How does PMOS impact sexual health? 

According to the 2024 study on Sexual Function in Women with PCOS, individuals with PMOS report lower sexual function and sexual satisfaction. 

Individuals with PMOS report lower sexual satisfaction and lower sexual function, particularly in the domains of desire and arousal.[1][2][3]  In individuals who have PMOS 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.

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

• Poor body image due to challenges maintaining weight or other symptoms of PMOS 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.

Diagnosis of sexual dysfunction will often combine a detailed medical, sexual and psychological history, a physical exam and lab tests to rule out underlying conditions.[12]  Your healthcare provider will seek to gather details about your physical and emotional symptoms as well as information about your lifestyle and relationships.[13]

Depending on the nature and root cause of sexual dysfunction, treatment may include a combination of medications, devices and therapy, including:[14]

• Libido-enhancing medication: flibanserin increases sexual desire and reduces distress around sexual function;[15]

• Anti-anxiety medication: buspirone helps regulate mood by balancing levels of serotonin and dopamine and may be prescribed for sexual dysfunction;[16]

• Anti-depressants: bupropion treats depression by increasing levels of norepinephrine and dopamine and may be prescribed for sexual dysfunction;[17]

• Hormone replacement therapy (HRT): if physical and/or mental health changes due to menopause are causing sexual dysfunction, HRT may be prescribed;[18]

• Vaginal dilators: if an individual has pain during penetrative intercourse, vaginal dilators can assist with stretching and/or strengthening muscles;[19]

• Sex and/or relationship therapy;

• Behavioral therapy; and/or

• Psychotherapy.

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/

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

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

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

[15] https://my.clevelandclinic.org/health/drugs/18608-flibanserin-oral-tablets

[16] https://my.clevelandclinic.org/health/drugs/20084-buspirone-tablets

[17] https://my.clevelandclinic.org/health/drugs/18782-bupropion-tablets-depressionmood-disorders

[18] https://my.clevelandclinic.org/health/treatments/15245-hormone-therapy-for-menopause-symptoms

[19] https://my.clevelandclinic.org/health/treatments/24971-vaginal-dilators