Sexual Function in Chinese Women with Polycystic Ovary Syndrome and Correlation with Clinical and Biochemical Characteristics

Xuanxuan Tian,Rui Ju,Juan Du,Juan Wang,Xiangyan Ruan,Dongmei Yin,Jiaojiao Cheng,Alfred O Mueck

doi:10.1007/s43032-021-00612-4

Abstract

To investigate sexual function in Chinese women with polycystic ovary syndrome (PCOS) and to explore the correlation with clinical and biochemical characteristics. A cross-sectional study was designed in 1000 PCOS women, aged 18–45 years, via the Chinese version of Female Sexual Function Index (FSFI) evaluating sexual function, with additional questions possibly related to sexual life. Clinical and biochemical characteristics likely to affect sexual function were determined, including anthropometric indicators, serum levels of hormones, luteinizing hormone to follicle-stimulating hormone ratio (LH/FSH ratio), prolactin (PRL), total testosterone (TT), free androgen index (FAI), sex-hormone-binding globulin (SHBG), glucose, and lipid metabolism indicators. Nine hundred ten PCOS women participated in the study, 685 patients were included after screening, and 211 were suitable to detect correlations of clinical and biochemical characteristics with sex function parameters. The mean total FSFI score was 24.19 ± 2.8; 79.56% of the women were at risk of female sexual dysfunction (FSD). Women doing regular aerobic exercise and use of contraception had higher FSFI scores, while those with a desire to conceive and clinical signs of hyperandrogenism had lower FSFI scores. There were negative associations of FSFI scores with age and body fat distribution. No significant associations between FSFI scores and hormonal factors (surprisingly including SHBG) were found, except for total testosterone and satisfaction (OR = 0.976, p = 0.002). HOMA-IR was significantly related to reduced desire score (OR = 0.914, p = 0.004) and lubrication score (OR = 0.964, p = 0.044). PCOS was associated with a high risk of FSD (defined according to FSFI) in about 80% of the women in our study, and clinical characteristics play a more important role.

Highlights

Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women of reproductive age, with an estimated prevalence of 10% around the world [1] and5.6% in Chinese women aged 19–45 years [2]
A total of 910 PCOS women participated in the study (91.0%, intent to treat study group), and 685 women (68.5%, per protocol study group) completed all questions of the Female Sexual Function Index (FSFI) and answered further questions regarding basic characteristics and information with possible links to sexual life
Using analysis of variance (ANOVA), we found that women performing regular aerobic exercise (> = 1 time per week) had higher total FSFI scores compared with women who rarely exercised (p < 0.001)

Summary

Introduction

Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women of reproductive age, with an estimated prevalence of 10% around the world [1] and5.6% in Chinese women aged 19–45 years [2]. We performed the first study in China to investigate 1010 young otherwise healthy women (i.e., no PCOS) via the Internet, whereby 60.2% were at risk of FSD [9] Within another survey in Beijing, 63.3% had increased risk of FSD [10], whilst in Nanjing, the overall prevalence of FSD was 56.8% [11]. The status of FSD in Chinese women is serious but unclear for PCOS patients up to now, a lot of studies have been done on various populations and recently a metaanalysis is published [12]. Current opinions on this topic in other countries are controversial. Some authors have reported impairment compared with the general population [13,14,15,16,17], but others did not find a significant reduction in sexual function for women with PCOS [18,19,20]

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