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Çıtar Dazıroğlu ME, Acar Tek N, Cevher Akdulum MF, Yılmaz C, Yalınay AM. Effects of kefir consumption on gut microbiota and health outcomes in women with polycystic ovary syndrome. Food Sci Nutr 2024; 12:5632-5646. [PMID: 39139979 PMCID: PMC11317752 DOI: 10.1002/fsn3.4212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 04/27/2024] [Accepted: 04/29/2024] [Indexed: 08/15/2024] Open
Abstract
Polycystic Ovary Syndrome (PCOS), which is common among women of reproductive age, is characterized by low-grade chronic inflammation and is associated with several health problems and dysbiosis. Kefir has been shown to have many beneficial health effects; however, its effect on PCOS is unknown. This study aimed to examine the effect of kefir on the intestinal microbiota and health outcomes in PCOS. In this intervention study, 17 women with PCOS consumed 250 mL/day of kefir (containing Lactobacillus kefiranofaciens subsp. kefiranofaciens, Lactobacillus kefiranofaciens subsp. kefirgranum, Lactobacillus kefiri, Lactobacillus acidophilus, Lactobacillus parakefiri, Lactobacillus bulgaricus, Lactobacillus reuteri, Lactobacillus casei, Lactobacillus fermentum, Lactobacillus helveticus, Lactococcus lactis, Leuconostoc mesentereoides, Bifidobacterium bifidum, Streptococcus thermophilus, Kluyveromyces marxianus, Kluyveromyces lactis, Acetobacter pasteurianus, and Saccharomyces cerevisiae) for 8 weeks. Food consumption and physical activity records, anthropometrical measurements, quality of life, and fecal and blood samples were taken at the study's beginning and end. Quality of life in mental health (58.8 ± 15.08; 64.0 ± 15.23, respectively) and physical function (95.00 and 100.00, respectively) categories showed a significant increase after kefir intervention (p < .05). Additionally, Interleukin-6 (IL-6), one of the inflammatory cytokines, significantly decreased (174.00 and 109.10 ng/L, respectively) (p < .05). The intestinal barrier permeability was evaluated with zonulin, and no significant change was observed. Gut microbiota analysis showed that while the relative abundance of the class Bacilli and genus Lactococcus significantly increased, the genus Holdemania decreased with kefir consumption (p < .05). In conclusion, kefir appears to be beneficial for improving the microbiota and some health outcomes, like reducing inflammation and improving quality of life in PCOS. Therefore, kefir may be useful in the treatment of PCOS.
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Affiliation(s)
| | - Nilüfer Acar Tek
- Department of Nutrition and DieteticsGazi UniversityAnkaraTurkey
| | | | - Canan Yılmaz
- Department of Medical BiochemistryGazi UniversityAnkaraTurkey
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Wang G, Liu X, Zhu S, Lei J. Regulatory emotional self-efficacy and self-compassion mediate anxiety, depression, body image distress and subjective well-being in women with polycystic ovary syndrome: A cross-sectional study. J Adv Nurs 2024. [PMID: 38712607 DOI: 10.1111/jan.16220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 09/14/2023] [Accepted: 04/24/2024] [Indexed: 05/08/2024]
Abstract
AIMS This study aims to investigate the mediating role of regulatory emotional self-efficacy and self-compassion in the relationship among anxiety, depression, body image distress and subjective well-being among women with polycystic ovary syndrome. DESIGN A cross-sectional study. METHODS The study recruited 510 women with polycystic ovary syndrome from a tertiary hospital affiliated with a university in Hunan Province, China. The study employed several tools to collect data, including the Generalized Anxiety Scale, the Patient Health Questionnaire-9, the Body Image States Scale, the Self-Compassion Scale, the Regulatory Emotional Self-Efficacy Scale and the Index of Well-being questionnaire. Data analysis was carried out using descriptive analysis, spearman correlation analysis, ordinary least squares regression and bootstrapping. RESULTS The study's findings indicate that regulatory emotional self-efficacy and self-compassion both act as mediators in the connection between anxiety, depression, body image distress and subjective well-being among women with polycystic ovary syndrome. CONCLUSION The study emphasizes the significance of regulatory emotional self-efficacy and self-compassion in promoting well-being among women with polycystic ovary syndrome. It also implies that interventions targeted at enhancing these factors could potentially enhance the subjective well-being of women affected by PCOS. IMPACT Our study's primary contribution is to underscore the crucial mediating roles of regulatory emotional self-efficacy and self-compassion in the relationship among anxiety, depression, body image distress and subjective well-being. Our study indicates that clinical practitioners should prioritize improving the regulatory emotional self-efficacy and self-compassion of women with polycystic ovary syndrome, reducing their anxiety, depression and body image distress and improving their subjective well-being. REPORTING METHOD This study was reported according to the Standards for Reporting Qualitative Research (SRQR). PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution outside of participation in the actual study for purposes of data collection.
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Affiliation(s)
- Guangpeng Wang
- The Third Xiangya Hospital of Central South University, Changsha, China
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Xueyan Liu
- School of Nursing, Shandong University, Jinan, China
| | - Shujuan Zhu
- The Third Xiangya Hospital of Central South University, Changsha, China
| | - Jun Lei
- The Third Xiangya Hospital of Central South University, Changsha, China
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Ligocka N, Chmaj-Wierzchowska K, Wszołek K, Wilczak M, Tomczyk K. Quality of Life of Women with Polycystic Ovary Syndrome. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:294. [PMID: 38399581 PMCID: PMC10890377 DOI: 10.3390/medicina60020294] [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: 01/12/2024] [Revised: 01/30/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024]
Abstract
Background and Objectives: Polycystic ovary syndrome (PCOS) is an endocrine disorder characterized by multiple hormonal and metabolic abnormalities, including insulin resistance, hyperandrogenism, and disturbances in lipid and carbohydrate metabolism. The objective of this study is to assess the quality of life of women diagnosed with polycystic ovary syndrome (PCOS) and to identify any factors within the study group that may impact the scores related to quality of life. Materials and Methods: This research was carried out among women diagnosed with PCOS. An original questionnaire, developed through an online Google Forms survey, was utilized as the research instrument and distributed through social networks and support groups to women facing PCOS. This study encompassed a participant pool of 200 women with PCOS, aged 24 years or older. For the analytical component, Pearson's χ2 test was employed-a nonparametric test designed to assess the relationship between two variables measured on a qualitative scale. The chosen level of statistical significance was set at p < 0.05. Results: The analysis revealed that the quality of life of the women under study was not linked to the duration of the disease or comorbidities. However, a significant association was observed with the inconvenience caused by PCOS symptoms. Women experiencing very bothersome symptoms of PCOS reported a lower quality of life compared to those with symptoms rated as not very bothersome. Despite the majority of women with PCOS rating their quality of life as good or very good, they often find the associated symptoms of PCOS bothersome. Women reporting lower quality of life tend to acknowledge the impact of PCOS on their lives, experience a sense of lack of control over the disease, struggle with depression, and do not accept their physical appearance. Conclusions: Hence, the support from specialists like endocrinologists, gynecologists, and nutritionists becomes crucial for many women dealing with PCOS. Adopting a healthy lifestyle, incorporating a balanced diet, and engaging in regular physical activity can assist in managing the troublesome symptoms of PCOS, thereby enhancing overall quality of life. In instances of emotional difficulties, seeking psychological support is equally important, and the significance of support and acceptance from loved ones should not be overlooked.
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Rizwan Khan AY, Abdullah MA, Gul R, Bhutta HR, Imran M, Mazhar SB, Tariq N. Prevalence of Anxiety and Depression Among Women With Polycystic Ovarian Syndrome: A Cross-Sectional Study From a Tertiary Care Hospital of Islamabad, Pakistan. Cureus 2024; 16:e52540. [PMID: 38371069 PMCID: PMC10874487 DOI: 10.7759/cureus.52540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2024] [Indexed: 02/20/2024] Open
Abstract
Background Depression and anxiety are common psychological conditions associated with polycystic ovarian syndrome (PCOS). It is important to understand the role of various demographic and socio-economic factors that contribute to the development of these psychological conditions. Objectives The aims of this study were to determine the prevalence of anxiety and depression in women with PCOS and to find the association of various demographic and socio-economic factors with anxiety and depression. Methods This was a single-center cross-sectional study conducted at a tertiary care hospital in Islamabad, Pakistan, from May 2021 to August 2022. All female patients, aged 18 to 40 years and diagnosed with PCOS, who presented to the department of Gynecology during the study period were eligible to be enrolled in the study. The Hospital Anxiety and Depression scale (HADS) was used to determine the level of anxiety and depression in the participants. HADS comprises 14 items scored on a Likert scale ranging from 0 to 3. Seven items correspond to depression and anxiety each. The scores range from 0 to 21 for both domains. A score of 7 or less was considered normal, 8-10 as borderline, and 11 or above as abnormal for both anxiety and depression. Data were analyzed using IBM SPSS Statistics for Windows, Version 26.0 (IBM Corp., Armonk, NY, USA). Results A total of 74 patients with PCOS were included in the study. The mean age of all the participants was 26.8 ± 5.2 and the mean body mass index (BMI) was 28.7 ± 5.4. The presence of PCOS-related symptoms was observed in all 74 cases. Menstrual cycle abnormalities were the most common symptom, which was present in 57 (77.0%) cases, followed by weight gain, which was present in 50 (67.6%) cases, and hirsutism, which was present in 41 (55.4%) cases. Diabetes mellitus and hypertension were present only in three (4.1%) and two (2.7%) cases, respectively, and positive family history of depression and/or anxiety was reported by 20 (27%) cases. The mean HAD score was 7 ± 3.8 for depression and 8 ± 3.7 for anxiety. Depression was diagnosed in 13 (17.6%) cases, and anxiety was diagnosed in 15 (20.3%) cases. Depression was found to be significantly associated with BMI (p = 0.015), level of education (p = 0.033), and monthly household income (p = 0.004). Anxiety was found to be associated with employment status (p = 0.009) and current pregnancy (p = 0.007). Rest of the factors such as age, marital status, ethnicity, menstrual irregularities, comorbidities such as diabetes mellitus and hypertension, and a family history of PCOS, anxiety, or depression did not show statistically significant association with either anxiety or depression (p < 0.05). Conclusion Anxiety and depression are common in patients with PCOS. These psychological conditions are associated with various demographic and socio-economic factors such as BMI, level of education, monthly household income, employment status, and pregnancy. It is recommended to involve a multidisciplinary team while managing patients with PCOS to timely identify and treat these psychological conditions in these patients.
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Affiliation(s)
| | | | - Rumaan Gul
- Medicine, Shifa College of Medicine, Shifa Tameer-e-Millat University, Islamabad, PAK
| | - Haider Raza Bhutta
- Medicine, Shifa College of Medicine, Shifa Tameer-e-Millat University, Islamabad, PAK
| | - Maryam Imran
- Medicine, Shifa College of Medicine, Shifa Tameer-e-Millat University, Islamabad, PAK
| | - Syeda Batool Mazhar
- Obstetrics and Gynecology, Pakistan Institute of Medical Sciences, Islamabad, PAK
| | - Nabia Tariq
- Obstetrics and Gynecology, Maroof International Hospital, Islamabad, PAK
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Polo-Kantola P, Toffol E. The Relationship Between Mood and Sleep in Different Female Reproductive States. Sleep Med Clin 2023; 18:385-398. [PMID: 38501512 DOI: 10.1016/j.jsmc.2023.06.002] [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] [Indexed: 03/20/2024]
Abstract
Mood and sleep are tightly interrelated. Mood and sleep symptoms and disorders are more common in women than in men and often associated with reproductive events. This article reviews the current literature on the reciprocal relationships between mood and sleep across reproductive phases in women, such as menstrual cycle and related disorders, pregnancy, climacteric, and use of hormonal contraception and hormone replacement therapy. Mood and sleep symptoms seem to covary in relation to physiologic and pathologic reproductive conditions, although the relationship seems more clear for subjective than objective sleep.
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Affiliation(s)
- Päivi Polo-Kantola
- Department of Obstetrics and Gynecology, Turku University Hospital, University of Turku, Turku, Finland.
| | - Elena Toffol
- Department of Public Health, University of Helsinki, PO Box 20, Helsinki 00014, Finland
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Bu N, Jamil A, Hussain L, Alshammari A, Albekairi TH, Alharbi M, Jamshed A, Bazmi RR, Younas A. Phytochemical-Based Study of Ethanolic Extract of Saraca asoca in Letrozole-Induced Polycystic Ovarian Syndrome in Female Adult Rats. ACS OMEGA 2023; 8:42586-42597. [PMID: 38024692 PMCID: PMC10652831 DOI: 10.1021/acsomega.3c05274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 09/29/2023] [Accepted: 10/10/2023] [Indexed: 12/01/2023]
Abstract
Polycystic ovarian syndrome (PCOS) is a complex metabolic and endocrine disorder which affects women of reproductive age. It is a condition in which ovaries produce an excessive amount of androgen (the male sex hormone). Saraca asoca (Roxb.) Willd. is a plant of the Fabaceae family. This plant has been traditionally used as a uterine tonic in leucorrhea and dysmenorrhea due to its various pharmacological activities. In this study, the ethanolic extract of S. asoca (EESA) was evaluated for its potential to be used for the management of PCOS. HPLC analysis revealed the presence of various phytoconstituents: kaempferol, rutin, (-)-epicatechin, salicylic acid, and gallic acid. For PCOS induction, 30 adult female rats were randomly divided into two groups: the control group (n = 5) and the PCOS group (n = 25). Letrozole (1 mg/kg/day) was administered per orally (p.o.) for a period of 7 weeks for the induction of disease. Weekly body weight measurements and daily vaginal cytology examinations were performed for disease confirmation. After disease induction, the PCOS group was further divided into five groups (n = 5), that is, disease control, metformin, and EESA (200, 400, and 600 mg/kg) groups, respectively, and given treatment doses for next 5 weeks. After the treatment period, all animals were weighed and euthanized humanly. Blood samples were collected for hormonal assays, lipid profiles, and liver function tests. For histological assessment of ovarian cysts, ovaries were dissected. Livers were preserved to evaluate EESA's antioxidant properties. Histopathology analysis revealed that EESA reduced body weight and the number of cystic follicles. Furthermore, it also lowered the elevated levels of serum testosterone, luteinizing hormone, insulin, and malonaldehyde in PCOS rats while increasing the levels of follicle-stimulating hormone, estradiol, progesterone, prolactin, and other antioxidant enzymes such as superoxide dismutase, glutathione, and catalase. It can be concluded that EESA exhibited beneficial effects in normalizing the perturbed hormonal profile and improved the ovary status by decreasing the cystic follicle and improving the ovulation status in a dose-dependent manner.
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Affiliation(s)
- Na Bu
- Department
of Pharmacy, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou 31006, P. R. China
| | - Alina Jamil
- Department
of Pharmacology, Faculty of Pharmaceutical Sciences, Government College University, Faisalabad 38040, Pakistan
| | - Liaqat Hussain
- Department
of Pharmacology, Faculty of Pharmaceutical Sciences, Government College University, Faisalabad 38040, Pakistan
| | - Abdulrahman Alshammari
- Department
of Pharmacology and Toxicology, College of Pharmacy, King Saud University, P.O. Box 2455, Riyadh 11451, Saudi Arabia
| | - Thamer H. Albekairi
- Department
of Pharmacology and Toxicology, College of Pharmacy, King Saud University, P.O. Box 2455, Riyadh 11451, Saudi Arabia
| | - Metab Alharbi
- Department
of Pharmacology and Toxicology, College of Pharmacy, King Saud University, P.O. Box 2455, Riyadh 11451, Saudi Arabia
| | - Ayesha Jamshed
- Department
of Pharmacology, Faculty of Pharmacy, Islamia
University Bahawalpur, Bahawalpur 63100, Pakistan
| | - Rizwan Rashid Bazmi
- Department
of Pharmaceutical Chemistry, Faculty of Pharmaceutical Sciences, Government College University, Faisalabad 38040, Pakistan
| | - Anam Younas
- Department
of Pharmacology, Faculty of Pharmaceutical Sciences, Government College University, Faisalabad 38040, Pakistan
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Wang G, Liu X, Lei J. Mental health latent profiles and emotion regulation in women with polycystic ovary syndrome: A cross-sectional study. J Health Psychol 2023; 28:1172-1185. [PMID: 37492985 DOI: 10.1177/13591053231186916] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2023] Open
Abstract
This cross-sectional study aimed to identify latent mental health subgroups of reproductive-aged women with polycystic ovary syndrome (PCOS) and examine differences in emotion regulation and social support. A total of 477 samples (age = 27.22 ± 5.37) diagnosed with PCOS were included in this study, all of whom were of the same ethnicity. Latent profile analysis (LPA) was conducted in Mplus version 8.3 to identify mental health latent profiles in women with PCOS based on the dual-factor approach. The current study identified three distinct mental health profiles within women with PCOS: High-Symptom and High-Well-being Profile, Low-Symptom and High-Well-being Profile, and High-Symptom and Low-Well-being Profile, with group proportions of 52.3%, 35.7%, and 11.1%, respectively. This study revealed that cognitive reappraisal and social support are important protective factors for the mental health of women with PCOS, whereas expressive suppression is a negative factor for their mental health.
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Affiliation(s)
- Guangpeng Wang
- The Third Xiangya Hospital of Central South University, China
- Xiangya School of Nursing, Central South University, China
| | - Xueyan Liu
- School of Nursing, Shandong University, China
| | - Jun Lei
- The Third Xiangya Hospital of Central South University, China
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Wei Z, Chen Z, Xiao W, Wu G. A systematic review and meta-analysis of the correlation between polycystic ovary syndrome and irritable bowel syndrome. Gynecol Endocrinol 2023; 39:2239933. [PMID: 37494961 DOI: 10.1080/09513590.2023.2239933] [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: 03/24/2023] [Revised: 07/09/2023] [Accepted: 07/17/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND Research on the prevalence of irritable bowel syndrome (IBS) among polycystic ovary syndrome (PCOS) patients has gained significant momentum over the years. However, it remains unclear whether PCOS is related to a higher prevalence of IBS. The objective of this systematic review and meta-analysis was to fully study IBS correlation with PCOS. METHODS From inception until October 16th, 2022, all observational studies documenting IBS prevalence in PCOS patients were collected from the China national knowledge infrastructure(CNKI), China Science and Technology Journal Database(VIP), Wanfang database, PubMed, Embase, Web of Science, and Cochrane databases. The quality of case-control studies was assessed with Newcastle-Ottawa Scale. Review Manager 5.3 was used to determine the pooled odds ratio (OR) and 95% confidence interval (CI). RESULTS 5 case-control studies involving 1268 individuals and one cross-sectional study involving 291 participants were included in our qualitative analysis. The quantitative analysis was conducted based on five case-control studies. Four case-control studies involving 1063 participants showed a higher prevalence of IBS in PCOS This meta-analysis revealed an almost twice higher risk of IBS in comparison with controls (OR = 2.23, 95%CI:1.58-3.14, p < 0.001; I2=41%, p = 0.150). Four sensitivity analyses validated the consistency of the aggregated findings. CONCLUSION This meta-analysis and systematic review demonstrated a significant association between PCOS and increased odds of IBS. However, more high-quality and well-controlled research is essential to increase the robustness of our conclusions.
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Affiliation(s)
- Zhaokang Wei
- Department of General Medicine, Jinan University First Affiliated Hospital, Guangzhou, China
| | - Zuhui Chen
- Department of General Medicine, Jinan University First Affiliated Hospital, Guangzhou, China
| | - Wenle Xiao
- Department of General Medicine, Jinan University First Affiliated Hospital, Guangzhou, China
| | - Gangjie Wu
- Department of General Medicine, Jinan University First Affiliated Hospital, Guangzhou, China
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Shoaib M, Saleem A, Zeb A, Khan MI, Akhtar MF. Chemical Characterization and Ameliorating Effect of Centratherum anthelminticum Extract against Polycystic Ovary Syndrome in Wistar Rats. Int J Endocrinol 2023; 2023:4978562. [PMID: 37483646 PMCID: PMC10359138 DOI: 10.1155/2023/4978562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 06/28/2023] [Accepted: 07/01/2023] [Indexed: 07/25/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) in females is an endocrine pathological condition of reproductive age which is usually caused by insulin resistance, hyperlipidemia, and oxidative stress. This research was aimed at evaluating the therapeutic effect of the Centratherum anthelminticum seed extract (CA) against PCOS in rodents as it is traditionally used to treat diabetes, inflammation, and gynecological problems. The CA was chemically characterized by high-performance liquid chromatography-diode array detection (HPLC-DAD). For the induction of PCOS, a high-fat diet (HFD) was given to all female Wistar rats for nine weeks except the normal control group, which was given a normal chow diet. Estradiol valerate was given to all rats except normal control. After the induction of PCOS, oral metformin (300 mg/kg) was given to the standard group, while CA was orally administered to diseased rats at 250, 500, and 750 mg/kg/day for 28 days. HPLC-DAD analysis revealed that kaempferol-3-pcoumaroylglucoside was present in the highest amount (146.8 ± 1.8 mg/g) of the extract followed by ferulic acid and malvidin-3-(6-caffeoyl)-glucoside. The in vivo results revealed a marked reduction in cholesterol and triglyceride levels in CA treatment groups. A significant rise was observed in progesterone and follicle stimulating hormone with a decrease in luteinizing hormone in the treatment groups as compared to disease control, which indicated normalization of the estrus cycle. The decrease in insulin resistance was characterized by low serum insulin levels in treatment groups. Treatment with CA also reduced inflammatory markers, such as IL-6 and NF-κB in PCOS rats. NrF2 and oxidative stress markers such as catalase, superoxide dismutase, malondialdehyde, and reduced glutathione were also improved by CA in the ovary of diseased rats. Histopathological examination showed the different developmental stages of normal follicles in CA-treated diseased rats which were indicative of a normal fertile estrous cycle. Overall, the results confirmed the efficacy of CA against PCOS in treating estradiol-HFD-induced PCOS due to its antidiabetic, anti-inflammatory, antihyperlipidemic, and antioxidant properties.
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Affiliation(s)
- Moonis Shoaib
- Riphah Institute of Pharmaceutical Sciences, Riphah International University Lahore, Lahore, Pakistan
| | - Ammara Saleem
- Department of Pharmacology, Faculty of Pharmaceutical Sciences, GC University Faisalabad, Faisalabad, Pakistan
| | - Alam Zeb
- Department of Biochemistry, University of Malakand, Lower Dir, Khyber Pakhtunkhwa 18800, Pakistan
| | - Muhammad Imran Khan
- Riphah Institute of Pharmaceutical Sciences, Riphah International University Lahore, Lahore, Pakistan
| | - Muhammad Furqan Akhtar
- Riphah Institute of Pharmaceutical Sciences, Riphah International University Lahore, Lahore, Pakistan
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Coffin T, Wray J, Sah R, Maj M, Nath R, Nauhria S, Maity S, Nauhria S. A Review and Meta-Analysis of the Prevalence and Health Impact of Polycystic Ovary Syndrome Among Medical and Dental Students. Cureus 2023; 15:e40141. [PMID: 37304389 PMCID: PMC10256275 DOI: 10.7759/cureus.40141] [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] [Accepted: 06/06/2023] [Indexed: 06/13/2023] Open
Abstract
Women currently comprise the majority of students graduating from medical school and face unique stressors not seen with their male counterparts. In particular, during their medical education, women with polycystic ovary syndrome (PCOS) experience symptoms of the disorder, which strongly impact both their academic and social lives. This in turn influences their academic and professional future. Although women as medical professionals, in general, are happy with their careers, awareness, and understanding on the part of medical educators will definitely be helpful to women medical students in their path to being successful medical professionals. The first objective of our current study is to find the prevalence of PCOS in medical and dental students. The second objective is to find the academic and health impacts of PCOS and what type of interventions are being adopted to relieve the symptoms. Using the keywords such as "PCOS," "medical students," and "dental students", the search engines PubMed, Embase, and Scopus were used to retrieve relevant articles published from 2020 to 2022. After removing the duplicates, 11 prospective cross-sectional studies were utilized for qualitative and quantitative analysis. The pooled prevalence of 2,206 female medical students diagnosed with PCOS was 24.7%. The students in the various studies were aware of their PCOS diagnosis and were taking therapeutic medications. The most common associated complications reported were BMI abnormalities, abnormal hair growth, and acne, along with other complications such as stress and poor academic and social life. The majority also had significant family histories of concurrent clinical conditions such as diabetes, hypertension, and other menstrual abnormalities. Considering the huge impact of PCOS, medical educators, policymakers, and all stakeholders should take proactive measures to accommodate students' needs and bridge the social gap. Special awareness of needed lifestyle changes should be a part of the medical education curriculum for an inclusive educational environment, as it will minimize the gender discrepancy in academic satisfaction and professional life.
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Affiliation(s)
- Tamara Coffin
- Medicine, St. George's University School of Medicine, St. George's, GRD
| | - Jadzia Wray
- Medicine, St. George's University School of Medicine, St. George's, GRD
| | | | - Mary Maj
- Biochemistry, St. George's University School of Medicine, St. George's, GRD
| | - Reetuparna Nath
- Educational Services, St. George's University, St. George's, GRD
| | | | - Sabyasachi Maity
- Physiology, St. George's University School of Medicine, St. George's, GRD
| | - Samal Nauhria
- Pathology, St. Matthew's University, Georgetown, CYM
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Rizvi M, Islam MA, Aftab MT, Naqvi AA, Jahangir A, Ishaqui AA, Iqbal MZ, Iqbal MS. Knowledge, attitude, and perceptions about polycystic ovarian syndrome, and its determinants among Pakistani undergraduate students. PLoS One 2023; 18:e0285284. [PMID: 37228116 DOI: 10.1371/journal.pone.0285284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 04/19/2023] [Indexed: 05/27/2023] Open
Abstract
OBJECTIVE The aim of the study was to evaluate knowledge, attitude, perception, and assess the determinants of polycystic ovarian syndrome (PCOS) among undergraduate students. METHODS A cross-sectional study was conducted among female undergraduate students in Pakistan using a survey. The questionnaire was formulated in English language by a review of literature and expert consensus. The sampling approach was convenient, and survey was available as electronic as well as hardcopy. Data were analyzed using IBM SPSS v23. Descriptive statistics namely mean ([Formula: see text]), standard deviation (SD), or median ([Formula: see text]) and interquartile range (IQR) were used dependent upon data distribution. In addition, range (R) was also utilized to express the results. The logistic and linear regression analyses were also conducted. Study received ethical clearance from ethics committees. RESULTS A total of 646 responses were analyzed. The average PCOS knowledge score was 11.58 ± 4.99 (overall), 12.02 ± 4.73 (medical students), 9.36 ± 5.65 (non-medical students) (α = 0.861). 68.6% participants did not feel embarrassed while discussing PCOS in the society, but 67.3% never discussed it with a doctor. Lack of self-knowledge (31.6%) and shyness/reluctance (21.4%) were identified as barriers by most students. Further, obesity, irregular menstrual periods, family history, hirsutism and contraceptive use were observed to be determinants for having PCOS (AOR > 2, p<0.05). The disease knowledge score was higher for participants studying in medical college (β = 0.184), having menstrual periods < 5 days (β = 0.125), and with a family history (β = 0.121) (p<0.05). CONCLUSION The disease knowledge among undergraduates was inadequate. However, there is greater acknowledgement of PCOS as a problem for Pakistani women and barriers have been identified in the study. Conducting awareness campaigns within academic institutions which include promoting disease education, arranging talks, distributing merchandise with disease awareness signage, would greatly help in raising awareness of the disease and lowering stigma and hesitancy.
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Affiliation(s)
- Mehwish Rizvi
- Dow College of Pharmacy, Dow University of Health Sciences, Karachi, Pakistan
| | - Md Ashraful Islam
- Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | | | - Atta Abbas Naqvi
- School of Pharmacy, University of Reading, Whiteknights Campus, Reading, United Kingdom
| | - Amnah Jahangir
- Department of Pharmacy, Tabba Heart Institute, Karachi, Pakistan
| | | | - Muhammad Zahid Iqbal
- Department of Pharmacy Practice, Lahore Pharmacy College, University of Health Sciences, Lahore, Pakistan
| | - Muhammad Shahid Iqbal
- Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam Bin Abdul Aziz University, Alkharj, Saudi Arabia
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12
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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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13
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Abstract
BACKGROUND The aim of this study was to find underlying genes and their interaction mechanism crucial to the polycystic ovarian syndrome (PCOS) by analyzing differentially expressed genes (DEGs) between PCOS and non-PCOS subjects. METHODS Gene expression data of PCOS and non-PCOS subjects were collected from gene expression omnibus (GEO) database. GEO2R were used to calculating P value and logFC. The screening threshold of DEGs was P < .05 and | FC | ≥ 1.2. GO annotation and Kyoto encyclopedia of genes and genomes (KEGG) signaling pathway enrichment analysis was performed by using DAVID (2021 Update). The protein-protein interaction (PPI) network of DEGs was constructed by using the STRING database, and the hub genes were recognized through Hubba plugin of Cytoscape software. RESULTS PCOS and non-PCOS subjects shared a total of 174 DGEs, including 14 upregulated and 160 downregulated genes. The GO biological processes enriched by DEGs mainly involved actin cytoskeleton organization, positive regulation of NF-κB signaling pathway, and positive regulation of canonical Wnt signaling pathway. The DEGs were significantly enriched in cytoplasm, nucleus and cytosol. Their molecular functions mainly focused on protein binding, calmodulin binding and glycerol-3-phosphate dehydrogenase activity. The PI3K/Akt signaling pathway and glycosaminoglycan biosynthesis were highlighted as critical pathways enriched by DEGs. 10 hub genes were screened from the constructed PPI network, of which EGF, FN1 and TLR4 were mainly enriched in the PI3K/Akt signaling pathway. CONCLUSION In this study, a total of 174 DEGs and 10 hub genes were identified as new candidate targets for insulin resistance (IR) in PCOS individuals, which may provide a new direction for developing novel treatment strategies for PCOS.
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Affiliation(s)
- Fei Zhou
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, Hebei, China
- Key Laboratory of Metabolic Diseases, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Yuling Xing
- Key Laboratory of Metabolic Diseases, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Tiantian Cheng
- Key Laboratory of Metabolic Diseases, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Linlin Yang
- Key Laboratory of Metabolic Diseases, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Huijuan Ma
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, Hebei, China
- Key Laboratory of Metabolic Diseases, Hebei General Hospital, Shijiazhuang, Hebei, China
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei, China
- *Correspondence: Huijuan Ma, Hebei Key Laboratory of Metabolic Diseases, Hebei General Hospital, Shijiazhuang 050017, Hebei, China (e-mail: )
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14
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Lefoulon N, Begon E, Perrissin-Fabert M, Grouthier V, Hocke C, Bernard V. [Impact of combined oral contraceptives and spironolactone on hirsutism and quality of life]. GYNECOLOGIE, OBSTETRIQUE, FERTILITE & SENOLOGIE 2022; 50:591-599. [PMID: 35697273 DOI: 10.1016/j.gofs.2022.06.001] [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: 01/24/2022] [Revised: 05/03/2022] [Accepted: 06/07/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES Combined oral contraceptives (COC) and spironolactone are the first and second-line treatments of mild hirsutism, since the use of cyproterone acetate was restricted to the treatment of severe hirsutism by the French guidelines for hyperandrogenism published in May 2020. Because spironolactone was until now barely used in France, the aim of this study was to evaluate the indication, efficacy and impact on quality of life of COC and spironolactone treatments on mild hirsutism in non-menopausal women. METHODS This retrospective monocentric study was conducted between June 2020 and October 2021. It included patients with mild hirsutism who received a prescription of COC or/and spironolactone. Modified Ferriman and Gallwey score (FGm) was performed by clinicians and self-rated by patients during the follow-up. Hirsutism-related quality of life was assessed using the Dermatology Life Quality Index (DLQI) and a visual analog scale. RESULTS A total of 44 patients were included, but only 30 patients received the treatment for 6 months. 70% of patients were free of side effects. Clinically we observed a decrease of 26% in the FGm score rated by clinicians and patients after 6 months of treatment (P<0,01). This was not correlated with an improvement in quality of life. CONCLUSIONS The data collected showed the clinical efficacy of both COC and spironolactone in the treatment of mild hirsutism. These two treatments were well-tolerated. However, the quality of life scores did not improve after 6 months. These treatments should be evaluated after a longer period.
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Affiliation(s)
- Nina Lefoulon
- Service de chirurgie gynécologique, gynécologie médicale et médecine de la reproduction, centre Aliénor d'Aquitaine, CHU de Bordeaux, Bordeaux, France
| | - Emmanuelle Begon
- Service de chirurgie gynécologique, gynécologie médicale et médecine de la reproduction, centre Aliénor d'Aquitaine, CHU de Bordeaux, Bordeaux, France
| | - Marie Perrissin-Fabert
- Service de gynécologie, CH de Mont de Marsan, avenue Pierre de Coubertin, 40000 Mont de Marsan, France
| | - Virginie Grouthier
- Service d'endocrinologie, diabétologie et nutrition, CHU de Bordeaux, Bordeaux, France
| | - Claude Hocke
- Service de chirurgie gynécologique, gynécologie médicale et médecine de la reproduction, centre Aliénor d'Aquitaine, CHU de Bordeaux, Bordeaux, France
| | - Valérie Bernard
- Service de chirurgie gynécologique, gynécologie médicale et médecine de la reproduction, centre Aliénor d'Aquitaine, CHU de Bordeaux, Bordeaux, France.
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15
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Objectification and ambiguity of body image in women with Polycystic Ovary Syndrome: A mixed-method study. J Affect Disord 2022; 310:296-303. [PMID: 35561883 DOI: 10.1016/j.jad.2022.05.028] [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: 11/01/2021] [Revised: 04/18/2022] [Accepted: 05/05/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND The manifestations of Polycystic Ovary Syndrome (PCOS), including acne, hirsutism, obesity, uncertain fertility, etc., can make women anxious, worried, or even depressed with their appearance and body. However, little relevant research has been conducted in the Chinese context. This mixed-method study aimed to understand how women with PCOS in China perceive their bodies and to examine the association between body image and depression. METHODS First, 101 PCOS patients participated in a survey using the Body Surveillance subscale of the Objectified Body Consciousness Scale, the Short-form Mishel Uncertainty in Illness Scale, the Appearance Anxiety Scale, and the Beck Depression Inventory-II, which measured participants' self-objectification, illness ambiguity, appearance anxiety, and depression, respectively. Second, fifteen women joined face-to-face semi-structured in-depth interviews, investigating their illness ambiguity, objectified experience, and behaviors to pursue beauty. RESULTS Results indicated a high level of self-objectification, illness ambiguity, appearance anxiety, and depression among women with PCOS in China and supported the significant associations among the outcomes. Qualitative findings presented a body image of the precarious body, indiscernible identity, and distraught mind. LIMITATIONS A convenient sampling method was used. The generalization of the study results needs further validation. Future longitudinal studies are necessary to clarify the causal relationships among outcomes. CONCLUSIONS This study presented women's body image with PCOS and found the negative impact of body image on their depression levels. This study was of both theoretical and practical significance. Appropriate mind-body therapies were suggested for them.
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16
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Comparison of health-related quality of life in different polycystic ovary syndrome phenotypes: a cross-sectional study. Eur J Obstet Gynecol Reprod Biol 2022; 271:189-194. [DOI: 10.1016/j.ejogrb.2022.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 01/29/2022] [Accepted: 02/13/2022] [Indexed: 11/18/2022]
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17
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Tan H, Gao L, Guo Y, Liu Y, Ding R, Yan X, Wang X, Wang Y, Wang L. Development and evaluation of a psychological adjustment communication system for adolescents with polycystic ovary syndrome at a high risk of depression: A mixed-method study protocol. Front Psychiatry 2022; 13:937280. [PMID: 36458120 PMCID: PMC9705960 DOI: 10.3389/fpsyt.2022.937280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 10/31/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Depression is a serious psychological disorder that causes substantial psychological and physical suffering in adolescents, contributes to over 50% of suicide attempts, and affects the health status and psychosocial functioning of 25% of the adult population. The prevalence of polycystic ovary syndrome (PCOS) in adolescents is 5.6∼11.04%, and the prevalence of depression in adolescents with PCOS is as high as 50-60%. Depression seriously affects the rehabilitation and quality of life of adolescents with PCOS. In this study, we present a protocol for a mixed-method study to develop and evaluate the effectiveness of a psychological adjustment communication system for reducing the prevalence of depression among adolescents with PCOS who are at a high risk of depression in China. This study utilizes social support theory to develop a mobile phone-based intervention for adolescents with PCOS at a high risk of depression. METHODS This sequential exploratory mixed-method study consists of four consecutive phases. In the first phase, we will review the literature to understand the disease experience and needs of adolescents with PCOS to construct an initial psychological adjustment communication system. In the second phase, researchers will interview patients and their parents using purposeful sampling methods and semi-structured interviews to appropriately modify the psychological adjustment communication system. In the third phase, the Delphi method will be used to improve the psychological adjustment communication system. The fourth phase will employ a quantitative approach using a before-and-after design to measure the effectiveness of the system. DISCUSSION The results of this study will indicate the effectiveness of the psychological adjustment communication system in adolescents with PCOS who are at a high risk of depression. REGISTRATION NUMBER ChiCTR2100050123.
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Affiliation(s)
- Huiwen Tan
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China.,Nursing College, Zunyi Medical University, Zunyi, China
| | - Li Gao
- Department of Reproductive Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Yunmei Guo
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China.,Nursing College, Zunyi Medical University, Zunyi, China
| | - Ying Liu
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China.,Nursing College, Zunyi Medical University, Zunyi, China
| | - Rui Ding
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China.,Nursing College, Zunyi Medical University, Zunyi, China
| | - Xin Yan
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China.,Nursing College, Zunyi Medical University, Zunyi, China
| | - Xueting Wang
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China.,Nursing College, Zunyi Medical University, Zunyi, China
| | - Yousha Wang
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China.,Nursing College, Zunyi Medical University, Zunyi, China
| | - Lianhong Wang
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China.,Nursing College, Zunyi Medical University, Zunyi, China
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18
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Haslan MA, Samsulrizal N, Hashim N, Zin NSNM, Shirazi FH, Goh YM. Ficus deltoidea ameliorates biochemical, hormonal, and histomorphometric changes in letrozole-induced polycystic ovarian syndrome rats. BMC Complement Med Ther 2021; 21:291. [PMID: 34844580 PMCID: PMC8628419 DOI: 10.1186/s12906-021-03452-6] [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] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 09/24/2021] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND Insulin resistance and hormonal imbalances are key features in the pathophysiology of polycystic ovarian syndrome (PCOS). We have previously shown that Ficus deltoidea var. deltoidea Jack (Moraceae) can improve insulin sensitivity and hormonal profile in PCOS female rats. However, biological characteristics underpinning the therapeutic effects of F. deltoidea for treating PCOS remain to be clarified. This study aims to investigate the biochemical, hormonal, and histomorphometric changes in letrozole (LTZ)-induced PCOS female rats following treatment with F. deltoidea. METHODS PCOS was induced in rats except for normal control by administering LTZ at 1 mg/kg/day for 21 days. Methanolic extract of F. deltoidea leaf was then orally administered to the PCOS rats at the dose of 250, 500, or 1000 mg/kg/day, respectively for 15 consecutive days. Lipid profile was measured enzymatically in serum. The circulating concentrations of reproductive hormone and antioxidant enzymes were determined by ELISA assays. Ovarian and uterus histomorphometric changes were further observed by hematoxylin and eosin (H&E) staining. RESULTS The results showed that treatment with F. deltoidea at the dose of 500 and 1000 mg/kg/day reduced insulin resistance, obesity indices, total cholesterol, triglycerides, low-density lipoprotein cholesterol (LDL), malondialdehyde (MDA), testosterone, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) to near-normal levels in PCOS rats. The levels of high-density lipoprotein cholesterol (HDL), estrogen, and superoxide dismutase (SOD) are also similar to those observed in normal control rats. Histomorphometric measurements confirmed that F. deltoidea increased the corpus luteum number and the endometrial thickness. CONCLUSIONS F. deltoidea can reverse PCOS symptoms in female rats by improving insulin sensitivity, antioxidant activities, hormonal imbalance, and histological changes. These findings suggest the potential use of F. deltoidea as an adjuvant agent in the treatment program of PCOS.
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Affiliation(s)
- Muhammad Aliff Haslan
- Faculty of Applied Sciences, Universiti Teknologi MARA, 40450 Shah Alam, Selangor Malaysia
| | - Nurdiana Samsulrizal
- Faculty of Applied Sciences, Universiti Teknologi MARA, 40450 Shah Alam, Selangor Malaysia
| | - Nooraain Hashim
- Faculty of Applied Sciences, Universiti Teknologi MARA, 40450 Shah Alam, Selangor Malaysia
| | | | - Farshad H. Shirazi
- Department of Pharmacology and Toxicology, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Pharmaceutical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Yong Meng Goh
- Department of Veterinary Preclinical Sciences, Faculty of Veterinary Medicine, Universiti Putra Malaysia (UPM), Serdang, Malaysia
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19
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Fatima I, Yaqoob S, Jamil F, Butt A. Relationship between loci of control and health-promoting behaviors in Pakistani women with polycystic ovary syndrome: coping strategies as mediators. BMC WOMENS HEALTH 2021; 21:356. [PMID: 34627210 PMCID: PMC8502314 DOI: 10.1186/s12905-021-01489-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 09/24/2021] [Indexed: 11/17/2022]
Abstract
Background/Objectives Understanding the factors that promote healthy lifestyle behaviors in women with polycystic ovary syndrome is of substantial importance. Health-promoting lifestyle behaviors (HPLB) have been observed to be effective in managing various symptoms related to PCOS. This study aimed to examine the relationship between loci of control and health-promoting lifestyle behaviors in Pakistani women with polycystic ovary syndrome and the mediating role of coping strategies. Method A correlational study was carried out with 145 unmarried women with polycystic ovary syndrome diagnosed by a gynecologist using the Rotterdam Criteria of 2003 (M age = 24.75 years). Participants were recruited from public sector hospitals in Lahore, Punjab, Pakistan and a series of hierarchical regression analyses were used to analyze results. Results Findings suggest that women with internal and powerful others locus of control use more active practical coping strategies and less active distractive coping strategies. These women also get more involved in health-promoting behaviors. On the other hand, those with a high level of chance locus of control use less active practical coping strategies and more active distractive coping strategies. In turn, they engage less in health-promoting behaviors. Conclusion Health professionals should consider the effects of different types of locus of control and coping strategies when planning interventions for women with polycystic ovary syndrome.
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Affiliation(s)
- Iram Fatima
- Institute of Applied Psychology, University of the Punjab, Canal Road, Quaid-e-Azam Campus, Lahore, Pakistan.
| | - Sahar Yaqoob
- Institute of Applied Psychology, University of the Punjab, Canal Road, Quaid-e-Azam Campus, Lahore, Pakistan
| | - Farhat Jamil
- Institute of Psychology, Beaconhouse National University, Lahore, Pakistan
| | - Amna Butt
- Institute of Psychology, Beaconhouse National University, Lahore, Pakistan
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20
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Miao C, Guo Q, Fang X, Chen Y, Zhao Y, Zhang Q. Effects of probiotic and synbiotic supplementation on insulin resistance in women with polycystic ovary syndrome: a meta-analysis. J Int Med Res 2021; 49:3000605211031758. [PMID: 34311599 PMCID: PMC8320576 DOI: 10.1177/03000605211031758] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Objective This meta-analysis evaluated the effect of probiotics and synbiotics on insulin resistance in patients with polycystic ovary syndrome (PCOS). Methods A systematic search was performed to identify all relevant publications listed on the electronic databases (PubMed®, Web of Science, Embase® and China National Knowledge Infrastructure) between inception and 30 October 2020. All statistical analyses were performed on randomized controlled trials (RCTs) using RevMan version 5.3 software provided by the Cochrane Collaboration. Results A total of 486 patients from seven RCTs were included in the meta-analysis. Probiotic and synbiotic supplementation appeared to improve levels of homeostatic model assessment of insulin resistance (mean difference = –0.37; 95% confidence interval –0.69, –0.05) and serum insulin (standardized mean difference = –0.66; 95% confidence interval –1.19, –0.12). The results failed to show any influence of probiotic and synbiotic supplementation on body mass index, waist circumference, hip circumference and fasting blood sugar. Conclusions Probiotics and synbiotics appear to have a partially beneficial effect on indices of insulin resistance in patients with PCOS.
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Affiliation(s)
- Chenyun Miao
- Department of TCM Gynaecology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China
| | - Qingge Guo
- Department of TCM, Hangzhou Women's Hospital, Hangzhou, Zhejiang Province, China
| | - Xiaojie Fang
- Department of Anorectal Surgery, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China
| | - Yun Chen
- Department of TCM Gynaecology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China
| | - Ying Zhao
- Department of TCM Gynaecology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China
| | - Qin Zhang
- Department of TCM Gynaecology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China
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21
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Pereira VM, Reis FM, Casalechi M, Reis AM. Angiotensin-(1-7), Angiotensin-Converting Enzyme 2 and Mas Receptor in Rat Polycystic Ovaries. Protein Pept Lett 2021; 28:249-254. [PMID: 32851948 DOI: 10.2174/0929866527666200826104410] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 06/28/2020] [Accepted: 07/08/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Hyperandrogenism is a pivotal mediator in the pathogenesis of the polycystic ovary syndrome (PCOS), but the mechanisms of androgen excess in this condition are not fully understood. Angiotensin (Ang)-(1-7) is an active peptide of the renin-angiotensin system (RAS) that stimulates ovarian follicular growth and testosterone release in vitro. OBJECTIVE To investigate whether Ang-(1-7), its receptor Mas and angiotensin-converting enzyme 2 (ACE2), the enzyme that converts Ang II into Ang-(1-7), are expressed in rat polycystic ovaries (PCO) and thus if this peptide system might be associated with excess androgen production in PCO. METHODS A rat model that shares some features of PCOS such as disruption of folliculogenesis and multiple ovarian cyst formation was used in the study. RESULTS We found reduced levels of Ang-(1-7) and Mas receptor in PCO compared to normal ovaries. Also, ACE2 mRNA expression was reduced in PCO compared to ovaries of control rats (p < 0.05). PCO had high levels of estrogen and testosterone and increased mRNA for upstream enzymes of the steroidogenic cascade, but not of P450 aromatase. CONCLUSION These findings suggest that the ovarian ACE2-Ang-(1-7)-Mas receptor axis is inhibited and therefore may not be a co-factor of excess testosterone production in rat PCO.
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Affiliation(s)
- Virginia M Pereira
- Department of Physiology and Biophysics, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Fernando M Reis
- Department of Obstetrics and Gynecology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Maíra Casalechi
- Department of Obstetrics and Gynecology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Adelina M Reis
- Department of Physiology and Biophysics, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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22
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Munawar Lone N, Babar S, Sultan S, Malik S, Nazeer K, Riaz S. Association of the CYP17 and CYP19 gene polymorphisms in women with polycystic ovary syndrome from Punjab, Pakistan. Gynecol Endocrinol 2021; 37:456-461. [PMID: 32960117 DOI: 10.1080/09513590.2020.1822803] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Polycystic ovarian syndrome (PCOS) is considered the most common multifactorial endocrinopathy. Genetic factors play an essential role in the pathogenesis of PCOS. CYP 17 enzyme is responsible for androgenesis, while CYP 19 enzyme works for androgen conversion into aromatic estrogen. Several studies have reported their association with PCOS. This study was aimed to investigate the association of cytochrome P450c17α gene (CYP17) 5'-untranslated region MspA1/(rs743572) genetic polymorphism and rs2414096 of cytochrome P450 or aromatase (CYP19) gene polymorphism with the susceptibility to PCOS in reproductive-age women from Punjab, Pakistan. METHODS We performed a case-control association study was conducted, including 204 PCOS patients and 100 controls. Genotyping of SNP rs2414096 (CYP 19 gene) and P450c17α gene (CYP17) 5'-untranslated region MspA1 was performed on genomic DNA using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Statistical analysis was performed to find out the association of phenotypic and genotypic characters in etiopathology of PCOS. RESULTS The genotype distribution for CYP 17 5'-UTR MspA1 (TT, TC, CC) revealed that the frequency of genotype TC is significantly higher in PCOS patients (54.9%) vs. controls (OR 4.97, 95% CI 2.75-8.33, p<.001) (12%). The genotype distribution for CYP 19 (GG, GA, AA) showed significantly higher frequency of GA (58.%) and AA (23.5%) in patients as compared to cases (18% and 8%, respectively) (OR 5.49, 95% CI 3.61-8.34, p<.001). Body mass index (BMI), waist, hip, infertility and family history of infertility, PCOS, diabetes, and hypertension were found significantly associated with PCOS. CYP 19 genotypes were found significantly associated with PCOS patients having paraclinical traits of infertility and family history of infertility, while CYP 17 genotypes showed no significant association with any paraclinical traits in PCOS patients. CONCLUSIONS This is the first study on PCOS genotypes from Pakistan and results suggest that CYP 17 5'-UTR MspA1 (rs743572) (genotype TC) and CYP 19 gene (rs2414096) (genotype GA) polymorphisms are significantly associated with susceptibility to PCOS in Pakistani women having the traits of infertility and family history of hypertension.
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Affiliation(s)
- Nasira Munawar Lone
- Department of Microbiology and Molecular Genetics, University of the Punjab, Lahore, Pakistan
| | - Sana Babar
- Department of Microbiology and Molecular Genetics, University of the Punjab, Lahore, Pakistan
| | - Sikandar Sultan
- Department of Microbiology and Molecular Genetics, University of the Punjab, Lahore, Pakistan
| | - Saira Malik
- Department of Microbiology and Molecular Genetics, University of the Punjab, Lahore, Pakistan
| | - Kiran Nazeer
- Department of Microbiology and Molecular Genetics, University of the Punjab, Lahore, Pakistan
| | - Saba Riaz
- Department of Microbiology and Molecular Genetics, University of the Punjab, Lahore, Pakistan
- Citi Lab and Research Centre, Lahore, Pakistan
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Tseng PH, Chiu HM, Tu CH, Wu MS, Ho HN, Chen MJ. Obesity Exacerbates Irritable Bowel Syndrome-Related Sleep and Psychiatric Disorders in Women With Polycystic Ovary Syndrome. Front Endocrinol (Lausanne) 2021; 12:779456. [PMID: 34867827 PMCID: PMC8635163 DOI: 10.3389/fendo.2021.779456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 11/01/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND/OBJECTIVES Polycystic ovary syndrome (PCOS) and irritable bowel syndrome (IBS) share similar clinical and psychosocial features. We aimed to investigate the clinical characteristics of IBS in women with PCOS, and its relationship with obesity, metabolic and hormonal profiles, as well as sleep and psychiatric disorders. SUBJECTS/METHODS This is a cross-sectional case-control study of 431 untreated women with PCOS and 259 healthy volunteers. All participants were assessed with a comprehensive clinical evaluation and two questionnaires: the Athens Insomnia Scale (AIS) and the Brief Symptom Rating Scale (BSRS-5). IBS was diagnosed using the Rome III criteria. Obesity was defined as a BMI ≥30 kg/m2. Anthropometric measurements, metabolic, hormonal profiles, and psychosocial morbidities were compared. RESULTS Women with PCOS were more likely to have IBS (10.7% vs 5.8%, p=0.029) and obesity (29% vs 4%, p<0.001) than healthy volunteers. Mixed-type IBS (IBS-M) was the most common subtype (74%) among patients with PCOS and IBS. There was a higher prevalence of psychiatric morbidities (total BSRS-5 score ≥10) in women with PCOS than in healthy women (11.4% vs 3.5%, p<0.001). Women with PCOS and IBS were more likely to have sleep difficulties (67.4% vs 30.9%, p<0.001) and psychiatric morbidities (21.7% vs 10.1%, p=0.019) than those without IBS. Anthropometrics, metabolic and hormonal profiles were similar between PCOS women with and without IBS. Among women with PCOS, those with both IBS and obesity had the highest risk of developing sleep difficulties (odds ratio: 5.91; 95% confidence interval: 1.77-19.77) and psychiatric distress (odds ratio: 4.39; 95% confidence interval: 1.26-15.29) than those without. CONCLUSION Women with PCOS have increased IBS, obesity, sleep and psychiatric disturbances. The presence of IBS in PCOS women is associated with sleep and psychiatric disorders. The coexistence of obesity and IBS exacerbates sleep difficulties and psychiatric distress. Screening and management of IBS and obesity might be warranted to improve sleep and psychiatric disturbances in women with PCOS.
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Affiliation(s)
- Ping-Huei Tseng
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Han-Mo Chiu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Chia-Hung Tu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Ming-Shiang Wu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
- College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Hong-Nerng Ho
- College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan
- Research Center for Cell Therapy and Regeneration Medicine, and College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Mei-Jou Chen
- College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan
- Livia Shang Yu Wan Chair Professor of Obstetrics and Gynecology, National Taiwan University, Taipei, Taiwan
- *Correspondence: Mei-Jou Chen,
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Shakil M, Ashraf F, Wajid A. Sexual functioning as predictor of depressive symptoms and life satisfaction in females with Polycystic Ovary Syndrome (PCOS). Pak J Med Sci 2020; 36:1500-1504. [PMID: 33235564 PMCID: PMC7674907 DOI: 10.12669/pjms.36.7.2562] [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: 11/18/2022] Open
Abstract
Background & Objective: PCOS is the one of the frequently diagnosed endocrine syndrome in Pakistani women. However, little attention has been devoted to empirical investigation of the role of sexual dysfunction in developing depressive symptoms and reducing life satisfaction. Our objective was to determine the contribution of Sexual dysfunction in developing depressive symptoms and life dissatisfaction in females diagnosed with PCOS. Methods: This correlation study was carried out from 1st September 2019 to 15th February 2020 at COMSATS University Islamabad, Lahore Campus. A sample of 60 women with PCOS between reproductive age 18 – 38 years (Mage = 27.86, SD = 4.58) was selected through purposive sampling technique from the government hospitals of Lahore, Pakistan. The participants responded to a Demographic Information Form, Female Sexual Functioning Index, Siddiqui Shah Depression and Life Satisfaction Scale. Results: Correlation analysis revealed significant positive link of sexual dysfunction with depressive symptoms and negative link with life satisfaction level. Further, regression analysis revealed sexual functioning as significant predictor of depressive symptoms only. Conclusion: Sexual dysfunction play a major role in general mental health of females, therefore, screening and identification as well as preventive measure need to be introduced at early level of development. In addition, current study findings suggest that once females are diagnosed with PCOS, they should be provided sufficient counselling services in order to deal with depressive symptoms and feeling of low life satisfaction. Further, targeted interventions and counselling services may also facilitate in optimising patient care.
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Affiliation(s)
- Muneeba Shakil
- Muneeba Shakil, Department of Humanities, COMSATS University Islamabad, Lahore Campus, Pakistan
| | - Farzana Ashraf
- Dr. Farzana Ashraf, Department of Humanities, COMSATS University Islamabad, Lahore Campus, Pakistan
| | - Amina Wajid
- Amina Wajid, Department of Humanities, COMSATS University Islamabad, Lahore Campus, Pakistan
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Lee CJ, Kapelemera AM, Tsai YZ, Lee CT, Xu MY, Wang CC. Evaluating the Therapeutic Efficacy of Si-Wu-Tang Decoction and Concentrated Extract in Follicular Maldevelopment-Related Menstrual Disorders Through Pharmacokinetic/Pharmacodynamic Studies. Front Pharmacol 2020; 11:1245. [PMID: 33013359 PMCID: PMC7500464 DOI: 10.3389/fphar.2020.01245] [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] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 07/29/2020] [Indexed: 01/25/2023] Open
Abstract
Si-Wu-Tang (SWT), a traditional Chinese formula, is commonly used to relieve menstrual discomfort and climacteric syndrome. Water decoction (WD) and concentrated herbal extract (CHE) are the two most common formulations of traditional Chinese medicine (TCM). However, few studies have reported the equivalency of these two formulations. In this study, 23 healthy volunteers were included to determine the pharmacokinetic (PK) equivalent dosage of WD and CHE, and 25 infertile women with follicular maldevelopment to evaluate the pharmacodynamic (PD) effects on menstrual disorders. The randomized, two-way crossover comparative PK study of SWT-WD and SWT-CHE analyzed the active component, ferulic acid. The results showed that clinical doses of 170 mL SWT-WD and 18 g SWT-CHE produced the same amount of ferulic acid in the blood. The PD study showed that patients who took both of these formulations had an initial luteinizing hormone/follicle-stimulating hormone ratio of <1; however, the value returned to normal and their symptoms all improved after taken SWT. Our results showed that WD and CHE, both prepared from 40 g of SWT, displayed bioequivalence upon PK/PD analysis.
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Affiliation(s)
- Chia-Jung Lee
- Graduate Institute of Pharmacognosy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan.,PhD Program in Clinical Drug Development of Herbal Medicine, College of Pharmacy, Taipei Medical University, Taipei, Taiwan.,Traditional Herbal Medicine Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - Alinafe Magret Kapelemera
- PhD Program in Clinical Drug Development of Herbal Medicine, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
| | - Yi-Zhe Tsai
- Graduate Institute of Pharmacognosy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
| | - Ching-Tzu Lee
- Department of Traditional Chinese Medicine, Taipei Municipal Wanfang Hospital, Taipei, Taiwan
| | - Ming-Yi Xu
- School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Ching-Chiung Wang
- Graduate Institute of Pharmacognosy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan.,PhD Program in Clinical Drug Development of Herbal Medicine, College of Pharmacy, Taipei Medical University, Taipei, Taiwan.,Traditional Herbal Medicine Research Center, Taipei Medical University Hospital, Taipei, Taiwan.,School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
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Amiri M, Nahidi F, Yarandi RB, Khalili D, Tohidi M, Tehrani FR. Effects of oral contraceptives on the quality of life of women with polycystic ovary syndrome: a crossover randomized controlled trial. Health Qual Life Outcomes 2020; 18:293. [PMID: 32867790 PMCID: PMC7460764 DOI: 10.1186/s12955-020-01544-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 08/26/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND AND OBJECTIVE A limited number of studies have evaluated the effects of oral contraceptives (OCs) on the quality of life (QOL) of polycystic ovary syndrome (PCOS) patients. This study aimed to compare the effects of using OCs containing levonorgestrel (LNG) and those containing desogestrel (DSG), cyproterone acetate (CPA) or drospirenone (DRSP) for 6 months on the QOL with PCOS. METHODS In this crossover randomized controlled 6-arm trial, 200 eligible patients with PCOS scheduled for OC therapy were randomly assigned to one of the 6 study arms. All 6 arms include two 6-month treatment periods, one period with OCs containing LNG, and the other with each of the 3 OCs containing DSG, CPA, or DRSP. Outcomes of interest were the total score of QOL and its domains, which were assessed using a specific and valid health-related quality of life questionnaire for PCOS, which is consisted of six domains, including psychosocial-emotional, self-image, fertility, sexual function, hirsutism, and obesity- menstrual disorders. RESULTS Finally, a total of 88 patients were analyzed for this study. The results showed that use of OCs containing DSG, CPA, and DRSP for 3 months was not associated with significant differences in the total scores of QOL compared to those OCs containing LNG, whereas, after 6 months of treatment, patients treated with OCs containing CPA had more improvements in their total scores of QOL, in comparison to OCs containing LNG (P < 0.042). We found no significant differences in QoL domains, including psychosocial-emotional, self-image, fertility, sexual function, hirsutism, and obesity-menstrual disorders after 3-6 months of treatment with DSG, CPA, or DRSP, compared to LNG. The sequence and period effects were not significant in any of the analyses at 3 and 6 months of treatment. The carry-over effect was not significant for most outcomes assessed. CONCLUSIONS This crossover study demonstrated non-inferiority of OCs with newer generation progestins on different domains of QOL, in comparison with older compounds, although usage of products containing CPA was significantly associated with more improvement in total QOL of PCOS patients, compared to those containing LNG after 6-month of treatment. TRIAL REGISTRATION IRCT201702071281N2 .
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Affiliation(s)
- Mina Amiri
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No 24, Parvane Street, Yaman Street, Velenjak, Tehran, Iran
| | - Fatemeh Nahidi
- Department of Midwifery and Reproductive Health, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Razieh Bidhendi Yarandi
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No 24, Parvane Street, Yaman Street, Velenjak, Tehran, Iran
- Department of Epidemiology and biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Davood Khalili
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University, Tehran, Iran
| | - Maryam Tohidi
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University, Tehran, Iran
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No 24, Parvane Street, Yaman Street, Velenjak, Tehran, Iran.
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Tong X, Liu Y, Xu X, Shi J, Hu W, Ma T, Cui P, Lu W, Pei Z, Xu M, Zhang F, Li X, Feng Y. Ovarian Innervation Coupling With Vascularity: The Role of Electro-Acupuncture in Follicular Maturation in a Rat Model of Polycystic Ovary Syndrome. Front Physiol 2020; 11:474. [PMID: 32547407 PMCID: PMC7273926 DOI: 10.3389/fphys.2020.00474] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 04/17/2020] [Indexed: 12/15/2022] Open
Abstract
Low-frequency electro-acupuncture (EA) has been shown to restore ovulation in patients with polycystic ovary syndrome (PCOS), and previous animal experiments showed that EA improves ovarian blood flow and angiogenesis. We performed EA for 4 weeks in dihydrotestosterone (DHT)-induced PCOS-like rats and investigated the three-dimensional (3D) ovarian innervation to determine the role of innervation in folliculogenesis and vascularity. Ovarian tissues were made transparent following the CUBIC 3D tissue-clearing protocol and were immunostained using antibodies against platelet endothelial cell adhesion molecule-1 and tyrosine hydroxylase to visualize the ovarian vasculature and innervation, respectively. This was followed by 3D imaging using lightsheet microscopy and analysis using the Imaris software. In control rats, ovarian innervation increased with age, and the neuronal branching started from the ovarian hilum and reached the individual follicles at different follicle stages. At the individual follicle level, each follicle was mainly innervated by one neuronal fiber. Compared with control rats, ovaries from DHT-treated PCOS-like rats had more antral follicles and fewer preovulatory follicles and corpora lutea. Furthermore, PCOS ovaries showed decreased innervation of blood vessels near the hilum and the surrounding individual antral follicles. EA in PCOS-like rats led to increased numbers of preovulatory follicles and corpora lutea together with increased innervation of blood vessels near the hilum. To determine the role of ovarian innervation, we further performed unilateral sectioning of the superior ovarian nerve (SON) in PCOS + EA rats and found that the left sectioned ovary had fewer preovulatory follicles and corpora lutea compared with those in the right non-sectioned ovary. In conclusion, ovarian innervation likely played an important role in folliculogenesis, and EA might restore PCOS pathophysiology by regulating ovarian innervation, at least partially mediated through the SON.
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Affiliation(s)
- Xiaoyu Tong
- Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, Institutes of Brain Science, Brain Science Collaborative Innovation Center, State Key Laboratory of Medical Neurobiology, Fudan Institutes of Integrative Medicine, Fudan University, Shanghai, China
| | - Yanjun Liu
- Department of Obstetrics and Gynecology, Shanghai Medical School, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Fudan University, Shanghai, China
| | - Xiaoqing Xu
- Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, Institutes of Brain Science, Brain Science Collaborative Innovation Center, State Key Laboratory of Medical Neurobiology, Fudan Institutes of Integrative Medicine, Fudan University, Shanghai, China
| | - Jiemei Shi
- Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, Institutes of Brain Science, Brain Science Collaborative Innovation Center, State Key Laboratory of Medical Neurobiology, Fudan Institutes of Integrative Medicine, Fudan University, Shanghai, China
| | - Wei Hu
- Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, Institutes of Brain Science, Brain Science Collaborative Innovation Center, State Key Laboratory of Medical Neurobiology, Fudan Institutes of Integrative Medicine, Fudan University, Shanghai, China
| | - Tong Ma
- Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, Institutes of Brain Science, Brain Science Collaborative Innovation Center, State Key Laboratory of Medical Neurobiology, Fudan Institutes of Integrative Medicine, Fudan University, Shanghai, China
| | - Peng Cui
- Department of Obstetrics and Gynecology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wenhan Lu
- Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, Institutes of Brain Science, Brain Science Collaborative Innovation Center, State Key Laboratory of Medical Neurobiology, Fudan Institutes of Integrative Medicine, Fudan University, Shanghai, China
| | - Zhenle Pei
- Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, Institutes of Brain Science, Brain Science Collaborative Innovation Center, State Key Laboratory of Medical Neurobiology, Fudan Institutes of Integrative Medicine, Fudan University, Shanghai, China
| | - Mingzhen Xu
- Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, Institutes of Brain Science, Brain Science Collaborative Innovation Center, State Key Laboratory of Medical Neurobiology, Fudan Institutes of Integrative Medicine, Fudan University, Shanghai, China
| | - Feifei Zhang
- Department of Obstetrics and Gynecology, Shanghai Medical School, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Fudan University, Shanghai, China
| | - Xin Li
- Department of Obstetrics and Gynecology, Shanghai Medical School, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Fudan University, Shanghai, China
| | - Yi Feng
- Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, Institutes of Brain Science, Brain Science Collaborative Innovation Center, State Key Laboratory of Medical Neurobiology, Fudan Institutes of Integrative Medicine, Fudan University, Shanghai, China
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