ECE2022 Poster Presentations Reproductive and Developmental Endocrinology (61 abstracts)
A systematic review and meta-analysis assessing psychosexual wellbeing in people with polycystic ovary syndrome
Halimah Khalil 1 , Kashish Malhotra 2 , Jameela Sheikh 1 , Meghnaa Hebbar 1 , Nawal Zia 1 , Sindoora Jayaprakash 3 , Saskia Wicks 4 , Anuradhaa Subramanian 5 , Rachel Chapman 6 , Helena Gleeson 7 , Lynne Robinson 8 , Justin Chu 8 , Tejal Lathia 9 , Chitra Selvan 10 , Michael W. O’Reilly 11,12 , Konstantinos Manolopoulos 11 , Wiebke Arlt 7,11 & Punith Kempegowda 7,11
1University of Birmingham, College of Medical and Dental Sciences, Birmingham, United Kingdom; 2Dayanand Medical College, Ludhiana, India; 3The Dudley Group NHS Foundation Trust, Dudley, United Kingdom; 4Barts Health NHS Foundation Trust, London, United Kingdom; 5University of Birmingham, Institute of Applied Health Research, Birmingham, United Kingdom; 6University Hospitals Coventry and Warwickshire NHS Trust, Birmingham, United Kingdom; 7Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom; 8Birmingham Women’s Hospital, Birmingham Women’s and Children’s NHS Foundation Trust, Birmingham, United Kingdom; 9Apollo Hospitals, Navi Mumbai, India; 10MS Ramaiah Medical College, Department of Endocrinology, Bengaluru, United Kingdom; 11University of Birmingham, Institute of Metabolism and Systems Research, Birmingham, United Kingdom; 12Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, Department of Medicine, Dublin, Ireland
Background: Polycystic ovarian syndrome (PCOS) is a common endocrine disorder, with an estimated prevalence of 10-15% worldwide. PCOS can have adverse consequences on the emotional wellbeing of the patient. However, evidence exploring the relationship between PCOS and psychosexual wellbeing, specifically sexual function, and dysmorphic appearance concerns, is largely inconclusive.
Aim: A systematic review and meta-analysis were undertaken to assess differences in sexual function and dysmorphic appearance concerns among people with and without PCOS.
Methods: Electronic databases (MEDLINE, EMBASE, APA PsycInfo, PUBMED, Web-of-Science Core Collection, and CENTRAL) were searched through August 2021. Observational studies (cross-sectional, case-control, cohort) and Randomised Control Trials (RCTs) were included. Outcome measures included validated questionnaires or Visual Analogue Scales (VAS) reporting on sexual function or dysmorphic appearance concerns. Methodological quality was assessed by adaptation to the Newcastle-Ottawa Quality Assessment Scale (NOS). The inverse variance method, based on a random- or fixed-effects model (Review Manager, Version 5) was used to perform meta-analyses.
Results: The search yielded 5964 publications and 53 full-text articles were included, of which 38 (71.7%) assessed sexual function outcomes, and 15 (39.5%) assessed dysmorphic appearance concerns using validated scales, in people with PCOS.
27 studies used the Female Sexual Function Index (FSFI) to assess domains of sexual function (desire, arousal, lubrication, orgasm, satisfaction, and pain). Meta-analysis of 11 comparative cohort studies (793 PCOS women and 1507 controls) revealed no significant differences between PCOS and controls in sexual desire (P=0.11); satisfaction (P=0.05); pain (P=0.56); arousal (P=0.05) and total FSFI score (P=0.27). PCOS women scored significantly lower on lubrication (SMD=−0.16; P=0.001) and orgasm (SMD=−0.16; P=0.02), indicating impaired sexual function. Included studies used 13 different validated scales to assess dysmorphic appearance concerns among people with PCOS. Meta-analysis of 3 comparative cohort studies (406 PCOS women and 394 controls) using the Multidimensional Body-Self Relations Questionnaire Appearance Scales (MBSRQ-AS) to assess appearance concerns was performed. PCOS women scored significantly lower on the appearance evaluation (SMD=−0.78; P<0.00001) and significantly higher on appearance orientation (SMD=0.22; P=0.0004), indicating higher overall dissatisfaction with physical appearance.
Conclusions: People with PCOS experience a greater degree of sexual dysfunction and body image concerns implying psychosexual wellbeing needs to feature in clinical assessment of people with PCOS. Further studies are needed to identify ways to minimise this impact.
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Endocrine Abstracts
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