Sexual Dysfunction in Women With Polycystic Ovary Syndrome: The Effects of Testosterone, Obesity, and Depression

Abstract

In Brief Objectives: We examine the relationship among sexual function, obesity, psychologic depression, and serum total (totT) and bioavailable (bioT) testosterone levels in a group of premenopausal women with polycystic ovary syndrome (PCOS). Methods: Women with PCOS were given the Female Sexual Function Index (FSFI), the Sexual Distress Scale, the Sexual Energy Scale, the Beck Depression Inventory, a Perceived Body Image Questionnaire, and a bioT and totT blood test. Two-tailed Pearson correlations were made between sexual function, body mass index, depression, and T levels. Results: Thirty-three women (mean age 36) completed the questionnaires, and 23 underwent bioT and totT levels. Twenty-one of 33 (64%) women reported sexually related personal distress, and 20/33 (61%) reported some degree of depression. Sexual distress and depression were each associated with lack of sexual desire, arousal, lubrication, and orgasm (P < 0.05). All women were either overweight or clinically obese. Negative self-image was associated with a higher totT, a higher body mass index, depression, sexual distress, and lack of arousal and lubrication (P < 0.05). BioT level correlated positively with sexual desire (r = 0.46, P = 0.03) and negatively with sexual distress (r = −0.49, P = 0.02). Conclusions: Our study population of women with PCOS demonstrated a high level of sexual dysfunction. All of these women were clinically obese, and negative body image was found to correlate with sexual dysfunction. The majority experienced psychologic depression, which also correlated with the degree of sexual dysfunction. Despite these variables, elevated serum bioavailable testosterone levels correlated positively with sexual desire. We used validated questionnaires to examine the relationship among sexual function, obesity, psychologic depression, and serum total and bioavailable testosterone levels in a group of premeno-pausal women with polycystic ovary syndrome. Elevated serum bioavailable testosterone levels correlated positively with sexual desire.