Skip to main content

Advertisement

SpringerLink
Log in

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

  • Original Paper
  • Published:
Sexuality and Disability Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Availability of Data and Material

Not Applicable

References

  1. Parker, R.: Sexuality, culture and society: shifting paradigms in sexuality research. Cult. Health Sex. 11(3 SPEC. ISS.), 251–266 (2009). https://doi.org/10.1080/13691050701606941

    Article  PubMed  Google Scholar 

  2. Wellings, K., Johnson, A.M.: Framing sexual health research: adopting a broader perspective. Lancet 382(9907), 1759–1762 (2013). https://doi.org/10.1016/S0140-6736(13)62378-8

    Article  PubMed  Google Scholar 

  3. Twenge, J.M., Sherman, R.A., Wells, B.E.: Changes in American adults’ sexual behavior and attitudes, 1972–2012. Arch. Sex. Behav. 44(8), 2273–2285 (2015). https://doi.org/10.1007/s10508-015-0540-2

    Article  PubMed  Google Scholar 

  4. Di Giulio, G.: Sexuality and people living with physical or developmental disabilities: a review of key issues. Can. J. Hum. Sex. 12(1), 53–68 (2003)

    Google Scholar 

  5. Shakespeare, T., Richardson, S.: The sexual politics of disability, twenty years on. Scand. J. Disabil. Res. 20(1), 82–91 (2018). https://doi.org/10.16993/sjdr.25

    Article  Google Scholar 

  6. Esmail, S., Darry, K., Walter, A., Knupp, H.: Attitudes and perceptions towards disability and sexuality. Disabil. Rehabil. 32(14), 1148–1155 (2010). https://doi.org/10.3109/09638280903419277

    Article  PubMed  Google Scholar 

  7. Pendergrass, S., Nosek, M.A., Holcomb, J.D.: Design and evaluation of an Internet site to educate women with disabilities on reproductive health care. Sex. Disabil. 19(1), 71–83 (2001). https://doi.org/10.1023/A:1010720921585

    Article  Google Scholar 

  8. Anderson, P., Kitchin, R.: Disability, space and sexuality: access to family planning services. Soc. Sci. Med. 51, 1163–1173 (2000). https://doi.org/10.1016/s0277-9536(00)00019-8

    Article  PubMed  Google Scholar 

  9. Shah, S.: “Disabled People Are Sexual Citizens Too”: supporting sexual identity, well-being, and safety for disabled young people. Frontiers in Education 2(46), 1–5 (2017). https://doi.org/10.3389/feduc.2017.00046

    Article  Google Scholar 

  10. Hunt, X., Swartz, L., Carew, M.T., Braathen, S.H., Chiwaula, M., Rohleder, P.: Dating persons with physical disabilities: the perceptions of South Africans without disabilities. Cult. Health Sex. 20(2), 141–155 (2018). https://doi.org/10.1080/13691058.2017.1334964

    Article  PubMed  Google Scholar 

  11. Löfgren-Mårtenson, L.: “May I?” About sexuality and love in the new generation with intellectual disabilities. Sex. Disabil. 22(3), 197–207 (2004). https://doi.org/10.1023/B:SEDI.0000039062.73691.cb

    Article  Google Scholar 

  12. Löfgren-Mårtenson, L.: “I want to do it right!” A pilot study of Swedish sex education and young people with intellectual disabilities. Sex. Disabil. 30(2), 209–225 (2012). https://doi.org/10.1007/s11195-011-9239-z

    Article  Google Scholar 

  13. Amos, N., McCabe, M.: The importance of feeling sexually attractive: Can it predict an individual’s experience of their sexuality and sexual relationships across gender and sexual orientation? Int. J. Psychol. 52(5), 354–363 (2017). https://doi.org/10.1002/ijop.12225

    Article  PubMed  Google Scholar 

  14. Tellier, S.A., Calleja, N.G.: Renegotiating sexuality following an acquired disability: Best practices for counselors. Adultspan J. 16(1), 47–59 (2017). https://doi.org/10.1002/adsp.12033

    Article  Google Scholar 

  15. Flynn, K.E., Lin, L., Bruner, D.W., Cyranowski, J.M., Hahn, E.A., Jeffery, D.D., Reese, J.B., Reeve, B.B., Shelby, R.A., Weinfurt, K.P.: Sexual satisfaction and the importance of sexual health to quality of life throughout the life course of US adults. J. Sex. Med. 13(11), 1642–1650 (2016). https://doi.org/10.1016/j.jsxm.2016.08.011

    Article  PubMed  PubMed Central  Google Scholar 

  16. Gurza, A. I’m disabled, I’m sexual, and we need to talk, doc. UofTMed Magazine (The Sex Issue). https://uoftmedmagazine.utoronto.ca/2019/summer/ (2019). Accessed 15 June 2019

  17. Gianotten, W.L., Bender, J.L., Post, M.W., Höing, M.: Training in sexology for medical and paramedical professionals: a model for the rehabilitation setting. Sex. Relatsh. Ther. 21(3), 303–317 (2006). https://doi.org/10.1080/14681990600754559

    Article  Google Scholar 

  18. Winarni, T.I., Hardian, H., Suharta, S., Ediati, A.: Attitudes towards sexuality in males and females with intellectual disabilities: indonesia setting. Intellect. Disabl. Diagn. J. 6(2), 43–48 (2018). https://doi.org/10.6000/2292-2598.2018.06.02.3

    Article  Google Scholar 

  19. Freysteinson, W., Thomas, L., Sebastian-Deutsch, A., Douglas, D., Melton, D., Celia, T., Reeves, K., Bowyer, P.: A study of the amputee experience of viewing self in the mirror. Rehabil. Nurs. 42(1), 22–32 (2017). https://doi.org/10.1002/rnj.256

    Article  PubMed  PubMed Central  Google Scholar 

  20. Horgan, O., MacLachlan, M.: Psychosocial adjustment to lower-limb amputation: a review. Disabil. Rehabil. 26(14–15), 837–850 (2004). https://doi.org/10.1080/09638280410001708869

    Article  PubMed  Google Scholar 

  21. Higgins, A., Sharek, D., Nolan, M., Sheerin, B., Flanagan, P., Slaicuinaite, S., Mc Donnell, S., Walsh, H.: Mixed methods evaluation of an interdisciplinary sexuality education programme for staff working with people who have an acquired physical disability. J. Adv. Nurs. 68(11), 2559–2569 (2012). https://doi.org/10.1111/j.1365-2648.2012.05959.x

    Article  PubMed  Google Scholar 

  22. Lumley, V.A., Scotti, J.R.: Supporting the sexuality of adults with mental retardation: current status and future directions. J. Posit. Behav. Interv. 3(2), 109–119 (2001). https://doi.org/10.1177/109830070100300208

    Article  Google Scholar 

  23. Haboubi, N.H., Lincoln, N.: Views of health professionals on discussing sexual issues with patients. Disabil. Rehabil. 25(6), 291–296 (2003). https://doi.org/10.1080/0963828021000031188

    Article  PubMed  Google Scholar 

  24. Booth, S., Kendall, M., Fronek, P., Miller, D., Geraghty, T.: Training the interdisciplinary team in sexuality rehabilitation following spinal cord injury: a needs assessment. Sex. Disabil. 21(4), 249–261 (2003). https://doi.org/10.1023/B:SEDI.0000010067.27044.7e

    Article  Google Scholar 

  25. Gozaydinoglu, S., Hosbay, Z., Durmaz, H.: Body image perception, compliance with a prosthesis and cognitive performance in transfemoral amputees. Acta Orthop. Traumato. 53(3), 221–225 (2019). https://doi.org/10.1016/j.aott.2019.03.014

    Article  Google Scholar 

  26. Atherton, R., Robertson, N.: Psychological adjustment to lower limb amputation amongst prosthesis users. Disabil. Rehabil. 28(19), 1201–1209 (2006). https://doi.org/10.1080/09638280600551674

    Article  PubMed  Google Scholar 

  27. Batty, R., McGrath, L., Reavey, P.: Embodying limb absence in the negotiation of sexual intimacy. Sexualities 17(5–6), 686–706 (2014). https://doi.org/10.1177/1363460714532935

    Article  Google Scholar 

  28. World Health Organization: Defining Sexual Health: Report of A Technical Consultation on Sexual Health. https://www.who.int/reproductivehealth/publications/sexual_health/defining_sexual_health.pdf?ua=1 (2006). Accessed 18 June 2019

  29. Belur, J., Tompson, L., Thornton, A., Simon, M.: Interrater reliability in systematic review methodology: exploring variation in coder decision-making. Sociol. Methods Res. (2018). https://doi.org/10.1177/0049124118799372

    Article  Google Scholar 

  30. Nguyen, L.H., Tran, B.X., Rocha, L.E.C., Nguyen, H.L.T., Yang, C., Latkin, C.A., Thorson, A., Strömdahl, S.: A systematic review of eHealth interventions addressing HIV/STI prevention among men who have sex with men. AIDS Behav. 23(9), 2253–2272 (2019). https://doi.org/10.1007/s10461-019-02626-1

    Article  PubMed  PubMed Central  Google Scholar 

  31. Nithiyanantham, S.F., Badawi, A.: Maternal infection with Zika virus and prevalence of congenital disorders in infants: systematic review and meta-analysis. Can. J. Public Health 110(5), 638–648 (2019). https://doi.org/10.17269/s41997-019-00215-2

    Article  PubMed  PubMed Central  Google Scholar 

  32. Downs, S.H., Black, N.: The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. J. Epidemiol. Community Health 52(6), 377–384 (1998). https://doi.org/10.1136/jech.52.6.377

    Article  PubMed  PubMed Central  Google Scholar 

  33. Trac, M.H., McArthur, E., Jandoc, R., Dixon, S.N., Nash, D.M., Hackman, D.G., Garg, A.X.: Macrolide antibiotics and the risk of ventricular arrhythmia in older adults. Can. Med. Assoc. J. 188(7), E120–E129 (2016). https://doi.org/10.1503/cmaj.150901

    Article  Google Scholar 

  34. Sweeney, M.R., O’Leary, K.G., Jeney, Z., Braunlin, M.C., Gibb, H.J.: Systematic review and quality ranking of studies of two phthalate metabolites and anogenital distance, bone health, inflammation, and oxidative stress. Crit. Rev. Toxicol. 49(4), 281–301 (2019). https://doi.org/10.1080/10408444.2019.1605332

    Article  PubMed  Google Scholar 

  35. Cunningham, J., Broglio, S., Wilson, F.: Influence of playing rugby on long-term brain health following retirement: A systematic review and narrative synthesis. BMJ Open Sport Exerc. Med. 4(1), e000356-e000367 (2018). 4:e000356. https://doi.org/10.1136/bmjsem-2018-000356

  36. Hitzig, S.L., Eng, J.J., Miller, W.C., Sakakibara, B.M.: An evidence-based review of aging of the body systems following spinal cord injury. Spinal Cord 49(6), 684–701 (2011). https://doi.org/10.1038/sc.2010.178

    Article  PubMed  Google Scholar 

  37. Akarsu, S., Tekin, L., Safaz, I., Goktepe, A.S., Yazicioglu, K.: Quality of life and functionality after lower limb amputations: comparison between uni- vs. bilateral amputee patients. Prosthet. Orthot. Int. 37(1), 9–13 (2013). https://doi.org/10.1177/0309364612438795

    Article  PubMed  Google Scholar 

  38. Akkaya, N., Atalay, N.S., Selcuk, S.T., Akkaya, S., Ardic, F.: Impact of body image on quality of life and mood in mastectomized patients and amputees in Turkey. Asian Pac. J. Cancer Prev. 12(10), 2669–2673 (2011)

    PubMed  Google Scholar 

  39. Akyol, Y., Tander, B., Goktepe, A.S., Safaz, I., Kuru, O., Tan, A.K.: Quality of life in patients with lower limb amputation: does it affect post-amputation pain, functional status, emotional status and perception of body image? J. Musculoskelet. Pain 21(4), 334–340 (2013). https://doi.org/10.3109/10582452.2013.851761

    Article  Google Scholar 

  40. Bumin, G., Bayramlar, K., Yakut Gül Sener, Y.: Cross cultural adaptation and reliability of the Turkish version of Amputee Body Image Scale (ABIS). J. Back Musculoskelet. 22(1), 11–16 (2009). https://doi.org/10.3233/BMR-2009-0208

    Article  Google Scholar 

  41. Desteli, E., İmren, Y., Erdoğan, M., Sarısoy, G., Coşgun, S.: Comparison of upper limb amputees and lower limb amputees: a psychosocial perspective. Eur. J. Trauma Emerg. S. 40(6), 735–739 (2014). https://doi.org/10.1007/s00068-014-0418-3

    Article  Google Scholar 

  42. Durmus, D., Safaz, I., Adiguzel, E., Uran, A., Sarisoy, G., Goktepe, A.S., Tan, A.K.: Psychiatric symptoms in male traumatic lower limb amputees: associations with neuropathic pain, locomotor capabilities, and perception of body image. J. Mood Disord. 5(4), 164–172 (2015). https://doi.org/10.5455/jmood.20150223054943

    Article  Google Scholar 

  43. Safaz, I., Yilmaz, B., Goktepe, A.S., Yazicioglu, K.: Turkish version of the Amputee Body Image Scale and relationship with quality of life. Klin. Psikofarmakol. B. 20(1), 79–83 (2010). https://doi.org/10.1080/10177833.2010.11790638

    Article  Google Scholar 

  44. Coffey, L., Gallagher, P., Horgan, O., Desmond, D., MacLachlan, M.: Psychosocial adjustment to diabetes-related lower limb amputation. Diabetic Med. 26(10), 1063–1067 (2009). https://doi.org/10.1111/j.1464-5491.2009.02802.x

    Article  PubMed  Google Scholar 

  45. Coffey, L., Gallagher, P., Desmond, D.: A prospective study of the importance of life goal characteristics and goal adjustment capacities in longer term psychosocial adjustment to lower limb amputation. Clin. Rehabil. 28(2), 196–205 (2014). https://doi.org/10.1177/0269215513497736

    Article  PubMed  Google Scholar 

  46. Gallagher, P., Horgan, O., Franchignoni, F., Giordano, A., MacLachlan, M.: Body image in people with lower-limb amputation: a Rasch analysis of the amputee body image scale. Am. J. Phys. Med. Rehab. 86(3), 205–215 (2007). https://doi.org/10.1097/PHM.0b013e3180321439

    Article  Google Scholar 

  47. Woods, L., Hevey, D., Ryall, N., O’Keeffe, F.: Sex after amputation: the relationships between sexual functioning, body image, mood and anxiety in persons with a lower limb amputation. Disabil. Rehabil. 40(14), 1663–1670 (2018). https://doi.org/10.1080/09638288.2017.1306585

    Article  PubMed  Google Scholar 

  48. Bodenheimer, C., Kerrigan, A.J., Garber, S.L., Monga, T.N.: Sexuality in persons with lower extremity amputations. Disabil. Rehabil. 22(9), 409–415 (2000). https://doi.org/10.1080/096382800406022

    Article  PubMed  Google Scholar 

  49. Henderson, A.W., Turner, A.P., Williams, R.M., Norvell, D.C., Hakimi, K.N., Czerniecki, J.M.: Sexual activity after dysvascular lower extremity amputation. Rehabil. Psychol. 61(3), 260–268 (2016). https://doi.org/10.1037/rep0000087

    Article  PubMed  PubMed Central  Google Scholar 

  50. Manucharian, S.R.: Changes in sexual functioning in persons with limb amputation. J. Prosthet. Orthot. 25(4), 177–183 (2013). https://doi.org/10.1097/JPO.0000000000000001

    Article  Google Scholar 

  51. Swanson, E., Stube, J., Edman, P.: Function and body image levels in individuals with transfemoral amputations using the C-Leg ®. J. Prosthet. Orthot. 17(3), 80–86 (2005). https://doi.org/10.1097/00008526-200507000-00004

    Article  Google Scholar 

  52. Couture, M., Desrosiers, J., Caron, C.D.: Cognitive appraisal and perceived benefits of dysvascular lower limb amputation: a longitudinal study. Arch. Gerontol. Geriat. 52(1), 5–11 (2011). https://doi.org/10.1016/j.archger.2009.11.002

    Article  Google Scholar 

  53. Desrochers, J., Frengopoulos, C., Payne, M.W.C., Viana, R., Hunter, S.W.: Relationship between body image and physical functioning following rehabilitation for lower-limb amputation. Int. J. Rehabil. Res. 42(1), 85–88 (2019). https://doi.org/10.1097/MRR.0000000000000329

    Article  PubMed  Google Scholar 

  54. Hoogendoorn, J.M., van der Werken, C.: Grade III open tibial fractures: functional outcome and quality of life in amputees versus patients with successful reconstruction. Injury 32(4), 329–334 (2001). https://doi.org/10.1016/s0020-1383(00)00250-3

    Article  PubMed  Google Scholar 

  55. Verschuren, J.E.A., Geertzen, J.H., Enzlin, P., Dijkstra, P.U., Dekker, R.: Sexual functioning and sexual well-being in people with a limb amputation: a cross-sectional study in the Netherlands. Disabil. Rehabil. 38(4), 368–373 (2016). https://doi.org/10.3109/09638288.2015.1044029

    Article  PubMed  Google Scholar 

  56. Whyte, A.S., Niven, C.A.: Psychological distress in amputees with phantom limb pain. J. Pain Symptom Manag. 22(5), 938–946 (2001). https://doi.org/10.1016/S0885-3924(01)00352-9

    Article  Google Scholar 

  57. Burden, N., Simpson, J., Murray, C., Overton, P.G., Powell, P.A.: Prosthesis use is associated with reduced physical self-disgust in limb amputees. Body Image 27, 109–117 (2018). https://doi.org/10.1016/j.bodyim.2018.08.001

    Article  PubMed  Google Scholar 

  58. Li, L., Reinhardt, J.D., Zhang, X., Pennycott, A., Zhao, Z., Zeng, X., Li, J.: Physical function, pain, quality of life and life satisfaction of amputees from the 2008 Sichuan earthquake: a prospective cohort study. J. Rehabil. Med. 47(5), 466–471 (2015). https://doi.org/10.2340/16501977-1951

    Article  PubMed  Google Scholar 

  59. Srivastava, K., Chaudhury, S.: Rehabilitation after amputation: psychotherapeutic intervention module in Indian scenario. Sci. World J. (2014). https://doi.org/10.1155/2014/469385

    Article  Google Scholar 

  60. Ide, M., Watanabe, T., Toyonaga, T.: Sexuality in persons with limb amputation. Prosthet. Orthot. Int. 26(3), 189–194 (2002). https://doi.org/10.1080/09638280410001708977

    Article  PubMed  Google Scholar 

  61. Holzer, L.A., Sevelda, F., Fraberger, G., Bluder, O., Kickinger, W., Holzer, G.: Body image and self-esteem in lower-limb amputees. PLoS ONE 9(3), e92943–e92943 (2014). https://doi.org/10.1371/journal.pone.0092943

    Article  PubMed  PubMed Central  Google Scholar 

  62. Demiralp, B., Ege, T., Kose, O., Yurttas, Y., Basbozkurt, M.: Amputation versus functional reconstruction in the management of complex hind foot injuries caused by land-mine explosions: a long-term retrospective comparison. Eur. J. Orthop. Surg. Tr. 24(4), 621–626 (2014). https://doi.org/10.1007/s00590-013-1345-4

    Article  Google Scholar 

  63. Ferreira, L., Meregui, A.G.M., Mainenti, M.R.M., Vigario, P.S., Neves, A.N.: Brazilian portuguese version of the amputee body image scale: cultural adaptation and a psychometric analysis. Percept. Mot. Ski. 125(3), 507–524 (2018). https://doi.org/10.1177/0031512518767755

    Article  Google Scholar 

  64. Herrera-Moreno, D., Carvajal-Ovalle, D., Cueva-Nuñez, M.A., Acevedo, C., Munévar, F.R., Camacho, K., Fajardo-Tejada, D.M., Clavijo-Moreno, M.N., Lara-Correa, D.L., Alpi, S.V.: Body image, perceived stress, and resilience in military amputees of the internal armed conflict in Colombia. Int. J. Psychol. Res. 11(2), 56–62 (2018). https://doi.org/10.21500/20112084.3487

    Article  Google Scholar 

  65. McDonald, S., Sharpe, L., Blaszczynski, A.: The psychosocial impact associated with diabetes-related amputation. Diabetic Med. 31(11), 1424–1430 (2014). https://doi.org/10.1111/dme.12474

    Article  PubMed  Google Scholar 

  66. Breakey, J.W.: Body image: the lower-limb amputee. J. Prosthet. Orthot. 9(2), 58–66 (1997)

    Article  Google Scholar 

  67. Cash, T.F.: The multidimensional body-self relations questionnaire. MBSRQ User’s Manual (Third Revision). https://mafiadoc.com/mbsrq-user-manual-3rd-ed_59ccec101723ddd52081b4ef.html (2000). Accessed 2 February 2020

  68. Avalos, L., Tylka, T.L., Wood-Barcalow, N.: The body appreciation scale: development and psychometric evaluation. Body Image 2(3), 285–297 (2005). https://doi.org/10.1016/j.bodyim.2005.06.002

    Article  PubMed  Google Scholar 

  69. Cash, T.F., Phillips, K.A., Santos, M.T., Hrabosky, J.I.: Measuring “negative body image”: validation of the Body Image Disturbance Questionnaire in a nonclinical population. Body Image 1(4), 363–372 (2004). https://doi.org/10.1016/j.bodyim.2004.10.001

    Article  Google Scholar 

  70. Jourard, S.M., Secord, P.F.: Body-cathexis and the ideal female figure. J. Abnorm. Psychol. 50(2), 243–246 (1955). https://doi.org/10.1037/h0041128

    Article  PubMed  Google Scholar 

  71. Cash, T.F., Fleming, E.C.: The impact of body image experiences: development of the body image quality of life inventory. Int. J. Eat. Disord. 31(4), 455–460 (2002). https://doi.org/10.1002/eat.10033

    Article  PubMed  Google Scholar 

  72. Bruchon-Schweitzer, M.: Dimensionality of the body-image: the body-image questionnaire. Percept. Mot. Ski. 65, 887–892 (1987)

    Article  Google Scholar 

  73. Cash, T.F.: The situational inventory of body-image dysphoria: psychometric evidence and development of a short form. Int. J. Eat. Disord. 32(3), 362–366 (2002). https://doi.org/10.1002/eat.10100

    Article  PubMed  Google Scholar 

  74. Beck, A.T., Ward, C.H., Mendelson, M., Mock, J., Erbaugh, J.: An inventory for measuring depression. JAMA Psychiatry 4, 561–571 (1961)

    Google Scholar 

  75. Byrne, M., Doherty, S., Murphy, A.W., McGee, H.M., Jaarsma, T.: The CHARMS study: cardiac patients’ experiences of sexual problems following cardiac rehabilitation. Eur. J. Cardiovasc. Nurs. 12(6), 558–566 (2013). https://doi.org/10.1177/1474515113477273

    Article  PubMed  Google Scholar 

  76. Enzlin, P., Weyers, S., Janssens, D., Poppe, W., Eelen, C., Pazmany, E., Elaut, E., Amy, J.J.: Sexual functioning in women using levonorgestrel-releasing intrauterine systems as compared to copper intrauterine devices. J. Sex. Med. 9(4), 1065–1073 (2012). https://doi.org/10.1111/j.1743-6109.2011.02266.x

    Article  PubMed  Google Scholar 

  77. Derogatis, L.R.: The derogatis interview for sexual functioning (DISF/DISF-SR): an introductory report. J. Sex Marital Therapy 23(4), 291–304 (2008). https://doi.org/10.1080/00926239708403933

    Article  Google Scholar 

  78. Hunt, S.M.: Measuring health status: a new tool for clinicians and epidemiologist. J. R. College General Pract. 35(273), 185–188 (1985)

    Google Scholar 

  79. Keller, A., McGarvey, E.L., Clayton, A.H.: Reliability and construct validity of the changes in sexual functioning questionnaire short-form (CSFQ-14). J. Sex Marital Ther. 32(1), 43–52 (2006). https://doi.org/10.1080/00926230500232909

    Article  PubMed  Google Scholar 

  80. Rust, J., Golombok, S.: The GRISS: a psychometric instrument for the assessment of sexual dysfunction. Arch. Sex. Behav. 15(2), 157–165 (1986). https://doi.org/10.1007/BF01542223

    Article  PubMed  Google Scholar 

  81. Gallagher, P., MacLachlan, M.: Adjustment to an artificial limb: a qualitative perspective. J. Health Psychol. 6(1), 85–100 (2001). https://doi.org/10.1177/135910530100600107

    Article  PubMed  Google Scholar 

  82. Hamill, R., Carson, S., Dorahy, M.: Experiences of psychosocial adjustment within 18 months of amputation: an interpretative phenomenological analysis. Disabil. Rehabil. 32(9), 729–740 (2010). https://doi.org/10.3109/09638280903295417

    Article  PubMed  Google Scholar 

  83. Liu, F., Williams, R.M., Liu, H., Chien, N.: The lived experience of persons with lower extremity amputation. J. Clin. Nurs. 19, 2152–2161 (2010). https://doi.org/10.1111/j.1365-2702.2010.03256.x

    Article  PubMed  Google Scholar 

  84. Richardson, L., Molyneaux, V., Murray, C.D.: Being a peer support mentor for individuals who have had a lower limb amputation: an interpretative phenomenological analysis. Disabil. Rehabil. 10, 1–8 (2019). https://doi.org/10.1080/09638288.2019.1611954

    Article  Google Scholar 

  85. Lu, C., Jiann, B., Sun, C., Lam, H., Chu, C., Lee, J.: Association of glycemic control with risk of erectile dysfunction in men with type 2 diabetes. J. Sex. Med. 6(6), 1719–1728 (2009). https://doi.org/10.1111/j.1743-6109.2009.01219.x

    Article  PubMed  Google Scholar 

  86. Nunes, K.P., Labazi, H., Webb, R.C.: New insights into hypertension-associated erectile dysfunction. Curr. Opin. Nephrol. Hy. 21(2), 163–170 (2012). https://doi.org/10.1097/MNH.0b013e32835021bd

    Article  Google Scholar 

  87. Miner, M., Billups, K.L.: Erectile dysfunction and dyslipidemia: relevance and role of phosphodiesterase type-5 inhibitors and statins. J. Sex. Med. 5, 1066–1078 (2008). https://doi.org/10.1111/j.1743-6109.2008.00783.x

    Article  PubMed  Google Scholar 

  88. Enzlin, P., Rosen, R., Wiegel, M., Brown, J., Wessells, H., Gatcomb, P., Rutledge, B., Chan, K., Cleary, P.A.: Sexual dysfunction in women with type 1 diabetes: long-term findings from the DCCT/EDIC study cohort. Diabetes Care 32(5), 780–785 (2009). https://doi.org/10.2337/dc08-1164

    Article  PubMed  PubMed Central  Google Scholar 

  89. Doumas, M., Tsiodras, S., Tsakiris, A., Douma, S., Chounta, A., Papadopoulos, A., Kanellakopoulou, K., Giamarellou, H.: Female sexual dysfunction in essential hypertension: a common problem being uncovered. J. Hypertens. 24, 2387–2392 (2006). https://doi.org/10.1097/01.hjh.0000251898.40002.5b

    Article  PubMed  Google Scholar 

  90. Esposito, K., Ciotola, M., Maiorino, M.I., Giugliano, F., Autorino, R., De Sio, M., Cozzolino, D., Saccomannom, F., Giugliano, D.: Hyperlipidemia and sexual function in premenopausal women. J. Sex. Med. 6, 1696–1703 (2009). https://doi.org/10.1111/j.1743-6109.2009.01284.x

    Article  PubMed  Google Scholar 

  91. Lochlainn, M.N., Kenny, R.A.: Sexual activity and aging. J. Am. Med. Dir. Assoc. 14(8), 565–572 (2013). https://doi.org/10.1016/j.jamda.2013.01.022

    Article  Google Scholar 

  92. Burton-Jeangros, C., Cullati, S., Sacker, A., Blane, D.: A Life Course Perspective on Health Trajectories and Transitions. https://www.ncbi.nlm.nih.gov/books/NBK385366/ (2015). Accessed 1 March 2020

  93. Boothby, C.A., Dada, B.R., Rabi, D.M., Campbell, T.S., Tang, K.L.: The effect of cardiac rehabilitation attendance on sexual activity outcomes in cardiovascular disease patients: a systematic review. Can. J. Cardiol. 34(12), 1590–1599 (2018). https://doi.org/10.1016/j.cjca.2018.08.020

    Article  PubMed  Google Scholar 

  94. Prior, S., Reeves, N., Peterson, G., Jaffray, L., Campbell, S.: Addressing the gaps in post-stroke sexual activity rehabilitation: patient perspectives. Healthcare 7(1), 25–25 (2019). https://doi.org/10.3390/healthcare7010025

    Article  Google Scholar 

  95. Pascual, A., Wighman, A., Littooij, E.C., Janssen, T.W.J.: Sexuality as part of rehabilitation? A qualitative study on the perceptions of rehabilitation nurses on discussing patient sexuality during clinical rehabilitation. Disabil. Rehabil. 15, 1–8 (2019). https://doi.org/10.1080/09638288.2019.1670271

    Article  Google Scholar 

  96. New, P.W., Seddon, M., Redpath, C., Currie, K.E., Warren, N.: Recommendations for spinal rehabilitation professionals regarding sexual education needs and preferences of people with spinal cord dysfunction: a mixed-methods study. Spinal Cord 54, 1203–1209 (2016). https://doi.org/10.1038/sc.2016.62

    Article  PubMed  Google Scholar 

  97. Varma, P., Stineman, M.G., Dillingham, T.R.: Epidemiology of limb loss. Phys. Med. Rehabil. Cli. 25(1), 1–8 (2014). https://doi.org/10.1016/j.pmr.2013.09.001

    Article  Google Scholar 

  98. World Health Organization: Sexual health. https://www.who.int/health-topics/sexual-health#tab=tab_1 (n.d.). Accessed 2 March 2020

  99. French, S., Swain, J.: Changing disability research: participating and emancipatory research with disabled people. Physiotherapy 83(1), 26–32 (1997). https://doi.org/10.1016/S0031-9406(05)66107-X

    Article  Google Scholar 

Download references

Acknowledgements

The authors would like to thank York University’s librarian services for their assistance in developing the search strategy used for this review.

Funding

Ontario Association for Amputee Care

Author information

Authors and Affiliations

  1. Faculty of Medicine, University of Toronto, Toronto, Canada

    Stephanie G. Brooks & Amanda L. Mayo

  2. St. John’s Rehab Research Program, Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, Canada

    Stephanie G. Brooks, Samantha L. Atkinson, Stephanie R. Cimino & Sander L. Hitzig

  3. Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada

    Stephanie R. Cimino, Crystal MacKay & Sander L. Hitzig

  4. West Park Healthcare Centre, Toronto, Canada

    Crystal MacKay

  5. Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, Canada

    Crystal MacKay

  6. St. John’s Rehabilitation Hospital, Sunnybrook Health Sciences Centre, Toronto, Canada

    Amanda L. Mayo

  7. Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of Toronto, Toronto, Canada

    Sander L. Hitzig

Authors
  1. Stephanie G. Brooks
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Samantha L. Atkinson
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Stephanie R. Cimino
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Crystal MacKay
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Amanda L. Mayo
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Sander L. Hitzig
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sander L. Hitzig.

Ethics declarations

Conflict of interest

The authors declare no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Brooks, S.G., Atkinson, S.L., Cimino, S.R. et al. Sexuality and Sexual Health In Adults with Limb Loss: A Systematic Review. Sex Disabil 39, 3–31 (2021). https://doi.org/10.1007/s11195-020-09665-w

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11195-020-09665-w

Keywords

Search

Navigation