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Sex and death: are they related? Findings from the Caerphilly cohort study

BMJ 1997; 315 doi: (Published 20 December 1997) Cite this as: BMJ 1997;315:1641
  1. George Davey Smith (zetkin{at}, professor of clinical epidemiologya,
  2. Stephen Frankel, professor of epidemiology and public health medicinea,
  3. John Yarnell, senior lecturerb
  1. a Department of Social Medicine, University of Bristol, Bristol, BS8 2PR
  2. b Department of Epidemiology and Public Health, Queen's University of Belfast, Belfast BT12 6BJ
  1. Correspondence to: Professor Davey Smith


Objective: To examine the relation between frequency of orgasm and mortality.

Study design: Cohort study with a 10 year follow up.

Setting: The town of Caerphilly, South Wales, and five adjacent villages.

Subjects: 918 men aged 45–59 at time of recruitment between 1979 and 1983.

Main outcome measures: All deaths and deaths from coronary heart disease.

Result: Mortality risk was 50% lower in the group with high orgasmic frequency than in the group with low orgasmic frequency, with evidence of a dose-response relation across the groups. Age adjusted odds ratio for all cause mortality was 2.0 for the group with low frequency of orgasm (95% confidence interval 1.1 to 3.5, test for trend P=0.02). With adjustment for risk factors this became 1.9 (1.0 to 3.4, test for trend P=0.04). Death from coronary heart disease and from other causes showed similar associations with frequency of orgasm, although the gradient was most marked for deaths from coronary heart disease. Analysed in terms of actual frequency of orgasm, the odds ratio for total mortality associated with an increase in 100 orgasms per year was 0.64 (0.44 to 0.95).

Conclusion: Sexual activity seems to have a protective effect on men's health.

Key messages

  • Sex and death are common variables in epidemiology, but the relation between them has been little studied

  • In this cohort study, mortality risk was 50% lower in men with high frequency of orgasm than in men with low frequency of orgasm; there was evidence of a dose-response relation across the groups

  • The question of causation is complex, as with all observational epidemiological findings; several explanations are possible, but the evidence for causation is as convincing here as in many areas where causation is assumed

  • These findings contrast with the view common to many cultures that the pleasure of sexual intercourse may be secured at the cost of vigour and wellbeing

  • If these findings are replicated, there are implications for health promotion programmes

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