Polycystic ovary syndrome (PCOS) is a common endocrine disorder affecting women of reproductive age. Whilst attention is often given to the classic symptoms such as irregular periods, weight gain, and infertility, the impact of PCOS on sexual function is overlooked.
Many women with PCOS can experience challenges such as low libido, pain during intercourse, and body image concerns, which can significantly affect their quality of life and intimacy .
Understanding the underlying causes and available treatment options will help improve sexual function and overall well-being.
How PCOS Affects Sexual Function
PCOS can impact sexual health in multiple ways, primarily due to hormonal imbalances, physical symptoms, and psychological factors:
- Hormonal Imbalances: Elevated androgen levels can lead to issues such as hirsutism (excess hair growth) and acne, which may contribute to self-consciousness and reduced sexual confidence. Low oestrogen levels can also cause vaginal dryness, leading to discomfort during intercourse.
- Insulin Resistance and Metabolism: Many women with PCOS will be insulin resistant, (which is associated with weight gain and fatigue). These factors can reduce energy levels and overall interest in sexual activity.
- Psychological wellbeing: Anxiety, depression, and body image dissatisfaction are more common in women with PCOS. These psychological challenges can decrease sexual desire and impair sexual satisfaction.
- Pain During Intercourse: Some women with PCOS report dyspareunia (painful intercourse), often linked to vaginal dryness or pelvic tension.
Strategies for Improving Sexual Function in PCOS
1. Hormonal and Medical Management
Balancing hormones is a key step in improving sexual health. Medical treatments may include:
- Combined Oral Contraceptives (COCs): These can regulate menstrual cycles, reduce androgen levels, and improve skin and hair conditions, which may enhance self-confidence and libido. They also reduce natural loss of follicles.
- Hormone Therapy: Oestrogen therapy may reduce vaginal dryness and improve overall sexual response.
- Insulin-Sensitising Medications: Metformin has been established to can help manage insulin resistance and weight, potentially boosting energy levels and libido.
- Vaginal Lubricants and Moisturisers: Over-the-counter lubricants can help alleviate discomfort caused by vaginal dryness during intercourse.
2. Lifestyle Changes
Improving your sex life, living with PCOS
We all appreciate that adopting a healthy lifestyle play is beneficial for our health and wellbeing, and in particular will help women with PCOS: improve symptoms and sexual function:
- Regular Exercise: Engaging in physical activity can help regulate insulin levels, reduce stress, and improve mood. Strength training, yoga, and aerobic exercises have been shown to improve sexual function.
- Balanced Diet: Eating a diet rich in whole foods, lean proteins, and healthy fats can help regulate blood sugar and hormone levels. Avoiding excessive sugar and processed foods can also reduce inflammation and improve energy levels. (This is because PCOS is associated with insulin insensitivity).
- Weight Management: Achieving and maintaining a healthy weight will positively impact hormonal balance and sexual health. Even a modest weight loss of 5-10% of your bodyweight can lead to improved ovulatory function and increased libido. It will also increase insulin sensitivity.
3. Addressing Psychological Barriers
As a Gynaecologist I am aware that PCOS can also have a profound impact on mental health, which in turn impacts sexual well-being. Strategies to address psychological concerns can include:
- Cognitive Behavioural Therapy (CBT): This can help women with PCOS address anxiety, depression, and negative body image, which may improve sexual confidence.
- Mindfulness and Stress Reduction: Techniques such as meditation, deep breathing, and mindfulness-based stress reduction (MBSR) can alleviate anxiety and enhance intimacy. There are apps freely available on the internet which provide full advice on meditation.
- Open Communication with Partners: Discussing your concerns with your partner can improve emotional intimacy and reduce feelings of isolation related to sexual dysfunction.
4. Treating Specific Sexual Dysfunctions
- Low Libido: If you have a reduced libido, addressing hormonal imbalances, reducing stress, and engaging in regular physical activity can help restore libido.
- Pain During Intercourse: If you experience dyspareunia, using vaginal lubricants, engaging in pelvic floor exercises, and consulting a Gynaecologist for personalized treatment options will help.
- Orgasmic Difficulties: PCOS-related hormonal imbalances can contribute to difficulties achieving orgasm. Exploring different forms of stimulation, relaxation techniques, and seeking guidance from a sexual health specialist can be beneficial.
When to Seek Medical Advice
If you experience a persistent loss of libido, you can consult your GP or a Consultant Gynaecologist. A comprehensive assessment will identify underlying causes. and the doctor can recommend appropriate treatments tailored to individual needs.
Final Thoughts
Sexual dysfunction is often a common but often overlooked aspect of PCOS. I believe that in addressing hormonal imbalances, implementing lifestyle modifications, and seeking appropriate psychological and medical support, women with PCOS can improve their sexual function and overall quality of life.
Open conversations with doctors and partners will further facilitate positive changes and help you regain confidence in their intimate relationships.
If you are living with PCOS and experiencing concerns around sexual health, you do not have to face it alone. At Rapid Access Gynaecology in London, you can receive expert, personalised care from a Consultant Gynaecologist who understands the unique challenges you may be facing. Contact us today to arrange a confidential consultation and take the first step towards improving your sexual well-being. We’ve included a link to our detailed PCOS services page for further information on how we can assist you on your journey to better health.
Click here for more information on our PCOS services
