Polycystic ovary syndrome.
Nature reviews. Disease primers
Despite affecting ~11-13% of women globally, polycystic ovary syndrome (PCOS) is a substantially understudied condition. PCOS, possibly extending to men's health, imposes a considerable health and economic burden worldwide. Diagnosis in adults follows the International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome, requiring two out of three criteria - clinical or biochemical hyperandrogenism, ovulatory dysfunction, and/or specific ovarian morphological characteristics or elevated anti-Müllerian hormone. However, diagnosing adolescents omits ovarian morphology and anti-Müllerian hormone considerations. PCOS, marked by insulin resistance and hyperandrogenism, strongly contributes to early-onset type 2 diabetes, with increased odds for cardiovascular diseases. Reproduction-related implications include irregular menstrual cycles, anovulatory infertility, heightened risks of pregnancy complications and endometrial cancer. Beyond physiological manifestations, PCOS is associated with anxiety, depression, eating disorders, psychosexual dysfunction and negative body image, collectively contributing to diminished health-related quality of life in patients. Despite its high prevalence persisting into menopause, diagnosing PCOS often involves extended timelines and multiple health-care visits. Treatment remains ad hoc owing to limited understanding of underlying mechanisms, highlighting the need for research delineating the aetiology and pathophysiology of the syndrome. Identifying factors contributing to PCOS will pave the way for personalized medicine approaches. Additionally, exploring novel biomarkers, refining diagnostic criteria and advancing treatment modalities will be crucial in enhancing the precision and efficacy of interventions that will positively impact the lives of patients.
10.1038/s41572-024-00511-3
What can be done to improve polycystic ovary syndrome (PCOS) healthcare? Insights from semi-structured interviews with women in Canada.
BMC women's health
BACKGROUND:Polycystic ovary syndrome (PCOS) is a common and perplexing condition affecting metabolic, reproductive, cardiovascular, and psychological health in women. Previous studies point to widespread dissatisfaction and frustration in women with the information and care they receive. Studies have found delays with the diagnosis of PCOS and gaps in knowledge in physicians regarding the diagnosis and management of PCOS. Little has been heard from women on what they think can be improved with PCOS care, especially in Canada. This qualitative study explores women's experiences navigating the healthcare system and their insights on what could be improved based on their lived experiences. METHODS:Twenty-five participants were interviewed remotely over the phone by the first author between October and December 2018.Interviews were semi-structured and in-depth. Data were analyzed using thematic analysis and interpretive description methodology. RESULTS:Twenty-five in-depth interviews conducted with participants across Canada (ages 18-63) revealed three overall areas in need of improvement. First, women emphasized a need for greater knowledge and awareness of PCOS in primary care physicians (PCPs) as well as the need for the medical community to prioritize women's health. Second, participants advocated for greater PCOS awareness and de-stigmatization in the general community and in women and girls, and any individuals with female reproductive systems. Third, participants brought up several needed resources, such as the need for more PCOS research to be funded and undertaken, more PCOS specialists and experts to be available, credible doctor-provided information (e.g., pamphlets, websites), and age-specific support groups and mental health supports to be available. Participants were generally unaware of existing PCOS organizations and brought up the need for established PCOS organizations to aid in the training and retraining of doctors and local awareness-building in communities. CONCLUSIONS:Participants believed that PCPs in Canada needed to be well-versed on how to diagnose and manage PCOS to prevent delays in diagnosis and provide easier access to care. Further, greater awareness and de-stigmatization in the general community are needed so women can identify symptoms early and have access to support from those around them. Overall, PCOS may be an overlooked and under-prioritized condition, both in the Canadian healthcare system and general community.
10.1186/s12905-022-01734-w
Awareness and opinion about polycystic ovarian syndrome (PCOS) among young women: a developing country perspective.
Jena Saubhagya Kumar,Mishra Lipsa,Naik Sushree Samiksha,Khan Shahnawaz
International journal of adolescent medicine and health
OBJECTIVE:To explore the perception on PCOS and its prevalence among adolescent and young women. METHODS:The study was conducted over 2 year period in a tertiary care teaching hospital from Eastern India. A pre-formed, validated questionnaire was used to record the details. Descriptive statistics was used to report the findings. RESULTS:Of 965 young patients with mean (SD) age 20.64 (2.1) years, 27 (2.79 %) were aware of an entity called PCOS. Awareness among adolescents with PCOS was 25.9 % (7/27). All aware patients belonged to the urban sector with professionals constituting around 48%, of which 11% were students. The major source of information among aware patients was from doctors (40.7%), and friends and Internet (25.9%); rest being from books, newspapers, and teachers. Majority (70%) were aware that diet restriction and exercise were the primary modalities of treatment, whereas, only 3.7% knew about the role of contraceptive pills in PCOS. CONCLUSIONS:Awareness regarding PCOS among the young women is very low mainly in the rural set up. Doctors and health staffs should play a major role in spreading awareness of the entity to prevent long term complications.
10.1515/ijamh-2018-0166
Incidence, prevalence, and trends in polycystic ovary syndrome diagnosis: a United States population-based study from 2006 to 2019.
American journal of obstetrics and gynecology
BACKGROUND:Polycystic ovary syndrome is the most common endocrine disorder in women of reproductive age, yet US incidence estimates do not exist, and prevalence estimates vary widely. OBJECTIVE:A population-based US study estimated the incidence, prevalence, and trends of polycystic ovary syndrome by age, race and ethnicity, and diagnosing provider type. STUDY DESIGN:A retrospective cohort study of patients enrolled in Kaiser Permanente Washington from 2006 to 2019 was conducted. All members identified as female, aged 16 to 40 years with at least 3 years of enrollment and at least 1 healthcare encounter during that time, were eligible for inclusion. Individuals were excluded if they had a history of oophorectomy or hysterectomy. Polycystic ovary syndrome cases were identified using the International Classification of Diseases diagnosis codes (International Classification of Diseases, Ninth Revision, 256.4 or International Classification of Diseases, Tenth Revision, E28.2). Individuals with a polycystic ovary syndrome diagnosis before study entry were excluded from incidence rate estimations. The incidence rates were adjusted by age using direct standardization to the 2010 US census data. Temporal trends in incidence were assessed using weighted linear regression (overall) and Poisson regression (by age, race and ethnicity, and provider type). Prevalent cases were defined as patients with a polycystic ovary syndrome diagnosis at any time before the end of 2019. Medical record review of 700 incident cases diagnosed in 2011-2019 was performed to validate incident cases identified by International Classification of Diseases codes using the Rotterdam criteria. RESULTS:Among 177,527 eligible patients who contributed 586,470 person-years, 2491 incident polycystic ovary syndrome cases were identified. The mean age at diagnosis was 26.9 years, and the mean body mass index was 31.6 kg/m. Overall incidence was 42.5 per 10,000 person-years; the rates were similar over time but increased in individuals aged 16 to 20 years from 31.0 to 51.9 per 10,000 person-years (P=.01) and decreased among those aged 26 to 30 years from 82.8 to 45.0 per 10,000 person-years (P=.02). A small decreasing temporal trend in incidence rates was only observed among non-Hispanic White individuals (P=.01). The incidence rates by diagnosing provider type varied little over time. Among the 58,241 patients who contributed person-time in 2019, 3036 (5.2%) had a polycystic ovary syndrome International Classification of Diseases diagnosis code; the prevalence was the highest among the Hawaiian and Pacific Islander group (7.6%) followed by Native American and Hispanic groups. Medical record review classified 60% as definite or probable incident, 14% as possible incident, and 17% as prevalent polycystic ovary syndrome. The overall positive predictive value of polycystic ovary syndrome International Classification of Diseases diagnosis code for identifying definite, probable, or possible incident polycystic ovary syndrome was 76% (95% confidence interval, 72%-79%). CONCLUSION:Among a cohort of nonselected females in the United States, we observed stable rates of incident polycystic ovary syndrome diagnoses over time. The incidence of polycystic ovary syndrome was 4- to 5-fold greater than reported for the United Kingdom. The prevalence of polycystic ovary syndrome (5.2%) was almost double before the published US estimates (2.9%) based on the International Classification of Diseases codes. Race and ethnicity and provider type did not seem to have a major impact on temporal rates. Incident diagnoses increased over time in younger and decreased in older age groups, perhaps related to shifting practice patterns with greater awareness among practitioners of the impact of polycystic ovary syndrome on long-term health outcomes and improved prevention efforts. Moreover, increasing obesity rates may be a factor driving the earlier ages at diagnosis.
10.1016/j.ajog.2023.04.010
The benefits and harms of receiving a polycystic ovary syndrome diagnosis: a qualitative study of women's experiences.
Human reproduction open
STUDY QUESTION:What are the benefits and harms of receiving a polycystic ovary syndrome (PCOS) diagnosis in a community sample of women, including impact on psychosocial wellbeing, lifestyle choices and behaviour? SUMMARY ANSWER:Although some women benefit considerably from the diagnosis, such as through increased awareness and reassurance, women with minimal symptoms may experience more harm than benefit, including long-lasting anxiety and altered life plans. WHAT IS KNOWN ALREADY:Disease labels can validate symptoms and play a vital role in understanding and coping with illness; however, they can also cause harm by evoking illness schemas about severity and permanence. Regarding PCOS, the diagnostic criteria have expanded over time to include women with milder phenotypes (such as those without signs of androgen excess). This has occurred despite limited investigation of the benefits and harms of the diagnosis and has increased the number of women diagnosed. STUDY DESIGN SIZE DURATION:Semi-structured interviews were conducted face-to-face or by telephone with 26 participants from April-July 2018 to explore women's experiences with the diagnosis, including the benefits and harms of receiving the diagnosis and the impact on their life. PARTICIPANTS/MATERIALS SETTING METHODS:In total, 26 women in the community self-reporting a diagnosis of PCOS (reporting mild to severe symptoms) made by a medical doctor, aged 18-45 years and living in Australia were recruited through social media. Data were analysed thematically using Framework analysis. MAIN RESULTS AND THE ROLE OF CHANCE:The study identified a range of both positive and negative effects of a PCOS diagnosis in the immediate, short and long-term, which were influenced by symptom severity, expectations and experience. For women with previously unexplained and bothersome symptoms, it was a relief to receive a diagnosis, and this resulted in an increased understanding about the importance of a healthy lifestyle. By contrast, women with milder symptoms often reported feeling shocked and overwhelmed by the diagnosis, consequently experiencing anxiety about the associated long-term risks. The majority of women, regardless of symptom severity, experienced prolonged worry and anxiety about infertility, resulting for some in risk taking with contraception, unintended pregnancies, pressure to conceive early or altered life plans. With time, many women developed positive coping strategies and perceived the diagnosis to be valuable, including those who felt they had experienced minimal benefit or even harm. LIMITATIONS REASONS FOR CAUTION:PCOS diagnosis was self-reported and the sample was highly educated. WIDER IMPLICATIONS OF THE FINDINGS:Fear of infertility was salient for many women, underscoring the need for accurate information, counselling and reassurance of fertility potential. Given the risk of significant consequences, health professionals should use a tailored approach to PCOS diagnosis to increase the benefits of appropriate and timely diagnosis for women affected by significant symptoms, while reducing the harms of unnecessarily labelling healthy women for whom the benefits of a diagnosis are small. STUDY FUNDING/COMPETING INTERESTS:The study was funded by the University of Sydney Lifespan Research Network and an NHMRC Program Grant (APP1113532). B.W.M. reports consultancy for ObsEva, Merck, Merck KGaA and Guerbet. No further competing interests exist. TRIAL REGISTRATION NUMBER:N/A.
10.1093/hropen/hoz026
Factors affecting the adoption of health-promoting behaviours in patients with polycystic ovary syndrome: a cross-sectional study.
BMJ open
OBJECTIVE:This study aimed to investigate health-promoting lifestyle status and associated risk factors in patients with polycystic ovary syndrome (PCOS). DESIGN:Cross-sectional study. SETTING:This study was conducted at a tertiary hospital in Guizhou, China from December 2020 to June 2021. PARTICIPANTS:A total of 366 participants (18-45 years) diagnosed with PCOS were recruited from the outpatient departments. MEASURES:Sociodemographic characteristics were collected, and health-promoting behaviours were measured using the Health-Promoting Lifestyle Profile scale. Anxiety status was measured using the Zung's Self-Rating Anxiety Scale, depression status using the Zung's Self-Rating Depression Scale and self-efficacy using the Managing Chronic Disease 6-Item Scale. Multiple stepwise linear regression was conducted to assess the risk factors associated with the health-promoting behaviours of the study participants. RESULTS:The participants had a poor health-promoting behaviours (88.54±17.44). The highest score in all dimensions was spiritual growth (16.68±4.98), while physical activity (12.71±2.68) was the lowest. Multiple regression analysis revealed that the main factors influencing the development and maintenance of health-promoting behaviours among participants were education (B=10.788, p<0.001), depression (B=-0.377, p<0.001), anxiety (B=-0.333, p<0.001) and self-efficacy (B=0.938, p=0.002). The model showed 74.40% variance shared between the dependent and independent variables (R=74.40, F=264.633, p<0.001). CONCLUSION:Health-promoting behaviours are minimal among patients with PCOS, and improving negative emotions and enhancing behavioural awareness and self-efficacy are necessary to increase the adoption of health-promoting behaviours among patients with PCOS. TRIAL REGISTRATION NUMBER:ChiCTR2000034572.
10.1136/bmjopen-2021-056478
Enhancing polycystic ovarian syndrome awareness using private social network.
Alotaibi Mohammed,Shaman Amani Ali
mHealth
Background:The purpose of the study is to evaluate the effectiveness of mobile health technology such as private social network (PCOS system) in creating awareness about the disease management among the women diagnosed with the polycystic ovarian syndrome. Methods:A pilot study was conducted in Tabuk, Saudi Arabia. The study was carried out for a period of three months using a private social network as an intervention. The private social network is used as an interface to educate and create awareness among the participants in the study. Fifty women diagnosed with PCOS were randomly selected and were distributed in to control group (doesn't use PCOS system) and intervention group (use the private social network). The level of the polycystic ovarian syndrome awareness was measured using a structured questionnaire at the beginning and end of the follow-up period. Results:More than 80 posts and 10 pictures contain data about PCOS were conveyed by medical staff. Also, about 120 private SMS messages between medical staff and the patients were refined. The after effects of this investigation demonstrated that the intervention had better awareness about polycystic ovary syndrome management compared to the control group (F =18.25; P<0.0001). Conclusions:This study of the private social network among the PCOS patients demonstrated that mobile health technology such as the private social network can substantially enhance the PCOS disease awareness levels among Saudi women. The PCOS System can also help in reducing the costs as most of the disease management process is handled over the application through the messages and feedbacks is provided through the application, and in saving time by avoiding hospital visits. This study is first-of-its kind conducted in Saudi Arabia.
10.21037/mhealth.2019.12.02
Prevalence of metabolic disturbances among women with polycystic ovary syndrome in different regions of Brazil.
Maffazioli Giovana D N,Lopes Caroline P,Heinrich-Oliveira Vanessa,Lobo Rogerio A,Hayashida Sylvia A Y,Soares José Maria,Maciel Gustavo A R,Baracat Edmund C
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics
OBJECTIVE:To describe the prevalence of metabolic disturbances in a large cohort of women with polycystic ovary syndrome (PCOS) in southeastern Brazil and to compare the findings with other cohorts of Brazilian women with PCOS. METHODS:A retrospective study analyzing clinical and laboratory data of 462 women with PCOS treated at an outpatient clinic in a tertiary hospital in southeastern Brazil. Prevalence of insulin resistance, glucose intolerance, type 2 diabetes, dyslipidemia, central obesity, hypertension, and metabolic syndrome was compared to that of other cohorts of age and body mass index-matched Brazilian women with PCOS. RESULTS:Women with PCOS had a median age of 25.0 (21.0-29.0) years and BMI of 28.7 (23.9-34.0) kg/m . Prevalence of insulin resistance, glucose intolerance, and type 2 diabetes varied from 39.6% to 55.0%, 7.2% to 28.1%, and 2.0% to 4.1%, respectively. Prevalence of central obesity, dyslipidemia due to decreased high-density lipoprotein cholesterol, hypertriglyceridemia, and metabolic syndrome ranged from 57.8% to 66.4%, 54.1% to 70.4%, 22.9% to 35.1%, and 27.4% to 38.3%, respectively, which did not differ among regions in Brazil. CONCLUSION:Prevalence of metabolic disturbances was high among Brazilian women with PCOS. This study suggests that, from a public health perspective, authorities in Brazil should be aware of and encourage screening for metabolic dysfunction in women with PCOS in all regions of the country.
10.1002/ijgo.13374
Current Awareness Status of and Recommendations for Polycystic Ovarian Syndrome: A National Cross-Sectional Investigation of Central Jordan.
International journal of environmental research and public health
Polycystic ovary syndrome (PCOS) is a common reproductive disorder that is related to a number of health issues and has an influence on a variety of metabolic processes. Despite its burden on the health of females, PCOS is significantly underdiagnosed, which is associated with lack of disease knowledge among females. Therefore, we aimed to gauge the awareness of PCOS in both the male and female population in Jordan. A descriptive cross-sectional study was conducted, targeting individuals over the age of 18 from Jordan's central region. Participants were recruited through stratified random sampling. The questionnaire consisted of two domains, including demographics and knowledge of PCOS domains. A total of 1532 respondents participated in this study. The findings revealed that participants have overall adequate knowledge regarding PCOS's risk factors, etiology, clinical presentation, and outcomes. However, participants demonstrated subpar familiarity of the association between PCOS and other comorbidities and the effect of genetics on PCOS. Women had more knowledge than men about PCOS (57.5 ± 6.06 vs. 54.1 ± 6.71, = 0.019). In addition, older, employed, and higher-income populations showed significantly better knowledge than younger, unemployed, self-employed, and lower-income populations. In conclusion, we demonstrated that Jordanian women demonstrate an acceptable yet incomplete level of knowledge towards PCOS. We recommend establishing educational programs by specialists for the general population as well as medical personnel to spread accurate medical information and clarify common misconceptions about signs, symptoms, management, and treatment of PCOS, and nutritional knowledge.
10.3390/ijerph20054018
The Experience of Living With Polycystic Ovary Syndrome in the Military.
Military medicine
INTRODUCTION:Polycystic ovary syndrome (PCOS) is the most prevalent reproductive endocrinopathy in women, ranging from 5% to 26% depending on diagnostic criteria applied. Common manifestations of PCOS include overweight and obesity, abnormal menstrual cycles, pelvic pain, increased facial and body hair, acne, and infertility. These abnormalities and associated complications have significant military operational and readiness implications. There is a large gap in research regarding active duty servicewomen (ADW) with PCOS. Therefore, the purpose of this study is to describe ADW's experience of living with PCOS and to describe the service-branch-specific differences among these women. MATERIALS AND METHODS:Moderator's guide, audiotapes, transcripts, and field notes. This was a qualitative descriptive study using focus groups and individual interviews. The David Grant Medical Center Institutional Review Board at Travis AFB, CA, USA, approved the study protocol. Women with PCOS were recruited from U.S. Air Force, Army, and Navy locations. Data were analyzed using constant comparative content analysis. RESULTS:Twenty-three servicewomen from 19 occupations across the Army, Navy, Air Force, and Marine Corps participated. Three overarching categories emerged: (1) challenges managing PCOS symptoms, (2) navigating the military health care system, and (3) navigating PCOS as a service member. CONCLUSIONS:Servicewomen may have significant career consequences related to PCOS sequelae, such as overweight, obesity, uncontrolled menstrual cycle, and pain. Managing the myriad of symptoms can distract women while deployed, in austere conditions, or at their home stations. As one of the most common cardiometabolic, reproductive endocrinologic conditions in women, PCOS has not received the attention, awareness, education, or research necessary to sufficiently support ADW with this condition. It is imperative that evidence-based strategies are developed to inform relevant and high-quality care for these warfighters. Future qualitative studies are needed to further describe specific stressors and needs of ADW with PCOS. Future intervention studies are also needed to evaluate effective management options for ADW with PCOS.
10.1093/milmed/usad241
Cardiometabolic Risk in Polycystic Ovary Syndrome: Current Guidelines.
Cooney Laura G,Dokras Anuja
Endocrinology and metabolism clinics of North America
Polycystic ovary syndrome is a common endocrine disorder in reproductive-aged women and is associated with an increased risk of metabolic abnormalities, including obesity, impaired glucose tolerance, diabetes, dyslipidemia, metabolic syndrome, venous thromboembolism, and subclinical atherosclerosis. Clinicians and patients alike need to be aware of these increased risks as well as new international guidelines that recommend frequent screening and active management of metabolic abnormalities. Given that the data on risk of cardiovascular events, such as myocardial infarction and stroke, in women with PCOS is mixed, future large-scale, longitudinal studies are needed to clarify these potential risks.
10.1016/j.ecl.2020.11.001
Exploration of Lifestyle Choices, Reproductive Health Knowledge, and Polycystic Ovary Syndrome (PCOS) Awareness Among Female Emirati University Students.
Pramodh Sreepoorna
International journal of women's health
Objective:Healthy lifestyle and adequate reproductive health knowledge are prerequisites for maintenance of physical and mental well-being of women across the world. With increasing prevalence of metabolic disorders such as polycystic ovary syndrome (PCOS), it is important that sufficient awareness of these issues is generated, especially in conservative communities in Arab regions. The main objective of this study is to assess reproductive health (RH) knowledge and awareness of PCOS among female Emirati students and also to explore their lifestyle choices. Materials and Methods:A total of 493 Emirati students were recruited based on convenience sampling and completed a survey containing questions related to demography, lifestyle preferences, RH knowledge, and PCOS awareness. Results:Of the students, 13% self-reported being diagnosed with PCOS, with 3.5% also taking medication for the same, 6% reported having high androgen levels, 30.7% reported polymenorrhea, and 3.5% reported oligomenorrhea for frequency of menstrual cycle. Also, 12.4% students experienced abnormal bleeding (heavy/none) during menstruation and 24% reported excessive body hair. It was found that 4.3% of students were taking medication for hyperglycemia and 75% of students reported a family history of diabetes. Students displayed low reproductive health knowledge and poor awareness of PCOS. Lifestyle preferences indicated low physical activity and high indulgence in fast food. Conclusion:Lifestyle choices adopted by Emirati University students may predispose them to disorders such as PCOS. Early detection and management of PCOS coupled with a dynamic awareness campaign for RH can help in improving fertility rates of Emirati women. The study identifies major gaps in knowledge and awareness of RH and PCOS in Emirati women that need to be addressed by creating a culturally congruent heathcare policy with emphasis on education and health promotion. Mandatory PA programs and increasing availability of healthy eating options in campus should be considered by all universities, particularly in Arab regions, for improving lifestyle and preventing metabolic disorders in young students.
10.2147/IJWH.S272867
Sexual function in women with polycystic ovary syndrome: a systematic review and meta-analysis.
Human reproduction update
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).
10.1093/humupd/dmad034
Prevalence and knowledge of polycystic ovary syndrome (PCOS) and health-related practices among women of Syria: a cross-sectional study.
Journal of psychosomatic obstetrics and gynaecology
Polycystic Ovarian Syndrome (PCOS) is a prevalent metabolic and hormonal disorder affecting women of reproductive age. Limited data exists on Syrian women's PCOS awareness and health behaviors. This study aimed to gauge PCOS prevalence, knowledge, awareness, and health-related practices among Syrian women. A cross-sectional online survey was conducted from 11 February to 27 October 2022, targeting Syrian women aged 18-45. Collaborators from specific medical universities distributed a questionnaire adapted from a Malaysian paper through social media platforms. Out of 1840 surveyed Syrian women, 64.2% were aged 21-29, and 69.6% held bachelor's degrees. Those with a bachelor's degree exhibited the highest mean knowledge score (12.86), and women previously diagnosed with PCOS had a higher mean knowledge score (13.74) than those without. Approximately 27.4% were confirmed PCOS cases, and 38.9% had possible cases. Women with PCOS were 3.41 times more likely to possess knowledge about the condition. The findings suggest a moderate level of PCOS knowledge and health-related practices among Syrian women, emphasizing the need for increased awareness. Consistent local PCOS screening programs, in collaboration with obstetrics and gynecology professionals, are crucial for improving understanding and clinical symptom recognition of this condition among Syrian women.
10.1080/0167482X.2024.2318194
Does polycystic ovary syndrome with phenotype D affect the cardiovascular endurance, core endurance, body awareness, and the quality of life? A prospective, controlled study
Doğan Hanife,Demir Çaltekin Melike
Turkish journal of obstetrics and gynecology
Objective:This study evaluates cardiovascular endurance, core endurance, body awareness, and the quality of life in normal-weight women with polycystic ovary syndrome. Materials and Methods:This study included a total of 101 normal-weight women (51 with and 50 without polycystic ovary syndrome). Cardiovascular endurance was evaluated with the 20-meter Shuttle Run test, and maximum oxygen consumption was calculated. Core endurance was evaluated with core stability tests, body awareness with the body awareness questionnaire, and the quality of life with short form-36. Blood lipids, glucose, insulin, homeostatic model assessment for insulin resistance (HOMA-IR), hormonal profile, and high-density and low-density lipoprotein cholesterols were measured. Results:Maximum oxygen consumption, core endurance, body awareness questionnaire, and short form-36 results were lower in women with polycystic ovary syndrome than healthy women (p<0.05). There was a significant correlation between core endurance tests, high-density lipoprotein cholesterol, maximum oxygen consumption, and homeostatic model assessment for insulin resistance scores (p<0.05). Conclusion:When normal-weight women with polycystic ovary syndrome and control groups with similar androgen levels and body mass index profiles were compared, women with polycystic ovary syndrome had lower aerobic capacity and muscle endurance. This suggests that the adverse metabolic profile of polycystic ovary syndrome can limit physical function.
10.4274/tjod.galenos.2021.72547
Knowledge and attitudes towards polycystic ovary syndrome.
African journal of reproductive health
Polycystic ovary syndrome (PCOS) is a complex condition affecting about 5% to 7% of women in their reproductive years. Adequate knowledge and a right attitude play an important role in the management of the disease and in the prevention of complications. This study aimed to assess the knowledge and attitude of women towards PCOS. A questionnaire-based cross-sectional study was conducted in women aged 18-75 years old at the outpatient department of Jordan University Hospital. The questionnaire consisted of three main parts: the respondents' sociodemographic variables, knowledge of PCOS, and attitude towards PCOS. There was a total of 400 participants, data was analyzed using SPSS version 23, 89% of the 400 participants were aware of the term PCOS. Most of the participants have adequate knowledge and positive attitude towards the disease. However, most of them lack knowledge on its complications. The level of education and occupation were found to have a positive association with knowledge and attitude towards the disease. Meanwhile, marital status and age were only found to have a positive association towards knowledge. Doctors were found to be the most preferred source of knowledge for further information about PCOS.
10.29063/ajrh2022/v26i1.10
Remote assessment and reinforcement of patient awareness of role of lifestyle modification and treatment adherence in polycystic ovary syndrome using an online video based educational module
Gour Aniket,Dubey Pankhuri,Goel Archana,Halder Ajay
Journal of the Turkish German Gynecological Association
Objective:To evaluate the role of an online, video-based, structured, educational module in increasing awareness in women with polycystic ovary syndrome (PCOS). Material and Methods:Patients with PCOS were assessed for baseline awareness about PCOS, quantified as “awareness score”, using a validated questionnaire. Topics assessed included factual and conceptual knowledge of the disease and awareness of behaviour-related lifestyle modification and therapy compliance in PCOS. An educational video module was shown to the participants which covered normal menstrual physiology, symptomatology, pathophysiology and natural history of PCOS, a comparative animation of healthy versus unhealthy lifestyle, indications of pharmacological intervention, and role of treatment adherence. The questionnaire was re-administered after exposure to the educational module, and effectiveness of the teaching method was evaluated by comparing pre and post test scores. Results:The total number of subjects was 41. Baseline knowledge was “fair” in 17.1%, “moderate” in 48.8% and “good” in 34.1%. Significant increase in awareness scores was noted among participants regarding PCOS after exposure to the learning module from 15.09±4.31 to 18.60±3.85 (p<0.00001) with a large effect size (Cohen’s d=0.85). Most (48.8%) of the respondents had baseline awareness in the “moderate” range (scores between; 11-17) whereas post intervention scores improved to the “good” category for 63.4% of the women. Conclusion:The educational module was effective in significantly increasing knowledge about PCOS. Patient education is likely to help reinforce the message about lifestyle modification and continued compliance and may aid in promoting a patient-driven healthcare model in PCOS.
10.4274/jtgga.galenos.2021.2021-9-29
Awareness of Lifestyle Modifications in the Management of Polycystic Ovarian Syndrome: A Hospital-Based Descriptive Cross-Sectional Study.
Cureus
OBJECTIVE:Polycystic ovarian syndrome (PCOS) is a prevalent endocrinological disorder in reproductive-age women. Due to varied presentations, it's often difficult to diagnose and manage women with PCOS. Management usually focuses on treating the symptoms and preventing long-term sequelae of the disease. This study was planned to assess the knowledge among reproductive-age women (15-44 years) regarding the risk factors, symptoms, complications, and management of PCOS. MATERIAL AND METHODS:This is a hospital-based descriptive cross-sectional study. A pre-validated well-structured questionnaire which included basic demographic data, menstrual history, knowledge about PCOS symptoms, risk factors, complications, prevention, and treatment, was administered. Completed questionnaires were analyzed to calculate the knowledge score of the participants and its association with their education level and occupation was seen. RESULTS:A total of 350 women participated but only 334 completed questionnaires were included for final evaluation. The mean age of the study population was 28.70±6.29 years. Around 9.3% of the participants were already diagnosed with PCOS. Most of the women (43.4%) had heard about PCOS. The source of information was doctors (26.6%), the internet (6.28%), teachers (5.6%), and friends (4.7%). Obesity (33.5%), unhealthy dietary habits (35%), and genetic predisposition (40.7%) were thought as risk factors for PCOS. Most of the participants were aware that subfertility (40.1%), abortions (34.4%), diabetes (28.7%), hypertension (31.7%), cardiovascular disease (33.5%), endometrial carcinoma (35.9%), and psychological disturbances (37.1%) are among the known PCOS related complications. Eating a healthy diet (37.1%) and weight reduction (41%) can help in the management of PCOS. Around 60.5% of women showed poor knowledge, 14.7% fair knowledge, and 24.9% good knowledge regarding PCOS. Education level and occupation status were found to be significantly related to the knowledge score (P≤0.001). CONCLUSION:PCOS is a prevalent condition with varied presentations which significantly affects one's quality of life. Since there is no definitive treatment for PCOS the management generally aims at managing symptoms and reducing the risk of long-term complications. To reduce the burden of PCOS-related long-term complications behavioral changes in terms of regular exercise and healthy dietary habits need to be incorporated from childhood.
10.7759/cureus.36889
Do Health Literacy and Awareness of Polycystic Ovary Syndrome Predict the Lifestyle Choices of Arabic-Speaking Female University Students.
Iranian journal of nursing and midwifery research
Background:Considering the increasing prevalence of Polycystic Ovarian Syndrome (PCOS) and its related complications-such as obesity, cardiovascular diseases, and infertility-in the Middle East, it is imperative to create sufficient public awareness about this issue. Accordingly, the potential link between PCOS awareness and health literacy level with the lifestyle choices of Arabic-speaking female university students was examined in this cross-sectional study. Materials and Methods:This research was conducted in the Sultanate of Oman and involved 446 Arabic-speaking female university students, who completed a self-administered online questionnaire, Single Item Literacy Screener, and PCOS Awareness Tool. Results:The findings showed that, while 53.50% of the study participants had inadequate health literacy, 79.80% demonstrated an acceptable level of PCOS awareness. However, this did not seem to influence their lifestyle, given that 59.20% of the respondents were physically inactive and 83.30% regularly consumed fast food. Regression analysis results nonetheless revealed that health literacy and PCOS awareness were significant predictors of lifestyle choices (F = 5.98, < 0.05, 95% CI [4.44-5.35]). Conclusions:The Arabic-speaking female university students' health literacy level and PCOS awareness are significant predictors of their lifestyle choices. Thus, the policymakers in the Arab region need to develop effective strategies aimed at PCOS prevention, focusing specifically on raising public awareness about PCOS and its negative consequences on female reproductive health. In addition, university administrators should ensure the availability of healthy food choices at their campuses as well as opportunities for physical activity to promote healthy lifestyle among all students.
10.4103/ijnmr.ijnmr_355_22
Bridging the Gap: Integrating Awareness of Polycystic Ovary Syndrome Into Mental Health Practice.
Focus (American Psychiatric Publishing)
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among women of reproductive age. Individuals with PCOS report reduced quality of life compared with those without PCOS, with possible contributing factors including infertility, hirsutism, irregular menses, and weight gain. Recent literature also supports increased associations between PCOS and co-occurring psychiatric conditions, particularly depression, anxiety, bipolar disorder, and eating disorders. It is concerning that a higher prevalence of suicidal ideation has been observed in individuals with PCOS. Given the high rates of psychiatric burden among those with PCOS, psychiatric care providers are well suited to be on the front lines of screening for psychiatric symptoms as well as initiating treatment. Current interventions include lifestyle changes (improving exercise and nutrition), pharmacological treatments (e.g., insulin-sensitizing agents, oral contraceptives, and psychotropic drugs), and psychotherapeutic interventions (e.g., cognitive-behavioral therapy and mindfulness-based therapy). This review provides an overview of recent research on the prevalence of comorbid psychiatric conditions, a foundation in PCOS-specific symptom screening and diagnosis, and an overview of treatments for psychiatric symptoms among individuals with PCOS.
10.1176/appi.focus.20230024
Polycystic ovary syndrome: An exploration of unmarried women's knowledge and attitudes.
Heliyon
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.
10.1016/j.heliyon.2022.e09835
Awareness of Polycystic Ovary Syndrome among Schoolgirls and Their Mothers: A Cross-Sectional Study.
International journal of fertility & sterility
BACKGROUND:One of the most common endocrine disorders of reproductive age women is polycystic ovary syndrome (PCOS). Women with PCOS are at risk for infertility, endometrial cancer, metabolic disorders, and cardiovascular disease. Awareness of the signs and symptoms of PCOS can be effective in diagnosing early stage PCOS and promoting quality of life (QoL). This study assesses the awareness of PCOS in schoolgirls and their mothers. MATERIALS AND METHODS:This cross-sectional study was carried out on 1580 high school girls and 480 of their mothers in Tehran (capital of Iran) in 2017 and 2018. We used the stratified sampling method and divided Tehran into five geographic regions: north, south, east, west, and central. Schools were randomly selected from each of these regions. Students and their mothers separately answered a self-administered questionnaire that pertained to their knowledge of PCOS. Statistical analyses were carried out with SPSS, version 22 (Inc. Chicago, IL, USA) and R version 3.2.1. RESULTS:Students had an average age of 16.97 ± 0.84 years and their mothers' average age was 45.19 ± 5.03 years. The average body mass index (BMI) of the students was 22.01 ± 5.54 kg/m2. The results of this study showed that only 48 students (3.2%) and 148 mothers (27%) had acceptable knowledge about PCOS. The knowledge of students about PCOS was positively related to their mothers' knowledge about PCOS (P<0.001). CONCLUSION:The level of PCOS awareness in Iranian women is insufficient and this may affect their QoL. Therefore, the health authorities should implement educational programs to challenge women's incorrect beliefs about PCOS and increase their awareness of this disease.
10.22074/ijfs.2023.543119.1224
Awareness of polycystic ovary syndrome among obstetrician-gynecologists and endocrinologists in Northern Europe.
PloS one
OBJECTIVE:To date, little is known about differences in the knowledge, diagnosis making and treatment strategies of health care providers regarding polycystic ovary syndrome (PCOS) across different disciplines in countries with similar health care systems. To inform guideline translation, we aimed to study physician reported awareness, diagnosis and management of PCOS and to explore differences between medical disciplines in the Nordic countries and Estonia. METHODS:This cross-sectional survey was conducted among 382 endocrinologists and obstetrician-gynaecologists in the Nordic countries and Estonia in 2015-2016. Of the participating physicians, 43% resided in Finland, 18% in Denmark, 16% in Norway, 13% in Estonia, and 10% in Sweden or Iceland, and 75% were obstetrician-gynaecologists. Multivariable logistic regression models were run to identify health care provider characteristics for awareness, diagnosis and treatment of PCOS. RESULTS:Clinical features, lifestyle management and comorbidity were commonly recognized in women with PCOS, while impairment in psychosocial wellbeing was not well acknowledged. Over two-thirds of the physicians used the Rotterdam diagnostic criteria for PCOS. Medical endocrinologists more often recommended lifestyle management (OR = 3.6, CI 1.6-8.1) or metformin (OR = 5.0, CI 2.5-10.2), but less frequently OCP (OR = 0.5, CI 0.2-0.9) for non-fertility concerns than general obstetrician-gynaecologists. The physicians aged <35 years were 2.2 times (95% CI 1.1-4.3) more likely than older physicians to recommend lifestyle management for patients with PCOS for fertility concerns. Physicians aged 46-55 years were less likely to recommend oral contraceptive pills (OCP) for patients with PCOS than physicians aged >56 (adjusted odds ratio (OR) = 0.4, 95% CI 0.2-0.8). CONCLUSION:Despite well-organized healthcare, awareness, diagnosis and management of PCOS is suboptimal, especially in relation to psychosocial comorbidities, among physicians in the Nordic countries and Estonia. Physicians need more education on PCOS and evidence-based information on Rotterdam diagnostic criteria, psychosocial features and treatment of PCOS, with the recently published international PCOS guideline well needed and welcomed.
10.1371/journal.pone.0226074
Awareness of polycystic ovary syndrome: A university students' perspective.
Annals of medicine and surgery (2012)
BACKGROUND:Polycystic ovary syndrome is the most common endocrine disorder in women of reproductive age. Women with this syndrome may have infrequent menstrual periods or amenorrhea and excess androgen levels. The ovaries develop numerous small follicles and fail to ovulate on a regular basis, with subsequent subfertility in those women that wish to conceive.The etiology of polycystic ovary syndrome is unclear. Early diagnosis and treatment may reduce the risk of long-term complications such as type 2 diabetes and heart disease. OBJECTIVES:To assess the knowledge and attitude of university students towards polycystic ovary syndrome at two universities in the north of Jordan. METHOD:ology: This is a cross-sectional online survey that polled female students at two universities in the north of Jordan. The main outcome measures included average polycystic ovary syndrome awareness score, predictors of high awareness scores, and sources of information. RESULTS:Formal diagnosis of polycystic ovary syndrome was reported by 29.9% of the 1182 students, the average polycystic ovary syndrome awareness score was M = 11.59 (SD = 4.95). Being a 6th and 5th year college student were the strongest independent predictors for recognizing the term polycystic ovary syndrome, in addition to be a student in the majors of veterinary medicine, nursing, pharmacy, or dentistry. Age was a significant predictor of polycystic ovary syndrome awareness score. Being investigated for, or being diagnosed with polycystic ovary syndrome were significant predictors of higher scores. Body mass index was a weak predictor of polycystic ovary syndrome awareness. Participants who reported to have hirsutism, acanthosis nigricans, or acne scored significantly higher than others.Healthcare professionals were the most common source of information reported by participants. Lectures were most effective in increasing awareness score but were poorly utilized outside the curriculum. CONCLUSION:Although students in this study demonstrated a satisfactory level of polycystic ovary syndrome awareness and were more likely to seek information from healthcare professionals, this level of awareness should spread-out to other segments of the population.
10.1016/j.amsu.2021.103123
Beyond fertility: polycystic ovary syndrome and long-term health.
Cooney Laura G,Dokras Anuja
Fertility and sterility
Polycystic ovary syndrome (PCOS) is a reproductive, endocrine, and metabolic disorder affecting millions of women worldwide. Women with PCOS are often identified in adolescence or early adulthood with symptoms of oligomenorrhea or hirsutism or when presenting for infertility care. The health risks associated out of PCOS, however, go far beyond management of these common presenting symptoms or fertility treatment and likely extend past the reproductive years through and beyond menopause. International surveys suggest that most patients are dissatisfied with long-term counseling related to medical and psychologic issues. We performed a review of comorbidities, including diabetes mellitus, dyslipidemia, obesity, hypertension, metabolic syndrome, depression, anxiety, obstructive sleep apnea, nonalcoholic fatty liver disease, endometrial cancer, and cardiovascular disease, in both reproductive-age and older women with PCOS. Most meta-analyses in reproductive-age women demonstrate increased risks independent from obesity. Longitudinal and cross-sectional studies including women with PCOS >40 years of age are limited in number and design, but many demonstrate that some of these comorbidities persist. All providers involved in the multidimensional care of women with PCOS should be aware of these long-term health risks to provide appropriate counseling, screening, and management options. We identify limitations that should be the focus of future studies designed to study health outcomes in postmenopausal women with PCOS.
10.1016/j.fertnstert.2018.08.021
Multi-system reproductive metabolic disorder: significance for the pathogenesis and therapy of polycystic ovary syndrome (PCOS).
Li Yan,Chen Changye,Ma Yan,Xiao Jiao,Luo Guifang,Li Yukun,Wu Daichao
Life sciences
Polycystic ovary syndrome (PCOS), a multisystem disease, is a major reason for female infertility around the world. It is no longer considered simply as a disease of ovary. Now researchers growing awareness of the multisystem features of this disease. PCOS has a higher relationship with metabolic disturbance and hypothalamic-pituitary-ovarian axis (HPOA) function disorders. This syndrome results in hyperandrogenemia (HA), hyperinsulinemia/insulin resistance (IR), increased estrone, luteinizing hormone (LH) and follicle-stimulating hormone (FSH) ratio imbalance, infertility, cardiovascular diseases, endometrial dysfunction, obesity, and including a litany of other health issues. Furthermore, PCOS has been garnered in recent times. Interventions like metformin, orlistat, hormonal contraceptives, GLP1 agonists, and VitD have been applied to ameliorate or reverse the pathological characterization of PCOS. Moreover, drug-combined therapy of PCOS is superior to single drug administration. This review will focus on the recent progress in pathogenesis and therapy of PCOS.
10.1016/j.lfs.2019.04.046