Abstract
Women’s sexual health is an important integrative indicator of physical, mental, and social well-being. In modern
research, increasing attention is paid to the role of chronic psychosocial stress as one of the key modifiable factors affecting the
functioning of the reproductive and sexual systems. Given the complex biopsychosocial nature of female sexuality, the study of the
mechanisms of stress and their clinical consequences is particularly relevant for the prevention and treatment of sexual disorders.
Objective. To analyze current data on the impact of chronic psychosocial stress on women’s sexual health, taking into account
neuroendocrine, psychological, social, and relational mechanisms, as well as correction possibilities.
Materials and methods. A targeted review of publications indexed in PubMed, Scopus, Web of Science, and open access
resources for the period approximately 2000-2025 was conducted. The search terms used in English were: chronic stress,
psychological stress, hypothalamic–pituitary–adrenal axis, female sexual function, female sexual dysfunction, FSFI, women,
depression, anxiety, mindfulness, intervention.
Results. Chronic stress is consistently associated with decreased sexual desire, impaired arousal, lubrication, orgasm, increased
incidence of dyspareunia, and sexual distress in women of all ages. At the biological level, stress, through activation of the
hypothalamic–pituitary–adrenal (HPA) axis and increased cortisol, suppresses the hypothalamic–pituitary–gonadal (HPG) axis,reducing gonadal steroid secretion and altering vascular reactivity. Psychologically, it is associated with anxiety, depression,
cognitive distraction, negative body and sexuality schemas, which increase subjective distress. Postpartum, perimenopausal/
postmenopausal women, cancer patients, and infertility are most vulnerable. The most convincing evidence for stress management
and sexual function improvement relates to mindfulness-based, cognitive-behavioral, psychosexual, and couples interventions,
especially in combination with medication for anxiety/depression and, when indicated, hormone therapy.
Conclusions. Chronic stress is a significant but potentially modifiable risk factor for sexual dysfunction in women. Integrated
approaches that combine psychotherapeutic, behavioral, and biomedical interventions are the most promising for reducing the
negative impact of stress on women’s sexual health.
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