Painful sex and low desire: what the studies show
Evidence last assessed 2026-10-14.
In short
- What the research shows
- Arousal, lubrication and satisfaction score lower on average; studies disagree on pain and desire.
- What it doesn't show
- The differences are small and vary between studies; they do not describe any one woman.
- PMOS
- Sexual health
- Pelvic pain
See studies and method
What the evidence says
Two reviews comparing women with and without the condition both found arousal, lubrication, orgasm and satisfaction lower on average. The differences are small and vary a lot between studies. On pain and desire the evidence disagrees: a 2018 review found no difference, and a larger 2025 review found both slightly worse with the condition. Either way, painful sex is never something to accept as normal. And low desire is not a fixed state: desire moves with mood, medication, relationship and cycle, it can be worked with, and a woman whose desire is low is not broken.
Two reviews pool studies of sexual function in women with and without the condition. The 2018 review (18 studies, 3,903 participants) found small impairments in arousal, lubrication, orgasm, satisfaction and the total score, and no difference in desire or pain. The 2025 review (40 studies) found worse scores in every domain, including desire and pain (meaning more pain), with very high variation between studies. The causes of painful sex (from too little arousal time and lubrication, infection or skin conditions, to pelvic floor tension and endometriosis, which specifically causes deep pain with sex) are questions for a clinician, and answerable. Desire deserves its own sentence: low or fluctuating desire is common and rarely asked about in ordinary care, and it can be worked with.
What this does not show
The studies disagree on pain and desire: the 2018 review found no difference, the 2025 review found both slightly worse with the condition, and neither answer is settled. The differences are small and vary a lot between studies; an average says nothing about you. Questionnaires are self-reported and culturally loaded, and women who avoid sex because of pain drop out of the pain scores, which can flatter the comparison. The list of possible causes is general clinical guidance, not a finding of these studies; it names causes so you can raise them with a doctor, and it is not a diagnosis. And if sex hurts because it is unwanted or unsafe, that is not a medical workup question. You deserve support, not a test list.
Sources, as Neta holds them
Pastoor H, Timman R, de Klerk C, Bramer WM, Laan ETM, Laven JSE. Sexual function in women with polycystic ovary syndrome: a systematic review and meta-analysis. Reprod Biomed Online. 2018;37(6):750-60. doi:10.1016/j.rbmo.2018.09.010
Systematic review · 3,903 participants
Bachega FS, Turri JAO, Baracat MCP, et al. New comprehension on polycystic ovary syndrome and sexual function: a systematic review and meta-analysis. J Sex Med. 2025;22(9):1612-28. doi:10.1093/jsxmed/qdaf163
Systematic review