Self-Esteem and Body Image as Predictors of Sexual Satisfaction: A Systematic Review

Abstract

Sexual satisfaction is a core dimension of sexual health, influenced by psychological and body-related factors, particularly self-esteem and body image. The main goal of this systematic review was to synthesize empirical evidence on the relationship between self-esteem, body image, and sexual satisfaction, and to identify moderating and mediating factors that may shape these associations. Quantitative, peerreviewed studies published between 2013 and 2024 were included if they assessed self-esteem, body image, and sexual satisfaction in adults. Studies were excluded if they were qualitative, case reports, or focused solely on clinical populations. Systematic searches were conducted in Web of Science and Scopus, with the last search in March 2024. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Analytical Cross-Sectional Studies. Nineteen studies, including 12,482 participants, met the inclusion criteria. Both self-esteem and body image were positively associated with sexual satisfaction, with these associations moderated by gender, sexual orientation, and mediators such as sexual communication. Stronger associations were observed in men and heterosexual participants, whereas no significant link was found between body dissatisfaction and sexual satisfaction among bisexual and lesbian individuals. Sociocultural norms, including traditional beauty ideals and heterosexist values, appeared to influence these relationships. In conclusion, self-esteem and body image serve as protective factors for sexual wellbeing. Future research should apply intersectional frameworks, longitudinal designs, and standardized measures. Findings provide implications for culturally sensitive sexual health promotion and early preventive interventions.