Sexual function in women with polycystic ovary syndrome and their hormonal and clinical correlations

Polycystic ovary syndrome (PCOS) appears to be related to sexual dysfunction, especially if associated with obvious clinical and hormonal signs of hyperandrogenism. The objective of this study was to determine the correlation of PCOS and its hormonal and clinical parameters with sexual function. This prospective, cross-sectional study conducted on 18-45-year-old PCOS women (according to the Rotterdam criteria), who were referred to the Reproductive Endocrinology Research Center, Iran, was invited to participate from January 2012 to December 2015. The Female Sexual Function Index (FSFI) was used to evaluate sexual function, and serum levels of total and free testosterone, androstenedione, and sex hormone-binding globulin (SHBG) were determined and employed to calculate free androgen index (FAI) values. Univariate and multiple logistic regression analyses were performed to examine the association between sexual dysfunction and independent variables. In all, 783 participated in the study and 492 women fully completed the Female Sexual Function Index (FSFI) questionnaire. Of these, 226 (45.75%) women met the criteria for sexual dysfunction. The mean age of women was 24.91 ± 4.90 years. No significant association between having a low score for any FSFI domain and having a low serum total or free testosterone or androstenedione and SHBG level was demonstrated. There was association between FAI > 4.5 and increased sexual function score but it is not significant. Logistic regression analysis showed that there were significant associations between sexual function score and the literacy, alopecia, and infertility. No evidence of associations between low scores for any of the sexual domains evaluated and low serum total and free testosterone levels, but the low literacy, alopecia, and infertility contributed to low sexual function in women with PCOS. The burden of PCOS and sexual dysfunction suggests the need for further attention to this patient population.