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/

Want to learn more about other health complications associated with PCOS? Check out the sections on eating disorders, depression and anxiety.



Complications - Mental Health