Psychological burden among women with polycystic ovarian syndrome in Oman: a case-control study

Polycystic Ovary Syndrome: A Comprehensive Exploration of Diagnosis Experience in Saudi Women

Background/Objectives: Polycystic Ovary Syndrome (PCOS) is a prevalent endocrine disorder among women of reproductive age, characterized by symptoms such as menstrual irregularities, hyperandrogenism, and polycystic ovaries. This study aimed to explore the diagnostic experiences of women with PCOS in Saudi Arabia, evaluating the timeline to diagnosis, the adequacy of information provided, and overall patient satisfaction with the healthcare process. Methods: A cross-sectional online survey was conducted with 1182 women diagnosed with PCOS across Saudi Arabia. The survey collected data on sociodemographic characteristics, the timeline from symptom onset to diagnosis, the number of healthcare visits required for diagnosis, and satisfaction with the information and support provided during the diagnostic process. Statistical analyses, including linear regression, were performed to identify factors influencing patient satisfaction. Results: The study found that 43.2% of participants sought medical attention within a year of symptom onset, yet significant delays in diagnosis were common, with 28.6% of women waiting six months or more after seeking medical care. Only 42.7% of women reported receiving adequate information at diagnosis, and satisfaction levels varied across different aspects of care. Key predictors of lower satisfaction included marital status and longer time since diagnosis, while quicker diagnosis and more healthcare visits before diagnosis positively influenced satisfaction. Conclusions: The findings highlight critical gaps in the diagnostic process and patient education for PCOS in Saudi Arabia. The widespread dissatisfaction with the information provided underscores the need for improved patient-centered care, comprehensive education, and standardized diagnostic protocols. Addressing these issues could enhance patient satisfaction and lead to better management of PCOS, both in Saudi Arabia and globally.

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

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.

Quality of Life of Women with Polycystic Ovary Syndrome

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.

New insights into the interaction between polycystic ovary syndrome and psychiatric disorders: A narrative review

Polycystic ovary syndrome (PCOS) is a prevalent endocrine disease characterized by hyperandrogenism, ovulatory dysfunction, and ovarian polycystic changes, which combines with reproductive problems, metabolic disorders, and psychological disorders to exhibit a far-reaching impact on the physical and mental health of women. We reviewed previous research and discovered that psychiatric disorders are more common in PCOS patients and their children, potentially exacerbating the condition and creating a vicious loop. To understand the reasons, relevant articles were collected following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines from PubMed, Web of Science, and Cochrane Library, through December 2022. Evidence suggested that PCOS-related clinical manifestations, hyperandrogenism, insulin resistance, obesity, gut dysbiosis, and other variables may increase the risk of psychiatric disorders in patients. In turn, psychiatric disorders may aggravate the pathologic process of PCOS and increase the difficulty of the treatment. We systematically reported the mechanisms underlying the psychiatric disorders-PCOS interactions, intending to provide potential ways to break the vicious cycle and lay the groundwork for future research. However, research on PCOS and psychiatric disorders were still in initial stages, which limited the scope of this review. More studies are needed to further verify our findings.

Experience of mental health in women with Polycystic Ovary Syndrome: a descriptive phenomenological study

Purpose: This study aims to investigate the experiences, emotional coping strategies, and help-seeking needs of women with PCOS from their perspective, considering common psychological issues such as stress, anxiety, and depression that are prevalent among individuals with PCOS. Materials and Methods: The study recruited 14 women with PCOS for semi-structured interviews between October and November 2022, using a descriptive phenomenology method design. The interviews were analyzed using NVivo 12 software. Results: Four themes and eleven subthemes were derived from the semi-structured interviews: (1) Negative Mental Health Status; (2) Four Patterns of Emotion Regulation; (3) The Psychological Double-Edged Sword: Family Social Network; (4) Strong Demands for Psychological Counseling and Lifestyle Guidance. Conclusion: The study suggests that interventions should focus on fostering internalized self-efficacy and emotional expression, promoting constructive familial support, and providing psychological counseling and lifestyle recommendations to alleviate psychological distress experienced by women with PCOS.

Obesity and hyperandrogenism are implicated with anxiety, depression and food cravings in women with polycystic ovary syndrome

INTRODUCTION

PCOS is associated with mood/eating disorders. Negative body image due to obesity, acne, hirsutism seems to play significant role, but hormonal derangements are probably implicated.

AIM

To investigate the relation between insulin resistance (IR), obesity and hyperandrogenism with mood and eating disorders in women with PCOS.

METHODS

Forty-nine (60.5%) PCOS women and 32(39.5%) age- and BMI-matched healthy controls were enrolled. Emotional/food disorders were evaluated by using self-administered questionnaires: Eating Attitudes Test (EAT)-26, Beck Depression Inventory-II (BDI-II), Hamilton anxiety scale (HAS) and Food Craving Questionnaire-Trait (FCQ-T).

RESULTS

The two groups had no significant differences regarding age, BMI and HOMA2-IR. PCOS women had significantly higher DHEA-S (p < 0.0001), Δ4Α (p < 0.0001) and Testosterone (p < 0.0001). When the two groups were subclassified according to the BMI, in lean (BMI < 25 kg/m2) or overweight (BMI ≥ 25 kg/m2), no significant differences were found with respect to EAT-26 and HAS. BDI-II was associated with obesity (overweight vs lean PCOS: 20.5 ± 6.4 vs 9.8 ± 3.9; p = 0.037) and hyperandrogenism (overweight PCOS vs overweight controls: 20.5 ± 6.4 vs 14.8 ± 8.1; p < 0.0001; lean PCOS vs overweight controls: 16.7 ± 4.7 vs 14.8 ± 8.1; p = 0.01). Additionally, a significant correlation between BDI-II and DHEA-S (rho = 0.305; p = 0.006), Δ4Α (rho = 0.259; p = 0.02) and Testosterone (rho = 0.328; p = 0.003) was reported. FCQ-T was associated with obesity (overweight PCOS vs lean PCOS: 47.6 ± 9.9 vs 29.3 ± 8.9; p < 0.0001; overweight controls vs lean PCOS: 45.5 ± 15.7 vs 29.3 ± 8.9; p < 0.0001), whereas a correlation between FCQ-T and BMI (rho = 0.593; p = 0.0001), waist circumference (rho = 0.554; p = 0.0001) and HOMA2-IR (rho = 0.328; p = 0.003) was documented.

CONCLUSIONS

Obesity and hyperandrogenism increase the risk of depression and food cravings in women with PCOS, leading to a vicious circle of further aggravation of obesity and metabolic syndrome.

Role of polycystic ovarian syndrome in developing psychological burden in Saudi Arabian females: A case control study

It is well known that polycystic ovarian syndrome (PCOS) may elevate psychological problems in patients, but there is a scarcity of the studies among Saudi Arabian population. This research was designed to investigate the influence of PCOS on the development of psychological load in terms of depression, anxiety, and stress in comparison to normal women who have no PCOS. Further, a correlation of psychological distress in PCOS females was done with their educational level. This is case-control research carried out in one of Riyadh's multispecialty hospitals. In the PCOS patients and control groups (each with 84 samples), samples were collected using convenience sampling and a simple random approach, respectively. The psychological burden was determined using DASS-21. The data obtained were analyzed using SPSS-IBM 25. Most participants (52.9%) were between the ages of 26 and 35 and had a university education (68.4%). A significantly higher percentage of PCOS patients (P = 0.001) had irregular menses, hirsutism, infertility, and acne in comparison to the mothers without PCOS. There was a significantly higher possibility of depression (P = 0.003), anxiety (P = 0.016), and stress (P = 0.001) among PCOS patients than in control subjects. Among the psychological domain tested in the study, the risk of developing stress (odds ratio, OR = 8.32) was high when compared to depression (OR = 3.12) and anxiety (OR = 2.127) in PCOS patients. Furthermore, when compared to PCOS females with less education, a significantly lower number of university-educated PCOS females developed depression. The study demonstrates a high prevalence of psychological burden among the PCOS population. Higher education has been shown to help in alleviating depression in PCOS females. Meeting PCOS women's psychological needs will improve their overall health status.

Body mass index and quality of life in individuals with polycystic ovary syndrome: Dysmorphic concerns and eating disorders as mediators

Objective

Weight issues, dysmorphic concerns and eating disorders are common among individuals with polycystic ovary syndrome (PCOS) and are linked to poor quality of life (QoL). The goal of the current study was to examine whether the association between body mass index (BMI) and QoL was mediated by dysmorphic concerns, examining also the relations with eating disorder symptomatology.

Methods

Questionnaires were administered to 435 individuals with PCOS aged between 18 and 40 years (M = 27.62; SD = 4.83) to measure dysmorphic concerns, eating disorder symptoms and QoL. Participants were also asked to report their height and weight to compute their BMI.

Results

Structural equation modeling was used to observe the relationship between the variables. The results revealed a direct relationship between QoL, BMI, dysmorphic concerns and eating disorder symptomatology. In addition, dysmorphic concerns were related to BMI and eating disorder symptomatology. Furthermore, the results showed the mediating role of dysmorphic concerns and eating disorder symptoms in the relationship between BMI and QoL.

Conclusion

The current results highlight the potential importance of harmful relationships with one's own body and food, explaining why weight issues may be linked to different levels of QoL in PCOS individuals. The implications of these findings are discussed.

Polycystic ovary syndrome: An exploration of unmarried women's knowledge and attitudes

Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder among women of reproductive age and a chief cause of subfertility attributed to ovulation. Besides, lack of knowledge about PCOS, its treatment, and lifestyle changes influence the prognosis. The present qualitative inquiry investigates the knowledge and attitudes of unmarried women towards the syndrome, associated treatment, and necessary lifestyle changes in the fight against the same. A total of 15 participants with PCOS were selected using purposive sampling (n from southern parts of India viz. Kerala and Tamil Nadu states. The telephonic interviews were conducted in late November and early December 2020. He conventional content analysis emerged with six major themes. The themes capsulated women’s knowledge, causes, complications and risk factors, treatment of PCOS their perceived importance of health promotive behaviours such as physical activity, sleep patterns, and perceived support from society. The importance of diet, exercise and a healthy lifestyle were additional relevant factors stressed by the respondents. Although the medicines helped participants attain regular menstrual cycles, they also had side effects reported in the discussion. Few respondents reported that they lacked the necessary awareness of PCOS when diagnosed at a younger age. The study enhances the understanding of PCOS from a qualitative approach that has cultural relevance apart from pertinent clinical and lifestyle implications.

Insulin Resistance, Hyperandrogenism, and Its Associated Symptoms Are the Precipitating Factors for Depression in Women With Polycystic Ovarian Syndrome

Polycystic ovarian syndrome (PCOS) is a combination of many symptoms resulting from hormonal imbalance, metabolic syndromes, hyperandrogenism, and anovulation. This paper explores the various etiopathology and mechanisms causing depression in women with PCOS and how to prevent and treat PCOS-induced depression. Women with PCOS present with multiple symptoms such as acne, hirsutism, androgenic alopecia, obesity, menstrual irregularities, infertility, and mood disturbances like depression and anxiety. Depression is the most common psychological problem faced by women with PCOS. The various pathophysiological mechanisms that lead to depression are Insulin resistance, disturbance in the hypothalamic pituitary adrenal (HPA) axis, hyperandrogenism and its clinical presentation, obesity, and infertility. Lifestyle modifications such as dietary changes and weight loss play a significant role in preventing and managing PCOS-induced depression. Cognitive behavioral therapy (CBT) and lifestyle modification have shown to be effective measures for weight loss in obese women with PCOS. Antidepressants also play a part in treating PCOS-induced depression. Over the last decade, the number of cases of depression in women with PCOS has increased. This paper provides detailed data on the fundamental causes of depression in women with PCOS to facilitate a more straightforward treatment approach.

Prevalence of acne vulgaris among women with polycystic ovary syndrome: a systemic review and meta-analysis

OBJECTIVE

The aim of this meta-analysis was to evaluate the prevalence of acne among women with PCOS worldwide, and in subgroups of patients with different age, geographical-region, and PCOS definition-criteria, compared to healthy non-PCOS counterparts.

METHODS

A comprehensive literature search was performed in PubMed (including Medline), Web of Science, and Scopus databases for retrieving articles in English investigating the prevalence of PCOS. 'Meta-prop' method was applied to estimate pooled prevalence of acne in both groups. Meta-regression was conducted to find the association between acne in women with and without PCOS.

RESULTS

We used 60 studies, included data of 240,213 women with PCOS and 1,902,022 healthy-controls for the meta-analysis. The overall pooled prevalence of acne among women with and without PCOS, was 43% (95% CI: 41-45%) and 21% (95% CI: 19-22%), respectively, which was 1.6-fold significantly higher than among healthy-controls. The pooled prevalence of acne in adults, and in adolescents PCOS patients were 42 and 59%, respectively, which were significantly higher than non-PCOS counterparts. The pooled estimated prevalence of acne in adult PCOS women was 76% using the NIH definition and 36% by Rotterdam-criteria; both were significantly higher than non-PCOS counterparts, respectively. In subgroups of adults, who used Rotterdam-definition, the highest prevalence of acne in PCOS patients was reported in East Asia and was 3.5-fold higher than non-PCOS counterparts.

CONCLUSIONS

Despite the presence of heterogeneity and publication bias among available literature, it may be concluded that acne is one of the common dermatological manifestations in PCOS. In addition, results highlight geographical differences among PCOS patients.

The mental health of women with polycystic ovary syndrome: a systematic review and meta-analysis

Polycystic ovary syndrome (PCOS) has been proposed to be associated with several mental health problems, including anxiety, depression, diminished sexual satisfaction, and lowered health-related quality of life, etc. A systematic review and meta-analysis of published literature was conducted comparing the mental health of women with and without PCOS. Ten English and Chinese databases were searched up to 12/31/2018. Random-effects models were introduced, and subgroup analysis, sensitivity test, and meta-regression were carried out to determine the source for heterogeneity among studies. Forty-six studies, including 30,989 participants (9265 women with PCOS and 25,638 controls), were qualified for review according to the inclusion criteria. Twenty-eight studies reported depression symptoms, 22 studies were on anxiety, 16 studies showed quality of life (QoL) status, 12 studies were about sexual dysfunction, five on emotional distress, four on binge eating, and four on somatization. Women with PCOS reported significantly higher depression (SMD = 0.64; 95% CI 0.50-0.78), anxiety (SMD = 0.63; 95% CI 0.50-0.77), lower QoL (SMD = - 0.55; 95% CI -0.69 to -0.40), and not significant sexual dysfunction (SMD = - 0.24; 95% CI - 0.49 to 0.01). Studies from different countries, adopting various diagnosis criteria, using diverse instruments, as well as in different years, have reported heterogenetic results. Women with PCOS in China reported a larger effect size of depression and anxiety than patients from other countries. The results of this study have indicated that women with PCOS suffer from depression, anxiety, and experience a lower quality of life, whereas their sexual function is not distinct from that of healthy women. Psychological health care interventions for women with PCOS were addressed.

Risk of psychological burden in polycystic ovary syndrome: A case control study in Riyadh, Saudi Arabia

BACKGROUND

While increased risk of psychiatric burden in patients with polycystic ovarian syndrome (PCOS) is reported in the literature, there is dearth of reports from Saudi Arabia on occurrence of psychological burden in women with PCOS. This study aimed to compare the sociodemographic and clinical features of PCOS cases with non-PCOS control and explore the prevalence of depression, anxiety and stress in PCOS and non-PCOS women.

MATERIALS AND METHODS

This is a case-control study carried out in PSMMC, Riyadh, Saudi Arabia from March 2019 to June 2019. Samples were recruited by convenience sampling and simple random method in PCOS cases (82) and control group (85), respectively. Depression, Anxiety and Stress Scale-21 (DASS-21) was used to measure the presence of psychological burden.

RESULTS

High percentage of participants were in an age group of 26-35 years (51%) and university educated (64%). Significantly (P = 0.001) high proportion of PCOS cases found with irregular menses, hirsutism, infertility and presence of acne (P = 0.001) when compared to control group. The odds of developing depression (P = 0.006), anxiety (P = 0.028) and stress (P = 0.000) was significantly higher in PCOS cases compared to control participants. Further, among the three parameters, the occurrence of stress (odds ratio, OR=10.45) in women with PCOS was more common than depression (OR=2.675) and anxiety (OR=2.056).

LIMITATIONS

Recall bias and inclusion of only one hospital.

CONCLUSION

In conclusion, most of the PCOS cases had stress, depression and anxiety compared to control group. Meeting the psychological need of the PCOS women will help in improving their quality of life.

Quality of Life and Emotional States of Depression, Anxiety and Stress in Adolescents with Polycystic Ovary Syndrome: A Cross-Sectional Study

BACKGROUND

The chronic condition of polycystic ovary syndrome (PCOS) in adolescents can affect different aspects of quality of life in them. This study aimed to determine the correlation between the quality of life with emotional states of depression, anxiety, and stress in adolescents with PCOS.

METHODS

This is a cross-sectional study conducted on 120 adolescents with PCOS in Tehran, Iran in 2019. The sociodemographic checklist, quality of life, depression, anxiety and stress (DASS) were assayed by valid and reliable questionnaires. The Pearson's correlation coefficient and linear regression were used for data analysis, which was performed by SPSS (V.22).

RESULTS

The mean (SD) age and menarche age of participants were 16.58 (1.36) and 12.52 (1.19) years, respectively. The most common clinical symptoms of adolescence were irregular menstruation (85%) and acne (61.7%). According to the result of this study, there was a significant reverse correlation between total score of SF-12 with total scores of depression, anxiety and stress (r=-0.395, p=0.001) and a significant reverse correlation was also found between each dimension of DASS scale and 12-Item Short Form Survey (SF-12) (p<0.001). Based on the linear regression model and after controlling the demographic variables, there was a linear regression relationship between total DASS score and SF-12 (Beta= -0.367, p= 0.003).

CONCLUSION

The study results reveal the role of emotional states of depression, anxiety, and stress in the quality of life of adolescents with PCOS. Based on our findings, we emphasize the interventional studies and guides for improving all dimensions of quality of life and reducing the psychological burden of PCOS in later life of adolescence.

Assessing Whether Meditation Improves Quality of Life for Adolescent Girls With Polycystic Ovary Syndrome: Protocol for a Randomized Controlled Trial

Background

Polycystic Ovary Syndrome (PCOS) is a common endocrine condition characterized by irregular periods and hyperandrogenism. Adolescents with PCOS have impaired quality of life (QOL) and increased psychological distress. Transcendental Meditation (TM) is a well-established self-management strategy that has been used to improve stress and well-being. A meta-analysis of TM trials has shown beneficial effects on stress and blood pressure in adults. Recent data are suggesting that another self-management strategy called a mindfulness stress management program has a role in improving QOL in women with PCOS, but there are no studies in adolescents.

Objective

This study aims to evaluate the effect of TM on QOL and psychological distress in adolescent girls with PCOS.

Methods

This study is a randomized controlled trial that will be conducted over eight weeks at the Women’s and Children’s Hospital in Adelaide, South Australia, to determine the effect of TM on QOL and psychological distress in adolescent girls (aged 12-20 years) with PCOS. A total of 40 girls will be randomized into either the TM (n=20) or control group (n=20). The TM group will be asked to practice TM in a comfortable sitting position with the eyes closed, for 15 minutes twice daily over eight weeks. The control group will be asked to sit quietly for 15 minutes twice daily for eight weeks. The primary outcomes are any effects on improving QOL and psychological distress, and the secondary outcomes are any effects on lowering blood pressure and salivary cortisol levels.

Results

The recruitment of study participants began in May 2019 and is expected to be completed by June 2020. It is expected that the adolescent girls with PCOS practicing TM over eight weeks will have a significant improvement in QOL and psychological distress compared to adolescents in the control group. Also, it is expected that adolescent girls in the TM group will have lower salivary cortisol levels and lower blood pressure.

Conclusions

This study will be the first to evaluate the effect of TM on QOL in adolescent girls with PCOS. The study will provide valuable information on a potential self-management strategy to improve QOL and well-being in adolescent girls with PCOS.

Trial Registration

Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN1261900019010; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=376657&amp;amp;isReview=true

International Registered Report Identifier (IRRID)

PRR1-10.2196/14542

Polycystic Ovary Syndrome in adolescents: a qualitative study

Background

Adolescents with Polycystic Ovary Syndrome (PCOS) use different coping strategies to confront the challenges of this disorder. Various studies extracted coping strategies amongst adult women with PCOS, but regarding the mental difference between adults and adolescents, specific study was conducted to gain a deep understanding of how adolescents cope to the many health issues they experience.

Methods

Fifteen adolescents aged 13–19 years with PCOS participated in comprehensive individual interviews with goal-oriented, semi-structured questions. Sampling was purposive and continued until data saturation was reached. Data were analyzed using the thematic analysis technique. The validity of the data was verified through measures including credibility, transferability, dependability, confirmability and authenticity.

Results

The analysis of the data helped extract the main theme of the research as “dealing with PCOS”. The main theme consisted of three themes and 12 sub-theme: (1) Escaping the problem (sub-themes: Adopting a forgetting mindset, and concealment and minimization of the disorder); (2) Depressive mood (sub-themes: Poor self-perception and low self-esteem, isolation, sleep disturbances, passive aggressive behavior, emotional turmoil, feelings of humiliation, and adolescents’ perceptions); and (3) Coping with the disease (sub-themes: Recovery of health, positive thinking, hope for recovery).

Conclusion

In this study, the adolescents with PCOS showed a coping response to their disorder in the form of problem-solving, developing a depressive mood or adjusting to the disorder. Recognizing the mental health needs of these adolescents and improving their quality of life require the identification of ways through which they deal with PCOS.

Polycystic ovarian syndrome is linked to increased oxidative stress in Omani women

Purpose

Literature emerging from Western countries has reported increased levels of serum oxidative stress markers among polycystic ovarian syndrome (PCOS) women. In the Arab region, there is limited research about the association between oxidative stress and PCOS. This study aimed to compare sociodemographic and clinical characteristics, sex hormones, and oxidative stress indices between PCOS women and non-PCOS women and to investigate the correlation between oxidative stress biomarkers and sex hormones.

Methods

This hospital-based case-control study was conducted among reproductive-aged women. The study included 51 women diagnosed with PCOS (as per Rotterdam 2003 criteria) and 45 control women who were not diagnosed with PCOS. Serum samples were collected to measure the mean levels of the following sex hormones: total testosterone, dehydroepiandrosterone sulfate, estradiol and progesterone, as well as to measure biomarkers of oxidative stress including glutathione peroxidase (GPx), glutathione reductase (GR), glutathione (GSH), and total antioxidant capacity (TAC).

Results

PCOS women exhibited clinical characteristics including irregular menses, hirsutism, and acne compared to the control group (P≤0.05). Significant differences were observed in the waist-hip ratio of PCOS women compared to controls (P=0.004). GPx and GR activity levels appeared to be higher among PCOS women compared to controls; however, no statistically significant differences were observed between the two groups (P>0.05). PCOS women had lower GSH and TAC levels compared to controls with a statistically significant difference observed for GSH levels (P=0.006). Correlation analysis showed a significant negative correlation between estradiol and TAC in the total sample (r=-0.284, P=0.005).

Conclusion

This study provides supportive evidence that oxidative stress might play a role in the pathogenesis of PCOS and, hence, oxidative stress parameters could be suggested as diagnostic markers for early diagnosis of high-risk groups. Also, the study provides supportive evidence that obesity and sex hormones, particularly estradiol, in PCOS may contribute to enhanced oxidative stress.