A cross-sectional study on prevalence of menstrual problems, lifestyle, mental health, and PCOS awareness among rural and urban population of Punjab, India

Risk perception, health behavior and mental health of women living with polycystic ovary syndrome

This study aimed to explore the psychological challenges faced by women living with polycystic ovary syndrome (PCOS) and their subjective experiences. Using a cross-sectional, questionnaire-based design, we first conducted a comparative analysis of responses from 54 PCOS patients and 54 age-matched healthy participants. The analysis revealed a significant difference in satisfaction with life (SWL) between the two groups (F = 9.426, p < .005), while no significant differences were found in levels of anxiety and depression. Additionally, depression was found to have a significant impact on SWL (F = 55.309, p < .001). To further investigate the subjective well-being of PCOS patients, a larger group of 389 PCOS patients (age: M = 32.18 years, SD = 8.34) completed the Polycystic Ovary Syndrome Questionnaire (PCOSQ) (QoL Scale). A ranking of their concerns revealed that obesity-related issues were the most significant, while concerns about developing cancer were ranked last. The PCOSQ scores showed a strong negative correlation with the BDI (r = -0.754, p < .001), highlighting the profound impact of PCOS symptoms on depression. These findings underscore the importance of prevention, screening and treatment for depression in PCOS patients, as well as the importance of educating patients to improve their risk perception and disease management strategies.

Prevalence, risk factors and health-seeking behavior of menstrual disorders among women in India: a review of two-decade evidence

BACKGROUND

Menstrual health is critical for women of reproductive age. It is also evident that menstrual disorders have contributed to the increasing burden of non-communicable diseases.

OBJECTIVE

To our knowledge, no literature review explicitly addresses the prevalence, risk factors, and health-seeking behaviour of menstrual disorders in India. Therefore, the current study aims to synthesize the available scientific evidence on the prevalence and risk factors of menstrual disorders in India over the last two decades.

METHODS

We followed PRISMA guidelines to conduct the review. We used Google Scholar, PubMed, JSTOR, Scopus, and Sci Direct search engines to find eligible research studies and extracted data from 2000 to 2022. We also conducted quality appraisals of included studies in the review.

RESULTS

Results show that the prevalence of any menstrual disorders ranges from 3% to 87%. Among all menstrual disorders, Dysmenorrhea was reported to be high (46% to 76%) among women, followed by premenstrual symptoms (PMS) (40% to 71%), while PCOS (3% to 14.14%) was less. The study further found that irregular lifestyle, obesity, inadequate diet, age at marriage, family history, smoking, and place of residence factors is associated with menstrual disorders in India. As far as health-seeking for menstrual disorders is concerned, one-third of women sought treatment for menstrual disorders.

CONCLUSION

The present study has revealed that most women reported high rates of Dysmenorrhea, while Polycystic Ovary Syndrome (PCOS) is less prevalent. The study findings suggest that health-seeking behaviour is the most important factor in reducing menstrual disorders, which has long-term effects of increasing other comorbidities.

Social Determinants of Health and Dysmenorrhea: A Systematic Review

Social determinants of health play a key role in health disparities. Dysmenorrhea is a highly prevalent and impactful public health problem affecting reproductive-age females. Systematically examining social determinants of health (SDoH) in dysmenorrhea is important for identifying gaps in the literature and informing research, policy, and clinical practice to reduce the public health burden associated with dysmenorrhea. The purpose of this systematic review was to synthesize the literature on SDoH and dysmenorrhea. The review protocol was prospectively registered. We searched Medline, EMBASE, CINAHL, PsycINFO, Scopus, and Google Scholar through February 2024 using search strategies informed by the literature. Screening of the articles, data extraction, and risk-of-bias (RoB) assessment were conducted independently by at least 2 reviewers on the Covidence platform. Among 2,594 unique records screened, 166 met eligibility criteria and were included for data extraction and RoB assessment. Evidence suggests traumatic experiences, toxic environmental exposures, female genital mutilation, job-related stress, lack of menstrual education, and low social support were associated with worse dysmenorrhea outcomes. However, evidence was equivocal regarding the relationships between dysmenorrhea outcomes and SDoH factors, including socioeconomic status, geographical location, race/ethnicity, employment, and religion. Nearly all articles (99.4%) had a high or very high overall RoB. The relationships between SDoH and dysmenorrhea outcomes were often inconsistent and complicated by heterogeneous study populations and methodologies. More rigorous research examining SDoH in dysmenorrhea is needed to inform policy and clinical practice. PERSPECTIVE: This systematic review synthesizes evidence linking SDoH and dysmenorrhea. The relationships between SDoH and dysmenorrhea were often equivocal and complicated by heterogeneous study populations and methodologies. We identify directions for future research and SDoH factors that could be addressed clinically (eg, trauma, menstrual education, and occupational stress).

Associations between psychological distress in adolescence and menstrual symptoms across life: Longitudinal evidence from the 1970 British Cohort Study

PURPOSE

This study aimed to investigate the association between psychological distress (PD) at age 16 and menstrual symptoms experienced across women's life.

METHODS

Up to 2584 females from the 1970 British Cohort Study, a study of individuals born within one week in 1970, were included. PD at age 16 was measured with the 12-item General Health Questionnaire. Three categories were derived: low PD (<11), moderate PD (11-15), and severe PD (>15). Five menstrual health symptoms were self-reported at each age (16, 30 and 42 years). Binomial logistic regressions examined associations between PD at age 16 and each individual symptom, adjusted for age of menarche, sleep and appetite problems, physical activity levels and socioeconomic position.

RESULTS

The most prevalent symptoms were "pain" (61 %), "painful period" (10 %) and "heavy period" (33 %) at ages 16, 30 and 42, respectively. At age 16, those with severe PD were more likely to experience depression (OR: 2.92; 95% CI: 2.31, 3.70)), irritability (1.67; 1.33, 2.11), menstrual pain (1.34; 1.01, 1.80), and headaches (1.29; 1.02, 1.63). A weak association was found between severe PD at age 16 and pre-menstrual tension at age 30 (1.72; 1.01, 2.83). At age 42, those with severe PD at age 16 were more likely to experience pre-menstrual tension (1.89; 1.46, 2.44), painful periods (1.64; 1.27, 2.11), and heavy periods (1.28; 1.00, 1.62).

DISCUSSION

Menstruating females with higher levels of PD in adolescence have an increased risk of menstrual symptoms across adolescence, early and mid-adulthood. Our findings suggest the need to consider early-life psychological interventions to improve women's menstrual experiences across their reproductive years.

Molecular Mechanisms in the Etiology of Polycystic Ovary Syndrome (PCOS): A Multifaceted Hypothesis Towards the Disease with Potential Therapeutics

Among the premenopausal women, Polycystic Ovary Syndrome (PCOS) is the most prevalent endocrinopathy affecting the reproductive system and metabolic rhythms leading to disrupted menstrual cycle. Being heterogeneous in nature it is characterized by complex symptomology of oligomennorhoea, excess of androgens triggering masculine phenotypic appearance and/or multiple follicular ovaries. The etiology of this complex disorder remains somewhat doubtful and the researchers hypothesize multisystem links in the pathogenesis of this disease. In this review, we attempt to present several hypotheses that tend to contribute to the etiology of PCOS. Metabolic inflexibility, aberrant pattern of gonadotropin signaling along with the evolutionary, genetic and environmental factors have been discussed. Considered a lifelong endocrinological implication, no universal treatment is available for PCOS so far however; multiple drug therapy is often advised along with simple life style intervention is mainly advised to manage its cardinal symptoms. Here we aimed to present a summarized view of pathophysiological links of PCOS with potential therapeutic strategies.

Dysmenorrhea and psychological distress: a meta-analysis

Dysmenorrhea is characterized by pelvic pain associated with menstruation. Similar to people with other pain conditions, females who experience dysmenorrhea report increased psychological distress. However, the pooled magnitude of this association has not been quantified across studies. Accordingly, this meta-analytic review quantifies the magnitude of the associations between dysmenorrhea severity and psychological distress. We conducted a systematic search of the literature using PsycINFO, PubMed, CINHAL, Embase, and Web of Science. Analyzed studies provided observational data on dysmenorrhea severity and anxiety symptoms, depressive symptoms, and/or global psychological distress. A total of 44 studies were included, and three random-effects meta-analyses were conducted, with average pooled effect sizes calculated using Person's r. We found significant, positive associations between measures of dysmenorrhea severity and measures of depressive symptoms (r = 0.216), anxiety symptoms (r = 0.207), and global psychological distress (r = 0.311). Our review suggests that females with greater dysmenorrhea severity experience greater psychological distress. Future directions include defining a clinically meaningful dysmenorrhea severity threshold, understanding the mechanisms and directionality underlying the dysmenorrhea-psychological distress relationship, and designing and testing interventions to jointly address dysmenorrhea and psychological distress.

Awareness of Polycystic Ovarian Syndrome among College Going Females in Gurgaon: A Cross-Sectional Study

Objectives Women not only take care of family members they are also source of power and symbol of progress in a society. At the same time, physical and mental well-being of women relies on healthy lifestyle and adequate reproductive health knowledge. With growing incidence of polycystic ovarian syndrome (PCOS), it is crucial to increase awareness about the disease among women at an early age in life. The present survey investigates awareness level of college going females about PCOS.

Materials and Methods A total of 428 females were recruited from 3 colleges in district Gurgaon, Haryana, India, based on convenience sampling. The respondents filled a self-completion questionnaire containing questions about sociodemographic details, menstrual cycle details, and questions related to PCOS.

Statistical Analysis Analysis was done using IBM SPSS Statistics for Windows, Version 23.0. Descriptive statistics was used to calculate frequency and percentage of variables. Pearson's chi-square test of independence was used to identify factors associated with awareness of PCOS. A p-value of < 0.05 was considered to be statistically significant.

Results The mean age of respondents was 19.9 ± 1.7 years (range = 18–24 years). Only 78 females (18.22%) had heard about PCOS. Being knowledgeable was significantly associated with mother's education (p = 0.001), length of menstrual cycle (p = 0.022), and family history of PCOS (p < 0.001).

Conclusion The present study indicates awareness of PCOS among college going females was very poor. There is an urgent need of increasing awareness about PCOS among young adult college going females to reduce the prevalence, for early diagnosis, and treatment of the disease. It is also needed to prevent long-term consequences of PCOS.