Abstract
BACKGROUND: Premature ovarian insufficiency (POI) and polycystic ovary syndrome (PCOS) are common reproductive disorders that negatively affect women's sexual and psychological health. AIM: This study aims to compare sexual function and psychological well-being in women with POI, PCOS, and healthy controls. METHODS: A total of 340 women were recruited: 68 with POI, 104 with PCOS, and 168 healthy controls. Participants completed standardized questionnaires assessing sexual function (Female Sexual Function Index, FSFI), anxiety (Generalized Anxiety Disorder-7 [GAD-7]), and depression (Patient Health Questionnaire-9 [PHQ-9]). Descriptive statistics, Chi-square tests, and multivariable logistic regression were used to analyze the data. OUTCOMES: The primary outcomes included sexual function, assessed via FSFI total and domain scores (desire, arousal, lubrication, orgasm, satisfaction, and pain), and psychological well-being, evaluated through GAD-7 and PHQ-9 scores. RESULTS: Women with POI and PCOS exhibited significantly lower FSFI total scores compared to controls (POI: 26.00 ± 3.50, PCOS: 26.13 ± 4.50, controls: 27.37 ± 3.24; P < 0.01). Women with POI had significantly lower scores in the arousal (3.83 ± 0.87) and satisfaction (4.44 ± 0.84) domains, while those with PCOS had significantly lower lubrication (4.92 ± 0.97) and arousal (3.92 ± 1.01) scores compared to controls (all P < 0.05). The prevalence of anxiety and depression were significantly higher in the POI and PCOS groups than in controls (P < 0.05). Multivariable logistic regression analysis demonstrated that POI was independently associated with a higher risk of coital pain (OR: 3.14, 95% CI: 1.19-8.26, P < 0.05) and lubrication disorder (OR: 4.93, 95% CI: 1.88-12.92, P < 0.05). Additionally, PCOS was independently linked to a significantly increased risk of lubrication disorder (OR: 8.57, 95% CI: 1.95-37.57, P < 0.05). Psychological factors, particularly anxiety and depression, were significant contributors to sexual dysfunction (all P < 0.05). CLINICAL IMPLICATIONS: Women with POI and PCOS require a comprehensive approach to care, addressing both sexual and psychological health to improve clinical outcomes. STRENGTHS AND LIMITATIONS: Strengths include a relatively large sample size and a comprehensive assessment of sexual and psychological health. Limitations include the case-control design and lack of long-term follow-up. CONCLUSION: POI and PCOS are significantly associated with sexual dysfunction and psychological distress, underscoring the need for integrated healthcare strategies to improve overall well-being.