So what support can you get if you have PCOS, low sexual desire, but high desire to get pregnant? Here’s your lowdown.
What is PCOS?
PCOS is a metabolic disorder that affects women’s hormonal health. One in every eight to ten women is thought to have this condition.
Scientists think it is caused by underlying issues such as:
- Genetic factors – PCOS tends to run in families.
- Insulin resistance – insulin is a hormone that controls your blood sugar levels. If you are resistant to it, your body has to produce more, which can increase the amount of testosterone your ovaries produce, and cause weight gain.
- Testosterone – higher sensitivity to, or raised levels of the ‘male’ hormone that women need in much smaller amounts.
It can bring about symptoms including irregular or no periods, weight gain, acne, excess face and body hair, thinning hair and depression. It also increases some long-term risks like diabetes and heart health.
“PCOS can also have a knock-on effect on fertility because hormone changes affect ovulation.”
How does PCOS affect sexual desire?
Scientists are still looking at PCOS and sexual function to find out why low sexual desire is common for women with the condition. There have been a lot of mixed findings and contradictions because PCOS seems to be very individual. The two main theories are:
- The hormonal changes, including higher sensitivity to testosterone or higher levels of it, can affect sex drive and desire. For some women there is a link with higher sex drive, arousal and satisfaction, but for many there doesn’t appear to be, or it can even have a negative impact.
- The psychology of sexual desire and satisfaction – our thoughts and feelings about sex are a huge influence on how we experience desire:
- For many women with PCOS, there are self-esteem and body image issues linked with symptoms like excess hair, weight gain, and fertility problems. There is some research that looked at the signs of higher testosterone such as excess body hair and acne and found lower sex drive, arousal and satisfaction in women with those symptoms despite the theory that testosterone might increase sex drive.
- The link between low mood and low libido – when women with PCOS are up to 8 times more likely to have depression due to a mix of hormonal changes and insulin resistance, low self-esteem, and societal pressures around fertility success.
- The stress of trying to get pregnant if it’s taking a long time or you need treatments to help, is one of the things that can affect sex drive, too.
What can help with PCOS desire and fertility?
There are some key steps you can take to get support on your PCOS journey.
Support from other women with PCOS
Talking to women with PCOS who have been through the same feelings and challenges is a great way to reduce feelings of isolation or failure, and discover how they manage or overcome these issues, too.
The PCOS charity, Verity, has social channels and groups, local in-person support groups and events.
Support from yourself: PCOS body acceptance
See if you can introduce some body acceptance into your daily routines – it’s been shown to help improve self-esteem and sexual satisfaction.
- Focus on what your body can do for you – consider a daily thank-you to your body for helping you laugh, smile, walk around, do your job, travel to new places, enjoy reading, appreciate the warmth of the sun on your skin, whatever it is.
- Keep a top 10 list of things you like about yourself – and compliments your partner gives you.
- Note when you give yourself negative self talk, especially relating to PCOS, your body image, your self-esteem. How can you pause, and say no thank-you to these thoughts?
- Ask yourself, “What impact does this thought have on my mood and my life?” How does it impact your relationships? How does it impact your sense of contentment and satisfaction?
- Ask yourself, “In what ways is this thought unrealistic, inaccurate, or inflexible? What is the evidence for and against your thought? Is it possible others may think differently than you do about your body/appearance?
- Remind yourself that many social media images and videos are unrealistic and edited with tools that turn people into something they’re not.
CBT for PCOS
One 2024 piece of research showed Cognitive Behavioral Therapy (CBT) can help women with PCOS improve self-esteem, body image and depression. And a review of research showed it has promise for depression in PCOS, too.
- Talk to your GP about getting referred or refer yourself using the NHS Talking Therapies portal.
Manage your PCOS to boost fertility and self esteem
Getting a treatment plan together that helps manage your symptoms and any weight gain can help improve fertility as well as self-esteem.
PCOS control: sleep, food, exercise – and flossing!
Getting the basics in place can have big benefits specifically for PCOS symptoms.
- Good quality sleep improves insulin resistance – and so does regularly cleaning and flossing your teeth by reducing inflammation caused by bleeding gums!
- Regular aerobic exercise improves insulin resistance, and strength training – plus possibly yoga – can reduce testosterone levels in the blood. Physical activity has also been shown to improve mental health, self esteem, sleep quality, mood and energy as well as reducing stress.
- Healthy eating regular meals and snacks keep blood sugar on an even keel to manage insulin resistance, and provides your body with the nutrients it needs.
Weight loss for PCOS
Losing 5% of your body weight can significantly improve symptoms and fertility for women with PCOS. Yet it can be tough to achieve, given PCOS bodies are designed to store more calories and may also have appetite dysregulation according to some research. If eating healthily and exercising regularly aren’t getting you where you need to be, ask your GP to discuss:
- Referral to a dietitian who is used to helping women with PCOS. You can also find a private dietitian. To check your dietitian is registered, the BDA recommends checking with the health and care professions council.
- Medicines that might help your weight loss – including diabetes drug Metformin, and potential GLP-1s which are being investigated for use in PCOS with some early results showing promise, but with a serious caution about use in pregnancy.
Fertility support for PCOS
Most women with PCOS who want to get pregnant can do so either naturally or with some help:
- If you’re not ovulating regularly you can get a medicine called clomifene prescribed to help with this. If you need further help, your doctor can add in Metformin to help increase the chances of ovulation further.
- There are also options with drugs called gonadotrophins to help more eggs develop, a surgery called laparoscopic ovarian drilling (LOD), and In vitro fertilisation (IVF).
