{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T11:30:48Z","timestamp":1768217448586,"version":"3.49.0"},"reference-count":103,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T00:00:00Z","timestamp":1768003200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Current Research Funds 2025, Ministry of Health, Italy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medical Sciences"],"abstract":"<jats:p>Background\/Objectives: Sexual dysfunction (SD) and broader sexual health problems are common after neurological disorders, yet interventional evidence is fragmented across conditions and outcomes. This umbrella review mapped and appraised systematic review-level evidence on interventions targeting SD and sexual health in neurological populations and qualified conclusions using certainty of evidence. Methods: PubMed, Web of Science, Cochrane Library, Embase, PsycINFO, EBSCOhost, and Scopus were searched from inception to 27 November 2025. Two reviewers screened records, extracted data, assessed review quality with AMSTAR 2, and rated certainty across intervention\u2013outcome pairings using a GRADE-informed approach that integrated review confidence and primary-study risk-of-bias as reported by the source reviews. Results: Twenty-six systematic reviews were included. Overall confidence was frequently limited (17\/26 critically low and 6\/26 low), with only a small subset rated moderate or higher. Evidence was most coherent for phosphodiesterase type 5 (PDE5) inhibitors improving erectile function in men with spinal cord injury, whereas most other interventions and outcomes were supported by low or very low certainty. Women were represented in 16\/26 reviews, yet validated female sexual function outcomes were synthesized in 6\/26 reviews and relationship\/couple outcomes in 3\/26; furthermore, 10\/26 reviews restricted inclusion to men, and no review synthesized pediatric intervention trials. Conclusions: Evidence supports PDE5 inhibitors for improving erectile function in men with spinal cord injury, while evidence for other interventions and sexual health domains remains limited. Methodological limitations highlight the need for more inclusive trials, broader standardized outcomes, and longer follow-up within neurorehabilitation pathways.<\/jats:p>","DOI":"10.3390\/medsci14010037","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T08:20:37Z","timestamp":1768206037000},"page":"37","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sexual Health After Neurological Disorders: A Comprehensive Umbrella Review of Treatment Evidence"],"prefix":"10.3390","volume":"14","author":[{"given":"Alfredo","family":"Manuli","sequence":"first","affiliation":[{"name":"Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Calderone","sequence":"additional","affiliation":[{"name":"IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C.da Casazza, 98124 Messina, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1812-8454","authenticated-orcid":false,"given":"Desiree","family":"Latella","sequence":"additional","affiliation":[{"name":"IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C.da Casazza, 98124 Messina, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabrizio","family":"Quattrini","sequence":"additional","affiliation":[{"name":"Universit\u00e0 degli Studi Niccol\u00f2 Cusano\u2014Telematica Roma (UniCusano), 00166 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianluca","family":"Pucciarelli","sequence":"additional","affiliation":[{"name":"Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8566-3166","authenticated-orcid":false,"given":"Rocco Salvatore","family":"Calabr\u00f2","sequence":"additional","affiliation":[{"name":"IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C.da Casazza, 98124 Messina, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"GBD 2021 Nervous System Disorders Collaborators (2024). 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