Sexual Medicine Service, Department of Gynecology and Obstetrics, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
J Sex Med. 2013 Feb;10(2):467-73. doi: 10.1111/jsm.12011. Epub 2012 Dec 4.
Polycystic ovary syndrome (PCOS) appears to be related to sexual dysfunction, especially if associated with obesity. However, it is not clear whether obesity per se is an independent factor for sexual dysfunction. We hypothesized that obese polycystic ovary syndrome (OPCOS) patients have poorer sexual function than controls and nonobese polycystic ovary syndrome (NOPCOS) women.
To assess the sexual function of women (either obese or nonobese) with PCOS compared to women with regular cycles.
The main outcome measures were the Female Sexual Function Index (FSFI) and Free Androgen Index (FAI) values.
We used a cross-sectional study design to evaluate 83 women, including 19 nonobese women without PCOS, 24 nonobese women with PCOS, 16 obese women without PCOS, and 24 obese women with PCOS. The FSFI questionnaire was used to gather data from all women, and free testosterone levels were determined and employed to calculate FAI values.
Higher androgen concentrations were evident in the PCOS groups compared to controls (NOC [nonobese control] 2.3 ± 0.7; OC [obese control] 2.1 ± 0.5; NOPCOS 3.1 ± 0.8; OPCOS 3.5 ± 1.2; P < 0.0001). This was also true for FAI, with the exception of obese controls and nonobese women with PCOS, in whom the levels were similar (NOC 4.9 ± 1.6; OC 6.5 ± 3.1; NOPCOS 7.5 ± 3.9; OPCOS 12.8 ± 5.2; P < 0.05). Evaluation of the total FSFI scores revealed that obese women without PCOS had below-normal sexual function scores, whereas both obese and nonobese women with PCOS had borderline scores compared to controls, who had normal FSFI findings. No association was observed between body mass index, the presence of PCOS, testosterone level, and FSFI score.
The obese women in our sample were at a higher risk for sexual dysfunction and lower FSFI scores, and women with PCOS had borderline FSFI values, regardless of their obesity status. Based on this result, larger studies using the methods described in this pilot study are warranted to elucidate if obesity can impair sexual function in PCOS women.
多囊卵巢综合征(PCOS)似乎与性功能障碍有关,尤其是与肥胖相关时。然而,肥胖本身是否是性功能障碍的独立因素尚不清楚。我们假设肥胖型多囊卵巢综合征(OPCOS)患者的性功能较对照组和非肥胖型多囊卵巢综合征(NOPCOS)女性更差。
评估多囊卵巢综合征女性(肥胖或非肥胖)的性功能与正常周期女性相比的差异。
主要观察指标为女性性功能指数(FSFI)和游离雄激素指数(FAI)值。
我们采用横断面研究设计,评估了 83 名女性,包括 19 名非肥胖无 PCOS 女性、24 名非肥胖 PCOS 女性、16 名非肥胖无 PCOS 肥胖女性和 24 名肥胖 PCOS 女性。所有女性均使用 FSFI 问卷收集数据,并测定游离睾酮水平以计算 FAI 值。
与对照组相比(NOC[非肥胖对照组]2.3 ± 0.7;OC[肥胖对照组]2.1 ± 0.5;NOPCOS[非肥胖 PCOS 组]3.1 ± 0.8;OPCOS[肥胖 PCOS 组]3.5 ± 1.2;P < 0.0001),PCOS 组的雄激素浓度更高。FAI 也是如此,除了肥胖对照组和非肥胖 PCOS 女性,她们的水平相似(NOC 4.9 ± 1.6;OC 6.5 ± 3.1;NOPCOS 7.5 ± 3.9;OPCOS 12.8 ± 5.2;P < 0.05)。FSFI 总分评估显示,非肥胖 PCOS 女性的性功能评分低于正常值,而肥胖和非肥胖 PCOS 女性的评分接近正常值,对照组的 FSFI 评分正常。体重指数、PCOS 存在、睾酮水平与 FSFI 评分之间均无相关性。
我们样本中的肥胖女性存在更高的性功能障碍风险和较低的 FSFI 评分,无论肥胖与否,PCOS 女性的 FSFI 值均接近边界值。基于这一结果,有必要进行更大规模的研究,采用本研究中描述的方法,以阐明肥胖是否会损害 PCOS 女性的性功能。