Associations of hirsutism and sexual function with mental health–related quality of life in women with polyendocrine metabolic ovarian syndrome

Polyendocrine metabolic ovarian syndrome (PMOS), formerly termed polycystic ovary syndrome (PCOS), is a complex endocrine-metabolic condition with reproductive and psychosocial consequences. Hirsutism is among its most visible and distressing manifestations, yet the relationship among hirsutism, sexual function, and mental health–related quality of life (HRQoL) remains incompletely understood. This single-center cross-sectional study included 118 women aged 18–45 years with a newly identified diagnosis of PMOS at a tertiary gynecology outpatient clinic. Written informed consent was obtained before data collection, and all questionnaires were completed before participants were informed of the diagnosis. The SF-36 Mental Health (MH) domain was the prespecified primary outcome. Sexual function (FSFI), depressive symptoms (BDI), anxiety symptoms (BAI), and clinical and psychosocial covariates were assessed. Multivariable linear regression with robust standard errors was used. The FSFI-inclusive analysis was restricted to participants with evaluable FSFI data and was considered secondary and exploratory. The mean age was 24.01 ± 5.25 years, and the median BMI was 26.0 kg/m2 (IQR 21.5–29.9). Hirsutism was present in 61.0% of participants. In the primary model (n = 118), hirsutism was associated with a 7.21-point lower SF-36 MH score (95% CI − 13.01 to − 1.42; p = 0.015). Evaluable FSFI data were available for 88 participants. In this subgroup, higher FSFI total score was associated with higher MH score (β = 0.57; 95% CI 0.15 to 0.99; p = 0.008). Because the models were fitted in different analytic samples and the study was cross-sectional, the observed change in the hirsutism coefficient after FSFI inclusion cannot establish mediation or temporal direction. Hirsutism and sexual function were associated with mental health–related HRQoL in women with newly identified PMOS. These findings highlight sexual health as a clinically relevant assessment domain but require confirmation in larger, longitudinal, multicenter studies.