PCOS, or polycystic ovary syndrome, is a common condition that affects about one-in-ten people born with ovaries.
Although PCOS is common, it’s also a little bit of a mystery. Even now the cause of PCOS is unknown and the symptoms of it vary so much that it can be difficult to diagnose, let alone manage.
While many people live very happy lives with PCOS, there’s no denying that it can have an effect on your sex and dating life.
In this article we’ll discuss the ins and outs of PCOS. We’ll go over what it is, what to do if you think you have it, how to support a loved one who has PCOS, and we’ll offer some tips on how to navigate sex and dating with PCOS.
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While the cause of PCOS is unknown, there are some common theories about what causes it and where it comes from.
The Jean Hailes Centre suggests that PCOS is caused by hormones. They write that increased levels of insulin in the body can cause the ovaries to function differently, which in turn increases levels of androgen hormones. These hormones can cause a lot of symptoms common to PCOS.
To diagnose PCOS, a person often must meet two of the following three criteria:
- They must have irregular or no periods
- They must have elevated androgen levels
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They must have at least 20 partly-formed eggs per ovary, which can be seen on an ultrasound
As you might imagine, some people find it really difficult to get a diagnosis of PCOS. Testing for the criteria can be time-consuming, and finding a doctor to hear your concerns and guide you through the diagnosis process can be tricky too.
There’s also the fact that PCOS can be accompanied by a whole range of symptoms, not all of which are things that we may recognise as being out of the ordinary or a ‘problem’. Some of those symptoms include:
- Acne and oily skin
- Excess body hair
- Thinning hair
- Weight gain, or difficulty losing weight
- Rough and dark patches of skin on the body
- Difficulty getting pregnant
- Low energy levels
- Depression, anxiety, and irregular moods
A lot of people—particularly those assigned female at birth—are raised to believe that many of these things are ‘just a part of life’. Many of us will probably experience one or even a few of them at some point, but for those with PCOS they can be long-lasting, severe, and seem to have no root cause.
If you feel that your experiences line up with the symptoms of PCOS, we recommend speaking with your doctor or finding a doctor who specialises in the diagnosis of PCOS. PCOS support groups online or in-person may be able to help with a recommendation here!
Although PCOS can’t be ‘cured’, the symptoms of it can be treated, managed, and reduced. Some common ways to manage PCOS include using hormonal contraception, taking medications to reduce insulin and/or androgens, using cosmetic treatments for hair loss and acne reduction, and making lifestyle changes. Not all of these treatments will be right for everyone, so it’s important to speak with a medical professional to find the best treatments for you.
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PCOS can also impact your desire for sex, and many report they want sex less than they’d like. The effect PCOS can have on your periods, mental health, and self-esteem can also affect your sex and dating life indirectly.
Lots of people with PCOS do have fulfilling and exciting sexual and romantic lives, but a lot of people have to put in some intentional work. Here are some tried-and-true tips for partners of those with PCOS…and those who themselves have PCOS.
If your partner has PCOS…
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Make an effort to understand their experience. Living with PCOS can be frustrating, scary, disappointing, and difficult. You don’t need to be an expert in their experience, but you can try to understand, ask questions, get curious and try to empathise with your partner as much as possible.
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Offer to attend some medical appointments with your partner. They might be happy to go solo, but they could also want someone there to support them, take notes, and help organise follow-up visits.
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Lean in to lifestyle changes together. Some people find that making lifestyle changes can help reduce the symptoms of PCOS. If your partner is keen to get active or change their diet, make it a team effort as much as you can. Do it together, take the reins, and help make it a part of your shared life to prove their health isn’t a burden.
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Be open to different kinds of sex. Sometimes the symptoms associated with PCOS can mean that penetrative sex is off the table. Keep an open mind to trying out different forms of intimacy with your partner, whether it’s foreplay, mutual masturbation, sexting and dirty talk, or using toys together.
- Remember that desire is a relational experience, not an individual problem. Many people with PCOS feel pressure to “fix” their desire, but desire is co-created between partners and shaped by emotional safety, connection, and reduced pressure. Framing one person as the problem misses the bigger picture, because there is often a lot both partners can do together. If therapy is an option, attending as a couple can help shift desire from an individual burden to a shared exploration. Try to be the one setting clear limits (your partner may be exhausted by being the one who always has to say no), like, “I don’t want to have sex tonight, but I do want to feel connected, so let’s just (kiss / have a shower together / use toys…)”. This is important as it allows desire to grow without pressure.
If you have PCOS…
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Track your symptoms. The symptoms of PCOS can be numerous and ever-changing, so we recommend keeping a symptom journal (even if it’s just in the Notes app on your phone). This can help you track changes over time, and can serve as a handy reminder in your next medical appointment.
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Remember it may take a few tries to find the right doctor. It sucks, and it’s so exhausting - but remember you are not broken and you are not the problem! Some doctors simply aren’t as educated about PCOS as they could be. Keep trying—you deserve to be heard and taken seriously.
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Remember that you don’t have to change your appearance unless you want to. PCOS can impact a person’s appearance, causing things like acne, excess hair, and thinning hair. You might choose to address some of these symptoms - but you can also totally choose to embrace them! There’s no ‘right’ way to look, and you don’t have to remove excess hair or hide thinning hair unless you really want to.
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Explore new forms of pleasure. As we know, penetrative sex can be uncomfortable or painful with PCOS, so think about whether you’d like to explore other types of pleasure like solo play, outercourse, or experimenting with toys.
- Find new pathways to pleasure. If you’re struggling with low desire, it's worth noting that your desire for sex may not always be spontaneous or constant. Focus on what helps you feel safe, relaxed, and connected in your body; communicate your needs and limits clearly, and allow desire to emerge in its own time. Often it’s useful to take sex off the cards and come back to what is possible. You could try connecting with your own body sexually everyday for a few minutes, sensually rubbing in moisturiser, listening to erotica, thinking about sex, or self-touch. When sex isn't in front of mind, we need to intentionally bring it to the front of mind in low stakes ways.
