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Everything You Should Know About PCOS and Sex Drive

Sex and PCOS: The two are not mutually exclusive. In fact, women with PCOS can actually have great sex. It just may take a little work ahead of time.

Polycystic Ovary Syndrome, or PCOS, is a common condition that affects about 1 in 10 women and manifests itself through a series of undesirable side effects. Think: everything from irregular periods to weight gain to unwanted hair growth to infertility. Luckily, there are treatments for the symptoms, including hormonal medications, electrolysis, and meal plans, as well as helpful tips and tricks for living your best life while living with PCOS.

Of course, living your best life means taking care of your mental, physical, and emotional health, so diet, exercise, meditation, and the like are required for any best life. But it also means tending to your sexual needs and gratifications. Beyond all the healthy-heart and psychological benefits one gets from doing the deed, there’s another reason—a big one—for why those with PCOS shouldn’t neglect sex. And we’re just going to say it: Sex should feel good. And you deserve to feel good.

Though the research surrounding sex and PCOS is relatively young, the growing assumption of the effects of PCOS on sex, sexual drive, and sexual satisfaction reveals that women living with PCOS are, well, less than impressed with their sex lives. Reasons for this dissatisfaction can be attributed to a few things—the lack of desire, never achieving climax, pain during sex—and we’ll take a closer look at those issues below. Also below, we’ll explore how to tell your partner you have the condition, how to ask for support in return, and why PCOS is messing with your sex life in the first place.

Why Is PCOS Affecting My Sex Life in the First Place?

Well, in a word: hormones.

As you well know, women with PCOS produce an excess of male hormones, called androgens. It’s these hormones that may be to blame for low sexual satisfaction in women with PCOS. To test this theory, researchers conducted a small study in 2011 (consisting of 88 participants) to determine the clinical and hormonal correlations between patients with PCOS and sexual dysfunction. What they found was that indeed hyperandrogenism (the act of producing too many male hormones) was correlated with the levels of total testosterone, luteinizing hormone, DHEA sulfate, a male hormone produced by the adrenal glands in both men and women.  

Another study, conducted a year later, took their findings a step further and concluded that though women with PCOS may have the same sexual drive as those without the condition, they were lacking in the climax zone. “Women with PCOS had a significantly lower orgasm/completion score compared with women in the control group,” the results said. As for why women with PCOS are having trouble orgasming, doctors remain unsure but point to hormonal imbalances.

But it’s not all about hormones. Negative body image can also play a role.

Beyond science, there are the less-than-desirable aesthetic changes that can accompany PCOS—symptoms that can lead to a negative body image, effectively altering how one feels about slipping between the sheets. Take for instance the hair loss and unwanted growth, the possible weight gain, the acne, the occasional surprise period—all the above can do a number on one’s body, mental state, and overall appearance. So we don’t need a fancy science experiment (but here is one, in case you do) to conclude that PCOS symptoms will likely take a toll on one’s sexual desire, satisfaction, and confidence.

But don’t worry: Romance can most definitely be in your cards. Especially, if you deal with your diagnosis up front with your partner—just laying it out on the table.

How to Tell Your Partner You Have PCOS

Sharing your condition with your partner can feel like another hurdle on a never-ending obstacle course. But it doesn’t have to. You’ve done the right thing so far—you listened to your body, you got diagnosed, and you sought out symptom relief. Now, you just have to talk about it.

Sharing your diagnosis with your romantic partner is important, as the symptoms of the condition might play a role in long-term plans, namely having children. But rather than stress, think about the disclosure as another step in your PCOS journey that will get you closer to your best life—and better sex.

Should all go well, you may even feel comfortable taking your partner to your doctor’s appointments. By not excluding them from your journey, they become educated on the condition and you gain yet another resource for support. But before we run, we must walk. So ahead, we outline out a few suggestions for how to talk to your significant other about your PCOS condition.

1) Be direct, with science. Schedule a time that works for both of you and come prepared. Bookmark a few expert articles detailing PCOS, its symptoms, and its challenges (we have a wealth of content right here at Astrid if you need) and read them together. Share the parts that are specific to your experience, as PCOS is different for everyone, and then give your partner the floor. Let them share their thoughts, be thoughtful about their concerns, and then make a plan together.

2) Keep it lax, with science. Again, carve out a time that works for both of you. Share your diagnosis and how the condition is affecting your health, body, and sex drive. And then offer links to science, research, and medical articles that your partner can read at their leisure. Regroup after they’ve read your suggested materials, and then make that plan for the future.

3) Stick to what you know. Should you feel as though you’re assigning your loved one PCOS homework, you can always just stick to what you know. You’ve been living with PCOS, so you are the pro here. First, explain to your S.O. what exactly PCOS is, how it’s affecting you physically and emotionally, and what you need from your partner. Be as scientific or layman as you prefer with that last part, but definitely be specific—whether that’s moral support during medical appointments or changing your diets together.

Above all, be honest with your lovely. If you’re struggling, a supportive partner can help ease you through your symptoms. If you’re just trucking along nicely and don’t feel the need for support, having another warrior on your team will only help on those inevitable bad days. Plus, sharing your innermost challenges with your partner is a building block to intimacy and long-term romantic success. And who doesn’t want that? 

Why Is Sex Sometimes Painful?

As doctors prefer to do, there is a scientific word for painful sex. It’s called dyspareunia. The possible result of a medical or physical condition, dyspareunia is important to diagnose, as its presence negates the purpose of sexual activity: that it’s supposed to be enjoyable.

Possible causes for dyspareunia in those with PCOS are ovarian cysts, emotional factors, use of certain medications, and more. If painful sex is an isolated incident, there may be no need to worry. But if it’s a regular occurrence, then definitely schedule an appointment with your medical professional to suss out a solution.

Where Do I Go to Get Help?

We’re so glad you asked! It IS possible to enjoy sex with PCOS, and we highly suggest you seek help from experts whom can help guide you through this complex, emotional topic. There are several outlets we recommend when it comes to finding a solution to better sexual health. Try each of them out in turn and decide what is best for you. They include:

  • A trained psychologist

Why see a psychologist?

Therapy can be immensely useful. 

In particular, when it comes to tackling the issue of PCOS and sex drive, a mental health professional can be helpful in navigating any body image struggles, unpacking your relationship to sex, and developing coping mechanisms for any stress, anxiety, or other negative emotions you may be experiencing when it comes to sexual relationships.  

Finding a therapist you click with 

Now, it’s important to point out that not everyone has the resources to speak with a psychologist, depending on your financial situation and where you live. Luckily, the evolution of telehealth means that – even if you live in a rural area, where social and psychological support is underfunded or non-existent – you can still get the help you deserve thanks to online therapy. Consider checking out Better Help, Talkspace, or Teladoc. You can also check with your insurance to see if they cover partial or full treatment for creating a mental health plan with a trusted professional. 

Next, we also want to point out that there are differences between psychologists, psychiatrists, and therapists; psychiatrists are likely to be more expensive, while therapists are likely to be less. Therapists and psychologists are likely to be your best bet, since they focus on ‘talk therapy’ and reframing negative thought patterns (versus psychiatrists which focus on the medical side of mental health issues).  In either case, though, we recommend that you ask any professionals you approach about whether they have a sliding scale system: this means that if you are lower income, you can pay a reduced rate, or in some cases nothing at all.

  • A sex therapist

What is a sex therapist? 

Before we tackle that question, let’s quickly answer: what’s the difference between a regular psychologist and a sex therapist? 

Well, psychologists typically hold a doctorate degree (either a PhD or a psyD), while therapists often hold a Master’s degree, and each have specialties that they focus on. For instance, licensed marriage and family therapists (LMFT) typically focus on – you guessed it! – interpersonal relationships and families, while a licensed clinical social worker (LCSW) may have devoted their clinical practice to helping individuals with eating disorders. 

Sex therapists can hold any of the above post-graduate degrees, and can be a great resource for either an individual or a couple to discuss sexual relationship issues in a neutral, judgement-free space. 

What should you look for in a sex therapist?

Here’s what you should look for in a sex therapist: 

  • A postgraduate degree
    • This can be either a Master’s or a doctorate 
  • State licensure 
    • This means they have completed the clinical hours (aka experience with clients), and passed the exams, necessary to practice in their state 
  • CBT or DBT, or another research-backed therapy 
    • CBT stands for cognitive behavioral therapy, while DBT stands for dialectical behavioral therapy. Both of these approaches prioritize identifying and replacing negative thought patterns, emotional regulation, 
  • A good connection 
    • Finding a good therapist is similar to finding anyone else you want to have a relationship with in your life, in that ideally you should like them. If you get weird or judgemental vibes in your first meeting, simply move on to another therapist on your list. Not all therapists practice the same approach, so invest time in finding the right one for you, based on what you want to get out of this experience. 
  • Your physician

If you’re experiencing pain during sex, you definitely need to schedule an appointment with your healthcare provider as your first point of call. Dyspareunia is the medical term for pain during intercourse and it can be the result of many factors, including PCOS, endometriosis, STDs, ovarian cysts, and so on. For not only peace of mind, but the opportunity to discuss a plan for treatment, you should see a trusted doctor who actively listens to your concerns. 

  •  Support groups

Support groups are an often overlooked, though fantastic, way to tackle the psychological implications of PCOS and its impact on sex drive. Sometimes the ‘side effects’ of PCOS can cause women who struggle with it to feel isolated and alone: afterall, it can be difficult to bring this topic up to someone who doesn’t struggle with the symptoms of PCOS. For that reason, we recommend seeking out online communities of people who: 1) understand what you’re going through; and 2) may have good advice for how to tackle your concerns. 

Looking for a community where you can discuss the issue of PCOS and sex drive freely with people who ‘get it’? The Allara Health community is a great place to start.

To wrap up? Don’t hesitate to reach out for help concerning your sexual health. Remember: an ounce of prevention is worth a pound of cure, so address any concerns you have regarding PCOS and your sex drive (or any other physical or psychological side effects of this condition) sooner rather than later, so you can develop a plan of action allieve your concerns.

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