Nov. 29, 2007 -- While past research has linked early sexual activity to health problems, a new study suggests that waiting too long to start having sex carries risks of its own.
Those who lose their virginity at a later age -- around 21 to 23 years of age -- tend to be more likely to experience sexual dysfunction problems later, say researchers at Columbia University and the New York State Psychiatric Institute's HIV Center for Clinical and Behavioral Studies.
The study will appear in the January 2008 issue of the American Journal of Public Health.
Men who lose their virginity in their 20s, in particular, seemed to be more likely to experience sexual problems that include difficulty becoming sexually aroused and reaching orgasm.
The increase in sexual problems was also seen in those who had a comparably earlier sexual debut. And the researchers were quick to point out that there isn't enough evidence to say for sure whether waiting to have sex necessarily leads to sexual dysfunction down the road.
"Our results do not allow for causal interpretations," the study authors write.
Rather, they note in the study, there may be factors common to both the delay of sexual activity and the onset of sexual dysfunction -- for example, they write, "[M]en with sexual problems may avoid sexual interactions and consequently start later."
The researchers, who looked at data from the 1996 National Sexual Health Survey, conducted by the Center for AIDS Prevention Studies (CAPS) at the University of California, San Francisco, also found that men and women who begin having sex in their early teens had their share of problems. They were more likely to have risky sexual partners, to contract a sexually transmitted infection (STI) and to have sex while under the influence of drugs or alcohol.
While sexuality experts not affiliated with the study agree that it is too early to draw a direct causal link about those who have sex later in life, they say the research offers some interesting new avenues for learning more about certain sexual problems that may be devastating to long-term relationships.
"Clinically, we see many individuals who marry late and who have had little or no sexual experience have great difficulty with developing a rich and satisfying sexual experience within their relationship," said Eli Coleman, academic chair in sexual health at the University of Minnesota Medical School Program in Human Sexuality.
"Sexual dysfunction is common. Difficulty in consummating the marriage is also a frequent problem," he added.
Sexual Hang-Ups May Have Physiological Effects
Even though the research stops short of indicating a causal relationship between the age at which one loses his or her virginity and sexual problems they may experience later, Coleman said a number of possible factors could contribute to both of these things.
"From a clinical standpoint, there are often dynamics other than the desire to be abstinent until marriage, such as fear of intimacy, body image problems, alcohol and drug abuse, and sexual dysfunction," he said. He adds that these factors "might influence the delay of sexual debut as a means of avoiding sexual issues."
Conditioning that results in shame over sexual expression may also be a factor, said Gina Ogden, a Boston-based sexuality expert and author of "The Heart and Soul of Sex."
"In my sex therapy office I see countless women and men who have received messages about sex that shame them about their sexual feelings and also terrify them about their sexual behavior."
These messages, she said, can differ between men and women.
For women, she said, the message that "good girls" should not engage in or enjoy sex may cause women to shut down sexually, leading to dysfunction.
"One of the many dysfunctions that arises is that women never develop the ability to ask for what they want, which leaves them open for life-long disappointment, desire disorders, orgasmic dysfunction, and worse -- they're ripe for abuse and violence," she said.
For men, the opposite message -- that "real men score" -- may lead to negative mindsets both among those who lose their virginity early and those who become sexually active only later -- mindsets that impact their ability to perform sexually.
Because of the intimate link between the psyche and sexual performance, some sexuality experts say the results of these conditions most likely bring about sexual dysfunction through their psychological impacts.
"There are mostly, if not exclusively, psychological factors at play here, based on poor sexual skills that lead to a poor sexual debut, with lasting negative effects," said Patti Britton, president of the American Association of Sexuality Educators, Counselors and Therapists and Los Angeles-based author of books including "The Art of Sex Coaching."
Coleman, however, said that biological factors may also be involved.
"There are probably both biological and psychological factors at play -- which cannot be elucidated from this study -- but suggests that further research needs to be conducted to explore those factors," he said.
The Role of Abstinence-Only Education
The researchers say this preliminary evidence may point up detrimental effects of abstinence-only education.
The authors write that the study "lends credence to research showing that abstinence-only education may actually increase health risks," adding that other approaches may better equip young people to avoid both short- and long-term sexual health consequences.
Many sexuality experts agree.
"In my view as a sexuality therapist since the 1970s, the abstinence-only approach is a public health hazard," Ogden said. "Sexual relationship is complex, and the moment of marriage is not a magic marker.
"Instead of making young people pledge 'no' until marriage, we need to be encouraging them to understand their own sexual responses and orientations, learn how to engage in sexual practices that are safe, and acquire intimacy skills that will lead them into caring relationships."
Said Coleman, "While abstinence only programs seem to be helpful in delaying onset of sexual activity, there have been suggestions that this approach could cause more problems when sexual debut takes place due to insufficient preparation and knowledge of responsible sexual behavior.
"This study is interesting because it suggests that sexual experimentation is a normal developmental process, and when this process is inhibited or not guided, there can be poor sexual health outcomes."