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Jiskoot G, Somers S, De Roo C, Stoop D, Laven J. Translation of the Modified Polycystic Ovary Syndrome Questionnaire (mPCOSQ) and the Polycystic Ovary Syndrome Quality of Life Tool (PCOSQOL) in Dutch and Flemish Women with PCOS. J Clin Med 2023; 12:3927. [PMID: 37373621 DOI: 10.3390/jcm12123927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 05/27/2023] [Accepted: 06/02/2023] [Indexed: 06/29/2023] Open
Abstract
This study aims to determine the test-retest reliability and to confirm the domain structures of the Dutch version of the modified polycystic ovary syndrome questionnaire (mPCOSQ) and the Polycystic Ovary Syndrome Quality of Life Scale (PCOSQOL) in Dutch and Flemish women with Polycystic Ovary Syndrome (PCOS). PCOS patients were contacted with a request to complete both questionnaires (including additional demographic questions) online in their home environment on T0 and on T1. The study was approved by the Ethics Committee of Erasmus Medical Centre and of Ghent University Hospital. In this study, 245 participants were included between January and December 2021. The mPCOSQ has excellent internal consistency (α: 0.95) and a high to excellent Intraclass Correlation Coefficient (ICC) for all six domains (ICC: 0.88-0.96). The PCOSQOL demonstrates excellent internal consistency (α: 0.96) and ICC (ICC: 0.91-0.96) for all four domains. The original six-factor structure of the mPCOSQ is partly confirmed. An extra domain is added to the PCOSQOL which included coping items. Most women have no preference for one of the two questionnaires (55.9%). In conclusion, The Dutch mPCOSQ and PCOSQOL are reliable and disease-specific QoL measures for women with PCOS. Both questionnaires are recommended for clinical practice.
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Affiliation(s)
- Geranne Jiskoot
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynaecology, Erasmus Medical Centre, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Sara Somers
- Department of Reproductive Medicine, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Ghent, Belgium
| | - Chloë De Roo
- Department of Reproductive Medicine, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Ghent, Belgium
| | - Dominic Stoop
- Department of Reproductive Medicine, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Ghent, Belgium
| | - Joop Laven
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynaecology, Erasmus Medical Centre, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
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Naous E, Zouein G, Asmar S, Saad E, Achkar A, Hajj G. Phenotype Prevalence and Health-Related Quality of Life of Lebanese Women With Polycystic Ovary Syndrome. Endocr Pract 2023; 29:127-134. [PMID: 36494019 DOI: 10.1016/j.eprac.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 11/30/2022] [Accepted: 12/02/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders. Our study aimed to assess, for the first time, the phenotype prevalence and the health-related quality of life of Lebanese women with PCOS. METHODS This was a cross-sectional study conducted on 322 Lebanese women with PCOS, using a questionnaire containing sociodemographic data, comorbidities, disease-related clinical questions, and the validated PCOS questionnaire (PCOSQ). The quality of life mean scores and phenotypes were compared and correlated among the different sociodemographic data, comorbidities, and disease-related questions. RESULTS Phenotype A (67%) was the most common phenotype. High waist circumference and higher Body Mass Index (BMI) were reported mostly in classic phenotypes in comparison with nonclassic (P < .05). The mean total score of all PCOSQ domains was 3.61 ± 1.60. The mean score for each domain (from the greatest to the least serious concern) was menstrual problems (3.31 ± 1.26), emotion (3.33 ± 1.22), weight (3.41 ± 2.12), body hair (3.86 ± 1.79), and infertility (4.15 ± 1.61). Age was negatively correlated only to weight domain score (r = -0.17, P = .002). BMI was associated only with emotion and weight domain scores (P = .017 and P < .001, respectively). A bigger impairment in nearly all subscales of the PCOSQ in patients presenting with abdominal obesity, glucose intolerance, and increased blood pressure was noted (P < .05). CONCLUSION Most Lebanese women with PCOS present phenotype A and have a serious impairment in their health-related quality of life, particularly in the menstrual and emotional domains. This highlights the need for community and individual support.
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Affiliation(s)
- Elie Naous
- Department of Internal Medicine, St. Elizabeth's Medical Center, Tufts Medical Center and Boston Medical Center, Brighton, Massachusetts.
| | - Georges Zouein
- Department of Internal Medicine, Endocrinology Division, Hotel Dieu de France Hospital, Saint Joseph University, Beirut, Lebanon
| | - Serena Asmar
- Department of Internal Medicine, Endocrinology Division, Hotel Dieu de France Hospital, Saint Joseph University, Beirut, Lebanon
| | - Eddy Saad
- Department of Internal Medicine, Endocrinology Division, Hotel Dieu de France Hospital, Saint Joseph University, Beirut, Lebanon
| | - Angela Achkar
- Department of Internal Medicine, Endocrinology Division, Hotel Dieu de France Hospital, Saint Joseph University, Beirut, Lebanon
| | - Georges Hajj
- Department of Internal Medicine, Endocrinology Division, Bellevue Medical Center, Beirut, Lebanon
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Mei LL, Abu MA, Chew KT, Ismail A, Zainuddin AA, Nur Azurah AG. The Reliability and Validity of the Malay Version of Polycystic Ovarian Syndrome Health-Related Quality of Life Questionnaire. Front Endocrinol (Lausanne) 2022; 13:848860. [PMID: 35692396 PMCID: PMC9178788 DOI: 10.3389/fendo.2022.848860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 03/30/2022] [Indexed: 11/13/2022] Open
Abstract
The Polycystic Ovary Syndrome Questionnaire is a reliable instrument for measuring health-related quality of life. This study aimed to develop a Malay version of the Polycystic Ovary Syndrome Questionnaire and to evaluate the health-related impact of Malaysian women with polycystic ovary syndrome. The participants were women who were diagnosed with polycystic ovary syndrome using Rotterdam criteria in a gynecology clinic. Reliability was determined by internal consistency using Cronbach's coefficient alpha and test-retest reliability using an intra-class correlation coefficient. Validity was assessed through convergent and discriminant validity. Examining the correlation between similar content of the Malay version of the Polycystic Ovary Syndrome Questionnaire and the SF-36 assessed the convergent validity. The discriminant validity was assessed using the known group comparison. Cronbach's alpha coefficient was over 0.70 for the total scale and over 0.60 for each subscale. Known group comparison supported the discriminant validity. The Malay version of the Polycystic Ovary Syndrome Questionnaire differentiated between the subgroups of women who differed in polycystic ovary syndrome-specific symptoms. Convergent validity was consistent with the good positive correlation between related subscales of the two instruments. Polycystic ovary syndrome women in Malaysia scored the lowest for the weight (3.74) and infertility (3.41) domains, thereby indicating worse health status in these domains. Body hair (5.42) was the least troublesome for the local population. The Malay version of the Polycystic Ovary Syndrome Questionnaire is a reliable and valid tool for assessing the health-related quality of life among women in the local population. It can be used to objectively assess the quality of life among Malaysian women with polycystic ovary syndrome and evaluate their responsiveness to treatment modalities.
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Affiliation(s)
- Lim Leek Mei
- Department of Obstetrics and Gynaecology, Hospital Sultan Ismail, Johor Bahru, Malaysia
| | - Muhammad Azrai Abu
- Advanced Reproductive Centre, Universiti Kebangsaan Malaysia (UKM) Medical Centre, Kuala Lumpur, Malaysia
- *Correspondence: Muhammad Azrai Abu,
| | - Kah Teik Chew
- Department of Obstetrics and Gynaecology, Universiti Kebangsaan Malaysia (UKM) Medical Centre, Kuala Lumpur, Malaysia
| | - Aniza Ismail
- Department of Public Health, Universiti Kebangsaan Malaysia (UKM) Medical Centre, Kuala Lumpur, Malaysia
| | - Ani Amelia Zainuddin
- Department of Obstetrics and Gynaecology, Universiti Kebangsaan Malaysia (UKM) Medical Centre, Kuala Lumpur, Malaysia
| | - Abdul Ghani Nur Azurah
- Department of Obstetrics and Gynaecology, Universiti Kebangsaan Malaysia (UKM) Medical Centre, Kuala Lumpur, Malaysia
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Ha L, Liu X, Liu Y, Zhi M, Jiang H, Zhao J, Wang Y, Xu X, Guo L, Cao J, Chen L, Yuan Y, Li T, Wang F. Scheme optimization of acupoints compatibility and influence factors of the effect. Medicine (Baltimore) 2021; 100:e27883. [PMID: 34918637 PMCID: PMC10545094 DOI: 10.1097/md.0000000000027883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 11/03/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Acupuncture may be a clinically effective treatment for insomnia. We will perform a multicenter, large-scale, single-blinded, randomized controlled trial to compare the differences in the clinical efficacy between the use of singleacupoints and compatibilityacupoints in the treatment of primary insomnia. METHODS/DESIGN A total of 333 participants will be randomly assigned to 2 acupoint treatment groups or 1 nonacupoint control group in a 1:1:1 ratio by a central stochastic system. The acupuncture groups are: the single acupoint group: Shenmen (HT7); and he compatibility acupoint group: Shenmen (HT7), Baihui (DU20), and Sanyinjiao (SP6). The observation period of this trial will be 10 weeks. All patients will be followed for 1 week before randomization (baseline phase). After randomization, the patients will receive 30 minutes of electro-acupuncture once per day for 5 weeks. In the fourth week after the treatment, follow-up will be performed once. The primary outcome will be the Pittsburgh sleep quality index score at 1 week before randomization and 2 and 8 weeks after randomization. The secondary outcomes will include data from sleep diaries, Athens insomnia scale scores, ShortForm-36 Health Survey scores, electroencephalogram technology results and polysomnogram) results. Patients will be required to complete a sleep diary every day during the treatment period. Patients will also undergo electroencephalogram technology and polysomnogram 1 week before randomization and 5 weeks after randomization. The other secondary outcomes will be measured 1 week before randomization and 5 and 9 weeks after randomization. DISCUSSION This trial will be helpful in identifying whether acupuncture at compatibility acupoints is more effective than acupuncture at single acupoints. TRIAL REGISTRATION Clinical Trials.govNCT02448602, Registered 5May 2015, https://www.clinicaltrials.gov/ct2/show/NCT02448602?term=NCT02448602&rank=1.
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Zhang J, Tang L, Kong L, Wu T, Xu L, Pan X, Liu GJ. Ultrasound-guided transvaginal ovarian needle drilling for clomiphene-resistant polycystic ovarian syndrome in subfertile women. Cochrane Database Syst Rev 2021; 11:CD008583. [PMID: 34735019 PMCID: PMC8567741 DOI: 10.1002/14651858.cd008583.pub3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Ovulatory disturbance is a key diagnostic feature of polycystic ovarian syndrome (PCOS), leading to infertility and correspondingly heavy disease burden. Many therapeutic strategies have been used to induce ovulation for women with PCOS who are infertile. Ultrasound-guided transvaginal ovarian needle drilling (UTND) is a novel surgical method used to induce ovulation for women with clomiphene-resistant PCOS at the outpatient clinic. OBJECTIVES: To evaluate the efficacy and safety of UTND for subfertile women with clomiphene-resistant PCOS. SEARCH METHODS We searched the Cochrane Gynaecology and Fertility Group Specialised Register, CENTRAL, MEDLINE, Embase, and other databases to December 2020. We checked conference abstracts, reference lists, and clinical trials registries. We also contacted experts and specialists in the field for any additional trials . SELECTION CRITERIA We planned to include randomised controlled trials comparing UTND to laparoscopic ovarian drilling, and UTND combined with gonadotropins to gonadotropins, in women of reproductive age with clomiphene-resistant PCOS and infertility. DATA COLLECTION AND ANALYSIS Two review authors independently screened the trials identified by the search for inclusion, assessed methodological quality and risk of bias, and extracted data. The primary outcomes were live birth rate and incidence of surgical complications (bleeding and infection). Secondary outcomes included pregnancy rate, ovulation rate, and ovarian hyperstimulation syndrome. We planned to calculate odds ratios with 95% confidence intervals for dichotomous data. We would assess overall quality of the evidence by applying the GRADE criteria. MAIN RESULTS We did not identify any trials for inclusion in the review. We were unable to assess the benefit or harm of applying UTND for women with clomiphene-resistant PCOS, as no studies could be included in the current review. We moved the previously included trials to studies awaiting classification due to concerns regarding methodology. AUTHORS' CONCLUSIONS Since we did not identify any studies for inclusion, we were unable to assess the benefit or harm of applying UTND for women with clomiphene-resistant PCOS.
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Affiliation(s)
- Jing Zhang
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
- Reproductive Endocrinology and Regulation Laboratory, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Liulin Tang
- Department of Obstetrics and Gynecology, Affiliated Hospital of Guilin Medical University, Guilin, China
| | - Linglingli Kong
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Taixiang Wu
- Chinese Clinical Trial Registry, Chinese Ethics Committee of Registering Clinical Trials, West China Hospital, Sichuan University, Chengdu, China
| | - Liangzhi Xu
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
- Reproductive Endocrinology and Regulation Laboratory, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Xin Pan
- Mother and Baby Center, School of Medicine and Public Health, The University of Newcastle, New Castle, China
| | - Guan J Liu
- Cochrane China, West China Hospital, Sichuan University, Chengdu, China
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Mandeville JS, Best DAJ, Waterman F. Characterizing the impact of menstrual and pelvic health disorders in a convenience sample of women in Barbados. JOURNAL OF ENDOMETRIOSIS AND PELVIC PAIN DISORDERS 2021. [DOI: 10.1177/22840265211024437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: To describe the impact of menstrual and pelvic health disorders on a sample of Barbadian women living with one or more disorders. Design and methods: Responses from a survey taken online by a sample of women living in Barbados (⩾18 years) were assessed. Variables collected included, age, disorder(s) diagnosed, and symptoms. The Work Productivity and Activity Impairment (WPAI) Questionnaire: Specific Health Problem, was administered to measure impact on work and other activities. T-tests, chi- square tests, odds ratios, ANOVA, and multivariate analysis were conducted to estimate the associations between patient characterization, disorder characteristics and outcomes. Results: A total of 247 unique responses were received and after data were reviewed 192 responses (77.7%) from this convenience sample were analyzed. Polycystic Ovary Syndrome was the most frequently reported diagnosis (34.7%). The most frequently reported symptom was fatigue (53%). There was an OR of 2.17 (95% CI 0.54–8.74) of missing work due to menorrhagia and 2.60 (95% CI: 1.31–5.17) of missing work if diagnosed with endometriosis. The WPAI revealed endometriosis to be the condition with the most substantial impact on work in the subgroup of persons with one diagnosis, with presenteeism of 49.2%, absenteeism of 13.3% and an impact on other activities of 56.4%. Conclusion: Pelvic and menstrual disorders have a significant impact on productivity and other activities of Barbadian women. More research is necessary to elucidate the impacts of menstrual and pelvic disorders and treatments on patient outcomes.
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Affiliation(s)
| | - Damian AJ Best
- Faculty of Medical Sciences, University of the West Indies Cave Hill Campus, Bridgetown, St. Michael, Barbados
| | - Fanta Waterman
- Serrette Brown Research and Consulting, LLC, Danbury, CT, USA
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Impact of polycystic ovary syndrome on quality of life of women in correlation to age, basal metabolic index, education and marriage. PLoS One 2021; 16:e0247486. [PMID: 33690645 PMCID: PMC7946178 DOI: 10.1371/journal.pone.0247486] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 01/01/2021] [Indexed: 01/24/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) is the major endocrine related disorder in young age women. Physical appearance, menstrual irregularity as well as infertility are considered as a sole cause of mental distress affecting health-related quality of life (HRQOL). This prospective case-control study was conducted among 100 PCOS and 200 healthy control cases attending tertiary care set up of AIIMS, Patna during year 2017 and 2018. Pre-validated questionnaires like Short Form Health survey-36 were used for evaluating impact of PCOS in women. Multivariate analysis was applied for statistical analysis. In PCOS cases, socioeconomic status was comparable in comparison to healthy control. But, PCOS cases showed significantly decreased HRQOL. The higher age of menarche, irregular/delayed menstrual history, absence of child, were significantly altered in PCOS cases than control. Number of child, frequency of pregnancy, and miscarriage were also observed higher in PCOS cases. Furthermore, in various category of age, BMI, educational status and marital status, significant differences were observed in the different domain of SF-36 between PCOS and healthy control. Altogether, increased BMI, menstrual irregularities, educational status and marital status play a major role in altering HRQOL in PCOS cases and psychological care must be given during patient care.
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Quality of Life in Infertile Women with Polycystic Ovary Syndrome: a Comparative Study. Reprod Sci 2020; 28:1901-1909. [PMID: 33215316 DOI: 10.1007/s43032-020-00394-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 11/09/2020] [Indexed: 10/22/2022]
Abstract
To investigate the quality of life (QoL) of infertile women with polycystic ovary syndrome (PCOS) and analyze the association between the clinical/biochemical features of PCOS and the physical/psychological well-being of patients. An observational study with three independent groups women was designed including 37 infertile PCOS patients, 36 women with tubal factor infertility, and 31 women with male factor infertility referred to the Reproductive Medicine Unit of the Hospital Clinic Barcelona from December 2017 to June 2019. Clinical history, physical examination including Ferriman-Gallwey scores, and vaginal ultrasound were carried out in all patients. All subjects completed the 36-item Short Form Health Survey, and PCOS patients were asked to fill out the Polycystic Ovary Syndrome Questionnaire. The IBM SPSS 23.0 was used for the statistical analysis. Infertile women with PCOS reported significantly worse QoL scores of social functioning (p = 0.049), emotional role functioning (p = 0.041), mental health (p = 0.002), and the mental component summary (p = 0.002) compared with women with other causes of infertility. In addition, body pain (p = 0.006), general health (p < 0.001), and vitality (p = 0.002) scores were significantly lower in women with PCOS compared with those with male factor infertility. Infertile PCOS patients showed low scores in all domains of the PCOSQ. Hirsutism and weight gain were the factors most associated with impaired health-related QoL in PCOS. Infertile PCOS women presented worse QoL mainly due to psychological and emotional distress. The main predictors were clinical manifestations of hyperandrogenism and weight gain.
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Boivin MJ, Fatehi F, Phillips-Chan AE, Richardson JR, Summers AN, Foley SA. Exploratory study of a screening measure for polycystic ovarian syndrome, quality of life assessment, and neuropsychological evaluation. BMC WOMENS HEALTH 2020; 20:132. [PMID: 32576264 PMCID: PMC7313190 DOI: 10.1186/s12905-020-00994-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 06/18/2020] [Indexed: 02/06/2023]
Abstract
Background The universally adopted 2018 PCOS medical diagnostic and treatment guidelines for Polycystic Ovarian Syndrome (PCOS) cites the need for a brief screening measure that can be easily administered in the clinical care setting. We evaluate a 12-item questionnaire emphasizing the medical symptoms of PCOS with a group of women with PCOS as well as comparison samples of college women not diagnosed with PCOS. Method Of 120 undergraduate psychology women 18 to 41 years of age, 86 screened negative on a 12-item PCOS symptoms inventory. They were compared to a group of PCOS patients diagnosed medically in a manner consistent with the Teede et al. (2018) evidence-based diagnostic guidelines. The screen-positive, screen-negative, and PCOS-confirmed groups were compared on the PCOS Quality-of-Life (QoL) questionnaire, Zung Self-Rating Depression Scale (ZDS), Spielberg State-Trait Anxiety Inventory (STAI), Fatigue Symptom Inventory (FSI), Spiritual well-being and Spiritual Beliefs Inventories, the computerized Automated Neuropsychological Assessment Metric (ANAM) battery, and an experimental tachistoscopic Bilateral Perceptual Asymmetries Letter and Dots Matching Bilateral Field Advantage (BFA) test (to evaluate the effects of early brain androgenization possible from PCOS). For each questionnaire and neuropsychological performance principal outcome, the Linear Mixed Effects (LME) model was employed to evaluate the predictive significance of demographic characteristics and group membership (confirmed cases, screen negative and screen positive cases) for these outcomes. Results The PCOS-confirmed women scored more poorly than the screen-negative (reference) and screen-positive groups on all the measures of physical, emotional, social, and spiritual well-being measures. On the ANAM neuropsychological battery, PCOS-confirmed women did more poorly on Sternberg Memory and Stimulus Response throughput measures. They also had slower correct response speed for both the unilateral and bilateral dot- and letter-matching tachistoscopic stimulus presentations. However, the bilateral field advantage throughput performance ratio did not differ among groups, which is a global measure of bilateral versus unilateral brain/behavior asymmetries. Conclusion PCOS screening can be a feasible and important part of women’s healthcare. PCOS-confirmed women should receive not only the medical standard of care from the 2018 guidelines, but also comprehensive psychosocial and neurocognitive support to enhance their quality of life.
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Affiliation(s)
- Michael J Boivin
- Department of Psychiatry and Neurology & Ophthalmology, Michigan State University, East Lansing, 909 Wilson Road, Rm 327, West Fee Road, East Lansing, MI, 48824, USA.
| | - Farnaz Fatehi
- Department of Psychiatry and Neurology & Ophthalmology, Michigan State University, East Lansing, 909 Wilson Road, Rm 327, West Fee Road, East Lansing, MI, 48824, USA
| | | | - Julia R Richardson
- Department of Psychology, Indiana Wesleyan University, Marion, Indiana, USA
| | - Amanda N Summers
- Department of Psychology, Indiana Wesleyan University, Marion, Indiana, USA
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Ribeiro VB, Lopes IP, Dos Reis RM, Silva RC, Mendes MC, Melo AS, de Souza HCD, Ferriani RA, Kogure GS, Lara LADS. Continuous versus intermittent aerobic exercise in the improvement of quality of life for women with polycystic ovary syndrome: A randomized controlled trial. J Health Psychol 2019; 26:1307-1317. [PMID: 31495231 DOI: 10.1177/1359105319869806] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Polycystic ovary syndrome predisposes alterations which contribute to the reduction of quality of life. This randomized controlled clinical trial study was to evaluate the effect of two protocols of aerobic exercise on quality of life in women with polycystic ovary syndrome. Women were allocated to three groups: continuous aerobic training (n = 28), intermittent aerobic training (n = 29), and control group (no training; n = 30). Testosterone levels, body composition indices, and quality of life were assessed at baseline and after 16 weeks of intervention. Both protocols were effective to improve testosterone levels, anthropometric indices, and quality of life in polycystic ovary syndrome women. Thus, these protocols should be included in the clinical environment to improve clinical parameters psychological, biological and social health to this population.
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Affiliation(s)
- Victor Barbosa Ribeiro
- Ribeirão Preto Medical School, Human Reproduction Sector, Department of Gynecology and Obstetrics, University of São Paulo, Ribeirão Preto, Brazil.,Federal Institute of São Paulo, Jacarei Campus, Brazil
| | - Iris Palma Lopes
- Ribeirão Preto Medical School, Human Reproduction Sector, Department of Gynecology and Obstetrics, University of São Paulo, Ribeirão Preto, Brazil
| | - Rosana Maria Dos Reis
- Ribeirão Preto Medical School, Human Reproduction Sector, Department of Gynecology and Obstetrics, University of São Paulo, Ribeirão Preto, Brazil
| | - Rafael Costa Silva
- Ribeirão Preto Medical School, Human Reproduction Sector, Department of Gynecology and Obstetrics, University of São Paulo, Ribeirão Preto, Brazil
| | - Maria Célia Mendes
- Ribeirão Preto Medical School, Human Reproduction Sector, Department of Gynecology and Obstetrics, University of São Paulo, Ribeirão Preto, Brazil
| | - Anderson Sanches Melo
- Ribeirão Preto Medical School, Human Reproduction Sector, Department of Gynecology and Obstetrics, University of São Paulo, Ribeirão Preto, Brazil
| | - Hugo Celso Dutra de Souza
- Department of Biomechanics, Medicine and Rehabilitation of the Locomotor System, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Rui Alberto Ferriani
- Ribeirão Preto Medical School, Human Reproduction Sector, Department of Gynecology and Obstetrics, University of São Paulo, Ribeirão Preto, Brazil
| | - Gislaine Satyko Kogure
- Ribeirão Preto Medical School, Human Reproduction Sector, Department of Gynecology and Obstetrics, University of São Paulo, Ribeirão Preto, Brazil
| | - Lúcia Alves da Silva Lara
- Ribeirão Preto Medical School, Human Reproduction Sector, Department of Gynecology and Obstetrics, University of São Paulo, Ribeirão Preto, Brazil
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Alur-Gupta S, Chemerinski A, Liu C, Lipson J, Allison K, Sammel MD, Dokras A. Body-image distress is increased in women with polycystic ovary syndrome and mediates depression and anxiety. Fertil Steril 2019; 112:930-938.e1. [PMID: 31395311 DOI: 10.1016/j.fertnstert.2019.06.018] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 05/17/2019] [Accepted: 06/11/2019] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To evaluate differences in body-image distress (BID) scores between women with polycystic ovary syndrome (PCOS) and controls and whether BID mediates anxiety and depression. DESIGN Cross-sectional study. SETTING Academic institution. PATIENT(S) Reproductive-aged women with PCOS (n = 189) and controls (n = 225). INTERVENTION Administering the Multidimensional Body-Self Relations-Appearance Subscale (MBSRQ-AS), Stunkard Figure Rating Scale (FRS), Hospital Anxiety and Depression Scale (HADS), and PCOS quality of life survey (MPCOS-Q). MAIN OUTCOME MEASURE(S) BID, depression, and anxiety scores and mediation of depression and anxiety scores by BID. RESULT(S) Women with PCOS had worse BID scores on all five MBSRQ-AS subscales adjusted for age, body mass index, race, pregnancy history, income, and employment, and larger differences on the FRS compared with the control women. In multivariable regression models, the prevalence of depressive (28% vs. 19.2%) and anxiety (76.5% vs. 56.5%) symptoms were also statistically significantly higher in women with PCOS compared with the controls. Most MBSRQ-AS subscale scores statistically significantly correlated with depression, anxiety, and quality of life scores. The association between PCOS/control status and higher anxiety and depression scores was completely mediated by the appearance evaluation and body areas satisfaction subscales and partially mediated by overweight preoccupation, appearance orientation, and self-classified weight. CONCLUSION(S) Women with PCOS have increased BID and depressive and anxiety symptoms. In our study different aspects of BID either fully or partially mediated the association between PCOS/control status and depression and anxiety scores, suggesting that therapeutic interventions targeted at improving body image may decrease depressive and anxiety symptoms.
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Affiliation(s)
| | - Anat Chemerinski
- Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Chang Liu
- University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jenna Lipson
- Pennsylvania Hospital, Philadelphia, Pennsylvania
| | - Kelly Allison
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Mary D Sammel
- Department of Biostatistics, Epidemiology & Informatics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Anuja Dokras
- Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
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Zhang J, Tang L, Kong L, Wu T, Xu L, Pan X, Liu GJ. Ultrasound-guided transvaginal ovarian needle drilling for clomiphene-resistant polycystic ovarian syndrome in subfertile women. Cochrane Database Syst Rev 2019; 7:CD008583. [PMID: 31425630 PMCID: PMC6699647 DOI: 10.1002/14651858.cd008583.pub2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Ovulatory disturbance is a key diagnostic feature of polycystic ovarian syndrome (PCOS), leading to infertility and correspondingly heavy disease burden. Many therapeutic strategies have been used to induce ovulation for women with PCOS who are infertile. Ultrasound-guided transvaginal ovarian needle drilling (UTND) is a novel surgical method used to induce ovulation for women with clomiphene-resistant PCOS at the outpatients clinic. Nevertheless, the quality in most of the studies seemed low, and the safety and efficacy of UTND is still uncertain. OBJECTIVES To evaluate the efficacy and safety of UTND for subfertile women with clomiphene-resistant PCOS. SEARCH METHODS We searched the Cochrane Gynaecology and Fertility Group (CGFG) Specialised Register, CENTRAL, MEDLINE, Embase, and six other databases to November 2018. We checked conference abstracts from the 2018 ESHRE, reference lists, and clinical trials registries. We contacted experts and specialists in the field. SELECTION CRITERIA We included randomised controlled trials (RCTs) comparing UTND to laparoscopic ovarian drilling (LOD), and UTND combined with gonadotropins to gonadotropins alone for women of reproductive age with clomiphene-resistant PCOS and infertility. DATA COLLECTION AND ANALYSIS Two review authors independently screened appropriate trials for inclusion, assessed methodological quality and risk of bias, and extracted data. The primary outcomes were live birth rate and incidence of surgical complications (bleeding and infection). We included ovarian hyperstimulation syndrome (OHSS) as a secondary outcome. Meta-analyses could only be conducted for the secondary outcomes pregnancy rate and ovulation rate in the comparison of UTND versus LOD using a random-effect model. We calculated odds ratios (OR) with 95% confidence intervals (CI) for dichotomous data. We assessed the overall quality of the evidence by applying GRADE criteria. MAIN RESULTS We included five trials involving 639 clomiphene-resistant women with PCOS. Three studies compared UTND with LOD, and two compared UTND combined with gonadotropins with gonadotropins alone. The evidence was of low to very low quality. The main limitations were serious risk of bias due to poor reporting of methods, inconsistency resulting from heterogeneity, imprecision induced by limited sample size, and lack of reporting of clinically relevant outcomes such as live birth and surgical complications.UTND versus LODNo studies reported on the main outcome live birth. One study reported on surgical complications; however, the evidence for this outcome was of very low quality because it was based on one study with small sample size and there were no events in either arm. Thus, we are uncertain whether there is any difference in surgical complications between UTND and LOD.We are also uncertain whether there is any difference in pregnancy rate when comparing UTND with LOD (OR 0.54, 95% CI 0.28 to 1.03; I2 = 56%; 3 RCTs, n = 473; very-low quality evidence). UTND may lead to a slight decrease in ovulation rate when compared to LOD (OR 0.66, 95% CI 0.45 to 0.97; I2 = 0%; 3 RCTs, n = 473; low-quality evidence). This suggests that among clomiphene-resistant women with PCOS using LOD with an expected ovulation rate of 69.5%, the ovulation rate among women using UTND may be between 50.6% and 68.8%No studies reported on the outcomes OHSS and multiple pregnancy. There was also insufficient evidence to reach a conclusion regarding miscarriage as there was only one study of very low quality.UTND combined with gonadotropins versus gonadotropins aloneNo studies reported on the main outcomes live birth and incidence of surgical complications. The evidence for the outcomes OHSS, pregnancy, ovulation, miscarriage, and multiple pregnancy in this comparison was of very low quality. Thus, we are uncertain whether there is any difference in these outcomes for women with clomiphene-resistant PCOS using UTND combined with gonadotropins as compared with gonadotropins. AUTHORS' CONCLUSIONS Based on very low-quality evidence, It is uncertain whether there is any difference in pregnancy rate, incidence of surgical complications, and miscarriage rate between UTND and LOD in women with clomiphene-resistant PCOS. UTND may lead to a slight decrease in ovulation rate when compared to LOD. No studies reported on the outcomes live birth rate, incidence of OHSS, and multiple pregnancy rate. No studies reported on the main outcomes live birth and surgical complications for the comparison UTND combined with gonadotrophins versus gonadotrophins alone. The evidence for the outcomes OHSS, pregnancy, ovulation, miscarriage, and multiple pregnancy in this comparison was of very low quality. Thus, it is unclear if there is a difference in any of the outcomes between UTND combined with gonadotrophins versus gonadotrophins alone.
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Affiliation(s)
- Jing Zhang
- West China Second University Hospital, Sichuan UniversityDepartment of Obstetrics and GynecologyChengduSichuanChina
- Ministry of EducationKey Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University)ChengduSichuanChina
- West China Second University Hospital, Sichuan UniversityReproductive Endocrinology and Regulation LaboratoryNO. 20, 3rd section, Renmin South RdChengduSichuanChina610041
| | - Liulin Tang
- Affiliated Hospital of Guilin Medical UniversityDepartment of Obstetrics and GynecologyNo. 15, Le Qun RoadGuilinGuangxiChina541001
| | - Linglingli Kong
- West China Second University Hospital, Sichuan UniversityDepartment of Obstetrics and GynecologyChengduSichuanChina
- Ministry of EducationKey Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University)ChengduSichuanChina
| | - Taixiang Wu
- West China Hospital, Sichuan UniversityChinese Clinical Trial Registry, Chinese Ethics Committee of Registering Clinical TrialsNo. 37, Guo Xue XiangChengduSichuanChina610041
| | - Liangzhi Xu
- West China Second University Hospital, Sichuan UniversityDepartment of Obstetrics and GynecologyChengduSichuanChina
- Ministry of EducationKey Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University)ChengduSichuanChina
- West China Second University Hospital, Sichuan UniversityReproductive Endocrinology and Regulation LaboratoryNO. 20, 3rd section, Renmin South RdChengduSichuanChina610041
| | - Xin Pan
- The University of NewcastleMother and Baby Center, School of Medicine and Public HealthNew CastleChina
| | - Guan J Liu
- West China Hospital, Sichuan UniversityCochrane ChinaNo. 37, Guo Xue XiangChengduSichuanChina610041
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