Abstract Introduction Obsessive-Compulsive Disorder (OCD) is a complex and heterogeneous condition characterized by intrusive thoughts and repetitive behaviors that individuals use to reduce anxiety. These obsessions are experienced as unwanted, uncontrollable, and distressing. The compulsions that follow are ritualized behaviors aimed at preventing feared outcomes or alleviating anxiety. sexuality in OCD remains a relatively neglected area of research. Objective This review explores the relationship between Obsessive-Compulsive Disorder (OCD) and sexual functioning. The aim is to highlight the clinical relevance of sexual health in OCD and encourage more comprehensive assessment and intervention strategies. Methods This study explores the association between Obsessive-Compulsive Disorder (OCD) symptoms and sexual pain or sexual functioning, using the DEPOR model (Desire, Excitement, Plateau, Orgasm, Resolution) as a conceptual framework. We conducted a PRISMA 2020-compliant systematic review, searching PsycINFO, MEDLINE, Scopus, and Web of Science for studies published until February 26, 2025, including adult participants assessed for OCD symptoms 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 10 articles. Research shows that individuals with OCD often experience difficulties across multiple phases of sexual response, though findings vary due to methodological inconsistencies and confounding factors such as medication use and sample composition. Most studies report significantly lower sexual desire among OCD patients compared to healthy controls, suggesting that obsessive thoughts, intrusive cognitions, and elevated disgust sensitivity interfere with sexual interest and increase avoidance behaviors. Reduced desire appears to be a consistent feature of OCD, possibly reflecting the disorder’s cognitive and emotional mechanisms rather than solely medication effects. Sexual arousal also tends to be impaired in OCD, with evidence showing that patients-especially women-report lower arousability despite normal physiological responses. These alterations persist even in unmedicated samples, reinforcing the role of obsessive symptoms rather than pharmacological side effects. Orgasmic functioning is frequently affected as well, with OCD patients often reporting difficulties such as anorgasmia or premature ejaculation, although results are not entirely consistent due to small or gender-limited samples. The relationship between OCD and sexual pain is less clear, with mixed results and limited research. Conclusions The available evidence supports the notion that OCD exerts a broad negative impact on sexual functioning, affecting desire, arousal, and orgasmic response. The severity and expression of these difficulties appear to be influenced by cognitive mechanisms, disgust sensitivity, and possibly age, with younger individuals showing stronger associations between OCD symptoms and sexual dysfunction. The results of this study emphasise the significance of evaluating patients with obsessive-compulsive disorder in regard to their sexual functioning, with a focus on enhancing their quality of life. Disclosure No
Doroldi et al. (Mon,) studied this question.