Physically active women tend to have better sexual function, experts say. But only to a point.

A recent Journal of Sexual Medicine study (article in press) suggests that women who exercise more than 6 hours a week may have poorer sexual function than those who spend less time on exercise.

Exercise may benefit sexual health by boosting physical health, self-esteem, and body image. However, research on physical activity and female sexual health has been limited, the authors said.

The study included 322 heterosexual women who were seeking help for sexual issues for the first time. All participants were seen at the Andrology, Women’s Endocrinology, and Gender Incongruence Unit at the University of Florence, Italy.

The women’s average age was 45 years. About 46% were postmenopausal. Over 90% were in stable relationships.

All of the women had been physically active during the previous three months. Exercise included activities like leisurely walking, yoga, aerobics, swimming, strength training, and jogging.

Their physical activity was categorized as follows:

• About 67% of the women were sedentary, with less than 1 hour of physical activity each week.
• About 23% were active. They exercised 1 to 3 hours each week.
• Just under 6% were very active, spending 4 to 6 hours of each week on physical activity.
• Roughly 4% were extremely active, exercising more than 6 hours each week.

The women underwent a variety of assessments, including visits with an endocrinologist, a mental health specialist, and a gynecologist. A Doppler ultrasound was performed to evaluate clitoral vascularization. The women also completed several questionnaires to assess their sexual function, sexual distress, body uneasiness, and psychopathological traits.

In addition, the women were screened for hypoactive sexual desire disorder (HSDD) and female genital arousal disorder (FGAD).

The researchers found that compared to sedentary women, most physically active women had better scores on sexual function assessments, particularly in desire, arousal, lubrication, and orgasm. They also had less sexual distress, had better results on the clitoral Doppler ultrasound, and were less likely to have HSDD or FGAD.

However, not all physically active women had better sexual function. Improvements were seen in a “stepwise” fashion for only the first three physical activity categories – sedentary, active, and very active. Women in the 4th category (extremely active) had worse sexual function than the very active women and lower sexual satisfaction than sedentary women.

The authors noted that excessive exercise is often a symptom of eating disorders. “Indeed, excessive [physical activity] might mirror the obsessive-compulsive need to control the body or it might represent a dysfunctional response to body dissatisfaction, commonly observed in eating disorder patients,” they wrote.

They pointed out that patients with sexual dysfunction may benefit sexually, physically, and emotionally from “regular, moderate” exercise. But clinicians may also tell patients that excessive exercise might not be as helpful, they said.

Resources

• The Journal of Sexual Medicine - “Physical Activity and Female Sexual Dysfunction: A Lot Helps, But Not Too Much”
  Maseroli, Elisa, MD, PhD, et al.
  (Full-text article in press. Published: June 5, 2021)
  https://www.jsm.jsexmed.org/article/S1743-6095(21)00427-6/fulltext