Dramatic Change in Sexual Behaviors

Deborah Brauser

November 27, 2013

Sexual behavior has changed dramatically in recent decades, including first sexual activity occurring at a younger age, more tolerance for same-sex relationships, and a growing number of older people who continue to be sexually active ― even though the average overall frequency of sexual encounters has declined for both men and women, new research suggests.

Results from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3), which surveyed more than 15,000 adults in the United Kingdom, were released in 6 articles published online November 26 in the Lancet.

Other findings showed that individuals are now less tolerant of married people having sex with others, that 1 in 6 pregnancies in the UK are unplanned, and that more than 40% of both men and women surveyed reported having had a recent sexual problem.

More troubling, 1 in 10 of the women and 1 in 70 of the men reported experiencing sex against their will sometime in the past, but few ever told anyone about it.

The first 2 Natsal surveys were conducted in 1990-1991 and 1999-2001, but only included adults between the ages of 16 and 44 years. The current survey includes data from individuals up to the age of 74 years.

"We now have a much greater understanding of the role that sex plays over the course of a person's lifetime," said principal investigator Anne Johnson, MD, professor at the University College London, UK, in a release.

"Although our results show that we are improving the uptake of some services, there are other areas where people may need more support and advice on health and sexual problems," said Dr. Johnson, adding that more needs to be done to create an environment in which individuals feel comfortable discussing sexual well-being as part of their normal health discussions.

Earlier Intercourse

The current survey was administered through interviews between September 2010 and August 2012 to 15,162 adults (8869 of whom were women). The interview questions asked about patterns of sexual behavior, attitudes, and health.

In addition, data from those who were between the ages of 16 and 44 years were compared with data from participants in Natsal-1 and Natsal-2 in the same age range.

Results showed that during the last 60 years, age at first intercourse declined to a median of 16 years. In addition, 31% of the men and 29% of the women who were between the ages of 16 and 24 years reported having first sex before the age of 16 years vs 15.4% and 4%, respectively, of those between the ages of 65 and 74 years.

"Young people today are having sex at an earlier age than previous generations did," said coinvestigator Cath Mercer, PhD, also from University College London.

"However, as men and women are living longer, have healthier lives, and continue to have active sex lives well beyond their reproductive years, we need to view sexual health and well-being as an issue of lifelong importance," she added.

A total of 41% of the female participants between the ages of 65 and 74 years reported having heterosexual sex with at least 1 partner in the previous year, as did 56% of the men in the same age range.

In the current survey, the women between the ages of 16 and 44 years reported an average number of 7.7 sexual partners of the opposite sex during their lifetime, which is more than double the median number of 3.7 partners reported by the same age group in Natsal-1.

Men in this age group reported 11.7 lifetime sexual partners of the opposite sex in the current study vs 8.6 partners in Natsal-1.

Less Frequent Sex

However, frequency of sex fell from a mean of 6.2 times per month for men between the ages of 16 and 44 years in Natsal-1 to 4.9 times per month in Natsal-3. The number also declined for women, from 6 times to 4.8 times per month.

A total of 4.8% of the men in the current study reported having at least 1 same-sex partner vs 3.6% of the men in Natsal-1. Although this percentage did not change drastically for the men, it did for the women, jumping from 1.8% to 7.9% between the first and last surveys.

Disapproval of nonexclusivity in marriage increased from 45% to 63% of the men and from 53% to 70% of the women.

The investigators also reported that 16.2% of the pregnancies experienced by the participants were unplanned, and 29% said they were "ambivalent" about the news.

"Our estimate of the rate of unplanned pregnancies in Britain is lower than estimates in some other high-income countries," said coinvestigator Kay Wellings, professor of sexual and reproductive health research at the London School of Hygiene and Tropical Medicine.

"This may be explained by differences in measurement, but it may also in part be due to contraception being available free of charge from the NHS [National Health Service]."

Other findings from the survey included the following:

  • 51% of the women and 42% of the men reported that they had had a recent sexual problem.

  • Lack of interest in sex was the most common problem reported.

  • 17% of the participants reported that their health affects their sex life; this increased to 60% of those who said they were in bad health.

  • Only 24% of the men and 18% of the women in this latter group reported seeking help from a healthcare professional.

Nonconsensual Sex

In the last of the 6 articles, which discussed nonvolitional sex, 9.8% of the women and 1.4% of the men said that someone had forced them to have sex against their will. Only 42% of these women and 33% of the men told anyone about it; and only 12.9% and 8%, respectively, reported the occurrence to the police.

In only 15% of all of these cases, the person responsible was a stranger. A total of 45% of the women who were between the ages of 13 and 15 years at the time of occurrence reported that the person responsible was a family member or friend; by contrast, 70% of those who were older than 24 years at time of occurrence reported that the person was a former or current partner.

"Our findings point to the necessity for intervention at an early age to prevent sex that is nonconsensual, and for greater efforts to be made to remove the barriers that prevent people from talking about their experience and seeking help," said coinvestigator Wendy Macdowall, who is also from the London School of Hygiene and Tropical Medicine.

The results also "support the need for training of health and other professionals to enable them to better provide appropriate services and guidance for people," she added.

The survey study was funded by the Medical Research Council and the Wellcome Trust, the Economic and Social Research Council, and the Department of Health. Dr. Johnson has been a governor of the Wellcome Trust since 2011, and 1 of the other study authors reports having received funding from Merck. The other authors have disclosed no relevant financial relationships.

Lancet. Published online November 26, 2013. Abstracts 1, 2, 3, 4, 5, 6

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