Effect of polycystic ovary syndrome on the life quality of young women.

OBJECTIVE: The study evaluated the opinions of polycystic ovary syndrome on the life quality of women. METHODS: A total of 249 women with polycystic ovary syndrome participated in this descriptive study between October 2022 and July 2023 in Istanbul, Turkey. FINDINGS: Polycystic Ovary Syndrome and Quality of Life was significantly correlated with age (p=0.000) and frequent weight loss diets (p=0.000) (p<0.01). Among the Polycystic Ovary Syndrome and Quality of Life total score and polycystic ovary syndrome symptoms, those with hormone imbalance and insulin resistance had the highest mean scores, while those with menstrual irregularity and fatigue had the lowest. CONCLUSION: Advancing age changes the quality of life of women with polycystic ovary syndrome. To prevent the negative impact of polycystic ovary syndrome on women's quality of life, it is recommended that health professionals develop effective care plans utilizing available evidence.

Social anxiety and psychological distress among polycystic ovarian syndrome patient's in Pakistan.

OBJECTIVE: To examine the fear of negative evaluation as a predictor, and to explore the association of social anxiety with psychological correlates among women with polycystic ovaries. Methods: The cross-sectional study was conducted from August 2020 to November 2021 after approval form the University of Central Punjab, Lahore, Pakistan, and comprised unmarried women aged 18-26 diagnosed with polycystic ovary syndrome. The sample was raised from different clinics and hospitals based in Lahore and Gujranwala cities. The sample was divided into obese, hirsutism and acne vulgaris groups. Data was collected using a demographic proforma along with standardised Derriford Appearance Scale, Brief Fear of Negative Evaluation Scale, University of California, Los Angeles, Loneliness Scale and the Social Interaction Anxiety Scale. Data was analysed using SPSS 24. RESULTS: Of the 180 patients, 60(33.3%) were in each of the 3 groups. The overall mean age was 21.4+/-2.27 years. A significant association of fear of negative evaluation was found with appearance distress, social anxiety and loneliness (p<0.05). The fear of negative evaluation and appearance distress also significantly predicted loneliness in the subjects (p<0.01). The obese group scored significantly higher in terms of fear of negative evaluation and social anxiety compared to the other groups (p<0.05). Conclusion: Women with polycystic ovaries were found to be suffering from adverse psychological outcomes and social anxiety.

The role of meditation and mindfulness in the management of polycystic ovary syndrome: a scoping review.

Polycystic Ovary Syndrome (PCOS) presents multifaceted challenges affecting women's reproductive, metabolic, and psychological systems, consequently impacting their psychological and emotional well-being. The utilization of meditation and mindfulness interventions (MMIs) is found to be increasing for the management of PCOS. This scoping review systematically explored the current literature to identify the type and application of MMIs for PCOS management. A systematic search of literature was conducted using CINAHL, PsycINFO, Scopus, MEDLINE, and PubMed databases for identifying studies conducted on the usage of MMIs in women diagnosed with PCOS, irrespective of age. The comprehensive search identified 14 trials (comprising 17 citations) meeting inclusion criteria, involving 723 participants across various age groups. Among these, nine were randomized controlled trials (RCTs), while the remaining comprised non-RCTs. Several types of MMIs, including Rajayoga of Brahmakumaris, Yoga Nidra, OM cyclic meditation, unspecified forms of meditation, mindfulness-based stress reduction programs, mindful yoga, and mindfulness-based activities, were used. Outcomes were predominantly assessed in psychological domains (n=11), followed by anthropometric (n=9), quality of life (n=7), and metabolic metrics (n=7). The review findings suggest the integration of meditation with conventional treatment modalities. Preliminary data indicate that MMIs have the potential to improve psychosocial well-being and quality of life among PCOS-affected women. However, adequately powered studies with extended follow-up periods are required to investigate the mechanisms and therapeutic efficacy of MMIs, particularly concerning reproductive outcomes and weight management. Furthermore, diligent monitoring and reporting of adverse events and adherence are essential for a comprehensive understanding of MMI utilization in PCOS management.

The effect of social network based motivational interviewing on health behaviors among infertile women with polycystic ovary syndrome: A randomized controlled trial.

Polycystic ovary syndrome is one of the commonest and complex endocrine disorders in females of reproductive age. Attention to self-care behaviors such as health-promoting behaviors can improve physiological and psychological conditions in women with PCOS. This study aimed to determine the efficacy of Social Network-Based Motivational Interviewing on health-promoting behaviors and quality of life of infertile women with polycystic ovary syndrome. In this randomized controlled trial, 60 infertile women with polycystic ovary syndrome were randomly selected and assigned to the interventio (n = 30) or a control group (n = 30). Participants in the control group received routine care. Those in the intervention group received five motivational group sessions in WhatsApp, which were conducted in five groups of six participants each. The data related to health-promoting behaviors and quality of life were collected through an online questionnaire. Both groups were followed up immediately and 2 months after the intervention. Data collected in the two stages were analyzed using the paired-samples t-test, Chi-square, and repeated measures analysis. No significant difference was observed between the two groups before the intervention means health-promoting behaviors and quality of life scores (p>0.05). Immediately and two months after the intervention, the mean scores of health-promoting behaviors and their domains increased in the intervention group. This increase is statistically compared to the first test, and the scores obtained by the control group in the second (p< 0.001, ES = 1.5) and the third test (p< 0.001, ES= 1.3) were significant. The score of the quality of life variable increase was not statistically significant compared to the first test and also to the scores obtained by the control group. However According to the Generalized estimating equations (GEE) test, the changes in quality of life score between the two groups in the three stages of measurement are statistically significant. WhatsApp support increases the health-promoting self-care behaviors rate and has favorable effects on follow-up.Trial registration: Iranian Registry for Clinical Trial (the link to trial: https://www.irct.ir/trial/48089 ). Registered August 11 2020.

Concerns about fertility, social appearance, and relationships in young adults with polycystic ovary syndrome.

BACKGROUND: Polycystic Ovary Syndrome (PCOS), affecting 1-11% of reproductive-age women, is characterised by many symptoms that cause important concerns especially in young adults. OBJECTIVE: This study aimed to evaluate the concerns about fertility, social appearance, and relationships in young adults with PCOS. METHODOLOGY: This descriptive study included 140 young female adults aged 18-26, who were diagnosed with PCOS, agreed to participate in the onlineresearch through social media between July and December 2022 in Turkey. Data were collected using the 'Participant Interview Form' and the "Social Appearance Anxiety Scale (SAAS). RESULTS: The mean age of the participants was 22.1 ± 2.1. As the most common symptoms, 78.6% experienced menstrual irregularities, 16.4% were overweight, 7.1% were obese, 67.1% had hirsutism and 65.7% had acne. Most of the participants expressed concerns about future infertility (72.9%), and worried about being unable to conceive due to PCOS in the future (sometimes = 61.4%). Over eighty percent of the participants expressed some level of dissatisfaction with their physical appearance. They commonly believe that their self-esteem, emotionalstate, social relationships and partner relationships could be negatively affected by PCOS. SAAS scores were significantly increased by low income, high BMI, hirsutism, dissatisfaction with physicalappearance, low self-esteem, emotional problems and concerns related to social and partner relationships (p < 0.05). CONCLUSION: Young adults have common concerns about the potential negative impacts of PCOS on fertility, social appearance, and relationships. Health professionals should be aware of their counselling needs about the possible physical and psycho-social effects of PCOS and provide continuous care and support.

Self-esteem and body image satisfaction in women with PCOS in the Middle East: Cross-sectional social media study.

BACKGROUND: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of childbearing age, associated with increased incidence of emotional disorders, anxiety and depression. OBJECTIVE: The aim was of this study was to investigate whether those women reporting PCOS differed to women without PCOS in measures of psychological well-being including body-image satisfaction and self-esteem across a Middle Eastern population. MATERIALS AND METHODS: An online survey link of 21 questions was shared and distributed across social media platforms (Instagram and WhatsApp). The main outcome measured was levels of self-esteem and body image satisfaction in association with symptoms experienced by the participants. RESULTS: 12,199 female subjects completed the survey of whom 3,329 respondents (27.3%) self-reported a diagnosis of PCOS. PCOS respondents felt less attractive compared to non-PCOS respondents (73.9% vs 80.5%, p<0.0001). More respondents with PCOS reported avoidance of their reflection in the mirror (61.7% vs 49.8%, p<0.001) and avoidance of social interactions (22.3% vs 32.3%, p<0.0001). More PCOS respondents wanted to lose weight (75.2% vs 68.5%, p<0.001) with increasing weight being associated with being less attractive (p<0.001). Fewer PCOS respondents felt satisfied/confident compared non-PCOS respondents (38.6% vs 50.7%, p<0.001). CONCLUSION: PCOS respondents reported significantly lower measures of self-esteem and body image satisfaction compared to non-PCOS respondents in this population.

Association between mild depressive states in polycystic ovary syndrome and an unhealthy lifestyle.

Objective: Polycystic Ovary Syndrome (PCOS) is a prevalent and frequently encountered gynecological disorder. Its high variability and the complexities associated with its management often lead to psychological stress in affected women, manifesting in symptoms of depression. Embracing a healthy lifestyle is fundamental in PCOS treatment. Consistent adherence to a healthy lifestyle not only aids in improving PCOS symptoms but also plays a role in enhancing mental well-being. However, there is currently limited research examining the extent of depression, its prevalence, and its correlation with lifestyle among individuals with PCOS. Therefore, this study aims to explore the impact of lifestyle factors on the depressive state of individuals with PCOS. Methods: This cross-sectional study gathered data from 411 individuals with PCOS at a comprehensive hospital in Henan, China. Depression status was assessed using the Hamilton Depression Scale, and demographic information as well as lifestyle habits were simultaneously collected. Univariate and multivariate analyses using logistic regression were conducted to identify risk factors associated with the depressive state in PCOS. Results: Among the surveyed 411 individuals with PCOS, approximately 49.4% exhibited symptoms of depression, with 83.7% experiencing mild depressive symptoms. A disease duration of 1-3 years, the presence of acne, and unhealthy lifestyle factors such as high-fat diet, staying up late, lack of exercise, and mental stress emerged as significant risk factors for the onset of depressive symptoms. Conclusion: Depressive symptoms in individuals with PCOS are predominantly mild. The risk of comorbid depression in PCOS is associated with the presence of acne, frequent high-fat diet, regular staying up late, lack of exercise, and mental stress.

Is polycystic ovary syndrome a risk factor for depression and anxiety?: a cross-sectional study.

OBJECTIVE: The objective of this study was to learn more about the prevalence and pathophysiology of depression and anxiety that may be caused by polycystic ovary syndrome and to make plans for taking necessary precautions for this vulnerable group. METHODS: This case-control study was conducted between January 2022 and October 2022. A total of 120 women with polycystic ovary syndrome and 143 controls were included in the study. All healthy volunteers and women with polycystic ovary syndrome were evaluated using self-administered questionnaires and physical examination. Anthropometric data such as weight and height and laboratory value were documented. RESULTS: There was no significant difference between the groups in terms of demographic characteristics. When the Hospital Anxiety and Depression Scale scores of both groups were compared, both depression and anxiety scores were found to be significantly higher in women with polycystic ovary syndrome compared with the control group (OR: 3.319, 95%CI, 1.563-7.047, p<0.001 and OR: 3.238, 95%CI, 1.659-6.315, p<0.001). In the Hospital Anxiety and Depression Scale questionnaire, the rate of irregular menstruation and Ferriman-Gallwey score were statistically significant in women with polycystic ovary syndrome with high depression and anxiety scores. While serum LH levels and LH/FSH ratios were significantly different in women with polycystic ovary syndrome with high depression scores, serum LH, LH:FSH ratios, and serum total testosterone levels were found significant in women with polycystic ovary syndrome with high anxiety scores. CONCLUSION: It is clear that depression and anxiety are more common in patients with polycystic ovary syndrome than in healthy women. Our findings support previous recommendations regarding routine screening for depression and anxiety in this population.

Unmet clinical needs in women with polycystic ovary syndrome in regard to mental health: a cross-sectional study.

PURPOSE: Polycystic ovary syndrome (PCOS) management has hardly been standardized until recent years. Despite the existence of a detailed, evidence-based guideline published by the European Society of Human Reproduction and Embryology (ESHRE), it remains unclear to what extent healthcare providers adhere to this guideline. Our aim is to evaluate the gynaecological medical care provided in women with PCOS, particularly in terms of mental health, from the patients' perspective. METHODS: For this cross-sectional online cohort study in women with PCOS, we designed a standardized, non-validated questionnaire covering aesthetic aspects, metabolism, menstrual cycle, reproduction, mental health, and prevention of chronic non-communicable diseases. RESULTS: Among 1879 participants, various mental health aspects were reported: body image (n = 1879), eating patterns/habits (n = 1878), and emotional well-being (n = 1874). Although nearly all women (99.7%) reported complaints on at least one session of mental health, consultation rates were low (body image 9.7%, eating patterns/habits 16.6%, emotional well-being 4.4%). Mean satisfaction with counselling on the different domains varied from moderate to fairly satisfying, with scores of 56.0 points (SD 31.7), 53.5 points (SD 32.0), and 63.7 points (SD 30.2), respectively. More complaints were associated with lower satisfaction. The overall satisfaction with the management provided by the healthcare practitioner (HCP) was low, averaging 36.5 points (SD 29.7). Consequently, most women wished for more counselling (58.9%). CONCLUSION: Women affected by PCOS are not properly managed according to ESHRE guideline in regard to mental health issues. Overall consultation rates and corresponding satisfaction with management were poor, highlighting the need for significant improvements in healthcare provision.

Exploratory factor and confirmatory analyses of the polycystic ovary syndrome health-related quality of life questionnaire (PCOSQ-50).

BACKGROUND: A condition-specific instrument is necessary to measure the health-related quality of life among those with polycystic ovary syndrome (PCOS), the most common chronic endocrinopathy among women. The first instrument was developed in 1988, followed by several revisions. However, further recommendations from all versions include additional application and measurement among different cultural populations of women with PCOS and psychometric testing based on use among larger samples of women with PCOS. Thus, the purpose of this study was to explore the factor structure of the Polycystic Ovary Syndrome Questionnaire (PCOSQ-50) using an international cross-sectional survey data from women with PCOS aged 18-42 years. METHODS: Using data from the largest known international cross-sectional study of women with PCOS aged 18-42 years (n = 935) to date, exploratory factor and confirmatory analyses were conducted for the PCOSQ-50, followed by factor labeling using a thematic analysis approach. RESULTS: Respondents were 31.0 ± 5.8 years of age, mostly White (72%), well-educated (56% had a college degree), married (69%), and employed full-time (65%). Three-quarters (74%) of the sample had one or more chronic conditions in addition to PCOS. Approximately 20% of the respondents originated from countries such as the United Kingdom, Australia, South Africa, etc. The PCOSQ-50 demonstrated good reliability but may be best described using a 7-factor model. The 7-factor model revealed goodness-of-fit. Thematic analysis suggested the following labels of those seven factors: hirsutism, fertility, isolation/trepidation, sexual function, self-esteem, emotional, and obesity. CONCLUSION: More research is needed to adapt the current PCOSQ-50, as well as to create an age-appropriate PCOS-specific HRQoL instrument for peri-postmenopausal women with PCOS.

Childbirth experiences in women with polycystic ovary syndrome: A cohort study.

INTRODUCTION: Women with polycystic ovary syndrome (PCOS) have more pregnancy complications like gestational diabetes, hypertension, and preterm labor than other women. Metformin has been used in an attempt to improve pregnancy outcomes. Our study aims to explore childbirth experiences in women with PCOS compared with a reference population. It also explores the potential influence of metformin, obesity, pregnancy complications, and the duration and mode of birth on childbirth experiences. MATERIAL AND METHODS: This study is a cohort study combining data from two randomized trials conducted in Norway, Sweden and Iceland. The PregMet2 study (ClinicalTrials.gov, NCT01587378) investigated the use of metformin vs. placebo in pregnant women with PCOS. The Labour Progression Study (ClinicalTrials.gov, NCT02221427) compared the WHO partograph to Zhang's guidelines for progression of labor and were used as the reference population. A total of 365 women with PCOS and 3604 reference women were included. Both studies used the Childbirth Experience Questionnaire (CEQ). Main outcome measures were total CEQ score and four domain scores. The CEQ scores were compared using Mann-Whitney U test for women in Robson group 1 with PCOS (n = 131) and reference women (n = 3604). CEQ scores were also compared between metformin-treated (n = 180) and placebo-treated (n = 185) women with PCOS, and for different subgroups of women with PCOS. RESULTS: There was no difference in total CEQ score between women with PCOS and reference women-Wilcoxon-Mann-Whitney (WMW)-odds 0.96 (95% confidence interval [CI] 0.78-1.17). We detected no difference in CEQ scores between the metformin- and placebo-treated women with PCOS (WMW-odds 1.13, 95% CI 0.89-1.43). Complications in pregnancy did not affect CEQ (WMW-odds 1, 95% CI 0.76-1.31). Higher body mass index (WMW-odds 0.75, 95% CI 0.58-0.96), longer duration of labor (WMW-odds 0.69, 95% CI 0.49-0.96), and cesarean section (WMW-odds 0.29, 95% CI 0.2-0.42) were associated with lower CEQ scores in women with PCOS. CONCLUSIONS: Women with PCOS experience childbirth similarly to the reference women. Metformin did not influence childbirth experience in women with PCOS, neither did pregnancy complications. Obesity, long duration of labor or cesarean section had a negative impact on childbirth experience.

Sexual function in women with polycystic ovary syndrome: a systematic review and meta-analysis.

BACKGROUND: Polycystic ovary syndrome (PCOS) is a common and distressing endocrine disorder associated with lower quality of life, subfertility, diabetes, cardiovascular disease, depression, anxiety, and eating disorders. PCOS characteristics, its comorbidities, and its treatment can potentially influence sexual function. However, studies on sexual function in women with PCOS are limited and contradictory. OBJECTIVE AND RATIONALE: The aim was to perform a systematic review of the published literature on sexual function in women with PCOS and assess the quality of the research and certainty of outcomes, to inform the 2023 International Guidelines for the Assessment and Management of PCOS. SEARCH METHODS: Eight electronic databases were searched until 1 June 2023. Studies reporting on sexual function using validated sexuality questionnaires or visual analogue scales (VAS) in PCOS populations were included. Random-effects models were used for meta-analysis comparing PCOS and non-PCOS groups with Hedges' g as the standardized mean difference. Study quality and certainty of outcomes were assessed by risk of bias assessments and the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) method according to Cochrane. Funnel plots were visually inspected for publication bias. OUTCOMES: There were 32 articles included, of which 28 used validated questionnaires and four used VAS. Pooled Female Sexual Function Index (FSFI) scores in random-effects models showed worse sexual function across most subdomains in women with PCOS, including arousal (Hedges's g [Hg] [95% CI] = -0.35 [-0.53, -0.17], I2 = 82%, P < 0.001), lubrication (Hg [95% CI] = -0.54 [-0.79, -0.30], I2 = 90%, P < 0.001), orgasm (Hg [95% CI] = -0.37 [-0.56, -0.19], I2 = 83%, P < 0.001), and pain (Hg [95% CI] = -0.36 [-0.59, -0.13] I2 = 90%, P < 0.001), as well as total sexual function (Hg [95% CI] = -0.75 [-1.37, -0.12], I2 = 98%, P = 0.02) and sexual satisfaction (Hg [95% CI] = -0.31 [-0.45, -0.18], I2 = 68%, P < 0.001). Sensitivity and subgroup analyses based on fertility status and body mass index (BMI) did not alter the direction or significance of the results. Meta-analysis on the VAS studies demonstrated the negative impact of excess body hair on sexuality, lower sexual attractiveness, and lower sexual satisfaction in women with PCOS compared to controls, with no differences in the perceived importance of a satisfying sex life. No studies assessed sexual distress. GRADE assessments showed low certainty across all outcomes. WIDER IMPLICATIONS: Psychosexual function appears to be impaired in those with PCOS, but there is a lack of evidence on the related distress scores, which are required to meet the criteria for psychosexual dysfunction. Health care professionals should discuss sexual function and distress and be aware of the multifactorial influences on sexual function in PCOS. Future research needs to assess both psychosexual function and distress to aid in understanding the degree of psychosexual dysfunction in PCOS. Finally, more diverse populations (e.g. non-heterosexual and more ethnically diverse groups) should be included in future studies and the efficacy of treatments for sexual dysfunction should also be assessed (e.g. lifestyle and pharmacological interventions).

The prevalence and odds of bipolar disorder in women with polycystic ovary syndrome (PCO) disease: a systematic review and meta-analysis.

BACKGROUND: Women with polycystic ovary syndrome (PCO) suffer from psychological difficulties like bipolar disorder. Various studies in the literature report several prevalence rates of bipolar disorder in women with PCO, while there is no systematic review in this field. So, we designed this systematic review and meta-analysis to estimate the pooled prevalence and odds of bipolar disorder in women with PCO disease. METHOD: PubMed, Scopus, EMBASE, Web of Science, Google Scholar, and references of the references, conference abstracts were comprehensively searched by two independent researchers. The search was done on May 1st, 2023. RESULTS: A literature search revealed 438 records, 35 full texts were evaluated, and finally, 11 studies remained for systematic review. Totally, 73,102 women with PCO and 340,724 controls were evaluated. Among cases, 1471 had bipolar diagnosis vs. 4321 controls. The prevalence of bipolar disorder in women with PCO ranged between 0 and 27%, and the pooled prevalence was estimated as 4% (95% CI, 2-5%; I2, 99.3%, p < 0.001). The odds of bipolar disorder in women with PCO ranged between 0.98 and 8.78, and the pooled estimate was 2.06 (95% CI, 1.61-2.63) (I2, 85.6%; p < 0.001). CONCLUSIONS: This systematic review and meta-analysis show that the pooled prevalence of bipolar disorder in women with PCO is 4%, and women with PCO are at a 2-fold higher risk of bipolar disorder.

PCOS health-related quality-of-life and depressive symptoms across the lifespan: Comparative study.

The purpose of this cross-sectional study was to compare health-related quality of life (HRQoL) and depressive symptoms among peri-postmenopausal women with polycystic ovary syndrome (PCOS) aged ≥43 years relative to premenopausal women with PCOS aged 18-42 years. An online survey link comprising questionnaires about demographics, HRQoL, and depressive symptoms was posted onto two PCOS-specific Facebook groups. Respondents (n = 1,042) were separated into two age cohorts: women with PCOS aged 18-42 years (n = 935) and women with PCOS aged ≥43 years (n = 107). Data from the online survey were analyzed using descriptive statistics, Pearson correlations, and multiple regression via SAS. Results were interpreted through the lens of life course theory. All demographic variables, except for the number of comorbidities, significantly differed between groups. HRQoL among older women with PCOS was significantly better as compared to those aged 18-42 years. Results indicated significant positive linear associations between the HRQoL psychosocial/emotional subscale and other HRQoL subscales and a significant negative association with age. The fertility and sexual function HRQoL subscales were not significantly associated with the psychosocial/emotional subscale among women aged ≥43 years. Women in both groups had moderate depressive symptoms. Study findings demonstrate the need to tailor PCOS management to women's life stage. This knowledge can inform future research about peri-postmenopausal women with PCOS and age-appropriate and patient-centered healthcare, including requisite clinical screenings (e.g., depressive symptoms) and lifestyle counseling across the lifespan.

Disordered Eating in Young Women with Polycystic Ovary Syndrome.

Polycystic ovary syndrome (PCOS) was the most prevalent endocrine disorder among women. Weight issues were commonly observed and found to be associated with comorbidities. This study aimed to compare Eating Disorder Examination Questionnaire (EDE-Q) scores and Night Eating Questionnaire (NEQ) scores in patients with and without PCOS and analyze the factors associated with disordered eating. Women aged 18-25 years with and without PCOS (n = 110 for each group) were included in the study. All patients completed the EDE-Q, NEQ, Beck Anxiety, and Beck Depression inventories. Disordered eating was found more frequently in women with PCOS than in controls (25.5% vs. 2.7%, p < 0.001). There were no significant differences in NEQ scores between the two groups. Anxiety and depression scores were higher in patients with PCOS than in controls (p = 0.002 and p = 0.001, respectively). PCOS diagnosis (OR: 7.4, CI: [1.63-33.7]; p = 0.010) and high BMI (OR: 1.24, CI: [1.10-1.39]; p < 0.001) were found to be independent factors for disordered eating (EDE-Q global score ≥ 4). Disordered eating was more common in young women with PCOS compared to the control group. PCOS diagnosis and having a high BMI (> 25) were found to be independent factors related to disordered eating in young women with PCOS. Young women with a high BMI or PCOS appear to be at a higher risk of disordered eating than women of the same age. Scanning this group may help clinicians in identifying women at high risk for eating disorders and preventing comorbidities associated with them.

Relationship between eating patterns and emotional distress, and perceived quality of life in women with polycystic ovarian syndrome.

INTRODUCTION AND OBJECTIVE: Polycystic Ovary Syndrome (PCOS) is a prevalent endocrine disorder with numerous hormonal, metabolic, and reproductive manifestations. Because of the variety of adverse consequences associated with the condition, women with PCOS suffer emotional distress, resulting in reduced health-related quality of life. Similar to other chronic conditions, eating patterns have been shown effective in impacting the quality of life of PCOS patients. Therefore, lifestyle modifications are recommended as a first-line therapy for PCOS, before prescribing any pharmaceutical management of the PCOS. The aim of the study was to investigate the relationship between dietary patterns, emotional distress, and perceived quality of life in women with diagnosed PCOS. MATERIAL AND METHODS: The cross-sectional study included 130 women with PCOS aged 18 - 60 years from the Polish population. The respondents were asked to complete a self-administered questionnaire developed for the purpose of the study, inspired by the Food Frequency Questionnaire (FFQ), Polycystic Ovary Syndrome Health-Related Quality of Life Questionnaire (PCOSQ), Three-Factor Eating Questionnaire (TFEQ-R18), and the Eating attitude questionnaire (Eat-26). RESULTS: Respondents were found to experience emotional distress regardless of how healthy their diet. Nonetheless, the results showed that women who followed a healthier eating pattern had lower occurrence of experiencing mood swings, and less often felt triggered in the social context. The group did not show a tendency to over-eat, gain weight, or binge eating. CONCLUSIONS: Healthier eating habits, besides providing advantages in weight management, may mitigate symptoms of emotional distress and improve the quality of life in women with PCOS.

Examining the proportions of food addiction among women with and without polycystic ovarian syndrome who do and do not take hormonal birth control.

Polycystic ovarian syndrome (PCOS) is a reproductive disorder driven by insulin resistance. Insulin resistance may increase weight gain and increase the rewarding intake of ultra-processed foods (UPFs). Individuals with PCOS may be more susceptible to the reinforcing properties of UPFs, increasing the risk to consume UPFs in addictive-like ways, operationalized by food addiction (FA). Additionally, hormonal birth control, commonly prescribed to women with PCOS, are found to increase food cravings and overeating. This study examined the relationships between PCOS status, FA, and hormonal birth control use. The study sample (N = 365, assigned female at birth) was drawn from Amazon Mechanical Turk, with half of the sample (n = 181) reporting having PCOS and the other half not (n = 184). Participants answered questions about women's reproductive health (i.e., PCOS, hormonal birth control use) and completed the modified Yale Food Addiction Scale 2.0 (mYFAS 2.0). A chi-square test found that 51.9 % of participants with PCOS (M = 6.23, SD = 3.82) met diagnostic criteria for FA (assessed by the mYFAS 2.0) compared to 16.8 % of participants without PCOS (M = 2.47, SD = 3.39). A hierarchical linear regression found independent main effects of PCOS status (ß = 0.40, t(352) = 8.61, p < .001) and hormonal birth control use (ß = 0.16, t(351) = 3.59, p < .001), to be associated with higher mYFAS symptom count scores. No differences were found between the types of hormonal birth control participants reported taking. The finding suggests that FA is an overlooked, understudied psychological condition impacting these individuals in weight loss treatments. Future studies are needed to understand the relationship between FA and PCOS in clinical samples.

The effects of weight loss on health-related quality of life in obese women with PCOS and controls.

BACKGROUND: Polycystic ovary syndrome (PCOS) is a complicated endocrine disorder with widespread symptoms that reduce women's quality of life. The adverse effect of associated obesity on this reduction is unclear, therefore the impact of weight loss on health-related quality of life (HRQOL) in obese women with PCOS is unknown. This study aimed to compare the impact of weight loss following a 24-week dietary intervention on HRQOL in obese women with and without PCOS. METHODS: In a 24-week hypocaloric LGI (low glycemic index) diet intervention study, 286 women were recruited (140 PCOS, 146 controls) and 216 participants (PCOS = 105, non-PCOS = 111) completed the study. HRQOL was assessed using the SF-36 questionnaire (Short Form Health Survey). Physical activity was measured using the short form of the International Physical Activity Questionnaire (IPAQ). Anthropometric assessments, dietary intake, physical activity levels, and HRQOL scores, according to the Iranian version of SF-36, were compared at baseline and 24 weeks with intervention. RESULTS: At the end of the intervention, there was no significant difference in the percentages of weight loss between the two groups (PCOS: 6.29 ± 3.32% vs. non-PCOS: 7 ± 3.62%, p = 0.1). At baseline, women with PCOS had lower mean scores in aspects of physical function (PF), general health perception (GH), role limitation due to emotional problem (RE), vitality (VT), mental health (MH), physical (PCS) and mental component summary scales (MCS), compared to non-PCOS (P < 0.01). At 24 weeks, the percentage of improvement in HRQOL in the non-PCOS group was higher compared to the PCOS group but this difference didn't reach statistical significance except for PCS. In both groups, greater weight loss was associated with further improvement in the physical aspects of HRQOL and vitality. In the non-PCOS group, with trivial exception, greater weight loss was associated with greater improvement in the mental aspects of HRQOL. CONCLUSIONS: Both obese PCOS and non-PCOS women achieved nearly similar levels of improvement in HRQOL due to weight loss induced by a hypocaloric LGI diet. TRIAL REGISTRATION: This study is registered in the Iranian Randomized Clinical Trials Registry (IRCT, code: IRCT2016092129909N1).

Sexual dysfunction in women with PCOS: a case control study.

STUDY QUESTION: What is the relationship of sex steroid levels with sexual function in women with and without polycystic ovary syndrome (PCOS)? SUMMARY ANSWER: Women with PCOS reported more sexual dysfunction and more sexual distress compared to those without PCOS, but only few and weak associations between androgen levels and sexual function were observed. WHAT IS KNOWN ALREADY: The literature shows that women with PCOS report lower levels of sexual function and sexual satisfactionand more sexual distress. Contributing factors seem to be obesity, alopecia, hirsutism, acne, infertility, anxiety, depression, and low self-esteem. In women with PCOS clinical and/or biochemical hyperandrogenism is common; its relationship with sexualfunction is, however, inconclusive. STUDY DESIGN, SIZE, DURATION: This observational prospective case control study with 135 women (68 PCOS, 67 control) was conductedfrom March 2017 until March 2020. PARTICIPANTS/MATERIALS, SETTING, METHODS: Heterosexual women with and without PCOS, aged 18-40 years, in a steady relationshipand without any comorbidities, underwent an extensive medical and endocrine screening using liquid chromatography-tandem mass spectrometry and validated sexual function questionnaires. MAIN RESULTS AND THE ROLE OF CHANCE: Women with PCOS reported significantly lower sexual function (Female Sexual Function Index (FSFI) P < 0.001, partial η2 = 0.104), higher levels of sexual distress (Female Sexual Distress Scale-Revised P < 0.001, partial η2 = 0.090), and they more often complied with the definition of sexual dysfunction (41.2% vs 11.9%, P < 0.001, Phi V = 0.331) and clinical sexual distress (51.5% vs 19.4%, P < 0.001, Phi V = 0.335). Regression analysis adjusted for confounders showed only few and weak associations between androgen levels and sexual function, with each model explaining a maximum of 15% sexual function. Following significant Group × Hormone interactions, analyses for both groups separately showed no significant associations in the PCOS group. The control group showed only weak negative associations between testosterone and FSFI pain (ß = -6.022, P = 0.044, Adj R2 = 0.050), between FAI and FSFI orgasm (ß = -3.360, P = 0.023, Adj R2 = 0.049) and between androstenedione and clinical sexual distress (ß = -7.293, P = 0.036, exp(ß) = 0.001). LIMITATIONS, REASONS FOR CAUTION: The focus of the study on sexual functioning potentially creates selection bias. Possibly women with more severe sexual disturbances did or did not choose to participate. Differences between women with PCOS and controls in relationship duration and hormonal contraceptive use might have skewed the sexual function outcomes. WIDER IMPLICATIONS OF THE FINDINGS: Sexual function is impaired in women with PCOS. However, endocrine perturbations seem to have minimal direct impact on sexual function. Addressing sexuality and offering psychosexual counseling is important in the clinical care for women with PCOS. STUDY FUNDING/COMPETING INTEREST(S): This study was funded by the departments of the participating centers: Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Erasmus University Medical Center, Rotterdam, the Netherlands; Department of Psychosomatic OBGYN and Sexology, Leiden University Medical Center, Leiden, the Netherlands; and Department of Sexology and Psychosomatic OBGYN, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands. J.S.E.L. received unrestricted research grants from the following companies (in alphabetical order): Ansh Labs, Ferring, Merck Serono and Roche Diagnostics. He also received consultancy fees from Ansh Labs, Ferring, Titus Healthcare and Roche Diagnostics. The other authors have no conflicts of interest. TRIAL REGISTRATION NUMBER: CCMO register, registration number: NL55484.078.16, 10 March 2016. https://www.toetsingonline.nl/to/ccmo_search.nsf/Searchform?OpenForm.

Understanding the Relationship between Illness Perceptions and Health Behaviour among Women with Polycystic Ovary Syndrome.

This paper aims to delineate the cognitive, emotional, and behavioural responses of women with polycystic ovary syndrome (PCOS) to their illness by applying the Common-Sense Model of Self-Regulation (CSM) to their health behaviour. An online cross-sectional design was used to examine the relationship between participants' illness perceptions (illness identity, consequence, timeline, control, and cause) and emotional representations of their PCOS, and their health behaviours (diet, physical activity, and risky contraceptive behaviour). The participants were 252 women between the ages of 18 and 45 years, living in Australia, and self-reporting a diagnosis of PCOS, recruited through social media. Participants completed an online questionnaire regarding illness perceptions as well as their diet, physical activity, and risky contraceptive behaviour. Illness identity was positively associated with the number of maladaptive dietary practices (B = 0.71, 95% CI: 0.003, 0.138; p = 0.04), and perception of longer illness duration was associated with reduced physical activity (OR = 0.898, 95% CI: 0.807, 0.999; p = 0.49) and risky contraceptive behaviour (OR = 0.856, 95% CI: 0.736, 0.997; p = 0.045). The limitations of the study include all data being self-reported (including PCOS diagnosis), and the potential for analyses of physical activity and risky contraceptive use being underpowered due to reduced sample sizes. The sample was also highly educated and restricted to those who use social media. These findings suggest that illness perceptions may play a role in influencing health behaviour in women with PCOS. A better understanding of the illness perceptions of women with PCOS is needed to increase health-promoting behaviour and improve health outcomes for women with PCOS.