Adherence to the Mediterranean diet and female sexual function: a scoping review.

Objective: This scoping review aimed to systematically map the available evidence on the association between Mediterranean diet adherence and female sexual health and to explore potential biological and psychological mechanisms underlying this relationship. Methods: The review was conducted according to the methodological frameworks of Arksey and O'Malley, Levac et al., and the Joanna Briggs Institute. MEDLINE, Scopus, Web of Science, Embase, PsycINFO, and CINAHL were systematically searched, supplemented by manual reference screening. Reporting followed the PRISMA-ScR guideline, and methodological quality was assessed using the Mixed Methods Appraisal Tool (MMAT). Results: Seven studies met the inclusion criteria. Overall, higher Mediterranean diet adherence was associated with more favorable female sexual health outcomes. Greater adherence was linked to lower rates of female sexual dysfunction and higher Female Sexual Function Index scores among women with type 2 diabetes; reduced deterioration in sexual function in randomized evidence; and improved lubrication, orgasm, and sexual satisfaction among women with severe obesity undergoing bariatric surgery. Favorable associations were also reported in women with inflammatory bowel disease and endometriosis, whereas in chronic liver disease, the initially observed associations were no longer statistically significant after multivariable adjustment. Proposed mechanisms included improved vascular and metabolic health, reduced inflammation and oxidative stress, and enhanced psychological well-being. Conclusion: Higher Mediterranean diet adherence was generally associated with more favorable female sexual function and well-being; however, the predominantly observational and cross-sectional nature of the evidence precludes causal inference. The limited evidence base highlights the need for high-quality longitudinal and interventional studies.