Low Sexual Satisfaction May Predict Memory Decline

Decreasing sexual health in middle-aged men may indicate an increased risk for cognitive decline, a new study finds.

The study published in the journal Gerontologist explored how physical changes, such as the microvascular changes relevant to erectile function, and psychological changes, like lower sexual satisfaction, affect cognition.

The researchers at the Pennsylvania State University examined 818 men across three waves at mean ages 56, 61, and 68. Using neuropsychological tests, such as memory and processing speed, they analyzed the cognitive changes of participants over the 12 years, adjusting for participants’ cognitive ability in young adulthood.

Erectile function and sexual satisfaction were measured using the International Index of Erectile Function. This self-report instrument addresses the most relevant aspects of male sexual function, including erectile strength, orgasm, and satisfaction with intercourse.

The researchers then built a statistical model to understand how the three variables changed as individuals aged. They found that decreases in erectile function and sexual satisfaction were both associated with memory decline.

"When we mapped the relationship over time, we found increases or decreases in erectile function and sexual satisfaction were associated with concurrent increases or decreases in cognitive function," says Riki Slayday, a doctoral candidate at Penn State and lead author on the study. "These associations survived adjustment for demographic and health factors, which tells us there is a clear connection between our sex lives and our cognition."

The authors conclude that discussing and tracking sexual health in middle-aged men may help to identify those at a higher risk of memory decline.

Such findings are consistent with previous research. A 2021 study that included 155 older, cognitively intact, married adults and followed them for 10 years found that those with greater sexual satisfaction were less likely to have mild cognitive impairment or dementia in the future.

Two meta-analyses suggest that men with erectile dysfunction, especially younger ones, are at a significantly increased risk of cardiovascular disease (CVD). Therefore, the treatment of ED not only restores sexual relations but may also prevent subsequent CVD events, including death.

In fact, Viagra (sildenafil), a common drug for ED, was originally studied to treat high blood pressure and angina pectoris, which is a form of cardiovascular disease. After observing an unexpected side effect, the researchers began trials to see if sildenafil could be effectively used as ED medication.

Erectile dysfunction commonly coexists with coronary artery disease (CAD), the most common heart disease in the United States. The conditions share risk factors such as obesity, diabetes, smoking, hypertension, and metabolic syndrome. There is evidence that ED may be a manifestation of systemic vascular disease.

Martin Sliwinski, professor of human development and family studies at Penn State and co-author on the study, says: "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."