Introduction

Sexual functioning is the ability to experience stages of the sexual response cycle involving sexual desire, sexual arousal, and orgasm without difficulty, and can vary from low to high among individuals (Fielder, 2013). To be diagnosed with sexual dysfunctions, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR; American Psychiatric Association, 2022), there should be a clinically significant disturbance in one’s sexual functioning that interferes with their ability to experience sexual pleasure. Sexual dysfunctions in the DSM-5-TR include female sexual arousal disorder, male hypoactive sexual desire disorder, erectile disorder, premature ejaculation, delayed ejaculation, female orgasmic disorder, and genito-pelvic pain disorder (American Psychiatric Association, 2022). Hence, according the Rosen et al. (2000), sexual functioning can be seen as comprising of six domains: sexual desire, sexual arousal, physiological changes of sexual arousal (vaginal lubrication or penile erection), orgasmic function, sexual satisfaction, and sexual pain. With an extensive list of risk factors, such as age, comorbid diseases ranging from psychological and physical conditions including anxiety, depression, obesity, hypertension, diabetes, and cardiovascular disease, as well as self-image issues that have been identified to contribute to sexual dysfunction, it is a pressing sexual health concern that the incidence of sexual dysfunction in various populations range from 20–56% (Gonçalves et al., 2022; Nabavi et al., 2021; Safdar et al., 2019).

More importantly, a substantial proportion of young adults appear to report symptoms of sexual difficulties, ranging from 20–53% and 23–31% in young adult females and males respectively (Ljungman et al., 2020; Moreau et al., 2016; Nguyen et al., 2017; Zheng et al., 2020). Young adulthood is a transitional period from adolescence to adulthood where significant psychological and social developments occur (Evan et al., 2006). During this stage of Erikson’s (1968) psychosocial development theory, young adults seek and form intimacy in connections with others via friendships, romantic relationships, and sexual relationships. The transition from adolescence to adulthood between 18 years to the late 20 s appears to be an essential period for the exploration of sexual behaviours as a large majority of young adults would have engaged in sexual activities irrespective of marital status (Kar et al., 2015). In the event that young adults are unsuccessful in cultivating intimacy as a result of social rejection, perceptions of isolation may arise and consequently hinder further attempts at seeking intimacy (Ellison, 2011). As the ability to form intimate relationships is built upon the prior stage of identity formation during adolescence⁠—a period where the self-esteem of an individual is reinforced upon the formation of a stable sense of self-image (Ragelienė, 2016)⁠—self-esteem may have sexual implications later in life.

Self-esteem, defined as how people positively or negatively appraise themselves (Rosenberg, 1965), has typically been studied as a global construct. The purpose of self-esteem has been described as representing a risk regulator or a gauge of one’s standing in their social environment (Leary, 2012; Murray et al., 2006). In addition, self-esteem can be viewed as a protective factor or a psychological resource that acts as a buffer against negative events and their impact (Mann et al., 2004). Considering self-esteem as a psychological resource, the conservation of resources theory proposes that people with an abundance of resources have more opportunities to gain more resources, while those with limited resources would be more vulnerable to further losses in resources (Hobfoll et al., 1990). This is echoed by the risk regulation model, which argues that having higher self-esteem motivates individuals to pursue relationship-promotion goals whereas those with lower self-esteem focus on self-protective goals (Murray et al., 2006). As a result, people with high self-esteem tend to engage in more rewarding social behaviours with others thus reflecting healthy functioning in various aspects of life (Baumeister et al., 2003; Cameron & Granger, 2019; Harris & Orth, 2020; Mann et al., 2004), such as sexual functioning.

While extant literature on global self-esteem and sexual functioning is limited, most studies find a significant positive relationship between self-esteem and sexual functioning whereas some studies yield non-significant findings (Ng et al., 2019; Safarinejad et al., 2013; Sánchez-Fuentes et al., 2014; Wang et al., 2022). Generally, a meta-analysis of self-esteem and sexual health by Sakaluk et al. (2020) found that the positive relationship between self-esteem and sexual functioning was significant, yet this effect was small. However, the authors noted that these results are limited by high heterogeneity indicating existing theories of self-esteem are too broad or lack specificity in their construct measurements. Based on their findings, it is apparent that one of the gaps in self-esteem literature is the extensive nature of the construct of self-esteem. Thus, this review aims to examine possible domains of global self-esteem in relation to sexual functioning.

Specific types of self-esteem that include contingencies of self-worth with components such as social self-esteem, achievement self-esteem, and appearance self-esteem (Jordan & Zeigler-Hill, 2018; Katz et al., 1995; Steinsbekk et al., 2021) have mainly been studied independently of each other in the literature. However, a bidimensional model of self-esteem was proposed to consist of self-liking and self-competence (Tafarodi & Milne, 2002; Tafarodi & Swann, 1995, 2001). This model was developed by the authors from a factor analysis of items of the Rosenberg Self-Esteem Scale (RSES; Rosenberg, 1965), which were classified into self-liking and self-competence components. Based on their account, self-liking refers to how people evaluate themselves or their sense of self-worth as social beings, whereas self-competence involves how individuals assess their skills and abilities or their capacity as agentic beings.

Self-competence, as explained in the self-determination theory (Deci & Ryan, 2000), shares similarities and is often used interchangeably with self-efficacy, a core component of the social cognitive theory (Bandura, 1986). These constructs share theoretical congruence in goal pursuit or attainment, thus promoting behavioural change (Rodgers et al., 2014). Therefore, the domain of self-competence in the bidimensional model of self-esteem may encompass self-efficacy or sexual self-efficacy, which includes the ability to possess autonomy, desirability, and achieve pleasure from their sexual activities and performance (Closson et al., 2018; Fichten et al., 2019), and is positively associated with sexual functioning (Manouchehri et al., 2021).

Sexual self-esteem or sexual esteem, defined as the positive regard for and confidence in oneself to be involved in satisfying experiences of sexuality (Snell et al., 1993), has also been broadly studied in sexual functioning literature. Definitions and measures of sexual self-esteem appear analogous to global self-esteem though it is specific to the sexual context, as sexual self-esteem includes both the components of self-liking and self-competence corresponding to the items of the RSES (Snell, 1998; Snell & Papini, 1989). It is not uncommon for people to evaluate individual aspects of the self differentially, thus a sense of one’s sexual self was suggested to contribute to, yet is distinct from, one’s global sense of self (Zeanah & Schwarz, 1996).

Due to the heterogeneous nature of these constructs with related yet distinct definitions of global self-esteem elements in the sexual functioning literature where the significance of this relationship is often mixed, it is unclear if evaluating global self-esteem in terms of both self-liking and self-competence would help generate a more accurate understanding of the role of self-esteem in sexual function. Apart from Sakaluk et al. (2020), no reviews have directly summarised the literature on self-esteem and sexual functioning and outlined the role of both self-liking and self-competence in sexual functioning. Compared to the unidimensional approach to self-esteem studied by Sakaluk et al. (2020), a bidimensional approach could allow for further understanding of the relationship between self-esteem and sexual functioning. Therefore, it would be worth reviewing the literature on aspects of the bidimensional conceptualisation of global self-esteem in relation to sexual functioning as this framework has not been widely studied and may provide insight into the gap discussed. The current review aimed to systematically investigate the relationship between domains of global self-esteem, namely self-liking and self-competence, with sexual functioning among young adults. This would incorporate self-esteem constructs that are specific to sexual situations such as sexual self-esteem, and also take into account constructs related to self-liking or self-competence, i.e., self-efficacy and sexual self-efficacy.

Methods

Search strategy

Systematic literature searches for original English-language peer-reviewed articles were conducted from inception until June 2022 using the PsycINFO, Ovid MEDLINE, Scopus, PubMed, Web of Science, and CINAHL Plus databases. Multiple search terms guided by database subject headings such as MeSH and Emtree were used for variations to keywords of self-esteem, self-liking, self-competence, sexual functioning, and young adults. The search strategy of [(“self esteem” OR “self worth” OR “self concept” OR “self perception*” OR “self evaluation*” OR “self assessment*” OR “self attitude*” OR “self liking” OR “self competen*” OR “self efficac*” OR “sexual esteem” OR “sexual self efficac*”) AND (“sexual function*” OR “sexual dysfunction*” OR “sexual desire” OR “sexual arousal” OR “vaginal lubrication” OR “erection” OR “erectile” OR “orgasm*” OR “sexual satisfaction” OR “sexual dissatisfaction” OR “sexual pain”) AND (“young adult*” OR “emerging adult*” OR “adolescen*” OR “college student*” OR “university student*”)] was executed in the above databases. This systematic review was registered under CRD42020190367 in the international prospective register of systematic reviews (PROSPERO; National Institute for Health Research, 2023). Reporting of this review is in accordance with the items required in the reporting of systematic reviews in the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA; Page et al., 2021).

Inclusion and exclusion criteria

The inclusion and exclusion criteria used in the screening process of the articles retrieved from the databases are reported in Table 1.

Table 1 Inclusion and exclusion criteria of articles in the screening process
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Data collection and extraction

Four reviewers (LVK, KRC, WH, WLO) independently screened the title and abstract of articles based on the inclusion criteria and, subsequently, the full-text articles using Covidence, an online collaboration platform to streamline the process of systematic reviews (Veritas Health Innovation, 2023). In cases of disagreement between the reviewers after discussion, other reviewers (RSKT, PHG) were consulted to settle the conflicts. Data extraction was performed using Microsoft Excel, where a standardised data extraction form was used to record the following information: authors, year, country, study design, study objectives, sample characteristics (subjects, sample size, mean age), self-esteem measures, sexual functioning measures, and main findings on the association between self-esteem and sexual functioning. Any measure of sexual functioning or its domains was eligible for inclusion, such that outcomes could consist of overall sexual functioning scores or domain-specific scores of sexual functioning.

Quality assessment

Methodological quality and risk of bias were independently assessed by three reviewers using the National Heart, Lung, and Blood Institute’s quality assessment tool for observational cohort and cross-sectional studies (National Heart, Lung and Blood Institute [NHLBI], 2021). This NHLBI quality assessment tool contains 14 criteria that evaluates a study’s internal validity through potential flaws in the study’s methods or implementation (NHLBI, 2021). Discrepancies in the ratings were resolved via discussion among the reviewers until consensus was reached. According to the NHLBI, instead of numeric scores, this quality assessment tool would yield an overall quality rating of either “good”, “fair”, or “poor” depending on evaluations of the studies’ flaws based on each item in the tool. Responses to the items are “yes”, “no”, or “cannot determine/not reported/not applicable”, where potential risk of bias due to flaws in the study design or methodology is considered. “Good” studies have low risk of bias thus results are considered valid, whereas “fair” studies may have some risk of bias but are not enough to invalidate results, and “poor” studies are considered to have a significant risk of bias.

Analysis

To synthesise the evidence, data extracted from each study were tabulated and analysed to understand study characteristics. The data that were extracted involved study characteristics such as the countries the studies were conducted in, the study designs used, sample characteristics including the sample sizes and mean ages, self-esteem measures used, sexual function measures used, and the main outcomes related to the association between self-esteem and sexual function. These data were analysed and reported as a summary to describe the proportion of studies with the aforementioned characteristics. Due to the heterogeneity of both independent and dependent variables, a meta-analysis was not feasible. Hence, a narrative synthesis approach was used to evaluate the results from the included studies in this review. The studies were conceptually grouped according to the different self-esteem measures: (a) global self-esteem, (b) sexual self-esteem, (c) sexual self-efficacy, and (d) specific dimensions related to self-liking and self-competence.

Results

A total of 6020 articles were retrieved from the databases, where 4653 articles were identified after 1367 duplicates were removed. At the title and abstract screening, 4274 articles were excluded. The remaining 379 full-text articles were assessed for eligibility. Upon assessing the articles, 362 studies were excluded from this review. Finally, 17 articles met all the inclusion and exclusion criteria. The PRISMA flowchart of the inclusion and exclusion process is shown in Fig. 1. Most of the excluded studies did not report the association between self-esteem and sexual functioning, involved participants outside the age range of 18–30 years old, or did not contain at least one component of self-esteem or sexual functioning.

Fig. 1
figure 1

PRISMA Flowchart of Included and Excluded Studies

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Study characteristics

The overview of the studies included in this review is summarised in Table 2. Most of the studies were conducted in North America and most were of a cross-sectional design. While self-esteem was mostly measured in terms of global self-esteem, various self-esteem constructs in accordance with the bidimensional model of self-esteem were used. The measure of sexual satisfaction domain of sexual functioning was most prevalent in these included studies. The number of studies with female-only samples was also comparable to mixed-gendered samples. All studies measured sexual functioning in continuous scores, where sexual functioning can range from low to high, instead of clinical cut-off scores indicating the presence or absence of clinical sexual dysfunction.

Table 2 Summary of Study Characteristics of 17 Included Studies
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The key characteristics and quality assessment outcomes for each included study are reported in Table 3. To summarise the quality assessment ratings, a) global self-esteem: five studies were fair, one study was poor, b) sexual self-esteem: two studies were good, three studies were fair, c) sexual self-efficacy: four studies were fair, d) self-acceptance: one study was fair, and e) self-competence: one study was good. Self-esteem constructs were measured with a wide range of instruments, where the Rosenberg Self-Esteem Scale (Rosenberg, 1965), subscales in the Multidimensional Sexuality Questionnaire (Snell et al., 1993), Multidimensional Sexual Self-Concept Questionnaire (Snell, 1998), Sexuality Scale (Snell & Papini, 1989), and Female Sexual Subjectivity Inventory (Horne & Zimmer-Gembeck, 2006) were most used. Measures of sexual satisfaction domain of sexual functioning also varied including the Index of Sexual Satisfaction (Hudson et al., 1981, 1998), Sexual Satisfaction Scale (Dove & Wiederman, 2000), and Global Measure of Sexual Satisfaction (Lawrence & Byers, 1995; Lawrence et al., 2011). Overall sexual functioning was most consistently measured using the Female Sexual Functioning Index (Rosen et al., 2000), International Index of Erectile Function (Rosen et al., 1997), and Derogatis Interview of Sexual Functioning (Derogatis, 1987). The results are presented under four categories of self-esteem measures: 1) global self-esteem, 2) sexual self-esteem, 3) sexual self-efficacy, and 4) specific dimensions related to self-liking and self-competence (self-acceptance and self-competence).

Table 3 Key Characteristics and Quality Assessment of Included Studies
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Global self-esteem

Of the 17 studies, six studies measured self-esteem as an overall or global construct. Five out of six studies (Durmala et al., 2015; Hally & Pollack, 1993; Lin & Lin, 2018; Rehbein-Narvaez et al., 2006; Stewart & Szymanski, 2012) used the Rosenberg Self-Esteem Scale, which defines global self-esteem as the extent to which individuals perceive their self-worth including both positive and negative feelings about oneself (Rosenberg, 1965). One study (Higgins et al., 2011) used a different approach to measure self-esteem, which was only by ratings of very poor, poor, fair, good, very good, and excellent; however, it was not reported in the study how self-esteem was operationalised and measured.

Four studies examined the relationship between global self-esteem and the domain of sexual satisfaction specifically (Hally & Pollack, 1993; Higgins et al., 2011; Lin & Lin, 2018; Stewart & Szymanski, 2012), whereas two studies considered overall sexual functioning (Durmala et al., 2015; Rehbein-Narvaez et al., 2006). Global self-esteem was consistently found to be significantly positively associated with sexual satisfaction. On the other hand, with overall sexual functioning, this relationship was not significant except for sexual desire and orgasm. All measures of sexual functioning were based on continuous scores indicating symptoms of difficulties in one’s sexual functioning.

Sexual self-esteem

Sexual self-esteem was measured in a total of five studies, where four different instruments were used among these five studies. Sexual self-esteem is defined in the Sexuality Scale (Snell & Papini, 1989), as well as in its subsequent versions the Multidimensional Sexuality Questionnaire (Snell et al., 1993) and the Multidimensional Sexual Self-Concept Questionnaire (Snell, 1998), as a generalised tendency for individuals to experience their sexuality in a positive way by relating sexually to their partners, in which the authors referred to the Rosenberg (1965) construct of global self-esteem as a related concept to their definition of sexual self-esteem. The final instrument used in the study by Clapp and Syed (2021) is Calogero and Thompson's (2009) revision of the Rosenberg Self-Esteem Scale, in which the global self-esteem construct was adapted specifically to the sexual context.

All five studies (Brassard et al., 2015; Clapp & Syed, 2021; La Rocque & Cioe, 2011; Peixoto et al., 2018; Schick et al., 2010) investigated the relationship between sexual self-esteem and sexual satisfaction. In addition, Brassard et al. (2015) and Peixoto et al. (2018) also measured overall sexual functioning, whereas La Rocque and Cioe (2011) also measured sexual desire. Three studies (Brassard et al., 2015; Clapp & Syed, 2021; Schick et al., 2010) consisted of female-only samples. Findings on the relationship between sexual self-esteem and sexual functioning were consistently positive and significant.

Sexual self-efficacy

Four studies examined the construct of sexual self-efficacy (Bond et al., 2020; Kohlberger et al., 2019; Nurgitz et al., 2021; Zimmer-Gembeck et al., 2015), which was measured by two instruments. Three of four studies (Bond et al., 2020; Kohlberger et al., 2019; Zimmer-Gembeck et al., 2015) used the ‘self-efficacy in achieving sexual pleasure’ subscale of the Female Sexual Subjectivity Inventory (FSSI; Horne & Zimmer-Gembeck, 2006), whereas the Sexual Health Practices Self-Efficacy Scale (SHPSES; Koch et al., 2013) was used in one study (Nurgitz et al., 2021). The self-efficacy subscale in the FSSI assesses partner-focused means of achieving sexual pleasure whereas, in the SHPSES, self-efficacy is described as how confident individuals are in performing various sexual health behaviours based on their skills, knowledge, and comfort.

Of the four studies, three studies (Kohlberger et al., 2019; Nurgitz et al., 2021; Zimmer-Gembeck et al., 2015) examined the relationship between sexual self-efficacy and sexual satisfaction while one study (Bond et al., 2020) looked at its relationship with orgasm frequency. While Nurgitz et al. (2021) and Zimmer-Gembeck et al. (2015) found a significant positive relationship between sexual self-efficacy and sexual satisfaction, Kohlberger et al. (2019) only found that this relationship was present among females but not among males in their sample. As opposed to the studies that found a significant positive relationship, Kohlberger et al. (2019) obtained dyadic data from heterogenous couples, where they could account for partner’s influence on the participant. Sexual self-efficacy was also significantly associated with orgasm frequency (Bond et al., 2020).

Specific dimensions related to self-liking and self-competence

Only one study (Gil, 2007) examined the construct of self-acceptance. This was measured by a subscale of the Psychological Well-being Inventory (Ryff, 1989), which defines self-acceptance as the extent to which people have a positive attitude towards and accept multiple aspects of themselves. The sexual satisfaction subscale of the Extended Satisfaction with Life Scale (Alfonso et al., 1996) was used to measure sexual satisfaction, where results found a significant positive association between self-acceptance and sexual satisfaction.

Besides that, the construct of self-competence was examined by Witvliet et al. (2018). Self-competence was measured using the Self-Perception Profile (Harter, 1985) for children and adolescents respectively, which contains six domains of competence, such as scholastic competence. Specifically, this study measured self-competence during childhood and adolescence to see whether it is predictive of sexual functioning in adulthood. The study found no significant correlations between perceived self-competence in childhood and sexual functioning in adulthood for both males and females.

Discussion

This systematic review summarised empirical research on the relationship between self-esteem and sexual functioning domains among young adults. Results from various studies included in this review show inconsistent findings on the relationship between elements of self-esteem, in accordance with the bidimensional framework of global self-esteem, and overall or specific domains of sexual functioning. While there are studies that found no significant relationship between self-esteem and sexual functioning, most studies found significant positive relationships. However, these results are inconclusive due to potential heterogeneity in both the independent and dependent variables as various instruments were used to measure these constructs. Even so, our results on the generally positive relationship between self-esteem and sexual functioning are similar to Sakaluk et al. (2020)’s findings, with the addition that their review found that this was true specifically among samples with older adults and also noted substantial variation in sexual function effects between studies.

Among the domains of sexual functioning, 13 of 17 studies included in this review investigated sexual satisfaction, where 10 studies measured only sexual satisfaction while 2 studies also measured overall sexual functioning with sexual satisfaction. Although the current review aimed to examine the relationship between self-esteem domains and sexual functioning in the literature, most of the findings specifically pertain to sexual satisfaction. These studies indicate a consensus in the positive relationship between self-esteem and sexual satisfaction, consistent with the findings of a systematic review on sexual satisfaction by Sánchez-Fuentes et al. (2014). Although the component of sexual satisfaction has been widely studied, the relationship between self-esteem and sexual functioning remains unclear until the gaps in the literature of other sexual functioning domains in relation to self-esteem are addressed.

In addition, the studies included in this review demonstrate consistently significantly positive findings between global self-esteem and sexual self-esteem pertaining to their relationship with sexual functioning. This is likely a reflection of the measures of sexual self-esteem, which were reconstructed based on Rosenberg’s conceptualisation of global self-esteem (Snell & Papini, 1989), hence the items of the sexual self-esteem scales may also reflect both sexual self-liking and sexual self-competence. For instance, the Sexuality Scale by Snell and Papini (1989) parallels the bidimensional characteristics of self-esteem with sexual self-competence items such as “I would rate my sexual skill quite highly” and sexual self-liking items like “I am a good sexual partner”. More importantly, this review highlights that self-liking and self-competence domains of self-esteem have not been studied together in the same study in regard to sexual functioning among samples of young adults. This likely corresponds with our finding that there is an apparent scarcity of literature comparing these two generic self-esteem constructs in their account of sexual functioning, as the majority of studies are specific to sexual self-esteem and sexual self-efficacy.

Overall, these results highlighting the nuances of various conceptualisations of self-esteem and sexual functioning domains contribute to clinical applications where healthcare providers can benefit from in the treatment of people with sexual difficulties and distress. As seen in most studies that found significant relationships between sexual functioning with not only global and sexual self-esteem but also with constructs related to self-efficacy or competence, more comprehensive interventions aimed at increasing self-esteem levels among clients with sexual difficulties could be developed by including aspects targeted towards both components of self-liking and self-competence. For instance, cognitive-behavioural therapy has been consistently shown to be an effective intervention for improving self-esteem levels as it involves the process of identifying relevant core beliefs about one’s self-worth in their social environment, confronting those beliefs, and developing self-compassion (Kolubinski et al., 2018). Among clients with sexual difficulties, these interventions could be supplemented with sexual skills training that focuses on improving clients’ sexual competence by increasing their sexual knowledge and sexual self-efficacy (Hungr et al., 2020).

Suggestions for future research

While it has been suggested that sexual self-esteem is better suited to be examined in the context of sexual relationships (Oattes & Offman, 2007), it would be beneficial for future research to also extend this knowledge to global or general self-esteem. As argued by Rosenberg et al. (1995), studying attitudes such as self-esteem, which is an attitude towards oneself as an object, should take into account the experience that people may have differing attitudes towards the object in its entirety as opposed to specific facets of the object. Thus, while much is known on how individuals’ attitudes towards themselves as sexual beings relate to their sexual function, studying global self-esteem may extend this understanding to individuals’ attitudes towards themselves an entity. Indeed, further research on self-liking and self-competence is needed to assess the utility of the bidimensional conceptualisation of global self-esteem. Although the bidimensional conceptualisation of global self-esteem has been validated by its authors (Tafarodi & Milne, 2002; Tafarodi & Swann, 2001), there remains a scarcity of research in this area to validate this framework.

The results of this review displaying heterogeneity in the measurements and definitions of self-esteem components prompts further inquiry into the need for unified scales that would encompass different aspects of self-esteem. Besides that, the RSES has been considered the most widely used and validated scale of global self-esteem; however, measures of sexual self-esteem, sexual self-efficacy, self-acceptance, and self-competence remain varied. It should be noted that, as the sexual self-esteem scales were developed based on the RSES, these sexual self-esteem scales could also be examined for the bidimensional framework of self-esteem thus comprising of sexual self-liking and sexual self-competence. Lastly, as many studies were conducted using cross-sectional study designs and were mostly of correlational data, more research should employ longitudinal research designs to directly examine the effect of self-esteem on sexual functioning such as in Witvliet et al. (2018).

Limitations

Although this review aimed to focus on the domains of the bidimensional conceptualisation of global self-esteem, both the self-liking and self-competence domains of self-esteem have rarely been explored in the field of sexual functioning. The unidimensional global self-esteem and sexual self-esteem constructs were relatively more widely studied in this area and were thus reflected in our results. During the screening process, qualitative studies were excluded from this review as only studies reporting the significance of the relationship between self-esteem and sexual functioning domains were included. Unlike the qualitative approach, the quantitative studies in this review were confined to the definitions and items of the instruments used. While this review included two studies using a longitudinal design, a large proportion of studies used a cross-sectional design. More longitudinal studies could be conducted in future research to determine the temporal effects of self-esteem, such as the effect of self-esteem levels during childhood and adolescence on sexual functioning in adulthood. Overall, these findings highlight a gap in the self-esteem and sexual functioning literature that could be addressed in future research for a deeper understanding of the underlying mechanism behind this relationship.

Conclusion

The positive relationship between sexual functioning with global self-esteem and its components is generally observed in the literature. However, with a scarcity of studies that include self-liking and self-competence as independent variables, it is still unclear how these domains contribute to sexual functioning. The lack of consistency in definitions and measures of self-esteem constructs in this area gives rise to difficulty in assessing the relationship between different domains of self-esteem. Further research is needed to evaluate the utility of the bidimensional conceptualisation of global self-esteem to gain a deeper understanding of the role of self-esteem in people’s perceptions of their sexual experiences, especially among young adults in the phases of self-concept development. By identifying the nuanced aspects of self-esteem, healthcare providers may benefit by building more responsive programmes to promote healthy sexual functioning among young adults.