Is Sex Good for Your Heart Health?

Dear Diabetes Health,

Both my husband and I are over 60 and have type 2 diabetes.  He lost interest in sex a few years back, I think because he couldn’t get erections. I don’t really miss sex. It wasn’t that great for me, anyway.  But I’ve been reading that sex is good for your health and that it prevents heart attacks. Is this really true?  Does sex help diabetes?  Should we try to be sexual because it’s good for us?

Elaine in Alabama
Dear Elaine,

Most of the studies saying that “sex prevents heart attacks” or things like that are “population studies,” sometimes called epidemiological studies.  For example, scientists at the New England Research Institute in Massachusetts tracked the sexual activity of about 1000 men ages 40 to 70. They found that those who had sex twice a week had only half the risk of heart attack, compared to men who had less sex.

In another study, scientists at Wilkes University in Pennsylvania tested the saliva of 112 college students who reported their frequency of sex.  Those having sex two to three times a week had higher levels of IgA, an immune molecule that fights infection, than those who were abstinent or had sex less than once week.

Writing on Web MD, health journalist Kathleen Doheny described a study in the journal Biological Psychology, wherein researchers reported that couples who lived together and had frequent sex tended to have lower diastolic blood pressure.

Population studies prove nothing about cause, though.  Did men have fewer heart attacks because they were having more sex, or were they having more sex because they were healthier? Maybe having stronger immune systems led the Pennsylvania students to have more sex, rather than the other way around. These studies are not strong evidence that sex improves health.

Different kinds of studies provide stronger evidence.  If you look at what happens in people’s blood while having sex or after orgasm, you can see changes that may well provide health benefits. Sex and orgasms both raise the level of oxytocin, the “bonding hormone.” Oxytocin lowers blood pressure and reduces levels of the stress hormone cortisol. Oxytocin and endorphins (which also increase after sex) help relieve pain and promote sleep. Several studies have shown that even moderate sleep deprivation increases insulin resistance.  So a good night’s sleep will likely help your glucose control.

In his blog “Conquering Diabetes,” Michael Dansiger, MD, wrote, “Healthy sleep habits are very important for diabetes management–and sex and sleep are closely related. Sex releases hormones that help promote sleep (especially in men), and sleep promotes hormones that favor good blood sugar control and appetite control. By the same token, inadequate sleep quality or quantity promotes hormones that worsen blood sugar control, appetite, weight gain, diabetes, and heart disease.”

Sex is also a mild form of exercise, although you would need a lot of it to see any effect. The strongest sex/health connections are with better sleep and the stress-reducing effects of oxytocin.

What’s the Downside?

Are there health risks to sex in a loving relationship?  If there are, they don’t seem significant. According to the physicians’ education website “UptoDate,” sex may increase the risk of heart attack by as much as one percent in men with existing cardiac problems.  But probably even this tiny increase is due more to anxiety than to the physical activity. A Japanese report found that most men who died during sex were cheating on their wives at the time.

Likewise, a population study from Wales found that frequency of sex was not associated with stroke in the 914 men they followed for 20 years. Sex seemed somewhat protective against death from heart attack in this group. So relaxed sex appears to be safe. Stressful sex may not be.  

Because good sex is healthy, but bad sex not so much, if neither you nor your partner wants sex, it’s probably not worth it.  You’ll definitely want to get lots of hugs and touching, though, and it doesn’t all have to come from your husband.  You might give more hugs to other family members and friends. Most human contact seems to promote oxytocin. You also can get some of the oxytocin benefit from pets, by petting a cat or a dog, for example.  

And we wouldn’t give up on sex prematurely. Sex does not have to mean intercourse, and erectile dysfunction does not have to mean “no sex.”  In fact, since intercourse “wasn’t that great” for you before, you might be able to have better sex if you try some new things. You can share touch and closeness, which can include intense pleasure and orgasm, without intercourse, or even without genital contact of any kind.

Even without the direct health benefits, sex can strengthen your relationship. Oxytocin binds mothers to infants, and it seems to have similar affects on sexual partners. You don’t necessarily need to go all the way to get some of the benefits.  “Oxytocin is like a hormone of attachment,” said Carol Rinkleib Ellison, former assistant clinical psychiatry professor at the University of California, San Francisco. “It creates feelings of calm and closeness.”

You and your husband need to talk about what you want as far as physical contact and sex. Though it may be difficult to start the conversation, you’ll probably both feel relieved once you do. Don’t be critical, though. Just say what you really feel. Remember, words can never hurt you if they’re said with love. But not saying what you feel can damage lives and relationships. Bottom line: sex is good for you, but only if you want it.

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