Table 2.

GRADE assessment and evidence profile.

COMPARISON: women with PCOS versus controls
	Quality assessment						No. participants
No. studies	Design	Risk of bias	Inconsistency	Indirectness	Imprecision	Other	PCOS	Control	Effect estimate: Hedges’ g [95% CI]	Favours	Certainty	Importance
Outcome: total sexual function
22	Case control, cross-sectional	Serious1	Serious2	Not serious	Not serious	None	1630	1684	−0.66 [−1.20, −0.12]	Controls	⊕⊕◯◯ LOW	CRITICAL
Outcome: sexual desire
21	Case control, cross-sectional	Serious1	Serious2	Not serious	Not serious	None	1735	1977	−0.21 [−0.39, 0.02]	Controls	⊕⊕◯◯ LOW	CRITICAL
Outcome: sexual arousal
19	Case control, cross-sectional	Serious1	Serious2	Not serious	Not serious	None	1577	1811	−0.33 [−0.50, −0.16]	Controls	⊕⊕◯◯ LOW	CRITICAL
Outcome: lubrication
19	Case control, cross-sectional	Serious1	Serious2	Not serious	Not serious	None	1549	1801	−0.50 [−0.74, −0.26]	Controls	⊕⊕◯◯ LOW	IMPORTANT
Outcome: orgasm
20	Case control, cross-sectional	Serious1	Serious2	Not serious	Not serious	None	1641	1780	−0.35 [−0.52, −0.18]	Controls	⊕⊕◯◯ LOW	IMPORTANT
Outcome: satisfaction
24	Case control, cross-sectional	Serious1	Serious2	Not serious	Not serious	None	1962	2246	−0.26 [−0.37, −0.15]	Controls	⊕⊕◯◯ LOW	IMPORTANT
Outcome: pain
18	Case control, cross-sectional	Serious1	Serious2	Not serious	Not serious	None	1485	1732	−0.36 [−0.59, 0.13]	Controls	⊕⊕◯◯ LOW	IMPORTANT
Outcome: VAS sexual thoughts and fantasies
3	Case control, cross-sectional	Serious1	Not applicable	Not applicable	Serious3	None	225	50	NA	No difference	⊕⊕◯◯ LOW	IMPORTANT
Outcome: VAS sex life satisfaction
3	Case control, cross-sectional	Serious1	Not applicable	Not applicable	Serious3	None	225	50	NA	Controls	⊕⊕◯◯ LOW	IMPORTANT
Outcome: VAS importance of satisfying sex life
3	Case control, cross-sectional	Serious1	Not applicable	Not applicable	Serious3	None	225	50	NA	No difference	⊕⊕◯◯ LOW	IMPORTANT
Outcome: VAS pain during intercourse
2	Case control, cross-sectional	serious1	Not applicable	Not applicable	Serious3	None	105	50	NA	No difference	⊕⊕◯◯ LOW	IMPORTANT
Outcome: VAS body hair impact
4	Case control, cross-sectional	serious1	not applicable	not applicable	serious3	none	297	50	NA	Controls	⊕⊕◯◯ LOW	IMPORTANT
Outcome: VAS social contact impact
4	Case control, cross-sectional	serious1	not applicable	not applicable	serious3	none	297	50	NA	Controls	⊕⊕◯◯ LOW	IMPORTANT
Outcome: VAS sexual attractiveness
4	Case control, cross-sectional	serious1	not applicable	not applicable	serious3	none	297	50	NA	Controls	⊕⊕◯◯ LOW	IMPORTANT

GRADE, Grading of Recommendations, Assessment, Development and Evaluations; VAS, visual analogue scale; NA, not applicable.

¹Downgraded once due to most studies being of moderate risk of bias.

²Downgraded once due to high statistical heterogeneity.

³Downgraded once due to small sample size of control group and the same controls used across all studies.