{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T17:45:44Z","timestamp":1790703944014,"version":"4.1.0"},"reference-count":80,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T00:00:00Z","timestamp":1737676800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Many primary studies and reviews have been published on the influence of chronic diseases (CDs) on sexual dysfunction (SD), but CDs not involving the genitals are less well represented in the literature. Aim: To determine the prevalence of SD in patients with non-genital CD and assess the overall impact on sexual functioning. Methods: An umbrella review was performed of published systematic reviews on the relationship between the occurrence of CDs not involving the genitals and patients\u2019 sexual functioning, following the PRISMA guidelines. PubMed, EMBASE, the Cochrane Library, PsycInfo, Scopus, and CINAHL were used to find publications for inclusion in the review, with two independent researchers performing the search and selection of articles, data extraction, and quality assessment. The relative risk (RR) or odds ratio (OR) with 95% confidence was used as an indicator of the association between CD and SD across studies. The quality of studies included in the review was assessed using Amstar-2. Outcomes: Forty-three systematic reviews, thirty of which included a meta-analysis, met the inclusion criteria, representing a total of 880,586 patients (756,629 (85.9%) men, 68,388 (7.8%) women, and 55,569 (6.3%) unspecified). Results: Among men, CD is associated with erectile dysfunction, and among females, with lower levels of desire, arousal, lubrication, orgasm, and sexual satisfaction and with increased pain during intercourse. For both men and women, depression, anxiety, and fatigue are also reported, while women with CD are more affected by a poor body image than men. Clinical implications: Patients with CD, especially females, should be more routinely assessed for the impact of their condition on sexual functioning. The impact of CD on men\u2019s sexuality has been extensively studied in terms of erectile capacity, but other aspects of their sexuality are largely neglected. Strengths and limitations: This is the first umbrella review to bring together the documented findings regarding sexual dysfunction among patients with various non-genital CDs. While the heterogeneity of the CDs makes the study unique and clinically relevant, it renders the interpretation of the results more difficult. The overrepresentation of men in existing studies reflects the current state of research but limits the applicability of the findings for women. Conclusions: Women and men with non-genital CDs can suffer from SD or reduced sexual function. Health professionals should pay more attention to managing these sexual disorders, even when the disease does not affect the genitals.<\/jats:p>","DOI":"10.3390\/ijerph22020157","type":"journal-article","created":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T10:46:07Z","timestamp":1737715567000},"page":"157","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Sexual Dysfunction in Patients with Chronic Non-Genital Physical Disease: An Umbrella Review"],"prefix":"10.3390","volume":"22","author":[{"given":"Charlotte","family":"Leemans","sequence":"first","affiliation":[{"name":"IPSY, 1348 Louvain-la-Neuve, Wallonia, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9090-8877","authenticated-orcid":false,"given":"Stephan","family":"Van den Broucke","sequence":"additional","affiliation":[{"name":"IPSY, 1348 Louvain-la-Neuve, Wallonia, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3505-6493","authenticated-orcid":false,"given":"C\u00e9line","family":"Jeitani","sequence":"additional","affiliation":[{"name":"IPSY, 1348 Louvain-la-Neuve, Wallonia, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,24]]},"reference":[{"key":"ref_1","unstructured":"WHO Department of Reproductive Health and Research (2006). Report of a Technical Consultation on Sexual Health, WHO. Available online: https:\/\/www.who.int\/teams\/sexual-and-reproductive-health-and-research\/key-areas-of-work\/sexual-health\/defining-sexual-health."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.maturitas.2016.09.013","article-title":"Female sexual dysfunction (FSD): Prevalence and impact on quality of life (QoL)","volume":"94","author":"Nappi","year":"2016","journal-title":"Maturitas"},{"key":"ref_3","first-page":"347","article-title":"Chronic illness and sexual functioning","volume":"67","author":"Nusbaum","year":"2003","journal-title":"Am. Fam. Physician"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.sexol.2016.01.008","article-title":"Dysfonctions sexuelles de la maladie chronique, l\u2019\u00e9tat des lieux. Premi\u00e8re partie: Fr\u00e9quence, impact et gravit\u00e9","volume":"25","author":"Colson","year":"2016","journal-title":"Sexologies"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Laporte, A., and Beltzer, N. (2008). Sexualit\u00e9 et maladies chroniques. Enqu\u00eate sur la Sexualit\u00e9 en France, La D\u00e9couverte.","DOI":"10.3917\/dec.bajos.2008.01.0509"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1080\/00224499.2017.1332153","article-title":"The burden of sexual problems: Perceived effects on men\u2019s and women\u2019s sexual partners","volume":"55","author":"Rowland","year":"2018","journal-title":"J. Sex Res."},{"key":"ref_7","unstructured":"La Communaut\u00e9 de Patients pour la Recherche (ComPare) (2022, March 21). Les Maladies Chroniques. Available online: https:\/\/compare.aphp.fr\/les-maladies-chroniques\/."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1093\/fampra\/cmh407","article-title":"Defining chronic conditions for primary care with ICPC-2","volume":"21","author":"Miller","year":"2004","journal-title":"Fam. Pract."},{"key":"ref_9","first-page":"303","article-title":"D\u00e9veloppement de la CIM-11 de l\u2019OMS dans les pays francophones","volume":"4","author":"Reed","year":"2013","journal-title":"L\u2019Information Psychiatr."},{"key":"ref_10","unstructured":"American Sexual Health Association (2022, December 04). Sexual functioning. Available online: http:\/\/www.ashasexualhealth.org\/sexual-health\/sexual-functioning\/."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1681","DOI":"10.1111\/j.1743-6109.2008.00838.x","article-title":"Risk factors for female sexual dysfunction in the general population: Exploring factors associated with low sexual function and sexual distress","volume":"5","author":"Hayes","year":"2008","journal-title":"J. Sex. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/j.jsxm.2015.12.019","article-title":"Definitions of sexual dysfunctions in women and men: A consensus statement from the Fourth International Consultation on Sexual Medicine 2015","volume":"13","author":"McCabe","year":"2016","journal-title":"J. Sex. Med."},{"key":"ref_13","first-page":"635","article-title":"Diagnosis and treatment of female sexual dysfunction","volume":"77","author":"Frank","year":"2008","journal-title":"Am. Fam. Physician"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"263","DOI":"10.5694\/j.1326-5377.2003.tb05535.x","article-title":"Chronic illness and sexuality","volume":"179","author":"McInnes","year":"2003","journal-title":"Med. J. Aust."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2658","DOI":"10.1111\/j.1743-6109.2012.02856.x","article-title":"Why don\u2019t healthcare professionals talk about sex? A systematic review of recent qualitative studies conducted in the United Kingdom","volume":"10","author":"Dyer","year":"2013","journal-title":"J. Sex. Med."},{"key":"ref_16","unstructured":"Reynaert, C., Dubois, T., Jacques, D., and Zdanowicz, N. (2018). Chapitre 61. Le patient avec des troubles sexuels. Psychiatrie de Liaison, Lavoisier."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1494","DOI":"10.1016\/j.dld.2022.05.016","article-title":"Sexual dysfunction in gastroenterological patients: Do gastroenterologists care enough? A nationwide survey from the Italian Society of Gastroenterology (SIGE)","volume":"54","author":"Romano","year":"2022","journal-title":"Dig. Liver Dis."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/j.sexol.2018.01.011","article-title":"La dysfonction \u00e9rectile du diab\u00e9tique","volume":"27","author":"Colson","year":"2018","journal-title":"Sexologies"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1111\/j.1442-2042.2009.02316.x","article-title":"Sexual problems and associated help-seeking behavior patterns: Results of a population-based survey in France","volume":"16","author":"Buvat","year":"2009","journal-title":"Int. J. Urol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1080\/00015458.2010.11680589","article-title":"Erectile Dysfonction, a Sentinel of Cardiovascular Disease. A symptom Not to Be Neglected","volume":"110","author":"Andrianne","year":"2010","journal-title":"Acta Chir. Belg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"264","DOI":"10.7326\/0003-4819-151-4-200908180-00135","article-title":"Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement","volume":"151","author":"Moher","year":"2009","journal-title":"Ann. Intern. Med."},{"key":"ref_22","first-page":"1","article-title":"Online tools supporting the conduct and reporting of systematic reviews and systematic maps: A case study on CADIMA and review of existing tools","volume":"7","author":"Kohl","year":"2018","journal-title":"Environ. Evid."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1080\/14397595.2016.1249538","article-title":"Primary Sj\u00f6gren\u2019s syndrome impact on smell, taste, sexuality and quality of life in female patients: A systematic review and meta-analysis","volume":"27","author":"Pathak","year":"2017","journal-title":"Mod. Rheumatol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1038\/s41443-018-0098-3","article-title":"The association between fibromyalgia and female sexual dysfunction: A systematic review and meta-analysis of observational studies","volume":"31","author":"Besiroglu","year":"2019","journal-title":"Int. J. Impot. Res."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1002\/ejp.1668","article-title":"Psychosocial factors associated with pain and sexual function in women with Vulvodynia: A systematic review","volume":"25","author":"Chisari","year":"2021","journal-title":"Eur. J. Pain"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1007\/s42000-020-00210-0","article-title":"Sexual dysfunction in polycystic ovary syndrome: A systematic review and meta-analysis","volume":"19","author":"Loh","year":"2020","journal-title":"Hormones"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"750","DOI":"10.1016\/j.rbmo.2018.09.010","article-title":"Sexual function in women with polycystic ovary syndrome: A systematic review and meta-analysis","volume":"37","author":"Pastoor","year":"2018","journal-title":"Reprod. Biomed. Online"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"936","DOI":"10.1016\/j.jsxm.2021.02.008","article-title":"Sexual dysfunction in women with end-stage renal disease: A systematic review and meta-analysis","volume":"18","author":"Pyrgidis","year":"2021","journal-title":"J. Sex. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1080\/13548506.2017.1338738","article-title":"Rheumatoid arthritis is associated with negatively variable impacts on domains of female sexual function: Evidence from a systematic review and meta-analysis","volume":"23","author":"Zhang","year":"2018","journal-title":"Psychol. Health Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1716","DOI":"10.1016\/j.jsxm.2018.09.016","article-title":"Association between multiple sclerosis and risk of female sexual dysfunction: A systematic review and meta-analysis","volume":"15","author":"Zhao","year":"2018","journal-title":"J. Sex. Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"979","DOI":"10.1016\/j.rbmo.2018.11.030","article-title":"Is polycystic ovary syndrome associated with risk of female sexual dysfunction? A systematic review and meta-analysis","volume":"38","author":"Zhao","year":"2019","journal-title":"Reprod. Biomed. Online"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s11906-019-0925-z","article-title":"Sexual dysfunction in women with hypertension: A systematic review and meta-analysis","volume":"21","author":"Santana","year":"2019","journal-title":"Curr. Hypertens. Rep."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1044","DOI":"10.1111\/jsm.12065","article-title":"Female sexual dysfunction and diabetes: A systematic review and meta-analysis","volume":"10","author":"Pontiroli","year":"2013","journal-title":"J. Sex. Med."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1021","DOI":"10.1093\/rheumatology\/keac457","article-title":"Sexual dysfunction in women with systemic autoimmune rheumatic disorders: A systematic review and meta-analysis","volume":"62","author":"Minopoulou","year":"2023","journal-title":"Rheumatology"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1833","DOI":"10.1111\/j.1743-6109.2011.02209.x","article-title":"Sexual functioning in male survivors of lymphoma: A systematic review (CME)","volume":"8","author":"Eiser","year":"2011","journal-title":"J. Sex. Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1185","DOI":"10.1111\/dme.13403","article-title":"High prevalence of erectile dysfunction in diabetes: A systematic review and meta-analysis of 145 studies","volume":"34","author":"Kouidrat","year":"2017","journal-title":"Diabet. Med."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1053","DOI":"10.1016\/j.jsxm.2021.03.078","article-title":"Erectile dysfunction and decreased libido in Klinefelter syndrome: A prevalence meta-analysis and meta-regression study","volume":"18","author":"Barbonetti","year":"2021","journal-title":"J. Sex. Med."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1177\/1557988316639050","article-title":"Association between periodontal disease and erectile dysfunction: A systematic review","volume":"12","author":"Kellesarian","year":"2018","journal-title":"Am. J. Men\u2019s Health"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1527","DOI":"10.1007\/s00296-019-04365-x","article-title":"Gout is associated with elevated risk of erectile dysfunction: A systematic review and meta-analysis","volume":"39","author":"Luo","year":"2019","journal-title":"Rheumatol. Int."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.jsxm.2020.10.012","article-title":"Prevalence of erectile dysfunction in patients with end-stage renal disease: A systematic review and meta-analysis","volume":"18","author":"Pyrgidis","year":"2021","journal-title":"J. Sex. Med."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"0300060521993318","DOI":"10.1177\/0300060521993318","article-title":"Prevalence of erectile dysfunction and its associated factors among patients with diabetes in Ethiopia: A systematic review and meta-analysis","volume":"49","author":"Weldesenbet","year":"2021","journal-title":"J. Int. Med. Res."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"2325","DOI":"10.1038\/oby.2012.104","article-title":"Sexual functioning and obesity: A review","volume":"20","author":"Kolotkin","year":"2012","journal-title":"Obesity"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1007\/s12072-021-10270-y","article-title":"Prevalence and risk factors of erectile dysfunction in patients with liver cirrhosis: A systematic review and meta-analysis","volume":"17","author":"Yoo","year":"2021","journal-title":"Hepatol. Int."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"e14384","DOI":"10.1111\/and.14384","article-title":"Hyperuricaemia is an important risk factor of the erectile dysfunction: A systematic review and meta-analysis","volume":"54","author":"Wang","year":"2022","journal-title":"Andrologia"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1111\/andr.13088","article-title":"Erectile dysfunction in hyperuricemia: A prevalence meta-analysis and meta-regression study","volume":"10","author":"Totaro","year":"2022","journal-title":"Andrology"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1016\/j.jsxm.2018.04.630","article-title":"Association between psoriasis and erectile dysfunction: A meta-analysis","volume":"15","author":"Wu","year":"2018","journal-title":"J. Sex. Med."},{"key":"ref_47","first-page":"3370","article-title":"Disfunci\u00f3n er\u00e9ctil en pacientes con EPOC. Una revisi\u00f3n sistem\u00e1tica y metaan\u00e1lisis. Revista Cl\u00ednica Espa\u00f1ola (English Edition). Female Sexual Function Index and validation in an Egyptian population","volume":"8","year":"2023","journal-title":"J. Sex. Med."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1016\/j.semarthrit.2020.02.002","article-title":"Sexual function and reproduction can be impaired in men with rheumatic diseases: A systematic review","volume":"50","author":"Winkel","year":"2020","journal-title":"Semin. Arthritis Rheum."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"297","DOI":"10.2147\/COPD.S347578","article-title":"Sexual health in COPD: A systematic review and meta-analysis","volume":"17","author":"Frederiksen","year":"2022","journal-title":"Int. J. Chronic Obstr. Pulm. Dis."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.1002\/acr.24711","article-title":"Chronic primary or secondary noninflammatory musculoskeletal pain and disrupted sexual function and relationships: A systematic review","volume":"74","author":"Briggs","year":"2022","journal-title":"Arthritis Care Res."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"4603","DOI":"10.1007\/s00520-021-06731-7","article-title":"Sexual problems in patients with hematological diseases: A systematic literature review","volume":"30","author":"Eeltink","year":"2022","journal-title":"Support. Care Cancer"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"2027","DOI":"10.1007\/s00384-021-03958-y","article-title":"Prevalence and risk factors of sexual dysfunction in patients with inflammatory bowel disease: Systematic review and meta-analysis","volume":"36","author":"Zhang","year":"2021","journal-title":"Int. J. Color. Dis."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"2382","DOI":"10.1016\/j.jsxm.2020.08.019","article-title":"Significant increase of sexual dysfunction in patients with renal failure receiving renal replacement therapy: A systematic review and meta-analysis","volume":"17","author":"Luo","year":"2020","journal-title":"J. Sex. Med."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.1002\/pon.5391","article-title":"Sexual health in colon cancer patients: A systematic review","volume":"29","author":"Stulz","year":"2020","journal-title":"Psycho-Oncology"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1016\/j.jsxm.2018.12.017","article-title":"Parkinson\u2019s disease is associated with risk of sexual dysfunction in men but not in women: A systematic review and meta-analysis","volume":"16","author":"Zhao","year":"2019","journal-title":"J. Sex. Med."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1177\/0961203320974081","article-title":"Systemic lupus erythematosus and risk of sexual dysfunction: A systematic review and meta-analysis","volume":"30","author":"Jin","year":"2021","journal-title":"Lupus"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1111\/ijcp.12751","article-title":"Determinants of sexual dysfunction and interventions for patients with obstructive sleep apnoea: A systematic review","volume":"70","author":"Steinke","year":"2016","journal-title":"Int. J. Clin. Pract."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"100345","DOI":"10.1016\/j.esxm.2021.100345","article-title":"Is There an Association Between Hypothyroidism and Sexual Dysfunction: A Systematic Review and Cumulative Analysis","volume":"9","author":"Shen","year":"2021","journal-title":"Sex. Med."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"e12969","DOI":"10.1111\/ijcp.12969","article-title":"Determinants of sexual function and dysfunction in men and women with stroke: A systematic review","volume":"71","author":"Dusenbury","year":"2017","journal-title":"Int. J. Clin. Pract."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1111\/jdv.16726","article-title":"Sexual impairment in patients with hidradenitis suppurativa: A systematic review","volume":"35","author":"Szepietowski","year":"2021","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"100392","DOI":"10.1016\/j.esxm.2021.100392","article-title":"Prevalence of sexual dysfunction in people with systemic sclerosis and the associated risk factors: A systematic review","volume":"9","author":"Gao","year":"2021","journal-title":"Sex. Med."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1007\/s11764-017-0643-y","article-title":"Sexual function in adolescents and young adults diagnosed with cancer: A systematic review","volume":"12","author":"Stanton","year":"2018","journal-title":"J. Cancer Surviv."},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Lombard, A., and Duffau, H. (2022). Sexual dysfunction of patients with diffuse low-grade glioma: A qualitative review of a neglected concern. Cancers, 14.","DOI":"10.3390\/cancers14123025"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1111\/ijd.16328","article-title":"A systematic review and meta-analysis of sexual dysfunction in patients with hidradenitis suppurativa","volume":"62","author":"Varney","year":"2023","journal-title":"Int. J. Dermatol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"946","DOI":"10.1080\/07853890.2023.2182906","article-title":"Association between vitiligo and sexual dysfunction: Current evidence","volume":"55","author":"Liang","year":"2023","journal-title":"Ann. Med."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1375","DOI":"10.3899\/jrheum.170956","article-title":"Rheumatoid arthritis and risk of sexual dysfunction: A systematic review and metaanalysis","volume":"45","author":"Zhao","year":"2018","journal-title":"J. Rheumatol."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"j4008","DOI":"10.1136\/bmj.j4008","article-title":"AMSTAR 2: A critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both","volume":"358","author":"Shea","year":"2017","journal-title":"BMJ"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"822","DOI":"10.1016\/S0090-4295(97)00238-0","article-title":"The international index of erectile function (IIEF): A multidimensional scale for assessment of erectile dysfunction","volume":"49","author":"Rosen","year":"1997","journal-title":"Urology"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1038\/sj.ijir.3900472","article-title":"Development and evaluation of an abridged, 5-item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction","volume":"11","author":"Rosen","year":"1999","journal-title":"Int. J. Impot. Res."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1080\/009262300278597","article-title":"The Female Sexual Function Index (FSFI): A multidimensional self-report instrument for the assessment of female sexual function","volume":"26","author":"Rosen","year":"2000","journal-title":"J. Sex Marital. Ther."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"1321","DOI":"10.1016\/j.jsxm.2022.06.007","article-title":"Sexual dysfunction as a harbinger of cardiovascular disease in postmenopausal women: How far are we?","volume":"19","author":"Cipriani","year":"2022","journal-title":"J. Sex. Med."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.parkreldis.2016.02.017","article-title":"The prevalence and clinical characteristics of hypersexuality in patients with Parkinson\u2019s disease following dopaminergic therapy: A systematic literature review","volume":"25","author":"Nakum","year":"2016","journal-title":"Park. Relat. Disord."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1097\/JCP.0b013e3181a5233f","article-title":"Treatment-emergent sexual dysfunction related to antidepressants: A meta-analysis","volume":"29","author":"Serretti","year":"2009","journal-title":"J. Clin. Psychopharmacol."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"2498","DOI":"10.1002\/nop2.773","article-title":"The information needs of people with COPD\u2014The holistic approach with special reference to gender and time since diagnosis","volume":"8","author":"Siltanen","year":"2021","journal-title":"Nurs. Open"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1177\/1474515120944518","article-title":"Acceptance of the disease and sexual functions of patients with heart failure","volume":"20","author":"Uchmanowicz","year":"2021","journal-title":"Eur. J. Cardiovasc. Nurs."},{"key":"ref_76","first-page":"613","article-title":"Conceptions et d\u00e9finitions de la sexualit\u00e9: Les diff\u00e9rentes approches","volume":"156","author":"Courtois","year":"1998","journal-title":"Ann. M\u00e9dico-Psychol. Rev. Psychiatr."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.maturitas.2016.02.009","article-title":"A biopsychosocial approach to women\u2019s sexual function and dysfunction at midlife: A narrative review","volume":"87","author":"Thomas","year":"2016","journal-title":"Maturitas"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"1094","DOI":"10.1017\/psa.2022.49","article-title":"Sex Differences in Sexual Desire","volume":"89","author":"Stegenga","year":"2022","journal-title":"Philos. Sci."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1111\/j.1365-2702.2008.02582.x","article-title":"Interviewing people with chronic illness about sexuality: An adaptation of the PLISSIT model","volume":"17","author":"Mercer","year":"2008","journal-title":"J. Clin. Nurs."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"e14504","DOI":"10.1111\/and.14504","article-title":"The relationship between obstructive sleep apnoea and erectile dysfunction: An underdiagnosed link? A prospective cross-sectional study","volume":"54","author":"Cantone","year":"2022","journal-title":"Andrologia"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/22\/2\/157\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T10:35:45Z","timestamp":1759919745000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/22\/2\/157"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,24]]},"references-count":80,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,2]]}},"alternative-id":["ijerph22020157"],"URL":"https:\/\/doi.org\/10.3390\/ijerph22020157","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,24]]}}}