Effect of individualized lifestyle intervention on sexual function in obese patients with polycystic ovary syndrome

doi:10.3969/j.issn.1006-7795.2025.04.005

Abstract

Abstract: Objective To investigate the effect of individualized lifestyle intervention on sexual function in obese patients with polycystic ovarian syndrome (PCOS). Methods The study was conducted on obese patients with PCOS in the Department of Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University from October 2022 to December 2023. There were 160 cases in both the experimental group and the control group, progesterone was administered to both groups for 3 months to regulate menstruation. For women in the experimental group received individualized comprehensive lifestyle intervention combining diet, exercise, and behavior modifications, along with dedicated follow-up and weight management. The control group received routine clinical education for lifestyle intervention aimed at weight loss. Female Sexual Function Index (FSFI) and 12-item Short-Form Health Survey (SF-12) scale were applied to evaluate the sexual function and quality of life. The clinical data that may affect sexual function were collected and sex hormone levels were measured, including anthropometric indicators, estradiol, sex hormone-binding globulin, total testosterone, bioactive testosterone, and dehydroepiandrosterone sulfate in serum. Results After 3 months of intervention, the body mass index, waist circumference, body fat percentage, insulin resistance index, total testosterone, bioactive testosterone and dehydroepiandrosterone sulfate in experimental groups were significantly lower（P<0.05）, and the sex hormone binding globulin level was significantly higher (P<0.001), compared with the control group. SF-12 mental health scores, FSFI total scores, sexual desire, orgasm and sexual satisfaction scores were significantly increased in experimental groups (P<0.05), however, there were no significant differences in SF-12 physical health scores, as well as the scores of sexual arousal, vaginal lubrication, and coital pain. Conclusions Individualized lifestyle intervention can better improve the sexual function and mental health of obese patients with PCOS.

Key words: polycystic ovary syndrome, lifestyle intervention, individuation, obese, sexual function, sexual dysfunction

CLC Number:

R711. 7

Tian Xuanxuan, Ruan Xiangyan, Zhao Yue, Jin Jing, Liu Shunyu, Jiang Lingling. Effect of individualized lifestyle intervention on sexual function in obese patients with polycystic ovary syndrome[J]. Journal of Capital Medical University, 2025, 46(4): 614-619.

References

［1］Ercan C M, Coksuer H, Aydogan U, et al. Sexual dysfunction assessment and hormonal correlations in patients with polycystic ovary syndrome［J］. Int J Impot Res, 2013, 25(4): 127－132.
［2］Naumova I, Castelo-Branco C, Kasterina I, et al. Quality of life in infertile women with polycystic ovary syndrome: a comparative study［J］. Reprod Sci, 2021, 28(7): 1901－1909.
［3］Pastoor H, Both S, Laan E, et al. Sexual dysfunction in women with PCOS: a case control study［J］. Hum Reprod, 2023, 38(11): 2230－2238.
［4］Tian X, Ruan X, Du J, et al. Sexual function in Chinese women with polycystic ovary syndrome and correlation with clinical and biochemical characteristics［J］. Reprod Sci, 2021, 28(11): 3181－3192.
［5］Pastoor H, Timman R, de Klerk C, et al. Sexual function in women with polycystic ovary syndrome: a systematic review and meta-analysis［J］. Hum Reprod Update, 2024, 30(3): 323－340.
［6］中华医学会妇产科学分会内分泌学组及指南专家组. 多囊卵巢综合征中国诊疗指南［J］. 中华妇产科杂志, 2018, 53 (1): 2－6.
［7］多囊卵巢综合征诊治路径专家共识编写组. 多囊卵巢综合征诊治路径专家共识［J］. 中华生殖与避孕杂, 2023, 43(4): 337－345.
［8］Rotterdam ESHRE/ASRM-Sponsored PCOS consensus workshop group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS)［J］. Hum Reprod, 2004, 19(1): 41－ 47.
［9］Wiegel M, Meston C, Rosen R. The Female Sexual Function Index (FSFI): cross-validation and development of clinical cutoff scores［J］. J Sex Marital Ther, 2005, 31(1): 1－20.
［10］Du J, Ruan X, Gu M, et al. Prevalence of and risk factors for sexual dysfunction in young Chinese women according to the Female Sexual Function Index: an internet-based survey［J］. Eur J Contracept Reprod Health Care, 2016, 21(3): 259－263.
［11］Zsoldos M, Pajor A, Pusztafalvi H. Relation between sexual dysfunction and metabolic syndrome［J］. Orv Hetil, 2019, 160(3): 98－103.
［12］Hashemi S, Tehrani F, Farahmand M, et al. Association of PCOS and its clinical signs with sexual function among Iranian women affected by PCOS［J］. J Sex Med, 2014, 11(10): 2508－2514.
［13］Mojahed B S, Ghajarzadeh M, Khammar R, et al. Depression sexual function and sexual quality of life in women with polycystic ovary syndrome (PCOS) and healthy subjects［J］. J Ovarian Res, 2023, 16(1): 105.
［14］Daneshfar Z, Sadatmahalleh I S, Jahangiri N. Comparison of sexual function in infertile women with polycystic ovary syndrome and endometriosis a crosssectional study［J］. Int J Reprod Biomed, 2022, 20(9): 761－768.
［15］Kogure G S, Ribeiro V B, Lopes I P, et al. Body image and its relationships with sexual functioning, anxiety, and depression in women with polycystic ovary syndrome［J］. J Affect Disord, 2019, 253: 385－393.
［16］Sarwer D B, Hanson A J, Voeller J, et al. Obesity and sexual functioning［J］. Curr Obes Rep, 2018, 7(4): 301－307.
［17］Sarwer D B, Wadden T A, Spitzer J C, et al. 4-year changes in sex hormones, sexual functioning, and psychosocial status in women who underwent bariatric surgery［J］. Obes Surg, 2018, 28(4): 892－899.
［18］Steffen K J, King W C, White G E, et al. Changes in sexual functioning in women and men in the 5 years after bariatric surgery［J］. JAMA Surg, 2019, 154(6): 487－498.
［19］Tian X, Ruan X, Du J, et al. Sexual function in Chinese women with different clinical phenotypes of polycystic ovary syndrome［J］. Gynecol Endocrinol, 2023, 39(1): 2221736.
［20］Kowalczyk R, Skrzypulec-Plinta V, Nowosielski K, et al. Sexuality in women with polycystic ovary syndrome［J］. Ginekol Pol, 2015, 86(2): 100－106.
［21］田玄玄，阮祥燕，金婧, 等. 多囊卵巢综合征患者不同临床表型的性功能分析［J］. 首都医科大学学报, 2024, 45(4): 616－622.
［22］Amiri M, Kabir A, Nahidi F, et al. Effects of combined oral contraceptives on the clinical and biochemical parameters of hyperandrogenism in patients with polycystic ovary syndrome: a systematic review and meta-analysis［J］. Eur J Contracept Reprod Health Care, 2018, 23(1): 64－77.

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