Abstract
Background/Objectives: Female sexual dysfunction (FSD) is common in PCOS, yet mean group comparisons can mask variability at the individual level. We aimed to identify and characterize person-centered profiles of sexual function from the six FSFI (Female Sexual Function Index) domains, and secondarily to describe the distribution of PCOS across profiles. Methods: In an age- and anthropometry-matched case–control sample, unsupervised clustering on FSFI domains was performed; clinical and psychosocial correlates were compared, and logistic regression tested prediction of FSFI-defined FSD. Results: Two profiles emerged—Sexual Dysfunction vs. Preserved Function—with clear multivariate separation. Dysfunction showed lower FSFI, higher adiposity, and worse body-image discomfort. PCOS was more frequent in Dysfunction but not significantly. Cluster membership predicted FSD. Conclusions: Person-centered profiling reveals clinically meaningful heterogeneity that transcends diagnosis and highlights adiposity and body-image distress as salient, potentially modifiable correlates.