有关。事实上，当考虑到除性交以外的性行为时，较早的性初潮可能带来的好处多于风险。
