Many factors influence sexual function, including mood, general wellbeing, self-esteem, medications and past sexual experiences. Studies suggest that women tend to have a higher risk for problems with sexual function compared to men, and the most commonly reported problem is a lowering of sexual desire (libido).
Women with PCOS have been found to report an increase in problems with sexual function. This may be because women may be overweight, they have acne or excess facial or body hair growth (hirsutism). Psychological factors in PCOS also contribute significantly, including lowered mood or wellbeing, lower levels of self-confidence or self-esteem, and the impact of having a chronic condition. The concern about lowered fertility in some women with PCOS may also impact sexual function in women who are trying to conceive.
A number of research studies have found that women with PCOS are less satisfied when it comes to their sex lives, and hirsutism and being overweight in particular, cause women to feel less sexual[2-3]. Other researchers suggest this also has an impact on relationships.
Questions to ask
It can be helpful to think about how PCOS has affected your sex life by asking yourself the following questions:
|During the last few months, have you often been bothered by problems with your sex life such as reduced satisfaction, diminished desire, pain or any other problems?|
|Do you feel that PCOS affects your sex life?|
|(If relevant) Do sexual problems affect a current relationship and/or have sexual problems affected any past relationships?|
If you answered 'Yes' to any of the above questions and feel your PCOS is impacting on your sex life, knowing you are not alone is helpful, but more importantly it can be beneficial to discuss this with your doctor and/or a psychologist.
Sex & PCOS treatments
Not many studies have examined the effects of PCOS treatments on sexual function, however one study reported an improvement in sexual function in women with PCOS who were treated with metformin. Sexual function has been found to be generally lower in women who take the oral contraceptive pill, which is commonly used to control acne and excess hair growth in women with PCOS, although this research was not carried out in women with PCOS.
PCOS & contraception
The average menstrual cycle is 28 days long (between 21-35 days is considered normal). Due to high levels of androgens (male hormones) and insulin in women with PCOS (polycystic ovary syndrome) menstruation is often disrupted and periods may be irregular or stop altogether. Some women with PCOS may also experience heavier or lighter bleeding.
Regular periods help to prevent excess thickening of the lining of the uterus (womb). Long gaps between periods can lead to abnormal cells building up inside the womb. It is recommended that at least four cycles per year are necessary to avoid this.
Medications such as a low-dose contraceptive pill, progesterone and metformin can be prescribed to help menstrual bleeding occur regularly. If you have PCOS and need contraception it is best to discuss the options with your doctor, as treatment for your PCOS may go hand in hand with a method of contraception, such as the oral contraceptive pill.
If you think your relationship and sex life have been affected by PCOS, seek help from your doctor, psychologist, or accredited health professional. Quality of life can be improved by:
Laumann et al. Sexual dysfunction in the United States: prevalence and predictors. JAMA, 1999. Feb 10;281(6):537-44
Hahn S et al. Clinical and psychological correlates of quality of life in polycystic ovary syndrome.. Eur J Endocrinol 2005;153:853-60
Elsenbruch S., et al. Quality of life, psychosocial well-being, and sexual satisfaction in women with polycystic ovary syndrome. J Clin Endocrinol Metab 2003;88:5801–5807
Drosdzol, A., et al., Quality of life and marital sexual satisfaction in women with polycystic ovary syndrome. Folia Histochemistry and Cytobiology, 2007(45; Suppl 1): p. S93-7
Hahn, S., et al., Metformin treatment of polycystic ovary syndrome improves health-related quality-of-life, emotional distress and sexuality. Human Reproduction, 2006. 21(7): p. 1925-1934
Davison S., et al. Sexual function in well women: stratification by sexual satisfaction, hormone use and menopause status. J Sex Med 2008 May;5(5): 1214-22
This web page is designed to be informative and educational. It is not intended to provide specific medical advice or replace advice from your health practitioner. The information above is based on current medical knowledge, evidence and practice as at March 2014.