Infertility caused by PCOS--health-related quality of life among Austrian and Moslem immigrant women in Austria.

Polycystic ovary syndrome (PCOS) is the most common endocrinopathy in women, affecting 4.8 % to 18.6 % of women of reproductive age. Between 10 and 19 years of age, PCOS occurs in 3.39 % to 8.03 % of adolescents. Confirmation of diagnosis in adolescent age is difficult because manifestations of PCOS are similar to normal puberty signs (e. g., irregular menstrual cycle, acne, etc.). New evidence-based guidelines have been issued in 2018 highlighting the diagnostic criteria for establishing PCOS diagnosis in adolescents. These guidelines also recommend a separate identification of risk group patients – adolescent patients for whom both diagnostic PCOS criteria have not yet been confirmed and who should continue to be monitored. It is important to diagnose this disease as early as possible in order to initiate lifestyle adjustments and possibly also begin treatment in a timely manner.In the long term, PCOS increases the risk of developing infertility and type 2 diabetes, cardiovascular disease, insulin resistance and metabolic syndrome. Increased body weight occurring in 40–70 % of adolescents with PCOS significantly increases the risk of chronic non-communicable diseases at a later stage, and maintains PCOS symptoms. PCOS and associated symptoms reduce health-related quality of life (HRQOL). Binge eating is more common in patients with PCOS. The most effective tactics of therapy are lifestyle changes, so it is particularly important to recognise patients at increased risk of developing PCOS, to diagnose them early and to offer treatment that is most relevant to the needs of the individual and improves their quality of life.The aim of the doctoral thesis is to explore intergenerational, genetic, quality of life and binge eating aspects in teenagers with PCOS.The study contains several sections. To evaluate the intergenerational bond, 57 teenagers with PCOS and their mothers were included in Section I. The section studies the relationship between patients with PCOS and their mothers. In addition to PCOS patients, Section II also includes healthy adolescent patients and patients at risk. The role of the most common variation of protein-coding genes involved in the activity of the Hypothalamic-Pituitary-Ovarian axis (FSHR, ESR2, LHCGR, GNRHR) in PCOS development and in the PCOS clinical presentation was studied by including 63 adolescents with a diagnosis of PCOS, 67 healthy control patients and 22 patients at risk. The role of CYP21A2 gene variations in PCOS development and clinical phenotype was established in 55 PCOS patients, 49 control patients and 23 patients at risk. Additionally, components of HRQOL, binge eating and factors affecting the total HRQOL were analysed in 63 PCOS patients and 66 control patients. The study concluded that it was not possible to predict clinical symptoms associated with PCOS in adolescents based on PCOS symptoms in their mothers. The role of protein-coding gene variations that are involved in the functioning of sex hormones was also not found, in regard to PCOS development. However, it was found that the homozygous minor allele carriers within variations of specific genes (ESR2 rs4986938 and LHCGR rs2293275) had a higher total testosterone level in blood than patients who were not carriers of these alleles. The most important components that affected HRQOL in adolescents with PCOS were the diagnosis of PCOS as such, the degree of binge eating, and the percentile of the body mass index. At the same time, HRQOL was most affected by concerns about body hair and body weight. There was no difference in the frequency of binge eating between PCOS patients and adolescent control group patients.In this study, no link was found between the diagnosis of PCOS or associated symptoms in mothers and the phenotype of adolescents with PCOS. Individual alleles have been associated with the clinical presentation of PCOS. There is a better understanding of the components of HRQOL that affect PCOS the most and require particular attention in clinical practice. Further research with a larger sample-size is needed. Furthermore, longitudinal data on the population studied in this project would provide a more accurate insight into the development of the disease at a later age.

Polycystic ovary syndrome (PCOS) is the most common endocrine-gynecologic disorder affecting women of childbearing age. It has a wide range of clinical manifestations, including menstrual irregularity, infertility, hirsutism, acne, and obesity. Studies have confirmed that PCOS can significantly reduce a patient's health-related quality of life (HRQoL). The pathophysiology of PCOS is poorly understood, but it is believed to be caused by the interaction of several factors. Moreover, there is a lack of information about HRQoL among PCOS women in Saudi Arabia. This study aims to assess the HRQoL of PCOS patients by using the Arabic Version of the Polycystic Ovarian Syndrome Health-Related Quality of life Questionnaire (AR-PCOSQ) in Riyadh city. A descriptive cross-sectional study was conducted on 281 women in Riyadh city using the translated questionnaire (AR-PCOSQ) to explore PCOS quality of life among Saudi females. The eligibility criteria were Saudi female who had been diagnosed with PCOS, living in Riyadh city, aged 18 and above, and willing to participate. The sample size was estimated using the 10-events-per variable rule for prediction models (REF). Informed consent was taken from all participants and a Google Form was used to create the survey and collect data. The higher score represents poor QOL. However, the analysis revealed that higher scores of the weight-related QOL had the greatest impact on patients' quality of life in older age groups, including women aged 26 to 35 (beta = 0.143, 95% CI, 0.023 to 0.304, p-value = 0.046) and women aged > 35 (beta = 0.229, 95% CI, 0.039 to 0.428, p = 0.011). Other domains of QOL, such as emotions, body hair, infertility, and menstrual problems, were not significantly predicted by any of the women's demographic characteristics. The findings revealed that PCOS-related conditions such as weight problems, menstrual irregularity, and infertility were associated with a reduction in quality of life.

We aimed to determine the impact of an oral contraceptive (OC) treatment on health-related quality of life (HRQOL), depressive and anxiety symptoms in polycystic ovary syndrome (PCOS). OC therapy in PCOS improves hirsutism and menstrual disturbances, along with HRQOL. This improvement is not associated with any change in the prevalence of depressive and anxiety symptoms. WHAT IS KNOWN AND WHAT THIS ARTICLE ADDS: Limited data are available regarding the effects of an OC on HRQOL, and depressive and anxiety symptoms in PCOS. This study reports the effects of the ethinyl estradiol/drospirenone (EE/DRSP) OC on an HRQOL questionnaire for women with PCOS (PCOSQ), depressive and anxiety symptoms after 6 months of treatment. Prospective observational study. All participants completed PCOSQ, Beck Depression Inventory, Hospital Anxiety and Depression Scale and General Health Questionnaire. Serum androgens, fasting insulin, fasting and postload glucose values during an oral glucose tolerance test were measured. Changes in these variables and the scores of questionnaires were evaluated after 6 months of treatment with EE/DRSP (3 mg/30 μg). Thirty-six patients with PCOS without a previous psychiatric diagnosis were included in the study. The main complaints of the patients were hirsutism and irregular menses. Accordingly, menstrual and hirsutism problems were the most serious concerns followed by emotional problems on the PCOSQ. Eight patients (22.2%) had clinical depression scores. After treatment, regular menstrual cycles were attained and hirsutism was significantly improved in all patients. Hirsutism and emotion domains of the PCOSQ improved at 6 months (P< 0.05 for both). Depression was improved in five of eight depressive patients and four new patients showed increased depression scores. Overall, depression, anxiety mean scores and depression rates did not show a significant change. The study is subject to the strengths and limitations of observational study design. A limitation of our study is the small sample size and lack of data related to possible confounding factors. Generalizable to Caucasian PCOS.

Polycystic ovary syndrome (PCOS) significantly impairs women’s health -related quality of life (HRQoL), yet evidence from Nepal remains limited. This study aimed to assess HRQoL and associated factors among women with PCOS attending an infertility center in Kathmandu, Nepal. A hospital-based cross-sectional study was conducted from March to September 2023 among 135 women aged 18–45 years diagnosed with PCOS, selected through simple random sampling. Data were collected through face-to-face interviews using validated instruments: the Polycystic Ovary Syndrome Questionnaire (PCOSQ), the International Physical Activity Questionnaire-Short Form (IPAQ-SF), and the Perceived Stress Scale (PSS-4). Statistical analyses included descriptive statistics, bivariate analyses, and multiple linear regression to identify the factors associated with HRQoL. The mean overall HRQoL score was 5.04 ± 1.44 on a 7-point scale, with the lowest domain scores observed for infertility (3.34 ± 1.72), emotional well-being (4.29 ± 0.97), and menstruation (4.32 ± 1.13) domains, while the body hair domain was least affected (8.58 ± 1.86). In adjusted regression, younger age, marital status, higher BMI, acne, menstrual irregularities, fertility-related history, physical inactivity, substance use, and high stress were significantly associated with poorer HRQoL (p < 0.05). Women with PCOS in Nepal experience significant impairment in HRQoL, most notably in relation to infertility, emotional well-being, and menstrual irregularities. Both modifiable and non-modifiable factors were associated with poorer HRQoL. These findings highlight the need for a holistic, patient-centered approach that integrates medical, psychological, and lifestyle interventions, particularly in resource-limited settings.

The aim of this study was to assess the psychological features in women with different polycystic ovary syndrome (PCOS) phenotypes [National Institute of Health (NIH) and non-NIH diagnostic criteria] and women without PCOS. An observational, cross-sectional study compared overweight (BMI ≥ 25 kg/m(2)) premenopausal women with PCOS (n = 29 NIH and n = 25 non-NIH) and controls (n = 27). Anxiety and depression were compared between women with NIH or non-NIH PCOS and women without PCOS. Health-related quality of life (HRQoL) domains related to emotions, body hair, weight, infertility and menstrual problems were compared between women with NIH and non-NIH PCOS. Overall, women with PCOS had worse anxiety (P = 0.007) and depression (P = 0.048) compared with women without PCOS. Both women with NIH PCOS and non-NIH PCOS presented more often with moderate anxiety (P = 0.005 and P = 0.01, respectively) compared with women without PCOS. Women with NIH PCOS had worse HRQoL related to infertility (P = 0.012), emotions (P = 0.02) and weight (P = 0.016). No significant differences were observed between the two PCOS phenotypes for HRQoL domains related to body hair or menstrual problems. Both NIH (β = 0.30, P = 0.024) and non-NIH (β = 0.32, P = 0.016) PCOS status predicted anxiety, whereas age (β = 0.35, P = 0.008) and free androgen index (β = 0.31, P = 0.027) predicted depression. PCOS is associated with anxiety and depression. Non-NIH phenotypes present with similar psychological profiles to NIH PCOS, indicating increased psychological dysfunction in PCOS, even in milder reproductive phenotypes. However, women with NIH PCOS appear to have worse HRQoL in some areas than women with non-NIH PCOS. Psychological function and HRQoL should be considered in all women with PCOS.

Background: Polycystic Ovary Syndrome (PCOS) is a prevalent endocrine disorder affecting reproductive-aged women, characterized by hyperandrogenism, ovulatory dysfunction, and polycystic ovarian morphology [1,2]. Beyond fertility concerns, PCOS has been associated with metabolic syndrome, insulin resistance, cardiovascular risk, and significant psychosocial distress [4,10,12]. The condition also profoundly affects health-related quality of life (HRQoL), with symptoms such as hirsutism, obesity, and menstrual irregularities contributing to psychological burden, especially among adolescents and women in culturally sensitive contexts [6,9,16]. Materials and Methods: This study employed a systematic literature review of peer-reviewed articles published between 1996 and 2023. Databases searched included PubMed, Scopus, and Web of Science using keywords such as "PCOS", "quality of life", "metabolic syndrome", and "psychological distress". A total of 16 key studies were included based on relevance, methodological rigor, and population diversity [1–16]. Data were extracted on diagnostic criteria, metabolic and psychological outcomes, and HRQoL assessments including validated instruments like SF-36 and PCOSQ [13,15]. Results: Findings indicate that PCOS is strongly associated with reduced HRQoL across multiple domains, particularly emotional well-being, body image, and social functioning [8,14]. Hirsutism was identified as the most impactful symptom on HRQoL in Iranian and South Asian populations [6,9]. Adolescents with PCOS reported greater psychosocial distress compared to their peers [11,16]. Furthermore, variations in diagnostic criteria (NIH, Rotterdam, AES) influenced prevalence estimates and clinical management strategies [7]. Several studies reported a bidirectional relationship between metabolic dysfunction and mental health deterioration [5,12]. Conclusion: PCOS significantly impairs both physical and mental health, with profound effects on quality of life that extend beyond reproductive concerns. Addressing PCOS requires a multidisciplinary approach that includes not only medical and hormonal management but also psychosocial support and culturally sensitive counseling. Future research should focus on individualized interventions targeting both metabolic and psychological outcomes to improve long-term health in women with PCOS.

BackgroundA condition-specific instrument is necessary to measure the health-related quality of life among those with polycystic ovary syndrome (PCOS), the most common chronic endocrinopathy among women. The first instrument was developed in 1988, followed by several revisions. However, further recommendations from all versions include additional application and measurement among different cultural populations of women with PCOS and psychometric testing based on use among larger samples of women with PCOS. Thus, the purpose of this study was to explore the factor structure of the Polycystic Ovary Syndrome Questionnaire (PCOSQ-50) using an international cross-sectional survey data from women with PCOS aged 18–42 years.MethodsUsing data from the largest known international cross-sectional study of women with PCOS aged 18–42 years (n = 935) to date, exploratory factor and confirmatory analyses were conducted for the PCOSQ-50, followed by factor labeling using a thematic analysis approach.ResultsRespondents were 31.0 ± 5.8 years of age, mostly White (72%), well-educated (56% had a college degree), married (69%), and employed full-time (65%). Three-quarters (74%) of the sample had one or more chronic conditions in addition to PCOS. Approximately 20% of the respondents originated from countries such as the United Kingdom, Australia, South Africa, etc. The PCOSQ-50 demonstrated good reliability but may be best described using a 7-factor model. The 7-factor model revealed goodness-of-fit. Thematic analysis suggested the following labels of those seven factors: hirsutism, fertility, isolation/trepidation, sexual function, self-esteem, emotional, and obesity.ConclusionMore research is needed to adapt the current PCOSQ-50, as well as to create an age-appropriate PCOS-specific HRQoL instrument for peri-postmenopausal women with PCOS.

Polycystic ovary syndrome (PCOS) is an endocrine disorder that can result in reduced health-related quality of life (HRQOL). Metabolic changes, particularly insulin resistance and obesity, play a significant role in PCOS pathogenesis. This study examined associations between metabolic factors and HRQOL in PCOS patients. A cross-sectional study of 77 patients was conducted at University Medical Center Mainz. At the time of inclusion in the study, patients had to be over 18 and not undergoing active PCOS therapy. A desire to conceive or fertility therapy led to exclusion. Participants were over 18, not undergoing PCOS therapy, and not seeking pregnancy. HRQOL and psychological distress were measured using the Modified-PCOS-Questionnaire (MPCOSQ) and Hospital Anxiety and Depression Scale (HADS). Linear regression analyses assessed associations between metabolic markers and HRQOL, with significant variables included in a multivariate model. Worsening metabolic markers were linked to lower HRQOL, especially in body hair and menstrual symptom domains. Markers such as HOMA-IR (Homeostatic Model Assessment for Insulin Resistance) levels (P=0.040), elevated VAI (Visceral Adiposity Index) (P=0.035), and increased FLI (Fatty Liver Index) (P=0.023) were associated with diminished HRQOL. In the multivariate regression analysis, only a BMI ≥25kg/m2 (P=0.001) emerged as a statistically significant value. This study showed a significant correlation between metabolic markers, including BMI, FLI, VAI, HOMA-IR, and HRQOL in PCOS patients. BMI was the most meaningful predictor for HRQOL. BMI, despite being controversial and prone to errors, may be more indicative of HRQOL than specific metabolic markers.

Health‐Related Quality of Life Among Adolescents with Polycystic Ovary Syndrome

The role of vitamin D in polycystic ovary syndrome

Hyperandrogenism in Polycystic ovary syndrome (PCOS) negatively affects health-related quality of life (HRQOL). Anti-androgens may improve both biochemical and patient-related outcomes. To evaluate the impact of combined finasteride and spironolactone on HRQOL in married and unmarried women with PCOS using PCOSQOL-47 and PCOSQOL-42, respectively. A total of 263 married and 236 unmarried women with PCOS were enrolled from two tertiary centers. All received finasteride (5mg) and spironolactone (100mg) daily and were followed every four months over a year. HRQOL was assessed using PCOSQOL-47 for married and PCOSQOL-42 for unmarried women, alongside evaluating their biochemical and clinical hyperandrogenism. After one year, significant reductions were observed in total and free testosterone, dehydroepiandrosterone sulfate, body mass index (BMI), and a decrease in modified Ferriman-Gallwey (mFG) scores. Both groups showed marked HRQOL improvement, greater in unmarried women. In PCOSQOL-47, psychological and emotional domains improved most, while fertility and sexual domains improved least. In PCOSQOL-42, menstrual and fertility domains had the highest gains, while coping improved least. Both groups had a 25% reduction in mFG score and 5% reduction in BMI. This is the first study to evaluate combined finasteride and spironolactone on HRQOL domains in PCOS using PCOSQOL-47 and PCOSQOL-42. Prior studies assessing anti- androgens used other tools, without distinction between married and unmarried women. Combined finasteride and spironolactone significantly improved all HRQOL scales and reduced hyperandrogenism within the first four months in women with PCOS, supporting its role alongside lifestyle measures.

The polycystic ovary syndrome (PCOS) is an endocrine-gynecologic disturbance characterized mainly by chronic anovulation and hyperandrogenism, affecting between 5 and 10% of reproductive-age women. The main manifestations of PCOS include the following symptoms: menstrual irregularity, excess body hair, infertility, acne, androgenetic alopecia, obesity and acantose nigricans. These symptoms appear quite heterogeneously, with marked differences in their prevalence and intensity among different groups of women with PCOS. Despite being a biological condition, PCOS is not only a physical problem, but also a psychosocial one, interfering and compromising the quality of life of the women affected. Based on a review of the literature, this study discusses the psychosocial aspects of women with PCOS, highlighting the impact of symptoms on health-related quality of life. Considering that every woman responds differently to the symptoms that present themselves, we emphasize the importance of integrating the individual perspective of women with PCOS to their social context. In this sense, research findings are discussed using quantitative and qualitative methodological approaches to better understand the experience of women faced with PCOS. The symptoms of PCOS may be associated with the occurrence of anxiety, sexual dysfunctions and feelings of inadequacy in the female role, and may also trigger depressive symptoms and social isolation, significantly compromising quality of life. The authors underscore the importance of multidisciplinary care for women with PCOS, considering this condition to be an important psychosocial problem. Attention to the psychosocial aspects of PCOS has increased in recent years; however, related scientific production is still scarce.

IntroductionUnderstanding the psychometric properties of health-related quality of life (HRQoL) questionnaires can help inform selection in clinical trials. Our objective was to assess the psychometric properties of HRQoL questionnaires in bronchiectasis using a systematic review and meta-analysis of the literature.MethodsA literature search was conducted. HRQoL questionnaires were assessed for psychometric properties (reliability, validity, minimal clinically important difference (MCID) and floor/ceiling effects). Meta-analyses assessed the associations of HRQoL with clinical measures and responsiveness of HRQoL in clinical trials.Results166 studies and 12 HRQoL questionnaires were included. The Bronchiectasis Health Questionnaire (BHQ), Leicester Cough Questionnaire (LCQ), Chronic Obstructive Pulmonary Disease (COPD) Assessment Test (CAT) and Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) had good internal consistency in all domains reported (Cronbach's α≥0.7) across all studies, and the Quality of Life-Bronchiectasis (QOL-B), St George's Respiratory Questionnaire (SGRQ), Chronic Respiratory Disease Questionnaire (CRDQ) and Seattle Obstructive Lung Disease Questionnaire (SOLQ) had good internal consistency in all domains in the majority of (but not all) studies. BHQ, SGRQ, LCQ and CAT had good test–retest reliability in all domains reported (intraclass correlation coefficient ≥0.7) across all studies, and QOL-B, CRDQ and SOLQ had good test–retest reliability in all domains in the majority of (but not all) studies. HRQoL questionnaires were able to discriminate between demographics, important markers of clinical status, disease severity, exacerbations and bacteriology. For HRQoL responsiveness, there was a difference between the treatment and placebo effect.ConclusionsSGRQ was the most widely used HRQoL questionnaire in bronchiectasis studies and it had good psychometric properties; however, good psychometric data are emerging on the bronchiectasis-specific HRQoL questionnaires QOL-B and BHQ. Future studies should focus on the medium- to long-term test–retest reliability, responsiveness and MCID in these HRQoL questionnaires which show potential in bronchiectasis.

Polycystic ovary syndrome and postpartum depression among Hispanics and non-Hispanics: a population-based study

ObjectiveHirsutism affects 5–15% of women of reproductive age. Health-related quality of life (HQOL) is a multidimensional assessment of well-being that considers the physical, social, and emotional aspects associated with a specific disease. The aim of this study is to evaluate HQOL in patients diagnosed with idiopathic hirsutism (IH) and compare it with patients diagnosed with polycystic ovary syndrome (PCOS).MethodsThis cross-sectional observational study was performed on 183 female individuals, consisting of 51 patients diagnosed with idiopathic hirsutism, 76 patients diagnosed with PCOS, and 56 healthy volunteers. Participants with a history of neuropsychiatric disorders, under 18 and over 45 years of age, during pregnancy and lactation, with any chronic disease that could interfere with diagnostic laboratory tests, and who had previously been treated for IH or PCOS were excluded from the study. Demographic, anthropometric, laboratory, and clinical data on the cases were recorded. The Short Form-36 (SF-36) questionnaire, the Beck Depression Inventory (BDI), and the Beck Anxiety Inventory (BAI) were administered in a face-to-face interview by related authors involved in the study.ResultsThe mean age, level of education, lifestyle, and marital status of all three groups were similar. There were no significant differences in body mass index (BMI) or waist circumference between the groups. Mean modified Ferriman-Gallwey (mFG) scores were similar in the IH and PCOS groups. In the IH patients, the general health and mental health domains of the SF-36 questionnaire scores were significantly lower than in the control group (p<0.001 and p=0.026, respectively). When the SF-36 questionnaire scores were compared between the IH and PCOS groups, the general health and role emotional domains were significantly lower in the PCOS group (p=0.013 and p<0.001, respectively), and the other domains were similar. All SF-36 questionnaire domains were significantly and negatively correlated with BMI and waist circumference measurements in IH patients. Both BDI and BAI scores were significantly and positively correlated with BMI (r=0.348, p<0.001, and r=0.162, p=0.012, respectively) and waist circumference (r=0.326, p<0.001, and r=0.344, p<0.001, respectively). Six out of eight domains of the SF-36 QOL scores were significantly and negatively correlated with the mFG scores.ConclusionPatients diagnosed with IH have impaired HQOL, similar to patients diagnosed with PCOS. Improving HQOL should be a goal when deciding on a management approach for hirsutism, which is one of the most common reasons for referral to endocrinology and dermatology outpatient clinics.