Too stressed for sex? Associations between stress and sex in daily life

Abstract

Objective: Although it is deeply ingrained in our beliefs that stress affects sexual experience and behavior, factual knowledge about this interplay is scarce despite significant impacts on health. This ambulatory assessment study examined the bidirectional association between stress and sexuality (desire, arousal, activity) in daily life, considering gender differences. Stress was assessed using a multidimensional measurement approach, with the inclusion of cortisol analysis for the first time in this context. Methods: For 14 consecutive days, healthy heterosexual men and women (n = 63) in a relationship rated their subjective stress, sexual desire, and sexual arousal using an iPod six times daily, collected saliva samples (for cortisol analysis) six times daily, and completed event-based measurements following sexual activity. Multilevel models were used for analysis. Results: Considering main associations, higher subjective stress was associated with lower concurrent sexual desire and arousal, while the reverse association was not significant. Previous sexual activity was associated with lower subsequent salivary cortisol levels. Furthermore, although main associations were insignificant, cross-level interactions with gender showed that higher sexual desire was more strongly associated with lower concurrent subjective stress in women than in men. Higher sexual arousal was more strongly associated with lower concurrent subjective stress in women than in men. Higher cortisol levels were more strongly associated with lower concurrent sexual desire in women than in men. Conclusions: This study demonstrates negative associations between stress and sexuality, with stronger effects in women. Generalizability is limited. Future studies should investigate possible beneficial effects of stress reduction interventions on sexuality in healthy and clinical samples.