Body image and its relationships with sexual functioning, anxiety, and depression in women with polycystic ovary syndrome

•Women with PCOS show anxiety, depression, and sexual dysfunction.•Anxiety, depression, sexual dysfunction and body image show solid associations.•The depression increases with degree higher body dissatisfaction.•Dissatisfaction body is considered risk factors for sexual dysfunction. Polycystic ovary syndrome (PCOS) is associated with lower levels of satisfaction with body image, which can affect sexuality and social well-being. Thus, we evaluated body image in women with PCOS and its association with body dis(satisfaction), anthropometric indices, sexual function, anxiety, and depression. In this cross-sectional study, 94 women of reproductive age were grouped by body mass index (BMI) and sexual function. The Female Sexual Function Index (FSFI), Body Shape Questionnaire (BSQ), Figure Rating Scale (FRS), hospital anxiety (HADS-A) and depression (HADS-D) measurement scales, and anthropometric indices were used for data collection. Women with PCOS presented with perceptual distortions of self-image independent of sexual function and BMI. There were negative correlations between HADS-A and HADS-D scores and the FSFI total score, and HADS-D scores had positive correlations with weight, anthropometric indices, and BSQ total score. The degree of dis(satisfaction) was a predictor of FSFI total score, depression, and anxiety, and the FSFI total score was predicted by HADS-D. Desired and ideal-gender BMIs were risk factors for sexual dysfunction, and overweight and obesity were risk factors for the degree of dis(satisfaction). This study had the limitations of using a cross-sectional design and it investigated a restricted number of clinical/biochemical parameters, as well as lacked objective measures of acne and hirsutism, and a control group. Perception and cognitive-affective dimensions appear to play important roles in body image dysfunction in women with PCOS, and impact sexual dysfunction and depression associated the syndrome. Furthermore, these results provide additional treatment considerations for women with PCOS.