I think the enormous media publicity on the University of Chicago's National Health and Social Life Survey of sexual behavior is entirely appropriate: Its well-qualified investigators rigorously questioned 3,432 Americans on private behavior and got answers that stimulate public policy debate. They used scientifically recognized procedures to gather information that would be accurate, believable and useful. And they openly disclosed the limitations of their study.
I believe the public can have confidence in the representative profile of the population studied because 79 percent of the selected sample actually agreed to participate.
However, many will wonder, with good reason, whether a person who cheats on his or her spouse will honestly reveal such information in face-to-face interviews with a sex researcher.
I am pleased that the study results are being widely reported and discussed in magazines, newspapers and on talk shows. For me, a key question is how the information can help improve the quality of health care for women.
My studies of women's sexuality began as a graduate student at the University of Pennsylvania 21 years ago, where undergraduate women and infertile women patients in a medical practice provided prospective data on who did what and how often.
I was interested in how these behaviors were linked to reproductive health. Later, at Stanford, I extended that research to cover women approaching menopause (click for more menopause research), and still study human sexual behavior at the Athena Institute [now at Chester Springs].
My collaborative research yielded some startling discoveries: Both younger women and those approaching menopause who had weekly sexual behavior with men (except during menstruation) tended to be more fertile. They had estrogen levels about twice as high as their contemporaries.
The premenopausal women with "weekly behavior" had fewer "hot flashes" and tended to age more slowly than their contemporaries who lacked weekly sexual behavior with men. Women with sporadic sexual behavior had a 50-50 chance of severely deprived estrogen levels normally seen in postmenopausal women who do not take hormone therapies. Celibate women did not show these extremely low estrogen levels nor the richer levels of the stable, sexually active woman.
I learned that steady, monogamous, weekly sexual behavior with a man provides wonderful benefits for a woman's physiology and reproductive health. Sporadic behavior-- feast or famine-- can have detrimental effects.
The Chicago survey finds that weekly sex is regularly experienced by most married couples and rarely experienced by most single women. Those findings suggest to me the health benefits inherent in a warm, loving marriage (click for Dr. Cutler's book, Love Cycles). A good marriage should promote longevity and wellbeing. The lesson I see is: Wellness behavior (including weekly sex in a monogamous relationship) improves a woman's physiology. Marriage is good for people!
A surgical factor in sexuality is hysterectomy (click for more hysterectomy research) -- removal of the uterus. In America, a hysterectomy is prescribed for one out of two women. Scientists and younger physicians are learning that the uterus plays profound roles in a woman's sexual response.
A new study published in the American Journal of Public Health reports that, despite the continued high frequency of hysterectomies (650,000 cases per year), women who go to younger gynecologists and assert that they value their uterus and do not want it removed unnecessarily are likely to be spared a hysterectomy. A virtual mountain of data demonstrates the unfortunate results of even medically necessary hysterectomy: accelerated aging, sharply increased rate of both heart disease and osteoporosis in untreated (or incorrectly treated) post-hysterectomized women.
The Chicago study results I reviewed did not discuss how hysterectomy might have accounted for some variations in data collected in the survey nor the role of hormonal therapies that are widely prescribed both as oral contraceptives and pre- and postmenopausal replacement.
And the study did not focus on the significant proportion of postmenopausal women. But the National Health and Social Life Survey reported that monogamy thrives, marital sexuality is frequent and intimacy alive. To me, that kind of behavior adds up to health and well-being.
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