Lifestyle modifications alone or combined with hormonal contraceptives improve sexual dysfunction in women with polycystic ovary syndrome

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Authors:

Marissa Steinberg Weiss, M.D., Andrea Hsu Roe, M.D., M.P.H., Kelly C. Allison, Ph.D., William C. Dodson, M.D., Penny M. Kris-Etherton, Ph.D., Allen R. Kunselman, M.A., Christy M. Stetter, B.S., Nancy I. Williams, M.S., Sc.D., Carol L. Gnatuk, M.D., Stepanie J. Estes, M.D., David B. Sarwer, Ph.D., Christos Coutifaris, M.D., Ph.D., Richard S. Legro, M.D., Anuja Dokras, M.D., Ph.D.

Abstract:

Objective

To describe the prevalence of female sexual dysfunction in a well-defined polycystic ovary syndrome (PCOS) population, and to assess the impact of common PCOS treatments on sexual function.


Design

Secondary analysis of a randomized controlled trial, oral contraceptive pills and weight loss in PCOS.


Setting

Two academic medical centers.


Patients

Women with PCOS (N = 114) defined by the Rotterdam criteria.


Interventions

Continuous oral contraceptive pill (OCP) or intensive lifestyle modification (Lifestyle) or the combination (Combined) for 16 weeks.


Main Outcome Measures

Change in Female Sexual Function Index (FSFI) and Female Sexual Distress Scale−Revised (FSDS-R) scores after 16 weeks.


Results

There was no change in total FSFI or FSDS-R score in any treatment group; however, an increase in the FSFI desire domain subscore was observed in the Lifestyle and Combined treatments, indicating improved sexual desire over the 16-week period. Overall, 33 participants (28.9%) met criteria for sexual dysfunction by FSFI criteria (baseline score ≤26.55). Among this group, FSFI score improved after 16 weeks of Lifestyle and Combined treatments. There was no change in prevalence of sexual dysfunction in treatment groups at 16 weeks. Use of OCPs did not alter FSFI scores.


Conclusion(s)

Female sexual dysfunction is highly prevalent among women with PCOS. Our findings suggest that common treatments for PCOS, including intensive lifestyle modification and the combination of intensive lifestyle modification and OCPs, have the potential to improve sexual function in these women; the mechanism for these improvements is likely multifactorial.


Clinical Trial Registration Number

NCT00704912.

Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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