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

OBJETIVO: La investigacion sugiere que una variedad de factores biologicos y psicosociales estan asociados con la salud sexual de las mujeres diagnosticadas con anorexia nervosa (AN). Esta revision exploratoria sistematica, realizada de acuerdo con las Directrices PRISMA, sintetiza la literatura actual sobre la funcion y la disfuncion sexual en mujeres con AN. METODOS: Se realizaron busquedas en PubMed, EMBASE y PsychInfo para la literatura publicada hasta abril de 2020. Todos los disenos de estudio fueron elegibles para su inclusion, siempre que se centraran en la funcion y la disfuncion sexual en mujeres con AN. Se excluyeron los estudios que solo incluyeron resultados relacionados con la identidad de genero u orientacion sexual. 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.