Do you feel sluggish? Still getting acne flare-ups way after they should be over and done with? Growing hair where hair has no right to be growing? And, um ... how’s your sex life? It could be PCOS.

I have PCOS: Polycystic ovary syndrome. Basically, my ovaries look like Swiss cheese (My OBGYN helpfully referred to it as "Swiss cheese syndrome." She may or may not have been joking.) They’re massively enlarged and filled with follicles containing unfertilized eggs that never ruptured during ovulation, and then turned into cysts.

Not all PCOS sufferers will actually have polycystic ovaries (yes, that is kind of confusing), but they do tend to share a set of criteria that normally includes ovarian cysts, because PCOS is a female endocrine disorder. That means it's caused by hormones. And let me tell you, hormones can really mess up your day.

Female Biology 101

Here's a quick lesson in female biology. Our ovaries are supposed to produce:


  • Estrogen (the female hormone)
  • Testosterone (the male hormone), and
  • Progesterone (the pregnancy hormone)

For those who suffer from PCOS, estrogen may be produced in low to normal amounts, while testosterone is produced in excessive amounts. Progesterone, which is normally produced during ovulation, is not produced at all. It's the imbalance in the ratio of estrogen to testosterone that produces many of the symptoms of PCOS.

Doctors aren't sure why some women develop PCOS. For some, it may run in the family. Weight gain can set it off too. And sometimes, there's just no clear reason for why someone suffers from PCOS. But it is fairly common, affecting up to 15 percent of the female population. Of course, the one side-effect few doctors mention is that it can kill your sex drive.

I’ve been lucky to have been spared from some of the common symptoms of PCOS, such as hirsutism and acne, but I spent years in agony not understanding what was happening to my own body - and my sex life.

There are a few reasons why PCOS has this common sexual side effect. First, balanced hormones are vital to your libido, particularly the balance between male and female hormones. Plus, PCOS sufferers may have to deal with things like ruptured cysts; they feel like appendicitis, and are often accompanied by bleeding. Even if you'd like to have sex, it may be too painful. Or at least you'll be afraid enough of possible pain that you'll avoid it. (Get more tips on avoiding pain sex in Illness? Injury? How to Get Back In the Sexual Saddle.)

I get that. This has happened to me more frequently since I had a child and one of my ovaries decided to drop. It’s like they’re engaging in battle with me. My doctor tells me it's now more prone to getting knocked around during sex.

How to Win the Battle With Your Body

I know this sounds pretty grim so far, but hang in there. There are thing you can do to reduce your pain and bring pleasure back to the bedroom. Here are a few things that have worked for me.

Think About Your Timing
The pain associated with PCOS tends to coincide with your cycle. You'll need to take the most care when you're menstruating.


Pick a Pain-Free Position
Experiment with positions to see which ones are most comfortable for you. Generally speaking, avoid being directly on top of your partner - even a slight angle makes a big difference. I don’t know if this goes for everyone, but positions like reverse cowgirl really hurt for me, even at times when the cysts aren’t as bad.


Stick With Soft Toys
Avoid very rigid sex toys, such as glass, wood and metal if playing with a partner. The lack of flexibility in these toys makes them very unforgiving when they hit a sore point.


Lube Up
Use a lot of lubrication. I personally like silicone lube since it doesn’t need to be reapplied, but others prefer water-based lubes. Either way, choose one that's glycerin free. Glycerin can contribute to yeast infections; you don’t need more problems going on down there, trust me! When you’re in pain, or anxious, your vagina won’t lubricate itself as efficiently or effectively - lube can be your best friend in this situation. (For more info on choosing a lube, see The Ins and Outs of Sexual Lubricants.)


Don't Power Through
If you feel any sharp stabbing pains during sex, stop. Don’t power through. That pain will turn into a dull throbbing pain that can stay with you for hours, or even days


Don't Forget Foreplay
Foreplay! It’s great for relaxing your body, and great for reducing pain during sex. Plus, it's fun! (Learn more in 10 Things You Didn't Know About Foreplay.)


Do Orgasm
If you can have an orgasm prior to penetration, it'll greatly reduce any pain you might experience during sex. If you can’t, have no fear - the above suggestions will all help you have better, more pleasurable, less painful sex.

Better Living, Better Loving

Another important aspect here is managing PCOS in your daily life. This will not only improve your sex life, but your quality of life overall, not to mention you future health. Managing weight gain is often a major part of this. The hormone imbalances that cause PCOS also cause your body to be poor at regulating insulin, which makes you more susceptible to weight gain. The weight gain makes the hormone imbalance worse, making weight loss a lot more difficult. The more weight you gain, the more out of control your hormones will be, which will make every symptom you have worse too. For people with mild PCOS, weight loss or management can reverse many of the effects of PCOS, including cyst formation and the subsequent pain that it causes.


And, of course, you should talk to your doctor. There are some treatments to help balance hormones for PCOS sufferers. They can also really help bring your libido back to life.

For a handy guide to both learning about and managing PCOS, its symptoms and even a guide to what you should eat, I’ve found "A Patient’s Guide to Understanding and Reversing Polycystic Ovary Syndrome" to be well written, easy to understand and very helpful.