Abstract
BACKGROUND: Infertility can adversely affect both sexual function and psychological well-being in women. Although physical activity is widely known to benefit overall health, its specific influence on the sexual and mental health of infertile women has not been clearly established. AIM: This study aimed to evaluate the associations between physical exercise frequency, sexual function, and psychological health in sexually active women with infertility. METHODS: A total of 728 infertile women were enrolled from a reproductive medicine center between 2021 and 2024. Participants were stratified into four groups according to self-reported exercise frequency. Sexual function was assessed using the Female Sexual Function Index (FSFI), anxiety with the Generalized Anxiety Disorder-7, depression with the Patient Health Questionnaire-9, and marital satisfaction with the Quality of Marriage Index. Descriptive statistics, chi-square tests, and multivariable logistic regression analyses were conducted. OUTCOMES: The primary outcomes were the FSFI total and domain scores assessing sexual function, along with Generalized Anxiety Disorder-7 and Patient Health Questionnaire-9 scores reflecting psychological well-being. RESULTS: Women who engaged in regular physical activity (≥once a week) had significantly higher FSFI scores than those who did not exercise. However, after adjusting for confounding variables, multivariable logistic regression showed that exercise frequency was not an independent predictor of sexual dysfunction. Significant predictors included longer infertility duration (odds ratio = 1.46, P < .01), lower frequency of sexual activity (odds ratio = 1.12, P = .03), and psychological distress index (odds ratio = 2.27, P < .01). CLINICAL IMPLICATIONS: Lifestyle modifications such as physical activity may support mental and relational well-being, but targeted psychological support is crucial for managing sexual dysfunction in infertile women. STRENGTHS AND LIMITATIONS: Strengths of the study include a large sample size and validated multidimensional assessments. Limitations include its cross-sectional design and reliance on self-reported measures. CONCLUSION: While regular physical activity is associated with better sexual and psychological health in infertile women, it is not an independent predictor of sexual function. Psychological distress, infertility duration, and sexual activity frequency are key determinants, emphasizing the need for integrated biopsychosocial care.