Impacts of obesity and comorbidities on sexual dysfunction in men and women: a systematic review

Introduction: Obesity, with more than 2.0 billion people worldwide, is associated with numerous comorbidities, affecting male and female sexual and reproductive function. Objective: This study explored the main clinical studies on the impacts of obesity on sexual dysfunction in men and women, as well as treatment proposals in an attempt to mitigate or resolve this condition. Methods: The systematic review rules of the PRISMA Platform were followed. The search was carried out from September to October 2024 in the Web of Science, Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 95 articles were found. A total of 30 articles were evaluated in full and 14 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 23 studies with high risk of bias and 25 studies that did not meet GRADE and AMSTAR-2. Most studies showed homogeneity in their results, with X2=72.5%>50%. It was concluded that obesity is associated with substantial and significant impairments in quality of life. Weight loss has been shown to improve sexual function in men and women with obesity. The impact of weight loss medications and the long-term effect of bariatric surgery on sexual function require further studies. Higher visceral adiposity index is independently related to the risk of erectile dysfunction and that early intervention is necessary to reduce the progression of erectile dysfunction with high levels of visceral adiposity index. It was shown that BMI, age, smoking, diabetes and hypertension were associated with higher odds of reporting decreased sexual function.