The Interplay Between Alexithymia and Sexual Function: A Systematic Review

Objective: Alexithymia represents a difficulty in identifying and describing emotions in oneself and others, and a reduced ability to reflect on one’s feelings. The relationship between alexithymia and sexual functioning is a key chapter of clinical psychosexology but has not been fully explored. In particular, the clinical relevance of alexithymic traits in individuals with sexual dysfunction deserves particular attention. This study explores the association between alexithymia and sexual function in the domains of desire, excitement, orgasm, and sexual pain. Methods: We conducted a PRISMA 2020-compliant systematic review, searching PsycINFO, MEDLINE, Scopus, and Web of Science for studies published until March 14, 2025, including adult participants assessed for alexithymic traits and at least one phase of the sexual response cycle or sexual pain. Data extracted included study design, participant characteristics, assessment tools, and the sexual functioning domains evaluated. Quality assessment was performed using the AXIS Tool. Results: We included 15 articles. The results demonstrate the existence of a relationship between alexithymic traits and sexual dysfunctions. The studies analyzed demonstrate that subjects who reported desire disorders exhibit significantly higher levels of alexithymia compared to control groups. Furthermore, a positive linear relationship has been identified between female arousal problems and levels of alexithymia. Subjects with arousal problems report higher levels of alexithymia than control subjects. The studies considered demonstrate that subjects experiencing erectile dysfunction exhibit higher levels of alexithymia than control groups. However, this result does not appear consistent in the case of female subjects encountering lubrication difficulties. There is also complete consensus among studies regarding the relationship between sexual pain problems and alexithymia. Orgasm difficulties do not appear to be related to levels of alexithymia. Conclusion: This study’s findings highlight the significance of addressing the alexithymic traits of individuals experiencing sexual dysfunction, as they could represent important predisposing and maintenance factors.