May 31, 2023
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Sexual satisfaction appears to play an important role in supporting cognitive function in aging men. Low satisfaction and erectile dysfunction are associated with declining memory, new research shows.
Men who have erectile dysfunction and feel sexually unfulfilled may be more likely than other men to experience memory loss and overall cognitive decline as they age, according to new research out of Penn State University.
About 30 million men in the U.S. suffer from erectile dysfunction, with more than half of men ages 40 to 70 estimated to experience some form of impotence. Men with ED may struggle to maintain satisfying sex lives, leading to psychological changes, such as depression and loss of libido, that impact cognitive performance as years go by.
The Penn State researchers looked at survey data from more than 800 men ages 56 to 68 who were followed over a 12-year span. The study included tests of memory and information processing alongside evaluations for ED using a standard, self-reported assessment. The men also were asked to rate their own levels of sexual satisfaction.
"What was unique about our approach is that we measured memory function and sexual function at each point in the longitudinal study, so we could look at how they changed together over time," said study author Martin Sliwinski, professor of human development and family studies at Penn State. "What we found connects to what scientists are beginning to understand about the link between life satisfaction and cognitive performance."
The study, published in the medical journal The Gerontologist, found strong correlations between low sexual satisfaction, ED and cognitive decline as the men aged, although the cause of the relationships is not clear.
"Scientists have found that if you have low satisfaction generally, you are at a higher risk for health problems like dementia, Alzheimer's disease, cardiovascular disease and other stress-related issues that can lead to cognitive decline," Sliwinski said. "Improvements in sexual satisfaction may actually spark improvement in memory function. We tell people they should get more exercise and eat better foods. We're showing that sexual satisfaction also has importance for our health and general quality of life."
Depression often is associated with varying levels of cognitive impairment that increase as people get older. If low sexual satisfaction contributes to depression, that may be another factor in declining cognitive performance with increasing age.
The Penn State researchers believe ED may be a valuable measure for doctors to assess whether men are at higher risk for cognitive decline before they turn 70. Since decreases in erectile function and sexual satisfaction were both associated with memory decline, the study suggests there is a connection between psychological and physical health related to sex. Increases in these two factors also corresponded to improved cognitive function.
"These associations survived adjustment for demographic and health factors, which tells us there is a clear connection between our sex lives and our cognition," said Riki Slayday, a doctoral candidate at Penn State and lead author on the study.
The study's approach differs from others that have attempted to analyze sexual health.
"Research on sexual health has historically focused on quantifiable facets of sexuality like number of sexual partners or frequency of sexual activity," Slayday said. "What we were interested in is the perception of that activity, how someone feels about their sex life, and how that influences cognitive function, because multiple people could be in the same situation physically but experience completely different levels of satisfaction."
Past studies have established links between cardiovascular health and erectile function. Viagra originally was developed to treat cardiovascular problems, but has emerged as one of the most widely prescribed medications for ED. Other health impacts of ED should become areas of greater focus, the researchers said.
A 2016 study found that sexual activity is associated with better cognition in older men, who were tested for word recall and number sequencing to evaluate executive function and memory. Men who were sexually active scored higher in word recall and number sequencing than those who were not sexually active. That study pointed to the possible benefits of physical activity during sex, including the production of the dopamine, a neurotransmitter and hormone that plays a role in memory, pleasure and motivation.
And although dopamine also is produced by exercise, there may be psychological benefits to sexual pleasure that help maintain healthy cognition. In one large, study of older couples, men and women saw cognitive benefits, such as improved memory, from more frequent sexual activity. Emotional closeness between partners corresponded to better memory performance.
Research on the relationship between sexuality and cognition specifically in older women is more limited than it is among men. One study found that heterosexual women who were more sexually active scored better on word recall tests than women who were not as sexually active. Notably, the memory tests that used image recall instead of words did not appear to be linked to levels of sexual activity. The researchers believe this may be due to the memory role of the hippocampus, a region of the brain where rats have been shown to grow more neurons when they have more sex.
In women, changes in sex hormones during menopause also are known to be associated with cognitive complaints including impaired memory function.
The Penn State researchers say more research on sexual health and cognition is needed, noting the older adult population in the U.S. is expected to double over the next 30 years. The number of men experiencing declines in erectile function and sexual satisfaction will increase.
"We already have a pill for treating erectile dysfunction. What we don't have is an effective treatment for memory loss," Sliwinski said. "Instead of the conversation being about treating ED, we should see that as a leading indicator for other health problems and also focus on improving sexual satisfaction and overall well-being, not just treating the symptom."
