Sexuality and Sexual Health In Adults with Limb Loss: A Systematic Review

Abstract

A systematic review was conducted to provide an overview of the current state of research regarding sexuality and sexual health in adults with limb loss. Five databases (Medline, CINAHL, Scopus, Web of Science and PsycINFO) were searched between January 1, 2000 and April 14, 2019. Two reviewers independently screened all titles and abstracts for primary inclusion and full texts for secondary inclusion. The inclusion criteria were peer-reviewed journal articles that were published in English, that addressed at least one aspect of sexuality or sexual health and included adults (18 years and older) who acquired a major limb amputation. A modified Sackett Scale was used to assign levels of evidence to each study. A total of 29 articles met the inclusion criteria. With regard to sexuality, the most common topics investigated were body image (n = 21), sexual desire (n = 6) and sexual activity (n = 4). The Amputee Body Image Scale was the most commonly used outcome measure to assess body image (n = 10). In terms of sexual health, the most frequently studied issues were sexual functioning (n = 5) and sexual counselling (n = 2). Sexuality and sexual health issues affect the health and wellbeing of adults with limb loss. The majority of studies were low in evidence; indicating that more robust intervention studies are needed to help people cope with limb loss as it relates to their sexual health and sexuality. In particular, more targeted efforts for women and individuals with upper limb loss are needed.