Depression, sexual function and sexual quality of life in women with polycystic ovary syndrome (PCOS) and healthy subjects

To our knowledge, this is the first study, evaluating sexual quality of life in Iranian PCO women.

The results show that 72% of patients had sexual dysfunction and BDI score was significantly higher in the group with sexual dysfunction. The results also show that SQOL-F score was significantly lower in PCO group with sexual dysfunction and there was significant positive correlation between FSFI and SQOL-F which indicates that the lower FSFI score, lower SQOL-F score. We also found that FSFI score and its subscales are significantly different between PCO and control groups.

It should be noted that most women with PCO suffer from infertility due to anovulation and oligoovulation which affects psychological well-being of these cases [8] and it is clear, infertility is related with higher levels of depression and anxiety [10].

Diamond et al. reported that sexual function is not different in PCO women in comparison with healthy subjects [15] which confirmed Shafti et al. findings [16].

By including 60 women with PCO, Shakil et al. found that sexual dysfunction had significant positive correlation with depressive symptoms and negative correlation with life satisfaction level [17].

In a study which was conducted in Turkey, Deniz and Kehribar reported significant higher BDI score and lower FSFI score in PCO women than controls. They also found that PCO group with infertility problem had higher BDI and lower FSFI scores [10].

In a study by Shahraki et al., they investigated significant positive correlation between SQOL-F and total FSFI score as well as significant negative correlation between SQOL-F and BDI in Iranian infertile women. In their study, BDI and FSFI were significant predictors of SQOL-F [18].

Infertility causes anxiety and stress which affects marital status and sexual intercourse frequency [10].

In a systematic review and meta-analysis which was conducted by Loh et al., it was shown that women with PCO had 30% higher risk of having SD [19].in another systematic review and meta-analysis, Pastoor et al. found lower scores in the arousal, lubrication, orgams, and satisfaction in PCO women than controls [20].

One explanation for sexual dysfunction in these women is menstrual irregularities and subfertility cause low self-esteem and emotional distress that affects sexual quality of life and well-being [21,22,23].

Female sexual function is multi-dimensional and endocrine disorders, psychological distress as the result of hyper-androgenic, body dissatisfaction, obesity and dermopathy result in low self-esteem and sexual dysfunction [24].

Trent et al. found that women with PCO have 2.8 fold less sexual activity than controls [25].

It is mentioned that considering and treating psychological problems in women with PCO should be done to improve self-esteem and sexual activity.

This study had some limitations. First, it was a single center study. Second, we did not assess the hormonal status. Larger, multi-centric studies with evaluating laboratory findings are recommended.

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