If you’re female, is sex healthy?

A wide range of psychological and physiological health factors benefit from penile-vaginal intercourse, but other sexual activities don’t seem to provide the same benefits, and masturbation and anal intercourse might even be detrimental to health. (Sorry.)

Our evidence-based analysis features 26 unique references to scientific papers.

Written by Kamal Patel
Last Updated:

Libido and arousal

Libido is the desire for sex, but arousal is harder to define.[1] It can, however, be assessed both subjectively (through self-reports) and objectively (through changes in body heat, breathing rate, and genital sensitivity),[2] and we know some of its chemistry.

Neurotransmitters and hormones mediate arousal.[3] Like male arousal, female arousal is mediated by hypothalamic dopamine[3] and androgens[4][5] — a case study has noted a lack of libido in a woman deficient in dihydrotestosterone (DHT), a potent androgen derived from testosterone.[6] Estrogens, on the other hand, are not highly related to the neurology of sex, but rather to the regulation of female sexual anatomy.[7][8][9]

Externally, arousal appears influenced by the scent of the desired gender: smelling androgens stimulates heterosexual females, whereas smelling estrogens stimulates homosexual females and heterosexual males.[10][11] In the latter, smelling estrogens even increases testosterone.[12] The study of human pheromones, however, is still in its infancy.

One of the main research techniques to induce sexual arousal — the showing of pictures and videos of sexual activities the subjects report enjoying — seems to be more effective in males than in females.[13][14][15] Nevertheless, females do get sexually aroused by erotic videos, though not by sexual documentaries.[16]

Sex and orgasm

A wide range of psychological and physiological health factors benefit from penile-vaginal intercourse,[17] which has been associated with greater satisfaction with regard to sex, partnership, mental health, and life in general.[18] Other sexual activities don’t seem to provide the same benefits, and masturbation and anal intercourse might even be detrimental to health.[17][19]

Orgasm can be defined as a peak of euphoria usually followed by a feeling of contentment.[20] Whereas libido is most affected by androgens and the neurotransmitters dopamine and norepinephrine (aka noradrenaline),[21] orgasm appears most affected by another neurotransmitter: serotonin.[22] Various brain regions are important for female arousal and orgasm.[2] 

At the moment, no supplement has a large body of evidence for the enhancement of female orgasm; all we have are promising routes that await more research.[23] Most studies to date have aimed to prevent the decrease in libido caused by antidepressants; the results of such studies may not apply to healthy women.[24][25]

Finally, let’s note that there are differences between primate and nonprimate sexual control, so studies in rodents may have little bearing on humans.[2][26]

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  1. ^ Basson R, et al. Revised definitions of women's sexual dysfunction. J Sex Med. (2004)
  2. ^ a b c Salonia A, et al. Physiology of women's sexual function: basic knowledge and new findings. J Sex Med. (2010)
  3. ^ a b Pfaus JG. Pathways of sexual desire. J Sex Med. (2009)
  4. ^ Traish AM, et al. Androgens in female genital sexual arousal function: a biochemical perspective. J Sex Marital Ther. (2002)
  5. ^ Kingsberg SA, Simon JA, Goldstein I. The current outlook for testosterone in the management of hypoactive sexual desire disorder in postmenopausal women. J Sex Med. (2008)
  6. ^ Riley AJ. Life-long absence of sexual drive in a woman associated with 5-dihydrotestosterone deficiency. J Sex Marital Ther. (1999)
  7. ^ Levine KB, Williams RE, Hartmann KE. Vulvovaginal atrophy is strongly associated with female sexual dysfunction among sexually active postmenopausal women. Menopause. (2008)
  8. ^ Genazzani AR, et al. The European Menopause Survey 2005: women's perceptions on the menopause and postmenopausal hormone therapy. Gynecol Endocrinol. (2006)
  9. ^ Maclaran K, Panay N. Managing low sexual desire in women. Womens Health (Lond). (2011)
  10. ^ Berglund H, Lindström P, Savic I. Brain response to putative pheromones in lesbian women. Proc Natl Acad Sci U S A. (2006)
  11. ^ Savic I, et al. Smelling of odorous sex hormone-like compounds causes sex-differentiated hypothalamic activations in humans. Neuron. (2001)
  12. ^ Miller SL, Maner JK. Scent of a woman: men's testosterone responses to olfactory ovulation cues. Psychol Sci. (2010)
  13. ^ Rupp HA, Wallen K. Sex-specific content preferences for visual sexual stimuli. Arch Sex Behav. (2009)
  14. ^ Polan ML, et al. Female sexual arousal: a behavioral analysis. Fertil Steril. (2003)
  15. ^ Tsujimura A, et al. Sex differences in visual attention to sexually explicit videos: a preliminary study. J Sex Med. (2009)
  16. ^ Park K, et al. Blood-oxygenation-level-dependent functional magnetic resonance imaging for evaluating cerebral regions of female sexual arousal response. Urology. (2001)
  17. ^ a b Brody S. The relative health benefits of different sexual activities. J Sex Med. (2010)
  18. ^ Brody S, Weiss P. Simultaneous penile-vaginal intercourse orgasm is associated with satisfaction (sexual, life, partnership, and mental health). J Sex Med. (2011)
  19. ^ Brody S, Costa RM. Satisfaction (sexual, life, relationship, and mental health) is associated directly with penile-vaginal intercourse, but inversely with other sexual behavior frequencies. J Sex Med. (2009)
  20. ^ Meston CM, et al. Disorders of orgasm in women. J Sex Med. (2004)
  21. ^ Hull EM, et al. Hormone-neurotransmitter interactions in the control of sexual behavior. Behav Brain Res. (1999)
  22. ^ Meston CM, Frohlich PF. Update on female sexual function. Curr Opin Urol. (2001)
  23. ^ Brown AD, Blagg J, Reynolds DS. Designing drugs for the treatment of female sexual dysfunction. Drug Discov Today. (2007)
  24. ^ Safarinejad MR. Reversal of SSRI-induced female sexual dysfunction by adjunctive bupropion in menstruating women: a double-blind, placebo-controlled and randomized study. J Psychopharmacol. (2011)
  25. ^ Stryjer R, et al. Trazodone for the treatment of sexual dysfunction induced by serotonin reuptake inhibitors: a preliminary open-label study. Clin Neuropharmacol. (2009)
  26. ^ Michael RP, Clancy AN, Zumpe D. Effects of mating on c-fos expression in the brains of male macaques. Physiol Behav. (1999)