CLINICAL RESEARCH
Health-Related Quality of Life Issues in Women With Polycystic Ovary Syndrome

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Objective:

To evaluate the influence of obesity, fertility status, and androgenism scores on health-related quality of life in women with polycystic ovary syndrome (PCOS).

Design:

Cross-sectional, correlational.

Setting:

Private reproductive endocrinology practice in two southeast U.S. cities.

Participants:

Convenience sample of 128 women with PCOS, half of whom were attempting to conceive in addition to being treated for PCOS. Most were White (97%), married (78%), with a mean age of 30.4 years (SD ± 5.5).

Main Outcome Measures:

The Health-Related Quality of Life Questionnaire (PCOSQ) for women with polycystic ovary syndrome. A laboratory panel and clinical measures, including body mass index, waist-to-hip ratio, and degree of hirsutism.

Results:

The most common health-related quality of life concern reported by women with PCOS was weight, followed in descending order by menstrual problems, infertility, emotions, and body hair.

Conclusions:

The psychological implications of PCOS are easily underestimated and have been largely ignored. Nursing has a pivotal role in recognizing these concerns and implementing therapy to improvequality of life in women with PCOS.

Section snippets

Design

This was a cross-sectional, correlational study of women with PCOS who were patients of a private reproductive endocrinology practice. Prior to the conduct of the study, permission was obtained from Human Subjects Review Committees at both the University of Michigan and East Tennessee State University. The reproductive medicine practice where the women were recruited was located in two small cities in southern Appalachia. Women who had been previously diagnosed with PCOS and were scheduled for

Results

During the 7-month enrollment, 179 women were invited to participate; 175 women consented and were enrolled, and 158 women completed surveys. The mean age of this sample was 30.4 years (SD ± 5.5). The majority of women were White (96.9%, n = 124) and married (78.1%, n = 100), and most had some education beyond high school (66.4%, n = 82), including either college or trade school. Most women were employed full time (75.8%, n = 97).

Table 1, Table 2, Table 3 present the clinical features of the

Discussion

This study is one of the first to systematically evaluate the influence of the major clinical features of PCOS on QOL in patients. The PCOSQ instrument correlated well with study variables that addressed specific PCOS symptoms. Not surprisingly, the more adverse the clinical feature (BMI, fertility loss, androgenism), the greater the impact on QOL.

Conclusions

The results of this study indicate that women with PCOS have the greatest concern in the area of weight, followed by menstrual problems and infertility. These concerns are directly reflected in their objective life experiences. Women with PCOS clearly need education and support regarding the effect of their condition on their QOL.

Consumer Web sites for patients are a phenomenon that has come of age. There are numerous PCOS information sites and support groups available on the Web. These sites

Limitations

The use of a relatively homogeneous sample of White, married women attending a private reproductive endocrinology practice in central Appalachia may limit generalization of the findings to the entire PCOS population. Patient populations undergoing or seeking medical treatment are known to differ on a number of sociocultural and psychological parameters compared to community samples. Nelson, Palmer, Pedersen, and Miles (1999) reported depression, anxiety, and impaired self-esteem in obese adults

Nursing Implications

The importance of including health-related QOL instruments to evaluate treatment from the patient’s perspective and to investigate clinical interventions over time has been established (Colwell et al., 1998, Mant and Fowler, 1990, Streiner, 1995). The PCOSQ is a brief screening tool nurses and other health care providers can use to help prioritize health-related concerns from the patient’s prospective. In this way, emotional concerns can be evaluated and prioritized along with physical concerns

Acknowledgment

Supported in part by East Tennessee State University College of Nursing, the University of Michigan School of Nursing, the Center for Applied Reproductive Science, and Diagnostics Products Corporation.

REFERENCES (18)

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