{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T00:57:18Z","timestamp":1792457838628,"version":"4.5.0"},"reference-count":94,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2024,1,18]],"date-time":"2024-01-18T00:00:00Z","timestamp":1705536000000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Erasmus MC"},{"name":"University Medical Center"},{"name":"Netherlands and the Centre for Research Excellence in Women\u2019s Health in Reproductive Life"},{"DOI":"10.13039\/501100001779","name":"Monash University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001779","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,5,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>BACKGROUND<\/jats:title>\n                  <jats:p>Polycystic ovary syndrome (PCOS) is a common and distressing endocrine disorder associated with lower quality of life, subfertility, diabetes, cardiovascular disease, depression, anxiety, and eating disorders. PCOS characteristics, its comorbidities, and its treatment can potentially influence sexual function. However, studies on sexual function in women with PCOS are limited and contradictory.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>OBJECTIVE AND RATIONALE<\/jats:title>\n                  <jats:p>The aim was to perform a systematic review of the published literature on sexual function in women with PCOS and assess the quality of the research and certainty of outcomes, to inform the 2023 International Guidelines for the Assessment and Management of PCOS.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>SEARCH METHODS<\/jats:title>\n                  <jats:p>Eight electronic databases were searched until 1 June 2023. Studies reporting on sexual function using validated sexuality questionnaires or visual analogue scales (VAS) in PCOS populations were included. Random-effects models were used for meta-analysis comparing PCOS and non-PCOS groups with Hedges\u2019 g as the standardized mean difference. Study quality and certainty of outcomes were assessed by risk of bias assessments and the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) method according to Cochrane. Funnel plots were visually inspected for publication bias.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>OUTCOMES<\/jats:title>\n                  <jats:p>There were 32 articles included, of which 28 used validated questionnaires and four used VAS. Pooled Female Sexual Function Index (FSFI) scores in random-effects models showed worse sexual function across most subdomains in women with PCOS, including arousal (Hedges\u2019s g [Hg] [95% CI]\u2009=\u2009\u22120.35 [\u22120.53, \u22120.17], I2\u2009=\u200982%, P\u2009&amp;lt;\u20090.001), lubrication (Hg [95% CI]\u2009=\u2009\u22120.54 [\u22120.79, \u22120.30], I2\u2009=\u200990%, P\u2009&amp;lt;\u20090.001), orgasm (Hg [95% CI]\u2009=\u2009\u22120.37 [\u22120.56, \u22120.19], I2\u2009=\u200983%, P\u2009&amp;lt;\u20090.001), and pain (Hg [95% CI]\u2009=\u2009\u22120.36 [\u22120.59, \u22120.13] I2\u2009=\u200990%, P\u2009&amp;lt;\u20090.001), as well as total sexual function (Hg [95% CI]\u2009=\u2009\u22120.75 [\u22121.37, \u22120.12], I2\u2009=\u200998%, P\u2009\u2009=\u2009\u20090.02) and sexual satisfaction (Hg [95% CI]\u2009=\u2009\u22120.31 [\u22120.45, \u22120.18], I2\u2009=\u200968%, P\u2009&amp;lt;\u20090.001). Sensitivity and subgroup analyses based on fertility status and body mass index (BMI) did not alter the direction or significance of the results. Meta-analysis on the VAS studies demonstrated the negative impact of excess body hair on sexuality, lower sexual attractiveness, and lower sexual satisfaction in women with PCOS compared to controls, with no differences in the perceived importance of a satisfying sex life. No studies assessed sexual distress. GRADE assessments showed low certainty across all outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>WIDER IMPLICATIONS<\/jats:title>\n                  <jats:p>Psychosexual function appears to be impaired in those with PCOS, but there is a lack of evidence on the related distress scores, which are required to meet the criteria for psychosexual dysfunction. Health care professionals should discuss sexual function and distress and be aware of the multifactorial influences on sexual function in PCOS. Future research needs to assess both psychosexual function and distress to aid in understanding the degree of psychosexual dysfunction in PCOS. Finally, more diverse populations (e.g. non-heterosexual and more ethnically diverse groups) should be included in future studies and the efficacy of treatments for sexual dysfunction should also be assessed (e.g. lifestyle and pharmacological interventions).<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/humupd\/dmad034","type":"journal-article","created":{"date-parts":[[2024,1,18]],"date-time":"2024-01-18T21:49:12Z","timestamp":1705614552000},"page":"323-340","source":"Crossref","is-referenced-by-count":35,"title":["Sexual function in women with polycystic ovary syndrome: a systematic review and meta-analysis"],"prefix":"10.1093","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9930-6816","authenticated-orcid":false,"given":"Hester","family":"Pastoor","sequence":"first","affiliation":[{"name":"Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center , Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7356-4523","authenticated-orcid":false,"given":"Aya","family":"Mousa","sequence":"additional","affiliation":[{"name":"Monash Centre for Health Research and Implementation, School of Clinical Sciences, Monash University and Monash Health , Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanneke","family":"Bolt","sequence":"additional","affiliation":[{"name":"Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center , Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2681-9180","authenticated-orcid":false,"given":"Wichor","family":"Bramer","sequence":"additional","affiliation":[{"name":"Medical Library, Erasmus MC, University Medical Center , Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7946-5314","authenticated-orcid":false,"given":"Tania S","family":"Burgert","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Endocrinology, Children\u2019s Mercy Kansas City , Kansas City, MO, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1085-3969","authenticated-orcid":false,"given":"Anuja","family":"Dokras","sequence":"additional","affiliation":[{"name":"Penn Medicine, Penn Fertility Care, Reproductive Endocrinology and Infertility , Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6228-2654","authenticated-orcid":false,"given":"Chau Thien","family":"Tay","sequence":"additional","affiliation":[{"name":"Monash Centre for Health Research and Implementation, School of Clinical Sciences, Monash University and Monash Health , Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7609-577X","authenticated-orcid":false,"given":"Helena J","family":"Teede","sequence":"additional","affiliation":[{"name":"Monash Centre for Health Research and Implementation, School of Clinical Sciences, Monash University and Monash Health , Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5444-9845","authenticated-orcid":false,"given":"Joop","family":"Laven","sequence":"additional","affiliation":[{"name":"Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center , Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,1,17]]},"reference":[{"key":"2024050205540162400_dmad034-B1","doi-asserted-by":"crossref","first-page":"1264","DOI":"10.1590\/1806-9282.20220367","article-title":"Body image and sexual function in women with polycystic ovary syndrome: a case-control study","volume":"68","author":"Aba","year":"2022","journal-title":"Rev Assoc Med Bras (1992)"},{"key":"2024050205540162400_dmad034-B2","first-page":"477","article-title":"Development and validation of female sexual quotient\u2014questionnaire to assess female sexual function. 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