Wu Xu, Gao Hui, Zhang Yuyang, Zhang Xiansheng
Department of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui, China.
Institute of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui, China.
J Sex Med. 2025 Jan 9;22(2):334-343. doi: 10.1093/jsxmed/qdae181.
Existing research is very limited in providing nationally representative data on the relationship between sexual activity and depression in U.S. female adults aged 20-59 years, particularly with regard to marital status differences.
Our specific objective was to explore the relationship between sexual activity and depression in adult women in the United States.
We conducted a study utilizing depression and sexuality data from the U.S. National Health and Nutrition Examination Survey (NHANES) for women aged 20-59 years between 2007 and 2016. Subsequently, we used survey-weighted logistic regression models to examine the relationship between low-frequency sexual activity and the risk of depression. To further explore the effects of different stratification factors on the relationship between low-frequency sexual activity and depression, we conducted subgroup analyses based on age, race, marital status, poverty-to-income ratio (PIR), education level, BMI, hypertension, diabetes mellitus, smoking, trouble sleeping, and urine Leakage. In addition, sensitivity analysis and smoothed curve fitting were performed to ensure the reliability of the results.
Sexual activity was assessed by sexual frequency, ≤11 sexual encounters in a 12-month period were categorized as low-frequency sexual activity; depression was diagnosed by the Patient Health Questionnaire (PHQ-9, ≥10 scores).
From the 2007 to 2016 NHANES, a total of 6061 participants were enrolled in the study. Of these participants, 1869 (30.84%) reported a sexual frequency of 0-11 times/year categorized as low-frequency sexual activity. After adjustment for the full covariates, the risk of depression was found to be higher in low-frequency sexual activity participants (sexual frequency ≤ 11) compared to normal-frequency sexual activity participants (sexual frequency > 11) (OR = 1.37, 95 % CI: 1.08, 1.73; P = 0.010), this association varied according to marital status.
Our findings have important clinical implications and suggest that clinicians should pay attention to the mental health of female patients with low-frequency sexual activity and screen depressed patients for sexual activity.
STRENGTHS & LIMITATIONS: Our study is the large, nationally representative study to assess the relationship between low-frequency sexual activity and depression in women aged 20 to 59 years. However, the cross-sectional study design was unable to demonstrate a causal relationship between low-frequency sexual activity and depression.
In conclusion, our study demonstrates a significant association between low frequency of sexual activity and risk of depression in a population of women aged 20 -59 years in the U.S, which may be bidirectional.
现有研究在提供关于美国20至59岁成年女性性行为与抑郁症之间关系的全国代表性数据方面非常有限，尤其是在婚姻状况差异方面。
我们的具体目标是探讨美国成年女性性行为与抑郁症之间的关系。
我们利用2007年至2016年美国国家健康和营养检查调查（NHANES）中20至59岁女性的抑郁症和性行为数据进行了一项研究。随后，我们使用调查加权逻辑回归模型来检验低频性行为与抑郁症风险之间的关系。为了进一步探讨不同分层因素对低频性行为与抑郁症之间关系的影响，我们根据年龄、种族、婚姻状况、贫困收入比（PIR）、教育水平、体重指数（BMI）、高血压、糖尿病、吸烟、睡眠问题和尿失禁进行了亚组分析。此外，还进行了敏感性分析和平滑曲线拟合以确保结果的可靠性。
性行为通过性频率进行评估，将12个月内性行为次数≤11次归类为低频性行为；抑郁症通过患者健康问卷（PHQ - 9，得分≥10分）进行诊断。
从2007年至2016年的NHANES中，共有6061名参与者纳入研究。在这些参与者中，1869名（30.84%）报告性频率为每年0至11次，归类为低频性行为。在对所有协变量进行调整后，发现低频性行为参与者（性频率≤11）患抑郁症的风险高于正常频率性行为参与者（性频率>11）（OR = 1.37，95%CI：1.08，1.73；P = 0.010），这种关联因婚姻状况而异。
我们的研究结果具有重要的临床意义，表明临床医生应关注低频性行为女性患者的心理健康，并对抑郁症患者进行性行为筛查。
我们的研究是评估20至59岁女性低频性行为与抑郁症之间关系的大型全国代表性研究。然而，横断面研究设计无法证明低频性行为与抑郁症之间的因果关系。
总之，我们的研究表明，在美国20至59岁女性人群中，低频性行为与抑郁症风险之间存在显著关联，这可能是双向的。
