PRT and the Sexual Function of Women with Polycystic Ovary Syndrome (POS)

Lúcia Alves Silva Lara MD, PhD; Fabiene Karine Piccki Ramos MS; Gislaine Satiko Kogure MS; Rafael Silva Costa MS; Marcos Felipe Silva de Sá MD, PhD; Rui Alberto Ferriani MD, PhD; and Rosana Maria dos Reis MD, PhD

ONLINE: May 18, 2015 – The Journal of Sexual Medicine

DOI: 10.1111/jsm.12909            


Estimated to affect between 5% and 10% of the fertile female population, polycystic ovary syndrome (PCOS) is characterized by hirsutism, acne, and obesity, among other symptoms. Women with PCOS have a “virilized” appearance, which can lead to poor self-image and reduced self-esteem. Overweight/obesity and depression are also common in women with PCOS.

Past studies have shown that physical resistance training (PRT) can benefit the health of women with PCOS, but until this study, there was little research on PRT’s effects on sexual functioning. The present study investigated this angle.


Ninety-four women between the ages of 18 and 37 participated in the study. Forty-three had PCOS (mean age 27.80). The remaining 51 women served as the control group (mean age 29.74). All of the women were sedentary, did not take hormones, and had a body mass index (BMI) of 18 – 39.9 kg /m2.

Before the PRT protocol began, the women were screened for diseases that could affect their ability to exercise. They were also taught the resistance exercises for two weeks. Instruction included the technical moves, correct posture, proper breathing, and the sequence of exercises.

Participants underwent the PRT protocol in pairs under the supervision of physical educators.  The protocol included four microcycles lasting four weeks each.
Each session began with muscle stretching. Next, at the apparatus, one muscle group was exercised at a time. The protocol included bench press, extensor bench, and biceps curl, and other exercises.

Two outcome measures were used at baseline and at the end of the PRT protocol (16 weeks):

Female Sexual Function Index (FSFI). This assessment evaluates sexual activity from the previous four weeks in the following domains: desire, excitement, lubrication, orgasm, satisfaction, and pain. Women whose scores are less than or equal to 26.55 are at risk for sexual dysfunction.

Hospital Anxiety and Depression Scale (HAD). Scores of ≥8 indicated risk for anxiety; scores of ≥9 indicated risk for depression.


FSFI Scores

At baseline, the FSFI total and domain scores were similar for both groups.

For the women with PCOS, the number of women with FSFI scores below or equal to 26.55 (indicating sexual dysfunction) dropped from 30 to 24 after 16 weeks. In the control group, the number decreased from 32 to 27.

Women with PCOS saw improvements on the desire, excitement, lubrication, and pain subscales of the FSFI.

Control group women had better scores on the pain domain after 16 weeks compared to baseline.

For the desire domain, women in the PCOS group had more improvement than those in the control group.

The HAD results were as follows:

  At Risk for Depression At Risk for Anxiety
PCOS Women at Baseline 15 19
PCOS Women After PRT 5 10
Control Women at Baseline 15 18
Control Women after PRT 11 15

In both groups, mean HAD scores dropped significantly for both depression and anxiety.


These results show that sexual function improved for women with PCOS, particularly on the desire, arousal, and lubrication domains. Both groups had reduced sexual pain and less depression and anxiety after PRT.

Better body shape after PRT, along with some relief from depression and anxiety, may have played an important role in sexual function improvements.

The authors acknowledged some limitations. Some factors, such as relationship status and subjective distress toward sexual activity, were not considered. The setup of the study (exercising in groups, supervision, and expected positive outcomes) could also have affected the results.

“Our results confirm an important role of physical therapy in promoting mental health and better sexual function, especially in PCOS women,” the authors wrote.

They added, “These preliminary promising results of PRT on sexual function should encourage health care professionals to consider PRT as a useful intervention in assisting health care protocols for PCOS women.”

Further research is needed to confirm these findings and to determine what type of PRT is most effective in improving the sexual function of women with PCOS.