Endocrine Abstracts

The current study evaluated the impact of metabolic and hormonal alterations on sexual and psychological function in women with Polycystic Ovary Syndrome (PCOS). Fifty consecutive women aged 24.16±5.97 years with a diagnosis of PCOS were recruited; metabolic and hormonal parameters were measured and questionnaires related to sexual function (Female Sexual Function Index-FSFI) and psychological traits (Middlesex Hospital Questionnaire-MHQ, Body Uneasiness Test A and B-BUT A and B)were administered. Correlation analysis was performed by Spearman test, intragroup comparison by Mann-Whitney test. Mean FSFI total score was 12.5±26.6 with a prevalence of sexual dysfunction of 34%. Anxiety was detected in 76%, phobia in 50%, obsession in 42%, somatization in 50%, depersonalization in 84%, and hysteria in 66% of patients. Body image concern positively correlated with BMI and Waist Circumference (WC) (P=0.031; P=0.022) and depersonalization positively correlated with WC (P=0.035). Positive Symptom Distress Index-PSDI positively correlated with Ferriman-Gallwey score (P=0.016). FSFI total score (P=0.009; P=0.019), desire (P=0.017; P=0.049), arousal (P=0.012; P=0.028), lubrication (P=0.011; P=0.022), orgasm (P=0.03; P=0.008) and satisfaction (P=0.013; P=0.016) negatively correlated with insulin and HOMA-IR. Positive Symptom Total-PST positively correlated with insulin (P=0.015). Global Severity Index-GSI (P=0.048), weight phobia (P=0.04), thighs (P=0.0443) and legs (P=0.008) negatively correlated with prolactin levels. Pathological somatization (P=0.011), body image concern (P=0.036), WC (P<0.0001), Hip Circumference-HC (P<0.0001), insulin (P=0.012) and HOMA-IR (P=0.003) were significantly worse in overweight/obese(n=25), compared to normal-weight(n=23) patients; no difference in any of assessed parameters was detected based on the presence/absence of insulin resistance. The results of the current study highlighted that sexual and psychological function of PCOS patients might be negatively influenced by insulin resistance and that higher PRL levels were associated with reduced body satisfaction. The underlying mechanism might rely in the known negative impact of insulin resistance on clitoral vascular flow, namely increased vascular flow resistance. A timely and individualized therapy is necessary not only for the resolution of metabolic complications but also to improve psycho-sexual health of patients affected by PCOS.