Disparate Relationship of Sexual Satisfaction, Self-Esteem, Anxiety, and Depression with Endocrine Profiles of Women With or Without PCOS

Abstract

Women with polycystic ovary syndrome (PCOS) are at increased risk of psychological distress including anxiety and depressive symptoms. However, less is known about sexual satisfaction and self-esteem as well as the relationship of these aspects of psychological function with clinical and hormonal profiles associated with PCOS. This cross-sectional study compared women with PCOS (N = 96) and healthy controls (N = 47). This study assessed sexual function (primary outcome), self-esteem, anxiety, and depression as well as evaluation of clinical, endocrine, and metabolic parameters. Overall, sexual satisfaction scores were comparable among women with and without PCOS. However, psychosexual function of women with PCOS exhibited distinguishing characteristics. The unconscious aspect of sexuality: frequency of erotic dreams, significantly correlated with free testosterone (ρ = 0.24, P = 0.03) and DHEAS (ρ = 0.31, P = 0.004) only in the PCOS group. In contrast, in women with PCOS, the frequency of masturbation did not correlate with endocrine profiles, but correlated with trait anxiety (ρ = 0.21, P = 0.049) and depression (ρ = 0.21, P = 0.05). Only one aspect of self-esteem (body appearance) was reduced in the PCOS group (P = 0.02) and was related to BMI and androgen. Women with PCOS had greater state anxiety (P = 0.02) and depression (P < 0.001); these scores correlated with BMI. However, anxiety and depression correlated with testosterone only in women without PCOS. The above findings indicate that PCOS is associated with a broad range of alterations of psychological function including psychosexual aspects; these alterations are in complex relationship with BMI and androgen levels.

Keywords: Anxiety; Depression; Polycystic ovary syndrome; Self-esteem; Sexual satisfaction.