Impact of PCOS on

sexual function of

women with infertility

Aboubakr Elnashar

Mona Hassan

Egypt

Aboubakr Elnashar

PCOS is a common endocrine disorder that

affects approximately 6.5% of reproductive-

aged women (Azizz et al, 2004).

It is characterized by:

chronic anovulation, and

hyperandrogenism (Elsenbruch et al, 2003).

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Many PCOS patients feel stigmatized in the

sense of a loss of feminine identity.

(Janssen et al, 2008)

Almost PCOS women have

negative emotions of frustration

anxiety, and,

to a lesser extent, sadness. (Sills et al, 2001).

Aboubakr Elnashar

The symptoms typically associated with

PCOS such as acne, hirsutism, irregular cycle,

obesity, and subfertility

can negatively affect

woman's self-esteeming,

quality of life, and

sexual satisfaction (Jone et al, 2008)

Though many studies have focused on

relationship between PCOS and subfertility,

only few studies investigated its impact on

sexual life of women.

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The results of these studies are contradictory:

One study found that patients with PCOS had

significantly less satisfaction with their sex life (Elsenbruch et al, 2003)

Another study, found that patients with PCOS

did not differ from controls in the number of

sexual thoughts and fantasies or in their views

of the importance of a satisfying sex life (Hahn et al, 2005)

They also found no differences in the

frequency of sexual intercourse between

controls and women with PCOS Aboubakr Elnashar

Objective

To investigate relationship of different aspects

of PCOS

e.g. serum testosterone, acne, hirsutism, and BMI

with sexual function of women suffering from

infertility.

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Material and Method

A cross-sectional study on 50 women

PCOS

infertility

were compared with a group of 50 women who

do not have PCO but, also

suffer infertility

{To avoid bias that may arise from possible

negative effect of subfertility on woman's sexual

function}.

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Inclusion criteria: Cases were collected from Al- Ahram Fertility Center in Mansoura Study group inclusion criteria

Infertile

Age 18 to 40 years

Rotterdam diagnostic criteria for PCO.

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Control group inclusion criteria:

• Infertile.

• No prior or current diagnosis of PCOS

• Age 18 to 40 years

• Nondiabetic

• Nonhirsute

• Regular monthly cyclic menses.

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Exclusion criteria

•Prior or current use of oral hypoglycemic agents

or insulin

•Currently pregnant or breastfeeding during the

prior 30 days

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Data Sources

Both hirsutism and acne were self-reported as

“yes” or “no.”

Height and weight were measured by a nurse for

all study participants.

BMI was calculated as weight in kilograms

divided by height in meters squared (kg/m2).

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Assessment of Sexual Function The modified Arizona Sexual Experience Scale

(ASEX).

The original ASEX is made up of 5 items rated on

a 6-point Likert scale.

Possible total scores range from 5 to 30, with the

higher scores indicating more sexual dysfunction (McGahuey et al, 2000).

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An additional two points were added:

frequency of sexual intercourse and

occurrence of sexual pain

as they may help to understand magnitude of

sexual function.

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Results

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PCOS

No (%)

Non-PCOS

No (%)

P value

Age

(year)

20 - 25 22 (42.3) 19 (37.3) <0.001

26 - 30 23 (44.2) 8 (15.7)

31 - 35 6 (11.5) 13 (25.5)

36 - 40 1 (1.9) 11 (21.6)

Education Non 0 (0%) 3 (5.9)

0.029 Moderate

level 25 (48.1) 31(60.8)

High Level 27 (51.9) 17 (33.3)

Job House Wife 43 (82.7) 39 (67.5) 0.347

Others 9 (17.3) 12 (23.5)

Income Sufficient 34(65.4) 19(41.7) 0.108

Insufficient 18(34.6) 28(58.3)

Duration

of Marriage

1 - 5 years 33 (63.5) 24 (47.1)

0.05 6 - 10 Years 15 (28.8) 14 (27.5)

11 - 15 Years 4 (7.7) 8 (15.7)

16 - 20 Years 0 (0) 5 (9.7)

Infertility

period

1 - 5 years 36 (69.2) 27 (54)

0.159 6 - 10 Years 13 (25) 15 (30)

11 - 15 Years 3 (5.8) 6 (12)

Table 1: Demographic Data

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PCOS

No (%)

Non-PCOS

No (%)

P value

Irregular Menses 45 (56.5) 7 (13.7) <0.001

Hairsutism 28(53.8) 6(11.8) <0.001

Acne 16 (30.8) 9 (17.6) 0.12

FGM 42 (80.8) 39 (76.5) 0.595

Med/surgical 1 (1.9) 5 (9.8) 0.088

BMI (Mean ±SD) 30.13±6.09 24.12±2.1 0.03

Table 2: Clinical data

There were significant differences as regard cycle irregularity

(56.5% Vs 13.7%); hairsutism (53.8% Vs 11.8%) and BMI

(30.13% Vs 24.12%) in PCOS and non-PCOS groups Aboubakr Elnashar

PCOS

(Mean±SD)

Non-PCOS

(Mean±SD)

P value

Desire 2.33±0.65 2.41±0.67 0.756

Arousal 2.19±0.91 2.22±0.95 0.882

Lubrication 1.96±0.79 1.92±0.87 0.732

Orgasm 2.62±0.99 2.67±0.99 0.601

Satisfaction 1.83±0.83 2.16±1.02 0.083

Arizona score Total 9.09±2.34 9.11±2.77 0.966

Sexual dysfunction

(Arizona score>19)

1 (1.9)

1 (1.9)

0.99

Table 3: Arizona score

No significant difference were found between the 2 groups as

regard the 5 items of Arizona score or the total Arizona score Aboubakr Elnashar

PCOS

No (%)

Non-PCOS

No (%)

P

value

Sexual

intercourse/week 3.94±2.28 3.73±2.94 0.13

Dysparunia 18 (34.6) 10 (19.6) 0.079

Other sexual

complaint 8(15.4) 12(23.5) 0.296

Table 4: Frequency of sexual intercourse,

dysparunia and other sexual complaint

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Arizona score FSH LH F.T BMI

Correlation Coefficient

1.000 .031 -.008 -.183 .024

Significance . .417 .480 .106 .435

N 52 49 48 48 51

Table 5: Correlations between the intensity of

Arizona score and clinical-Laboratory variables

in PCOS

* Correlation is significant at the 0.05 level

(1-tailed). *

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Conclusions

No significant difference between infertile

women with and without PCOS as regard

5 items of Arizona score

Total Arizona score .

Dysparunia, other sexual complaints or

sexual dysfunction

Frequency of sexual intercourse

No correlations between sexual dysfunction

and clinical-Laboratory variables in PCOS

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