Sexual desire in a sample of married Egyptian women with polycystic ovarian syndrome

Elkhiat, Yasser; Zedan, Ali; Mostafa, Mona; Elhalwagi, Ahmed; Alhosini, Sara

doi:10.1097/01.xha.0000470182.71509.1b

Cited by 4 publications

(4 citation statements)

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“…Eight studies used the FSFI (Gateva and Kamenov, 2012;Ercan et al, 2013;Ferraresi et al, 2013b;Benetti-Pinto et al, 2015;Lara et al, 2015;Noroozzadeh et al, 2016;Shafti and Shahbazi, 2016;Diamond et al, 2017). Other studies used different scales: the CSFQ (Stovall et al, 2012), the SQ-F (Zueff et al, 2015), the MFSQ (Mansson et al, 2011), the FSDQ (Elkhiat et al, 2015), the ISS (Drosdzol et al, 2007) and the MSQ (Kowalczyk et al, 2015). Four studies used VAS to assess sexual function and effect of clinical characteristics on sexual function (Elsenbruch et al, 2003;Hahn et al, 2005;Tan et al, 2008;Caruso et al, 2009).…”

Section: Search Resultsmentioning

confidence: 99%

“…Another limitation is the diversity between the studies; for example four studies were from Islamic countries, including only married women (Ercan et al, 2013;Elkhiat et al, 2015;Noroozzadeh et al, 2016;Shafti and Shahbazi, 2016). Other studies did not mention relationship status or sexual activity of participants (Gateva and Kamenov, 2012;Stovall et al, 2012;Lara et al, 2015).…”

Section: Discussionmentioning

confidence: 99%

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Sexual function in women with polycystic ovary syndrome: a systematic review and meta-analysis

Pastoor

Timman

Klerk

et al. 2018

Reproductive BioMedicine Online

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We present the first systematic review and meta-analysis of sexual function in women with polycystic ovary syndrome (PCOS) compared with women without PCOS. Data on this topic are limited and often contradicting. Sexual function is influenced by endocrine, mental and social factors, which are often compromised in women with PCOS. The main outcome measures were validated sexual function questionnaires and visual analogue scales (VAS). We identified and assessed 1925 original articles; 18 articles were included. Significant small effect sizes were found on sexual function subscales (total score: P = 0.006; arousal: P = 0.019; lubrication: P = 0.023; satisfaction: P = 0.015; orgasm: P = 0.028), indicating impaired sexual function in women with PCOS. Large effect sizes for the effect of body hair on sex were shown on VAS (P = 0.006); social effect of appearance (P = 0.007); sexual attractiveness (P < 0.001). Satisfaction with sex life was impaired (P < 0.001), but sexual satisfaction was rated equally important in women with PCOS and controls. We conclude that a satisfying sex life is important for women with PCOS; however, sexual function and feelings of sexual attractiveness are impaired. The findings imply that sexual function, sexual satisfaction and psychosocial functioning need to be part of every clinical assessment of women with PCOS.

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Section: Search Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Sexual function in women with polycystic ovary syndrome: a systematic review and meta-analysis

Pastoor

Timman

Klerk

et al. 2018

Reproductive BioMedicine Online

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“…Several studies have attempted to shed light on the relationship between androgens and sexual function in women with PCOS. Studies that found higher androgen levels to be related to lower sexual function in women with PCOS reported: a negative association between testosterone levels and sexual desire ( Elkhiat etal. , 2015 ); a negative relationship between free and total testosterone and total FSFI score ( Ercan etal.…”

Section: Discussionmentioning

confidence: 99%

Sexual dysfunction in women with PCOS: a case control study

Pastoor,

Both,

Laan

et al. 2023

Human Reproduction

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STUDY QUESTION What is the relationship of sex steroid levels with sexual function in women with and without polycystic ovary syndrome (PCOS)? SUMMARY ANSWER Women with PCOS reported more sexual dysfunction and more sexual distress compared to those without PCOS, but only few and weak associations between androgen levels and sexual function were observed. WHAT IS KNOWN ALREADY The literature shows that women with PCOS report lower levels of sexual function and sexual satisfactionand more sexual distress. Contributing factors seem to be obesity, alopecia, hirsutism, acne, infertility, anxiety, depression, and low self-esteem. In women with PCOS clinical and/or biochemical hyperandrogenism is common; its relationship with sexualfunction is, however, inconclusive. STUDY DESIGN, SIZE, DURATION This observational prospective case control study with 135 women (68 PCOS, 67 control) was conductedfrom March 2017 until March 2020. PARTICIPANTS/MATERIALS, SETTING, METHODS Heterosexual women with and without PCOS, aged 18–40 years, in a steady relationshipand without any comorbidities, underwent an extensive medical and endocrine screening using liquid chromatography-tandem mass spectrometry and validated sexual function questionnaires. MAIN RESULTS AND THE ROLE OF CHANCE Women with PCOS reported significantly lower sexual function (Female Sexual Function Index (FSFI) P < 0.001, partial η2 = 0.104), higher levels of sexual distress (Female Sexual Distress Scale-Revised P < 0.001, partial η2 = 0.090), and they more often complied with the definition of sexual dysfunction (41.2% vs 11.9%, P < 0.001, Phi V = 0.331) and clinical sexual distress (51.5% vs 19.4%, P < 0.001, Phi V = 0.335). Regression analysis adjusted for confounders showed only few and weak associations between androgen levels and sexual function, with each model explaining a maximum of 15% sexual function. Following significant Group × Hormone interactions, analyses for both groups separately showed no significant associations in the PCOS group. The control group showed only weak negative associations between testosterone and FSFI pain (β = −6.022, P = 0.044, Adj R2 = 0.050), between FAI and FSFI orgasm (β = −3.360, P = 0.023, Adj R2 = 0.049) and between androstenedione and clinical sexual distress (β = −7.293, P = 0.036, exp(β) = 0.001). LIMITATIONS, REASONS FOR CAUTION The focus of the study on sexual functioning potentially creates selection bias. Possibly women with more severe sexual disturbances did or did not choose to participate. Differences between women with PCOS and controls in relationship duration and hormonal contraceptive use might have skewed the sexual function outcomes. WIDER IMPLICATIONS OF THE FINDINGS Sexual function is impaired in women with PCOS. However, endocrine perturbations seem to have minimal direct impact on sexual function. Addressing sexuality and offering psychosexual counseling is important in the clinical care for women with PCOS. STUDY FUNDING/COMPETING INTEREST(S) This study was funded by the departments of the participating centers: Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Erasmus University Medical Center, Rotterdam, the Netherlands; Department of Psychosomatic OBGYN and Sexology, Leiden University Medical Center, Leiden, the Netherlands; and Department of Sexology and Psychosomatic OBGYN, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands. J.S.E.L. received unrestricted research grants from the following companies (in alphabetical order): Ansh Labs, Ferring, Merck Serono and Roche Diagnostics. He also received consultancy fees from Ansh Labs, Ferring, Titus Healthcare and Roche Diagnostics. The other authors have no conflicts of interest. TRIAL REGISTRATION NUMBER CCMO register, registration number: NL55484.078.16, 10 March 2016. https://www.toetsingonline.nl/to/ccmo_search.nsf/Searchform?OpenForm

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“…Eight studies used different scales: the CSFQ ( Stovall et al , 2012 ), the SQ-F ( Zueff et al , 2015 ), the MFSQ ( Karsten et al , 2021 ), the FSDQ ( Elkhiat et al , 2015 ), the ISS ( Drosdzol et al , 2007 ), the MSQ ( Kowalczyk et al , 2015 ), Sexual Satisfaction Scales ( Glowinska et al , 2020 ), and the SSQ ( Kałużna et al , 2021 ).…”

Section: Resultsmentioning

confidence: 99%

Sexual function in women with polycystic ovary syndrome: a systematic review and meta-analysis

Pastoor,

Mousa,

Bolt

et al. 2024

Human Reproduction Update

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BACKGROUND Polycystic ovary syndrome (PCOS) is a common and distressing endocrine disorder associated with lower quality of life, subfertility, diabetes, cardiovascular disease, depression, anxiety, and eating disorders. PCOS characteristics, its comorbidities, and its treatment can potentially influence sexual function. However, studies on sexual function in women with PCOS are limited and contradictory. OBJECTIVE AND RATIONALE The aim was to perform a systematic review of the published literature on sexual function in women with PCOS and assess the quality of the research and certainty of outcomes, to inform the 2023 International Guidelines for the Assessment and Management of PCOS. SEARCH METHODS Eight electronic databases were searched until 1 June 2023. Studies reporting on sexual function using validated sexuality questionnaires or visual analogue scales (VAS) in PCOS populations were included. Random-effects models were used for meta-analysis comparing PCOS and non-PCOS groups with Hedges’ g as the standardized mean difference. Study quality and certainty of outcomes were assessed by risk of bias assessments and the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) method according to Cochrane. Funnel plots were visually inspected for publication bias. OUTCOMES There were 32 articles included, of which 28 used validated questionnaires and four used VAS. Pooled Female Sexual Function Index (FSFI) scores in random-effects models showed worse sexual function across most subdomains in women with PCOS, including arousal (Hedges’s g [Hg] [95% CI] = −0.35 [−0.53, −0.17], I2 = 82%, P < 0.001), lubrication (Hg [95% CI] = −0.54 [−0.79, −0.30], I2 = 90%, P < 0.001), orgasm (Hg [95% CI] = −0.37 [−0.56, −0.19], I2 = 83%, P < 0.001), and pain (Hg [95% CI] = −0.36 [−0.59, −0.13] I2 = 90%, P < 0.001), as well as total sexual function (Hg [95% CI] = −0.75 [−1.37, −0.12], I2 = 98%, P = 0.02) and sexual satisfaction (Hg [95% CI] = −0.31 [−0.45, −0.18], I2 = 68%, P < 0.001). Sensitivity and subgroup analyses based on fertility status and body mass index (BMI) did not alter the direction or significance of the results. Meta-analysis on the VAS studies demonstrated the negative impact of excess body hair on sexuality, lower sexual attractiveness, and lower sexual satisfaction in women with PCOS compared to controls, with no differences in the perceived importance of a satisfying sex life. No studies assessed sexual distress. GRADE assessments showed low certainty across all outcomes. WIDER IMPLICATIONS Psychosexual function appears to be impaired in those with PCOS, but there is a lack of evidence on the related distress scores, which are required to meet the criteria for psychosexual dysfunction. Health care professionals should discuss sexual function and distress and be aware of the multifactorial influences on sexual function in PCOS. Future research needs to assess both psychosexual function and distress to aid in understanding the degree of psychosexual dysfunction in PCOS. Finally, more diverse populations (e.g. non-heterosexual and more ethnically diverse groups) should be included in future studies and the efficacy of treatments for sexual dysfunction should also be assessed (e.g. lifestyle and pharmacological interventions).

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Sexual desire in a sample of married Egyptian women with polycystic ovarian syndrome

Cited by 4 publications

References 24 publications

Sexual function in women with polycystic ovary syndrome: a systematic review and meta-analysis

Sexual function in women with polycystic ovary syndrome: a systematic review and meta-analysis

Sexual dysfunction in women with PCOS: a case control study

Sexual function in women with polycystic ovary syndrome: a systematic review and meta-analysis

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