Individuals with PCOS report lower sexual satisfaction and lower sexual function, particularly in the domains of desire and arousal.[1],[2],[3]  In individuals who have PCOS and are infertile the rate of sexual dysfunction may be as high as almost 60%.[4]

The World Health Organization (WHO) defines sexual health as “a state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity.”[5]

Sexual dysfunction can take four different forms:[6],[7]

• Desire disorders, where there is a lack of interest or desire towards sexual activity;

• Arousal disorders, where there is a lack of physical arousal response;

• Orgasm disorders, where there is a difficulty or delay in achieving orgasm or climax; and

• Pain disorders, where pain is experienced during intercourse or other forms of vaginal contact.

PCOS may interfere with sexual health in a number of ways:[8]

• Poor body image due to challenges maintaining weight or other symptoms of PCOS such as acne, hirsutism and hair thinning;

• Higher prevalence of mental health issues, including depression, anxiety and eating disorders;

• Irregular menstruation, heavy bleeding and/or spotting between periods interfering with sexual activity; and

• Higher prevalence of fertility challenges and the associated emotional burden.

Risk factors for sexual dysfunction include:[9]

• Chronic conditions such as kidney or liver failure, diabetes, heart and vascular disease

• Neurological conditions such as multiple sclerosis (MS) or nerve damage;

• Alcohol use disorder (AUD) or substance use disorder (SUD);

• Hormonal changes;[10]

• Pregnancy or breastfeeding;

• Menopause and increasing age;

• Certain medications including antidepressants, medications to treat high blood pressure, and some antihistamines and decongestants;

• Mental illness such as depression and anxiety;

• Situational stress and anxiety;

• Marital or relationship problems;

• Lower level of educational achievement;[11]

• Poor body image; and

• History of sexual abuse or trauma.

  
  

Reviewed by Keila Turino Miranda, an expert on PCOS and cardiovascular outcomes in transgender men

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Sources

[1] https://link.springer.com/referenceworkentry/10.1007/978-1-4419-1005-9_668

[2] https://academic.oup.com/humupd/article/30/3/323/7571334

[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4233312/

[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4233312/

[5] https://www.who.int/health-topics/sexual-health#tab=tab_2

[6] https://my.clevelandclinic.org/health/diseases/9121-sexual-dysfunction

[7] https://www.mayoclinic.org/diseases-conditions/female-sexual-dysfunction/symptoms-causes/syc-20372549

[8] https://academic.oup.com/humupd/article/30/3/323/7571334

[9] https://my.clevelandclinic.org/health/diseases/9121-sexual-dysfunction

[10] https://my.clevelandclinic.org/health/diseases/22673-hormonal-imbalance

[11] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9619128/