QUALITY OF LIFE & PCOS
In women with PCOS, what is the prevalence and severity of reduced quality
of life and should quality of life be assessed as part of standard care?
In women with PCOS, what dimensions of quality of life are most affected?
In women with PCOS, what is the most effective tool/method to assess quality of life?
Health related quality of life (HRQoL) is a well-recognised and important health outcome, especially in chronic disease and relates to patient reported physical, social and emotional effects of a condition and its associated treatments.
Assessment is self-reported and can be measured through a variety of tools. Generic tools include the Short Form-36 (SF-36) and World Health Organisation (WHO) tools, yet these are not ideal for PCOS with a significant focus on mobility, impact on work, pain, environment and propensity to infective illnesses. They do not consider key dimensions
of PCOS such as infertility and hirsutism and PCOS specific tools are now available. The polycystic ovary syndrome questionnaire (PCOSQ) has 26 items across emotions, body hair, weight, infertility and menstrual abnormalities and the modified polycystic ovary syndrome questionnaire (MPCOSQ) adds acne . These tools have been adapted and tested in different ethnic populations. The role of these tools in clinical care remains unclear and the key dimensions affecting quality of life (QoL) are controversial.
Meta-analysis of five studies using SF-36 and three studies using the WHO tool in adult women, all of which were low quality and low certainty, suggest that women with PCOS have lower quality of life compared to women without PCOS.
Statistical heterogeneity was present in meta-analysis for six out of the ten domains in SF-36 and in one out of four domains in the WHO tool. These generic QoL tools are poorly tailored and include features unrelated to PCOS such as immobility, pain, risk of infections and environment with limited relevance in PCOS. However they are the only tools that can compare HRQoL across women with and without PCOS, with studies demonstrating reduced HRQoL scores in PCOS, compared to controls and normative population data.
The commonly used tools for screening women with PCOS are the PCOSQ scale with domains to assess emotions, body hair, weight, infertility difficulties and menstrual problems and the acne domain . In PCOS, HRQoL occurs in the context of the multitude of clinical features and is affected by anxiety, poor body image and low selfesteem,
depressive symptoms, delayed diagnosis and inadequate education and information provision by health professionals . A meta-analysis and recent update have showed that key domains were hirsutism, menstruation and infertility , yet this varied by population studied, life stage and cultural factors and heterogeneity is to be expected.
Primarily, health professionals should be armed with awareness of the impact of PCOS
on QoL and should capture patient priorities to deliver meaningful outcomes when partnering with women with PCOS in their care.
Gyinos, dietary supplement,Myo-inositol (2g) and Folic Acid (200µg) coping with ovarial disfunction in PCOS. Myo-inositol supplementation in women with polycystic ovary syndrome (PCOS) has been evaluated over the last years. Many hormonal and reproductive impairments associated with this disorder seem relieved by the supplement.
