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International Journal of Sexual Health logoLink to International Journal of Sexual Health
. 2022 Dec 1;35(1):82–90. doi: 10.1080/19317611.2022.2148802

Sexual Function, Behavior, and Satisfaction in Masters Athletes

Tianyu Wang 1, Melanie A Heath 1, Sebastian K Tanaka 1, Hirofumi Tanaka 1,✉
PMCID: PMC10903591  PMID: 38596768

Abstract

Objectives

Masters athletes are endowed with high functional capacity, long-term health, and psychological outlook. However, their sexual activity and function are largely unknown. We investigated the influence of sustained moderate to vigorous exercise on sexual life using a model of masters athletes.

Methods

A 55-item survey adapted from previous American Association of Retired People (AARP) sexuality study were distributed to masters athletes associations. The responses from 166 masters athletes were compared with AARP dataset that represented a general population.

Results

Both male and female masters athletes demonstrated more frequent sexual desire and greater involvements in different types of sexual activities (i.e., kissing or hugging, touching or caressing, sexual intercourse, oral sex, and self-stimulation; all p < 0.05). Sexual satisfaction was greater in female masters athletes than in female general population (p = 0.025), but no such group difference was observed in men. Male athletes had a lower degree of erectile dysfunction. No difference was observed in orgasm frequency between the two population groups. Age-associated decline in sexual activity was apparent in general population (p < 0.05) but absent in masters athletes. Females recorded lower engagements in partner-involved sexual behaviors than men in the general population, but no such gender difference was observed in women. The primary factor predicting improvement in sexual satisfaction was “better health for myself” (29.7%) in the general population, whereas master athletes identified “better health for partner” (23.5%).

Conclusion

Masters athletes in general and female athletes in particular demonstrate superior sexual function, satisfaction, and behavior presumably due to their better overall health status.

Keywords: Healthy aging, sexuality, lifelong exercise, erectile dysfunction

Introduction

Sexuality, defined here as “the dynamic outcome of physical capacity, motivation, attitudes, opportunity for partnership and sexual conduct” (Lindau et al., 2003), is one of the most important dimensions in life satisfaction (Skałacka & Gerymski, 2019). Sexually active older adults have higher enjoyment of life scores compared with those who are not sexually active (Smith et al., 2019), and sexual satisfaction is closely associated with overall life satisfaction in older adults (Skałacka & Gerymski, 2019; Woloski-Wruble et al., 2010). Sexual satisfaction is impacted by multifactors such as physiological, psychological, spiritual, and cultural factors (Morton, 2017). For example, age-related increases in chronic diseases are associated with sexual dysfunction in both men (e.g., erectile dysfunction, hypogonadism) and women (e.g., sexual desire, dyspareunia) (Meston, 1997), which negatively impact sexual activity and quality of life in older populations (Merghati-Khoei et al., 2016). In marked contrast to the prevalent public perception, many older adults remain highly sexually active (Lindau et al., 2007). In a national survey of U.S. adults 57–85 years of age, the prevalence of sexual activity were 73% in 57–64 year olds, 53% in 65–74 year olds, and 26% in 75–85 year olds (Lindau et al., 2007). In a Swedish sample, ∼10% of older adults over the age 90 were sexually active (Stentagg et al., 2021). Understanding of sexual function and satisfaction at older ages is becoming increasingly important in more recent years. Considering that the number of older adults is progressively increasing and that both men and women are living longer, aging couples spend more time together affording a greater opportunity to engage in sexual activities.

Regular physical activity is a well-established lifestyle changing strategy to promote physiological and psychological functions (Mandolesi et al., 2018). A higher level of regular aerobic exercise is inversely associated with erectile dysfunction in physically active men and protect against female sexual dysfunctions (i.e., disorders of desire, arousal, pain, and orgasm; Fergus et al., 2019; Gerbild et al., 2018). Masters or veteran athletes demonstrate substantial physical function, reduced disease risks, and enhanced mental outlook in spite of their chronological age (Tanaka & Seals, 2003; Trappe, 2001). However, currently it is unknown whether masters athletes who engage in life-long strenuous exercise on a regular basis could maintain sexuality. This may not be a straight-forward question as age-related physical changes do not necessarily lead to corresponding declines in sexual function (Delamater, 2012) and an extremely active lifestyle negatively affects sexual satisfaction (Maseroli et al., 2021).

Accordingly, the primary purpose of the present study was to investigate the influence of sustained exercise on sexuality using masters athletes as an experimental model. To investigate the impact on sexuality as comprehensively as possible, a variety of factors including sexual attitude, desire, function, behavior, and satisfaction were included. In addition, because sexual satisfaction is defined as a multidimensional experience involving thoughts and personal and sociocultural attitudes and beliefs (Sánchez-Fuentes et al., 2014), the secondary aim was to evaluate extraneous factors and elements that lead to sexual satisfaction in masters athletes versus general population. We hypothesized that masters athletes would have higher sexual satisfaction and sexual desire, more frequent sexual activity, and less degree of sexual dysfunction. The present study focused on cisgender men and cisgender women and referred them as “men” and “women” thereafter.

Materials and methods

Participants

Masters athletes were recruited from local and national masters athletes organizations in the United States (e.g., U.S. Masters Swimming). A comprehensive questionnaire containing questions regarding participant demographics, health history, exercise training, sexual satisfaction, behavior, and function was distributed via Qualtrics. This 55-item self-administered questionnaire was adapted from the American Association of Retired People (AARP) study on sexual function, behaviors, and satisfaction among middle-aged and older population (Fisher et al., 2010b). The informed consent was obtained on the first page of the questionnaire. All procedures were approved by the Institutional Review Board. The dataset of the previous AARP study (n = 1,670) was used as the comparison group representing a general population (Fisher et al., 2010a).

Data analyses

The responses from 166 masters athletes were included in the data analysis, with 65% swimmers and 30% cyclists and triathletes. The remaining 5% of the participants were in the disciplines outside swimming, cycling, or triathlon (e.g., running, rowing). The overlapping variables in AARP general population dataset and masters athletes were extracted form a combined dataset. The main variables of interest were sexual satisfaction, behaviors (i.e., partner involved sexual activity, such as kissing or hugging, sexual caressing or touching, sexual intercourse and oral sex; solitary sexual activity: masturbation), and function (i.e., degree of erectile dysfunction, orgasm frequency, and sexual desire) expressed with Likert scales. Other variables in the questionnaire included demographics of the participants, physical activity levels, attitudes toward sexual activity, partner relationship, health history, quality of life, and overall health status.

All the data were analyzed using SPSS 27.0 (IBM, Chicago, IL). The Shapiro-Wilk test and Levene’s test were used to test normality and homogeneity of variance for dependent variables in each group. Two-way analysis of variance (ANOVA) was used to explore the differences in groups (masters athletes vs. general population) × gender/sex (male vs. female) and groups × age (<50, 50–60, 60–70, >70 year) on sexuality-related variables. Bonferroni post-hoc test was performed if main effect of age was found. Factor analysis was used to confirm underlying constructs out of multiple variables in the questionnaire. The extracted factors were used in logistic regression to explore predictors for sexual satisfaction. Mann-Whitney test was used to compare continuous variable (e.g., age) between two population groups, and chi-square test was used to compare the proportion differences in demographics, health history, and factors for improving sexual satisfaction between two population groups. Descriptive statistics were used to define the demographic of participants. Significance level of p < 0.05 was used for all the statistical analyses.

Results

A total of 166 masters athletes were studied with the majority being swimmers (Table 1). Approximately 95% of participants were heterosexual White people, and rest were heterosexual Hispanics. The mean age of the two groups was not different. The physical activity level was evaluated by the frequency of moderate to vigorous exercise per week. Approximately 90% of masters athletes exercised 4 or more days per week, whereas less than 50% of the general population were at the same exercise level. The prevalence of smoking was significantly less in masters athletes, whereas masters athletes tended to drink alcohol beverages more frequently than the general population. Masters athletes displayed a lower prevalence of most major chronic diseases compared with the general population (Table 1).

Table 1.

Selected Participant Characteristics and Medical Conditions.

Variable General population (n = 1,670) Master athletes (n = 166)
Age (year) 60 ± 10 57 ± 13
Male/female 47.4%/53.6% 58.4%/42.6%*
Smoker 20.5% 1.2%*
Alcohol intake    
 None 39.1% 18.1%*
 <1 day/month 22.0% 11.4%*
 <1 day/week 11.2% 13.9%
 1–2 days/week 10.9% 22.3%*
 3–4 days/week 6.9% 13.9%*
 5+ days/week 9.9% 20.5%*
Sexual partner (yes) 64.5% 83.6%*
Frequency of aerobic exercise    
 None 24.1% 0.0%*
 1–3 times/week 26.3% 13.9%*
 4–5 times/week 24.0% 44.6%*
 6+ times/week 25.7% 41.6%*
Medical conditions    
 Diabetes 281 (16.9%) 4 (2.4%)*
 Hypertension 677 (40.8%) 17 (10.2%)*
 Arthritis or rheumatism 531 (32.0%) 18 (10.8%)*
 Depression 294 (17.7%) 16 (9.6%)*
 Swollen or enlarged prostate 122 (15.4%) 9 (9.3%)*
 Prostate cancer 25 (3.2%) 4 (4.1%)
 Breast cancer 48 (5.5%) 5 (7.2%)
 Cervical cancer 18 (2.1%) 0 (0.0%)
 Ovarian cancer 5 (0.6%) 0 (0.0%)
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Note. Data are M ± SD or n (%).

*p < 0.05 vs. the general population.

Both male and female masters athletes showed greater sexual desires than the general population (p < 0.001) with females showing lower sexual desire than males in both groups (p < 0.001) (Table 2). In women, the overall sexual satisfaction was greater in masters athletes than in the general population (p = 0.025), but no such group difference was observed in men. No significant population difference was observed in the frequency of orgasm. Masters athletes reported a lower degree of erectile dysfunction than the general population (p = 0.004) (Table 2).

Table 2.

Rating of Sexual Desire and Satisfaction and Partner-Involved and Self-Sexual Activities.

Variable General population
 Masters athletes
  Males (n = 783) Females (n = 861) Males (n = 97) Females (n = 69)
Sexual desire and satisfaction        
 Sexual desire 5.7 ± 2.3 3.4 ± 2.2† 6.6 ± 1.2* 5.1 ± 1.7†*
 Sexual satisfaction 3.4 ± 1.2 3.4 ± 1.1 3.6 ± 1.1 3.7 ± 1.1*
 Orgasm frequency 4.5 ± 1.0 3.6 ± 1.4† 4.5 ± 0.7 3.9 ± 1.2†
 Degree of erectile dysfunction 1.9 ± 1.0 ----------- 1.6 ± 0.8* ------------
Partner-involved sexual activities        
 Kissing or hugging 4.3 ± 1.9 3.7 ± 2.2† 5.0 ± 1.5* 4.8 ± 1.8*
 Sexual touching or caressing 3.6 ± 1.8 2.9 ± 1.9† 4.0 ± 1.6 3.9 ± 1.9*
 Sexual intercourse 2.8 ± 1.6 2.3 ± 1.6† 3.2 ± 1.5* 3.1 ± 1.6*
 Oral sex 2.1 ± 1.5 1.8 ± 1.3† 2.5 ± 1.6* 2.5 ± 1.5*
Solitary sexual activity        
 Masturbation 2.7 ± 1.7 1.9 ± 1.3† 3.8 ± 1.4* 2.5 ± 1.3†*
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Note. Data are M ± SD. Scales: Sexual desire: 1 (not at all), 2 (<once a month), 3 (once a month), 4 (2–3 times a month), 5 (once a week), 6 (2–3 times a week), 7 (once a day), and 8 (>once a day); Sexual satisfaction: 1 (extremely dissatisfied), 2 (slightly dissatisfied), 3 (neither satisfied nor dissatisfied), 4 (somewhat satisfied), and 5 (extremely satisfied); Orgasm frequency: 1 (do not attempt), 2 (never), 3 (sometimes), 4 (usually), and 5 (always); Degree of erectile dysfunction: 1 (not at all), 2 (minimal erectile dysfunction), 3 (moderate erectile dysfunction), and 4 (complete erectile dysfunction). Sexual activities: 1 (not at all), 2 (<once a month), 3 (once or twice a month), 4 (∼once a week), 5 (>once a week), and 6 (daily).

*p < 0.05 vs. the general population in the same gender/sex. †p < 0.05 vs. males.

The engagement in partner-involved sexual behaviors was significantly greater in masters athletes than in the general population (Table 2). In the general population, females had lower engagements in partner-involved sexual behaviors than men (all p < 0.05). But in masters athletes, no such gender difference was observed. The frequency of solitary sexual activity was greater in males than in females in both populations and higher in masters athletes than in the general population in both males and females (all p < 0.05). In addition, the frequency of sexual activities decreased progressively with increasing age groups in the general population while it was maintained in masters athletes across age groups (Figure 1).

Figure 1.

Figure 1.

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Frequency of sexual behaviors by age in the general population and masters athletes. *p < 0.05 vs. the general population. †p < 0.05 vs. <50 years, ‡p < 0.05 vs. 50–59 years, ‖p < 0.05 vs. 60–69 years. Scale: 1 (not at all), 2 (less than once a month), 3 (once or twice a onth), 4 (about once a week), 5 (more than once a week), 6 (daily).

Masters athletes agreed more on positive attitude toward sexual activity (admitting necessity and importance of sexual activity) and agreed less on the negative ones (denying the necessity of sexual activity with aging) compared with the general population (p < 0.001) (Table 3). The logistic regression model (R2 = 0.674) showed that in masters athletes, significant positive predictors for sexual satisfaction were the frequency of partner-involved sexual activities (odds ratio [OR] = 47.22) and quality of life (OR = 22.78) (Table 4). The negative predictors in masters athletes were negative sexual attitudes (OR = 6.32), and frequency of solitary sexual activity (OR =10.04). In the general population, positive predictors for sexual satisfaction were a composite score of partner-involved sexual activities and orgasm frequency (OR = 296.55), positive attitudes toward sex (OR = 45.80), and the factor composed of health, exercise, and quality of life (OR =137.24). Negative predictors were frequency of self-stimulation (OR = 29.10) and sexual desire (OR = 11.49) (model R2 = 0.418). The primary factor predicting improvement in sexual satisfaction was “better health for myself” (29.7%) in the general population whereas master athletes identified “better health for partner” (23.5%) (Table 5).

Table 3.

Rating of Positive and Negative Attitudes Toward Sexual Activities in the General Population and Masters Athletes.

Attitude General population (n = 1,662) Masters athletes (n = 166)
Positive attitudes toward sex    
 Sexual activity is important to my overall quality of life. 3.3 ± 1.2 4.1 ± 0.9**
 Sexual activity is a critical part of a good relationship. 3.7 ± 1.0 4.1 ± 0.8**
 Sexual activity is a duty to one’s spouse/partner. 3.0 ± 1.1 3.0 ± 1.1
Negative attitudes toward sex    
 Sexual activity is a pleasurable, but not necessary, part of a good relationship. 3.2 ± 1.1 2.8 ± 1.1**
 Sex becomes less important to people as they age. 3.2 ± 1.1 3.0 ± 1.1*
 I do not particularly enjoy sex. 2.0 ± 1.0 1.6 ± 1.0**
 I would be quite happy never having sex again. 2.1 ± 1.1 1.6 ± 1.1**
 Sex is only for younger people. 1.8 ± 0.8 1.4 ± 0.7**
 People should not have a sexual relationship if they are not married. 2.6 ± 1.3 1.8 ± 1.2**
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Note. Data are M ± SD. Scale: 1 (strongly disagree), 2 (disagree), 3 (neither agree nor disagree), 4 (agree) and 5 (strongly agree).

*p < 0.05, **p < 0.001 vs. the general population.

Table 4.

Ordinal logistic regression with factors for sexual satisfaction prediction.

  β 95% CI ORs p value Adjusted R2
Sexual satisfaction (masters athletes)          
 Negative attitudes toward sex −0.49 −0.87, −0.10 6.32 0.013 0.674
 Partner-involved sexual activities 2.15 1.54, 2.76 47.22 <0.001  
 Self-sexual activity and sexual desire −0.67 −1.09, −0.26 10.04 0.002  
 Quality of life 0.92 0.54, 1.30 22.78 <0.001  
 Height −0.50 −0.95, −0.05 4.67 0.031  
Sexual satisfaction (General population)          
 Partner-involved sexual activities and orgasm frequency 1.45 1.28, 1.61 296.55 <0.001 0.418
 Positive attitudes toward sex 0.46 0.33, 0.60 45.80 <0.001  
 Sexual desire −0.10 −0.16, −0.04 11.49 <0.001  
 Health, exercise, and quality of life 0.67 0.56, 0.79 137.24 <0.001  
 Self-stimulation −0.22 −0.30, −0.14 29.10 <0.001  
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Note. Negative sexual attitudes includes “sexual activity is only for young people,” “I don’t enjoy sex,” “I would like no sex,” and “Sex becomes less important to people as they age.” Partner-involved sexual activities includes sexual touching or caressing, sexual intercourse, kissing or hugging, and oral sex. Positive attitudes toward sex is a composite factor negatively correlated to negative sexual attitudes including “I would be quite happy never having sex again,” “I do not particularly enjoy sex,” “Sex is only for younger people,” and sexual desire, and positively correlated to “sexual activity is important to my overall quality of life”.

Table 5.

Self-Reported Factors for Improvement of Sexual Satisfaction.

Factor General population (n = 1,670) (%) Master athletes (n = 166) (%)
Better financial situation 21.7 4.8*
Better health for myself 29.7 9.0*
Better health for partner 23.4 23.5
More free time 14.4 21.7*
Better relationship with my partner 14.7 19.9
Different partner 5.3 7.8
More privacy 8.7 10.8
More favorable social attitudes toward aging and sexuality 9.4 7.8
Less stress 25.6 21.1
Others 6.1 21.7*
No change needed 20.9 19.3
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Note. Others include factors related to partner (e.g., having a partner, getting in a loving relationship, improving partner’s interest and function, and more frequency), physiological dysfunction (alleviating vaginal dryness, improving erectile function, reducing menopause syndrome, being younger), sociopsychological aspects (e.g., better body image and increasing self-esteem), and using accessory sexual tools.

*p < 0.05 vs. the general population.

Discussion

The primary finding of the present study is that masters athletes demonstrated substantially better sexuality as evidenced by significantly greater sexual desires, more frequent engagements in partner-involved and solitary sexual activities and less degree of erectile dysfunction. Age-related decrease in sexual activity observed in the general population was absent in masters athletes. The overall satisfaction in sexuality was greater in female masters athletes than the general population counterparts although no such difference was observed in men. Health status is the top concern in sexual satisfaction in general population but not in masters athletes. The primary factor predicting improvement in sexual satisfaction was “better health for myself” in the general population whereas master athletes identified “better health for partner.” Taken together, these results suggest that masters athletes in general and female athletes in particular demonstrate superior sexuality presumably through their better overall health status. The current study is the first comprehensive investigation to determine the influence of sustained vigorous exercise on a variety of elements involved in sexuality in masters athletes.

With advancing age, there is an apparent decrease in the frequency of sexual activities (Karraker et al., 2011). This was also observed in the general population in the present study. However, such decline was absent in masters athletes. In a study using college students, the increased time spent participating in physical activity is associated with higher frequencies of sexual behaviors and sexual desires (Frauman, 1982). The current study demonstrate that this association also exists in middle-aged and older population with long-term exercise habits. There are a very limited number of research studies on sexuality in masters athletes. One non-peer reviewed survey mentioned in a swimming book showed that 100% of masters swimmers in their 40s and 60s engaged in sexual intercourse at least once per week (Whitten, 2012). In the present study, however, only 26% of masters swimmers in their 40s and 22% in their 60s reported the same frequency level of sexual intercourse. Nevertheless, these findings are consistent in that masters athletes including masters swimmers engage in far greater sexual activities than their sedentary counterparts.

Erectile dysfunction (ED) is a key factor that affects the sexual activity and satisfaction in aging men (Ni Lochlainn & Kenny, 2013) and increases in prevalence with aging (Fisher et al., 2020). ED has been proposed as a harbinger of concomitant cardiovascular disease (Thompson et al., 2005), and vascular dysfunction (e.g., endothelial dysfunction) is a major cause for ED (Lamina et al., 2011; Patel et al., 2012). A normal erection requires increased perfusion into corpus cavernosum (Simonsen et al., 2002), and nitric oxide (NO) secreted by endothelium is a key regulator (Lamina et al., 2011). A moderate exercise training improves erectile function through improved markers of endothelial function in 38–62 year old men with ED (La Vignera et al., 2011). In addition, high volume of moderate-intensity exercise produces greater improvements in sexual function than low-volume exercise among middle-aged and older obese men (Khoo et al., 2013). In the current study, masters athletes who engages in long-term strenuous exercise demonstrated a much less degree of ED than the general population. Taken together, these results suggest that habitual exercise plays an important role in attenuating age-associated ED presumably through its impact on endothelial function.

One interesting observation of the present study is the group difference in attitude toward sexual activity. Older adults are exposed to social stigma toward sexual activity that could negatively affect their sexuality (Syme & Cohn, 2016). Although the general population was more negative toward sexual activity, masters athletes attached more importance to sexual activity in older age. This positivelyoriented sexual attitudes in maters athletes might be derived from better body image. Individuals with higher body satisfaction have more frequent sexual experiences, engage in a wider range of sexual activities, feel more sexually desirable, and report fewer sexual difficulties than those with lower body satisfaction in both men and women (Weaver & Byers, 2006). A negative body image impacts an individual’s entire sense of self and global self-evaluation (Penhollow & Young, 2008). In addition, sexual attitude is both a cause and a result of social and sexual experiences, choices, and behaviors (Ni Lochlainn & Kenny, 2013). Furthermore, the negative trend in general population might also be associated with physiological (e.g., impaired sexual function, health status, and physical debility), psychological (e.g., depression, lower self-esteem, performance anxiety, insecurity and traumatic sexual experience), and socioeconomic (e.g., lower level of education, disturbed family relationship, strong religious belief and guilty related to new relationship after loss of spouse) factors (Hartmann et al., 2004; Morton, 2017; Ni Lochlainn & Kenny, 2013; Syme & Cohn, 2016; Tiefer & Schuetz–Mueller, 1995; Waite et al., 2009). In this context, masters athletes demonstrated a significantly better health status, a lower depression rate, and a higher rate of spousal relationship, which might contribute to the relatively positive attitude toward the sexual activity compared with the general population. It should be noted that socioeconomic and psychological factors for sexual attitudes were not evaluated fully in the present study. Further study will be needed to consider these factors in masters athletes.

A significantly greater sexual satisfaction observed in masters athletes was more robust in females. Among the patients consulting for female sexual dysfunction, “excessive physical activity” (>6 hours/week) was inversely related to sexual satisfaction even when compared with sedentary lifestyle (Maseroli et al., 2021). In the present study, the majority of female masters athletes exercised more than 6 hours/week, yet they demonstrated higher satisfaction than those in the general population. An availability of partners, perceived importance of sexuality and intimacy, overall self-rated mental and physiological health, and menopausal symptoms can predict sexual satisfaction among middle-aged and older women (Dundon & Rellini, 2010; Skałacka & Gerymski, 2019; Woloski-Wruble et al., 2010). In our analyses, approximately 80% of female masters athletes have sexual partners. From exploration of predictors for sexual satisfaction, partner-involved sexual activity is the top predictor for sexual satisfaction in both groups. In our subgroup correlation analysis, physical relationship satisfaction was strongly associated with sexual satisfaction in masters athletes. Subjective well-being was also greater in masters athletes. Participation in physical activity is associated with a lower risk of female sexual dysfunction (e.g., orgasm disorder, low sexual desire; Allen & Walter, 2018). Interestingly, in the general population, more men engaged in partner-involved sexual activity than women but such gender difference in sexual satisfaction was absent in masters athletes. All of the factors above can contribute to the greater sexual satisfaction observed in masters athletes.

Inclusion of solitary sexual activities is important as it makes the sexual activity of unpartnered people visible to society. It has the advantage of offering sexual pleasure and satisfaction without a partner’s availability, physical health, and sexual function. Similar to partner-involved sexual activity, solitary sexual activity decreases with increasing age (Fisher et al., 2020). However, it is a prevalent activity as 40–65% of men and 27–40% of European adults aged 60–75 years report any masturbation in the preceding month (Fisher et al., 2020). Although the frequency of solitary sexual activity was negatively associated with sexual satisfaction, masters athletes displayed a greater frequency of masturbation, as well as a greater sexual satisfaction. The primary factor predicting improvement in sexual satisfaction was “better health for myself” in the general population whereas master athletes identified “better health for partner.” The greater overall health of masters athletes may be contributing to these research findings.

The English Longitudinal Study of Aging demonstrated that decline in frequency of sexual activities in both men and women were closely associated with self-rated health status and incidence of chronic illness in older adults (Jackson et al., 2020). Consistent with this, health status was another important construct for sexual satisfaction in the general population, but this was not the case in masters athletes. Health concern was the primary factor reported to improve sexual satisfaction in general population while a very small percentage of masters athletes selected it. Masters athletes are situated in the totally opposite side of the spectrum in health and disease states to fail elderly population. These results indicate that forming a long-term and relatively vigorous exercise habit is important in improving sexual satisfaction among middle-aged and older adults through attenuating chronic disease risks and enhancing overall health status.

There are several limitations of the present study that should be emphasized. First, the general population sample using the AARP had fairly high regular physical activity levels. Accordingly, the impact of regular exercise on sexual function might have been underestimated. Second, multiple factors contributing to female sexual function have not been sufficiently studied, and the most common scale encompasses multiple domains, including sexual desire, sexual arousal, lubrication, satisfaction, orgasm, and pain (Rosen et al., 2000). The current study did not assess sexual arousal, pain, and lubrication. Third, the difference in sample size between masters athletes and the general population is relatively large. However, this sample size discrepancy has been mitigated through specific statistical methods used in the present study (e.g., non-parametric method–Mann-Whitney test). Fourth, most of the participants in the present study were heterosexual White adults. As sexuality is influenced greatly by cultural factors, more studies that include a wide diversity of races and sexual and gender minorities are needed.

Conclusion

In conclusion, masters athletes demonstrated greater sexual desire and satisfaction, lower degree of sexual dysfunction and erectile dysfunction, and higher frequency in both partner-involved and solitary sexual activities. An age-associated decrease in the frequency of sexual activities was absent in masters athletes. Health status has a substantial impact on sexual satisfaction, which potentially support the benefits gained from lifelong vigorous exercise training on sexuality in masters athletes.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

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