Benefits of Sexual Activity on Psychological, Relational, and Sexual Health During the COVID 19 Breakout
Background The COVID 19 related lockdown has profoundly changed human behaviors and habits, impairing general and psychological well being. Along with psychosocial consequences, it is possible that sexual behavior was also affected. Aims With the present study we evaluated the impact of the community wide containment and consequent social distancing on the intrapsychic, relational, and sexual health through standardized psychometric tools. Methods A case control study was performed through a web based survey and comparing subjects of both genders with (Group A, N=2608) and without (Group B, N=4213) sexual activity during lockdown. The Welch and chi square tests were used to assess differences between groups. Univariate analysis of covariance, logistic regression models and structural equation modeling (SEM) were performed to measure influence and mediation effects of sexual activity on psychological, relational, and sexual outcomes. Outcomes Main outcome measures were General Anxiety Disorder 7 for anxiety, Patient Health Questionnaire 9 for depression, Dyadic Adjustment Scale for quality of relationship and a set of well validated sexological inventories (International Index of Erectile Function, Female Sexual Function Index, and male female versions of the Orgasmometer) Results Anxiety and depression scores were significantly lower in subjects sexually active during lockdown. Analysis of covariance identified gender, sexual activity and living without partner during lockdown as significantly affecting anxiety and depression scores (p<0.0001) Logistic regression models showed that lack of sexual activity during lockdown was associated with a significantly higher risk of developing anxiety and depression (OR: 1.32 [95% CI: 1.12 1.57, p<0.001] and 1.34 [95% CI: 1.15 1.57, p<0.0001] respectively) SEM evidenced the protective role of sexual activity towards psychological distress (bmales= 0.18 and bfemales= 0.14) relational health (bmales=0.26 and bfemales=0.29) and sexual health, both directly (bmales=0.43 and bfemales=0.31) and indirectly (bmales=0.13 and bfemales=0.13) Clinical translation The demonstrated mutual influence of sexual health on psychological and relational health could direct the clinical community towards a re interpretation of the relationship among these factors. Strengths and limitations Based on a large number of subjects and well validated psychometric tools, this study elucidated the protective role of sexual activity for psychological distress, as well for relational and sexual health. Main limitations were the web based characteristics of the protocol and the retrospective nature of pre lockdown data on psycho relational and sexual health of subjects recruited. Conclusions COVID 19 lockdown dramatically impacted on psychological, relational and sexual health of the population. In this scenario, sexual activity played a protective effect, in both genders, on the quarantine related plague of anxiety and mood disorders.
The Journal of Sexual Medicine