Sexual Function in Patients with PCOS and/or Obesity before and after Metformin Treatment

The clinical signs of hyperandrogenemia, commonly seen in polycystic ovarian syndrome (PCOS) patients combined with obesity and infertility can cause emotional distress. There are however few data about the psychosocial and sexual function of patients with PCOS. Objectives: The aim of the study was to investigate the sexual function in patients with obesity and/or PCOS using Female sexual function inventory (FSFI) before and after metformin treatment. Design and Methods: In the present study were included 79 patients divided into three groups—group 1 Obese (n = 22); group 2 Lean PCOS (n = 41) and group 3 Obese PCOS (n = 16). All of the subjects completed FSFI questionnaire. In patients who had insulin resistance (OGTT + IRI) metformin treatment was started in dose 1700 3000 mg/day. Results: Obese women without PCOS showed significantly higher scores on total FSFI and all domains except from desire compared to lean PCOS subjects. Although the differences do not reach statistical significance, lean PCOS patients have the lowest scores on all domains. FSFI score correlates negatively only with androstendione levels. Women with and without hyperandrogenemia do not show differences in FSFI score. It is interesting to note that LH but not FSH shows moderate positive correlation to all domains of FSFI. FSFI scores do not show correlation to the indices of carbohydrate metabolism (blood glucose and IRI during OGTT), lipid profile, and arterial pressure. After metformin treatment there was an increase in all FSFI domain scores although statistical significance was noted only for the total FSFI score and the domains lubrication and pain, probably because of the small number of patients. Conclusions: Lean PCOS patients have lower scores on FSFI than obese patients with or without PCOS. The hyperandrogenemia is not a determinant for sexual dysfunction in PCOS women. Metformin treatment has a favorable effect on sexual function.