What is the ideal frequency of sex per week for a man's health?

Optimal Sexual Frequency for Men's Health

Based on the strongest available evidence, men should aim for sexual activity 1-2 times per week (52-103 times per year) to optimize both physical and mental health outcomes.

Evidence-Based Recommendation

The most recent and highest quality study examining this question directly found that sexual frequency of 1-2 times per week provides the greatest protective effects against depression and optimizes psychological well-being 1. This 2025 cross-sectional analysis of 15,794 U.S. adults aged 20-59 demonstrated a saturation effect, meaning that benefits plateau at this frequency rather than continuing to increase with more frequent activity 1.

Physical Health Benefits

Erectile Function Protection

Regular sexual activity at least twice weekly significantly reduces the risk of erectile dysfunction (ED). A cross-sectional study of 332 men aged 30-75 years in China demonstrated that:

• Men engaging in intercourse twice per week had 63% lower risk of ED (adjusted OR = 0.37; 95% CI: 0.18-0.77) 2
• Men engaging in intercourse three or more times per week had 85% lower risk of ED (adjusted OR = 0.15; 95% CI: 0.07-0.35) 2
• These protective effects remained significant after adjusting for age, hyperlipidemia, hypertension, diabetes, BMI, smoking, and drinking 2

The mechanism appears to be that maintaining regular sexual activity helps preserve vascular and neurological function necessary for erectile capacity 2.

Mental Health Benefits

Depression Risk Reduction

The relationship between sexual frequency and depression shows a clear dose-response pattern up to an optimal threshold 1:

• Sexual activity once per month but less than weekly reduced depression odds by 42% (OR: 0.58; 95% CI: 0.48-0.70) compared to less than monthly activity 1
• Sexual activity at least once per week reduced depression odds by 40% (OR: 0.6; 95% CI: 0.51-0.69) 1
• The optimal protective effect occurs at 52-103 times per year (1-2 times weekly), beyond which additional frequency provides diminishing returns 1

Cardiovascular Safety Considerations

Before recommending any specific sexual frequency, cardiovascular risk must be assessed, particularly in men with known cardiovascular disease 3. According to the American Urological Association guidelines endorsed by NCCN:

• Sexual activity is equivalent to walking 1 mile in 20 minutes or climbing 2 flights of stairs in 20 seconds 3
• Men who cannot perform these exercises without symptoms are at high risk for adverse cardiovascular events during sexual activity 3
• These high-risk men require cardiology referral before engaging in sexual activity 3

Age-Related Considerations

Sexual frequency naturally varies with age, but the health benefits remain consistent across age groups 4:

• In men presenting to sexual health clinics, age itself was not a significant predictor of intercourse frequency when controlling for other factors 4
• Younger men (18-24 years) and those aged 25-34 years have experienced increasing rates of sexual inactivity in recent years, with approximately 1 in 3 young men aged 18-24 reporting no sexual activity in the past year 5
• Relationship duration (not age) was the primary factor associated with decreased frequency, though longer relationships showed higher overall sexual satisfaction 4

Risk Factors for Sexual Inactivity

Men at higher risk for sexual inactivity who may need targeted counseling include 5:

• Those with lower income (OR for annual income ≥$50,000 vs $0-$9,999: 0.37; 95% CI: 0.15-0.90) 5
• Men with part-time employment (OR vs full-time: 2.08; 95% CI: 1.48-2.93) or no employment (OR vs full-time: 2.08; 95% CI: 1.48-2.93) 5
• Students (OR vs full-time employment: 2.94; 95% CI: 2.06-4.21) 5
• Unmarried men, who showed the greatest increases in sexual inactivity over time (16.2% to 24.4%; OR for trend: 1.14; 95% CI: 1.04-1.25) 5

Clinical Implementation

When counseling male patients about sexual health:

• Screen for sexual function at regular intervals using validated questionnaires such as the Sexual Health Inventory for Men 3
• Assess cardiovascular fitness before recommending increased sexual activity, particularly in men with cardiovascular disease or risk factors 3
• Target 1-2 times weekly as the optimal frequency for both physical and mental health benefits 1
• Address modifiable risk factors including smoking cessation, weight loss, increased physical activity, and limiting alcohol consumption 3
• Screen for psychosocial factors (anxiety, depression, relationship issues, substance use) that may contribute to sexual dysfunction 3

Common Pitfalls

• Do not assume age alone determines sexual capacity or frequency needs—relationship factors and overall health are more important predictors 4
• Do not overlook cardiovascular risk assessment—sexual activity carries cardiovascular demands that may precipitate adverse events in high-risk men 3
• Do not ignore the mental health implications—sexual inactivity is independently associated with higher depression odds, and optimal frequency may serve as a reference standard during depression treatment 1