Blood pressure reactivity to stress is better for people who recently had penile–vaginal intercourse than for people who had other or no sexual activity
Introduction
Blood pressure reactivity to stress can predict the development of higher resting blood pressure levels (Matthews et al., 2003) and left ventricular hypertrophy as well as (in patients with cardiovascular disease) risk of myocardial infarction (Treiber et al., 2003).
Greater rates of sexual intercourse have been associated longitudinally with lower risk of mortality (Davey Smith et al., 1997). The present study considers one mechanism (blood pressure stress reactivity) by which sexual activity might affect cardiovascular risk, and differentiates between sexual behaviors.
There are several theoretical reasons why specifically penile–vaginal intercourse frequency would be expected to be associated with better physical and psychological health. First, if psychosexual development goes awry, the resulting “pre-genital” sexual behavior (inhibition of frequency or quality of intercourse in favor of noncoital activities) might be associated with both less psychological maturity and the psychophysiological effects thereof (Freud, 1953). Freud conjectured that noncoital sexual activity is “incomplete”, and hence its tension “disburdening” function is inadequate (p. 124). A lessened ability to discharge tension might manifest itself in many ways, including heightened stress reactivity. Second, there is the evolutionary preeminence of the lone potentially reproductive sexual endeavor. Selection advantages might be conferred on intercourse, including perhaps enhanced health and emotional function. Third, intercourse is more of a synchronized sensorimotor and emotional interaction than other sexual behaviors, which might lead to avoidance of intercourse by persons who prefer less emotionally intimate sexual interactions (Brody, 2003). Fourth, intercourse requires more complex brain activity than other sexual behavior. Lesions of the male primate medial preoptic area severely reduce intercourse frequency but do not alter masturbation or social interaction (Slimp et al., 1978). Fifth, there are afferent neuronal and psychoneuroendocrine differences between intercourse and other sexual behaviors. Manual or oral manipulation of the clitoris stimulates the pudendal nerve, but the vaginocervical stimulation provided by intercourse additionally stimulates the pelvic, hypogastric, and vagal nerves (Komisaruk and Whipple, 1998, Peters et al., 1987, Whipple and Komisaruk, 2002). It is the pelvic nerve that appears essential for some of the behavioral actions of oxytocin (Komisaruk and Whipple, 1998). Both oxytocin and improved vagal tone might be among the mechanisms involved in intercourse but not other sexual behaviors being associated with better psychophysiological function (Brody and Preut, 2003, Brody et al., 2000).
Frequency of penile–vaginal intercourse but not of other sexual behaviors is associated with indices of better emotional awareness (less alexithymia; Brody, 2003) and better cardiovascular autonomic tone (greater resting heart rate variability and lesser resting blood pressure; Brody and Preut, 2003, Brody et al., 2000).
Those empirical studies correlated sexual behavior frequency with psychological and physiological variables. The present study uses a different approach, by comparing the blood pressure responses of persons who engaged at all in penile–vaginal intercourse but not other sexual behavior (in one analysis, masturbation, in the other analysis partnered sexual behavior in the absence of penile–vaginal intercourse) with those of persons who engaged in other combinations of sexual behaviors (including none) during a 2-week recording period. This approach has the advantage of allowing comparisons of various qualitative patterns of recent sexual behavior, with an emphasis placed on engaging and not engaging in the behaviors, rather than assuming linear or independent effects of the behaviors.
Section snippets
Participants
Participants were recruited from advertisements posted at universities, shops and sports centers for a randomized trial of high-dose ascorbic acid on stress reactivity (Brody et al., 2002). Because the ascorbic acid group demonstrated both decreased stress reactivity (Brody et al., 2002) and increased frequency (Brody, 2002b) of penile–vaginal intercourse (but not other sexual behavior), only subjects from the placebo arm are examined in the present analyses. Because of their risk of
Penile–vaginal intercourse versus masturbation
MANOVA revealed multivariate within-subjects effects on blood pressure of time interacting with intercourse/masturbation group (F(18, 91) = 1.8, p < .05, η2 = .25, Wilks’ λ = .43), and a main effect of time (F(6, 32) = 3.8, p < .01, η2 = .41, Wilks’ λ = .58); as well as between subjects effects for intercourse/masturbation group (F(6, 72) = 2.4, p < .05, η2 = .17, Wilks’ λ = .69), biological sex (F(2, 36) = 16.4, p < .001, η2 = .48, Wilks’ λ = .52), and age (F(2, 36) = 6.7, p < .005, η2 = .27, Wilks’ λ = .73). Male biological sex and
Discussion
People who had intercourse but did not masturbate or even have partnered sexual behavior in the absence of penile–vaginal intercourse in the two-week period had blood pressure values that were lower than persons who did not engage in any sexual activity, as well as those who only masturbated or only had partnered sexual behavior in the absence of penile–vaginal intercourse. The intercourse-only group also had lower blood pressure values than subjects who had intercourse but also had one or more
Acknowledgements
Portions of this report were presented at a symposium conducted at the annual meeting of the Society for Psychophysiological Research, Sante Fe, October 2004.
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