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Pehlivan MJ, Sherman KA, Wuthrich V, Gandhi E, Zagic D, Kopp E, Perica V. The effectiveness of psychological interventions for reducing poor body image in endometriosis, PCOS and other gynaecological conditions: a systematic review and meta-analysis. Health Psychol Rev 2024; 18:341-368. [PMID: 37675797 DOI: 10.1080/17437199.2023.2245020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 08/01/2023] [Indexed: 09/08/2023]
Abstract
Gynaecological conditions (e.g., endometriosis, PCOS) result in bodily changes that negatively impact body image. Psychological interventions (e.g., CBT, psychoeducation) have shown promise in reviews with the general population for alleviating body image concerns. This systematic review and meta-analysis aims to provide asynthesis of the impact of psychological interventions for reducing body image concerns for individuals with gynaecological conditions. Electronic databases were searched for relevant psychological intervention studies with body image outcomes. Twenty-one eligible studies were included in the systematic review (ten were included in a random-effects meta-analysis). Studies included participants (N = 1483, M = 71.85, SD = 52.79) with a range of gynaecological conditions, ages (Mage = 35.08, SD = 12.17) and cultural backgrounds. Most included studies reported at least one positive effect with the meta-analysis indicating psychological interventions were moderately superior to control conditions for reducing body image concerns (SMD -.41, 95% CI [-0.20 -0.62]). However, there was a high risk of bias and moderate heterogeneity. Results suggest psychological interventions may hold promise for reducing body image concerns among individuals gynaecological conditions in the short term. Further, preliminary support was found for the use of theory-guided psychological interventions delivered in group settings in particular, with further research needed on optimal intervention length and particular psychotherapeutic approach.
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Affiliation(s)
- Melissa J Pehlivan
- Lifespan, Health and Wellbeing Research Centre, School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Kerry A Sherman
- Lifespan, Health and Wellbeing Research Centre, School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Viviana Wuthrich
- Lifespan, Health and Wellbeing Research Centre, School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Esther Gandhi
- Lifespan, Health and Wellbeing Research Centre, School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Dino Zagic
- Lifespan, Health and Wellbeing Research Centre, School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Emily Kopp
- Lifespan, Health and Wellbeing Research Centre, School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Valentina Perica
- Lifespan, Health and Wellbeing Research Centre, School of Psychological Sciences, Macquarie University, Sydney, Australia
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Percy C, Turner A, Orr C. Developing a Novel Web-Based Self-Management Support Intervention for Polycystic Ovary Syndrome: Mixed Methods Study With Patients and Health Care Professionals. JMIR Form Res 2024; 8:e52427. [PMID: 38451567 PMCID: PMC10958350 DOI: 10.2196/52427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 10/18/2023] [Accepted: 01/10/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) represents a significant global health burden requiring urgent attention. This common chronic endocrine and cardiometabolic condition affects around 1 in 10 women and individuals assigned female at birth, with significant adverse effects on well-being, quality of life, and mental health, as well as serious and complex long-term health consequences. International guidelines for best health care practice recommend the provision of comprehensive cognitive behavioral interventions to support self-management and improve health outcomes for those living with PCOS. Web-based health interventions have the potential to meet this need in an accessible and scalable way. OBJECTIVE We aim to identify barriers to self-management and psychological well-being in women with PCOS and adapt a web-based self-management program to provide a prototype digital support intervention for them. METHODS We adapted an existing support program (HOPE) for PCOS using the antecedent target measure approach. We conducted qualitative interviews with 13 adult women living with PCOS, 3 trustees of a patients with PCOS advocacy charity, and 4 endocrinologists to identify "antecedents" (barriers) to self-management and psychological well-being. Framework analysis was used to identify potentially modifiable antecedents to be targeted by the novel intervention. At a national conference, 58 key stakeholders (patients and health professionals) voted for the antecedents they felt were most important to address. We used research evidence and relevant theory to design a prototype for the PCOS intervention. RESULTS Voting identified 32 potentially modifiable antecedents, relating to knowledge, understanding, emotions, motivation, and behaviors, as priorities to be targeted in the new intervention. A modular, web-based prototype HOPE PCOS intervention was developed to address these, covering six broad topic areas (instilling HOPE for PCOS; managing the stress of PCOS; feeding your mind and body well; body image, intimacy, and close relationships; staying healthy with PCOS; and keeping PCOS in its place). CONCLUSIONS We identified barriers to self-management and psychological well-being in women with PCOS and used these to adapt a web-based self-management program, tailoring it for PCOS, which is a comprehensive group intervention combining education, empowerment, lifestyle management, peer support with cognitive behavioral tools, and goal-setting (to be delivered by peers or codelivered with health care professionals). The modular structure offers flexibility to adapt the program further as new clinical recommendations emerge. The intervention has the potential to be delivered, evaluated for feasibility, and, if effective, integrated into health care services. Self-management interventions are not designed to replace clinical care; rather, they serve as an additional source of support. The HOPE PCOS program conveys this message in its content and activities. Future research should evaluate the prototype intervention using primary outcomes such as measures of psychological well-being, self-management self-efficacy, depression, anxiety, and PCOS-related quality of life. They should also assess the intervention's acceptability, scalability, and cost-effectiveness.
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Affiliation(s)
- Carol Percy
- Centre for Intelligent Healthcare, Coventry University, Coventry, United Kingdom
| | - Andrew Turner
- Centre for Intelligent Healthcare, Coventry University, Coventry, United Kingdom
| | - Charys Orr
- Harris Church of England Academy, Diocese of Coventry Multi Academy Trust, Coventry, United Kingdom
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Wugalter K, Perovic M, Karkaby L, Einstein G. The double-edged sword of PCOS and gender: exploring gender-diverse experiences of polycystic ovary syndrome. INTERNATIONAL JOURNAL OF TRANSGENDER HEALTH 2023; 25:251-267. [PMID: 38681493 PMCID: PMC11044764 DOI: 10.1080/26895269.2023.2183448] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
Background: Past research on polycystic ovary syndrome (PCOS), a chronic endocrine condition, has focused on the experiences of cisgender women. Aims: The purpose of the present study was to address the knowledge gap about gender-diverse individuals by exploring their lived experiences with PCOS and to better understand if and how their gender identity affected their experience of PCOS. Methods: To explore this, we recruited nine non-binary people and one transgender man with a PCOS diagnosis for qualitative interviews. Results: Three overarching themes emerged: PCOS as a burden, PCOS as an occasion, and PCOS as a benefit. While some aspects of PCOS created an additional burden for our participants, other symptoms such as excess body and facial hair could be empowering and affirming, revealing a positive aspect of this chronic condition. Conclusion: This study is the first to describe the lived experiences of gender-diverse individuals with PCOS, uncovering burdens as well as some benefits. Future research in this population may reveal not only the particulars of what PCOS is like for them but also more generalizable insights into the highly gendered perception and treatment of PCOS.
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Affiliation(s)
- Katrina Wugalter
- Department of Psychology, University of Toronto, Toronto, Ontario, Canada
- Department of Psychology, University of Illinois Chicago, Chicago, Illinois, USA
| | - Mateja Perovic
- Department of Psychology, University of Toronto, Toronto, Ontario, Canada
| | - Laurice Karkaby
- Department of Psychology, University of Toronto, Toronto, Ontario, Canada
| | - Gillian Einstein
- Department of Psychology, University of Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Tema Genus, Linköping University, Linköping, Sweden
- Rotman Research Institute, Baycrest Hospital, Toronto, Ontario, Canada
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Ismayilova M, Yaya S. What can be done to improve polycystic ovary syndrome (PCOS) healthcare? Insights from semi-structured interviews with women in Canada. BMC Womens Health 2022; 22:157. [PMID: 35538531 PMCID: PMC9092874 DOI: 10.1186/s12905-022-01734-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 04/25/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is a common and perplexing condition affecting metabolic, reproductive, cardiovascular, and psychological health in women. Previous studies point to widespread dissatisfaction and frustration in women with the information and care they receive. Studies have found delays with the diagnosis of PCOS and gaps in knowledge in physicians regarding the diagnosis and management of PCOS. Little has been heard from women on what they think can be improved with PCOS care, especially in Canada. This qualitative study explores women's experiences navigating the healthcare system and their insights on what could be improved based on their lived experiences. METHODS Twenty-five participants were interviewed remotely over the phone by the first author between October and December 2018.Interviews were semi-structured and in-depth. Data were analyzed using thematic analysis and interpretive description methodology. RESULTS Twenty-five in-depth interviews conducted with participants across Canada (ages 18-63) revealed three overall areas in need of improvement. First, women emphasized a need for greater knowledge and awareness of PCOS in primary care physicians (PCPs) as well as the need for the medical community to prioritize women's health. Second, participants advocated for greater PCOS awareness and de-stigmatization in the general community and in women and girls, and any individuals with female reproductive systems. Third, participants brought up several needed resources, such as the need for more PCOS research to be funded and undertaken, more PCOS specialists and experts to be available, credible doctor-provided information (e.g., pamphlets, websites), and age-specific support groups and mental health supports to be available. Participants were generally unaware of existing PCOS organizations and brought up the need for established PCOS organizations to aid in the training and retraining of doctors and local awareness-building in communities. CONCLUSIONS Participants believed that PCPs in Canada needed to be well-versed on how to diagnose and manage PCOS to prevent delays in diagnosis and provide easier access to care. Further, greater awareness and de-stigmatization in the general community are needed so women can identify symptoms early and have access to support from those around them. Overall, PCOS may be an overlooked and under-prioritized condition, both in the Canadian healthcare system and general community.
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Affiliation(s)
- Miya Ismayilova
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Sanni Yaya
- School of International Development and Global Studies, Faculty of Social Sciences, University of Ottawa, 120 University Private, Ottawa, ON K1N 6N5 Canada
- The George Institute for Global Health, Imperial College London, London, UK
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Kim JH, Kim O, Jung H, Pang Y, Dan H. Body mass index, menstruation, acne, and hirsutism of polycystic ovary syndrome in women: A cross-sectional study. Health Care Women Int 2021; 43:85-97. [PMID: 34292855 DOI: 10.1080/07399332.2021.1939348] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
We examined to compare menstruation and body mass index (BMI) in women with and without polycystic ovary syndrome (PCOS) and to explore the effects of BMI on menstruation, facial acne, and hirsutism in women with PCOS of child-bearing age. Data from the Korea Nurses' Health Study were analyzed. The effect of BMI on irregularity of menstruation, acne, and hirsutism in the PCOS group was analyzed by logistic regression. The prevalence of PCOS was 7.1% among 11,866 participants. We found that BMI affects menstrual irregularity, facial acne, and hirsutism in PCOS women. Healthcare providers should consider weight control to improve irregularity of menstruation and hirsutism in PCOS women.
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Affiliation(s)
- Jung-Hee Kim
- College of Nursing, The Catholic University of Korea, Seoul, Republic of Korea
| | - Oksoo Kim
- College of Nursing, Ewha Womans University, Seoul, Republic of Korea
| | - Heeja Jung
- College of Nursing, Konyang University, Daejeon, Republic of Korea
| | - Yanghee Pang
- College of Nursing, Ewha Womans University, Seoul, Republic of Korea
| | - Hyunju Dan
- College of Nursing, Ewha Womans University, Seoul, Republic of Korea
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Sayer-Jones K, Sherman KA. Body image concerns in individuals diagnosed with benign gynaecological conditions: scoping review and meta-synthesis. Health Psychol Behav Med 2021; 9:456-479. [PMID: 34104570 PMCID: PMC8158251 DOI: 10.1080/21642850.2021.1920949] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Background Benign gynaecological conditions (BCGs) and body image-related concerns are commonly experienced by reproductive-aged female-identified individuals. Qualitative evidence from cancer populations identifies a link between diseases of the sexual organs and body image distress encompassing appearance, sensory and functional aspects. Most BCGs and the impacts on body image have been studied separately. However, commonalities exist between these conditions including chronicity, diagnostic delays, and menstrual-related social stigma. This systematic scoping review and meta-synthesis aimed to compare and contrast the experience of body image in the benign conditions of endometriosis, polycystic ovarian cysts, uterine fibroids, and vulvar intraepithelial neoplasia. Method Electronic databases (MEDLINE, PsycINFO, Scopus, CINAHL, Embase, and Allied and Complementary Medicine) were searched in February 2020 and relevant articles were examined to identify papers that qualitatively explored the relationship between body image and BCGs. Meta-synthesis was used to analyse the 17 papers that met the inclusion criteria. Results Six main themes evolved from this iterative analysis: loss of control; regained control; silence – menstrual concealment; cultural differences; feeling abnormal, and functional impairment. Body image concerns were widespread although impacts on individual’s lives were dependent on the unique symptom profile of each disease which interacted with socio-cultural factors, daily functioning, and feminine identity. Body image concerns were a common, but hidden, experience rarely screened in routine clinical settings despite causing significant distress. Conclusions The chronicity and severity of individuals unique symptom profile often determined the intensity and type of body image concerns individuals described. Across conditions, body image concerns were often left untreated, were concealed, and were associated with reduced quality of life.
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Affiliation(s)
- Katherine Sayer-Jones
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, Australia
| | - Kerry A Sherman
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, Australia
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Kogure GS, Lopes IP, Ribeiro VB, Mendes MC, Kodato S, Furtado CLM, Silva de Sá MF, Ferriani RA, Lara LADS, Reis RMD. The effects of aerobic physical exercises on body image among women with polycystic ovary syndrome. J Affect Disord 2020; 262:350-358. [PMID: 31735408 DOI: 10.1016/j.jad.2019.11.025] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 09/11/2019] [Accepted: 11/08/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND Both physical and mental health care for women with polycystic ovary syndrome (PCOS) require a multidisciplinary approach. We evaluated the effects of continuous (CAT) and intermittent (IAT) aerobic training in different protocols that measure body image, anxiety, depression and sexual dysfunction in women with PCOS. METHODS In this controlled clinical trial, women with PCOS were randomly allocated for 16 weeks to 1 out of 3 groups: CAT (n = 28), IAT (n = 29), or control group (CG, n = 30). For data collection, we used the Body Shape Questionnaire (BSQ), Figure Rating Scale (FRS), Female Sexual Function Index (FSFI), Hospital Anxiety and Depression Measurement Scales (HADS). RESULTS No effects of CAT, IAT or CG groups were identified in the perceptual dimension of body image. The dis(satisfaction) grade improved after exercise in the CAT group (p ≤ 0.01) compared to the CG, as well as improved within CAT and IAT groups. Total FSFI, and HADS-A and HADS-D scores improved after exercise in the both groups. At baseline and after the study period, there were positive correlations between scores for dis(satisfaction), HADS-A and HADS-D scores. HADS-A and HADS-D scores had a negative correlation with FSFI total in the IAT (p = =0.02) group compared to the CG, as well as within CAT and IAT groups. LIMITATIONS The participants were not matched for body mass index (normal, overweight and obese) which may interfere on body image dimensions. CONCLUSION Aerobic exercise improves sexual function and indices related to anxiety and depression. Likewise, it interferes in cognitive-affective dimension of the body image.
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Affiliation(s)
- Gislaine Satyko Kogure
- Ribeirão Preto Medical School, Human Reproduction sector, Departament of Gynecology and Obstetrics, University of São Paulo, Ribeirão Preto, Brazil.
| | - Iris Palma Lopes
- Ribeirão Preto Medical School, Human Reproduction sector, Departament of Gynecology and Obstetrics, University of São Paulo, Ribeirão Preto, Brazil
| | - Victor Barbosa Ribeiro
- Ribeirão Preto Medical School, Human Reproduction sector, Departament of Gynecology and Obstetrics, University of São Paulo, Ribeirão Preto, Brazil; Federal Institute of São Paulo, Jacareí campus, Brazil
| | - Maria Célia Mendes
- Ribeirão Preto Medical School, Human Reproduction sector, Departament of Gynecology and Obstetrics, University of São Paulo, Ribeirão Preto, Brazil
| | - Sérgio Kodato
- Department of Psychology, Faculty of Philosophy, Science and Letters, University of São Paulo, Ribeirão Preto, Brazil
| | | | - Marcos Felipe Silva de Sá
- Ribeirão Preto Medical School, Human Reproduction sector, Departament of Gynecology and Obstetrics, University of São Paulo, Ribeirão Preto, Brazil
| | - Rui Alberto Ferriani
- Ribeirão Preto Medical School, Human Reproduction sector, Departament of Gynecology and Obstetrics, University of São Paulo, Ribeirão Preto, Brazil
| | - Lúcia Alves da Silva Lara
- Ribeirão Preto Medical School, Human Reproduction sector, Departament of Gynecology and Obstetrics, University of São Paulo, Ribeirão Preto, Brazil
| | - Rosana Maria Dos Reis
- Ribeirão Preto Medical School, Human Reproduction sector, Departament of Gynecology and Obstetrics, University of São Paulo, Ribeirão Preto, Brazil
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Saei Ghare Naz M, Ramezani Tehrani F, Ahmadi F, Alavi Majd H, Ozgoli G. Threats to Feminine Identity as the Main Concern of Iranian Adolescents with Polycystic Ovary Syndrome: A Qualitative Study. J Pediatr Nurs 2019; 49:e42-e47. [PMID: 31645273 DOI: 10.1016/j.pedn.2019.08.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 08/13/2019] [Accepted: 08/13/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE Polycystic Ovary Syndrome (PCOS) is a prevalent hormonal disorder in adolescents; this study seeks to elaborate the main concerns of adolescents with PCOS. DESIGN AND METHODS This qualitative content analysis was conducted on 15 adolescents with PCOS using purposive sampling in 2018. Semi-structured in-depth interviews were held for data collection, and data saturation occurred when no new data were being obtained. Data were analyzed concurrently with data collection. RESULTS Fifteen adolescents with PCOS aged 13-19 years were enrolled into the study. Thirteen were single and two were married. The data analysis led to the extraction of "threats to feminine identity" as the main theme of this research, which was then divided into two categories: 1) concerns about attractiveness, with subcategories including fashion-related stress and the loss of physical beauty 2) concerns about femininity, with subcategories including the underlying issues of worrying about future marriage prospects, anxiety about infertility in the future and stress about menstrual abnormalities. CONCLUSION According to the results of this study, attractiveness and threat to femininity is the main concern of adolescents with PCOS that should be further considered in the management of their treatment. IMPLICATIONS FOR PRACTICE Understanding the main concerns of adolescents with PCOS can help healthcare professionals better manage this disease in this population subgroup.
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Affiliation(s)
- Marzieh Saei Ghare Naz
- Student Research Committee, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fazlollah Ahmadi
- Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Hamid Alavi Majd
- Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Giti Ozgoli
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Thorpe C, Arbeau KJ, Budlong B. 'I drew the parts of my body in proportion to how much PCOS ruined them': Experiences of polycystic ovary syndrome through drawings. Health Psychol Open 2019; 6:2055102919896238. [PMID: 31903221 PMCID: PMC6928539 DOI: 10.1177/2055102919896238] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Polycystic ovary syndrome is a chronic endocrine disorder associated with persistent physical symptoms and psychological and lifestyle repercussions. Eighty-nine participants (83 females, 6 non-binary) aged 19-43 years described their experiences of polycystic ovary syndrome through drawings and personal accounts. Four descriptive themes were identified: awareness of visible and invisible symptoms, misshapen self and body, limitations and barriers and resignation. Taken together, participants described a condition with all-encompassing effects: much more than symptom management alone. Findings support the use of drawings as an appropriate method with this population and suggest continuing need for supports for individuals with polycystic ovary syndrome.
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10
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Martin ML, Halling K, Eek D, Krohe M, Paty J. Understanding polycystic ovary syndrome from the patient perspective: a concept elicitation patient interview study. Health Qual Life Outcomes 2017; 15:162. [PMID: 28821294 PMCID: PMC5562990 DOI: 10.1186/s12955-017-0736-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 08/07/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of this study was to explore the need for a new disease-specific patient reported outcome (PRO) measure for use in clinical trials of drugs designed to target the underlying causes of polycystic ovary syndrome (PCOS), and in the process contribute to our understanding of the symptoms and impacts that define the patient experience with PCOS. METHODS Semi-structured interviews were conducted in 20 women diagnosed with PCOS according to the Rotterdam criteria who had not menstruated in the previous month. The relative importance of PCOS symptoms and impact concepts to patients was determined by analyzing the frequency of their expression in the interview transcripts. These insights were compared to clinicians' perceptions of PCOS. RESULTS Pain- and discomfort-related symptoms accounted for the highest proportion (27.6%) of the 735 patient expressions, although clinicians did not consider pain to be important to patients with PCOS. The most frequently expressed individual symptoms were cramping (70% of patients; 14.7% of concepts), irregular menstruation (95% of patients; 12.2% of concepts), facial hair growth (75% of patients; 10.6% of concepts), heavy bleeding (70% of patients; 8.8% of concepts), infertility (70% of patients; 5.4% of concepts), and bloating (60% of patients; 5.2% of concepts). Cramping, heavy bleeding, and bloating were not identified by clinicians as being important to patients with PCOS. The impacts most frequently reported by patients with PCOS related to emotional well-being (e.g. anxiety/stress) and coping behaviors (e.g. acne medication, hair removal). CONCLUSIONS The only validated PCOS-specific PRO, the PCOSQ, does not capture some key PCOS symptoms and impacts expressed by patients with PCOS, most notably those related to pain and discomfort, bleeding intensity and coping behaviours. Furthermore, some key PCOS symptoms may be under-recognized in the clinic.
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Affiliation(s)
- Mona L. Martin
- Health Research Associates, 6505 216th St SW, Mountlake Terrace, Seattle, WA 98043 USA
| | - Katarina Halling
- AstraZeneca Gothenburg, Pepparedsleden 1, 431 83 Mölndal, SE Sweden
| | - Daniel Eek
- AstraZeneca Gothenburg, Pepparedsleden 1, 431 83 Mölndal, SE Sweden
| | - Meaghan Krohe
- Adelphi Values, 7th Floor, 290 Congress St, Boston, MA 02210 USA
| | - Jean Paty
- Quintiles, 8 Skyline Dr, Hawthorne, New York, NY 10532 USA
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