Sexual function and dysfunction among women with anorexia nervosa: A systematic scoping review

Abstract

Objective Research suggests that a variety of biological and psychosocial factors are associated with the sexual health of women diagnosed with anorexia nervosa (AN). This systematic scoping review, conducted in accordance to Preferred Reporting Items for Systematic Reviews and Meta‐Analyses Guidelines, synthesizes the current literature concerning sexual function and dysfunction in women with AN. Method We searched PubMed, EMBASE, and PsychInfo for literature published until April 2020. All study designs were eligible for inclusion, providing they focused on sexual function and dysfunction in women with AN. Studies that only included outcomes related to gender identity or sexual orientation were excluded. Results N = 28 studies met criteria for inclusion in the review. All studies were conducted in Western countries and the majority employed either a cohort or cross‐sectional design. Although measures of sexual function and dysfunction varied markedly across studies, most studies adopted a biopsychosocial framework. Libido may be linked to body mass index (BMI), while other aspects of sexual functioning and behavior might not be specifically associated with weight status. Limited data are available on evidence‐based interventions. Discussion Sexual dysfunction in women with AN is common. Although some of the variance is explained by low BMI, associated physiological sequelae and other psychosocial factors are also involved. Sexual dysfunction is a relevant clinical problem and clinicians should sensitively incorporate questions related to sexual function into their eating disorder assessments. Future research, using more robust designs and validated outcome measures, is needed to better understand causal pathways between the biological and psychosocial correlates of AN and sexual dysfunction. Identifying predictors of sexual function and dysfunction in more diverse groups of people with AN will support the development of evidence‐based therapies.

Erectile and sexual dysfunction in male and female patients with celiac disease: A cross‐sectional observational study

“…The majority of our patients (107, 93.8%), who had no hypertension, had a median IIEF-5 score of 23 (20)(21)(22)(23)(24)(25), compared with patients (seven, 6.2%) with hypertension, who showed significantly lower IIEF-5 score, with a median of 15 (15-15) (p = 0.045). We also assessed whether the serum level of anti-transglutaminase antibodies had any influence on IIEF-5 score and found no correlation (data not shown).…”

“…Several evidence shows how BMI within normal limits is associated with better sexual function than obesity or excessive thinness. 24,25 Additionally, Wekker et al 26 showed that improving lifestyle in patients with obesity and infertility was associated, within 6 months, with increased sexual intercourse, improved vaginal lubrication as well as improved overall sexual function. On the other side, use of antianxiety or antidepressant drugs did not seem to be associated with altered sexual function in our female CD population.…”

“…However, it should be considered that in our female population only 23 patients had a BMI >24.99, that is, higher than normal, and only four had a BMI compatible with true obesity. Several evidence shows how BMI within normal limits is associated with better sexual function than obesity or excessive thinness 24,25 . Additionally, Wekker et al 26 .…”

Dietary Approaches to Women’s Sexual and Reproductive Health

“…This likely stems from a combination of endocrine dysregulation as well as psychological factors. 42 A nutritionally adequate diet rich in whole foods and plants is supportive of health on multiple levels, including for promotion of optimal sexual function.…”

Exploring the link between eating disorders and persistent genital arousal disorder/genito-pelvic dysesthesia: first description and a systematic review of the literature

“…Sexual dysfunction is common in patients with ED; nevertheless, there are few studies dedicated to this topic [ 15 ]. A scoping review failed to include any study related to sexual dysfunction in adolescent patients with AN [ 16 ]. This is noteworthy because ED often occur during puberty and adolescence, which are also sensitive periods for psychosexual development.…”