Female Sexual Function Inventory Score Research Articles

Psychosocial predictors of change in sexual activity and sexual function after hysterectomy in women with pelvic pain

Potential impact on sexual function is an often-cited concern for many patients considering hysterectomy. The existing literature indicates that sexual function remains stable to slightly improved for most patients who undergo hysterectomy, but most studies demonstrate a small subset of patients in whom sexual function declines after surgery. Unfortunately, there is a lack of clarity as to surgical, clinical, and psychosocial factors that may influence the likelihood of sexual activity after surgery or the magnitude and direction of change in sexual function. Although psychosocial factors are strongly associated with overall female sexual function, there is minimal data exploring the potential impact of these factors on the change in sexual function after hysterectomy. This study aimed to evaluate the relationship between baseline psychosocial factors and both sexual activity and sexual function at 6 months after hysterectomy. Patients undergoing hysterectomy for benign, non-obstetric indications were prospectively recruited as part of an observational cohort study evaluating presurgical predictors of posthysterectomy outcomes on pain, quality of life, and sexual function. The Female Sexual Function Index was administered before hysterectomy and 6 months after surgery. Presurgical psychosocial assessments included validated self-reported measures of depression, resilience, relationship satisfaction, emotional support, and social participation. Complete data was available for 193 patients, of whom 149 (77.2%) reported sexual activity at 6 months after hysterectomy. In the binary logistic regression model examining sexual activity at 6 months, older age was associated with a lower likelihood of sexual activity (odds ratio, 0.91; 95% confidence interval, 0.85-0.96; P=.002). Higher relationship satisfaction before surgery was associated with a greater likelihood of sexual activity at 6 months (odds ratio, 1.09; 95% confidence interval, 1.02-1.16; P=.008). As expected, preoperative sexual activity was associated with a greater likelihood of postoperative sexual activity (odds ratio, 9.78; 95% confidence interval, 3.95-24.19, P<.001). Analyses using Female Sexual Function Index scores were limited to patients who were sexually active at both time points (n=132 [68.4%]). The total Female Sexual Function Index score did not change significantly from baseline to 6 months, but there were statistically significant changes in several individual domains of sexual function. Patients reported significant improvement in desire (P=.012), arousal (P=.023), and pain (P<.001) domains. However, significant decreases were reported in orgasm (P<.001) and satisfaction (P<.001) domains. The proportion of patients who met the criteria for sexual dysfunction was quite high (>60%) at both time points, but there was not a statistically significant change in the proportion from baseline to 6 months. In the multivariate linear regression model, there was no relationship between change in sexual function score and any of the variables examined, including age, endometriosis history, pelvic pain severity, or psychosocial measures. In this cohort of patients with pelvic pain undergoing hysterectomy for benign indications, both sexual activity and sexual function remained fairly stable after hysterectomy. Higher relationship satisfaction, younger age, and preoperative sexual activity were associated with a greater probability of sexual activity at 6 months after surgery. Psychosocial factors, such as depression, relationship satisfaction, and emotional support, and history of endometriosis were not related to change in sexual function among patients who were sexually active both before hysterectomy and at 6 months after surgery.

The impact of the COVID-19 pandemic-related quarantine on female sexual behavior: a cross-sectional study in China

To investigate the impact and factors of home quarantine life on women’s sexual lives and behaviors in different areas of China and analyze the prevalence of female sexual dysfunction (FSD) during the COVID-19 pandemic. We surveyed adult women who had a regular sexual life (including regular masturbation) and had been isolated at home for at least one month during the COVID-19 outbreak using online questionnaires. This survey recovered 678 complete questionnaires after screening. According to the findings, the overall score of the Female Sexual Function Inventory (FSFI) during the pandemic was 21.98 ± 6.38, the frequency of FSD was 61.9%, and the frequencies of FSD in Shanghai, Nanjing, and Ningxia were 60.6%, 75.2%, and 52.2%, respectively. The frequency of FSFI scores and other specific items (Desire, Arousal, Lubrication, Orgasm, Satisfaction, and Pain) varied significantly across the three regions (P < 0.05). The overall frequency of FSD in the masturbation population was 34.4%, which was lower than the frequency of FSD in women having paired sexual intercourse (60.1%) (p < 0.05). Further analysis revealed that the occurrence of FSD during the pandemic was related to different age stages, menopause, mode of delivery, level of anxiety and depression, and sexual lifestyles. The COVID-19 pandemic has had a great impact on people’s spiritual and sexual lives, which are caused by multiple different variables related to both the individual and the environment. We should emphasize the importance of sexual health in epidemics, and having a harmonious and stable sex life will help us survive the boring life of isolation.

The Effect of Cervical Conization on Women's' Sexual Function and Psychological Health, A Prospective Observational Study

Diagnosis of cervical dysplasia and subsequent conization of the uterine cervix might affect women's' sexual health. To assess the effect of cervical conization on women's sexual function and psychological wellbeing. Patients undergoing conization of the cervix were assessed before, and 6 months after conization. Assessment of sexual distress and function was done using the female sexual distress scale-revised (FSDS-r) and the female sexual function inventory (FSFI), respectively. Risk for anxiety and depression, was assessed using the Hospital Anxiety and Depression Scale (HADS). FSDS-r, FSFI and HADS scores before and after conization RESULTS: From October 2018 to March 2021, 55 patients undergoing cervical conization were recruited. No significant differences were found in FSDS-r scores before and after conization. An equal number of patients indicated having sexual distress (29 patients, 53%, before and after conization, P=1.0). No significant changes were noticed on any FSDS domains or the total FSDS score before and after conization, (26.8 vs. 26.0, p=0.461). The percent of patients that indicated an overall sexual dysfunction, increased from 49 percent before conization, to 59 percent after conization, P=0.388. A high percent of patients indicated signs of anxiety on the HADS questionnaire, both before and after conization (49% and 47%, respectively). The median anxiety and depression scores did not change after conization, p=1.0. A high percent of patients undergoing conization suffer from sexual distress, sexual dysfunction and general anxiety, both before and after conization. The conization procedure itself did not seem to effect questionnaire scores. This was a prospective cohort, with comprehensive assessment of female sexual and psychological wellbeing after conization. Not all subjects reported sexual intercourse prior to questionnaire completion. Gynecologists should be aware of the psychological and sexual effect of the diagnosis and treatment of cervical pre-cancerous lesions, patients should be counselled accordingly. Michaan N, Loboda N, Ochshorn I, et al., The Effect of Cervical Conization on Women's' Sexual Function and Psychological Health, A Prospective Observational Study. J Sex Med 2022;19:257-262.

Correlates of Sexual Function in a Sample of Spanish Women with Endometriosis.

Background: In the present study, we aim to report on the sexual function of women experiencing symptoms of endometriosis, analysing the clinical and psychosocial factors that may be associated. Methods: A multicentre cross-sectional study was performed to analyse the sexual function in a sample of 196 Spanish women with endometriosis, using the Female Sexual Function Inventory. Results: The Female Sexual Function Inventory (FSFI) was validated in our endometriosis study group. The mean FSFI score for the sample was 22.5 (SD 6.6), with 20.9 and 26.9 being in the 25th and 75th percentiles, respectively. Although physical sexual pain and dyspareunia were factors that influenced the sexual function of women with endometriosis, our results show that the impairment was multifactorial. Conclusions: We found impaired sexual function in women diagnosed with endometriosis. The final model included deep endometriosis, depression, age, and unemployment as strongest predictive factors for poor (deteriorated) sexual function.

Sexual dysfunction in patients with neuromyelitis optica spectrum disorder

BackgroundSexual dysfunction (SD) is a common but poorly understood symptom in patients with neuromyelitis optica spectrum disorder (NMOSD). The study was designed to compare SD between NMOSD patients and healthy controls (HCs), and to investigate factors that influenced SD in NMOSD patients. MethodsThe study enrolled 102 sexually active NMOSD patients and 110 HCs. SD was investigated with the Female Sexual Function Inventory (FSFI), the abridged International Index of Erectile Function-5 (IIEF-5) and the Chinese Index of Premature Ejaculation-5 (CIPE-5). Disability, lower urinary tract dysfunction (LUTD), fatigue, depression and anxiety were also evaluated. ResultsThe prevalence of SD, including female sexual dysfunction (FSD), erectile dysfunction (ED), and premature ejaculation (PE), was significantly higher in NMOSD patients than in HCs (P < .01). The FSFI, IIEF-5 and CIPE-5 scores were all significantly lower in NMOSD patients than in HCs (P < .01). Correlation analysis showed that SD was strongly correlated with age, age at onset, disability, LUTD, fatigue, depression and anxiety (P < .05). Regression analysis further revealed that age at onset (OR = 1.057, P = .036), disability (OR = 1.591, P = .011), and depression (OR = 1.111, P = .041) were independent predictors of FSD in NMOSD patients. ConclusionsThis study provided evidence that SD is a common problem in NMOSD patients and that age at onset, disability, and depression are independent predictors of FSD. More attention should be paid to SD in patients with NMOSD.

Sexual Function in Iranian Female Multiple Sclerosis Patients.

BACKGROUND:One of the typical complaints in females with multiple sclerosis (MS) is Sexual dysfunction (SD).AIM:This study aimed to compare the sexual function of women with and without MS and to recognise factors that possibly related to sexual dysfunction of women with MS.MATERIAL AND METHODS:Sexual function of 64 women with MS as a case study group were compared to a group of control comprised of 64 women. Female Sexual Function Inventory (FSFI) and Beck Depression Inventory (BDI) were used accordingly to assess sexual function and severity of depression of case and control groups. Functional status of MS Patients was assessed by the Expanded Disability Status Scale (EDSS). The data were analysed using chi-square, independent Samples t, Pearson’s correlation coefficients, and multiple linear regression tests.RESULTS:There were no differences in the Total FSFI and 4 FSFI subscale scores (i.e. sexual desire, arousal, lubrication and satisfaction) between women with MS and controls. The only significant difference between the two groups was the dimension of orgasm (p = 0.016). Multivariate analysis demonstrated that only BDI and FSFI total scores have significantly related (B = -0.436, P < 0.001). In women with MS, a significant negative correlation was found between FSFI and EDSS scores (rho = -0.35, P = 0.032), as well as between FSFI scores and disease duration (rho = -0.25, P = 0.01).CONCLUSION:Depression was associated to sexual dysfunction in women. It could be advantageous to evaluate and treat depression in women with MS who suffer from sexual dysfunction.

Female Sexual Dysfunction Among Greek Women With Multiple Sclerosis: Correlations With Organic and Psychological Factors.

IntroductionMultiple Sclerosis (MS) is a degenerative neurological disease that usually occurs between the ages of 20 and 50 years. Sexuality issues are important factors that affect the quality of life of patients.AimTo determine and evaluate the prevalence of female sexual dysfunction (FSD) in Greek women with MS and correlate it with organic and psychological factors.Methods248 consecutive women with MS, aged over 18 who admitted to our outpatient clinics from February 2016 to March 2017 were included in the study. Demographics (age, marital status, menopause status, number of children) and disease-related data such as the duration of the disease, Expanded Disability Status Scale (EDSS) and medication for MS obtained.Main Outcome MeasureAll participants completed the Greek validated versions of the Depression, Anxiety, Stress Scale (DASS-21) and the Female Sexual Function Inventory (FSFI) questionnaires. Statistics used to estimate the prevalence of FSD and its correlation with organic (age, EDSS, duration of the disease, menopause status) and psychological factors (depression, anxiety, stress).ResultsFSD was diagnosed in 64.5% of our sample. Age was associated with most subscales of the FSFI. There was no significant correlation in FSFI subscales with the disease duration. Correlation of EDSS and FSFI scores was found to be statistically significant with a negative correlation in all subscales apart from the Satisfaction subscale. Regarding the association between DASS domains and FSFI subscales, there were no significant correlations.ConclusionFSD is common among Greek women; it is influenced by age, severity of disease, and it is independent of the existence of depression, anxiety, and stress.Konstantinidis C, Tzitzika M, Bantis A, et al. Female sexual dysfunction among Greek women with multiple sclerosis: Correlations with organic and psychological factors. Sex Med 2019;7:19–25.

Assessment of Body Image, Sexual Function, and Attractiveness in Women With Genital Prolapse: A Cross-Sectional Study With Validation of the Body Image in the Pelvic Organ Prolapse (BIPOP) Questionnaire

IntroductionWomen’s sense of attractiveness and body image, and the impact of pelvic organ prolapse (POP) over these constructs, are likely influenced by social and cultural background. AimTo evaluate sexual function and body image in women with POP, to compare the sense of attractiveness between women with and without POP, and to translate the Body Image in the Pelvic Organ Prolapse (BIPOP) questionnaire into Brazilian Portuguese and validate it in this population. MethodsIn this cross-sectional study of 105 Brazilian women with POP, we administered the BIPOP (scored from 1 to 5, with higher scores indicating worse body image), the Female Sexual Function Inventory (FSFI) (scored from 2 to 36, with higher scores indicating lower risk for sexual dysfunction), and the Attractiveness subscale of the Body Attitudes Scale questionnaire (BAQ) (scored from 5 to 35, with higher score indicating better body image). We also included 100 control women who completed the BAQ Attractiveness subscale questionnaire. Main Outcome MeasureThe main outcome measure included BIPOP, FSFI, and BAQ Attractiveness scores. ResultsMean BIPOP scores were 3.09 ± 1.08 in women with any POP, 3.05 ± 1.00 in those with lesser-stage POP (1 or 2), and 3.13 ± 1.15 in those with advanced-stage POP (3 or 4). There were no significant differences in score according to prolapse staging (P = .71). FSFI scores were independently associated with BIPOP scores (β = –0.052; P = .02). The mean scores for the BAQ Attractiveness subscale was 17.01 ± 4.07 in women with POP and 16.97 ± 4.60 in those without POP (P = .93). Older age was the sole characteristic associated with being sexually inactive in women with POP; regarding sexual function, a better body image and higher attractiveness scores were independently associated with a higher FSFI score. As for the Portuguese validation of the BIPOP instrument, the adapted version maintained good internal consistency (α = 0.908), good reliability (intraclass correlation coefficient, 0.94), and adequate construct validity. Clinical ImplicationsWomen with POP may not relate sexual function or attractiveness to POP extension. An impaired body image is associated with worse perception of attractiveness and increased risk for sexual dysfunction. Strength & LimitationsAs strengths, we used a specific genital body image scale, and this is first study of its kind among Brazilian women. As for weaknesses, we encountered low educational levels in the women with POP. ConclusionAmong women with POP, the anatomic features of the prolapse do not seem to interfere with genital body image or with sexual function. In addition, the presence of POP was not associated with being sexually active or inactive.Moroni RM, da Silva Lara LA, Ferreira CHJ, et al. Assessment of Body Image, Sexual Function, and Attractiveness in Women With Genital Prolapse: A Cross-Sectional Study With Validation of the Body Image in the Pelvic Organ Prolapse (BIPOP) Questionnaire. J Sex Med 2019;16:126–136.

Dorsal onlay graft urethroplasty for female urethral stricture improves sexual function: Short-term results of a prospective study using vaginal graft.

Introduction:Both dorsal and ventral approaches are acceptable options for the surgical reconstruction of female urethral strictures (FUS), but damage to the sphincter and the clitoral nerves resulting in sexual dysfunction is the chief argument against the dorsal approach. Most of the reported case series are retrospective and none has evaluated sexual functions. This study prospectively evaluates the early sexual and functional results after dorsal onlay vaginal graft urethroplasty (DVGU) for FUS.Materials and Methods:All women with a history of obstructive voiding symptoms and previous urethral dilatation were evaluated with urodynamic study, voiding cystourethrography, and cystoscopy for the presence of FUS, which was defined as visual demonstration of anatomical narrowing on urethro-cystoscopy. DVGU was offered as a definitive management for all those identified with FUS. Surgical outcomes were assessed at 3 and 6 months with the International Prostate Symptom Score (IPSS), uroflowmetry, and postvoid residual (PVR) estimation. For sexually active females, sexual function was assessed using the Female Sexual Function Inventory (FSFI) score both preoperatively and at 3 months following surgery.Results:Seventy-one women were evaluated. FUS was identified in 29 women (flimsy in 12 and dense in 17). Thirteen women with dense strictures underwent DVGU. The mean improvement in the IPSS score, Qmax, and PVR was 12.6, 16.64 ml/s, and 103.08 ml at 3 months, respectively. The FSFI score improved with a mean of 6.42 points after urethroplasty. None of the patients developed incontinence. There were three failures after a mean follow-up of 8.5 months.Conclusion:The early functional results after DVGU are good without any negative impact on the continence or the sexual functions.

Dysfonction sexuelle féminine et sclérose en plaques : étude cas-témoins

To compare the scores of the different dimensions of sexual function of women with multiple sclerosis to a group of control women and to identify possible factors associated with sexual dysfunction in women with multiple sclerosis. This is a descriptive and analytical case-control study. Twenty-six women with multiple sclerosis were compared to 26 control women matched for age and socioeconomic status. The evaluation focused on demographic and clinical data. Patients with multiple sclerosis were evaluated by Expanded Disability Status Scale (EDSS) for functional status, by Female Sexual Function Inventory (FSFI) for sexual function and by Beck Depression Inventory-Short Form (BDI-DF) for severity of depression. Our results confirmed the high prevalence of sexual dysfunction among patients with multiple sclerosis (69.2%) compared to controls (26.9%) (P=0.002). Sexual desire, arousal and orgasm were the most altered sexual phases in our study. Total FSFI, and FSFI subscale scores (sexual desire, arousal, lubrication, orgasm and satisfaction) were lower in women with multiple sclerosis compared with controls. The analytical study showed that in women with multiple sclerosis, the total FSFI score was correlated with age (rs=-0.68; P<0.001), duration of marriage (rs=-0.57; P=0.002), level of disability (rs=-0.45; P=0.021) and BDI-SF score (rs=-0.51; P=0.008). FSFI score was also associated to low education level (P=0.02) and urinary dysfunction (P=0.04). Our study highlighted the importance of sexual dysfunction in women with multiple sclerosis. The inclusion of this aspect in the clinical assessment will improve the quality of life of these patients. 3.

The evaluation of sexual function in women with stroke.

Although very common, sexual dysfunction is a neglected disorder in women with stroke. To investigate the physical, psychological and sexual changes in women with stroke, and to determine the factors related to these changes. This descriptive study was conducted at a tertiary care university hospital. A total of 112 women (51 stroke patients, 61 healthy controls) were included in the study. The independence level of stroke patients was evaluated with the Modified Rankin Scale (mRS); the severity of stroke and the clinical status of patients after stroke, with the National Institute of Health Stroke Scale (NIHSS); depression levels, with the Beck Depression Inventory (BDI); and, patients' sexual function, with the Female Sexual Function Inventory (FSFI). The Kolmogorov-Smirnov, the student's t, the Chi-square and the Mann- Whitney-U tests, and the Spearman's correlation analysis were performed in the appropriate conditions. While the scores of total FSFI and FSFI subgroups in women with stroke were lower than in healthy controls, BDI scores were found to be higher than those of controls. A negative correlation was detected between the total FSFI scores, and BDI, MRS, NIHSS, age, duration of marriage and number of children in women with stroke, while a positive correlation was found between total FSFI scores and educational level. Sexual dysfunction is a commonly seen disorder in women with stroke, and is influenced by the severity of disease, level of dependence and accompanying depression. Therefore, evaluation of sexual dysfunction, depression and levels of physical function should be done in women with stroke during their follow up.

Blood Pressure, Sexual Activity, and Dysfunction in Women With Hypertension: Baseline Findings From the Systolic Blood Pressure Intervention Trial (SPRINT)

IntroductionSexual function, an important component of quality of life, is gaining increased research and clinical attention in older women with hypertension. AimTo assess the association between systolic blood pressure (SBP) and other variables, and sexual activity and sexual dysfunction in hypertensive women. MethodsBaseline analysis of 635 women participants of a larger randomized clinical trial of 9361 men and women. Main Outcome MeasuresSelf-reported sexual activity (yes/no), and sexual function using the Female Sexual Function Inventory (FSFI). Results452 participants (71.2%) reported having no sexual activity during the previous 4 weeks. The mean (SD) FSFI score for sexually active participants was 25.3 (6.0), and 52.6% of the sample reported a FSFI score ≤26.55 designating sexual dysfunction. In logistic regression models, SBP was not significantly associated with sexual activity (AOR = 1.002; P > .05). Older age (AOR = 0.95, P < .05), and lower education (AOR for < high school vs college degree = 0.29, P < .05) were associated with lower odds of being sexually active, as was living alone versus living with others (AOR = 0.56, P < .05). Higher weekly alcohol consumption was associated with increased odds of being sexually active (AOR = 1.39; P < .05). In logistic regression models among sexually active participants, SBP was not associated with sexual dysfunction (AOR = 1.01; P > .05). Higher depressive symptoms from the Patient Health Questionnaire-9 (PHQ-9) was associated with higher odds of sexual dysfunction (AOR = 1.24, P < .05), as was increased number of physical comorbidities (AOR = 1.25, P < .05). Diuretic use was associated with lower odds of being sexually active in participants with chronic kidney disease (AOR = 0.33, P < .05). ConclusionYounger age, higher education, living with others, and higher weekly alcohol consumption were significantly associated with higher odds of being sexually active in a sample of middle-aged and older women with hypertension. Increased depressive symptoms and increased physical comorbidities were significantly associated with increased odds of sexual dysfunction. SBP was not significantly associated with sexual activity or sexual dysfunction.

Effects of Multiple Sclerosis on Female Sexuality: A Controlled Study

The aim of this study was to investigate the effects of multiple sclerosis (MS) on female sexuality. Present study included 142 females (70 MS patients, 72 healthy controls). MS patients were evaluated by Expanded Disability Status Scale (EDSS) for functional status, by Beck Depression Inventory (BDI) for severity of depression, by Visual Analog Scale (VAS) for severity of pain, and by Female Sexual Function Inventory (FSFI) for sexual function. FSFI, BDI, EDSS, and VAS were the main outcome measures. The number of weekly sexual intercourse, total FSFI, and FSFI subscale scores were lower in MS women compared with controls. FSFI total and FSFI subscale scores were statistically significantly lower in MS women with BDI score ≥ 17 compared with those with BDI score <17. A negative correlation was found between total FSFI score and BDI, EDSS, VAS, age, and duration of complaint, but a positive correlation was found with education level in MS women. Sexual functions are negatively affected in MS women. Sexual functions in MS women seem to be associated with enhanced disability, pain, duration of the disease, and degree of concomitant depression. Therefore, women with MS should also be evaluated in terms of sexual function during routine follow-ups.

The prevalence of autoantibodies in ms patients in Riga East Clinical University Hospital, Latvia

The prevalence of autoantibodies in ms patients in Riga East Clinical University Hospital, Latvia

Effect of Intensive Lifestyle Intervention on Sexual Dysfunction in Women With Type 2 Diabetes

OBJECTIVESexual dysfunction is a prevalent problem in obese women with type 2 diabetes. This study examined the effects of intensive lifestyle intervention (ILI) in these women.RESEARCH DESIGN AND METHODSLook AHEAD is a 16-center, randomized, controlled trial evaluating the health effects of ILI compared with a control group (diabetes support and education [DSE]). The Look AHEAD Sexual Function Ancillary study included 375 female participants at five Look AHEAD sites. Participants completed the Female Sexual Function Inventory (FSFI) and Beck Depression Inventory (BDI), and assessments of weight and cardiovascular risk factors at baseline and 1 year were made.RESULTSAt baseline, 50% of the 229 participants who reported being sexually active met criteria for female sexual dysfunction (FSD); only BDI score was related to FSD. One-year weight losses were greater in the ILI group than in the DSE group (7.6 vs. 0.45 kg; P < 0.001). Among women with FSD at baseline, those in the ILI group (N = 60) compared with those in the DSE group (N = 53) were significantly more likely to remain sexually active (83 vs. 64%; P < 0.008), reported greater improvement in total FSFI scores and in most FSFI domains (P < 0.05), and were more likely to experience remission of FSD (28 vs. 11%; P < 0.04) at 1 year. No significant differences between ILI and DSE were seen in women who did not have FSD at baseline.CONCLUSIONSParticipation in ILI appeared to have beneficial effects on sexual functioning among obese women with diabetes, particularly in those who had FSD at baseline.

Sexual Function in Patients with PCOS and/or Obesity before and after Metformin Treatment

The clinical signs of hyperandrogenemia, commonly seen in polycystic ovarian syndrome (PCOS) patients combined with obesity and infertility can cause emotional distress. There are however few data about the psychosocial and sexual function of patients with PCOS. Objectives: The aim of the study was to investigate the sexual function in patients with obesity and/or PCOS using Female sexual function inventory (FSFI) before and after metformin treatment. Design and Methods: In the present study were included 79 patients divided into three groups—group 1 Obese (n = 22); group 2 Lean PCOS (n = 41) and group 3 Obese PCOS (n = 16). All of the subjects completed FSFI questionnaire. In patients who had insulin resistance (OGTT + IRI) metformin treatment was started in dose 1700 - 3000 mg/day. Results: Obese women without PCOS showed significantly higher scores on total FSFI and all domains except from desire compared to lean PCOS subjects. Although the differences do not reach statistical significance, lean PCOS patients have the lowest scores on all domains. FSFI score correlates negatively only with androstendione levels. Women with and without hyperandrogenemia do not show differences in FSFI score. It is interesting to note that LH but not FSH shows moderate positive correlation to all domains of FSFI. FSFI scores do not show correlation to the indices of carbohydrate metabolism (blood glucose and IRI during OGTT), lipid profile, and arterial pressure. After metformin treatment there was an increase in all FSFI domain scores although statistical significance was noted only for the total FSFI score and the domains lubrication and pain, probably because of the small number of patients. Conclusions: Lean PCOS patients have lower scores on FSFI than obese patients with or without PCOS. The hyperandrogenemia is not a determinant for sexual dysfunction in PCOS women. Metformin treatment has a favorable effect on sexual function.