Body image and sexual function in women with polycystic ovary syndrome: a case-control study

Arzu, Yılda; Şık, Bulat Aytek

doi:10.1590/1806-9282.20220367

Cited by 4 publications

(7 citation statements)

References 23 publications

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“…Twenty studies used the FSFI ( Gateva and Kamenov, 2012 ; Ercan et al , 2013 ; Ferraresi et al , 2013 ; Benetti-Pinto et al , 2014 ; Lara et al , 2015 ; Noroozzadeh et al , 2016 ; Shafti and Shahbazi, 2016 ; Yildiz et al , 2017 ; Basirat et al , 2019 ; Aydogan Kirmizi et al , 2020 ; Deniz and Kehribar, 2020 ; Akbari Sene et al , 2021 ; Mantzou et al , 2021 ; Naumova et al , 2021 ; Taghavi et al , 2021 ; Aba and Aytek Şik, 2022 ; Ashrafi et al , 2022 ; Çetinkaya Altuntaş et al , 2022 ; Daneshfar et al , 2022 ; Mojahed et al , 2023 ).…”

Section: Resultsmentioning

confidence: 99%

Sexual function in women with polycystic ovary syndrome: a systematic review and meta-analysis

Pastoor,

Mousa,

Bolt

et al. 2024

Human Reproduction Update

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BACKGROUND Polycystic ovary syndrome (PCOS) is a common and distressing endocrine disorder associated with lower quality of life, subfertility, diabetes, cardiovascular disease, depression, anxiety, and eating disorders. PCOS characteristics, its comorbidities, and its treatment can potentially influence sexual function. However, studies on sexual function in women with PCOS are limited and contradictory. OBJECTIVE AND RATIONALE The aim was to perform a systematic review of the published literature on sexual function in women with PCOS and assess the quality of the research and certainty of outcomes, to inform the 2023 International Guidelines for the Assessment and Management of PCOS. SEARCH METHODS Eight electronic databases were searched until 1 June 2023. Studies reporting on sexual function using validated sexuality questionnaires or visual analogue scales (VAS) in PCOS populations were included. Random-effects models were used for meta-analysis comparing PCOS and non-PCOS groups with Hedges’ g as the standardized mean difference. Study quality and certainty of outcomes were assessed by risk of bias assessments and the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) method according to Cochrane. Funnel plots were visually inspected for publication bias. OUTCOMES There were 32 articles included, of which 28 used validated questionnaires and four used VAS. Pooled Female Sexual Function Index (FSFI) scores in random-effects models showed worse sexual function across most subdomains in women with PCOS, including arousal (Hedges’s g [Hg] [95% CI] = −0.35 [−0.53, −0.17], I2 = 82%, P < 0.001), lubrication (Hg [95% CI] = −0.54 [−0.79, −0.30], I2 = 90%, P < 0.001), orgasm (Hg [95% CI] = −0.37 [−0.56, −0.19], I2 = 83%, P < 0.001), and pain (Hg [95% CI] = −0.36 [−0.59, −0.13] I2 = 90%, P < 0.001), as well as total sexual function (Hg [95% CI] = −0.75 [−1.37, −0.12], I2 = 98%, P = 0.02) and sexual satisfaction (Hg [95% CI] = −0.31 [−0.45, −0.18], I2 = 68%, P < 0.001). Sensitivity and subgroup analyses based on fertility status and body mass index (BMI) did not alter the direction or significance of the results. Meta-analysis on the VAS studies demonstrated the negative impact of excess body hair on sexuality, lower sexual attractiveness, and lower sexual satisfaction in women with PCOS compared to controls, with no differences in the perceived importance of a satisfying sex life. No studies assessed sexual distress. GRADE assessments showed low certainty across all outcomes. WIDER IMPLICATIONS Psychosexual function appears to be impaired in those with PCOS, but there is a lack of evidence on the related distress scores, which are required to meet the criteria for psychosexual dysfunction. Health care professionals should discuss sexual function and distress and be aware of the multifactorial influences on sexual function in PCOS. Future research needs to assess both psychosexual function and distress to aid in understanding the degree of psychosexual dysfunction in PCOS. Finally, more diverse populations (e.g. non-heterosexual and more ethnically diverse groups) should be included in future studies and the efficacy of treatments for sexual dysfunction should also be assessed (e.g. lifestyle and pharmacological interventions).

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Section: Resultsmentioning

confidence: 99%

Sexual function in women with polycystic ovary syndrome: a systematic review and meta-analysis

Pastoor,

Mousa,

Bolt

et al. 2024

Human Reproduction Update

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“…It also influences social behaviour and interpersonal relationships. [16] The decrease in self-esteem is strongly associated with obesity or overweight, acne, androgenetic alopecia and hirsutism. In a study conducted by M. Himelein and S. Thatcher, a higher percentage of depression and dissatisfaction with body appearance was found in women with PCOS compared to the control group.…”

Section: Body Imagementioning

confidence: 99%

“…Irregular menstrual cycles increase the risk of sexual dysfunction 2.99 times, while hirsutism 2.43 times. [16] Vitamin D Vitamin D deficiency increases the risk of many chronic diseases, including obesity, insulin resistance, type 2 diabetes, cardiovascular diseases and psychological disorders. Women with PCOS often suffer from insulin resistance that raises inflammatory markers and leads to diabetes.…”

Section: Body Imagementioning

confidence: 99%

Polycystic Ovary Syndrome - increased risk of depression development. Links and risk factors

SZYMAŃSKA¹,

Kamil²,

Weronika

et al. 2023

J Educ Health Sport

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PCOS is a common endocrine disorder affecting up to 6-10% of women in reproductive age. Patients suffer from many manifestations of this disease including symptoms of hyperandrogenism (hirsutism, acne, androgenetic alopecia), ovulation disorders, infertility, overweight and obesity, glucose-insulin homeostasis disorders (insulin resistance, type 2 diabetes). Many studies emphasize the relationship between the presence of PCOS in patients and the appearance of depression. The median incidence of depression in women with this syndrome was 36.6%, while in the group of women without PCOS it was 14.2%. The exact mechanism of this relationship is still unknown, but many factors may play an important role in it, e.g. increased BMI, infertility, high cortisol levels, body image, vitamin D deficiency or elevated inflammation markers.

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“…Twenty-eight studies assessed SD through the overall FSFI score [5,9,10,; and, among them, 12 were significantly lower in PCOS women than controls [5,10,[25][26][27][28][29][30][31][35][36][37]. Twenty-four studies analyzed the FSFI subdomains scores [5, 9, 10, 25-31, 35-39, 41-49].…”

Section: Overall Fsfi and Subdomains Scores Of Included Studies In Th...mentioning

confidence: 99%

“…Twenty-four studies analyzed the FSFI subdomains scores [5, 9, 10, 25-31, 35-39, 41-49]. Orgasm, lubrication, satisfaction, arousal, desire and pain subdomains were significantly lower in PCOS women than controls in 14 [9, 10, 27-31, 35-37, 44, 46, 48, 49], 15 [5, 10, 26-31, 35-37, 41, 46, 47, 49], 14 [5, 10, 27-31, 36-38, 43, 44, 46, 49], 13 [5, 26-28, 30, 31, 35-37, 41, 43, 46, 49], 7 [10,28,29,[35][36][37]49] and 10 studies [5, 26, 28-30, 35-37, 41, 46], respectively.…”

Section: Overall Fsfi and Subdomains Scores Of Included Studies In Th...mentioning

confidence: 99%

New Comprehension on Polycystic Ovary Syndrome and Sexual Function: A Systematic Review and Meta-Analysis

Bachega,

Baracat,

Simões

et al. 2023

Preprint

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Polycystic ovary syndrome (PCOS) is a prevalent condition characterized by manifestations that can influence self-image and potentially result in psychological distress; however, data from literature on sexual function (SF) in PCOS women are contradictory. We aimed to evaluate sexual dysfunction (SD) in PCOS women by carrying out a systematic review and meta-analysis, using the gold-standard assessment tool SD-diagnosis (Female Sexual Function Index:FSFI). Seven databases were analyzed until August-2023; study quality was assessed by risk of bias and Newcastle Ottawa Scale. Our analysis encompassed 25 case-control studies (9933 women). PCOS group presented significantly lower scores in arousal (MD= -0.36 CI95%-0.60;-0.11), lubrication (MD= -0.52 CI95%-0.75;-0.28), orgasm (MD= -0.39 CI95%-0.57;-0.20), satisfaction (MD= -0.32 CI95%-0.50;-0.14) and pain subdomains (MD= -0.46 CI95%-0.75;-0.16), as in overall FSFI score (MD= -2.27 CI95%-3.23;-1.31). Overweight/obese (OW/O) patients exhibited significantly higher overall FSFI than OW/O controls (MD=1.98 CI95%0.68;3.27), particularly in lubrication (MD= -0.34), orgasm (MD= -0.26) and satisfaction (MD= -0.25) subdomains. These findings offer insights regarding SD in PCOS women and emphasize the need to incorporate SF assessment into multidisciplinary care. By this way, PCOS can be also considered a gateway diagnosis to other long-term consequences. Further research should focus on controlling variables, as ethnicity, culture, religion and economic disparities.

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Body image and sexual function in women with polycystic ovary syndrome: a case-control study

Cited by 4 publications

References 23 publications

Sexual function in women with polycystic ovary syndrome: a systematic review and meta-analysis

Sexual function in women with polycystic ovary syndrome: a systematic review and meta-analysis

Polycystic Ovary Syndrome - increased risk of depression development. Links and risk factors

New Comprehension on Polycystic Ovary Syndrome and Sexual Function: A Systematic Review and Meta-Analysis

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