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Almhmoud H, Alatassi L, Baddoura M, Sandouk J, Alkayali MZ, Najjar H, Zaino B. Polycystic ovary syndrome and its multidimensional impacts on women's mental health: A narrative review. Medicine (Baltimore) 2024; 103:e38647. [PMID: 38905372 PMCID: PMC11191963 DOI: 10.1097/md.0000000000038647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 05/30/2024] [Indexed: 06/23/2024] Open
Abstract
Polycystic ovary syndrome (PCOS) is a common endocrine disorder that affects approximately 8% to 13% of women of reproductive age worldwide. It is characterized by a range of symptoms, including hirsutism, acne, and menstrual irregularities, and poses a significant psychological burden, including anxiety and depression. The evolving definition of PCOS, from the 1990 NIH conference to the 2003 Rotterdam conference, highlights its multifaceted nature, encompassing metabolic, reproductive, and psychological aspects. This overview aims to elucidate the complex interplay between PCOS's physiological and psychological dimensions. It focuses on understanding the heightened risk of psychiatric disorders, including depression and anxiety, among women with PCOS and explores the contributing factors, such as obesity, body image issues, and stress. The etiology of PCOS involves a complex mixture of genetic, hormonal, and lifestyle factors that contribute to its pathophysiology and the associated mental health challenges. Stress, in various forms, including metabolic, inflammatory, oxidative, and emotional, is identified as a significant contributor to the pathogenesis of PCOS. Management strategies highlighted include lifestyle modifications, dietary and exercise interventions, and psychological therapies, underscoring the need for comprehensive and integrated care approaches that address the broad spectrum of PCOS effects. A multifaceted treatment approach that goes beyond just the physical symptoms of PCOS to also include its significant psychological effects is emphasized, reinforcing the necessity for a comprehensive, integrated care strategy to manage this complex condition effectively.
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Affiliation(s)
- Haya Almhmoud
- Faculty of Medicine-Tishreen University, Lattakia, Syria
| | - Lara Alatassi
- Department of Laboratory Medicine, Aleppo University Hospital, Aleppo, Syria
| | - Mouna Baddoura
- Faculty of Medicine-Damascus University, Damascus, Syria
| | - Joudy Sandouk
- Faculty of Medicine-Damascus University, Damascus, Syria
| | | | - Hasan Najjar
- Faculty of Medicine-Damascus University, Damascus, Syria
| | - Basem Zaino
- Department of Pathology, Tishreen University Hospital, Lattakia, Syria
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Dewani D, Karwade P, Mahajan KS. The Invisible Struggle: The Psychosocial Aspects of Polycystic Ovary Syndrome. Cureus 2023; 15:e51321. [PMID: 38288169 PMCID: PMC10823298 DOI: 10.7759/cureus.51321] [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: 11/26/2023] [Accepted: 12/30/2023] [Indexed: 01/31/2024] Open
Abstract
Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder with multifaceted manifestations, affecting both physiological and psychosocial aspects of affected individuals. This abstract provides a succinct overview of the hormonal underpinnings in the pathogenesis of PCOS, focusing on altered luteinizing hormone (LH) action, insulin resistance, and hyperandrogenism. A prevailing theory suggests that insulin resistance exacerbates hyperandrogenism by influencing the synthesis of sex hormone-binding globulin and increasing androgen production from adrenal and ovarian sources. PCOS diagnosis relies on specific criteria related to hyperandrogenism, ovulatory dysfunction, and the presence of polycystic ovaries. Beyond its physical symptoms, PCOS profoundly impacts women's mental health and quality of life. The prevalence of PCOS underscores the urgency of understanding its hormonal intricacies. Insulin resistance and hyperandrogenism, particularly in the context of sex hormone-binding globulin suppression, play a central role in PCOS pathogenesis. Recognizing the key role of hormones, particularly insulin resistance and hyperandrogenism, provides a foundation for targeted interventions and treatment strategies. A comprehensive approach to PCOS must consider both its physiological and psychosocial dimensions to address the challenges faced by affected individuals.
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Affiliation(s)
- Deepika Dewani
- Department of Obstetrics and Gynecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Pravin Karwade
- Department of Obstetrics and Gynecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Kalyani S Mahajan
- Department of Obstetrics and Gynecology, Symbiosis Medical College for Women, Symbiosis International University, Pune, IND
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Farajzadegan Z, Kazemi A, Salehi M, ZareMobini F. Psychological Experiences in Women with Polycystic Ovary Syndrome: A Qualitative Study. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2023; 28:391-397. [PMID: 37694209 PMCID: PMC10484384 DOI: 10.4103/ijnmr.ijnmr_139_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/24/2022] [Accepted: 05/21/2023] [Indexed: 09/12/2023]
Abstract
Background Polycystic Ovary Syndrome (PCOS) is the most common endocrine disorder among women of reproductive years. In addition to multiple physical problems, this syndrome has many psychological complications. Thus, the present study attempted to explore the psychological experiences of women with PCOS in Iran's sociocultural context. Materials and Methods The study was carried out in Isfahan, Iran, using a qualitative content analysis method. The participants were selected through purposive sampling from women with PCOS, their spouses, and healthcare providers in hospitals, clinics, workplaces, universities, and physicians' offices between September 2018 and November 2019. Data collection was performed through semi-structured interviews until data saturation. Data analysis was based on conventional content analysis. The interviews were transcribed and coded. Afterward, categories and concepts were extracted by grouping similar codes. Results A total of 13 women with PCOS, four spouses, and 13 healthcare providers participated in this study. Data analysis yielded five main categories, including the patient's psychological reactions following infertility and its probability, psychological issues following menstrual disorders, patients' fear and concerns about the probability of developing chronic diseases, psychological problems following the disease, and psychological problems resulting from body appearance. Conclusions The results of this study showed that women with PCOS were exposed to multiple psychological problems. Therefore, preventing and controlling the psychological consequences of PCOS and its complications requires healthcare providers' support and comprehensive and long-term planning to promote the mental health of these women.
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Affiliation(s)
- Ziba Farajzadegan
- Department of Community and Family Medicine, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ashraf Kazemi
- Nursing and Midwifery Care Research Center, Nursing and Midwifery School, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehrdad Salehi
- Behavioral Sciences Research Center, University of Medical Sciences, Isfahan, Iran
| | - Fatemeh ZareMobini
- Assistant Professor, Research Center for Nursing and Midwifery Care, Department of Midwifery, Faculty of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Jin L, Yu J, Chen Y, Pang H, Sheng J, Huang H. Polycystic Ovary Syndrome and Risk of Five Common Psychiatric Disorders Among European Women: A Two-Sample Mendelian Randomization Study. Front Genet 2021; 12:689897. [PMID: 34211505 PMCID: PMC8239353 DOI: 10.3389/fgene.2021.689897] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 05/25/2021] [Indexed: 12/18/2022] Open
Abstract
Background: Observational studies have implied an association between polycystic ovary syndrome (PCOS) and psychiatric disorders. Here we examined whether PCOS might contribute causally to such disorders, focusing on anxiety disorder (AD), bipolar disorder (BIP), major depression disorder (MDD), obsessive compulsive disorder (OCD), and schizophrenia (SCZ). Methods: Causality was explored using two-sample Mendelian randomization (MR) with genetic variants as instrumental variables. The genetic variants were from summary data of genome-wide association studies in European populations. First, potential causal effects of PCOS on each psychiatric disorder were evaluated, and then potential reverse causality was also assessed once PCOS was found to be causally associated with any psychiatric disorder. Causal effects were explored using inverse variance weighting, MR-Egger analysis, simulation extrapolation, and weighted median analysis. Results: Genetically predicted PCOS was positively associated with OCD based on inverse variance weighting (OR 1.339, 95% CI 1.083–1.657, p = 0.007), simulation extrapolation (OR 1.382, 95% CI 1.149–1.662, p = 0.009) and weighted median analysis (OR 1.493, 95% CI 1.145–1.946, p = 0.003). However, genetically predicted OCD was not associated with PCOS. Genetically predicted PCOS did not exert causal effects on AD, BIP, MDD, or SCZ. Conclusions: In European populations, PCOS may be a causal factor in OCD, but not AD, BIP, MDD, or SCZ.
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Affiliation(s)
- Luyang Jin
- Department of Reproductive Endocrinology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Key Laboratory of Reproductive Genetics, Ministry of Education, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jia'en Yu
- Department of Reproductive Endocrinology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Key Laboratory of Reproductive Genetics, Ministry of Education, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yuxiao Chen
- The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Haiyan Pang
- Department of Reproductive Endocrinology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Key Laboratory of Reproductive Genetics, Ministry of Education, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jianzhong Sheng
- Key Laboratory of Reproductive Genetics, Ministry of Education, School of Medicine, Zhejiang University, Hangzhou, China.,Department of Pathology and Pathophysiology, School of Basic Medical Sciences, Zhejiang University, Hangzhou, China
| | - Hefeng Huang
- Department of Reproductive Endocrinology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Key Laboratory of Reproductive Genetics, Ministry of Education, School of Medicine, Zhejiang University, Hangzhou, China
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Zhao J, Chai G, Yang F, Xu L, Zhao J, Wang Y, Liu C. Analysis of the change of clinical nursing pathway in health education among patients with ovarian carcinoma. Am J Transl Res 2021; 13:3138-3146. [PMID: 34017482 PMCID: PMC8129265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 01/21/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To investigate the effect of health education via clinical nursing pathway (CNP) on self-care agency, quality of life, negative emotions and nursing satisfaction among patients with ovarian carcinoma. METHODS The clinical data of 61 patients with ovarian carcinoma admitted to the Oncology Department of our hospital from January 2019 to January 2020 were analyzed retrospectively. According to the different nursing methods, the patients were divided into a control group (n=31) and an observation group (n=30). The postoperative complications, the scores of self-care agency and quality of life before and after intervention, sleep quality and negative emotions were compared and analyzed between the two groups. RESULTS Patients in the observation group had higher mastery of health knowledge and lower incidence of postoperative complications than those in the control group. The scores of SDS, SAS and PSQI were significantly decreased in both groups after intervention compared with those before intervention (P<0.05), and the scores in the observation group were significantly lower than those in the control group (P<0.05). After intervention, both groups showed higher scores of self-care agency and quality of life than before intervention (P<0.05), and patients in the observation group showed higher scores than those in the control group (P<0.05). The overall nursing satisfaction of patient was relatively high. CONCLUSION Health education via CNP can help patients better understand the diseases, reduce their psychological burden and improve sleep quality. Informing patients of the methods of postoperative restorative exercise through health education is able to reduce complications incidence and improve self-care agency and quality of life of patients.
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Affiliation(s)
- Jing Zhao
- Department of Gynecology and Mammary Gland II, Tangshan People’s HospitalTangshan City, Hebei Province, China
| | - Guozhe Chai
- Obstetrics and Gynecology Area l, People’s Hospital of Qianxi CountyTangshan City, Hebei Province, China
| | - Fangjie Yang
- Operating Room, Tangshan People’s HospitalTangshan City, Hebei Province, China
| | - Lizhuo Xu
- Department of Obstetrics and Gynecology, Tangshan People’s HospitalTangshan City, Hebei Province, China
| | - Jie Zhao
- Department of Obstetrics and Gynecology, Tangshan People’s HospitalTangshan City, Hebei Province, China
| | - Yaoping Wang
- Department of Obstetrics and Gynecology, Tangshan People’s HospitalTangshan City, Hebei Province, China
| | - Cuiying Liu
- Department of Obstetrics and Gynecology, Tangshan People’s HospitalTangshan City, Hebei Province, China
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Authier M, Normand C, Jego M, Gaborit B, Boubli L, Courbiere B. Qualitative study of self-reported experiences of infertile women with polycystic ovary syndrome through on-line discussion forums. ANNALES D'ENDOCRINOLOGIE 2020; 81:487-492. [PMID: 32827451 DOI: 10.1016/j.ando.2020.07.1110] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 07/16/2020] [Accepted: 07/24/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To highlight the self-reported experiences and disease perceptions of infertile women with polycystic ovary syndrome (PCOS). METHODS A qualitative study using an inductive method was conducted on infertile women with PCOS who shared their self-reported experiences on French-speaking on-line forums. RESULTS 785 comments by 211 women on 7 forums were analyzed. Women complained of late diagnosis and lack of information regarding PCOS. PCOS and infertility showed negative psychological impact on daily life. This impact appeared to be alleviated by the sharing of knowledge and experience enabled by these forums. CONCLUSION The self-reported experience of infertile women with PCOS is interesting for health practitioners. The psychological impact of PCOS and perceptions of illness appear to be improved by sharing experiences between women with PCOS, suggesting a beneficial support role of online discussion forums.
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Affiliation(s)
- Magali Authier
- Département de médecine générale, faculté des sciences médicales et paramédicales - Timone, Aix-Marseille Université, 27, boulevard Jean-Moulin, 13385 Marseille, France.
| | - Caroline Normand
- Département de médecine générale, faculté des sciences médicales et paramédicales - Timone, Aix-Marseille Université, 27, boulevard Jean-Moulin, 13385 Marseille, France
| | - Maëva Jego
- Département de médecine générale, faculté des sciences médicales et paramédicales - Timone, Aix-Marseille Université, 27, boulevard Jean-Moulin, 13385 Marseille, France
| | - Bénédicte Gaborit
- Département d'endocrinologie, diabète et maladies métaboliques, AP-HM, Aix Marseille Université, INSERM, INRA, C2VN, Marseille, France
| | - Léon Boubli
- Pôle femmes-parents-enfants, centre clinico-biologique d'AMP - CECOS, AP-HM Hôpital Nord/Hôpital La Conception, 147, boulevard Baille, 13005 Marseille, France
| | - Blandine Courbiere
- Pôle femmes-parents-enfants, centre clinico-biologique d'AMP - CECOS, AP-HM Hôpital Nord/Hôpital La Conception, 147, boulevard Baille, 13005 Marseille, France; Aix-Marseille Université, CNRS, IRD, IMBE, Avignon Université, Marseille, France
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A mental health intervention program for the oocyte donors: protocol for a mixed methods study. Reprod Health 2020; 17:10. [PMID: 31959209 PMCID: PMC6971919 DOI: 10.1186/s12978-020-0864-9] [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: 12/15/2019] [Accepted: 01/14/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Oocyte donation is one of the assisted reproductive techniques that can undermine the mental health of the women donor. As such, the aim of this study is to design a mental health promotion program for oocyte donors. METHODS This is an exploratory mixed methods study (qualitative-quantitative) that consists of three phases. In the first phase, a qualitative study will be conducted to identify the needs and strategies of the mental health promotion program for the women donors. In this phase, the participants will be selected using purposeful sampling method and the data will be collected through semi-structured interviews. In the second phase, the initial draft of the program is designed and validated in the panel of experts and using the classic Delphi technique and, then, the program is finalized. In the third phase, the designed program will be implemented as a quasi-experimental study in two groups of program recipients (intervention) and control, and the effectiveness of the intervention program will be evaluated. DISCUSSION In order to design a documentation-based mental health promotion program for the oocyte donors, their experience during the process of oocyte donation should be evaluated. Doing so, the program will be developed based on the specific circumstances of the target population and their social and cultural context and, hence, will have the highest impact.
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The Current Description and Future Need for Multidisciplinary PCOS Clinics. J Clin Med 2018; 7:jcm7110395. [PMID: 30373317 PMCID: PMC6262499 DOI: 10.3390/jcm7110395] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 10/23/2018] [Accepted: 10/26/2018] [Indexed: 12/19/2022] Open
Abstract
Polycystic Ovarian Syndrome (PCOS), with common symptoms of irregular menstrual cycles, ovarian cysts, and hirsutism, is thought to be the most common endocrine disorder found in women, and use of multidisciplinary teams has been shown to be effective. The purpose of this review is to determine the future need for specialized, comprehensive, multidisciplinary treatment for PCOS and the current description and efficacy of existing multidisciplinary clinics. The literature was searched using PubMed, CINAHL, PsycINFO, Medline, and the Cochrane Library. Keywords included treatment efficacy, polycystic ovary syndrome, treatment and collaboration. Results showed that while an increasing number of studies continue to come out expressing the need for multidisciplinary approaches to and clinics for the treatment of PCOS, there is still a large gap in the literature documenting actual multidisciplinary PCOS treatment facilities. The limited literature documenting the efficacy of multidisciplinary PCOS clinic have demonstrated increased weight loss, high patient satisfaction, and high retention compared to single-care providers. Data showed that these teams are most commonly made up of a combination of endocrinologists, psychologists, dietitians, gynecologists, and endocrine-specialized nurses. Data showed that there is a high degree of variability and rates of diagnosis between types of single-care providers, such as: endocrinology, dermatology, gynecology, and fertility. Individuals with PCOS are in need for specialized, individualized, and focused care from a diverse team of healthcare providers to treat PCOS comprehensively.
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