Systematic review and meta-analysis of pregnancy outcomes in women with polycystic ovary syndrome.

Screening for polycystic ovary syndrome (PCOS) in antenatal care is inadequate, largely owing to the lack of clarity around whether PCOS is an independent risk factor for pregnancy complications. This systematic review and meta-analysis include 104 studies and 106,690 pregnancies in women with and without PCOS from inception until 13th July 2022. We report that women with PCOS are younger and have higher body mass index (BMI) around conception and have greater gestational weight gain. The odds of miscarriage, gestational diabetes mellitus, gestational hypertension, pre-eclampsia and cesarean section are higher in women with PCOS. The increased odds of adverse outcomes in PCOS remain significant when age and BMI are matched and when analyses are restricted to high-quality studies. This work informed the recommendations from the 2023 international evidence-based guideline for the assessment and management of polycystic ovary syndrome, emphasizing that PCOS status should be captured in all women who are planning to, or have recently become pregnant to facilitate prevention of adverse outcomes and improve pregnancy outcomes.

Systematic review and meta-analysis of birth outcomes in women with polycystic ovary syndrome.

It is unclear whether polycystic ovary syndrome (PCOS) is an independent risk factor for adverse birth outcomes in the offspring of affected women. Here, we investigate the association of PCOS with birth outcomes in the offspring of women with PCOS overall and by potential confounders. This systematic review and meta-analysis included 73 studies and 92,881 offspring of women with and without PCOS from inception until 13th July 2022. We report that mothers with PCOS are younger and have higher body mass index (BMI) around conception and have greater gestational weight gain. The odds of preterm birth, fetal growth restriction and low birth weight are higher and mean birthweight is lower in PCOS of which a lower mean birthweight and a higher small for gestational age are probably independent of BMI. This work informed the recommendations from the 2023 international evidence-based guideline for the assessment and management of polycystic ovary syndrome, emphasizing that PCOS status should be captured at pregnancy to identify risk and improve birth outcomes in the offspring.

Determinants of medication adherence among elderly with high blood pressure living in deprived areas.

INTRODUCTION: The current study was conducted to determine the impact of health literacy and factors related to adherence to drug treatment, using the model proposed by the World Health Organization, in older adults with hypertension residing in informal settlements in Hamadan. METHODS: This cross-sectional study was conducted on 405 patients in Hamadan city, located in the western part of Iran. Data were collected using an interviewer-administered questionnaire that included the 5-dimensional model proposed by the World Health Organization, Health Literacy for Iranian Adults, and Morisky Medication Adherence Scale-8. A two-stage sampling procedure was used to select patients from 14 comprehensive health service centers and health bases. The data were analyzed using SPSS v.24. RESULTS: The study found that medication adherence was suboptimal in 63% of the participants. Additionally, 87.5% of patients had inadequate or insufficient health literacy. Factors related to medication adherence included age (odds ratio (OR) = 1.07), annual income (OR = 0.17), duration of hypertension (OR = 7.33), health literacy (OR = 1.03), self-reported health status (P < 0.05), and regular medication use (P < 0.008). CONCLUSION: The results of this study indicate that more than half of the older adults in the study had suboptimal medication adherence and insufficient health literacy. The study also found that various factors, such as socioeconomic status, disease and treatment-related factors, and patient-related factors, influence medication adherence among older adults.

Comparative analysis of cytotoxicity effects of two denture hard lining materials on human gingival fibroblasts: an in vitro study.

Background: The objective of this study was to compare the cytotoxicity of TDV and Rebase II denture hard liners on human gingival fibroblasts, aiming to address issues associated with incomplete polymerization and free monomers that affect material properties. Methods: Seventy-two specimens (24 each of TDV, Rebase II, and controls) were prepared under aseptic conditions according to factory instructions. Cytotoxicity was determined using the MTT test with methyl tetrazolium salt added to the cell culture medium. A two-way ANOVA and a post-hoc Tukey test was used to evaluate the results of incubation before mitochondrial activity was measured using Multiscan spectrophotometry (570 nm). Results: There were significant differences in cell viability between the groups after 24 hours (P < 0.001), with TDV having higher viability than Rebase II. The difference between Rebase II and TDV, however, was not significant at 48 and 96 hours (P > 0.131). At 24 hours, Rebase II exhibited significantly lower viability than TDV liner, with a significant difference between the two groups (P = 0.001). Conclusion: Due to the maximum monomer release in the early hours of incubation, the amount of cytotoxicity decreased with increasing incubation time.

Health-related quality of life and its related factors in patients with systemic lupus erythematosus in southwest Iran: a cross-sectional study.

BACKGROUND: Quality of life (QoL) is an important measure in health assessment. It is impacted by unclear factors in Systemic Lupus Erythematosus (SLE) patients. The study aimed to investigate the factors related to QoL in SLE patients. METHODS: This cross-sectional study was performed on 140 (136 women and four men) Iranian SLE patients of Hafiz Hospital from June 2019 to August 2020. The Lupus Erythematosus Quality of Life Questionnaire (LEQoL) was used to evaluate the quality of life. The patients were evaluated with this questionnaire for four weeks in eight dimensions health, emotional health, body image, pain, planning, intimate relationships, and the burden of others. Related factors of LEQoL were evaluated using multivariable linear regression. RESULTS: The mean age was 34.09(8.96) years. The total mean QoL Score was 65.5 ± 22.4. The multivariable analysis showed that duration of disease (ß:-1.12, 95% CI:-1.44 to -0.79, P:0.001), physical activity(ß:-12.99, 95% CI:-19.2 to -6.13, P:0.001), kidney involvement (ß:-9.2, 95% CI:-16.61 to -2.79, P:0.03) and skin involvement(ß:-8.7, 95% CI:-17.2 to -0.2, P:0.031) were significantly related to the total mean QOL score of SLE patients. CONCLUSION: The QoL of Iranian patients with SLE was low. Age and gender can be related to the decrease in the QoL of patients with SLE. Increasing the disease duration, physical activity, kidney involvement, and skin involvement can be related to the decrease in the QOL of Iranian patients with SLE.

Effects of combined aerobic and anaerobic exercise training on cytokine profiles in patients with systemic lupus erythematosus (SLE); a randomized controlled trial.

BACKGROUND: Systemic lupus erythematosus (SLE) is an inflammatory rheumatic disease characterized by production of autoantibodies and organ damage. Elevated levels of cytokines have been reported in SLE patients. Physical activity could be considered one of the factors that affect the immune system status and function. The aim of the present study was to evaluate the effects of an 8-week supervised aerobic and anaerobic training program on the immune system of SLE patients through evaluation of serum cytokine levels. METHODS: This cross-sectional study included 24 SLE patients selected between September 2015 and March 2016. The patients were randomly divided into two groups, including exercise (n = 14) and control (n = 10) groups. The exercise group participated in an 8-week combined supervised exercise training program consisting of three times per week in 60-min exercise sessions. After collection of whole peripheral blood, peripheral blood mononuclear cells (PBMCs) were isolated from the blood samples. Following RNA extraction and cDNA synthesis, the expression levels of IFN-γ, TNF-α, IL-6, IL-2, IL-4, IL-5, IL-9, IL-10, IL-13, IL-17A, IL-17F, IL-21, and IL-22 were determined using in-house SYBER Green-based real-time polymerase chain reaction (PCR). Lastly, the data obtained were analyzed using t-test. RESULTS: The mean and standard deviation of age were 29.00 ± 3.19 and 21.50 ± 5.52 in the intervention and control groups, respectively. No significant differences were found among the mean serum levels of IFN-γ, IL6, IL-9, IL-17A, IL-17F and IL-21 among SLE patients in the intervention and control groups. The mean serum levels of TNF-α, IL2, IL-4, and IL-5 decreased significantly in the intervention as compared with the control group. The mean serum levels of IL-10, IL-13 and IL-22 significantly increased in the control group after eight weeks, as compared with the intervention group. CONCLUSIONS: Our findings indicated that the 8-week supervised aerobic and anaerobic training program could result in decreased inflammatory cytokines.

Comparison of Metabolic and Hormonal Profiles of Women With and Without Premenstrual Syndrome: A Community Based Cross-Sectional Study.

BACKGROUND: Premenstrual syndrome (PMS) is reported by up to 85% of women of reproductive age. Although several studies have focused on the hormone and lipid profiles of females with PMS, the results are controversial. OBJECTIVES: This study was designed to investigate the association of hormonal and metabolic factors with PMS among Iranian women of reproductive age. MATERIALS AND METHODS: This study was a community based cross-sectional study. Anthropometric measurements, biochemical parameters, and metabolic disorders were compared between 354 women with PMS and 302 healthy controls selected from among 1126 women of reproductive age who participated in the Iranian PCOS prevalence study. P values < 0.05 were considered significant. RESULTS: Prolactin (PRL) and triglycerides (TG) were significantly elevated in women with PMS, whereas their testosterone (TES), high density lipoprotein (HDL) and 17-hydroxyprogesterone (17-OHP) levels were significantly less than they were in women without the syndrome (P < 0.05). After adjusting for age and body mass index (BMI), linear regression analysis demonstrated that for every one unit increase in PMS score there was 12% rise in the probability of having metabolic syndrome (P = 0.033). CONCLUSIONS: There was a significant association between PMS scores and the prevalence of metabolic syndrome. Further studies are needed to confirm and validate the relationships between lipid profile abnormalities and metabolic disorders with PMS.

Of PCOS symptoms, hirsutism has the most significant impact on the quality of life of Iranian women.

INTRODUCTION: Polycystic ovary syndrome is a common endocrine disorder affecting women both physically and psychologically and can lead to a poor quality of life compared to their normal counterparts. The aim of the present study was to assess the impact of various clinical features of polycystic ovary syndrome on the health-related quality of life of Iranian women diagnosed with this syndrome. MATERIALS AND METHODS: A total of 796 women diagnosed with polycystic ovary syndrome, aged 15-49 years, completed the questionnaires, interviews, and medical assessments required for this study. A reliable and validated Persian version of the health-related quality of life questionnaire for polycystic ovary syndrome patients was used. Linear regression models were used to assess the association between the symptoms of polycystic ovary syndrome and health-related quality of life. RESULTS: The mean age of participants was 28.02 years. 35.4% of the subjects were classified as overweight or obese. Hirsutism, was reported to have the strongest impact on the patients' health-related quality of life, followed in descending order by body mass index, irregular menses and infertility. The relative level of hirsutism was directly proportional to decrease in health-related quality of life score (p<0.001). CONCLUSIONS: The results of the study found that hirsutism had the strongest impact on the health-related quality of life measures in Iranian women diagnosed with polycystic ovary syndrome. Health care officials need to evaluate in depth the effect of each clinical feature of polycystic ovary syndrome separately and design management strategies, keeping in mind the psychological and physical manifestations.

A population-based study on infertility and its influencing factors in four selected provinces in Iran (2008-2010).

BACKGROUND: Infertility has a varied impact on multiple dimensions of health and functioning of women. OBJECTIVE: We aimed to identify the burden of infertility and its influencing factors based on a population based study conducted in four provinces of Iran. MATERIALS AND METHODS: A sample of 1126 women, aged 18-45 years, was selected using the multi stage, stratified probability sampling procedure; those met the eligibility criteria were invited for further comprehensive interview. This study used the definition of infertility proposed by World Health Organization "the woman has never conceived despite cohabitation and exposure to pregnancy for a period of 1 year". Results : The overall prevalence of lifetime infertility and current primary infertility were 21.1% (95% CI: 18.4- 23.8) and 6.4% (95% CI: 4.8-8) respectively. The probability of first pregnancy at the end of 2 years of marriage was 94% for all ever-married women. Infertility were observed as significantly higher among women age 31-35 (OR: 4.6; 95% CI: 1.9-11.5; p=0.001) and women with more than 9 years of education (OR: 2.8; 95% CI: 1.5-3.3; p<0.0001). CONCLUSION: The necessities of modern living have compelled many women to postpone childbearing to their late reproductive years; however they must be informed of being at risk of infertility with ageing.

Association of PCOS and its clinical signs with sexual function among Iranian women affected by PCOS.

INTRODUCTION: Polycystic ovary syndrome (PCOS) and its physiological and psychological changes influence the sexual function of women affected. AIM: In the present study, we aimed to investigate the association of PCOS and its clinical signs with sexual function among a population of married Iranian women affected by PCOS. MAIN OUTCOME MEASURE: The impact of clinical signs of PCOS on sexual function of affected women was the main outcome measure in the present study. METHODS: This cross-sectional study was carried out on 591 married women with PCOS, aged 18-45 years. Data were collected using a questionnaire including information on demographic and reproductive status and the Female Sexual Function Index. Data were analyzed using chi-square test, Mann-Whitney test, and logistic regression analysis. RESULTS: The participants' mean age was 30.6 years. Among associated manifestations of PCOS, infertility and hair loss have significant adverse effects on female sexual function. Logistic regression analysis showed that PCOS women with infertility have a significantly lower sexual function score compared with those who are fertile. Subgroup analysis demonstrated that compared with their fertile counterparts, PCOS women with infertility had significant sexual dysfunction in all aspects except desire and pain. CONCLUSION: Among various manifestations of PCOS, infertility mainly disrupts the sexual function of affected women.

The time of prenatal androgen exposure affects development of polycystic ovary syndrome-like phenotype in adulthood in female rats.

BACKGROUND: Polycystic ovary syndrome (PCOS) is one of the most common reproductive disorders in women. Previous studies have shown that prenatal exposure of female fetuses to androgen can be considered an important factor in the development of PCOS. OBJECTIVES: In the present study we aimed to examine the effects of prenatal exposure of female rat fetuses to previously documented doses of testosterone on different embryonic days on the development of PCOS phenotype in adulthood. MATERIALS AND METHODS: Pregnant rats were divided into four groups, experimental and control groups. Three mg of free testosterone was administered subcutaneously to experimental group 1 on gestational days 16-19, daily and 20 mg on day 20, to experimental group 2, and the controls received solvent at the same times. Female offspring of these mothers aged between 90-100 days were examined for development and function of the reproductive system. Independent-sample student t test was used to compare the results between the experimental groups and controls. RESULTS: Anogenital distance (P < 0.001) and clitoris length were significantly increased in the offspring of both experimental groups (P < 0.001 and P < 0.05 respectively). Nipples were not formed in the offspring of experimental group 1, whereas in experimental group 2 the number of nipples was unchanged. Vaginal length was significantly decreased in the offspring of experimental group 1 (P < 0.001), whereas in experimental group 2, no significant difference was observed. In the offspring of experimental group 1, hormonal profiles did not differ, but in experimental group 2, levels of testosterone (P < 0.05) and LH (P < 0.01) were significantly increased, but estrogen (P < 0.05) and anti-Mullerian hormone levels (P < 0.001) were significantly decreased. A significant increase in the number of preantral and antral follicles was observed in the ovaries of offspring of experimental group 1 (P < 0.05); whereas there was no such a difference in experimental group 2. CONCLUSIONS: The time of prenatal exposure to androgens may have a significant role in the development of PCOS. Increased prenatal androgen levels are associated with hormonal changes and morphological disorders of the reproductive system. Therefore, avoiding exposure to androgen excess during critical periods of fetal development may prevent or reduce adulthood PCOS manifestations caused by prenatal excess androgen.

Secular trend of menopausal age and related factors among Tehrani women born from 1930 to 1960; Tehran Lipid and Glucose Study.

BACKGROUND: Menopause is an important milestone of a woman's reproductive life. There is limited data on the secular trend of menopausal age. The purpose of this study is to identify the secular trend of menopausal age and its related factors among Tehrani women born during 1930 - 1960. METHODS: A total number of 2266 women, born between 1930 and 1960, were recruited among TLGS participants. The World Health Organization classification was used to define menopause status. Birth cohorts were created using 10-year periods, and statistical comparisons were performed with analysis of covariance (ANCOVA). RESULTS: The means for menopausal age of women born in the 1930s, 1940s and 1950s were 48.5, 49.5 and 49.9 years, respectively. After adjustment for possible confounding factors in the linear regression model, the increasing trend of menopausal age was constant (P = 0.029). CONCLUSION: There is an increasing trend in menopausal age in female residents of Tehran. These findings have implications for endogenous lifetime exposure of women to gonadal steroids.

Normal cut-off values for hyperandrogenaemia in Iranian women of reproductive age.

OBJECTIVE: The normal cut-off values for hyperandrogenaemia differ between populations. Although there are various ways to determine the normal range of hormones in a population, use of a gold standard and the 95th percentile approach are not appropriate to diagnose hyperandrogenism. This study aimed to determine normative cut-off androgen levels for Iranian women of reproductive age using k-means cluster analysis. STUDY DESIGN: The subjects were 1126 women, aged 18-45 years, initially selected at random from women of reproductive age from different geographic regions of Iran. Serum levels of hormones were measured, and complete data were available for 923 women following the implementation of exclusion criteria. The reference group comprised 423 eumenorrhoeic non-hirsute women selected from the total population. Normative cut-off levels were computed using k-means cluster analysis (k=3). Analyses were also conducted based on age and body mass index (BMI) groups for the 923 subjects. RESULTS: Cluster cut-off values for the total study population were similar to the 95th percentile values, whereas the percentiles for the free androgen index, total testosterone, dehydroepiandrostenedione sulphate and androstenedione were 79.3%, 74.1%, 96.7% and 71%, respectively, in the reference group. CONCLUSIONS: Determination of cut-off values for hyperandrogenism based on age and BMI categories provides the most objective way of determining normal upper limits of androgen levels among Iranian women of reproductive age.

Sexual behavior of married Iranian women, attending taleghani public health center.

BACKGROUND: Sexual practices as an important aspect of reproductive health have many physical and psychological effects on people's lives, there is limited evidence on such practices and their pattern among Iranian women. Hence we aimed to determine different types of sexual practices among 19-45 year old married Iranian women. METHODS: This cross-sectional study was conducted among 200 married women, aged 19-45 years, attending Taleghani Public Health Center for annual gynecologic examination during November 2008 to May 2009 using convenient sampling. The participants were enquired about their experience regarding different types of sex, as well as their views and feelings about such practices, using an anonymous questionnaire. RESULTS: The mean age of the participants was 34 years. All had ever experienced vaginal sex and 50.9% reported ever experience of other types of sex (non-vaginal), as well. Due to some stigma attached to non-vaginal sexual practices among women in Iran, the feelings of women with regard to different sexual practices were also examined in this paper. CONCLUSION: This study showed that non-vaginal sex among women is considerable and because of less favourable views of women towards such practices, it seems that these practices might have psychologically impacts on women's life. Hence, counseling and educational programs designed for married men and women can include some factual information about different types of sex.

Hypertensive pregnancy disorders as a risk factor for future cardiovascular and metabolic disorders (Tehran Lipid and Glucose Study).

BACKGROUND: Although hypertensive pregnancy disorders (HPD) are common worldwide, there is no consensus regarding their long-term cardiovascular and metabolic consequences. We aimed to ascertain the association between HPD and the development of cardiovascular and metabolic disturbances later in life. MATERIAL AND METHODS: A cohort of 226 women with a history of HPD was selected as the case group, and a group of 226 age- and body-mass-index-matched women, with no history of HPD, was selected as controls. Both groups were selected from among participants of the Tehran Lipid and Glucose Study and were compared for concentrations of metabolic parameters and incidence of hypertension, type 2 diabetes mellitus (T2DM) and dyslipidemia over a follow up of 10 years. RESULTS: Women with a history of HPD, compared with age- and body-mass-index-matched women without such a history, had an increased risk of cardiovascular and metabolic disorders, including a twofold increased risk for hypertension (95% confidence interval [CI]: 1.4-3.2), a threefold increased risk for T2DM (95% CI: 1.8-5.2) and a 1.3-fold increased risk for dyslipidemia (95% CI: 1.2-1.5). CONCLUSIONS: Women with a history of hypertension in pregnancy are at increased risk for subsequent diagnosis of hypertension, dyslipidemia and T2DM later in life. These women may benefit from close monitoring and timely implementation of primary prevention measures of cardiovascular and metabolic risk factors and lifestyle modifications.

Relationship between polymorphism of insulin receptor gene, and adiponectin gene with PCOS.

BACKGROUND: Polycystic ovary syndrome (PCOS) is a complex disease having both genetic and environmental components and candidate genes on obesity and insulin metabolism have been hypothesized to be involved in its etiology. OBJECTIVE: We examined the possible association of adiponectin and insulin receptor gene polymorphisms with PCOS. MATERIALS AND METHODS: A total of 186 women with PCOS using NIH criteria and 156 healthy women were recruited. Their samples were genotyped for the polymorphism in exon 17 and 8 of the insulin receptor gene or exon and intron 2 of the adiponectin gene. RESULTS: The distributions of genotypes and alleles of both polymorphisms were not different in women with PCOS and controls. There was no significant differences on the anthropometric and hormonal profiles of various adiponectin and insulin receptor genes polymorphisms among both groups. CONCLUSION: Adiponectin and insulin receptor gene polymorphisms are not associated with PCOS in a sample of Iranian population.

Evaluation of sexual attitude and sexual function in menopausal age; a population based cross-sectional study.

UNLABELLED:   BACKGROUND: Menopause and its physical, hormonal and psychosocial changes could affect women's sexual function. There are controversial results regarding relationship between sexual attitudes and function. OBJECTIVE: We aimed to evaluate sexual attitudes and sexual function among Iranian menopausal age women. MATERIALS AND METHODS: This population based cross-sectional study was carried out on 225 menopausal women, aged 45-65 years. Based on a self-made questionnaire data were collected about women's socio-demographic characteristics, attitudes regarding sexuality and sexual function. Data were analyzed using SPSS and sexual function was compared between three groups of women who had positive, medium and negative attitudes regarding sexuality. RESULTS: The mean age of women was 53.11±4.56 years. Seventy percent of them had at least one sexual problem. Feeling of dyspareunia was significantly different between three categories of attitudes regarding sexuality (p=0.03). Comparing data obtained on their attitudes, sexual desire, orgasm and dyspareunia demonstrated significant differences (p=0.03, 0.04, and 0.04 respectively). CONCLUSION: Attitude regarding sexual function has a great impact on sexual activity of postmenopausal women that need to be considered in their health care programming.

Anxiety and success of in vitro fertilization.

OBJECTIVE: To assess the effects of anxiety on pregnancy rate after in vitro fertilization (IVF). STUDY DESIGN: This was a prospective study of 180 infertile women who were referred for IVF treatment to two selected infertility treatment centers in Tehran. They were recruited at the last visit before the procedure by quota sampling and their anxiety was assessed using the State and Trait Anxiety Inventory, following which they were categorized, based on their anxiety scores, to high and low anxiety groups. A positive pregnancy test was considered as the criterion of success of treatment. Data were analyzed using SPSS 17. Pregnancy rates in the low and high anxiety groups were compared using the Chi square test. RESULTS: Pregnancy rates in the groups with high and low levels of state anxiety were not significantly different (11.1 vs. 10.1 percent; X(2), p>0.05); neither were these rates significantly different in groups with high and low levels of trait anxiety (14.5 vs. 9 percent; X(2), P>0.05). CONCLUSION: High or low levels of state or trait anxiety have no effect on the pregnancy rate after IVF treatment. Counseling is necessary, however, to decrease anxiety in infertile women to improve their quality of life.

Follow-up of women with gestational diabetes in the Tehran Lipid and Glucose Study (TLGS): a population-based cohort study.

AIM: Women with gestational diabetes (GDM) are at increased risk of developing type 2 diabetes mellitus (T2DM), but there is disagreement regarding this conversion rate or its cardiovascular consequences. We investigated the metabolic and cardiovascular consequences of women with GDM in a population-based cohort study. MATERIAL AND METHODS: Three groups of women were selected from the Tehran Lipid and Glucose Study (TLGS) and followed up for an average 9 years: women with prior history of GDM (n = 29); women with history of macrosomia or stillbirth without GDM (MC-ST) (n = 570), and age- and BMI-matched controls (n = 628). The incidence of T2DM, hypertension (HTN) and dyslipidemia were compared between these groups. Statistical significance was set at P < 0.05. RESULTS: During the 9-year follow-up, T2DM was diagnosed in 27.3% of women with GDM in comparison to 9.5% among the control group (P < 0/001); 7.4% of the MC-ST group versus 8.9% of control group developed T2DM during the study follow-up (P = 0/03). There was no significant difference in the incidence of HTN or dyslipidemia between these groups (P > 0/05). CONCLUSION: Women with a history of GDM are at higher risk for developing T2DM later in life. The timely recognition of GDM may provide a 'teachable moment' during which women could be motivated to implement lifestyle modifications to reduce their T2DM risk.

Screening of the pelvic organ prolapse without a physical examination; (a community based study).

BACKGROUND: Pelvic organ prolapse (POP) is a silent disorder with a huge impact on women's quality of life. There is limited data from community-based studies conducted to determine the prevalence of POP as its assessment needs a pelvic examination. We aimed to develop a simple screening inventory for identification of pelvic organ prolapse and then evaluate its sensitivity and specificity. METHODS: This study had two phases. In the first phase in order to develop a simple inventory for assessment of POP, the Pelvic Floor Disorder Inventory (PFDI) was completed for a convenience sample of 200 women, aged 18-45 years, referred for annual gynecologic examination, and their pelvic organ prolapse was assessed using the standard protocol. The most sensitive and specific questions were selected as pelvic organ prolapse simple screening inventory (POPSSI). In the second phase, using a stratified multistage probability cluster sampling method, the sensitivity and specificity of the POPSSI was investigated in a non selected sample of 954 women recruited from among reproductive aged women living in four randomly selected provinces of Iran. RESULTS: The sensitivity and specificity of POPSSI for identification of pelvic organ prolapse in the general population were 45.5 and 87.4% respectively; these values were 96.7 and 20% among those women who were aware of their pelvic dysfunction. CONCLUSION: Community based screening studies on pelvic organ prolapse could be facilitated by using the POPSSI, the sensitivity of which would be enhanced through conducting of public awareness programs.