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Cecilia Lundin Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden

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Agota Malmborg Obstetrics and Gynaecology, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden

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Julia Slezak Clinical Chemistry, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden

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Kristina Gemzell Danielsson Department of Women’s and Children’s Health, Karolinska Institutet, and Karolinska University Hospital, Stockholm, Sweden

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Marie Bixo Department of Clinical Science, Obstetrics and Gynaecology, Umeå University, Umeå, Sweden

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Hanna Bengtsdotter Department of Obstetrics and Gynaecology, Örebro University, Örebro, Sweden

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Lena Marions Department of Clinical Science and Education, Karolinska Institutet Södersjukhuset, Stockholm, Sweden

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Ingela Lindh Department of Obstetrics and Gynaecology, Sahlgrenska Academy at Gothenburg University, Sahlgrenska University Hospital, Gothenburg, Sweden

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Elvar Theodorsson Clinical Chemistry, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden

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Mats Hammar Obstetrics and Gynaecology, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden

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Inger Sundström-Poromaa Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden

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COC users report decreased sexual desire ( 2 ). At present, despite the bulk of literature, only two randomised placebo-controlled trials have investigated the causal influence of COCs on sexual function ( 3 , 4 ). Both of these studies evaluated a

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Anastasia K Armeni Division of Reproductive Endocrinology, Department of Obstetrics and Gynaecology, University of Patras Medical School, Patras, Greece

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Konstantinos Assimakopoulos Department of Psychiatry, University of Patras Medical School, Patras, Greece

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Dimitra Marioli Division of Reproductive Endocrinology, Department of Obstetrics and Gynaecology, University of Patras Medical School, Patras, Greece

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Vassiliki Koika Division of Reproductive Endocrinology, Department of Obstetrics and Gynaecology, University of Patras Medical School, Patras, Greece

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Euthychia Michaelidou Department of Biology, University of Patras, Patras, Greece

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Niki Mourtzi Department of Biology, University of Patras, Patras, Greece

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Gregoris Iconomou Department of Psychiatry, University of Patras Medical School, Patras, Greece

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Neoklis A Georgopoulos Division of Reproductive Endocrinology, Department of Obstetrics and Gynaecology, University of Patras Medical School, Patras, Greece

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Introduction Over the past decades, research attention has been increasingly paid to the examination of the neurobio­logical component of sexual function. Female sexual desire and arousal have been shown to have a heritable component of

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M Jensterle Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia

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A Podbregar University Rehabilitation Institute Republic of Slovenia, Ljubljana, Slovenia

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K Goricar University of Ljubljana, Faculty of Medicine, Institute of Biochemistry, Pharmacogenetics Laboratory, Ljubljana, Slovenia

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N Gregoric Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia

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A Janez Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia

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been poor responders to LSM, by means of reversal of FH and WR. The primary outcome measures were changes in testosterone, sexual function and gonadotropins. The secondary outcomes were measures of obesity and metabolic profile. Materials and

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Kaisu Luiro Department of Obstetrics and Gynecology, Reproductive Medicine Unit, Helsinki University Hospital and University of Helsinki, Helsinki, Finland

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Kristiina Aittomäki Department of Medical Genetics, Helsinki University Hospital, Helsinki, Finland

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Pekka Jousilahti Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland

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Juha S Tapanainen Department of Obstetrics and Gynecology, Reproductive Medicine Unit, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
Department of Obstetrics and Gynecology, University of Oulu and Oulu University Hospital, Medical Research Center, PEDEGO Research Unit, Oulu, Finland

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due to CVD, osteoporosis and fractures. In addition, impairment of cognitive functions, dementia, Parkinsonism, and reduced sexual function and psychological well-being have been reported ( 12 ). Most of the evidence comes from observational studies of

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Meghnaa Hebbar College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom

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Halimah Khalil College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom

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Nawal Zia College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom

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Jameela Sheikh College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom

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Eka Melson University of Leicester, Leicester, United Kingdom

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Meri Davitadze Clinic NeoLab, Tbilisi, Georgia

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Helena Gleeson Department of Endocrinology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom

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Tejal Lathia Apollo Hospitals, Mumbai, India

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Chitra Selvan Department of Endocrinology, M S Ramaiah Medical College, Bengaluru, India

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Punith Kempegowda Clinic NeoLab, Tbilisi, Georgia
Department of Endocrinology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom

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PCOS SEva Working Group
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PCOS SEva Working Group

-related bias ( 16 ). Female Sexual Function Index (FSFI) assesses the domains of sexual function: desire, arousal, lubrication, orgasm, satisfaction, and pain and provides a score regarding sexual function. Total score achievable is 36, a lower FSFI score

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Małgorzata Kałużna Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland

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Agnieszka Nomejko Institute of Psychology, Faculty of Pedagogical and Historical Sciences, University of Wrocław, Wrocław, Poland

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Aleksandra Słowińska Institute of Psychology, Faculty of Pedagogical and Historical Sciences, University of Wrocław, Wrocław, Poland

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Katarzyna Wachowiak-Ochmańska Endocrinology, Metabolism and Internal Diseases Ward, Heliodor Swiecicki University Hospital, Poznan, Poland

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Katarzyna Pikosz Department of Pharmacognosy, Poznan University of Medical Sciences, Poznan, Poland

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Katarzyna Ziemnicka Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland

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Marek Ruchała Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland

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often observed in PCOS women ( 4 , 5 , 6 ). Irregular menstrual cycles, hirsutism, acne, and infertility may aggravate stress and psychological disorders ( 7 , 8 ). PCOS patients deal with biopsychosocial changes that may affect sexual functioning

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Milou Cecilia Madsen Department of Internal Medicine and Center of Expertise on Gender Dysphoria, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands

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Martin den Heijer Department of Internal Medicine and Center of Expertise on Gender Dysphoria, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands

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Claudia Pees Walaeus Library, Leiden University Medical Center, Leiden, the Netherlands

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Nienke R Biermasz Division of Endocrinology, Department of Medicine, Leiden University Medical Center, Leiden, the Netherlands

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Leontine E H Bakker Division of Endocrinology, Department of Medicine, Leiden University Medical Center, Leiden, the Netherlands

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concentrations in serum in the morning on at least two occasions (<10.4 nmol/L) ( 2 , 3 ). Low androgen levels cause morbidity and affect health-related quality of life (HR-QoL) due to infertility, decrease of sexual functions, muscle mass, strength and vitality

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Willem de Ronde Department of Internal Medicine, Spaarne Gasthuis, Haarlem, the Netherlands

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Diederik L Smit Department of Internal Medicine, Spaarne Gasthuis, Haarlem, the Netherlands

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testosterone to oestradiol is vital to reach and maintain bone mass, and the long-term effects of SERM administration on bone health in hypo- or eugonadal men have not been established. Also, there is evidence that sexual function in men depends on the combined

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Shota Dzemaili University of Lausanne, Institute of Higher Education and Research in Healthcare, Lausanne, Switzerland

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Jitske Tiemensma University of California Merced, Psychological Science, Merced, CA, USA

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Richard Quinton Department of Endocrinology, Institute for Human Genetics, University of Newcastle-upon-Tyne, Newcastle-upon-Tyne, United Kingdom

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Nelly Pitteloud Endocrinology, Diabetes & Metabolism Service of the Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland

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Diane Morin University of Lausanne, Institute of Higher Education and Research in Healthcare, Lausanne, Switzerland
Faculty of Nursing Science, Laval University, Québec City, Canada

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Andrew A Dwyer University of Lausanne, Institute of Higher Education and Research in Healthcare, Lausanne, Switzerland
Endocrinology, Diabetes & Metabolism Service of the Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland

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types of congenital hypogonadism (14 with CHH, 7 with 46XX gonadal dysgenesis) whose SF-36 scores were quite similar. A subset of these patients completed the Female Sexual Function Index revealing impaired sexual desire, arousal, lubrication, orgasm and

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Diana-Alexandra Ertl Department of Pulmonology, Allergology and Endocrinology, University Clinic for Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria

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Andreas Gleiss Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria

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Katharina Schubert Department of Pulmonology, Allergology and Endocrinology, University Clinic for Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria

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Caroline Culen Department of Pulmonology, Allergology and Endocrinology, University Clinic for Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria

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Peer Hauck Pediatric Heart Center Vienna, University Clinic for Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria

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Johannes Ott Clinic Division for Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, Vienna, Austria

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Alois Gessl Division of Endocrinology, University Clinic of Internal Medicine III, Medical University of Vienna, Vienna, Austria

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Gabriele Haeusler Department of Pulmonology, Allergology and Endocrinology, University Clinic for Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria

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’s syndrome . In Growth, Stature and Psychological Well-Being , pp 95 – 103 . Eds Eiholzer U , Haverkamp F & Voss LD . Seattle, WA, USA : Hogrefe & Huber , 1999 . 21 Pavlidis K McCauley E Sybert VP. Psychosocial and sexual functioning in women

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