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Systematic review and meta-analysis on the beneficial effect of exercise on sexual dysfunction in women
Iñaki Ruiz-Pérez1,2, Maitane Ruiz-Rios3,4, Sara Cuesta-Ibáñez1
1Department of Physical Education and Sport, Faculty of Education and Sport-Physical Activity and Sport Sciences Section, University of the Basque Country (EHU), 01007 Vitoria-Gasteiz, Araba/Álava, Basque Country, Spain.
Background:
Sexual dysfunction is a condition that affects more than 43% of women worldwide, with a multifactorial aetiology and whose diagnosis and treatment are often poorly studied in women.
Aim:
The present systematic review with meta-analysis aimed to evaluate the effects of exercise compared with non-intervention control groups (CG) on women's sexual dysfunction.
Methods:
PubMed/MEDLINE, Cochrane, Scopus, and Web of Science were searched until August 2025. Controlled trials in adult women comparing exercise/physical activity (PA) with usual care controls were included if sexual function was assessed using validated questionnaires. Interventions (≥4 weeks) comprised pelvic-floor, aerobic, resistance, combined, yoga, aquatic, or core programs. English-language, peer-reviewed studies were included; those lacking controls, post-intervention data, validated measures, or appropriate design were excluded. Methodological quality was assessed using a modified PEDro scale, and certainty of evidence was evaluated using Grading of Recommendations Assessment, Development, and Evaluation, considering risk of bias, inconsistency, indirectness, and imprecision. Meta-analysis was restricted to Female Sexual Function Index (FSFI) outcomes; other measures were narratively synthesized.
Results:
Twenty-three studies were included in the systematic review. Eighteen studies reported significant differences between experimental and CG, and 20 showed improvements in sexual function following exercise intervention. FSFI. Meta-analysis of 15 studies using the FSFI demonstrated significant benefits versus controls (mean difference: 5.31 points; 95% CI, 4.87-5.75), with improvements across all subdomains (range 0.59-0.96 points). Heterogeneity was high (I2 = 76%-94%). Study quality was predominantly good to excellent, although overall certainty of evidence was rated as low due to heterogeneity.
Conclusion:
A wide range of exercise interventions positively impacted women's sexual function, improving domains including desire, arousal, lubrication, orgasm, satisfaction, and dyspareunia. These findings support the role of PA in enhancing both overall health and sexual wellbeing in women.
Trial Registration:
PROSPERO (CRD42023492467).
