Sexual frequency occupies an awkward place in medical research. It is easy to ask about, uncomfortable to answer honestly, and it moves with a great deal of what is happening elsewhere in a person’s life and body. Three recent observational analyses of a large US national health survey have found that adults reporting very low sexual frequency also have a higher risk of death, particularly when heart disease is already present.
That pattern raises an obvious question for couples. Does less sex cause harm, or does it signal harm already underway? The data cannot settle it, but they fit the second reading better, with one extra detail: risk rises again at the very high end.
What does new data say about sexual frequency and mortality?
A 2024 observational study followed 17,243 young and middle-aged US adults from the 2005-2016 national survey for a median of 106 months. Those reporting sex fewer than 12 times a year had the highest cardiovascular and all-cause mortality risk; risk fell as frequency rose.
Listening to a partner’s heartbeat: research now examines sexual frequency alongside heart health. — Image: AI-generated / Nano Banana 2 via fal.ai
In that analysis 443 people, or 2.57% of the sample, died during follow-up. The association was not linear. Risk of cardiovascular disease and all-cause death fell as frequency increased and reached its lowest point at roughly 52-103 times a year. Above that range the pattern reversed, and very high frequency was also linked with higher risk. The design is observational, so causation cannot be proved, and frequency was self-reported.
In my consulting room I have repeatedly seen a sudden drop in sexual frequency become the first sign a couple mentions of exhaustion, depression or illness in one partner. The survey numbers fit that clinical picture without confirming it. Frequency is behaviour, and behaviour shifts when energy, mood or physical health shifts.
All three analyses share a measurement problem. They count acts rather than satisfaction, and they rely on what participants reported about themselves.
Why is heart disease plus infrequent sex more worrying?
Among adults aged 20-59 in the same 2005-2016 survey, the 2025 analysis defined low frequency as less than once a month. Unadjusted, people with cardiovascular disease had a hazard ratio for death of 5.1 compared with those without.
After adjustment for demographic and health factors, people with both cardiovascular disease and low sexual frequency had 2.3 times the risk of death. People with cardiovascular disease who reported moderate-to-high frequency had a hazard ratio close to 1. In this sample, the excess risk after adjustment appeared in the combination of heart disease and infrequent sex rather than in the diagnosis on its own.
The authors concluded that taking a sexual history should be part of care for people with cardiovascular or other chronic disease. That recommendation rests on a simple idea: a question about sex can surface information a routine review of symptoms misses. Someone who has stopped having sex because of breathlessness, fatigue or fear is describing something clinically relevant, whether or not frequency itself changes survival.
What role does depression play?
A second 2025 analysis followed 4,978 people aged 20-59 from the 2015-2016 survey who had sex fewer than 12 times a year. Within that group, 215 people, or 4.3%, died during follow-up. Depression was associated with 1.86 times the risk of death.
Depression combined with abdominal obesity raised the risk of death beyond either condition alone. Because the sample was restricted to people already reporting low frequency, the finding describes that subgroup and cannot be extended to adults in general. The design is observational, so the direction of influence is unsettled: low mood can reduce desire, and poor health can reduce both.
For couples, the practical reading is that a fall in frequency and a fall in mood often arrive together, and that the pairing is worth raising rather than hiding. That makes the bedroom a reasonable place to notice a health change, and a poor place to diagnose one. Mood is treatable, and so are many of the conditions that accompany it.
Is more always better?
No. In the 2024 analysis the lowest risk of death sat in a middle band, roughly 52-103 times a year, and risk rose again above it. Very high frequency was linked with higher mortality as well, so the relationship is not a simple case of more being better.
Talking about sex belongs in health care, especially for people living with heart disease. — Image: AI-generated / Nano Banana 2 via fal.ai
Our position is clear: sexual frequency is a marker of health, not a prescription to be forced. Frequency reflects energy, mood, relationship quality and physical comfort. When those change, frequency usually changes with them and becomes visible before anything else does. Treating the number as a target inverts that logic. A couple who force frequency to chase a figure are acting on an untested assumption.
High frequency is not automatically protective either. It can accompany good health, a new relationship or a stretch of high energy, and it can accompany anxiety or an attempt to prove something. Observational data cannot separate those possibilities. [Further research needed: no trial has yet shown that deliberately increasing sexual frequency by itself extends life.]
In the 2025 analyses, low frequency meant less than once a month, or fewer than 12 times a year. The 2024 study used fewer than 12 times a year. These are research thresholds, not clinical cut-offs for individuals.
If I have heart disease, should I talk to my doctor about my sex life?
Yes. The authors of the 2025 analysis concluded that taking a sexual history should be part of care for people with cardiovascular or other chronic disease. Bring it up directly if your clinician does not.
Does infrequent sex mean our relationship is in trouble?
Not by itself. Low frequency appeared in the surveys alongside heart disease and depression, not as a standalone sign of relationship failure. Couples differ widely in what they want, and a change from your own baseline matters more.
If desire has dropped, where should we start?
Begin with a conversation and a health review rather than a target. Mood, relationship strain and physical illness all touch desire. If the change is recent and unexplained, mention it to a clinician.
Conclusion: what does sex tell us about our health?
Sexual frequency tells us something about health rather than about duty. In these surveys it moved with heart disease, depression and mortality, and the association was strongest among people who were already ill. None of the three analyses can show that changing frequency changes survival.
That is grounds for attention to your health, not for pressure in your bedroom. Frequency is one signal among many, and it is one you can raise with a partner and a clinician.
Looking for professional support with your relationship or mental health?
1. Teng TQ, Liu J, Wang MM, Mo DG, Chen R, Xu JC, Dong ZH, Zhang N, Yu HC. The association of sexual frequency with cardiovascular diseases incidence and all-cause mortality. Scientific Reports. 2024;14(1):31925. PMID: 39738405 — DOI
2. Davis WS, Anderson P, Banerjee S. Cardiovascular Disease and All-Cause Mortality Among Individuals with Low Sexual Frequency. Healthcare (Basel). 2025;13(5). PMID: 40077024 — DOI
3. Teng TQ, Wang MM, Mo DG, Xie YY, Chen R, Xu JC, Liu J, Yu HC. Synergistic effects of a body shape index and depression on mortality in individuals with low sexual frequency. Journal of Affective Disorders. 2025;380:104-112. PMID: 40122262 — DOI
Sources retrieved from PubMed.
Image Credits
All three images in this article were generated with AI (Nano Banana 2 via fal.ai) and depict no real people.
