Prevalence and factors associated with sexlessness among married Chinese adults in Hong Kong: A population-based study with a comparative analysis of single adults

Background: With the advent of Viagra, there has been growing interest in sustaining sexual activity into advanced age. There is, however, a dearth of scientific studies examining the absence of sexual activity, particularly in non-Western countries.

Objectives: To examine and compare the prevalence, predictors and mental health outcomes of past year sexlessness among married Chinese individuals and unmarried individuals of the same age.

Methods: An anonymous, population-based telephone survey was conducted on 2846 married men and women between the ages of 25 and 59 were compared with 1000 unmarried Chinese adults in Hong Kong.

Results: The prevalence of past year sexlessness among respondents between the ages of 25-34 years, 35-44 years and 45-59 years was 5.5%, 5.1%, 17.0% among married males, 15.5%, 24.2%, 23.4% among unmarried males, 8.3%, 12.4%, 31.6% among married females, and 54.7%, 70.4%, 82.6% among unmarried females. Poor spousal relationship was the most consistent predictor of past year sexlessness for married women whereas lack of interest was the strongest predictor for both and married and unmarried men. Married women demonstrated the strongest associations with poorer mental health outcomes such as depression and feelings of being bothered by lack of a sex partner. Stress-related variables and sexual problems such as erectile dysfunction were not generally associated with lack of sexual activity.

Conclusion: Sexlessness is prevalent among certain subgroups of urban Chinese and the large discrepancy in sexlessness between married men and women, particularly among those reporting poor spousal relationships, suggests a high prevalence of extra-marital relationships.