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Background: 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.
Objectives: Our specific objective was to explore the relationship between sexual activity and depression in adult women in the United States.
Methods: 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.
Main Outcome Measure: 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).
Results: 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.
Clinical Implications: 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.
Conclusion: 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.
