The relationship between stress, anxiety and depression with sexual function among women with premature ovarian insufficiency in the West of Iran.

INTRODUCTION

Given the prevalence of Primary ovarian insufficiency (POI) in the community and the limited number of studies on the impact of psychological factors on the sexual health of affected women, this study aimed to investigate the relationship between stress, anxiety and depression with sexual function among women with POI in the west of Iran.

METHODS

This cross-sectional study was conducted on 240 women between December 2023 and April 2025. Participants included women with POI undergoing infertility treatment at the Fatemieh Infertility Center, a referral hospital in Hamadan, Iran. Data collection tools included a demographic and laboratory information form, the short form of the Depression, Anxiety, and Stress Scale (DASS-21), and the Female Sexual Function Index (FSFI) questionnaire. Statistical analyses were performed using Stata software (version 14; StataCorp LLC, College Station, TX, USA), with a significance level of 0.05 set for all p-values.

RESULTS

Depression, anxiety, and stress exhibit strong inter-correlations (0.48-0.57) and robust inverse correlations with all sexual function domains (negative correlations up to -0.65). Components of the FSFI questionnaire (e.g., desire, arousal, satisfaction) demonstrate high correlations (0.57-0.85). In addition, among the categorical variables analyzed, only economic status (mean FSFI score: 14.55 for low-incomevs. 15.87 for middle-income, p = 0.02) and family history of infertility (mean FSFI: 14.24 with history vs. 15.86 without, p = 0.009) show statistically significant associations with total sexual function. The analysis of total mental health scores across categorical variables revealed that family history of infertility showed a statistically significant association (p = 0.009), with individuals reporting a family history scoring higher (Mean = 47.94, SD = 5.68) compared to those without (Mean = 45.15, SD = 6.87).

CONCLUSION

Depression, anxiety, and stress robust inverse correlations with all sexual function domains.Economic status and family history of infertility show statistically significant associations with total sexual function.Family history of infertility showed a statistically significant association with total mental health scores.Finding is recommended that psychological counseling classes be offered to women with POI.