Evaluation of clinical manifestations, health risks, and quality of life among women with polycystic ovary syndrome

Abstract

This study aimed to evaluate the clinical manifestations and health risks associated with polycystic ovary syndrome (PCOS) and its impact on quality of life (QOL) in Pakistan. A detailed cross-sectional study was conducted on PCOS among women of reproductive age visiting the gynecology and obstetrics and endocrinology departments at primary and tertiary care hospitals located in Abbottabad, Kohat, and Islamabad. In total, 440 patients meeting the inclusion criteria were included. A checklist was specifically designed to identify symptoms and health risks, including adverse drug reactions, complications, irrational prescription or underprescription, and drug–drug interactions. The Short Form-12 questionnaire was used to evaluate the QOL of patients with PCOS. Data collected were analyzed for descriptive and inferential statistics using chi-square test, analysis of variance, and post hoc analysis. All patients exhibited the cardinal symptoms of PCOS, including obesity (n = 352, 80%), acne (n = 296, 67.3), hirsutism (n = 299, 68%), hyperglycemia (n = 278, 63.2%), and irregular menstruation (n = 316, 71.8%). Ultrasonography confirmed that 268 (61%) patients had multiple cysts of >10 mm in diameter. Patients with untreated PCOS exhibited a high prevalence of health risks including hypertension (n = 87, 19.8%), diabetes (n = 268, 60.9%), sleep apnea (n = 11, 2.5%), infertility (n = 146, 33.2%), increased endometrial thickness (n = 21, 4.8%), miscarriages (n = 68, 15.5%), high cholesterol level (n = 85, 19.3%), and hyperandrogenism (n = 342, 77.7%). Most patients exhibited low QOL scores (n = 374, 85%), with depression being the largest contributor to low QOL. Apart from novel results, this study found an association between depression and low QOL in patients with PCOS, suggesting the need for reviewing the management guidelines and psychological health assessment of women with PCOS.

Effects of oral contraceptives on the quality of life of women with polycystic ovary syndrome: a crossover randomized controlled trial

“…One cross-sectional showed that 87 % of PCOS patients with hirsutism had poor QOL; they found that those patients with hirsutism had lower QOL than non-hirsute patients. In this study, most patients had not been used any treatment for hirsutism [6]. Two studies showed a signi cant improvement of the hirsutism aspect after 6 months [14] and 12 months [12] of OC therapy; however, these studies did not compare different OCs regarding their progestin component.…”

“…They observed that PCOS was managed in only 74.6 % of these patients with depression. In addition, poor QOL was observed in 87.8 % of these patients, whereas only 9.2 % of PCOS patients who received treatment had poor QOL [6], ndings suggesting the need for managing psychological disorders in women with PCOS. According to the American Association of Clinical Endocrinologists, the American College of Endocrinology, and the Androgen Excess and PCOS Society recommendations for evaluation and treatment of PCOS patients, all women with PCOS should be screened for anxiety and depressive disorders during the initial examination and its use at further stages of treatment and after it [42].…”

“…In addition to endocrine and metabolic disorders, women with PCOS frequently experience several psychological comorbidities, such as depression, anxiety, sexual dysfunction, and social problems [3][4][5], which can negatively in uence their feminine identity and health-related quality of life (HRQOL) [4,6].…”

“…The goals of all therapies are to improve biochemical, and clinical outcomes of PCOS as well as the QOL. It is well-documented that oral contraceptives (OCs) as rst-line treatment can decrease menstrual irregularity and hyperandrogenism, and leads to improvements in speci c domains of QOL in patients with PCOS [6].…”

“…Despite numerous studies on the association between PCOS and QOL [6][7][8][9][10], a limited number of studies have evaluated the effects of OCs on the QOL of PCOS patients [11][12][13][14]. Besides, to the best our knowledge, there is no study comparing the effectiveness of these pharmacological treatments on the QOL of patients based on their progestin component.…”