Elsevier

Sexual Medicine Reviews

Volume 8, Issue 2, April 2020, Pages 256-264
Sexual Medicine Reviews

Review
Diet and Female Sexual Health

https://doi.org/10.1016/j.sxmr.2019.08.004Get rights and content

Abstract

Introduction

Female sexual dysfunction is common, and there is growing interest in the relationship between everyday dietary habits and female sexuality. Most of the research at this point is focused on pathological states such as metabolic syndrome, obesity, and eating disorders, which seem to exacerbate sexual dysfunction.

Aim

To characterize sexual dysfunction in the presence of comorbidities including metabolic syndrome, obesity, and disordered eating states and to examine the effect of dietary patterns on female sexuality.

Methods

A comprehensive review of peer-reviewed publications on the topic was performed through a PubMed search. Key search terms and phrases included female sexual dysfunction, diet, dietary patterns, metabolic syndrome, obesity, Mediterranean diet, and eating disorders.

Main Outcome Measure

The main outcome measures were female sexual function scores as measured on the Female Sexual Function Index and domain-specific dysfunctions.

Results

Metabolic syndrome negatively affects sexual function in women, and this effect is most pronounced in younger, premenopausal women. Obesity may also detract from female sexuality, but the data on this comorbidity are more mixed. Endothelial dysfunction, which can result from excess inflammation seen in metabolic syndrome and obesity, can lead to poor blood flow to genitourinary organs, thus providing a pathophysiological link between these diseases and sexual dysfunction. Patients with disordered eating also suffer from sexual morbidity, which may be due to comorbid psychiatric illness and emaciation-induced hypogonadism. Promising data show that the Mediterranean diet helps alleviate sexual dysfunction in women, but other dietary patterns require more formal investigation.

Conclusion

Incorporation of healthy dietary patterns into everyday life may positively influence female sexuality, but more substantial data are needed to confirm this idea.

Towe M, La J, El-Khatib F, et al. Diet and Female Sexual Health. Sex Med Rev 2020;8:256–264.

Introduction

The prevalence of female sexual dysfunction is high, with up to 43% of women experiencing a sexual complaint at some point in life.1 This estimate may be higher than what is reported, as oftentimes women are uncomfortable bringing up sexual concerns with their physician, and their physician may also be reluctant to ask out of fear of providing inadequate treatment. The multifactorial nature of female sexual dysfunction, along with a lack of accepted measurement methods to assess it, may also contribute to its underdiagnosis and undertreatment.

Sexual health is closely related to overall wellbeing. Disturbances in one area of health generally have an adverse effect on the other. Chronic conditions such as neurological impairment, renal disease, inflammatory disorders, and cancer can all negatively impact sexual health.2,3 Because general health is largely influenced by what is eaten, everyday dietary patterns have the potential to either positively or negatively affect sexual life. This may be especially relevant for patients with metabolic disorders, as diet and metabolism are closely related.

The role of diet in female sexual health is an area of study that is gaining attention from the scientific community. Previous research at this point has focused on male sexual dysfunction, with less emphasis on the correlation between diet and female sexuality. Furthermore, the studies in females that are available specifically investigate the role of dietary intervention in women with comorbid disorders of metabolism, which is a topic that requires attention and synthesis in this review. Preliminary data are sparse, but it seems that diet can influence sexuality mainly through correction of underlying metabolic pathophysiology that can result from such comorbidities. The role of this review is to describe the current literature regarding female sexual function in relation to metabolic syndrome (MetS), obesity, and eating disorders and to assess the effect of certain dietary patterns on sexual function, as well.

Section snippets

Metabolic syndrome and female sexual dysfunction

Metabolic syndrome occurs due to aberrancies in metabolic pathways and manifests as dyslipidemia, insulin resistance, atherogenesis, and central obesity. The presence of MetS raises the risk of cardiovascular events and all-cause mortality.4,5 Additionally, MetS has been cited as an associated factor for both male and female sexual dysfunction. In males, MetS is commonly linked to erectile dysfunction, for which the proposed pathophysiology involves endothelial dysfunction and excessive

Obesity and female sexual dysfunction

Obesity can be a component of MetS but has also been studied separately with regard to its effect on sexual health. Obesity in isolation is cited as a risk factor for female sexual dysfunction in some studies,19, 20, 21 but others have not found a strong link between excess body weight and female sexual health.22,23 Two randomized clinical trials that assessed weight loss as an intervention for improving function for women with sexual dysfunction have found contradictory results, as well. A

Specific diets

Food is becoming increasingly more accessible than it has ever been, which has sprouted a multitude of diets. The most discussed diet in the literature with regard to sexual health is the Mediterranean diet; however, a recent trial utilizing the ketogenic diet examined its effect on quality-of-life outcomes. Although not discussed below, the Western diet and its components are indirectly associated with sexual morbidity. The Western diet is characterized by processed foods, refined

Specific female sexual dysfunctions

Female sexual dysfunction can be broadly classified into 4 distinct groups: disorders of desire, arousal, orgasm, or pain.46 Most studies examing dietary influence on female sexual health use a quantitative score to assess sexual health; they correlate diet with a linear measure of sexual function such as the FSFI, and very few isolate specific dysfunctions for this discussion. Two that have been previously reported on are vulvodynia and persistent sexual arousal syndrome, but others such as

Eating disorders and female sexual dysfunction

In the realm of diet and sexual function, a few groups have looked at sexuality in patients with disordered eating. Females with eating disorders such as anorexia nervosa and bulimia nervosa suffer from higher rates of sexual dysfunction than the general population.51 The sexual difficulties seen in patients with disordered eating is most likely multifactorial in etiology. From a physiologic point of view, these patients experience disruptions in metabolism and body homeostasis from restricting

Conclusion

There is still a wide gap in our knowledge regarding diet and its influence over female sexual health. Much more of the contemporary literature has focused on comorbidities such as metabolic syndrome and obesity and their subsequent impact on sexual functioning. Specifically, these diseases seem to negatively affect sexuality by putting the body in a state of excess inflammation, resulting in endothelial dysfunction and compromised blood flow through the genitourinary system. More recently, a

Statement of authorship

Category 1

  1. (a)

    Conception and Design

    • Maxwell Towe; Justin La; Natalie Roberts; Faysal A. Yafi; Rachel Rubin

  2. (b)

    Acquisition of Data

    • Maxwell Towe; Justin La

  3. (c)

    Analysis and Interpretation of Data

    • Maxwell Towe; Justin La; Natalie Roberts; Farouk El-Khatib

Category 2
  1. (a)

    Drafting the Article

    • Maxwell Towe; Justin La

  2. (b)

    Revising It for Intellectual Content

    • Maxwell Towe; Justin La; Natalie Roberts; Farouk El-Khatib; Faysal A. Yafi; Rachel Rubin

Category 3
  1. (a)

    Final Approval of the Completed Article

    • Maxwell Towe; Justin La; Natalie Roberts; Farouk El-Khatib; Faysal

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    Conflict of Interest: None.

    Funding: None.

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