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Gürbuzer Eİ, Pelit P, Kızılkan MP, Baklacı AB, Tüzün Z, Mumuşoğlu S, Akgül S. Comparison of Diagnosis Experiences of Adolescent and Young Adult Polycystic Ovary Syndrome Patients. J Pediatr Adolesc Gynecol 2024:S1083-3188(24)00236-5. [PMID: 38906217 DOI: 10.1016/j.jpag.2024.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Revised: 06/12/2024] [Accepted: 06/16/2024] [Indexed: 06/23/2024]
Abstract
STUDY OBJECTIVE The manner in which an individual experiences a polycystic ovary syndrome (PCOS) diagnosis may affect prognosis and vary with age. This study aimed to evaluate and compare the diagnosis experiences of adolescent and young adult PCOS patients. METHODS PCOS patients from the same institution were divided into two groups according to age and clinic (adolescents diagnosed in the adolescent medicine clinic and young adults diagnosed in the obstetrics and gynecology clinic). Patients completed a questionnaire designed to assess the information and support received during diagnosis, their satisfaction with this information, existing concerns regarding PCOS symptoms, and support requirements. RESULTS Thirty-six patients were included in each group. Among the participants, 52.8% of the adolescents and 63.9% of the young adults reported that they had consulted more than one specialist before receiving a diagnosis. We found that 83.3% of adolescents and 63.9% of young adults were satisfied with their overall PCOS diagnosis experience. The highest ratio of information given in both groups was related to medical treatment (88.9% in both groups), and the lowest ratios were associated with emotional support (13.9% vs 5.6%). Irregular menstruation was reported to be the most disturbing concern in both groups (94.4% vs 86.1%), and the biggest difference between the two groups was related to body dissatisfaction, which was observed more in adolescents (33.3% vs 5.6%). CONCLUSION While overall diagnosis experiences and satisfaction levels were similar across both groups, we identified distinct differences that may warrant attention to address age-specific needs and preferences.
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Affiliation(s)
- Eda İpek Gürbuzer
- Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Pelin Pelit
- Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Melis Pehlivanturk Kızılkan
- Department of Pediatrics, Division of Adolescent Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Ayse Bilge Baklacı
- Department of Pediatrics, Division of Adolescent Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Zeynep Tüzün
- Department of Pediatrics, Division of Adolescent Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Sezcan Mumuşoğlu
- Department of Obstetrics and Gynecology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Sinem Akgül
- Department of Pediatrics, Division of Adolescent Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
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Peerwani G, Rozi S, Lakhdir MPA, Zuberi N, Asad N. Association of depressive symptoms and quality of life in Pakistani youth (15-24 years) with polycystic ovarian syndrome: a web-based analytical cross-sectional study. Front Glob Womens Health 2023; 4:967883. [PMID: 37415597 PMCID: PMC10321523 DOI: 10.3389/fgwh.2023.967883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 05/02/2023] [Indexed: 07/08/2023] Open
Abstract
Introduction Polycystic ovarian syndrome (PCOS) is associated with impaired quality of life (QOL) of individuals, predominantly in youth, who are most vulnerable to its impact. Psychological morbidity could be one of the factors influencing QOL. The study investigated the association between depressive symptoms and QOL in Pakistani youth (15-24 years) with PCOS and determined other factors associated with QOL. Methods We conducted an analytical-cross-sectional survey on 213 single Pakistani females aged 15-24 years recruited via a web-based approach. Depression and QOL were assessed through Center-of-Epidemiological-Studies-Depression tool and Polycystic-ovarian-syndrome-quality-of-life-scale. Multiple-linear-regression was used to determine factors associated with QOL, and adjusted regression-coefficients along with a 95% confidence interval were reported. Results The mean QOL score: 2.9 ± 1.1. The domain of obesity had the lowest mean score (2.5 ± 1.6) whereas domain of hirsutism had the highest (3.2 ± 1.9). 172/213 (80%) participants were screened positive for depressive symptoms. Participants with depressive symptoms reported reduced mean QOL scores than respondents with no such symptoms (2.8 ± 1.0 vs. 3.4 ± 1.3, p < 0.001). No differences were found in overall QOL and individual domains between participants 15-19 years (n = 36, 17%) and participants >19-24 years (n = 177, 83%) (2.9 ± 1.1 vs. 2.9 ± 1.1) (p > 0.05). We found a significant interaction between depressive symptoms and PCOS duration, indicating that the estimated mean overall QOL score decreases by 25.1 (-36.6, -13.6) for every year increase in PCOS duration among participants screened positive for depressive symptoms. Furthermore, for those respondents who had family history of PCOS and were not satisfied with their healthcare provider treating PCOS, the estimated mean QOL score was 17.47 (-26.1, -8.8) lower than participants who had no family history of PCOS and were satisfied with their healthcare provider. Other factors associated with reduced quality of life included societal pressure to improve appearance affected by PCOS, parental criticism related to PCOS, education, socioeconomic status, working status and BMI. Conclusion Depressive symptoms with increasing duration of PCOS were significantly associated with reduced QOL. Therefore, to improve the overall QOL of PCOS youth, screening and timely addressing of psychological morbidities should be considered.
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Affiliation(s)
- Ghazal Peerwani
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
- Department of Clinical Research Cardiology, Tabba Heart Institute, Karachi, Pakistan
| | - Shafquat Rozi
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | | | - Nadeem Zuberi
- Department of Obstetrics and Gynaecology, Aga Khan University, Karachi, Pakistan
| | - Nargis Asad
- Department of Psychiatry, Aga Khan University, Karachi, Pakistan
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Fossey B, McCaffery KJ, Cvejic E, Jansen J, Copp T. Understanding the Relationship between Illness Perceptions and Health Behaviour among Women with Polycystic Ovary Syndrome. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5998. [PMID: 37297602 PMCID: PMC10252798 DOI: 10.3390/ijerph20115998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 05/24/2023] [Accepted: 05/26/2023] [Indexed: 06/12/2023]
Abstract
This paper aims to delineate the cognitive, emotional, and behavioural responses of women with polycystic ovary syndrome (PCOS) to their illness by applying the Common-Sense Model of Self-Regulation (CSM) to their health behaviour. An online cross-sectional design was used to examine the relationship between participants' illness perceptions (illness identity, consequence, timeline, control, and cause) and emotional representations of their PCOS, and their health behaviours (diet, physical activity, and risky contraceptive behaviour). The participants were 252 women between the ages of 18 and 45 years, living in Australia, and self-reporting a diagnosis of PCOS, recruited through social media. Participants completed an online questionnaire regarding illness perceptions as well as their diet, physical activity, and risky contraceptive behaviour. Illness identity was positively associated with the number of maladaptive dietary practices (B = 0.71, 95% CI: 0.003, 0.138; p = 0.04), and perception of longer illness duration was associated with reduced physical activity (OR = 0.898, 95% CI: 0.807, 0.999; p = 0.49) and risky contraceptive behaviour (OR = 0.856, 95% CI: 0.736, 0.997; p = 0.045). The limitations of the study include all data being self-reported (including PCOS diagnosis), and the potential for analyses of physical activity and risky contraceptive use being underpowered due to reduced sample sizes. The sample was also highly educated and restricted to those who use social media. These findings suggest that illness perceptions may play a role in influencing health behaviour in women with PCOS. A better understanding of the illness perceptions of women with PCOS is needed to increase health-promoting behaviour and improve health outcomes for women with PCOS.
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Affiliation(s)
- Brittany Fossey
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW 2006, Australia
| | - Kirsten J. McCaffery
- Sydney Health Literacy Lab, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Erin Cvejic
- Sydney Health Literacy Lab, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Jesse Jansen
- Department of Family Medicine, School Care and Public Health Research Institute (CAPHRI), Faculty of Health Medicine and Life Sciences (FHML), Maastricht University, 6229 ER Maastricht, The Netherlands
| | - Tessa Copp
- Sydney Health Literacy Lab, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
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Presswala B, De Souza LR. The diagnostic experience of polycystic ovary syndrome: A scoping review of patient perspectives. PATIENT EDUCATION AND COUNSELING 2023; 113:107771. [PMID: 37141692 DOI: 10.1016/j.pec.2023.107771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 03/02/2023] [Accepted: 04/21/2023] [Indexed: 05/06/2023]
Abstract
OBJECTIVE Polycystic Ovary Syndrome (PCOS) is a common endocrine condition with a complex diagnostic process. The present study aims to understand patient perceptions of the process of PCOS diagnosis, and how challenges during diagnosis can influence patient understanding of PCOS and trust in healthcare providers (HCPs). METHODS A scoping review framework was followed. Six databases were searched for patient experiences of PCOS diagnosis, between January 2006 - July 2021. Data extraction and thematic analyses were conducted. RESULTS Of the 338 studies screened, 21 studies fulfilled the inclusion criteria. Patient experiences of the diagnostic process were stratified into three themes: emotional, negotiating, and incomplete. As a result of these experiences, patients begin to perceive their HCPs as lacking knowledge and empathy. CONCLUSION There are prevailing gaps in how PCOS diagnostic criteria are understood and applied in the clinical setting, leading to a lengthy diagnostic process. Additionally, poor HCP communication negatively affects patient trust in HCPs. PRACTICE IMPLICATIONS Practicing patient-centered care and empowering patients by addressing their specific information needs are essential to improving the diagnostic experience and care of individuals living with PCOS. These recommendations may also apply to the diagnosis of other complex chronic conditions.
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Affiliation(s)
- Batul Presswala
- Faculty of Health Sciences, McMaster University, 1280 Main St. West, MDCL 3500, Hamilton, ON L8S 4K1, Canada; Public Health Agency of Canada, 785 Carling Avenue, Ottawa, ON K1A 0K9, Canada.
| | - Leanne R De Souza
- Human Biology Program, Health Studies Program, University College, University of Toronto, Room 281, 15 King's College Circle, Toronto, ON M5S 3H7, Canada
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The Psychosocial Impact of Polycystic Ovary Syndrome. REPRODUCTIVE MEDICINE 2023. [DOI: 10.3390/reprodmed4010007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
Polycystic ovary syndrome is a common endocrine disorder affecting 5–20% of women in association with metabolic disorders and insulin resistance. Patients with PCOS are also at increased risk of developing cardiovascular sound aspects of polycystic ovaries and metabolic complications, a psychosocial impact that exists, which is poorly known, assessed and treated. The delay, sometimes long, for diagnosis and its announcement has a strong impact on the feelings and life projects of these patients. Psychological co-morbidities such as depression, anxiety, eating disorders as well as a decrease in self-esteem and quality of life are frequently described in these patients and must, therefore, be screened and treated.
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Hariprasath L, Selvakumar D, Dharani V, Durgalakshmi KK, Abilash VG, Gopenath TS, Nishu S. Infertility and Social Issue Have the Most Significant Impact on Health-related Quality of Life among Polycystic Ovarian Syndrome Women in South India. J Hum Reprod Sci 2023; 16:36-41. [PMID: 37305774 PMCID: PMC10256948 DOI: 10.4103/jhrs.jhrs_175_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 03/04/2023] [Accepted: 03/05/2023] [Indexed: 06/13/2023] Open
Abstract
Background Infertility can have a significant impact on the identity of women. Individual women, who are infertile, experience tragic emotions, as well as those who are sad for great losses, like the death of a loved one. In this case, the woman is experiencing the loss of the ability to procreate. Aim In the present study, our major concern was to implement the health-related quality of life (HRQOL) Questionnaire on South Indian polycystic ovarian syndrome (PCOS) women to assess the impact of various clinical features of polycystic ovary syndrome on the HRQOL of South Indian women diagnosed. Settings and Design A total of 126 females in the first phase and 356 females in the second phase between the age group of 18-40 years characterised under the Rotterdam criteria were selected for the study. Materials and Methods The study was carried out in three different phases which included a one-to-one interview, group discussion and questionnaire session. In our study, we found that all the females who attend the study showed positivity for all the domains developed in the previous study and suggested that further domain can be developed. Statistical Analysis Used Suitable statistical methods were used with Graph pad PRISM (version 6). Results Hence, in our study, we developed a further new sixth domain called as 'social impact domain'. Among South Indian PCOS women, we found that infertility and social issue have the most significant impact on HRQOL. Conclusion The revised questionnaire by including the sixth domain called 'Social issue' is likely to be useful in measuring the quality of health of female having PCOS in regard to South Indian population.
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Affiliation(s)
- L. Hariprasath
- Department of Biochemistry, School of Life Sciences (Ooty Campus), JSS Academy of Higher Education and Research, Ooty, Tamil Nadu, India
| | - D. Selvakumar
- Department of Biochemistry, School of Life Sciences (Ooty Campus), JSS Academy of Higher Education and Research, Ooty, Tamil Nadu, India
| | - V. Dharani
- Department of Biotechnology, School of Life Sciences (Ooty Campus), JSS Academy of Higher Education and Research, Ooty, Tamil Nadu, India
| | - K. K. Durgalakshmi
- Department of Food and Nutrition, School of Life Sciences (Ooty Campus), JSS Academy of Higher Education and Research, Ooty, Tamil Nadu, India
| | - V. G. Abilash
- Department of Biomedical Sciences, School of Bio Sciences and Technology, VIT, Vellore, Tamil Nadu, India
| | - T. S. Gopenath
- Department of Biotechnology and Bioinformatics, JSS Academy of Higher Education and Research (Deemed to be University), Mysore, Karnataka, India
| | - S. Nishu
- Department of Biotechnology, School of Life Sciences (Ooty Campus), JSS Academy of Higher Education and Research, Ooty, Tamil Nadu, India
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KORKMAZ N, ÇETİN S. The factors affecting sexual satisfaction and sexual myths in married women: A prospective study. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2022. [DOI: 10.32322/jhsm.1135045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Aim: The cultural differences and taboos of the society affect women’s sexual life and sexual relationship qualities and their belief in sexual myths. In addition, women’s demographic characteristics and living conditions are also effective on sexual myths. Our aim in this study is to analyze the frequency of believing in sexual myths in married women and to examine the factors affecting sexual life and sexual relationship qualities.
Material and Method: Married women between the ages of 18-55 in the tertiary gynecology and obstetrics clinic were included in the study, prospectively. Demographic characteristics of women such as age, marital status, marriage and employment status, monthly income, family structure and number of children, sexual life and sexual relationship qualities and sexual myths were compared. The Golombok-Rust Inventory of Sexual Satisfaction (GRISS) Scale, which is used to evaluate the quality of sexual intercourse and sexual dysfunctions, and The Sexual Myth Scale to determine the status of having sexual myths were used.
Results: Overall 171 married women were included in the study. The median age was 35 years (IQR 29-43) and 60.8% (n=104) were university graduates and 20.5% (n=35) were graduate/doctoral graduates. The rate of believing in sexual myths among married women was 21.4%. As the age of the women increased, the frequency of sexual intercourse decreased (p
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Mei LL, Abu MA, Chew KT, Ismail A, Zainuddin AA, Nur Azurah AG. The Reliability and Validity of the Malay Version of Polycystic Ovarian Syndrome Health-Related Quality of Life Questionnaire. Front Endocrinol (Lausanne) 2022; 13:848860. [PMID: 35692396 PMCID: PMC9178788 DOI: 10.3389/fendo.2022.848860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 03/30/2022] [Indexed: 11/13/2022] Open
Abstract
The Polycystic Ovary Syndrome Questionnaire is a reliable instrument for measuring health-related quality of life. This study aimed to develop a Malay version of the Polycystic Ovary Syndrome Questionnaire and to evaluate the health-related impact of Malaysian women with polycystic ovary syndrome. The participants were women who were diagnosed with polycystic ovary syndrome using Rotterdam criteria in a gynecology clinic. Reliability was determined by internal consistency using Cronbach's coefficient alpha and test-retest reliability using an intra-class correlation coefficient. Validity was assessed through convergent and discriminant validity. Examining the correlation between similar content of the Malay version of the Polycystic Ovary Syndrome Questionnaire and the SF-36 assessed the convergent validity. The discriminant validity was assessed using the known group comparison. Cronbach's alpha coefficient was over 0.70 for the total scale and over 0.60 for each subscale. Known group comparison supported the discriminant validity. The Malay version of the Polycystic Ovary Syndrome Questionnaire differentiated between the subgroups of women who differed in polycystic ovary syndrome-specific symptoms. Convergent validity was consistent with the good positive correlation between related subscales of the two instruments. Polycystic ovary syndrome women in Malaysia scored the lowest for the weight (3.74) and infertility (3.41) domains, thereby indicating worse health status in these domains. Body hair (5.42) was the least troublesome for the local population. The Malay version of the Polycystic Ovary Syndrome Questionnaire is a reliable and valid tool for assessing the health-related quality of life among women in the local population. It can be used to objectively assess the quality of life among Malaysian women with polycystic ovary syndrome and evaluate their responsiveness to treatment modalities.
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Affiliation(s)
- Lim Leek Mei
- Department of Obstetrics and Gynaecology, Hospital Sultan Ismail, Johor Bahru, Malaysia
| | - Muhammad Azrai Abu
- Advanced Reproductive Centre, Universiti Kebangsaan Malaysia (UKM) Medical Centre, Kuala Lumpur, Malaysia
| | - Kah Teik Chew
- Department of Obstetrics and Gynaecology, Universiti Kebangsaan Malaysia (UKM) Medical Centre, Kuala Lumpur, Malaysia
| | - Aniza Ismail
- Department of Public Health, Universiti Kebangsaan Malaysia (UKM) Medical Centre, Kuala Lumpur, Malaysia
| | - Ani Amelia Zainuddin
- Department of Obstetrics and Gynaecology, Universiti Kebangsaan Malaysia (UKM) Medical Centre, Kuala Lumpur, Malaysia
| | - Abdul Ghani Nur Azurah
- Department of Obstetrics and Gynaecology, Universiti Kebangsaan Malaysia (UKM) Medical Centre, Kuala Lumpur, Malaysia
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Ismayilova M, Yaya S. 'I'm usually being my own doctor': women's experiences of managing polycystic ovary syndrome in Canada. Int Health 2022; 15:56-66. [PMID: 35567790 PMCID: PMC9808519 DOI: 10.1093/inthealth/ihac028] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 04/07/2022] [Accepted: 04/16/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is a complex, chronic condition characterized by anovulation, polycystic ovarian morphology and hyperandrogenism that requires lifelong management. To reduce the risk of comorbidity and to manage symptoms, lifestyle management and pharmaceuticals such as oral contraceptives are the most common forms of treatment and should be tailored to the individual patient. The literature to date has shown PCOS patients to experience widespread dissatisfaction with the amount and quality of information they receive from providers, along with lower levels of trust in physicians. Little is known about the lived experiences of women managing PCOS in Canada, across age groups. METHODS In-depth remote interviews explored women's lived experiences managing PCOS and the barriers and facilitators they encountered in their management journeys. Data were analyzed using thematic analysis and interpretive description methodology. RESULTS Twenty-five in-depth, telephone interviews conducted with participants (aged 18-63 y) across Canada revealed participants lacking sufficient information and guidance from physicians, especially in primary care. Areas in need of more guidance included lifestyle management and mental health. Lack of empathy and weight bias among physicians were also perceived by participants. Older participants received little guidance on treatment options postmenopause. Loss of trust and withdrawal from seeking medical care were prominent themes, along with greater self-reliance on self-management, including self-educating and self-experimenting with treatments. CONCLUSIONS Most women in this study were frustrated with the level of involvement and information provision from their doctors. Key recommendations are identified for the provision of care to younger and older patients with PCOS. Improved education for physicians may be needed to improve the quality of healthcare provision for PCOS.
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Affiliation(s)
- Miya Ismayilova
- Interdisciplinary School of Health sciences, University of Ottawa, 25 University Private, Ottawa, ON K1N 7K4, Canada
| | - Sanni Yaya
- Corresponding author: Tel: +1-613-562-5800; E-mail:
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Zamora M, Sabado-Liwag M. Mental Health and PCOS Information-Sharing: Interviews with Health Care Providers in a Low-Income Urban Community. J Racial Ethn Health Disparities 2022; 10:1086-1095. [PMID: 35534681 DOI: 10.1007/s40615-022-01295-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 03/27/2022] [Accepted: 03/30/2022] [Indexed: 11/26/2022]
Abstract
Polycystic ovary syndrome (PCOS) is a female metabolic-endocrine disorder typically characterized by menstrual dysfunction, hyperandrogenism, and/or polycystic ovaries. While comorbidity with poor mental health is often observed, it is less understood if women of color are given information on PCOS, mental health, or both by healthcare providers. This paper examines the information-sharing practices of healthcare providers serving a low-income, predominantly Latino/Hispanic municipality in Southeast Los Angeles, CA. Of 65 providers identified across 27 clinics in the service area, four participated in one-on-one semi-structured interviews. Four themes relating to PCOS and mental health information were identified using content analysis. Results suggest that information-sharing on PCOS is limited to symptomatic patients and varies by provider specialization. Poor mental health as a side effect of PCOS is not elaborated on during patient-provider interactions within the explored service area. Implications and directions for further research are discussed, including mixed methods approaches for contextual information on PCOS among women of color and recommendations for improving communication among healthcare providers.
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Affiliation(s)
- Mayra Zamora
- Department of Public Health, California State University, Los Angeles, Los Angeles, CA, 90032, USA
| | - Melanie Sabado-Liwag
- Department of Public Health, California State University, Los Angeles, Los Angeles, CA, 90032, USA.
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11
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Gour A, Dubey P, Goel A, Halder A. Remote assessment and reinforcement of patient awareness of role of lifestyle modification and treatment adherence in polycystic ovary syndrome using an online video based educational module. J Turk Ger Gynecol Assoc 2022; 23:1-7. [PMID: 35263832 PMCID: PMC8907435 DOI: 10.4274/jtgga.galenos.2021.2021-9-29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objective: To evaluate the role of an online, video-based, structured, educational module in increasing awareness in women with polycystic ovary syndrome (PCOS). Material and Methods: Patients with PCOS were assessed for baseline awareness about PCOS, quantified as “awareness score”, using a validated questionnaire. Topics assessed included factual and conceptual knowledge of the disease and awareness of behaviour-related lifestyle modification and therapy compliance in PCOS. An educational video module was shown to the participants which covered normal menstrual physiology, symptomatology, pathophysiology and natural history of PCOS, a comparative animation of healthy versus unhealthy lifestyle, indications of pharmacological intervention, and role of treatment adherence. The questionnaire was re-administered after exposure to the educational module, and effectiveness of the teaching method was evaluated by comparing pre and post test scores. Results: The total number of subjects was 41. Baseline knowledge was “fair” in 17.1%, “moderate” in 48.8% and “good” in 34.1%. Significant increase in awareness scores was noted among participants regarding PCOS after exposure to the learning module from 15.09±4.31 to 18.60±3.85 (p<0.00001) with a large effect size (Cohen’s d=0.85). Most (48.8%) of the respondents had baseline awareness in the “moderate” range (scores between; 11-17) whereas post intervention scores improved to the “good” category for 63.4% of the women. Conclusion: The educational module was effective in significantly increasing knowledge about PCOS. Patient education is likely to help reinforce the message about lifestyle modification and continued compliance and may aid in promoting a patient-driven healthcare model in PCOS.
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Affiliation(s)
- Aniket Gour
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Bhopal, India
| | - Pankhuri Dubey
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Bhopal, India
| | - Archana Goel
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Bhopal, India
| | - Ajay Halder
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Bhopal, India
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Joham AE, Peña AS. Polycystic Ovary Syndrome in Adolescence. Semin Reprod Med 2022; 40:e1-e8. [PMID: 36096151 DOI: 10.1055/s-0042-1757138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Polycystic ovary syndrome (PCOS) is a common, complex, and chronic condition that presents many diagnostic and management challenges for managing clinicians. PCOS diagnosis in adolescents presents a particular challenge for treating clinicians due to the overlap of diagnostic features with normal physiological changes during adolescence. Adolescent diagnostic criteria include well-defined menstrual irregularity according to time postmenarche and hyperandrogenism, but does not require the use of pelvic ultrasound. Adolescents with only one criterion should be considered at risk of PCOS and be followed up around transition to adult care. While PCOS was traditionally considered to be a reproductive disorder, PCOS is now recognized to have major metabolic and cardiovascular health consequences and psychological sequelae that can be present from adolescence. Management of PCOS includes healthy lifestyle, metformin, combined oral contraceptive pill, and/or antiandrogens according to symptoms of concern even in adolescents at risk of PCOS.
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Affiliation(s)
- Anju E Joham
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.,Department of Diabetes and Vascular Medicine, Monash Health, Melbourne, Australia
| | - Alexia S Peña
- Discipline of Paediatrics, Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia.,Department of Endocrinology and Diabetes, Women's and Children's Hospital, North Adelaide, South Australia, Australia
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Ismayilova M, Yaya S. "I felt like she didn't take me seriously": a multi-methods study examining patient satisfaction and experiences with polycystic ovary syndrome (PCOS) in Canada. BMC Womens Health 2022; 22:47. [PMID: 35197027 PMCID: PMC8864824 DOI: 10.1186/s12905-022-01630-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 02/10/2022] [Indexed: 11/10/2022] Open
Abstract
Background Polycystic ovary syndrome (PCOS) is a common and complex condition affecting metabolic, reproductive, cardiovascular, and psychological health in women. Previous studies point to widespread dissatisfaction and delays with the diagnosis of PCOS and a lack of information provision by doctors, with few studies on Canadian populations. This multi-methods study explored the perceptions and experiences of PCOS diagnosis in Canada using an online-distributed survey and follow-up, in-depth, semi-structured phone interviews. Methods The online questionnaire was completed by 296 women aged 18–60 with a self-reported diagnosis of PCOS. The survey measured time to diagnosis, number of doctors seen, and information provided. Descriptive statistics, Chi-square tests, Fisher’s exact tests, and Spearman’s rank correlations were used to analyze the sample characteristics and correlations between the demographic factors and the outcome measures. Twenty-five follow-up interviews were held over the phone and analyzed using thematic analysis and interpretive description methodology. Results Survey respondents were dissatisfied with the information provided about PCOS (66%), lifestyle management (34%), and medical therapy (38%) at the time of diagnosis. Approximately 34% of respondents waited for more than 2 years and 41% saw 3 or more doctors before attaining diagnosis. Many did not receive any information about lifestyle management (42%) or medical therapy (28%). Interview participants encountered doctors who lacked sufficient knowledge on PCOS to diagnose, chronically dismissed concerns, and did not provide necessary medical information about the condition. Women described benefitting from self-advocation to receive the care they needed from doctors, and self-educating about PCOS using materials they could find online. Younger interview participants whose symptoms began in adolescence would often not understand the significance of symptoms until much later in life, contributing to delayed diagnoses. Conclusions Greater education on PCOS for physicians, particularly in primary care, is needed to prevent delayed diagnoses and ensure that patients are provided with reliable medical information about their condition. Greater awareness of PCOS may be necessary for the general population to help women identify symptoms, especially for adolescents and their parental figures. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-022-01630-3.
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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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Lathia T, Joshi A, Behl A, Dhingra A, Kalra B, Dua C, Bajaj K, Verma K, Malhotra N, Galagali P, Sahay R, Mittal S, Bajaj S, Moorthy S, Sharma S, Kalra S. A Practitioner's Toolkit for Polycystic Ovary Syndrome Counselling. Indian J Endocrinol Metab 2022; 26:17-25. [PMID: 35662757 PMCID: PMC9162262 DOI: 10.4103/ijem.ijem_411_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 01/23/2022] [Accepted: 01/30/2022] [Indexed: 11/14/2022] Open
Abstract
Polycystic ovary syndrome (PCOS), a frequently occurring health issue, has a significant effect on the cosmetic, metabolic, psychosocial and fertility aspects of women. A multidisciplinary team approach based on the core pillars of screening, assessment and counselling to detect, prevent and treat physiological and psychological issues in PCOS is very essential. Women are treated medically, but the psychosocial part is often forsaken. Hence, counselling forms an integral part of PCOS management that enables enhanced clinical outcomes and patient satisfaction. Digital tools and PCOS support groups have built an opportunity for physicians to create awareness, help timely diagnosis and overcome PCOS symptoms. The absence of clear guidelines to tackle the often less discussed aspects of PCOS warrants the need for consensus on PCOS counselling. This review summarizes the biopsychosocial health, clinical assessment and treatment strategies of PCOS and associated co-morbidities. The review article will discuss the clinician's role in patient education with the special focus on counselling of females with PCOS regardless of age group.
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Affiliation(s)
- Tejal Lathia
- Department of Endocrinology, Fortis, Apollo, MGM and Cloud Nine Hospitals, Navi Mumbai, Maharashtra, India
| | - Ameya Joshi
- Department of Endocrinology, Bhaktivedanta Hospital and Research Institute, Mira Road, Maharashtra, India
| | - Arti Behl
- Department of Psychiatry, Apollo BGS Hospital, Adichuchanagiri Road, Mysore, Karnataka, India
| | - Atul Dhingra
- Department of Endocrinology, Gangaram Bansal Superspeciality Hospital, Sri Ganganagar, Rajasthan, India
| | - Bharti Kalra
- Department of Gynaecology, Bharti Hospital and B.R.I.D.E, Karnal, Haryana, India
| | - Charu Dua
- Clinical Nutrition and FandB - Max Healthcare Patparganj and Vaishali, Delhi, India
| | - Kiran Bajaj
- Department of Dermatology, Kiran Bajaj Skin and Laser Centre, Karnal, Haryana, India
| | - Komal Verma
- Department of Psychology, Amity Institute of Behavioral and Allied Sciences, Amity University Rajasthan, India
| | - Neharika Malhotra
- Department of Gynaecology and Obstetrics, Rainbow IVF, Agra, Uttar Pradesh, India
| | - Preeti Galagali
- Department of Pediatrics, Bangalore Adolescent Care and Counseling Centre, Bangalore, Karnataka, India
| | - Rakesh Sahay
- Department of Endocrinology, Osmania Medical College and Osmania General Hospital, Hyderabad, Telangana, India
| | - Samta Mittal
- Department of Oral Medicine and Radiology, I.T.S. Dental College, Hospital and Research Centre, Greater Noida, Uttar Pradesh, India
| | - Sarita Bajaj
- Department of Medicine, MLN Medical College, Prayagraj, Uttar Pradesh, India
| | - Smitha Moorthy
- Department of Gynaecology and Obstetrics, Sanjeevani Hospital, Mira Road, Thane, Maharashtra, India
| | - Suresh Sharma
- College of Nursing, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Sanjay Kalra
- Department of Endocrinology, Bharti Hospital and B.R.I.D.E, Karnal, Haryana, India
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15
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Peña AS, Teede H, Hewawasam E, Hull ML, Gibson-Helm M. Diagnosis experiences of adolescents with polycystic ovary syndrome: Cross-sectional study. Clin Endocrinol (Oxf) 2022; 96:62-69. [PMID: 34585425 DOI: 10.1111/cen.14604] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 08/28/2021] [Accepted: 09/06/2021] [Indexed: 01/30/2023]
Abstract
OBJECTIVE Women with polycystic ovary syndrome (PCOS) report delayed diagnosis of the condition and receiving inadequate information at diagnosis. No studies have investigated the diagnosis experiences of adolescents with PCOS. Our objective was to investigate the adolescents' experiences of PCOS diagnosis and their concerns about the condition. DESIGN Cross-sectional study. PATIENT(S) Eighty-six adolescents (aged 13-19 years) were diagnosed with PCOS by a medical practitioner. Adolescents were recruited consecutively from paediatric and women's outpatient hospital clinics in South Australia and online PCOS support organisations in Australia and the United Kingdom (May 2017-June 2019). MEASUREMENTS PCOS diagnosis experience and information received at the time of diagnosis were evaluated using a validated questionnaire. RESULTS The majority of the adolescents (n = 67, 78%) were diagnosed with PCOS in less than 1 year from their first doctor's visit but 11 (13%) were diagnosed more than 2 years from that visit. Fifty-three adolescents (66%) saw 1-2 health professionals before the diagnosis was made. Forty-nine adolescents (57%) were satisfied with the overall diagnosis experience but adolescents were either dissatisfied or reported that the information was not mentioned after diagnosis in relation to lifestyle management (n = 47, 55%), long-term complications (n = 53, 62%) and emotional support and counselling (n = 65, 76%). CONCLUSIONS The majority of adolescent girls with PCOS are receiving a timely diagnosis, but delayed diagnosis still occurs in a minority of adolescents. Current information provided at diagnosis is not meeting the needs of adolescents and is a lost opportunity for preventive healthcare at a critical transition to adult care period.
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Affiliation(s)
- Alexia S Peña
- Discipline of Paediatrics, Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia
- Department of Endocrinology and Diabetes, Women's and Children's Hospital, North Adelaide, South Australia, Australia
| | - Helena Teede
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Erandi Hewawasam
- Discipline of Paediatrics, Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia
- Department of Endocrinology and Diabetes, Women's and Children's Hospital, North Adelaide, South Australia, Australia
| | - Mary Louise Hull
- Department of Obstetrics and Gynaecology, Women's and Children's Hospital, North Adelaide, South Australia, Australia
- Department of Obstetrics and Gynaecology, Robinson Research Institute, The University of Adelaide, North Adelaide, South Australia, Australia
| | - Melanie Gibson-Helm
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
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Van Niekerk LM, Bromfield H, Matthewson M. Physical and psychological correlates of self and body compassion in women with polycystic ovary syndrome. J Health Psychol 2021; 27:2566-2580. [PMID: 34865539 DOI: 10.1177/13591053211059390] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This international cross-sectional study examined the level and potential correlates of self and body compassion in women (n = 227) with polycystic ovary syndrome (PCOS). Participants completed an online survey examining quality of life, psychological health, body image and self and body compassion. Low levels of self and body compassion were found, with depression and body image concern identified as negative correlates of self and body compassion. Physical health was identified as a positive correlate of body compassion. The findings identify the important relationship between body image, psychological health and self and body compassion in women with PCOS.
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17
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Kałużna M, Nomejko A, Słowińska A, Wachowiak-Ochmańska K, Pikosz K, Ziemnicka K, Ruchała M. Lower sexual satisfaction in women with polycystic ovary syndrome and metabolic syndrome. Endocr Connect 2021; 10:1035-1044. [PMID: 34319905 PMCID: PMC8428045 DOI: 10.1530/ec-21-0257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 07/28/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is a multi-symptom disorder linked with a range of metabolic and hormonal disturbances. Psychological and sexual aspects of PCOS also need to be considered. OBJECTIVE OF THE STUDY This study aimed to assess sexual satisfaction (SS) in PCOS patients and eumenorrheic controls (CON). The relationships between SS, depressive symptoms, health-related quality of life (HRQoL), and hormonal and metabolic profiles were evaluated. METHODS In this study, 190 patients with PCOS (mean age 26.34 ± 5.47 years) and 197 age-matched CON (mean age 27.12 ± 4.97 years) were enrolled. All subjects completed Polish version of the Sexual Satisfaction Questionnaire (SSQ), WHO Quality of Life-BREF (WHOQOL-BREF), and the Center for Epidemiologic Studies Depression Scale-Revised (CESD-R) questionnaire. Fasting blood samples were collected to assess hormonal, lipid, and glucose profiles. Anthropometric measures were collected. Metabolic syndrome (MS) was evaluated according to the IDF-AHA/NHLBI criteria. RESULTS Patients with PCOS and MS had lower SS vs non-MS-PCOS. There were no significant differences in the level of SS, presence of depressive symptoms, or HRQoL between PCOS and CON (P > 0.05). Negative correlations were found between the SS level and BMI, waist circumference, and waist-to-height ratio in PCOS women. However, overweight or obese PCOS women did not differ in SS levels vs normal-weight PCOS patients. The social dimension of WHOQOL-BREF was the only significant predictor of SS in PCOS patients. CONCLUSIONS SS in PCOS women appears to be undisturbed. However, MS in PCOS patients could negatively influence SS. The level of SS should be assessed in PCOS women, especially if MS is present.
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Affiliation(s)
- Małgorzata Kałużna
- Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland
- Correspondence should be addressed to M Kałużna:
| | - Agnieszka Nomejko
- Institute of Psychology, Faculty of Pedagogical and Historical Sciences, University of Wrocław, Wrocław, Poland
| | - Aleksandra Słowińska
- Institute of Psychology, Faculty of Pedagogical and Historical Sciences, University of Wrocław, Wrocław, Poland
| | | | - Katarzyna Pikosz
- Department of Pharmacognosy, Poznan University of Medical Sciences, Poznan, Poland
| | - Katarzyna Ziemnicka
- Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Marek Ruchała
- Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland
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18
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Self-Concept, Depression, and Anxiety Levels of Adolescents with Polycystic Ovary Syndrome. J Pediatr Adolesc Gynecol 2021; 34:311-316. [PMID: 33347988 DOI: 10.1016/j.jpag.2020.12.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 12/10/2020] [Accepted: 12/12/2020] [Indexed: 12/20/2022]
Abstract
STUDY OBJECTIVE In this study we explored the level and severity of issues related to self-concept, depression, and anxiety in adolescents with polycystic ovary syndrome (PCOS). DESIGN Cross-sectional and case-control study. SETTING The research was conducted in the outpatient Pediatric Endocrinology Clinic of Adiyaman University School of Medicine in Turkey. PARTICIPANTS The study population comprised 153 patients with PCOS and 161 healthy adolescents. INTERVENTIONS AND MAIN OUTCOME MEASURES The Personal Information Form, State-Trait Anxiety Inventory for Children, Children's Depression Inventory, and Piers-Harris Children's Self-Concept Scale were administered to all of the participants who took part in the study. RESULTS The Piers-Harris Children's Self-Concept Scale scores were lower in the PCOS group than in the control group (P < .001). In addition, the scores for the Children's Depression Inventory were also significantly higher in the PCOS group (P < .001). The State-Trait Anxiety Inventory for Children scores showed statistically significant higher levels of state anxiety and trait anxiety in the PCOS group (P < .001). CONCLUSION Adolescents with PCOS had lower self-concept scores, greater anxiety levels, and increased depressive symptoms than the healthy controls. Future studies are needed to examine the psychiatric problems in adolescents with PCOS.
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19
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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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20
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Copp T, Doust J, McCaffery K, Hersch J, Jansen J. Polycystic ovary syndrome: why widening the diagnostic criteria may be harming women. BMJ 2021; 373:n700. [PMID: 33863701 DOI: 10.1136/bmj.n700] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
| | - Jenny Doust
- University of Queensland, Brisbane, Australia
| | | | | | - Jesse Jansen
- Maastricht University, Maastricht, Netherlands
- University of Sydney, Sydney, Australia
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21
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Naumova I, Castelo-Branco C, Casals G. Psychological Issues and Sexual Function in Women with Different Infertility Causes: Focus on Polycystic Ovary Syndrome. Reprod Sci 2021; 28:2830-2838. [PMID: 33763818 DOI: 10.1007/s43032-021-00546-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 03/09/2021] [Indexed: 12/30/2022]
Abstract
The objectives of this study are to assess the prevalence of psychological complaints and changes in sexual function in infertile PCOS women compared with patients with other infertility causes (tubal and male infertility factors) and to identify the predisposing factors. An observational study with three cohorts of infertile women was designed including 37 PCOS patients, 36 women with tubal factor, and 31 women with male factor. Clinical history and physical examination were carried out in all patients. All subjects completed the Hamilton Anxiety Rating Scale, the Beck Depression Inventory, and the Female Sexual Function Index questionnaires. Women with infertility due to PCOS showed a significantly higher prevalence of depressive (48.6 vs 19.4 and 12.9%, p < 0.01) and anxiety symptoms (21.6 vs 5.6 and 3.2%, p = 0.041) than respondents of reference groups. Sexual function in PCOS subjects was impaired in the areas orgasm and satisfaction (p < 0.01 for both) compared to patients of reference groups. Clinical, biochemical hyperandrogenism, and overweight were associated with a higher incidence of depressive and anxiety symptoms in the infertile PCOS group (p < 0.01 for all). Besides, the severity of anxiety symptoms was associated with the number of medically assisted reproduction attempts (p = 0.014). Weight gain and age (p = 0.04 and p = 0.047) were associated with impaired sexual functioning. The relation between reduced sexuality and depressive/anxiety symptoms was found (p = 0.038 and p = 0.012, respectively). Infertile PCOS patients showed the highest prevalence of psychological complaints and some impairment in their sexual functioning. Mental health and sexual functioning need to be part of the routine clinical screening of every PCOS patient. The study was registered at clinicaltrials.gov (identifier: NCT03306459) https://clinicaltrials.gov/ct2/show/NCT03306459?cond=PCOS&cntry=ES&city=Barcelona&draw=2&rank=3.
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Affiliation(s)
- Iuliia Naumova
- Clinic Institute of Gynecology, Obstetrics and Neonatology, Faculty of Medicine, Hospital Clinic-Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Villarroel 170, 08036, Barcelona, Spain
- Department of Obstetrics and Gynecology, Faculty of General Medicine, Saratov State Medical University n.a. V.I. Razumovsky, Saratov, Russian Federation
| | - Camil Castelo-Branco
- Clinic Institute of Gynecology, Obstetrics and Neonatology, Faculty of Medicine, Hospital Clinic-Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Villarroel 170, 08036, Barcelona, Spain.
| | - Gemma Casals
- Clinic Institute of Gynecology, Obstetrics and Neonatology, Faculty of Medicine, Hospital Clinic-Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Villarroel 170, 08036, Barcelona, Spain
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Impact of polycystic ovary syndrome on quality of life of women in correlation to age, basal metabolic index, education and marriage. PLoS One 2021; 16:e0247486. [PMID: 33690645 PMCID: PMC7946178 DOI: 10.1371/journal.pone.0247486] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 01/01/2021] [Indexed: 01/24/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) is the major endocrine related disorder in young age women. Physical appearance, menstrual irregularity as well as infertility are considered as a sole cause of mental distress affecting health-related quality of life (HRQOL). This prospective case-control study was conducted among 100 PCOS and 200 healthy control cases attending tertiary care set up of AIIMS, Patna during year 2017 and 2018. Pre-validated questionnaires like Short Form Health survey-36 were used for evaluating impact of PCOS in women. Multivariate analysis was applied for statistical analysis. In PCOS cases, socioeconomic status was comparable in comparison to healthy control. But, PCOS cases showed significantly decreased HRQOL. The higher age of menarche, irregular/delayed menstrual history, absence of child, were significantly altered in PCOS cases than control. Number of child, frequency of pregnancy, and miscarriage were also observed higher in PCOS cases. Furthermore, in various category of age, BMI, educational status and marital status, significant differences were observed in the different domain of SF-36 between PCOS and healthy control. Altogether, increased BMI, menstrual irregularities, educational status and marital status play a major role in altering HRQOL in PCOS cases and psychological care must be given during patient care.
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Psychological Distress in Women Living with Polycystic Ovary Syndrome: The Role of Illness Perceptions. Womens Health Issues 2021; 31:177-184. [DOI: 10.1016/j.whi.2020.11.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 09/23/2020] [Accepted: 11/03/2020] [Indexed: 12/15/2022]
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Abstract
Polycystic ovary syndrome (PCOS) is a common endocrinopathy that has been associated with impaired fertility. This chapter reviews the underlying pathophysiology of PCOS and the associated fertility barriers of the condition. Psychologic concerns, hypothalamic-pituitary, ovarian, and mitochondria dysfunction, obesity, and the role of vitamin D in PCOS are considered with respect to fertility. Lastly, pregnancy risk factors associated with PCOS are also reviewed.
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Affiliation(s)
- Jessica A Lentscher
- Walter Reed National Military Medical Center
- Program of Reproductive Endocrinology and Infertility, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
| | - Breonna Slocum
- Department of Obstetrics and Gynecology, Georgetown University, Washington, District of Columbia
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Aliyev U, Pehlivantürk-Kızılkan M, Düzçeker Y, Kanbur N, Aycan Z, Akgül S, Derman O. Is There Any Association Between Hirsutism and Serum Zinc Levels in Adolescents? Biol Trace Elem Res 2020; 198:403-409. [PMID: 32124229 DOI: 10.1007/s12011-020-02086-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Zinc has shown to have an anti-androgenic effect through 5 alpha-reductase enzyme activity inhibition in skin. However, there are contradicting findings concerning the effect of zinc on hirsutism mainly from studies including adult women with polycystic ovary syndrome (PCOS). The aim of our study was to investigate the association between serum zinc levels and hirsutism in adolescents. Between October 2017 and June 2018, 51 female adolescents with hirsutism (mean age: 16.11 ± 1.47 years) and 51 healthy female controls were included in the study (mean age: 15.5 ± 1.40 years). Adolescents with hirsutism were classified under two groups; PCOS (n = 34, 66.7%) and idiopathic causes of hirsutism (idiopathic hirsutism (n = 9, 17.6%) and idiopathic hyperandrogenemia (n = 8, 15.7%)). The serum zinc levels were measured via atomic absorption spectrophotometry. The mean zinc levels of adolescents with hirsutism (102.02 ± 11.64 μg/dl) and the control group (101.72 ± 16.71 μg/dl) were similar (p = 0.915). Additionally, there was no significant difference among the mean zinc levels of the hirsutism sub-groups and the control group (p = 0.979). While some studies demonstrated low zinc levels in women with hirsutism, some studies similar to ours showed no association. Adolescence is a developmental phase where generally isolated mild hirsutism is not associated with hyperandrogenism and more studies are needed to evaluate the effect of zinc on hirsutism in this age group.
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Affiliation(s)
- Ulvi Aliyev
- Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University Medical School, 06610, Ankara, Turkey
| | - Melis Pehlivantürk-Kızılkan
- Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University Medical School, 06610, Ankara, Turkey.
| | - Yasemin Düzçeker
- Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University Medical School, 06610, Ankara, Turkey
| | - Nuray Kanbur
- Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University Medical School, 06610, Ankara, Turkey
| | - Zehra Aycan
- Department of Pediatrics, Division of Pediatric Endocrinology, Ankara University Medical School, Ankara, Turkey
| | - Sinem Akgül
- Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University Medical School, 06610, Ankara, Turkey
| | - Orhan Derman
- Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University Medical School, 06610, Ankara, Turkey
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Al Khalifah RA, Florez ID, Zoratti MJ, Dennis B, Thabane L, Bassilious E. Efficacy of Treatments for Polycystic Ovarian Syndrome Management in Adolescents. J Endocr Soc 2020; 5:bvaa155. [PMID: 33324861 PMCID: PMC7724745 DOI: 10.1210/jendso/bvaa155] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Indexed: 02/07/2023] Open
Abstract
Limited evidence on treatment options for polycystic ovarian syndrome (PCOS) has led to considerable variation in health care practices. We aimed to compare the effects of metformin and/or oral contraceptive pills (OCP) in combination with pioglitazone, spironolactone, flutamide, and lifestyle interventions among adolescents aged 11 to 19 years with PCOS. Literature searches were performed in Medline, Embase, and the Cochrane Central Register of Controlled Trials from database inception through December 2018, with no language restriction. Two reviewers screened titles and abstracts, assessed full text eligibility, and extracted information from eligible trials. Evidence was synthesized through network meta-analyses (NMA) using a Bayesian random-effects approach. We identified 37 randomized controlled trials, in which 2400 patients were randomized. NMA showed no statistically important difference among all interventions to improve menstrual regulation or body mass index. Moderate-quality evidence showed hirsutism scores were reduced by multiple interventions that included single and combination medications namely; lifestyle intervention, metformin, OCP, spironolactone, pioglitazone, metformin-OCP, metformin-spironolactone, and metformin-flutamide against placebo. Moderate-quality evidence showed OCP results in more dysglycemia compared to metformin (odds ratio, 2.98; 95% credible interval, 1.02-8.96), no intervention resulted in dysglycemia reduction. In conclusion, metformin and OCP as monotherapy or in combination with other interventions compared with placebo can reduce hirsutism scores, but none of these medications lead to effective menstrual cycle regulation or weight reduction. However, the use of OCP leads to worse cardiometabolic risk factors. Further research into new treatment options is urgently needed. PROSPERO registration number CRD42015016148.
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Affiliation(s)
- Reem A Al Khalifah
- Department of Pediatrics, Division of Pediatric Endocrinology and Metabolism, College of Medicine, King Saud University, Riyadh, Saudi Arabia.,Department of Health Research Methodology, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Ivan D Florez
- Department of Health Research Methodology, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.,Department of Pediatrics, Universidad de Antioquia, Medellín, Colombia
| | - Michael J Zoratti
- Department of Health Research Methodology, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Brittany Dennis
- Department of Health Research Methodology, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.,Department of medicine, McMaster University, Hamilton, Ontario, Canada
| | - Lehana Thabane
- Department of Health Research Methodology, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.,Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.,Department of Pediatrics and Anesthesia, McMaster University, Hamilton, Ontario, Canada
| | - Ereny Bassilious
- Department of Pediatrics, Division of Endocrinology and Metabolism, McMaster University, Hamilton, Ontario, Canada
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Ee C, Smith C, Moran L, MacMillan F, Costello M, Baylock B, Teede H. "The whole package deal": experiences of overweight/obese women living with polycystic ovary syndrome. BMC Womens Health 2020; 20:221. [PMID: 33008386 PMCID: PMC7532653 DOI: 10.1186/s12905-020-01090-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Accepted: 09/27/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Polycystic Ovary Syndrome (PCOS) is a common female reproductive disorder with multiple manifestations. There are relatively few qualitative studies exploring the nature of living with PCOS despite its high prevalence. Qualitative research can enhance clinical practice via the provision of patient insights into the experience of living with their condition. METHODS We conducted two focus groups and three semi-structured interviews of Australian overweight/obese women with PCOS aged 18-46 years between March and April 2017 who were recruited through social media advertising. Interviews and focus groups were audio recorded and transcribed verbatim. Thematic analysis was applied to the data, using the method of constant comparison. RESULTS Ten women contributed data from two focus groups and two semi-structured interviews. Five themes emerged from the data: complexity of the condition with its multiple manifestations, difficulties with delayed diagnosis and lack of information provided after diagnosis, negative experiences on social media and online forums and the need for support, frustration over lack of a "cure"; and the impact of symptoms and concern about long-term sequelae. CONCLUSIONS Living with PCOS appears to generate a significant degree of anxiety about the future, dissatisfaction with current treatment models, and loss of feminine identity. Gaps in timely diagnosis, information and support provision need to be addressed. This includes supporting weight management as a fundamental concern for women with PCOS.
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Affiliation(s)
- Carolyn Ee
- NICM Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751 Australia
| | - Caroline Smith
- Graduate Research School, and NICM Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751 Australia
| | - Lisa Moran
- Monash Centre for Health Research and Implementation - MCHRI, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, Vic 3168 Australia
| | - Freya MacMillan
- School of Health Sciences, and the Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751 Australia
| | - Michael Costello
- School of Women’s and Children’s Health, UNSW, Royal Hospital for Women, Barker St, Randwick, NSW 2031 Australia
| | - Brandi Baylock
- Western Sydney University, Locked Bag 1797, Penrith, NSW 2751 Australia
| | - Helena Teede
- Monash Centre for Health Research and Implementation – MCHRI, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, Vic 3168 Australia
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28
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Wilson NA, Peña AS. Quality of life in adolescent girls with polycystic ovary syndrome. J Paediatr Child Health 2020; 56:1351-1357. [PMID: 32810373 DOI: 10.1111/jpc.15097] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 05/24/2020] [Accepted: 07/06/2020] [Indexed: 12/20/2022]
Abstract
Quality of life (QoL) is an important aspect of health and well-being. QoL is reduced in women with polycystic ovary syndrome (PCOS), but there is limited data in adolescents. This review aimed to assess studies regarding the QoL of adolescent girls with PCOS. Five databases were searched for relevant studies. Studies were included if they were conducted in adolescent girls with PCOS, aged 12-22 years old, and used a questionnaire to measure QoL. The search identified a total of 254 studies, and after exclusions, 11 relevant studies were included in the review. Most studies had a relatively small sample size, but overall included a total of 512 adolescents with PCOS. In most cases, adolescent girls with PCOS have reduced QoL when compared to healthy girls, and PCOS symptoms/excess weight impact on their QoL. Further research is required due to limited data on QoL in adolescents with PCOS of normal weight.
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Affiliation(s)
- Nina A Wilson
- Discipline of Paediatrics, Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia.,Department of Endocrinology and Diabetes, Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - Alexia S Peña
- Discipline of Paediatrics, Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia.,Department of Endocrinology and Diabetes, Women's and Children's Hospital, Adelaide, South Australia, Australia
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Ekramzadeh M, Hajivandi L, Noroozi M, Mostafavi F. Psychological Experiences of Adolescent Girls with Polycystic Ovary Syndrome: A Qualitative Study. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2020; 25:341-347. [PMID: 33014747 PMCID: PMC7494171 DOI: 10.4103/ijnmr.ijnmr_276_19] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 02/29/2020] [Accepted: 04/28/2020] [Indexed: 11/04/2022]
Abstract
Background Polycystic Ovary Syndrome (PCOS) is one of the most common endocrine disorders in the women of reproductive age. In addition to multiple physical problems, this syndrome has many psychological manifestations. Thus, the present research was conducted aimed at investigating the psychological experiences of the adolescent girls with PCOS. Materials and Methods This research was conducted using the qualitative content analysis method. A total of 18 adolescent girls with PCOS and 15 healthcare providers were selected by the purposive sampling method. The data were collected through in-depth interviews, focus group discussions, and field notes, which were analyzed using the conventional content analysis method. Results After analyzing, three main categories and seven subcategories were extracted. First, the psychological experiences related to the disease symptoms had three subcategories: "psychological experiences related to hirsutism, alopecia, and acne," "psychological experiences related to obesity," and "psychological experiences related to menstrual disorders." Second, the psychological experiences related to disease complications had two subcategories: "psychological experiences related to infertility" and "psychological experiences related to disease progression." Third, the psychological experiences related to treatment of the disease had two subcategories: "psychological experiences related to prolongation of the treatment and uncertain fate of the disease" and "psychological experiences related to the complications of the medical treatment." Conclusions Results of the study showed that adolescent girls with PCOS were exposed to multiple concerns endangering their psychological health. Therefore, it is recommended to provide adequate and appropriate information about the disease and its consequences, as well as psychosocial supports and regular assessment of psychological state by the team of healthcare providers in the adolescent girls with PCOS.
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Affiliation(s)
- Maryam Ekramzadeh
- Nutrition Research Center, Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Leila Hajivandi
- Department of Nursing and Midwifery, Kazerun Medical Sciences Branch, Islamic Azad University, Kazerun, Iran
| | - Mahnaz Noroozi
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Firoozeh Mostafavi
- Department of Health Education and Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
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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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Copp T, Cvejic E, McCaffery K, Hersch J, Doust J, Mol BW, Dokras A, Mishra G, Jansen J. Impact of a diagnosis of polycystic ovary syndrome on diet, physical activity and contraceptive use in young women: findings from the Australian Longitudinal Study of Women’s Health. Hum Reprod 2020; 35:394-403. [DOI: 10.1093/humrep/dez274] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 11/15/2019] [Accepted: 11/22/2019] [Indexed: 12/31/2022] Open
Abstract
Abstract
STUDY QUESTION
Do diet, physical activity and contraceptive use change after receiving a diagnosis of polycystic ovary syndrome (PCOS)?
SUMMARY ANSWER
Using longitudinal data 12 months apart, young women newly diagnosed with PCOS were more likely to stop using contraception but did not change their physical activity or vegetable intake.
WHAT IS KNOWN ALREADY
Diagnostic criteria for PCOS have widened to capture more women, despite limited evidence of the benefits and harms. Possible benefits of a PCOS diagnosis are that it may help women with family planning and motivate them to implement healthy lifestyle changes to reduce the reproductive, metabolic and cardiovascular risks associated with PCOS. However, there are no empirical studies investigating how women respond to a diagnosis of PCOS with respect to their health behaviour, and longitudinal population-based studies are lacking.
STUDY DESIGN, SIZE, DURATION
This is a longitudinal analysis of two waves of data collected 12 months apart from the cohort born 1989–1995 in the Australian Longitudinal Survey on Women’s Health, a population-based cohort study. Women in this cohort were first surveyed in 2012-2013, aged 18-23 years.
PARTICIPANTS/MATERIALS, SETTING, METHODS
Women who responded to the 2014 survey (aged 19–24, n = 11 344) and 2015 survey (aged 20–25, n = 8961) were included. Using logistic regression, multinomial logistic regression and linear regression, change in vegetable intake, physical activity and contraceptive use were compared for women newly diagnosed with PCOS to women not reporting a diagnosis of PCOS. Changes in psychological distress and BMI were also examined.
MAIN RESULTS AND THE ROLE OF CHANCE
Young women reporting a new diagnosis of PCOS were no more likely to increase their vegetable intake or physical activity than women not reporting a PCOS diagnosis. Women newly diagnosed with PCOS were 3.4 times more likely to stop using contraception during the 12-month study period than women without PCOS (14% versus 4%, 95% CI = 2.3 to 5.1, P < 0.001). This difference remained significant after controlling for demographics, chronic conditions associated with PCOS, endometriosis, BMI and psychological distress (P < 0.001).
LIMITATIONS, REASONS FOR CAUTION
All data was self-reported including PCOS diagnosis, assessment of diet quality was limited to vegetable intake only. The exact timing of diagnosis within the 12-month period and whether the women intended to conceive are unknown. The number of women reporting a new diagnosis of PCOS was also relatively small.
WIDER IMPLICATIONS OF THE FINDINGS
These findings suggest that a diagnosis of PCOS may not produce short-term benefits by way of improving health behaviour. The observed reduction in contraception use suggests some women may be at increased risk of unplanned pregnancies, highlighting the importance of counselling about contraceptive needs. Both potential benefits and harms must be considered when determining the appropriateness of a PCOS diagnosis.
STUDY FUNDING/COMPETING interest(s)
The Australian Longitudinal Study on Women’s Health is funded by the Australian Government Department of Health. BWM reports consultancy for ObsEva, Merck, Merck KGaA and Guerbet. No further competing interests exist.
TRIAL REGISTRATION NUMBER
N/A
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Affiliation(s)
- Tessa Copp
- Wiser Healthcare, Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
- Sydney Health Literacy Lab, School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
| | - Erin Cvejic
- Wiser Healthcare, Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
- Sydney Health Literacy Lab, School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
| | - Kirsten McCaffery
- Wiser Healthcare, Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
- Sydney Health Literacy Lab, School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
| | - Jolyn Hersch
- Wiser Healthcare, Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
- Sydney Health Literacy Lab, School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
| | - Jenny Doust
- Wiser Healthcare, Centre for Research in Evidence-Based Practice, Bond University, Robina, 4226, Australia
| | - Ben W Mol
- Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC, 3800, Australia
| | - Anuja Dokras
- Penn PCOS Centre, Department of Obstetrics and Gynaecology, University of Pennsylvania, Philadelphia, 19104, USA
| | - Gita Mishra
- School of Public health, Faculty of Medicine, The University of Queensland, QLD, 4006, Australia
| | - Jesse Jansen
- Wiser Healthcare, Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
- Sydney Health Literacy Lab, School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
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Hewawasam E, Brennan L, Giles L, Hull ML, Short A, Norman R, Peña AS. Assessing Whether Meditation Improves Quality of Life for Adolescent Girls With Polycystic Ovary Syndrome: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2020; 9:e14542. [PMID: 32012099 PMCID: PMC7013635 DOI: 10.2196/14542] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 08/20/2019] [Accepted: 08/21/2019] [Indexed: 02/03/2023] Open
Abstract
Background Polycystic Ovary Syndrome (PCOS) is a common endocrine condition characterized by irregular periods and hyperandrogenism. Adolescents with PCOS have impaired quality of life (QOL) and increased psychological distress. Transcendental Meditation (TM) is a well-established self-management strategy that has been used to improve stress and well-being. A meta-analysis of TM trials has shown beneficial effects on stress and blood pressure in adults. Recent data are suggesting that another self-management strategy called a mindfulness stress management program has a role in improving QOL in women with PCOS, but there are no studies in adolescents. Objective This study aims to evaluate the effect of TM on QOL and psychological distress in adolescent girls with PCOS. Methods This study is a randomized controlled trial that will be conducted over eight weeks at the Women’s and Children’s Hospital in Adelaide, South Australia, to determine the effect of TM on QOL and psychological distress in adolescent girls (aged 12-20 years) with PCOS. A total of 40 girls will be randomized into either the TM (n=20) or control group (n=20). The TM group will be asked to practice TM in a comfortable sitting position with the eyes closed, for 15 minutes twice daily over eight weeks. The control group will be asked to sit quietly for 15 minutes twice daily for eight weeks. The primary outcomes are any effects on improving QOL and psychological distress, and the secondary outcomes are any effects on lowering blood pressure and salivary cortisol levels. Results The recruitment of study participants began in May 2019 and is expected to be completed by June 2020. It is expected that the adolescent girls with PCOS practicing TM over eight weeks will have a significant improvement in QOL and psychological distress compared to adolescents in the control group. Also, it is expected that adolescent girls in the TM group will have lower salivary cortisol levels and lower blood pressure. Conclusions This study will be the first to evaluate the effect of TM on QOL in adolescent girls with PCOS. The study will provide valuable information on a potential self-management strategy to improve QOL and well-being in adolescent girls with PCOS. Trial Registration Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN1261900019010; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=376657&amp;isReview=true International Registered Report Identifier (IRRID) PRR1-10.2196/14542
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Affiliation(s)
- Erandi Hewawasam
- Discipline of Paediatrics, Robinson Research Institute, University of Adelaide, Adelaide, Australia.,Department of Endocrinology and Diabetes, Women's and Children's Hospital, North Adelaide, Australia
| | - Leah Brennan
- School of Behavioural and Health Sciences, Australian Catholic University, Fitzroy, Australia.,Centre for Eating, Weight and Body Image, Melbourne, Australia.,School of Psychology and Public Health, La Trobe University, Wodonga, Australia
| | - Lynne Giles
- School of Public Health, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - Mary Louise Hull
- Department of Obstetrics and Gynaecology, Women's and Children's Hospital, North Adelaide, Australia.,Obstetrics and Gynaecology, Robinson Research Institute, The University of Adelaide, North Adelaide, Australia
| | - Asha Short
- Department of Obstetrics and Gynaecology, Women's and Children's Hospital, North Adelaide, Australia
| | - Robert Norman
- Obstetrics and Gynaecology, Robinson Research Institute, The University of Adelaide, North Adelaide, Australia
| | - Alexia S Peña
- Discipline of Paediatrics, Robinson Research Institute, University of Adelaide, Adelaide, Australia.,Department of Endocrinology and Diabetes, Women's and Children's Hospital, North Adelaide, Australia
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Vatopoulou A, Tziomalos K. Management of obesity in adolescents with polycystic ovary syndrome. Expert Opin Pharmacother 2020; 21:207-211. [DOI: 10.1080/14656566.2019.1701655] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Anastasia Vatopoulou
- First Department of Obstetrics and Gynecology, Medical School, Aristotle University Thessaloniki, Papageorgiou Hospital, Thessaloniki, Greece
| | - Konstantinos Tziomalos
- First Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
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Çoban ÖG, Tulacı ÖD, Adanır AS, Önder A. Psychiatric Disorders, Self-Esteem, and Quality of Life in Adolescents with Polycystic Ovary Syndrome. J Pediatr Adolesc Gynecol 2019; 32:600-604. [PMID: 31362114 DOI: 10.1016/j.jpag.2019.07.008] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 07/12/2019] [Accepted: 07/22/2019] [Indexed: 02/06/2023]
Abstract
STUDY OBJECTIVE To assess psychiatric disorders in adolescents with polycystic ovary syndrome (PCOS) and evaluate health-related quality of life and self-esteem in this group. DESIGN Cross-sectional design. The survey was composed of validated measures and a semistructured interview. SETTING University School of Medicine, Turkey. PARTICIPANTS Female adolescents aged 13-18 years. INTERVENTIONS AND MAIN OUTCOME MEASURES Assessment of psychiatric disorders through a semistructured interview (Schedule for Affective Disorders and Schizophrenia for School Age Children) conducted by a child and adolescent psychiatrist. Health-related quality of life was measured using the Pediatric Quality of Life Inventory (PedsQL) and self-esteem was measured using the Rosenberg Self-Esteem Scale (RSES). RESULTS A total of 28 adolescent with PCOS and 31 age- and sex-matched healthy peers were recruited. The psychiatric diagnosis rate was higher in the PCOS group than in the control group (P < .5). In the patient group, 6 of 28 patients (21%) were diagnosed with depressive disorder and the most common single diagnosis was major depressive disorder. There were no significant differences in the PCOS and control groups in terms of RSES and PedsQL scores. There was no significant relationship between RSES scores and body image related to hirsutism, acne, and body mass index. Also, there was no significant relationship between PedsQL scores and hirsutism, acne, and body mass index. CONCLUSION Adolescents with PCOS frequently experience psychiatric disorders. Physicians should be aware that adolescents with PCOS are at a high risk for major depression and anxiety disorders.
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Affiliation(s)
- Özge Gizli Çoban
- Department of Child and Adolescent Psychiatry, Akdeniz University School of Medicine, Antalya, Turkey.
| | - Özge Demircan Tulacı
- Department of Child and Adolescent Psychiatry, Uşak University Research and Training Hospital, Uşak, Turkey
| | - Asli Sürer Adanır
- Department of Child and Adolescent Psychiatry, Akdeniz University School of Medicine, Antalya, Turkey
| | - Arif Önder
- Department of Child and Adolescent Psychiatry, Akdeniz University School of Medicine, Antalya, Turkey
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35
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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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Copp T, Hersch J, Muscat DM, McCaffery KJ, Doust J, Dokras A, Mol BW, Jansen J. The benefits and harms of receiving a polycystic ovary syndrome diagnosis: a qualitative study of women's experiences. Hum Reprod Open 2019; 2019:hoz026. [PMID: 31687475 PMCID: PMC6822814 DOI: 10.1093/hropen/hoz026] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 08/08/2019] [Accepted: 08/22/2019] [Indexed: 12/22/2022] Open
Abstract
STUDY QUESTION What are the benefits and harms of receiving a polycystic ovary syndrome (PCOS) diagnosis in a community sample of women, including impact on psychosocial wellbeing, lifestyle choices and behaviour? SUMMARY ANSWER Although some women benefit considerably from the diagnosis, such as through increased awareness and reassurance, women with minimal symptoms may experience more harm than benefit, including long-lasting anxiety and altered life plans. WHAT IS KNOWN ALREADY Disease labels can validate symptoms and play a vital role in understanding and coping with illness; however, they can also cause harm by evoking illness schemas about severity and permanence. Regarding PCOS, the diagnostic criteria have expanded over time to include women with milder phenotypes (such as those without signs of androgen excess). This has occurred despite limited investigation of the benefits and harms of the diagnosis and has increased the number of women diagnosed. STUDY DESIGN SIZE DURATION Semi-structured interviews were conducted face-to-face or by telephone with 26 participants from April-July 2018 to explore women's experiences with the diagnosis, including the benefits and harms of receiving the diagnosis and the impact on their life. PARTICIPANTS/MATERIALS SETTING METHODS In total, 26 women in the community self-reporting a diagnosis of PCOS (reporting mild to severe symptoms) made by a medical doctor, aged 18-45 years and living in Australia were recruited through social media. Data were analysed thematically using Framework analysis. MAIN RESULTS AND THE ROLE OF CHANCE The study identified a range of both positive and negative effects of a PCOS diagnosis in the immediate, short and long-term, which were influenced by symptom severity, expectations and experience. For women with previously unexplained and bothersome symptoms, it was a relief to receive a diagnosis, and this resulted in an increased understanding about the importance of a healthy lifestyle. By contrast, women with milder symptoms often reported feeling shocked and overwhelmed by the diagnosis, consequently experiencing anxiety about the associated long-term risks. The majority of women, regardless of symptom severity, experienced prolonged worry and anxiety about infertility, resulting for some in risk taking with contraception, unintended pregnancies, pressure to conceive early or altered life plans. With time, many women developed positive coping strategies and perceived the diagnosis to be valuable, including those who felt they had experienced minimal benefit or even harm. LIMITATIONS REASONS FOR CAUTION PCOS diagnosis was self-reported and the sample was highly educated. WIDER IMPLICATIONS OF THE FINDINGS Fear of infertility was salient for many women, underscoring the need for accurate information, counselling and reassurance of fertility potential. Given the risk of significant consequences, health professionals should use a tailored approach to PCOS diagnosis to increase the benefits of appropriate and timely diagnosis for women affected by significant symptoms, while reducing the harms of unnecessarily labelling healthy women for whom the benefits of a diagnosis are small. STUDY FUNDING/COMPETING INTERESTS The study was funded by the University of Sydney Lifespan Research Network and an NHMRC Program Grant (APP1113532). B.W.M. reports consultancy for ObsEva, Merck, Merck KGaA and Guerbet. No further competing interests exist. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- T Copp
- Wiser Healthcare, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, 2006, Australia
- Sydney Health Literacy Lab, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, 2006, Australia
| | - J Hersch
- Wiser Healthcare, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, 2006, Australia
- Sydney Health Literacy Lab, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, 2006, Australia
| | - D M Muscat
- Wiser Healthcare, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, 2006, Australia
- Sydney Health Literacy Lab, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, 2006, Australia
| | - K J McCaffery
- Wiser Healthcare, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, 2006, Australia
- Sydney Health Literacy Lab, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, 2006, Australia
| | - J Doust
- Wiser Healthcare, Centre for Research in Evidence-Based Practice, Bond University, Robina 4226, Australia
| | - A Dokras
- Penn PCOS Centre, Department of Obstetrics and Gynaecology, University of Pennsylvania, Philadelphia 19104, USA
| | - B W Mol
- Department of Obstetrics and Gynaecology, Monash University, Clayton, 3800, Australia
| | - J Jansen
- Wiser Healthcare, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, 2006, Australia
- Sydney Health Literacy Lab, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, 2006, Australia
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Ribeiro VB, Lopes IP, Dos Reis RM, Silva RC, Mendes MC, Melo AS, de Souza HCD, Ferriani RA, Kogure GS, Lara LADS. Continuous versus intermittent aerobic exercise in the improvement of quality of life for women with polycystic ovary syndrome: A randomized controlled trial. J Health Psychol 2019; 26:1307-1317. [PMID: 31495231 DOI: 10.1177/1359105319869806] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Polycystic ovary syndrome predisposes alterations which contribute to the reduction of quality of life. This randomized controlled clinical trial study was to evaluate the effect of two protocols of aerobic exercise on quality of life in women with polycystic ovary syndrome. Women were allocated to three groups: continuous aerobic training (n = 28), intermittent aerobic training (n = 29), and control group (no training; n = 30). Testosterone levels, body composition indices, and quality of life were assessed at baseline and after 16 weeks of intervention. Both protocols were effective to improve testosterone levels, anthropometric indices, and quality of life in polycystic ovary syndrome women. Thus, these protocols should be included in the clinical environment to improve clinical parameters psychological, biological and social health to this population.
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Affiliation(s)
- Victor Barbosa Ribeiro
- Ribeirão Preto Medical School, Human Reproduction Sector, Department of Gynecology and Obstetrics, University of São Paulo, Ribeirão Preto, Brazil.,Federal Institute of São Paulo, Jacarei Campus, Brazil
| | - Iris Palma Lopes
- Ribeirão Preto Medical School, Human Reproduction Sector, Department of Gynecology and Obstetrics, University of São Paulo, Ribeirão Preto, Brazil
| | - Rosana Maria Dos Reis
- Ribeirão Preto Medical School, Human Reproduction Sector, Department of Gynecology and Obstetrics, University of São Paulo, Ribeirão Preto, Brazil
| | - Rafael Costa Silva
- Ribeirão Preto Medical School, Human Reproduction Sector, Department of Gynecology and Obstetrics, University of São Paulo, Ribeirão Preto, Brazil
| | - Maria Célia Mendes
- Ribeirão Preto Medical School, Human Reproduction Sector, Department of Gynecology and Obstetrics, University of São Paulo, Ribeirão Preto, Brazil
| | - Anderson Sanches Melo
- Ribeirão Preto Medical School, Human Reproduction Sector, Department of Gynecology and Obstetrics, University of São Paulo, Ribeirão Preto, Brazil
| | - Hugo Celso Dutra de Souza
- Department of Biomechanics, Medicine and Rehabilitation of the Locomotor System, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Rui Alberto Ferriani
- Ribeirão Preto Medical School, Human Reproduction Sector, Department of Gynecology and Obstetrics, University of São Paulo, Ribeirão Preto, Brazil
| | - Gislaine Satyko Kogure
- Ribeirão Preto Medical School, Human Reproduction Sector, Department of Gynecology and Obstetrics, University of São Paulo, Ribeirão Preto, Brazil
| | - Lúcia Alves da Silva Lara
- Ribeirão Preto Medical School, Human Reproduction Sector, Department of Gynecology and Obstetrics, University of São Paulo, Ribeirão Preto, Brazil
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Witchel SF, Oberfield SE, Peña AS. Polycystic Ovary Syndrome: Pathophysiology, Presentation, and Treatment With Emphasis on Adolescent Girls. J Endocr Soc 2019; 3:1545-1573. [PMID: 31384717 PMCID: PMC6676075 DOI: 10.1210/js.2019-00078] [Citation(s) in RCA: 214] [Impact Index Per Article: 42.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 05/30/2019] [Indexed: 02/06/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) is a heterogeneous disorder characterized by hyperandrogenism and chronic anovulation. Depending on diagnostic criteria, 6% to 20% of reproductive aged women are affected. Symptoms of PCOS arise during the early pubertal years. Both normal female pubertal development and PCOS are characterized by irregular menstrual cycles, anovulation, and acne. Owing to the complicated interwoven pathophysiology, discerning the inciting causes is challenging. Most available clinical data communicate findings and outcomes in adult women. Whereas the Rotterdam criteria are accepted for adult women, different diagnostic criteria for PCOS in adolescent girls have been delineated. Diagnostic features for adolescent girls are menstrual irregularity, clinical hyperandrogenism, and/or hyperandrogenemia. Pelvic ultrasound findings are not needed for the diagnosis of PCOS in adolescent girls. Even before definitive diagnosis of PCOS, adolescents with clinical signs of androgen excess and oligomenorrhea/amenorrhea, features of PCOS, can be regarded as being "at risk for PCOS." Management of both those at risk for PCOS and those with a confirmed PCOS diagnosis includes education, healthy lifestyle interventions, and therapeutic interventions targeting their symptoms. Interventions can include metformin, combined oral contraceptive pills, spironolactone, and local treatments for hirsutism and acne. In addition to ascertaining for associated comorbidities, management should also include regular follow-up visits and planned transition to adult care providers. Comprehensive knowledge regarding the pathogenesis of PCOS will enable earlier identification of girls with high propensity to develop PCOS. Timely implementation of individualized therapeutic interventions will improve overall management of PCOS during adolescence, prevent associated comorbidities, and improve quality of life.
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Affiliation(s)
- Selma Feldman Witchel
- UPMC Children’s Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Sharon E Oberfield
- Division of Pediatric Endocrinology, Columbia University Medical Center, New York–Presbyterian Morgan Stanley Children’s Hospital, New York, New York
| | - Alexia S Peña
- Robinson Research Institute, University of Adelaide, North Adelaide, South Australia, Australia
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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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Young CC, Rew L, Monge M. Transition to Self-Management among Adolescents with Polycystic Ovary Syndrome: Parent and Adolescent Perspectives. J Pediatr Nurs 2019; 47:85-91. [PMID: 31079016 PMCID: PMC6642853 DOI: 10.1016/j.pedn.2019.04.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 04/22/2019] [Accepted: 04/22/2019] [Indexed: 01/08/2023]
Abstract
PURPOSE Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among females. The foundation of PCOS self-management is engaging in healthy lifestyle habits, however, there is limited literature regarding adolescents' transition to PCOS self-management. The purpose of this study, therefore, is to explore parental and adolescent views of the transition to PCOS self-management. DESIGN AND METHODS A qualitative descriptive approach was used through focus groups (N = 4) with adolescents diagnosed with PCOS and their parents. RESULTS A total of seven adolescents and eight parents participated in two focus groups each. The primary theme from the parent groups was Concerns for Transition to Self-Care with the subthemes of facilitation versus direction and recognition of personal habits. The primary theme identified from the adolescent groups was Taking Control with subthemes of managing symptoms, cognitive dissonance, support, and balance. CONCLUSIONS Study findings provide insight into the experiences of adolescents with PCOS and their parents as they navigate both a family-level transition in health habits and anticipate the adolescent transition to self-management as an emerging adult. PRACTICE IMPLICATIONS Nurses and other health care providers can help facilitate transition to self-management among adolescents with PCOS by encouraging increased independence in health behavior decisions while they are still living at home. Middle and older adolescents who begin to take ownership of their physical activity, nutritional choices, and sleep hygiene will have a firm foundation on which to build as they transition into life beyond high school.
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Affiliation(s)
- Cara C Young
- University of Texas at Austin, School of Nursing, TX, United States of America.
| | - Lynn Rew
- University of Texas at Austin, School of Nursing, TX, United States of America
| | - Maria Monge
- The University of Texas at Austin, Dell Medical School, TX, United States of America
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Gomez AM, Arteaga S, Ingraham N, Arcara J. Medical conditions, pregnancy perspectives and contraceptive decision-making among young people: an exploratory, qualitative analysis. Contraception 2019; 100:72-78. [PMID: 30980830 PMCID: PMC6589374 DOI: 10.1016/j.contraception.2019.03.046] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 03/23/2019] [Accepted: 03/27/2019] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To explore perspectives on family planning among young people who perceive they are infertile or will have difficulty carrying a pregnancy to term owing to medical conditions or procedures. METHODS This exploratory analysis examined pregnancy plans and contraceptive behavior among 12 young adults with a diagnosed medical condition or who had undergone a medical procedure associated with impaired fertility, and who had discussed fertility with a healthcare provider. We utilized data from a larger study investigating prospective pregnancy intentions and plans among 50 young (ages 18-24) women and their male partners (n=100). RESULTS Medical conditions included endometriosis, polycystic ovary syndrome, and lupus. For some, medical conditions/procedures led to use of no or less effective contraception; perceived risk for pregnancy was low, though seven participants had previously experienced pregnancies. Participants also described how medical conditions altered their timelines for pregnancy and overall desire for children; for example, one participant described continuing an unplanned pregnancy because she feared it would be her only chance to parent. CONCLUSION This exploratory analysis suggests that among young people, medical issues perceived to affect fertility and pregnancy may influence pregnancy planning and contraceptive behavior. Young people may lack knowledge about fertility and the impact of a medical condition; thus it is critical that providers clarify the difference between anticipated difficulty conceiving and complete infertility. Tailored contraceptive care is needed for young adults with medical conditions that may affect fertility to ensure they have the necessary information to make informed family planning decisions. IMPLICATIONS Medical conditions known to affect fertility may influence young people's family planning desires and behaviors. Understanding how young adults process information about medical conditions' impact on their fertility and change or make plans in response is important in order to best meet their family planning needs.
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Affiliation(s)
- Anu Manchikanti Gomez
- Sexual Health and Reproductive Equity Program, School of Social Welfare, University of California, Berkeley, 110 Haviland Hall MC 7400, Berkeley, CA 94720-7400, USA.
| | - Stephanie Arteaga
- Sexual Health and Reproductive Equity Program, School of Social Welfare, University of California, Berkeley, 110 Haviland Hall MC 7400, Berkeley, CA 94720-7400, USA
| | - Natalie Ingraham
- Department of Sociology and Social Services, California State University, East Bay, 25800 Carlos Bee Boulevard, Hayward, CA 94542, USA
| | - Jennet Arcara
- Sexual Health and Reproductive Equity Program, School of Social Welfare, University of California, Berkeley, 110 Haviland Hall MC 7400, Berkeley, CA 94720-7400, USA
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Fliegner M, Richter-Appelt H, Krupp K, Brunner F. Sexual Function and Socio-Sexual Difficulties in Women with Polycystic Ovary Syndrome (PCOS). Geburtshilfe Frauenheilkd 2019; 79:498-509. [PMID: 31148850 PMCID: PMC6529231 DOI: 10.1055/a-0828-7901] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Revised: 12/23/2018] [Accepted: 01/02/2019] [Indexed: 01/23/2023] Open
Abstract
Introduction
PCOS is the most common endocrine syndrome in women of the reproductive age that has manifold effects on the life of affected women. Little scientific attention has been devoted to these womenʼs sexual lives.
Aim
To investigate sexual quality of life in women with PCOS.
Methods
The sample size was n = 44. Measures employed were: An extended list of sexual dysfunctions and perceived distress based on DSM-IV-TR, Female Sexual Function Index (FSFI), German Questionnaire on Feelings of Inadequacy in Social and Sexual Situations (FUSS), Rosenberg Self-Esteem Scale (RSE), Brief Symptom Inventory (BSI) subscale depression. The relationships of these components were examined including further variables (body mass index, degree of hirsutism using the Ferriman-Gallwey Score, wish for a child). An open question about what participants see as the source of their sexual problems was presented.
Results
Only moderate impairment in sexual function was detected, but feelings of inadequacy in social and sexual situations were markedly elevated and positively correlated with the degree of hirsutism. Depression showed to be a major problem.
Conclusion
Patients with PCOS should be screened for socio-sexual difficulties and emotional problems. Specialized psychological and sexological counselling can complement patient care.
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Affiliation(s)
- Maike Fliegner
- Institut für Sexualforschung und Forensische Psychiatrie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Hertha Richter-Appelt
- Institut für Sexualforschung und Forensische Psychiatrie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Kerstin Krupp
- Institut für Sexualforschung und Forensische Psychiatrie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Franziska Brunner
- Institut für Sexualforschung und Forensische Psychiatrie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
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Zhao S, Wang J, Xie Q, Luo L, Zhu Z, Liu Y, Luo J, Zhao Z. Is polycystic ovary syndrome associated with risk of female sexual dysfunction? A systematic review and meta-analysis. Reprod Biomed Online 2019; 38:979-989. [PMID: 30926178 DOI: 10.1016/j.rbmo.2018.11.030] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 11/28/2018] [Indexed: 01/08/2023]
Abstract
The aim of this study was to evaluate whether polycystic ovary syndrome (PCOS) is a risk factor for female sexual dysfunction (FSD) by conducting a systematic review and meta-analysis. The databases PubMed, EMBASE and the Cochrane Library were searched for relevant studies. The association between PCOS and risk of FSD was assessed by relative risk or standard mean differences with 95% confidence interval. The protocol for this meta-analysis is available from PROSPERO (CRD42018102247). Overall, 2626 participants (mean age 25-36 years) were included from 10 studies (five cross-sectional and five case-control studies), 1163 of whom were women with PCOS. The pooled results from eight included studies providing the number of cases revealed no significant association between PCOS and increased risk of FSD (RR = 1.09, 95% CI 0.9 to 1.32; heterogeneity: I2 = 11.0%). The combined overall standard mean difference from five studies reporting Female Sexual Function Index (FSFI) scores showed that patients with PCOS had similar values in total FSFI scores compared with healthy controls (standard mean difference = -0.03, 95% CI -0.12 to 0.05; heterogeneity: I2 = 0.0%). Sensitivity analyses yielded similar results. This meta-analysis suggests no direct association between PCOS and risk of FSD. Well-controlled trials with large sample sizes, however, are needed to validate this evidence.
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Affiliation(s)
- Shankun Zhao
- Department of Urology and Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Guangdong 510230, China
| | - Jiamin Wang
- Department of Urology and Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Guangdong 510230, China
| | - Qiang Xie
- Department of Reproduction, Southern Medical University Affiliate Dongguan People's Hospital, Dongguan 523059, China
| | - Lianmin Luo
- Department of Urology and Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Guangdong 510230, China
| | - Zhiguo Zhu
- Department of Urology and Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Guangdong 510230, China
| | - Yangzhou Liu
- Department of Urology and Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Guangdong 510230, China
| | - Jintai Luo
- Department of Urology and Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Guangdong 510230, China
| | - Zhigang Zhao
- Department of Urology and Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Guangdong 510230, China.
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Holton S, Hammarberg K, Johnson L. Fertility concerns and related information needs and preferences of women with PCOS. Hum Reprod Open 2018; 2018:hoy019. [PMID: 30895260 PMCID: PMC6276660 DOI: 10.1093/hropen/hoy019] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 10/07/2018] [Accepted: 10/14/2018] [Indexed: 01/09/2023] Open
Abstract
STUDY QUESTION What are the fertility and childbearing concerns and related information needs and preferences of women with polycystic ovary syndrome (PCOS)? SUMMARY ANSWER Women with PCOS have concerns about fertility and childbearing mainly because they believe that it will be difficult for them to conceive, and identify a need for evidence-based information and preconception care so that they can make informed decisions about having children and achieve their reproductive goals. WHAT IS KNOWN ALREADY Women with chronic conditions seek reproductive health information from a range of sources, including their healthcare provider, the internet, other women with the condition, patient associations and support groups, and scientific publications. Little is known about the fertility concerns and information needs of women with PCOS or their preferences for how and when to receive information about the effect of their condition and its treatment on fertility and childbearing. STUDY DESIGN SIZE DURATION A qualitative study of 13 women of reproductive age with self-reported PCOS living in Australia participated in an online discussion group conducted from May to June 2018. Women were recruited via targeted advertisements on social media. PARTICIPANTS/MATERIALS SETTING METHODS In a closed-group moderated discussion, participants responded to questions about fertility concerns and the related information needs and preferences of women with PCOS. Non-identifiable demographic information was sought via a separate online anonymous survey. The discussion transcript was analysed thematically. MAIN RESULTS AND THE ROLE OF CHANCE Women identified a number of concerns about childbearing including whether they could become pregnant, how to prepare for pregnancy and what they should do before trying to conceive given their PCOS. Women reported seeking information about fertility and PCOS from a range of sources, and views about the most useful types and sources of fertility information for women with PCOS varied. LIMITATIONS REASONS FOR CAUTION Due to the small sample size and recruitment of participants via advertisements on Facebook, women who participated in the study may not be representative of women with PCOS in the general population. Women currently contemplating childbearing or who have recently had children or fertility difficulties may also have been more likely to participate in the study. Women in this study self-reported PCOS, and this may not necessarily reflect a confirmed diagnosis of PCOS. No formal diagnostic criteria were used to confirm their PCOS status. WIDER IMPLICATIONS OF THE FINDINGS Women with PCOS would benefit from evidence-based information in a range of formats to help them make informed decisions about childbearing and achieving their reproductive goals. Preconception care, including counselling and information about appropriate interventions and self-management strategies to optimise health and improve chances of conception, may be of particular assistance to women with PCOS. STUDY FUNDING/COMPETING INTERESTS The Victorian Assisted Reproductive Treatment Authority (VARTA) commissioned researchers at Monash University to generate evidence to guide the development of resources to assist women with PCOS make informed fertility and childbearing decisions and achieve their reproductive goals. The authors have no conflict of interests to declare. TRIAL REGISTRATION NUMBER Not applicable.
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Affiliation(s)
- S Holton
- Global and Women's Health, School of Public Health and Preventive Medicine, Monash University, 4/553 St Kilda Rd, Melbourne, Victoria, Australia
| | - K Hammarberg
- Global and Women's Health, School of Public Health and Preventive Medicine, Monash University, 4/553 St Kilda Rd, Melbourne, Victoria, Australia
- Victorian Assisted Reproductive Treatment Authority, Level 30/570 Bourke Street Melbourne, Victoria, Australia
| | - L Johnson
- Victorian Assisted Reproductive Treatment Authority, Level 30/570 Bourke Street Melbourne, Victoria, Australia
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Lopes IP, Ribeiro VB, Reis RM, Silva RC, Dutra de Souza HC, Kogure GS, Ferriani RA, Silva Lara LAD. Comparison of the Effect of Intermittent and Continuous Aerobic Physical Training on Sexual Function of Women With Polycystic Ovary Syndrome: Randomized Controlled Trial. J Sex Med 2018; 15:1609-1619. [DOI: 10.1016/j.jsxm.2018.09.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Revised: 08/19/2018] [Accepted: 09/01/2018] [Indexed: 12/16/2022]
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46
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Behboodi Moghadam Z, Fereidooni B, Saffari M, Montazeri A. Polycystic ovary syndrome and its impact on Iranian women's quality of life: a population-based study. BMC Womens Health 2018; 18:164. [PMID: 30305063 PMCID: PMC6180458 DOI: 10.1186/s12905-018-0658-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 09/30/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is a major public health concern worldwide affecting up to one in five women at reproductive age. It is associated with biochemical and hormonal disturbances as well as adverse cosmetic, reproductive, metabolic, and psychological consequences, resulting in worsened quality of life. The aim of the present study is evaluating the quality of life and determining its degrading factors among Iranian women suffering from this syndrome. METHODS This cross-sectional study was conducted on 200 PCOS women in Hamadan, Iran. In order to measure quality of life we used the Persian version of Health-related Quality of Life Questionnaire for PCOS (PCOSQ). Descriptive statistics was used to explore the data. In addition linear regression analysis was performed to assess factors affecting health-related quality of life in this population. RESULTS The mean score for quality of life domains (from the greatest to the least serious concern) were: infertility (3.43 ± 1.63), emotions (3.55 ± 1.17), menstrual problems (3.77 ± 1.36), body hair (3.80 ± 2.05) and weight (4.32 ± 1.80), respectively. The higher score represents better function. However, multivariate analysis revealed that hirsutism had the strongest impact on the patients' quality of life (p < 0.001) followed by infertility (p = 0.038) and menstrual irregularity (p = 0.003). CONCLUSION The findings showed that impairment of quality of life was associated with PCOS related conditions such as hirsutism, infertility and menstrual problems.
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Affiliation(s)
- Zahra Behboodi Moghadam
- Department of Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Bita Fereidooni
- Department of Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohsen Saffari
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Ali Montazeri
- Population Health Research Group, Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
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47
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Behboodi Moghadam Z, Fereidooni B, Saffari M, Montazeri A. Measures of health-related quality of life in PCOS women: a systematic review. Int J Womens Health 2018; 10:397-408. [PMID: 30123008 PMCID: PMC6078086 DOI: 10.2147/ijwh.s165794] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Introduction Polycystic ovary syndrome (PCOS) is associated with biochemical and hormonal disturbance and adverse cosmetic, reproductive, metabolic, and psychological consequences, resulting in reduced health-related quality of life (HRQoL). Various generic and specific questionnaires have been used for assessing different dimensions of HRQoL in PCOS women. The purpose of this systematic review was to identify those general and specific instruments and to determine the factors that affect HRQoL in PCOS women. Materials and methods The research strategy involved general and specific terms in relation to PCOS women and their QoL. A review was performed on studies that were published between 1945 to 2017 and that were indexed in MEDLINE, ISI Web of Science, and Scopus. A narrative synthesis of the data was provided. Results In total, 52 studies (9 qualitative and 43 quantitative) were included in the review. The analysis indicated that 3 specific and 5 general instruments were used to measure the QoL in PCOS women. Of these, the 36-Item Short Form Health Survey (SF-36) and the Polycystic Ovary Syndrome Health-Related Quality of Life Questionnaire (PCOSQ) were used most frequently. All studies assessed different aspects of QoL in PCOS women and found that PCOS had negative effects on QoL in this population. Conclusion The PCOSQ and the SF-36 were used most frequently for the assessment of QoL in PCOS women. Perhaps using either a specific questionnaire solely or a specific questionnaire in conjunction with a generic measure would be more appropriate when measuring QoL in PCOS women. However, both questionnaires showed that they are able to capture different aspects of QoL in PCOS women and to identify areas that can help to improve QoL in these women.
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Affiliation(s)
- Zahra Behboodi Moghadam
- Department of Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Bita Fereidooni
- Department of Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran,
| | - Mohsen Saffari
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Ali Montazeri
- Population Health Research Group, Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran,
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48
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Holton S, Papanikolaou V, Hammarberg K, Rowe H, Kirkman M, Jordan L, McNamee K, Bayly C, McBain J, Sinnott V, Fisher J. Fertility management experiences of women with polycystic ovary syndrome in Australia. EUR J CONTRACEP REPR 2018; 23:282-287. [DOI: 10.1080/13625187.2018.1483020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Sara Holton
- Jean Hailes Research Unit, Monash University, Melbourne, VIC, Australia
| | | | - Karin Hammarberg
- Jean Hailes Research Unit, Monash University, Melbourne, VIC, Australia
| | - Heather Rowe
- Jean Hailes Research Unit, Monash University, Melbourne, VIC, Australia
| | - Maggie Kirkman
- Jean Hailes Research Unit, Monash University, Melbourne, VIC, Australia
| | - Lynne Jordan
- Family Planning Victoria, Box Hill, VIC, Australia
| | - Kathy McNamee
- Family Planning Victoria, Box Hill, VIC, Australia
- Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC, Australia
| | - Chris Bayly
- The Royal Women’s Hospital, Parkville, VIC, Australia
| | - John McBain
- Melbourne IVF, East Melbourne, VIC, Australia
| | - Vikki Sinnott
- Victorian Government Department of Health, Melbourne, VIC, Australia
| | - Jane Fisher
- Jean Hailes Research Unit, Monash University, Melbourne, VIC, Australia
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49
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Callender KA. Polycystic Ovary Syndrome Across the Life Span of Women: A Wellness-Based Integrative Intervention. ADULTSPAN JOURNAL 2018. [DOI: 10.1002/adsp.12052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Karisse A. Callender
- Department of Counseling and Educational Psychology; Texas A&M University-Corpus Christi
- Now at Department of Counselor Education and Counseling Psychology; Marquette University
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50
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Sanchez N. Suitability of the National Health Care Surveys to Examine Behavioral Health Services Associated with Polycystic Ovary Syndrome. J Behav Health Serv Res 2018; 45:252-268. [PMID: 27966057 PMCID: PMC5869872 DOI: 10.1007/s11414-016-9543-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The National Institutes of Health, Office of Disease Prevention, has described polycystic ovary syndrome (PCOS) as a major public health problem for women in the USA. This study examines the suitability of the National Health Care Surveys, collected by the Centers for Disease Control and Prevention, to understand patient demographics and behavioral health services associated with PCOS-related medical visits. Data were from the 2005-2010 National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey. PCOS-related medical visits were identified using the International Classification of Diseases, 9th Revision, Clinical Modification code 256.4. Items on mental health and health education ordered or provided did not meet the National Center for Health Statistics criteria necessary to produce reliable national estimates (i.e., at least 30 unweighted records and a relative standard error <30%). Findings underscore the need to strengthen national surveillance to further understand behavioral health care for patients with PCOS.
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Affiliation(s)
- Ninive Sanchez
- School of Social Work, University of Missouri, 712 Clark Hall, Columbia, MO, 65211, USA.
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