Division of Endocrinology - Department of Internal Medicine, University of Patras School of Health Sciences, Patras, Greece; Department of Obstetrics and Gynecology, University of Patras School of Health Sciences, Patras, Greece.
Massachusetts General Hospital, Boston, MA, USA.
J Sex Med. 2021 Nov;18(11):1872-1879. doi: 10.1016/j.jsxm.2021.09.004. Epub 2021 Oct 2.
Even though polycystic ovary syndrome (PCOS) is a common reproductive disorder affecting young women, its impact on their sexual health is not well known.
To examine the different aspects of female sexuality in young women with PCOS and attempt to associate hormonal changes and ovulatory status with their sexual function.
Anthropometric characteristics, hormonal levels and sexual function based on the Female Sexual Function Index (FSFI) questionnaire were assessed in 76 young women with PCOS and 133 matched controls.
Sexual function is significantly impaired in young women with PCOS.
Women with PCOS demonstrated lower scores than controls in arousal (5.04 ± 1.19 vs 4.48 ± 1.44, P < .001), lubrication (5.29 ± 1.17 vs 4.69 ± 1.54, P < .001), orgasm (4.78 ± 1.40 vs 4.11 ± 1.61, P = .001), satisfaction (5.22 ± 1.10 vs 4.78 ± 1.31, P = .016), and total score of the FSFI (29.51 ± 5.83 vs 26.76 ± 6.81, P < .001), even after correction for BMI. When corrected for total testosterone, the domains of lubrication, satisfaction, and total score of FSFI remained significantly impaired in women with PCOS (P values .037, .024, & .044 respectively). In multivariate logistic regression analysis, after adjusting for the effect of BMI and hormone levels, dysfunction in orgasm, satisfaction and the total FSFI score were still 3-4 times more common in PCOS (adjusted OR [95% CI]: 3.54, P = .020; 2.96, P = .050; 3.87, P = .027). Even though no statistically significant differences were observed between women with ovulatory PCOS and controls, we detected statistically significant differences in all domains of sexual function apart from pain between controls and PCOS women with anovulation (desire P value .04, arousal P value <.001, lubrication P value <.001, orgasm P value .001, satisfaction P value .001 and FSFI total score P value <.001).
Women with PCOS have compromised sexual function, which is independent of their BMI and highly dependent on their ovulatory status.
This is the first study in women with PCOS that implicates anovulation as a risk factor for sexual impairment in PCOS. Further studies are needed to elucidate the mechanisms implicated and to examine the effect of PCOS therapy on the patients' sexual function.
The adverse effect of PCOS status on the female sexual function is independent of BMI and only partially dependent on hormonal changes characterizing the syndrome. Anovulation appears to be the major determinant of sexual impairment among women with PCOS. Mantzou D, Stamou MI, Armeni AK, et al. Impaired Sexual Function in Young Women With PCOS: The Detrimental Effect of Anovulation. J Sex Med 2021;18:1872-1879.
多囊卵巢综合征（PCOS）是一种常见的影响年轻女性的生殖系统疾病，但它对女性性健康的影响尚不清楚。
研究年轻女性多囊卵巢综合征患者的不同性健康方面，并尝试将激素变化和排卵状态与她们的性功能相关联。
对 76 名年轻女性多囊卵巢综合征患者和 133 名匹配对照者的人体测量特征、激素水平和基于女性性功能指数（FSFI）问卷的性功能进行评估。
年轻女性多囊卵巢综合征患者的性功能明显受损。
与对照组相比，多囊卵巢综合征患者的性欲（5.04 ± 1.19 对 4.48 ± 1.44，P <.001）、润滑（5.29 ± 1.17 对 4.69 ± 1.54，P <.001）、性高潮（4.78 ± 1.40 对 4.11 ± 1.61，P =.001）、满意度（5.22 ± 1.10 对 4.78 ± 1.31，P =.016）和 FSFI 总分（29.51 ± 5.83 对 26.76 ± 6.81，P <.001）均显著降低，即使在调整了 BMI 后也是如此。在对总睾酮进行校正后，多囊卵巢综合征患者的润滑、满意度和 FSFI 总分的各域仍显著受损（P 值分别为.037、.024 和.044）。在多变量逻辑回归分析中，在调整了 BMI 和激素水平的影响后，性高潮、满意度和 FSFI 总分的功能障碍在多囊卵巢综合征患者中仍增加 3-4 倍（调整后的 OR [95%CI]：3.54，P =.020；2.96，P =.050；3.87，P =.027）。尽管排卵性多囊卵巢综合征患者和对照组之间没有观察到统计学上的显著差异，但我们在对照组和无排卵性多囊卵巢综合征患者之间的所有性功能领域（除疼痛外）都检测到了统计学上的显著差异（欲望 P 值.04，性欲 P 值 <.001，润滑 P 值 <.001，性高潮 P 值.001，满意度 P 值.001 和 FSFI 总分 P 值 <.001）。
多囊卵巢综合征患者的性功能受损，这与其 BMI 无关，且高度依赖于其排卵状态。
这是第一项研究多囊卵巢综合征患者的研究，表明排卵障碍是多囊卵巢综合征患者性功能障碍的一个危险因素。需要进一步的研究来阐明所涉及的机制，并研究多囊卵巢综合征治疗对患者性功能的影响。
多囊卵巢综合征状态对女性性功能的不良影响独立于 BMI，仅部分取决于该综合征特征的激素变化。排卵障碍似乎是多囊卵巢综合征患者性功能障碍的主要决定因素。
