Photo purchased from iStock, used with permission.
Source: Photo purchased from iStock, used with permission.

As a psychotherapist specializing in sexual and intimacy disorders, I can tell you that for a lot of individuals and couples the amount of sex they’re having (or not having) can be worrisome.

They ask me, “How much sex is healthy?" and, "How much sex should we be having in order to be healthy and happy?”

Most of the time the expressed concern, except in cases of sexual compulsivity, is that the individual or couple is not being sexual often enough. But whatever the fear, whether too much or not enough, the individuals who pose these questions typically feel a considerable amount of stress and anxiety about what they view as a potentially unhealthy sexual life.  

What Is Healthy?

That, dear readers, is a bit of a loaded question. If you Google this request, you’ll get an astounding array of answers. Some of the most methodically obtained data (and therefore the most likely to be accurate) is provided by the General Social Survey, which has tracked American sexual behaviors since the early 1970s. The GSS suggests that married couples have sex approximately 58 times per year. But this number does not consider the age of the couple or how long they’ve been together. In other words, this statistic doesn’t differentiate between people in their 20s and senior citizens, or people who just got married and those who’ve been together for a half-century. Other information provided by the GSS more helpfully suggests that couples in their 20s have sex an average of 111 times per year, and that the frequency of sex drops approximately 20 percent per decade as couples get older.

Are you counting decades and percentages on your fingers right now? I sure am. After all, I’m human, and this issue, despite my years of clinical experience, nags at me too.

Unfortunately for those seeking accurate answers about “normality," even the GSS data may be misleading, as discussed in a January 2015 New York Times article by Seth Stephens-Davidowitz. He writes:

I analyzed data from the General Social Survey, a classic research site. Heterosexual men 18 and over say that they average 63 sex acts per year, using a condom in 23 percent of them. This adds up to more than 1.6 billion heterosexual condom uses per year. Heterosexual women say they average 55 sex acts per year, using a condom in 16 percent of them. This adds up to about 1.1 billion heterosexual condom uses per year. Who is telling the truth, men or women? Neither. According to Nielsen, fewer than 600 million condoms are sold every year.

So: Apparently people tend to lie when asked about sex—even when asked by anonymous scientific researchers such as those employed by the GSS. Who would have ever guessed?

My point is that “average number of sexual encounters” figures provided even by the GSS may be wildly inaccurate, and probably skewing much higher than reality. In other words, most people don’t have sex nearly as often as they’d like other people to think they do.

So, again, what constitutes normal? Perhaps the most recent Diagnostic and Statistical Manual of Mental Disorders (commonly referred to as the DSM-5)—the book that serves as the American Psychiatric Association’s “diagnostic bible”—can clear things up for us.

The DSM-5 lists two disorders related to lack of sexual activity and/or interest, one for each gender. Women could have Female Sexual Interest/Arousal Disorder; and men, Male Hypoactive Sexual Desire Disorder. Interestingly, the diagnostic criteria for the two issues are extremely similar. (So why have two?) Essentially, whether male or female, a lack of sexual activity or interest is pathologized if and when:

  • Sexual disinterest lasts for six months or longer.
  • Sexual disinterest causes significant distress to the individual—stress, anxiety, depression, fear, etc.
  • Sexual disinterest is not attributable to an external factor such as substance abuse, side effects of medication, a medical condition, or severe relationship trauma (as occurs with domestic violence, for instance).

Notice that even the DSM-5 does not give a specific number of sexual encounters that makes a person undersexed. So in terms of knowing how much sex people should (or shouldn’t) be having, the DSM-5 is not very helpful. Nor should it be, because sexual frequency is an individual preference. One person might be having sex two or three times per week and feel that he or she is not getting nearly enough, whereas another person might by having sex once in a blue moon and feel that’s more than sufficient.

Neither person should be pathologized for this difference.

The point that I am trying to make here is that either way—lots of sex or very little—there is no need to panic. Yes, you may be having sex much more often than you think is normal (whatever that is), but this does not make you hypersexual, nor does having sex infrequently (or not at all) make you clinically undersexed and in need of psychotherapeutic treatment. If either of these extremes is causing you significant distress, of course, and if hearing the facts about sexual frequency (such as they are) does not help to alleviate your distress, you may want to seek professional assistance. On the other hand, if the simple realization that you are probably more "normal" than you thought diminishes your stress and anxiety, then you should proceed accordingly.

One overarching factor that science is just beginning to explore is the difference between physical sexual arousal and the desire to actually have sex. Until recently, it was thought that if men and/or women were experiencing sexual arousal, then they would also want and probably have sex. Now we are finding that this is not in fact the case, particularly for women, who, generally speaking, need to feel not just physical arousal but an emotional connection before they fully desire sex. In other words, physical arousal is not always enough.

And in truth it’s not just women who need an emotional connection in order to fully desire and enjoy sex. Many men do, too. Interestingly, this realization has recently spawned a new genre of sexuality identifiers. These days, people don’t just identify as straight, gay, lesbian, or bi; we’ve also got shifting labels like demisexual and gray-asexual. (In case you’re wondering, demisexuals say they only rarely feel sexual desire, and when they do it is only in the context of a close relationship, while gray-asexuals fluctuate between asexuality and a more normal level of interest—whatever they feel normal might be.) Regardless of the terminology, there are growing numbers of people who freely accept that it is perfectly okay to have little or no interest in sexual activity. In other words, they understand and accept that it is only when lack of sex is causing significant distress to a person and/or his or her romantic partner(s) that it becomes problematic.

So where are you on the spectrum of sexual? And does the answer really matter?

The simple truth is that human sexuality cuts a wide swath in terms of what people like to do, how often they like to do it, and who they like to do it with (if anyone at all). Further, these desires, especially as they relate to sexual frequency, can be significantly influenced by all sorts of internal and external factors—age, physical health, psychological wellbeing, emotional intimacy, medications, substance abuse, grief, work, financial stress, hormonal imbalances, etc. Knowing this, it is easier to understand that there just isn’t a norm when it comes to the amount of sex that you should be having.

If you’re comfortable with the amount of sex that you’re having, then you’re having the right amount of sex. Period. Even if the amount of sex you’re having is “very little” or “none at all.”

Just as people can be heterosexual, homosexual, or bisexual, we can also be hypersexual, asexual, demisexual, gray-asexual, or anything else. And there is nothing inherently wrong with any of this. As long as your sexual activity (or lack thereof) is not causing you stress and anxiety, diminishing your self-esteem, harming others, breaking the law, causing problems in your relationship, if you’re in one, or creating negative life consequences, you needn’t worry.

You should also understand, if you are still worried about your lack of sexual activity, that many times hyposexuality is a medical issue that can be treated with various medications and/or lubricants. And in cases where the issue is not physical in nature, there are plenty of therapists who specialize in helping individuals heal from sexual issues. (The American Association of Sexuality Educators, Counselors and Therapists is an excellent referral source.)

wavebreakmedia/Shutterstock
Source: wavebreakmedia/Shutterstock

Robert Weiss LCSW, CSAT-S is Senior Vice President of Clinical Development with Elements Behavioral Health. A licensed UCLA MSW graduate and personal trainee of Dr. Patrick Carnes, he founded The Sexual Recovery Institute in Los Angeles in 1995. He is author of Cruise Control: Understanding Sex Addiction in Gay Men and Sex Addiction 101: A Basic Guide to Healing from Sex, Porn, and Love Addiction, and co-author with Dr. Jennifer Schneider of both Closer Together, Further Apart: The Effect of Technology and the Internet on Parenting, Work, and Relationships and Always Turned On: Sex Addiction in the Digital Age. For more information you can visit his website, www.robertweissmsw.com.

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