Objective: To review the literature on the relationship between obesity and sexual function. Method: A search in the medical literature from 1966 and onwards was carried out through Medline and Embase for publications on obesity, in combination with Medical Subject Heading words related to sexual function and dysfunction. Comments: Four prospective and seven cross-sectional studies were found describing association between obesity and erectile dysfunction (ED). One cross-sectional study was found describing obesity and female sexual dysfunction (FSD). The prospective studies on ED all demonstrated a direct association and so did five of the seven cross-sectional studies. The single FSD study did not find any relationship. Eight intervention studies on weight loss and sexual difficulties were identified. All included few individuals and results were mixed even if most indicated an increase of sexual activity among both men and women after weight loss intervention. Conclusion: Support for the assumption that obesity is associated with ED was found in both prospective and cross-sectional studies. FSD was not adequately described in the literature and prospective studies are needed here. Results from weight loss intervention studies are less conclusive, but also point toward improvement in sexual dysfunction with reduced weight. Keywords: body mass index; sexual function; sexual dysfunction; weight loss; metabolic syndrome; erectile dysfunction
IntroductionAt present, 10-30% of all individuals from developed countries are obese. In addition, 1/3-2/3 are considered to be overweight.1 Obesity is on the increase throughout the world, and increasing trends cause concern among health authorities about the associated comorbidities, for example, type 2 diabetes, heart disease, hypertension, certain cancers, reduced life expectancy 1 and their cost to society. Other somatic and psychological malfunctions are also known to follow obesity such as fertility problems, osteoarthritis, social disabilities caused by stigmatization, sleeping problems or apnea. Sexual dysfunctions may also relate to obesity, but are rarely mentioned, and may, for both individual and partner, cause concern and constitute a great problem. Obesity is also rarely mentioned as a cofactor to sexual problems in textbooks on human sexuality, and, if so, with no reference to data in support of a causal relationship.
2,3The aim of the present review was therefore to evaluate the current evidence from the scientific literature of a possible association between obesity and sexual dysfunction among men and women.Obesity and sexual dysfunction There seems to be no available evidence that sexual dysfunction may cause obesity, but there are indicators that obesity may cause sexual dysfunction. However, it may be difficult to single out the independent effects on dysfunction of obesity from other causes, as obesity is a known independent risk factor for vascular risk factors such as dyslipidemia, hypertension, diabetes mellitus and depression, all known to be direct...