Conceptual Frameworks Linking Sexual Health to Physical, Mental, and Interpersonal Well-Being: A Comprehensive Systematic Review and Meta-Analysis

The current systematic review modified the Enduring Vulnerability Stress Adaptation model of relationship functioning and the Attachment System Activation model of individual functioning to incorporate various aspects of orgasmic functioning within the broader context of sexual health and sexual satisfaction. This provided conceptual frameworks for integrating the findings on a wide range of correlates of orgasms, sexual satisfaction, and other components of sexual health into comprehensive models of individual and interpersonal functioning to guide future research. A systematic search of the <i>ProQuest</i>, <i>PubMed</i>, and <i>Web of Science</i> databases (through September, 2025) for records linking sexual satisfaction with at least one other component of sexual health or at least one correlate (distress, well-being, physical health, relationship satisfaction, attachment avoidance, or attachment anxiety) yielded 3369 unique records, resulting in a final set of 228 records, representing 281 independent (sub)samples and a final combined sample of 248,021 participants. A total of 1201 effects were extracted, yielding 44 meta-analytic effects (using random effects modeling). Path analyses of meta-analytic correlation matrices revealed that dimensions of sexual health (i.e., sexual satisfaction, orgasms, sexual desire, lack of sexual pain, vaginal lubrication) demonstrated unique links to greater health, interpersonal functioning, and individual functioning (i.e., higher psychological well-being, physical health, and relationship satisfaction; lower psychological distress, attachment anxiety, and attachment avoidance). Meta-regression moderation analyses revealed that the effect linking orgasms to higher sexual satisfaction was especially pronounced for women and for individuals in clinical (sub)samples. In addition, the link between orgasms and lower distress was especially pronounced for older individuals. The findings were limited by the cross-sectional nature of the vast majority of the findings (96%), leaving the directions of causality unclear. Taken together, these results highlight the central role that sexual health might play in individual and relationship health, supporting the proposed conceptual models and highlighting directions for future research.