Sexual dysfunction in men with fibromyalgia: a systematic review with structured narrative synthesis (SWiM-Compliant)

Indiamara Deggerone^1,*, Tamy Colonetti², Luciane Bisognin Ceretta², Maria Inês da Rosa², Antônio José Grande
1 Family Medicine in the Brazilian Unified Health System (SUS), Department of Health, Erechim, Rio Grande do Sul, Brazil
2 Laboratory of Translational Biomedicine, Postgraduate Program in Health Sciences, Universidade do Extremo Sul Catarinense, Criciúma, Santa Catarina, Brazil
3 Evidence-Based Health Laboratory, Universidade Estadual de Mato Grosso do Sul, Campo Grande, Brazil
* Corresponding Author: Indiamara Deggerone. Email: email

Canadian Journal of Urology https://doi.org/10.32604/cju.2026.081322

Received 10 March 2026; Accepted 27 May 2026; Published online 29 July 2026

Abstract

Background: Sexual dysfunction is an underrecognized dimension of functional impairment in men with fibromyalgia, a chronic pain condition associated with substantial multisystem burden. This study aimed to systematically review and narratively synthesize the available evidence on sexual dysfunction in men with fibromyalgia, positioning sexual health as a clinically relevant functional outcome. Methods: A systematic search of MEDLINE/PubMed, Scopus, EMBASE, Web of Science, and the Cochrane Library (January 1990–December 2025) was conducted to identify observational studies assessing sexual function in adult men diagnosed with fibromyalgia. Due to marked clinical and methodological heterogeneity, including variability in diagnostic criteria, outcome measures (IIEF, CSFQ, SHIM), and confounder adjustment, a quantitative meta-analysis was considered inappropriate.
A structured narrative synthesis was conducted in accordance with PRISMA 2020 and SWiM guidelines. Forest plots were generated solely for descriptive visualization and not for inferential analysis. Risk of bias was assessed using the AXIS tool and the Newcastle–Ottawa Scale, and certainty of evidence was evaluated using GRADE. Results: Five observational studies met the inclusion criteria, comprising a total of 54,137 men with fibromyalgia. Importantly, more than 99% of the total sample was derived from a single population-based study, substantially limiting the balance and interpretability of cross-study comparisons, while the remaining studies were small and clinically heterogeneous.
Across studies, fibromyalgia was consistently associated with poorer sexual outcomes compared with control groups. Reported estimates indicated increased likelihood of erectile dysfunction and lower scores in domains of sexual desire and satisfaction, although effect sizes varied substantially across studies.
This variability likely reflects differences in study design, measurement instruments, and adjustment for relevant confounders. The overall certainty of evidence ranged from low to very low. Conclusions: Sexual dysfunction appears to be a relevant but underrecognized functional concern in men with fibromyalgia. However, the limited number of studies, the disproportionate influence of a single dataset, and substantial methodological heterogeneity preclude robust conclusions regarding effect magnitude or causality.
These findings underscore the need for standardized, high-quality studies incorporating validated sexual health outcomes into the broader assessment of functional impairment in men with chronic pain.