Hypertension is an important factor contributing to SD. Although the number of people with hypertension is increasing in China, research into sexual life, with implications for quality of life, is limited. We compared sexual activity and the influence of daily behaviors and sexual factors of hypertensive and normotensive males and females in south China and found that lifestyle factors dictated SD in this area. Hypertensive and normotensive subjects differed in frequency of orgasms and sexual satisfaction, as well as duration of sexual activity. For hypertensive men, low frequency of sexual activity and orgasms and sexual satisfaction were associated with unemployed or retired status than physical labor work, and long sexual duration was associated with never drinking alcohol than heavy drinking. For hypertensive women, low frequency and duration of sexual activity and low satisfaction were associated with never drinking tea than heavy tea drinking.
Hypertension, especially mild to moderate, is usually considered an asymptomatic condition [22
]. Reports of quality of life with hypertension by the Medical Outcomes Survey SF-36 are abundant in western countries. In China, quality of life was greater for people with normotension than hypertension and greater for patients receiving treatment and with controlled hypertension than for those with poorly controlled hypertension [23
]. However, these studies did not focus on sexual activity.
Our results were similar to those of the Caerphilly study of frequency of sexual intercourse for 914 males in the United Kingdom [24
]: 197 (21.5%) had sexual intercourse less than once per month, 231 (25.3%) twice or more per week, and the remaining 486 (53.2%) reported intermediate frequency. For our males, the frequency of orgasm was comparable to the reported satisfaction, which suggests that the assessment of sexual satisfaction was mainly based on orgasm experience. Almost two-thirds of females experienced no orgasm, but only about one-third were unsatisfied with sexual encounters, which is consistent with reports of middle-aged and older women in the United States [25
]. Indeed, female satisfaction in sexual intercourse in both western and Asian societies is related more to the emotional than physical experience [26
The decreased number of orgasms we found for hypertensive females may be associated with most females being in peri-or postmenopause status. As well, the low sexual activity for females might be the result of declining estrogen and testosterone levels affecting sexual desire [25
]. In a cohort of older postmenopausal women (mean age 68
years) with osteoporosis, at baseline, only 46% reported some sexual activity; the most-reported problem was difficulty in achieving orgasm [27
]. Sex hormones are essential for sex-specific behaviors [28
], and levels of oestrogens and androgens do account for gender differences in sexuality [29
We found that sexual activity decreased with age. Because most unemployed or retired men were older subjects, their sexual frequency, orgasm and therefore satisfaction were lower than for younger subjects. We found less tea drinking related to low number of orgasms, satisfaction and sexual duration for hypertensive women. Clinical studies of men suggest that tea drinking may inhibit the proliferation of smooth muscle cells and overall improvement in endothelial function, which may play a role in erectile function. An epidemiological survey found that long-term green tea consumption changed androgen levels in women. However, the precise nature of the association of tea drinking and sexuality needs further study.
In an American study [30
], women with high levels of education and income reported a high frequency of sexual activity. As well, those with at least monthly sexual frequency were more likely to have never smoked or currently drink alcohol and had better health status. Results from our study may differ from the previous results because Chinese women tend to drink tea rather than alcohol and to not smoke. Alcohol drinking is a risk factor for hypertension. Recent research of Chinese men found that compared with non-alcohol drinkers, alcohol drinkers who consumed 3 or more drinks a week (1 drink equals 12
g of alcohol) were more likely to report erectile dysfunction as defined by having both sexual dissatisfaction and erectile difficulty (OR
]. In our hypertensive subjects, heavy alcohol consumption was associated with short duration of sexual activity.