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Taieb A, Asma G, Jabeur M, Fatma BA, Nassim BHS, Asma BA. Rethinking the Terminology: A Perspective on Renaming Polycystic Ovary Syndrome for an Enhanced Pathophysiological Understanding. Clin Med Insights Endocrinol Diabetes 2024; 17:11795514241296777. [PMID: 39494232 PMCID: PMC11528641 DOI: 10.1177/11795514241296777] [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: 07/20/2024] [Accepted: 10/16/2024] [Indexed: 11/05/2024] Open
Abstract
Polycystic Ovary Syndrome (PCOS) is a complex endocrine disorder that affects women at various stages of life, presenting a wide range of symptoms and health implications. The term "Polycystic Ovary Syndrome" can be misleading, prompting many within the medical community and advocacy groups to advocate for a name change. Critics argue that this terminology can complicate understanding and awareness of the disease among patients. The primary concern is that PCOS emphasizes the ovarian aspect, fostering the misconception that PCOS is merely a gynecological disorder. In reality, PCOS impacts multiple organ systems, particularly metabolic health. Patients frequently experience insulin resistance, weight gain, irregular menstrual cycles, and hirsutism-symptoms that extend beyond ovarian dysfunction. In light of these issues, there is increasing support for renaming PCOS to better reflect its systemic implications and minimize confusion. The current name may hinder understanding and potentially lead to inadequate disease management. Alternative names have been proposed, including "Ovarian Dysmetabolic Syndrome," which our team supports, as well as "Metabolic Reproductive Syndrome" and "Hyperandrogenic Persistent Ovulatory Dysfunction Syndrome." These alternatives aim to highlight the hormonal imbalances and metabolic disturbances associated with the condition, fostering inclusivity and reducing stigma for all affected individuals. This narrative review provides a historical overview of PCOS, tracing its recognition from early descriptions to contemporary guidelines. We discuss the evolving understanding of its pathophysiology and the rationale behind the proposed name change. By adopting a new nomenclature, we can enhance understanding among healthcare professionals, increase inclusivity for affected women, reduce the stigma and anxiety linked to the diagnosis, and offer a more accurate representation of the condition's complex pathophysiology.
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Affiliation(s)
- Ach Taieb
- Department of Endocrinology, University Hospital of Farhat Hached Sousse, Tunisia
- University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia
- Laboratory of Exercise Physiology and Pathophysiology; L.R, Sousse, Tunisia
| | - Gorchane Asma
- Department of Endocrinology, University Hospital of Farhat Hached Sousse, Tunisia
- University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia
| | - Methnani Jabeur
- University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia
- Laboratory of Exercise Physiology and Pathophysiology; L.R, Sousse, Tunisia
| | - Ben Abdessalem Fatma
- Department of Endocrinology, University Hospital of Farhat Hached Sousse, Tunisia
- University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia
| | - Ben Haj Slama Nassim
- Department of Endocrinology, University Hospital of Farhat Hached Sousse, Tunisia
- University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia
| | - Ben Abdelkrim Asma
- Department of Endocrinology, University Hospital of Farhat Hached Sousse, Tunisia
- University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia
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McGowan M, Garad R, Wadhwani G, Torkel S, Rao V, Maunder A, Osei-Safo EK, Moran LJ, Cowan S. Understanding barriers and facilitators to lifestyle management in people with polycystic ovary syndrome: A mixed method systematic review. Obes Rev 2024:e13854. [PMID: 39462252 DOI: 10.1111/obr.13854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 09/06/2024] [Accepted: 09/27/2024] [Indexed: 10/29/2024]
Abstract
Polycystic ovary syndrome (PCOS) is an endocrine disorder affecting 10-13% of reproductive-aged women. Lifestyle management through diet and physical activity changes can improve reproductive, metabolic, and psychological comorbidities. The aim of this systematic review is to understand the barriers and facilitators to lifestyle changes from the perspective of people with PCOS and health care professionals (HCP) using the theoretical domains framework and capability, opportunity, motivation, and behavior model. Six databases were systematically searched for qualitative, quantitative, and mixed-methods studies to 22nd September 2022. Quantitative outcomes from quantitative and mixed-methods studies were narratively synthesized and all studies were thematically analyzed. Sixty-eight papers met the eligibility criteria. HCP education on lifestyle management in PCOS was viewed by all to be inadequate, impacting the quality of care and health outcomes. Lifestyle advice delivered by a multidisciplinary team, including dietitians, was identified as a key component for change. All agreed that there was a need for individualized and PCOS-specific lifestyle advice. Weight stigma was identified as negatively impacting both those in larger and smaller bodies with PCOS, reducing the quality of care and affecting self-perception and mental health. People with PCOS perceived that lifestyle management was overly focused on weight loss and fertility, independent of their own personal motivations and goals. Systemic changes, including increasing HCP education on lifestyle management and multidisciplinary collaboration, focusing on lifestyle advice that meets individual needs, and reducing the use of weight-centric care are necessary for long-term sustainable changes and improvements in health outcomes in people with PCOS.
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Affiliation(s)
- Margaret McGowan
- Monash Centre of Health Research Implementation, Monash University, Clayton, Australia
| | - Rhonda Garad
- Monash Centre of Health Research Implementation, Monash University, Clayton, Australia
| | | | - Sophia Torkel
- Monash Centre of Health Research Implementation, Monash University, Clayton, Australia
| | - Vibhuti Rao
- NICM Health Research Institute, Western Sydney University, Penrith, Australia
| | - Alison Maunder
- NICM Health Research Institute, Western Sydney University, Penrith, Australia
| | - Elaine K Osei-Safo
- Monash Centre of Health Research Implementation, Monash University, Clayton, Australia
| | - Lisa J Moran
- Monash Centre of Health Research Implementation, Monash University, Clayton, Australia
| | - Stephanie Cowan
- Monash Centre of Health Research Implementation, Monash University, Clayton, Australia
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Harrison C, Tay CT, Busby MA, Mousa A, Teede H, Boivin J. Challenges experienced by those with polycystic ovary syndrome in healthcare interactions: a qualitative evidence synthesis. Reprod Biomed Online 2024; 49:104293. [PMID: 39067213 DOI: 10.1016/j.rbmo.2024.104293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 05/16/2024] [Accepted: 05/20/2024] [Indexed: 07/30/2024]
Abstract
Studies report interaction difficulties between patients with polycystic ovary syndrome (PCOS) and healthcare professionals (HCP). This systematic review and qualitative evidence synthesis aimed to collate and synthesize the existing peer-reviewed literature investigating challenges for people with PCOS when interacting with HCP. Medline, PsycInfo, EMBASE, All EBM and CINAHL were searched from 1990 to September 2022. Study risk of bias (RoB) was performed and all textual data relevant to challenging interactions between patients with PCOS and HCP were extracted and analysed using thematic synthesis. Of the 6353 studies identified, 28 were included. Two were appraised as high, four as moderate and 22 as low RoB. Four analytic themes were derived illustrating that interactions were challenging when: (i) medical information (PCOS, its management) was not shared in the best way; (ii) information provision and deliberation opportunities were insufficient to achieve outcomes that mattered to patients; (iii) interactions prompted but did not support patient activation; and (iv) health system-level barriers (e.g. policies and guidelines) were present or made worse by HCP behaviour. Future research should examine methods for the implementation and evaluation of established frameworks for sharing medical information and supporting patient agency in the context of PCOS care.
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Affiliation(s)
- China Harrison
- National Institute for Health Research Applied Research Collaboration West (NIHR ARC West), Bristol, UK; National Institute for Health Research, Health Protection Research Unit (HBU) in Behavioural Science and Evaluation, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Chau Thien Tay
- Monash Centre for Health Research and Implementation, Monash University, Melbourne, Clayton, Australia
| | | | - Aya Mousa
- Monash Centre for Health Research and Implementation, Monash University, Melbourne, Clayton, Australia
| | - Helena Teede
- Monash Centre for Health Research and Implementation, Monash University, Melbourne, Clayton, Australia
| | - Jacky Boivin
- Cardiff Fertility and Reproductive Research, School of Psychology, Cardiff University, Cardiff, Wales, UK..
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Kim AE, Lee IT, Ottey S, Dokras A. Lack of adequate counseling about pregnancy complications in patients with polycystic ovary syndrome: a cross-sectional survey study. F S Rep 2024; 5:312-319. [PMID: 39381657 PMCID: PMC11456671 DOI: 10.1016/j.xfre.2024.05.004] [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: 02/27/2024] [Revised: 05/08/2024] [Accepted: 05/14/2024] [Indexed: 10/10/2024] Open
Abstract
Objective To assess the counseling experiences of patients with polycystic ovary syndrome (PCOS) related to obstetric complications and preconception management of comorbidities. Design Cross-sectional survey study. Setting Not applicable. Patients Patients with PCOS with a history of or attempt at pregnancy. Interventions Not applicable. Main Outcome Measures Demographic characteristics, medical history, and counseling experiences. Results Of the 302 respondents, 72.9% had a previous pregnancy, with 66.8% reporting complications during pregnancy. Of the entire cohort, 52.7% received preconception counseling on PCOS-related obstetric complications, and 41.5% were satisfied with their counseling experience. Five percent were counseled on related postpartum complications, and 43.4% received counseling about prepregnancy weight management, with the minority satisfied with their counseling. Among the respondents with existing comorbidities including hypertension, diabetes, and anxiety or depression, the minority received counseling on their preconception management. Although there were no racial disparities in the overall counseling of pregnancy complications, more black patients were counseled about preeclampsia, cesarean section, and preterm birth than white patients. Of the patients who had a single provider managing their PCOS care, 78.6% who saw a reproductive endocrinologist, 53.2% who saw a general gynecologist, and 35.0% who saw a primary care physician reported receiving counseling on related pregnancy complications. Conclusions Despite the high prevalence of obstetric complications associated with PCOS, our study revealed inadequate patient counseling about both the antepartum and postpartum periods and preconception management of existing comorbidities. Our findings highlight the urgent need to increase provider education and patient awareness to optimize maternal and neonatal outcomes.
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Affiliation(s)
- Anne E. Kim
- Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Iris T. Lee
- Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Sasha Ottey
- PCOS Challenge: The National Polycystic Ovary Syndrome Association, Atlanta, Georgia
| | - Anuja Dokras
- Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
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Sacca L, Lobaina D, Knopf E, Burgoa S, Jimenez S, Okwaraji G, Etzel M, Vardanyan V, Tharp M, Rao M, Jhumkhawala V, Sohmer J, Densley S, Linzer N, Meka P, Diaz D, Knecht M, Hopkins DK, Kitsantas P, Mejia M, Wilson C. Assessment of the Validity and Quality of Polycystic Ovarian Syndrome (PCOS) Screening Tools Available for Women Globally: A Systematic Review. Clin Pract 2024; 14:1625-1649. [PMID: 39311281 PMCID: PMC11417729 DOI: 10.3390/clinpract14050131] [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: 08/02/2024] [Revised: 08/16/2024] [Accepted: 08/19/2024] [Indexed: 09/26/2024] Open
Abstract
Background: This systematic review has the following aims: (1) to identify measurement tools used globally by healthcare providers to diagnose PCOS in women at elevated risk; (2) to assess the comprehensiveness of these tools regarding mental health and chronic pain; (3) to list strategies for validating, disseminating, and implementing these tools; and (4) to provide future recommendations for experts in healthcare settings. Methods: This review utilized the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) and the Arksey and O'Malley York methodology. Studies were sourced from the PubMed, Embase, and Cochrane Library databases, with inclusion criteria focusing on peer-reviewed articles addressing PCOS diagnosis and associated comorbidities. Data extraction and analysis followed the Joanna Briggs Institute (JBI) recommendations. Results: A total of 63 studies met the inclusion criteria. Findings indicate that current screening tools for PCOS often lack comprehensive integration of mental health and chronic pain assessments. Tools like the PCOSQ and its updated version, PCOSQ-50, inadequately address pain-related symptoms, highlighting a gap in holistic patient evaluation. This review identified significant associations between PCOS and mental health disorders, including anxiety and depression, emphasizing the need for mental health screenings as part of PCOS management. Conclusions: There is a critical need for validated PCOS screening tools that encompass both physical and psychological aspects of the condition. Educating healthcare providers on the cultural and social determinants influencing PCOS can improve diagnosis and patient outcomes. Future research should focus on developing holistic screening tools and culturally relevant educational resources, aiming to enhance the overall quality of life for women with PCOS.
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Affiliation(s)
- Lea Sacca
- Department of Population Health and Social Medicine, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL 33431, USA; (D.L.); (E.K.); (S.B.); (S.J.); (G.O.); (M.E.); (V.V.); (M.T.); (M.R.); (V.J.); (J.S.); (S.D.); (N.L.); (P.M.); (M.K.); (P.K.); (M.M.)
| | - Diana Lobaina
- Department of Population Health and Social Medicine, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL 33431, USA; (D.L.); (E.K.); (S.B.); (S.J.); (G.O.); (M.E.); (V.V.); (M.T.); (M.R.); (V.J.); (J.S.); (S.D.); (N.L.); (P.M.); (M.K.); (P.K.); (M.M.)
| | - Elisheva Knopf
- Department of Population Health and Social Medicine, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL 33431, USA; (D.L.); (E.K.); (S.B.); (S.J.); (G.O.); (M.E.); (V.V.); (M.T.); (M.R.); (V.J.); (J.S.); (S.D.); (N.L.); (P.M.); (M.K.); (P.K.); (M.M.)
| | - Sara Burgoa
- Department of Population Health and Social Medicine, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL 33431, USA; (D.L.); (E.K.); (S.B.); (S.J.); (G.O.); (M.E.); (V.V.); (M.T.); (M.R.); (V.J.); (J.S.); (S.D.); (N.L.); (P.M.); (M.K.); (P.K.); (M.M.)
| | - Samantha Jimenez
- Department of Population Health and Social Medicine, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL 33431, USA; (D.L.); (E.K.); (S.B.); (S.J.); (G.O.); (M.E.); (V.V.); (M.T.); (M.R.); (V.J.); (J.S.); (S.D.); (N.L.); (P.M.); (M.K.); (P.K.); (M.M.)
| | - Goodness Okwaraji
- Department of Population Health and Social Medicine, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL 33431, USA; (D.L.); (E.K.); (S.B.); (S.J.); (G.O.); (M.E.); (V.V.); (M.T.); (M.R.); (V.J.); (J.S.); (S.D.); (N.L.); (P.M.); (M.K.); (P.K.); (M.M.)
| | - Madison Etzel
- Department of Population Health and Social Medicine, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL 33431, USA; (D.L.); (E.K.); (S.B.); (S.J.); (G.O.); (M.E.); (V.V.); (M.T.); (M.R.); (V.J.); (J.S.); (S.D.); (N.L.); (P.M.); (M.K.); (P.K.); (M.M.)
| | - Vartiter Vardanyan
- Department of Population Health and Social Medicine, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL 33431, USA; (D.L.); (E.K.); (S.B.); (S.J.); (G.O.); (M.E.); (V.V.); (M.T.); (M.R.); (V.J.); (J.S.); (S.D.); (N.L.); (P.M.); (M.K.); (P.K.); (M.M.)
| | - Madison Tharp
- Department of Population Health and Social Medicine, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL 33431, USA; (D.L.); (E.K.); (S.B.); (S.J.); (G.O.); (M.E.); (V.V.); (M.T.); (M.R.); (V.J.); (J.S.); (S.D.); (N.L.); (P.M.); (M.K.); (P.K.); (M.M.)
| | - Meera Rao
- Department of Population Health and Social Medicine, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL 33431, USA; (D.L.); (E.K.); (S.B.); (S.J.); (G.O.); (M.E.); (V.V.); (M.T.); (M.R.); (V.J.); (J.S.); (S.D.); (N.L.); (P.M.); (M.K.); (P.K.); (M.M.)
| | - Vama Jhumkhawala
- Department of Population Health and Social Medicine, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL 33431, USA; (D.L.); (E.K.); (S.B.); (S.J.); (G.O.); (M.E.); (V.V.); (M.T.); (M.R.); (V.J.); (J.S.); (S.D.); (N.L.); (P.M.); (M.K.); (P.K.); (M.M.)
| | - Joshua Sohmer
- Department of Population Health and Social Medicine, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL 33431, USA; (D.L.); (E.K.); (S.B.); (S.J.); (G.O.); (M.E.); (V.V.); (M.T.); (M.R.); (V.J.); (J.S.); (S.D.); (N.L.); (P.M.); (M.K.); (P.K.); (M.M.)
| | - Sebastian Densley
- Department of Population Health and Social Medicine, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL 33431, USA; (D.L.); (E.K.); (S.B.); (S.J.); (G.O.); (M.E.); (V.V.); (M.T.); (M.R.); (V.J.); (J.S.); (S.D.); (N.L.); (P.M.); (M.K.); (P.K.); (M.M.)
| | - Niko Linzer
- Department of Population Health and Social Medicine, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL 33431, USA; (D.L.); (E.K.); (S.B.); (S.J.); (G.O.); (M.E.); (V.V.); (M.T.); (M.R.); (V.J.); (J.S.); (S.D.); (N.L.); (P.M.); (M.K.); (P.K.); (M.M.)
| | - Pranav Meka
- Department of Population Health and Social Medicine, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL 33431, USA; (D.L.); (E.K.); (S.B.); (S.J.); (G.O.); (M.E.); (V.V.); (M.T.); (M.R.); (V.J.); (J.S.); (S.D.); (N.L.); (P.M.); (M.K.); (P.K.); (M.M.)
| | - Daniella Diaz
- Charles E. Schmidt College of Science, Boca Raton, FL 33431, USA;
| | - Michelle Knecht
- Department of Population Health and Social Medicine, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL 33431, USA; (D.L.); (E.K.); (S.B.); (S.J.); (G.O.); (M.E.); (V.V.); (M.T.); (M.R.); (V.J.); (J.S.); (S.D.); (N.L.); (P.M.); (M.K.); (P.K.); (M.M.)
| | - Dawn Kimberly Hopkins
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA;
| | - Panagiota Kitsantas
- Department of Population Health and Social Medicine, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL 33431, USA; (D.L.); (E.K.); (S.B.); (S.J.); (G.O.); (M.E.); (V.V.); (M.T.); (M.R.); (V.J.); (J.S.); (S.D.); (N.L.); (P.M.); (M.K.); (P.K.); (M.M.)
| | - Maria Mejia
- Department of Population Health and Social Medicine, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL 33431, USA; (D.L.); (E.K.); (S.B.); (S.J.); (G.O.); (M.E.); (V.V.); (M.T.); (M.R.); (V.J.); (J.S.); (S.D.); (N.L.); (P.M.); (M.K.); (P.K.); (M.M.)
| | - Candy Wilson
- Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL 33431, USA;
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Wright PJ, Dawson RM, Corbett CF. Exploring the Experiential Journey of Women with PCOS Across the Lifespan: A Qualitative Inquiry. Int J Womens Health 2024; 16:1159-1171. [PMID: 38948241 PMCID: PMC11214577 DOI: 10.2147/ijwh.s467737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 06/12/2024] [Indexed: 07/02/2024] Open
Abstract
Introduction Peri-postmenopausal women with the chronic condition polycystic ovary syndrome (PCOS) remain at cardiometabolic risk and/or subsist with established comorbidity while continuing to manage persistent PCOS signs and symptoms, such as hirsutism. Thus, PCOS transcends the reproductive years, yet there is sparse scientific literature on the peri-postmenopausal years of women with PCOS. Purpose To explore how peri-postmenopausal women's perceptions about PCOS have changed over the lifespan since their PCOS diagnosis. Methods A cross-sectional survey with one qualitative question was conducted via Research Electronic Data Capture (REDCap) among women with PCOS aged ≥43 years, who were all recruited from PCOS-specific Facebook pages. Of the 107 women completing the survey, 72 substantively answered the qualitative question. The qualitative responses were analyzed using the steps of reflexive thematic analysis. Themes were interpreted and discussed through the lens of the bioecological conceptual model. Results Respondents were 47.6 (±4.1) years of age, primarily White (87.5%), employed full time (65.3%), and married (75%) with children (68%). Four overall themes were identified: 1) dismissal 2) information desert, 3) PCOS experience over the lifespan, and 4) mindset. Conclusion The study findings illustrated the unique healthcare needs among peri-postmenopausal women with PCOS. Further research is needed to further explore their healthcare concerns and psychosocial needs followed by studies that develop and assess interventions that promote symptom and adaptive coping strategies across their lifespan.
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Affiliation(s)
- Pamela J Wright
- Advancing Chronic Care Outcomes through Research and iNnovation (ACORN) Center, Department of Biobehavioral Health & Nursing Science, College of Nursing, University of South Carolina, Columbia, SC, USA
| | - Robin M Dawson
- Advancing Chronic Care Outcomes through Research and iNnovation (ACORN) Center, Department of Biobehavioral Health & Nursing Science, College of Nursing, University of South Carolina, Columbia, SC, USA
| | - Cynthia F Corbett
- Advancing Chronic Care Outcomes through Research and iNnovation (ACORN) Center, Department of Biobehavioral Health & Nursing Science, College of Nursing, University of South Carolina, Columbia, SC, USA
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Sacca L, Okwaraji G, Densley S, Marciniak A, Knecht M, Wilson C, Pilitsis JG, Kimberly Hopkins D. Polycystic ovary syndrome and chronic pain among females and individuals of childbearing age: A scoping review. SAGE Open Med 2024; 12:20503121241262158. [PMID: 38903491 PMCID: PMC11189018 DOI: 10.1177/20503121241262158] [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: 03/16/2024] [Accepted: 05/30/2024] [Indexed: 06/22/2024] Open
Abstract
Objectives The purpose of this scoping review is to explore research studies on the association between chronic pain and polycystic ovary syndrome to create local (U.S.-based) and global recommendations to improve access to and quality of affordable symptom management and treatment options for patients with polycystic ovary syndrome. Methods The study sections used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews as a checklist reference. The review followed the York methodology by Arksey and O'Malley for the extraction, analysis, and presentation of results in scoping reviews. Results Final analysis included two conference abstracts published in peer-reviewed journals and two peer-reviewed articles. The relationship between pain perception and health-related quality of life warrants further investigation in patients with polycystic ovary syndrome as the interconnected pathophysiology of symptoms renders exploring associations between the two factors difficult. A comprehensive understanding of the causes of polycystic ovary syndrome-associated symptoms, particularly those relating to pain perceptions can provide more insight into polycystic ovary syndrome pathophysiology and aid in the development of innovative therapeutic approaches for long-term polycystic ovary syndrome management and care. Conclusion Future studies are necessary to examine associations between the disease and pathophysiological symptoms for a better quality of life for patients with polycystic ovary syndrome.
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Affiliation(s)
- Lea Sacca
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA
| | - Goodness Okwaraji
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA
| | - Sebastian Densley
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA
| | - Adeife Marciniak
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA
| | - Michelle Knecht
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA
| | - Candy Wilson
- Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL, USA
| | - Julie G Pilitsis
- Department of Neurosurgery, University of Arizona College of Medicine, Tucson, AZ, USA
| | - Dawn Kimberly Hopkins
- Graduate School of Nursing, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
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Sydora BC, Wilke MS, McPherson M, Chambers S, Ghosh M, Vine DF. Challenges in diagnosis and health care in polycystic ovary syndrome in Canada: a patient view to improve health care. BMC Womens Health 2023; 23:569. [PMID: 37925392 PMCID: PMC10625259 DOI: 10.1186/s12905-023-02732-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 10/26/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND Polycystic Ovary Syndrome (PCOS) is the most common endocrine-metabolic disorder affecting health and quality of life of those affected across the lifespan. We currently have limited evidence-based data on the experience of those living with PCOS in the health care system including diagnosis, health concerns and disease management. The aim of this study was to assess the perceptions of health status, health care experience and disease management support in those affected by PCOS in Alberta, Canada. METHODS An online questionnaire was completed via REDCap by individuals self-reporting a diagnosis of PCOS. Question categories included demographics, symptoms of PCOS and time to confirm a diagnosis, follow-up care, health concerns, and information resources. Descriptive statistics were used and thematic analyses was applied to open-response questions. RESULTS Responses from 194 participants living in Canada (93% in Alberta) were included. The average age was 34 ± 8 years and BMI was 35 ± 9. Menstrual irregularity was identified in 84% of respondents as the first symptom noticed and the primary reason for seeking a medical consultation. A PCOS diagnosis occurred on average 4.3 years following awareness of first symptoms and required consultation with more than one primary care provider for 57% of respondents. Half (53%) of respondents reported not receiving a referral to specialists for follow-up care and 70% were not informed about long-term health morbidity such as diabetes or cardiovascular disease. Most respondents (82%) did their own research about PCOS using on-line sources, academic literature and advice from peer support. The participant themes from open questions for improving health care included more resources and support, increased and reliable information, better education and training for clinicians, timely diagnosis, prompt referrals to specialists, and generally more compassion and empathy to the challenges faced by those managing their disease. CONCLUSION Our findings highlight the health concerns and challenges in health care for those with PCOS. In Alberta, Canada we have identified major gaps in health care including a timely diagnosis, follow up care and supports, and multidisciplinary care. This evidence-based data can be used to inform development of pathways to improve the health care experience in those affected by PCOS.
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Affiliation(s)
- Beate C Sydora
- Metabolic and Cardiovascular Disease Laboratory, University of Alberta, Edmonton, Canada
| | - Michaelann S Wilke
- Metabolic and Cardiovascular Disease Laboratory, University of Alberta, Edmonton, Canada
| | - Maggie McPherson
- Metabolic and Cardiovascular Disease Laboratory, University of Alberta, Edmonton, Canada
| | - Sarah Chambers
- Metabolic and Cardiovascular Disease Laboratory, University of Alberta, Edmonton, Canada
| | - Mahua Ghosh
- Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Canada
| | - Donna F Vine
- Metabolic and Cardiovascular Disease Laboratory, University of Alberta, Edmonton, Canada.
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9
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Wugalter K, Perovic M, Karkaby L, Einstein G. The double-edged sword of PCOS and gender: exploring gender-diverse experiences of polycystic ovary syndrome. INTERNATIONAL JOURNAL OF TRANSGENDER HEALTH 2023; 25:251-267. [PMID: 38681493 PMCID: PMC11044764 DOI: 10.1080/26895269.2023.2183448] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
Background: Past research on polycystic ovary syndrome (PCOS), a chronic endocrine condition, has focused on the experiences of cisgender women. Aims: The purpose of the present study was to address the knowledge gap about gender-diverse individuals by exploring their lived experiences with PCOS and to better understand if and how their gender identity affected their experience of PCOS. Methods: To explore this, we recruited nine non-binary people and one transgender man with a PCOS diagnosis for qualitative interviews. Results: Three overarching themes emerged: PCOS as a burden, PCOS as an occasion, and PCOS as a benefit. While some aspects of PCOS created an additional burden for our participants, other symptoms such as excess body and facial hair could be empowering and affirming, revealing a positive aspect of this chronic condition. Conclusion: This study is the first to describe the lived experiences of gender-diverse individuals with PCOS, uncovering burdens as well as some benefits. Future research in this population may reveal not only the particulars of what PCOS is like for them but also more generalizable insights into the highly gendered perception and treatment of PCOS.
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Affiliation(s)
- Katrina Wugalter
- Department of Psychology, University of Toronto, Toronto, Ontario, Canada
- Department of Psychology, University of Illinois Chicago, Chicago, Illinois, USA
| | - Mateja Perovic
- Department of Psychology, University of Toronto, Toronto, Ontario, Canada
| | - Laurice Karkaby
- Department of Psychology, University of Toronto, Toronto, Ontario, Canada
| | - Gillian Einstein
- Department of Psychology, University of Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Tema Genus, Linköping University, Linköping, Sweden
- Rotman Research Institute, Baycrest Hospital, Toronto, Ontario, Canada
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10
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Lu KT, Ho YC, Chang CL, Lan KC, Wu CC, Su YT. Evaluation of Bodily Pain Associated with Polycystic Ovary Syndrome: A Review of Health-Related Quality of Life and Potential Risk Factors. Biomedicines 2022; 10:biomedicines10123197. [PMID: 36551953 PMCID: PMC9776021 DOI: 10.3390/biomedicines10123197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 11/25/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022] Open
Abstract
Polycystic ovary syndrome (PCOS) is the most common reproductive disease affecting the hormone and metabolic status of women. Its associated symptoms are diverse among the patients, including hyperandrogenism, insulin resistance, anovulation, infertility, obesity, hirsutism, acne, and more. In addition, PCOS can potentially increase the risk of dysmenorrhea, endometriosis, endometrioma, and irritable bowel syndrome, which are highly related to pelvic pain and sexual difficulty. However, little known is whether PCOS exacerbates other chronic bodily pain or contributes to hyperalgesia. Health-related quality of Life (HRQoL) reflects the life satisfaction and quality derived by an individual from mental, physical, emotional, and social activities under specific conditions. In this study, we reviewed pain perception from HRQoL of PCOS patients (SF-36). The review data evidently indicated that pain perception is significantly more prevalent in patients with PCOS than in healthy controls, and obesity and infertile status could be the rationales associated with pain development. Nevertheless, underlying causes remain undetermined due to the limited information from SF-36. Furthermore, we reviewed pathophysiologic factors to pain development or exacerbation, such as the deregulation of inflammation levels, adipokines, and insulin resistance. Although current evidence of pain perception and pathophysiologic risk factors are solid in PCOS, patients' pain perception is often ignored in clinical settings. Clinicians should note the perception and treatment of pain in PCOS patients. The correlation or causality between pain and PCOS warrants further clinical examination and basic studies, thereby providing new insights into this topic in the context of clinical diagnosis and health care.
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Affiliation(s)
- Kuan-Ta Lu
- Department of Anesthesiology, Changhua Christian Hospital, Changhua City 50094, Taiwan
| | - Yu-Cheng Ho
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung City 82445, Taiwan
| | - Chen-Lin Chang
- Medical Laboratory, Medical Education and Research Center, Kaohsiung Armed Forces General Hospital, Kaohsiung City 80284, Taiwan
- Department of Psychiatry, Kaohsiung Armed Forces General Hospital, Kaohsiung City 80284, Taiwan
| | - Kuo-Chung Lan
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung City 83301, Taiwan
- Center for Menopause and Reproductive Medicine Research, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung City 83301, Taiwan
| | - Cheng-Chun Wu
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung City 82445, Taiwan
- Correspondence: (C.-C.W.); (Y.-T.S.)
| | - Yu-Ting Su
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung City 83301, Taiwan
- Center for Menopause and Reproductive Medicine Research, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung City 83301, Taiwan
- Correspondence: (C.-C.W.); (Y.-T.S.)
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11
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GÜRKAN N, AĞAR M, GÜRBÜZ T. The relationship between polycystic ovary syndrome and irritable bowel syndrome. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2022. [DOI: 10.32322/jhsm.1122473] [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
Introduction: Polycystic ovary syndrome (PCOS) causes endocrine disorders that affect the functioning of the reproductive system and the body's metabolic system. Bowel movement disorders and abdominal pain are common complaints of PCOS patients. Few studies have been performed on the relationship between PCOS and irritable bowel syndrome (IBS), and the association between the two syndromes is unclear.
Material and Method: In the study, 72 patients were enrolled at gynecology and obstetric clinic in Turkey. The control group were (n=34) and women with PCOS (n=38). IBS diagnosis was made by using Roma IV criteria.
Results: The results showed that IBS prevalence was similar in PCOS (52%) and the control group (50%) (p>0.05). No statistically significant association was found between IBS-PCOS and non-IBS-PCOS in terms of gastrointestinal symptoms (p=0.685). These symptoms were associated with PCOS rather than IBS. Significant differences have been observed between IBS-PCOS and non-IBS-PCOS for fasting insulin (FI), luteinizing hormone (LH) and Homeostasis model assessment for insulin resistance (HOMA-IR) (p
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Affiliation(s)
- Naziye GÜRKAN
- Samsun Medical Park Hospital Gynecology and Obstetrics Clinic
| | - Mehmet AĞAR
- Private Gynecology and Obstetrics Clinic, Sanlıurfa, Turkey
| | - Tuğba GÜRBÜZ
- Medistate Hospital, Gynecology and Obstetric Clinic ,Istanbul/Turkey
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12
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Ismayilova M, Yaya S. What can be done to improve polycystic ovary syndrome (PCOS) healthcare? Insights from semi-structured interviews with women in Canada. BMC Womens Health 2022; 22:157. [PMID: 35538531 PMCID: PMC9092874 DOI: 10.1186/s12905-022-01734-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 04/25/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is a common and perplexing condition affecting metabolic, reproductive, cardiovascular, and psychological health in women. Previous studies point to widespread dissatisfaction and frustration in women with the information and care they receive. Studies have found delays with the diagnosis of PCOS and gaps in knowledge in physicians regarding the diagnosis and management of PCOS. Little has been heard from women on what they think can be improved with PCOS care, especially in Canada. This qualitative study explores women's experiences navigating the healthcare system and their insights on what could be improved based on their lived experiences. METHODS Twenty-five participants were interviewed remotely over the phone by the first author between October and December 2018.Interviews were semi-structured and in-depth. Data were analyzed using thematic analysis and interpretive description methodology. RESULTS Twenty-five in-depth interviews conducted with participants across Canada (ages 18-63) revealed three overall areas in need of improvement. First, women emphasized a need for greater knowledge and awareness of PCOS in primary care physicians (PCPs) as well as the need for the medical community to prioritize women's health. Second, participants advocated for greater PCOS awareness and de-stigmatization in the general community and in women and girls, and any individuals with female reproductive systems. Third, participants brought up several needed resources, such as the need for more PCOS research to be funded and undertaken, more PCOS specialists and experts to be available, credible doctor-provided information (e.g., pamphlets, websites), and age-specific support groups and mental health supports to be available. Participants were generally unaware of existing PCOS organizations and brought up the need for established PCOS organizations to aid in the training and retraining of doctors and local awareness-building in communities. CONCLUSIONS Participants believed that PCPs in Canada needed to be well-versed on how to diagnose and manage PCOS to prevent delays in diagnosis and provide easier access to care. Further, greater awareness and de-stigmatization in the general community are needed so women can identify symptoms early and have access to support from those around them. Overall, PCOS may be an overlooked and under-prioritized condition, both in the Canadian healthcare system and general community.
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Affiliation(s)
- Miya Ismayilova
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Sanni Yaya
- School of International Development and Global Studies, Faculty of Social Sciences, University of Ottawa, 120 University Private, Ottawa, ON K1N 6N5 Canada
- The George Institute for Global Health, Imperial College London, London, UK
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13
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Yosri MM, Hamada HA, Yousef AM. Effect of visceral manipulation on menstrual complaints in women with polycystic ovarian syndrome. J Osteopath Med 2022; 122:411-422. [PMID: 35488711 DOI: 10.1515/jom-2021-0255] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 02/02/2022] [Indexed: 11/15/2022]
Abstract
CONTEXT Research is lacking regarding osteopathic approaches in treating polycystic ovary syndrome (PCOS), one of the prevailing endocrine abnormalities in reproductive-aged women. Limited movement of pelvic organs can result in functional and structural deficits, which can be resolved by applying visceral manipulation (VM). OBJECTIVES This study aims to analyze the effect of VM on dysmenorrhea, irregular, delayed, and/or absent menses, and premenstrual symptoms in PCOS patients. METHODS Thirty Egyptian women with PCOS, with menstruation-related complaints and free from systematic diseases and/or adrenal gland abnormalities, prospectively participated in a single-blinded, randomized controlled trial. They were recruited from the women's health outpatient clinic in the faculty of physical therapy at Cairo University, with an age of 20-34 years, and a body mass index (BMI) ≥25, <30 kg/m2. Patients were randomly allocated into two equal groups (15 patients); the control group received a low-calorie diet for 3 months, and the study group that received the same hypocaloric diet added to VM to the pelvic organs and their related structures, according to assessment findings, for eight sessions over 3 months. Evaluations for body weight, BMI, and menstrual problems were done by weight-height scale, and menstruation-domain of Polycystic Ovary Syndrome Health-Related Quality of Life Questionnaire (PCOSQ), respectively, at baseline and after 3 months from interventions. Data were described as mean, standard deviation, range, and percentage whenever applicable. RESULTS Of 60 Egyptian women with PCOS, 30 patients were included, with baseline mean age, weight, BMI, and menstruation domain score of 27.5 ± 2.2 years, 77.7 ± 4.3 kg, 28.6 ± 0.7 kg/m2, and 3.4 ± 1.0, respectively, for the control group, and 26.2 ± 4.7 years, 74.6 ± 3.5 kg, 28.2 ± 1.1 kg/m2, and 2.9 ± 1.0, respectively, for the study group. Out of the 15 patients in the study group, uterine adhesions were found in 14 patients (93.3%), followed by restricted uterine mobility in 13 patients (86.7%), restricted ovarian/broad ligament mobility (9, 60%), and restricted motility (6, 40%). At baseline, there was no significant difference (p>0.05) in any of demographics (age, height), or dependent variables (weight, BMI, menstruation domain score) among both groups. Poststudy, there was a statistically significant reduction (p=0.000) in weight, and BMI mean values for the diet group (71.2 ± 4.2 kg, and 26.4 ± 0.8 kg/m2, respectively) and the diet + VM group (69.2 ± 3.7 kg; 26.1 ± 0.9 kg/m2, respectively). For the improvement in the menstrual complaints, a significant increase (p<0.05) in the menstruation domain mean score was shown in diet group (3.9 ± 1.0), and the diet + VM group (4.6 ± 0.5). On comparing both groups poststudy, there was a statistically significant improvement (p=0.024) in the severity of menstruation-related problems in favor of the diet + VM group. CONCLUSIONS VM yielded greater improvement in menstrual pain, irregularities, and premenstrual symptoms in PCOS patients when added to caloric restriction than utilizing the low-calorie diet alone in treating that condition.
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Affiliation(s)
- Mahitab M Yosri
- Women's Health Department, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Hamada A Hamada
- Department of Biomechanics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Amel M Yousef
- Women's Health Department, Faculty of Physical Therapy, Cairo University, Giza, Egypt
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14
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Tay CT, Pirotta S, Teede HJ, Moran LJ, Robinson T, Skouteris H, Joham AE, Lim SS. Polycystic Ovary Syndrome Models of Care: A Review and Qualitative Evaluation of a Guideline-Recommended Integrated Care. Semin Reprod Med 2021; 39:133-142. [PMID: 34187051 DOI: 10.1055/s-0041-1727191] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Polycystic ovary syndrome (PCOS) is a heterogeneous disorder and many women are dissatisfied with their healthcare under the current fragmented health services. Here, we review existing literature on PCOS healthcare services and qualitatively evaluate an integrated PCOS service based on experiences of women with PCOS. Limited prior PCOS-dedicated services have been studied and their quantitative and efficacy-focused evaluations are summarized. Here, we also provide a broader PCOS service evaluation via semistructured interviews and surveys, with thematic analysis based on a predetermined evaluation framework. Fifteen women completed interviews and surveys. Overall the integrated, evidence-based PCOS service was well-received and women were generally satisfied with appropriateness, effectiveness, and reported positive health impact resulting from the service. Integrated care, tailored treatments, education, lifestyle support, and laser therapy were highly valued. Patients reported improvements on symptoms, understanding and confidence in managing PCOS, and emotional well-being. Elements of efficiency in the initial stages, awareness and communication, and the need for service expansion and tensions between evidence-based treatments and patient preferences were also captured to guide improvement. Further research into models of care is recommended to meet the needs of women with PCOS.
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Affiliation(s)
- Chau Thien Tay
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia.,Department of Diabetes and Vascular Medicine, Monash Health, Clayton, Victoria, Australia
| | - Stephanie Pirotta
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Helena J Teede
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia.,Department of Diabetes and Vascular Medicine, Monash Health, Clayton, Victoria, Australia
| | - Lisa J Moran
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Tracy Robinson
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia.,School of Nursing, Midwifery and Indigenous Health, Charles Sturt University, Wagga Wagga, New South Wales, Australia
| | - Helen Skouteris
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Anju E Joham
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia.,Department of Diabetes and Vascular Medicine, Monash Health, Clayton, Victoria, Australia
| | - Siew S Lim
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
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15
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Kelly L, Kurinczuk JJ, Rivero-Arias O, Fitzpatrick R, Gibbons E, Alderdice F. Exploring the use of health and wellbeing measures during pregnancy and the first year following birth in women living with pre-existing long-term conditions: qualitative interviews with women and healthcare professionals. BMC Health Serv Res 2021; 21:597. [PMID: 34162368 PMCID: PMC8223316 DOI: 10.1186/s12913-021-06615-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 06/01/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND One way in which care for pregnant and postpartum women living with long-term health conditions (LTCs) may be improved is through the adoption of standardised measures to provide evidence of health outcomes and wellbeing from the woman's perspective. AIM The study explores the views of pregnant and postpartum women living with LTCs, and healthcare professionals to better understand the potential value of using standardised health and wellbeing measures within this patient population. METHODS Qualitative semi-structured telephone interviews were conducted to explore the perceived value of using measures with pregnant and postpartum women living with LTCs within maternity services. Participants were asked to provide feedback on three exemplar measures: the Long Term Conditions Questionnaire, the Wellbeing in Pregnancy Questionnaire and the EuroQol EQ-5D-5L instrument. Thematic analysis was used in the analysis of the transcripts. RESULTS Eleven women and 11 healthcare professionals took part in semi-structured interviews. Analysis identified five themes as relevant to the use of measures within maternity services: 1) Improving care, 2) Assessing outcomes, 3) Interpretation and application of data, 4) Engagement challenges and implementation and, 5) Women and healthcare professionals alignment. CONCLUSIONS Despite varying prior experience and expressing some questions about implementation, respondents were cautiously positive about the use of standardised health and wellbeing measures. Their use offers the opportunity for both affected women and healthcare professionals caring for them to collectively identify and assess important areas of unmet needs and improve outcomes. Incorporating the perspectives of women with LTC's will help bring awareness to elements of women centred care which health services may seek to address.
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Affiliation(s)
- Laura Kelly
- Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
- Harris Manchester College, Oxford, UK.
| | - Jennifer J Kurinczuk
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Oliver Rivero-Arias
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Ray Fitzpatrick
- Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | | | - Fiona Alderdice
- Harris Manchester College, Oxford, UK
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
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Saei Ghare Naz M, Ramezani Tehrani F, Behroozi Lak T, Mohammadzadeh F, Nasiri M, Kholosi Badr F, Ozgoli G. Quality of Life and Emotional States of Depression, Anxiety and Stress in Adolescents with Polycystic Ovary Syndrome: A Cross-Sectional Study. Psychol Res Behav Manag 2020; 13:203-209. [PMID: 32184681 PMCID: PMC7053650 DOI: 10.2147/prbm.s241192] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 02/12/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The chronic condition of polycystic ovary syndrome (PCOS) in adolescents can affect different aspects of quality of life in them. This study aimed to determine the correlation between the quality of life with emotional states of depression, anxiety, and stress in adolescents with PCOS. METHODS This is a cross-sectional study conducted on 120 adolescents with PCOS in Tehran, Iran in 2019. The sociodemographic checklist, quality of life, depression, anxiety and stress (DASS) were assayed by valid and reliable questionnaires. The Pearson's correlation coefficient and linear regression were used for data analysis, which was performed by SPSS (V.22). RESULTS The mean (SD) age and menarche age of participants were 16.58 (1.36) and 12.52 (1.19) years, respectively. The most common clinical symptoms of adolescence were irregular menstruation (85%) and acne (61.7%). According to the result of this study, there was a significant reverse correlation between total score of SF-12 with total scores of depression, anxiety and stress (r=-0.395, p=0.001) and a significant reverse correlation was also found between each dimension of DASS scale and 12-Item Short Form Survey (SF-12) (p<0.001). Based on the linear regression model and after controlling the demographic variables, there was a linear regression relationship between total DASS score and SF-12 (Beta= -0.367, p= 0.003). CONCLUSION The study results reveal the role of emotional states of depression, anxiety, and stress in the quality of life of adolescents with PCOS. Based on our findings, we emphasize the interventional studies and guides for improving all dimensions of quality of life and reducing the psychological burden of PCOS in later life of adolescence.
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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
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, 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
| | - Tahereh Behroozi Lak
- Reproductive Health Research Center, Department of Infertility, Urmia University of Medical Sciences, Urmia, Iran
| | - Farnaz Mohammadzadeh
- School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Malihe Nasiri
- Department of Biostatistics, Faculty of Paramedic, Shahid Beheshti University of Medical Science, Tehran, Iran
| | | | - Giti Ozgoli
- Department of Midwifery and Reproductive Health, Midwifery and Reproductive Health Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Grace RF, Cohen J, Egan S, Wells T, Witherspoon B, Ryan A, Salek SS, Bodie S, Klaassen RJ. The burden of disease in pyruvate kinase deficiency: Patients’ perception of the impact on health-related quality of life. Eur J Haematol 2018; 101:758-765. [DOI: 10.1111/ejh.13128] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 06/20/2018] [Indexed: 01/19/2023]
Affiliation(s)
- Rachael F. Grace
- Pediatric Hematology/Oncology; Dana-Farber/Boston Children's Cancer and Blood Disorders Center; Boston Massachusetts
| | | | - Shayna Egan
- Endpoint Outcomes; Boston Massachusetts
- Endpoint Outcomes; Long Beach California
| | - Ted Wells
- Endpoint Outcomes; Boston Massachusetts
- Endpoint Outcomes; Long Beach California
| | - Brooke Witherspoon
- Endpoint Outcomes; Boston Massachusetts
- Endpoint Outcomes; Long Beach California
| | - Aisling Ryan
- Endpoint Outcomes; Boston Massachusetts
- Endpoint Outcomes; Long Beach California
| | - Sam S. Salek
- School of Life and Medical Sciences; University of Hertfordshire; Hatfield UK
- Institute for Medicines Development; Cardiff UK
| | - Susan Bodie
- Agios Pharmaceuticals, Inc.; Cambridge Massachusetts
| | - Robert J. Klaassen
- Division of Hematology/Oncology; Children's Hospital of Eastern Ontario; Ottawa ON Canada
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18
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Rzońca E, Bień A, Wdowiak A, Szymański R, Iwanowicz-Palus G. Determinants of Quality of Life and Satisfaction with Life in Women with Polycystic Ovary Syndrome. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15020376. [PMID: 29470449 PMCID: PMC5858445 DOI: 10.3390/ijerph15020376] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 02/06/2018] [Accepted: 02/17/2018] [Indexed: 12/17/2022]
Abstract
The purpose of the study was to assess the quality of life (QoL) and satisfaction with life (SwL) of women with polycystic ovary syndrome (PCOS) in comparison with those of healthy controls, and to identify and analyze factors determining QoL and SwL in women with PCOS. The cross-sectional study was performed between January and November 2016 in 504 women using health care services in Poland. The study group comprised women with PCOS, the control group women without PCOS. The study used a diagnostic survey with questionnaires. Research instruments included the World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire, the satisfaction with life scale (SWLS), and a standardized interview questionnaire comprising questions on the participants’ characteristics. Women with PCOS have lower QoL and SwL than healthy controls (p < 0.05). Factors affecting QoL in PCOS patients included socio-economic standing, time from PCOS diagnosis, BMI, age, and professional activity (p < 0.05). Factors affecting SwL in PCOS patients included socio-economic standing, having children, BMI, and time from PCOS diagnosis (p < 0.05). The higher the PCOS patients’ QoL, the higher their SwL (p < 0.05). Further studies are required, focusing both on PCOS and its etiology, and on its impact on the women diagnosed with the disease.
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Affiliation(s)
- Ewa Rzońca
- Faculty of Health Sciences, Medical University of Lublin, 4-6 Staszica St., 20-081 Lublin, Poland.
| | - Agnieszka Bień
- Faculty of Health Sciences, Medical University of Lublin, 4-6 Staszica St., 20-081 Lublin, Poland.
| | - Artur Wdowiak
- Diagnostic Techniques Unit, Medical University of Lublin, 4-6 Staszica St., 20-081 Lublin, Poland.
| | - Ryszard Szymański
- Gynecological-obstetrics Ward, Independent Public Complex of Health Care Facilities in Nowa Dęba, 1a M.C. Skłodowska St., 39-460 Nowa Dęba, Poland.
| | - Grażyna Iwanowicz-Palus
- Faculty of Health Sciences, Medical University of Lublin, 4-6 Staszica St., 20-081 Lublin, Poland.
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