ReviewDiet and Female Sexual Health
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 Conception and Design Maxwell Towe; Justin La; Natalie Roberts; Faysal A. Yafi; Rachel Rubin
Acquisition of Data
Maxwell Towe; Justin La
Analysis and Interpretation of Data
Maxwell Towe; Justin La; Natalie Roberts; Farouk El-Khatib
- (a)
Drafting the Article
Maxwell Towe; Justin La
- (b)
Revising It for Intellectual Content
Maxwell Towe; Justin La; Natalie Roberts; Farouk El-Khatib; Faysal A. Yafi; Rachel Rubin
- (a)
Final Approval of the Completed Article
Maxwell Towe; Justin La; Natalie Roberts; Farouk El-Khatib; Faysal
References (64)
- et al.
Sexual function in chronic illness
J Sex Med
(2010) - et al.
Prevalence of sexual dysfunction among postmenopausal women with and without metabolic syndrome
J Sex Med
(2012) - et al.
Sexuality and psychopathological aspects in premenopausal women with metabolic syndrome
J Sex Med
(2014) - et al.
The metabolic syndrome and sexual function in climacteric women: a cross-sectional study
J Sex Med
(2015) - et al.
Does metabolic syndrome impair sexual function in middle-to old-aged women?
J Sex Med
(2011) - et al.
Safety and efficacy of sildenafil citrate for the treatment of female sexual arousal disorder: a double-blind, placebo controlled study
J Urol
(2003) - et al.
Premenopausal women affected by sexual arousal disorder treated with sildenafil: a double-blind, cross-over, placebo-controlled study
BJOG
(2001) - et al.
Decreased sexual interest and its relationship to body build in postmenopausal women
Maturitas
(1996) - et al.
Sexual function, obesity, and weight loss in men and women
Sex Med Rev
(2017) - et al.
Weight loss by multidisciplinary intervention improves endothelial and sexual function in obese fertile women
J Sex Med
(2013)
Sexual function among overweight and obese women with urinary incontinence in a randomized controlled trial of an intensive behavioral weight loss intervention
J Urol
Cardiometabolic risk and female sexuality: focus on clitoral vascular resistance
J Sex Med
Cardiometabolic risk and female sexuality-Part II. Understanding (and overcoming) gender differences: the key role of an adequate methodological approach
Sex Med Rev
Diabetes and sexuality
Sex Med Rev
Association between dietary patterns and plasma biomarkers of obesity and cardiovascular disease risk
Am J Clin Nutr
Adherence to Mediterranean diet and sexual function in women with type 2 diabetes
J Sex Med
Effects of Mediterranean diet on sexual function in people with newly diagnosed type 2 diabetes: the MÈDITA trial
J Diabetes Complications
Impact of iron supplementation on sexual dysfunction of women with iron deficiency anemia in short term: a preliminary study
J Sex Med
Sexual function and depressive symptoms in young women with low vitamin D status: a pilot study
Eur J Obstet Gynecol Reprod Biol
Arriving at the diagnosis of female sexual dysfunction
Fertil Steril
Persistent sexual arousal syndrome associated with increased soy intake
J Sex Med
Urinary oxalate excretion and its role in vulvar pain syndrome
Am J Obstet Gynecol
Multi-impulsivity of Japanese patients with eating disorders: primary and secondary impulsivity
Psychiatry Res
Early puberty and early sexual activity are associated with bulimic-type eating pathology in middle adolescence
J Adolesc Health
Self-injurious behavior and attempted suicide in purging bulimia nervosa: associations with psychiatric comorbidity
J Affect Disord
Anorectic and bulimic patients suffer from relevant sexual dysfunctions
J Sex Med
Sexuality and reproduction in bulimia nervosa patients over 10 years
J Psychosom Res
Substance use and impulsive behaviors among adolescents with eating disorders
Addict Behav
Sexual function in obese women with and without binge eating disorder
J Sex Med
Sexual dysfunction in the United States: prevalence and predictors
JAMA
Sexual function of women with chronic illness and cancer
Women’s Health
The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men
JAMA
Cited by (10)
Sexual Activity and Related Factors of Older Women in Hunan, China: A Cross-Sectional Study
2022, Journal of Sexual MedicineCitation Excerpt :At the same time, a study by Allen found that a healthy diet was associated with higher libido.51 A systematic review from Maxwell et al. showed that there is no special study on the relationship between women's sexual health and vegetarian diets.52 However, it can be speculated that this diet will bring women the risk of malnutrition, such as iron deficiency anemia.
Mediterranean diet in type 2 diabetes: An updated overview of pharmacological activities of cardiometabolic and reproductive outcomes
2021, Current Opinion in PharmacologyCitation Excerpt :Human life is highly influenced by dietary patterns and everyday food choices may also have an impact on sexual life. Both female and male sexual dysfunctions are frequent comorbidities of obesity, metabolic syndrome, and diabetes [38,39]. Lifestyle changes, with a Mediterranean-style diet and increased physical activity, are associated with an improvement in sexual dysfunctions in men and women [5,40].
Obesity and sexual health: focus on postmenopausal women
2024, Climacteric
Conflict of Interest: None.
Funding: None.