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Warchala A, Madej P, Kochanowicz M, Krzystanek M. Sexual Function in Women with Polycystic Ovary Syndrome Living in Stable Heterosexual Relationships: A Cross-Sectional Study. J Clin Med 2024; 13:2227. [PMID: 38673500 PMCID: PMC11050871 DOI: 10.3390/jcm13082227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 03/28/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024] Open
Abstract
Background/Objective: The prevalence and character of female sexual dysfunction (FSD) in polycystic ovary syndrome (PCOS) have not been precisely determined. The aim of this study was to assess FSD using the Changes in Sexual Functioning Questionnaire (CSFQ-14) in women with PCOS and their partners compared to a control group, as well as correlations between five subscales, the total score of the CSFQ, and seven questions of the Visual Analogue Scale (VAS). Methods: The study sample (N = 160) comprised two groups: (1) women with PCOS and their partners (n = 91) and (2) women without PCOS and their partners (control group; n = 69). Results: The total scores of the CSFQ did not reveal FSD in either group of women. Regarding all subscales and the total score, the analysis showed a statistically significant difference between women and their partners (in all cases: p < 0.001). The discrepancy in arousal between women and men in the PCOS group was large (the mean difference was -2.32; t = -11.29, p < 0.001, Cohen's d = -1.26). The importance (VAS1), the level (VAS7) of sexual satisfaction, and the intensity of sexual thoughts (VAS2) correlated with almost all domains of the CSFQ. Conclusions: In conclusion, normal sexual function in PCOS does not mean proper sexual functioning in a sexual relationship.
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Affiliation(s)
- Anna Warchala
- Department and Clinic of Psychiatric Rehabilitation, Faculty of Medical Sciences, Medical University of Silesia in Katowice, Ziołowa 45/47, 40-635 Katowice, Poland;
| | - Paweł Madej
- Department of Gynecological Endocrinology, Faculty of Health Science in Katowice, Medyków 14, Medical University of Silesia, 40-752 Katowice, Poland
| | - Marta Kochanowicz
- Clinical Department of Obstetrics, Gynecology and Gynecological Oncology in Kędzierzyn-Koźle, Roosvelta Str. 2, 47-200 Kędzierzyn-Koźle, Poland;
| | - Marek Krzystanek
- Department and Clinic of Psychiatric Rehabilitation, Faculty of Medical Sciences, Medical University of Silesia in Katowice, Ziołowa 45/47, 40-635 Katowice, Poland;
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Sexual Dysfunction in Women With Polycystic Ovary Syndrome: Systematic Review and Meta-Analysis. J Sex Med 2019; 16:542-550. [PMID: 30833151 DOI: 10.1016/j.jsxm.2019.01.313] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 01/22/2019] [Accepted: 01/26/2019] [Indexed: 01/11/2023]
Abstract
INTRODUCTION Sexual dysfunction occurs in any phase of sexual performance or any period of the sexual response cycle, and polycystic ovary syndrome (PCOS) affects self-image with repercussions on sexuality. AIM To evaluate sexual dysfunction in women with PCOS. METHODS A systematic review was undertaken following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. The primary databases MEDLINE, EMBASE, Cochrane, and Lilacs were accessed using specific terms. There was no constraint against year of publication. The meta-analysis was conducted with RevMan program version 5.3. MAIN OUTCOME MEASURE We evaluated the relationship between sexual dysfunction and PCOS. RESULTS The systematic review encompassed 19 studies. The analysis indicated that 11 specific and 6 general instruments were used to measure the sexual function in PCOS women. Of these, the Female Sexual Function Index scale was used most frequently. All studies assessed different aspects of sexual performance in PCOS women, and no difference was found in between women with PCOS and control subjects. CLINICAL IMPLICATIONS Although there were disparities regarding ethnicity, culture, religion, and economy among studies, the available evidence failed to prove a significant link between PCOS and sexual dysfunction. STRENGTH & LIMITATIONS This systematic review addressed a multidimensional theme with many variables and with a wide diversity of measurement tools. Studies were small, and populations were not homogeneous. CONCLUSION Despite potential risk of bias, such as inhomogeneity of study population, sexual function of both PCOS patients and women with regular menstrual cycles might, in general, be similar. Firmino Murgel AC, Santos Simões R, Maciel GAR, et al. Sexual Dysfunction in Women With Polycystic Ovary Syndrome: Systematic Review and Meta-Analysis. J Sex Med 2019;16:542-550.
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Steffen KJ, King WC, White GE, Subak LL, Mitchell JE, Courcoulas AP, Flum DR, Strain G, Sarwer DB, Kolotkin RL, Pories W, Huang AJ. Sexual functioning of men and women with severe obesity before bariatric surgery. Surg Obes Relat Dis 2016; 13:334-343. [PMID: 27986585 DOI: 10.1016/j.soard.2016.09.022] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 09/15/2016] [Accepted: 09/23/2016] [Indexed: 12/31/2022]
Abstract
BACKGROUND Obesity may impair sexual function through multiple mechanisms, but little is known about sexual dysfunction among adults with severe obesity seeking bariatric procedures. OBJECTIVES To describe sexual function and associated factors before bariatric surgery. SETTING Ten U.S. clinical facilities. METHODS Before bariatric surgery, 2225 of 2458 Longitudinal Assessment of Bariatric Surgery-2 study participants (79% female, median age 45 years and median body mass index 46 kg/m2) completed a survey about sexual function over the past month. Mixed effects ordinal logistic regression models were used to identify factors independently related to 4 domains of sexual function. RESULTS One third of women (34%) and one quarter of men (25%) were not sexually active, alone or with a partner, in the past month. Twenty-six percent of women and 12% of men reported no sexual desire. Physical health limited sexual activity at least moderately in 38% of women and 44% of men. About one half of the women (49%) and the men (54%) were moderately or very dissatisfied with their sexual life. Among women, older age, being Caucasian, urinary incontinence, depressive symptoms, and antidepressant medication use were associated with poorer sexual function in multiple domains. In men, older age, not being married, depressive symptoms, and antidepressant medication use were associated with poorer sexual function in multiple domains. CONCLUSION Before bariatric surgery, approximately one half of women and men with severe obesity are dissatisfied with their sexual life. Older age, severity of depressive symptoms, and antidepressant medication use are associated with poorer sexual function in both sexes.
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Affiliation(s)
- Kristine J Steffen
- North Dakota State University, Fargo ND; Neuropsychiatric Research Institute, Fargo, ND.
| | - Wendy C King
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | - Gretchen E White
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
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Alves da Silva Lara L, Dos Santos Lima ML, Salata Romão G, Ferriani RA, de Albuquerque Salles Navarro PA. Response to Letter to Editor Entitled "Obesity, Overweight, Female Sexual Function, and Penile-Vaginal Intercourse Frequency". JOURNAL OF SEX & MARITAL THERAPY 2016; 42:387-390. [PMID: 26644003 DOI: 10.1080/0092623x.2015.1113592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- Lucia Alves da Silva Lara
- a Sexual Medicine Service, Sector of Human Reproduction, Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto-SP , Brazil
| | - Maria Lucia Dos Santos Lima
- a Sexual Medicine Service, Sector of Human Reproduction, Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto-SP , Brazil
| | - Gustavo Salata Romão
- a Sexual Medicine Service, Sector of Human Reproduction, Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto-SP , Brazil
| | - Rui Alberto Ferriani
- b Sexual Medicine Service, Sector of Human Reproduction, Department of Gynecology and Obstetrics, and INCt/CNPq Hormones, Protection and Risks for Women's Health, Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto-SP , Brazil
| | - Paula Andrea de Albuquerque Salles Navarro
- b Sexual Medicine Service, Sector of Human Reproduction, Department of Gynecology and Obstetrics, and INCt/CNPq Hormones, Protection and Risks for Women's Health, Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto-SP , Brazil
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Costa RM, Brody S. Obesity, Overweight, Female Sexual Function, and Penile-Vaginal Intercourse Frequency. JOURNAL OF SEX & MARITAL THERAPY 2016; 42:293-296. [PMID: 26167661 DOI: 10.1080/0092623x.2015.1069434] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Rui M Costa
- a William James Center for Research , ISPA-Instituto Universitário , Lisbon , Portugal
| | - Stuart Brody
- b Charles University , Department of General Anthropology, Faculty of Humanities , Prague , Czech Republic
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Lassek WD, Gaulin SJC. What Makes Jessica Rabbit Sexy? Contrasting Roles of Waist and Hip Size. EVOLUTIONARY PSYCHOLOGY 2016; 14:1474704916643459. [PMCID: PMC10481102 DOI: 10.1177/1474704916643459] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 02/14/2016] [Indexed: 09/09/2023] Open
Abstract
While waist/hip ratio (WHR) and body mass index (BMI) have been the most studied putative determinants of female bodily attractiveness, BMI is not directly observable, and few studies have considered the independent roles of waist and hip size. The range of attractiveness in many studies is also quite limited, with none of the stimuli rated as highly attractive. To explore the relationships of these anthropometric parameters with attractiveness across a much broader spectrum of attractiveness, we employ three quite different samples: a large sample of college women, a larger sample of Playboy Playmates of the Month than that has been previously examined, and a large pool of imaginary women (e.g., cartoon, video game, graphic novel characters) chosen as the “most attractive” by university students. Within-sample and between-sample comparisons agree in indicating that waist size is the key determinant of female bodily attractiveness and accounts for the relationship of both BMI and WHR with attractiveness, with between-sample effect sizes of 2.4–3.2. In contrast, hip size is much more similar across attractiveness groups and is unrelated to attractiveness when BMI or waist size is controlled.
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Affiliation(s)
- William D. Lassek
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Steven J. C. Gaulin
- Department of Anthropology, University of California at Santa Barbara, Santa Barbara, CA, USA
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Dural S, Cetinkaya H, Gülbetekin E. Hemispheric specialization in the assessment of female physical attractiveness. Laterality 2015; 20:232-48. [DOI: 10.1080/1357650x.2014.955503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Brody S, Weiss P. Erectile Dysfunction and Premature Ejaculation: Interrelationships and Psychosexual Factors. J Sex Med 2015; 12:398-404. [DOI: 10.1111/jsm.12738] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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De Frène V, Verhofstadt L, Loeys T, Stuyver I, Buysse A, De Sutter P. Sexual and relational satisfaction in couples where the woman has polycystic ovary syndrome: a dyadic analysis. Hum Reprod 2014; 30:625-31. [PMID: 25534460 DOI: 10.1093/humrep/deu342] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION How are objective characteristics of polycystic ovary syndrome (PCOS) and PCOS-related concerns associated with the sexual and relational satisfaction of PCOS women and their partners? SUMMARY ANSWER Both objective PCOS characteristics (parity, women's body mass index (BMI) and current unfulfilled wish to conceive) and PCOS-related concerns (women's infertility-related and acne-related concerns) were associated with sexual and/or relational satisfaction, although some associations differed for PCOS women and their partners. WHAT IS KNOWN ALREADY There is some evidence indicating an association between objective PCOS characteristics and sexual satisfaction of PCOS women, but this evidence is conflicting, scarce, and often validated questionnaires have not been used to evaluate sexual satisfaction. No evidence is available about the association of: (i) PCOS with relational satisfaction; (ii) PCOS-related concerns with sexual and relational satisfaction; and (iii) PCOS with sexual and relational satisfaction as experienced by partners of PCOS women. STUDY DESIGN, SIZE, DURATION We set up a cross-sectional study from April 2007 until April 2009, including 31 overweight (BMI ≥ 25 kg/m(2)) women with PCOS and at a reproductive age as well as their partners with whom they had a committed intimate relationship at the time of recruitment. PARTICIPANTS/MATERIALS, SETTING, METHODS The study was performed at the fertility center of the Ghent University Hospital. Objective PCOS characteristics were registered and PCOS-related concerns were evaluated by the PCOS Questionnaire. Sexual (SS) and relational (RS) satisfaction were measured by the Maudsley Marital Questionnaire (MMQ). Dyadic statistical analyses were performed using linear mixed models (α < 0.05). MAIN RESULTS AND THE ROLE OF CHANCE A lower parity tended to be associated with higher levels of sexual and relational satisfaction, with a significantly stronger association in PCOS women than in their partners (p(SS) = 0.015 and p(RS) = 0.009). A higher BMI tended to be associated with lower and higher satisfaction levels (sexual and relational) in PCOS women and their partners, respectively, with a significantly stronger association in the partners (p(SS) = 0.029 and p(RS) = 0.021). The presence of a current unfulfilled wish to conceive and a higher level of infertility-related concerns was significantly more strongly associated with a higher level of relational satisfaction for PCOS women than for their partners (p(RS) = 0.021 and p(RS) = 0.011, respectively). Higher levels of acne-related concern were significantly associated with lower levels of sexual satisfaction in both PCOS women (p(SS) = 0.025) and their partners (p(SS) = 0.002). LIMITATIONS, REASONS FOR CAUTION The fact that this study was performed in a sample of PCOS women who were all overweight and the small sample size are important limitations. Data were partially missing in some couples but this limitation was dealt with by using linear mixed models. WIDER IMPLICATIONS OF THE FINDINGS Our results suggest a differential association of PCOS with sexual and relational satisfaction between PCOS women and their partners. This should be kept in mind during the psychological guidance of couples dealing with PCOS. STUDY FUNDING/COMPETING INTERESTS V.D.F. is holder of a Special PhD Fellowship of the Flemish Foundation for Scientific Research (FWO-Vlaanderen). P.D.S. is holder of a fundamental clinical research mandate of the Flemish Foundation for Scientific Research (FWO-Vlaanderen). This research also received financial support by Merck Serono and Artevelde University College Ghent. There are no competing interests.
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Affiliation(s)
- V De Frène
- Department of Reproductive Medicine, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent, Belgium
| | - L Verhofstadt
- Department of Experimental-Clinical and Health Psychology, Ghent University, Henri Dunantlaan 2, B-9000 Ghent, Belgium
| | - T Loeys
- Department of Data Analysis, Ghent University, Henri Dunantlaan 1, B-9000 Ghent, Belgium
| | - I Stuyver
- Department of Reproductive Medicine, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent, Belgium
| | - A Buysse
- Department of Experimental-Clinical and Health Psychology, Ghent University, Henri Dunantlaan 2, B-9000 Ghent, Belgium
| | - P De Sutter
- Department of Reproductive Medicine, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent, Belgium
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Costa RM, Brody S. Orgasm and women's waist circumference. Eur J Obstet Gynecol Reprod Biol 2014; 182:118-22. [PMID: 25268779 DOI: 10.1016/j.ejogrb.2014.09.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Revised: 08/23/2014] [Accepted: 09/03/2014] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Given that adiposity is related to poorer female sexual function, among many other health problems, the present study aimed at testing the hypothesis that larger waist circumference, an index of subcutaneous and abdominal fat mass, is associated with lack of specifically vaginal orgasm. Study design One hundred and twenty Portuguese women of reproductive age had their waist measured and reported their past month frequency of penile-vaginal intercourse (PVI), vaginal orgasm, orgasm from clitoral masturbation during PVI, non-coital partnered sex (in the absence of same-day PVI), non-coital partnered sex orgasm (regardless of same-day PVI), masturbation, and masturbation orgasm. RESULTS In both simple and partial correlations (controlling for age, social desirability responding, relationship status, and cohabitation status), larger waist circumference was associated with lack of any vaginal orgasm and with having masturbated in the past month. In a multiple regression, larger waist circumference was independently predicted by lesser frequency of vaginal orgasm, greater frequency of masturbation, and older age. CONCLUSION Abdominal fat mass appears to be adversely associated with lesser capacity for vaginal orgasm, but not for orgasms from other sexual activities. Results are discussed in the context of vaginal orgasm being relatively more contingent on situations of increased fitness in both partners.
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Affiliation(s)
- Rui Miguel Costa
- ISPA-Instituto Universitário, Unidade de Investigação em Eco-Etologia (Eco-Ethology Research Unit), Lisbon, Portugal
| | - Stuart Brody
- Charles University, Department of General Anthropology, Faculty of Humanities, Prague, Czech Republic.
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Zueff LN, Lara LADS, Vieira CS, Martins WDP, Ferriani RA. Body composition characteristics predict sexual functioning in obese women with or without PCOS. JOURNAL OF SEX & MARITAL THERAPY 2014; 41:227-237. [PMID: 24274091 DOI: 10.1080/0092623x.2013.864369] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Polycystic ovary syndrome is frequently related to obesity and hyperandrogenism that potentially may impair sexual function. This case-control study aimed to determine the effect of the polycystic ovary syndrome on the sexual functioning of obese women and to determine which body measures can predict sexual functioning among 87 sexually active women obese women with and without polycystic ovary syndrome, 18-40 years old, divided in two groups; obese women (n = 44) or obese women with polycystic ovary syndrome (n = 43). The groups were compared using the Sexual Quotient-Female version and Hospital Anxiety and Depression scales, and by serum tests. No significant difference between groups was observed in weight, waist-hip ratio, body mass index, serum glucose, cholesterol, triglycerides, total testosterone, sex hormone binding globulin, total Sexual Quotient-Female version score, and the total score of ≤ 60 for subjects (risk for sexual dysfunction) and Hospital Anxiety and Depression. Significant difference was observed in age, parity, and Free Androgen Index. Each unit increase in waist-hip ratio conferred a greater chance of score of ≤ 60. A height of less than 161 cm and the presence of depression were found to be risk factors with a score of ≤ 60. Women with a score of ≤ 60 had significantly smaller hip measurements and waist-hip ratio. The presence of polycystic ovary syndrome was not a risk factor for decreased sexual functioning.
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Affiliation(s)
- Lucimara Nobre Zueff
- a Sector of Human Reproduction, Department of Gynaecology and Obstetrics, Faculty of Medicine of Ribeirão Preto , São Paulo University , Ribeirão Preto , Brazil
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