Sexual function is the most commonly investigated aspect of sexuality in individuals with spinal cord injury or disease – a systematic review

Abstract

Systematic review. To create an overview of standardized assessments to evaluate sexuality after SCI/D in a systematic literature review. Furthermore, we explored the various dimensions of sexuality assessed by these tools and analyzed sex and gender differences. In a systematic review (PROSPERO CRD42023416855), we reviewed published assessments of sexuality in individuals with SCI/D with a focus on differences between women and men. The comprehensive search was conducted in PUBMED, Medline, CINAHL and psychINFO in March 2023. The extracted publications were grouped and analyzed according to their objectives. A total of 264 papers were included in the analysis and divided into three categories: “physiological aspects of sexuality”, “psychological aspects of sexuality”, and “sexual adjustment”. Most assessments of sexuality after SCI/D concern physiological aspects (n = 176, 66.7%). Fewer studies focus on psychological aspects (n = 49, 18.6%), and sexual adjustment (n = 39, 14.8%) is the least investigated topic. More research has been published on men’s compared to women’s sexuality (n = 195, 73.9% versus n = 125, 47.3%). In men, the most frequently used standardized assessment is the International Index for Erectile Function (IIEF). In women, the equivalent to the IIEF, the Female Sexual Function Index (FSFI), is most frequently used. Most assessments focus primarily on sexual function in men. New assessments are needed to address other aspects of sexuality as well. Furthermore, more research on female sexuality is needed.