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This meta-analytic review addresses whether the major dimensions of trait personality relate to components of human sexuality. A comprehensive literature search identified 137 studies that met inclusion criteria (761 effect sizes; total n = 420,595). Pooled mean effects were computed using inverse-variance weighted random effects meta-analysis. Mean effect sizes from 100 separate meta-analyses provided evidence that personality relates to theoretically predicted components of sexuality and sexual health. Neuroticism was positively related to sexual dissatisfaction (r+ = .18), negative emotions (r+ = .42), and symptoms of sexual dysfunction (r+ = .16). Extraversion was positively related to sexual activity (r+ = .17) and risky sexual behavior (r+ = .18), and negatively related to symptoms of sexual dysfunction (r+ = -.17). Openness was positively related to homosexual orientation (r+ = .16) and liberal attitudes toward sex (r+ = .19). Agreeableness and conscientiousness were negatively related to sexually aggressive behavior (r+ = -.20; r+ = -.14) and sexual infidelity (r+ = -.18; r+ = -.17). Less robust evidence indicated that extraversion related negatively, and neuroticism positively, to child sexual abuse, and that openness related negatively to homophobic attitudes. Random effects metaregression identified age, gender, and study quality as important moderators of pooled mean effects. These findings might be of interest to health care professionals developing health care services that aim to promote sexually healthy societies. (PsycINFO Database Record

Background Sexual dysfunction is a common problem among men and women and is associated with negative individual functioning, relationship difficulties, and lower quality of life. Aim To determine the magnitude of associations between 6 health-related lifestyle factors (cigarette smoking, alcohol intake, physical activity, diet, caffeine, and cannabis use) and 3 common sexual dysfunctions (erectile dysfunction, premature ejaculation, and female sexual dysfunction). Methods A comprehensive literature search of 10 electronic databases identified 89 studies that met the inclusion criteria (452 effect sizes; N = 348,865). Pooled mean effects (for univariate, age-adjusted, and multivariable-adjusted estimates) were computed using inverse-variance weighted random-effects meta-analysis and moderation by study and population characteristics were tested using random-effects meta-regression. Results Mean effect sizes from 92 separate meta-analyses provided evidence that health-related lifestyle factors are important for sexual dysfunction. Cigarette smoking (past and current), alcohol intake, and physical activity had dose-dependent associations with erectile dysfunction. Risk of erectile dysfunction increased with greater cigarette smoking and decreased with greater physical activity. Alcohol had a curvilinear association such that moderate intake was associated with a lower risk of erectile dysfunction. Participation in physical activity was associated with a lower risk of female sexual dysfunction. There was some evidence that a healthy diet was related to a lower risk of erectile dysfunction and female sexual dysfunction, and caffeine intake was unrelated to erectile dysfunction. Publication bias appeared minimal and findings were similar for clinical and non-clinical samples. Clinical Translation Modification of lifestyle factors would appear to be a useful low-risk approach to decreasing the risk of erectile dysfunction and female sexual dysfunction. Strengths and Limitations Strengths include the testing of age-adjusted and multivariable-adjusted models and tests of potential moderators using meta-regression. Limitations include low statistical power in models testing diet, caffeine, and cannabis use as risk factors. Conclusion Results provide compelling evidence that cigarette smoking, alcohol, and physical activity are important for sexual dysfunction. Insufficient research was available to draw conclusions regarding risk factors for premature ejaculation or for cannabis use as a risk factor. These findings should be of interest to clinicians treating men and women with complaints relating to symptoms of sexual dysfunction.

Introduction Erectile dysfunction (ED) is a major health care problem that has implications for quality of life. Aim This umbrella review sought to synthesize all meta-analytic research on risk factors, treatment, and prevalence of ED. Methods 8 electronic databases were searched for relevant meta-analyses in June 2018. The evidence was graded with 2 measures that use quantitative criteria to establish the quality of report writing and confidence in the effect size reported. Main Outcome Measures Lifestyle factors, genetic markers, medical conditions, treatments. Results In total, 98 meta-analyses were identified that included 421 meta-analytic effects, 4,188 primary-effects, and 3,971,122 participants. Pooled estimates showed that an unhealthy lifestyle, genetic markers, and medical conditions were associated with an increased risk of ED. Testosterone therapy and phosphodiesterase type 5 inhibitors showed the greatest treatment efficacy, with mild adverse events observed across treatments. Psychological and behavior change interventions produced effect sizes that were comparable to medication but had greater imprecision in effect sizes. There was little evidence that combined treatments were more efficacious than single treatments. Meta-analyses of prevalence estimates showed consistent age trends but were limited to particular regions or clinical samples, meaning that global estimates of ED are difficult to determine. Clinical Implications The umbrella review synthesized findings for many treatment options that might aid evidence-based clinical decision-making. Based on prevalence estimates, we recommend that primary care physicians take a proactive approach and enquire about erectile problems in all men over age 40 displaying any health-related issue (eg, overweight, cigarette smoking). Strengths & Limitations Strengths include the calculation and comparison of summary estimates across multiple meta-analyses. Limitations include heterogeneity in research quality across research themes limiting effect size comparisons. Conclusion The review provides summary estimates for 37 risk factors and 28 treatments. Meta-analyses of risk factors often did not control for important confounders, and meta-analyses of randomized trials were not exclusive to double-blinded trials, active placebo controls, or tests of long-term effects. We recommend further meta-analyses that eliminate lower quality studies and further primary research on behavioral and combined treatments.