Sexuality and psychological wellbeing in women with polycystic ovary syndrome compared with healthy controls Mattias Ma ˚ nsson a, *, Kajsa Norstro ¨m b , Jan Holte c , Kerstin Landin-Wilhelmsen d , Eva Dahlgren e , Mikael Lande ´n b,f a Department of Clinical Neuroscience, Karolinska Institutet, Section of Psychiatry, Psychiatry Karolinska Northwest, Danderyd Hospital, SE-182 88 Stockholm, Sweden b Institute of Neuroscience and Physiology, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden c Carl von Linne ´ Clinic, Uppsala, Sweden d Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden e Department of Gynecology and Obstetrics, Sahlgrenska University Hospital, Gothenburg, Sweden f Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden 1. Introduction Polycystic ovary syndrome (PCOS) is a common endocrinopathy affecting approximately five percent of women of reproductive age [1]. PCOS is defined as a disorder of irregular menstrual cycles, polycystic ovaries, and signs of hyperandrogenicity [2]. Several traits of PCOS might potentially affect sexual health. First, PCOS is associated with infertility [3,4], which has been linked to decreased sexual satisfaction [5]. Second, a large proportion of women with PCOS is obese [6] and that also has been associated with decreased sexual satisfaction though not decreased sexual activity [7]. Third, women with PCOS have a high functional activity of testosterone, which might be associated with increased sexual functioning [8–10]. Given that PCOS is very common and that the syndrome is associated with many factors that might influence sexual function- ing, it is surprising that the literature on this topic is scarce. The objective of this study was to compare sexual functioning – defined as the integration of physical, socioemotional and intellectual aspects of sexual expression and performance – in PCOS women with a matched population-based control group, and to study potential relationships between serum testosterone levels, psycho- logical wellbeing, and sexual functioning. 2. Materials and methods 2.1. Subjects This study was part of an overarching endeavor to survey behavior in PCOS patients. Patients and controls were recruited during 2002–2005. The recruitment sites were chosen in order to provide a representative clinical cohort of women with PCOS. It is European Journal of Obstetrics & Gynecology and Reproductive Biology 155 (2011) 161–165 ARTICLE INFO Article history: Received 27 May 2010 Received in revised form 10 November 2010 Accepted 14 December 2010 Keywords: Hyperandrogenism Sexuality Polycystic ovary syndrome Testosterone Infertility ABSTRACT Objectives: Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders affecting women of fertile age. The aim was to study whether PCOS has an effect on sexual functioning. Study design: Women meeting the Rotterdam criteria for PCOS (n = 49), and 49 age-matched controls identified from the population registry, were recruited. Sexual functioning was assessed by means of (i) an in-person, structured interview covering various aspects of sexuality, and (ii) the nine-item McCoy questionnaire of female sexual satisfaction. Participants also completed the Psychological General Well- Being Index. Results: Almost half the women with PCOS reported that the disorder had a great impact on their sex life. Despite having the same number of partners and about the same frequency of sexual intercourse, women with PCOS were generally less satisfied with their sex lives compared to the population-based controls. Within the group of women with PCOS, high body mass index had only a minor effect on sexual functioning, while the total serum level of testosterone correlated positively to sexual satisfaction. PCOS women scored numerically lower than controls on the McCoy total score, but this difference was not statistically significant. Conclusion: Women with PCOS reported decreased satisfaction with their sex life. Sexual function should be taken into account in treatment trials of PCOS, which traditionally target only symptoms related to insulin resistance, overweight, and hirsutism. ß 2010 Elsevier Ireland Ltd. All rights reserved. * Corresponding author. Tel.: +46 704840428. E-mail addresses: mattias.mansson@sll.se, mattias.mansson@ki.se (M. Ma ˚ nsson). Contents lists available at ScienceDirect European Journal of Obstetrics & Gynecology and Reproductive Biology journal homepage: www.elsevier.com/locate/ejogrb 0301-2115/$ – see front matter ß 2010 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.ejogrb.2010.12.012