Psychological, perinatal, lifestyle and health-economic aspects of the polycystic ovary syndrome : what really matters for the patient, her family and the society

Study question: How are objective characteristics of the polycystic ovary syndrome (PCOS) and PCOS-related concerns associated with the sexual and relational satisfaction of PCOS women and their partners? Summary answer: Both objective PCOS characteristics (parity, women’s body mass index (BMI) and current unfulfilled wish to conceive) and PCOS-related concerns (women’s infertility-related and acne-related concerns) were associated with sexual and/or relational satisfaction, although some associations differed for PCOS women and their partners. What is known already: There is some evidence indicating an association between objective PCOS characteristics and sexual satisfaction of PCOS women, but this evidence is conflicting, scarce, and often no validated questionnaires are used to evaluate sexual satisfaction. No evidence is available about the association of (i) PCOS with relational satisfaction; (ii) PCOS-related concerns with sexual and relational satisfaction; and (iii) PCOS with sexual and relational satisfaction as experienced by partners of PCOS women. Study design, size, duration: We set up a cross sectional study from April 2007 till April 2009 including 31 overweight (BMI ≥ 25 kg/m²) women with PCOS at reproductive age as well as their partners with who they had a committed intimate relationship at the time of recruitment. Participants/materials, setting, methods: The study was performed at the fertility center of the Ghent University Hospital. Objective PCOS characteristics were registered and PCOS-related concerns were evaluated by the PCOS Questionnaire. Sexual (SS) and relational (RS) satisfaction were measured by the Maudsley Marital Questionnaire (MMQ). Dyadic statistical analyses were performed using linear mixed models (α < 0.05). Main results and the role of chance: A lower parity tended to be associated with higher levels of sexual and relational satisfaction, with a significantly stronger association in PCOS women than their partners (p(SS) = .015 and p(RS) = .009). A higher BMI tended to be associated with lower and higher satisfaction levels (sexual and relational) in PCOS women and their partners, respectively, with a significantly stronger association in the partners (p(SS) = .029 and p(RS) = .021). The presence of a current unfulfilled wish to conceive and a higher level of infertility-related concerns was significantly stronger associated with a higher level of PCOS women’s relational satisfaction than their partners’ (p(RS) = .021 and p(RS) = .011, respectively). And higher levels of acne-related concern were significantly associated with lower levels of sexual satisfaction in PCOS women (p(SS) = .025) and their partners (p(SS) = .002). Limitations, reasons for caution: The fact that this study was performed in a sample of PCOS women who were all overweight and the small sample size are important limitations. Data were partially missing in some couples but this limitation was dealt with by using linear mixed models. Wider implications of the findings: Our results suggest a differential association of PCOS with sexual and relational satisfaction between PCOS women and their partners. This should be kept in mind during the psychological guidance of couples dealing with PCOS

Sexual and relational satisfaction in couples where the woman has polycystic ovary syndrome: a dyadic analysis

STUDY QUESTION: How are objective characteristics of polycystic ovary syndrome (PCOS) and PCOS-related concerns associated with the sexual and relational satisfaction of PCOS women and their partners? SUMMARY ANSWER: Both objective PCOS characteristics (parity, women's body mass index (BMI) and current unfulfilled wish to conceive) and PCOS-related concerns (women's infertility-related and acne-related concerns) were associated with sexual and/or relational satisfaction, although some associations differed for PCOS women and their partners. WHAT IS KNOWN ALREADY: There is some evidence indicating an association between objective PCOS characteristics and sexual satisfaction of PCOS women, but this evidence is conflicting, scarce, and often validated questionnaires have not been used to evaluate sexual satisfaction. No evidence is available about the association of: (i) PCOS with relational satisfaction; (ii) PCOS-related concerns with sexual and relational satisfaction; and (iii) PCOS with sexual and relational satisfaction as experienced by partners of PCOS women. STUDY DESIGN, SIZE, DURATION: We set up a cross-sectional study from April 2007 until April 2009, including 31 overweight (BMI >= 25 kg/m(2)) women with PCOS and at a reproductive age as well as their partners with whom they had a committed intimate relationship at the time of recruitment. PARTICIPANTS/MATERIALS, SETTING, METHODS: The study was performed at the fertility center of the Ghent University Hospital. Objective PCOS characteristics were registered and PCOS-related concerns were evaluated by the PCOS Questionnaire. Sexual ((SS)) and relational ((RS)) satisfaction were measured by the Maudsley Marital Questionnaire (MMQ). Dyadic statistical analyses were performed using linear mixed models (alpha < 0.05). MAIN RESULTS AND THE ROLE OF CHANCE: A lower parity tended to be associated with higher levels of sexual and relational satisfaction, with a significantly stronger association in PCOS women than in their partners (p((SS)) = 0.015 and p((RS)) = 0.009). A higher BMI tended to be associated with lower and higher satisfaction levels (sexual and relational) in PCOS women and their partners, respectively, with a significantly stronger association in the partners (p((SS)) = 0.029 and p((RS)) = 0.021). The presence of a current unfulfilled wish to conceive and a higher level of infertility-related concerns was significantly more strongly associated with a higher level of relational satisfaction for PCOS women than for their partners (p((RS)) = 0.021 and p((RS)) = 0.011, respectively). Higher levels of acne-related concern were significantly associated with lower levels of sexual satisfaction in both PCOS women (p((SS)) = 0.025) and their partners (p((SS)) = 0.002). LIMITATIONS, REASONS FOR CAUTION: The fact that this study was performed in a sample of PCOS women who were all overweight and the small sample size are important limitations. Data were partially missing in some couples but this limitation was dealt with by using linear mixed models. WIDER IMPLICATIONS OF THE FINDINGS: Our results suggest a differential association of PCOS with sexual and relational satisfaction between PCOS women and their partners. This should be kept in mind during the psychological guidance of couples dealing with PCOS

Quality of life and body mass index in overweight adult women with polycystic ovary syndrome during a lifestyle modification program

Objective: To evaluate changes in body mass index (BMI) and health-related quality of life (HRQoL), including an acne parameter, of overweight adult women with polycystic ovary syndrome (PCOS) during a lifestyle modification program. Design: Prospective longitudinal within-patient study. Setting: Department of Reproductive Medicine of the Ghent University Hospital (Belgium). Participants: Thirty-three overweight (BMI >= 25 kg/m(2)) women with PCOS between age 18 and 43 years. Methods: Participants followed a 24-week lifestyle modification programconsisting of a diet, exercise, and psychological subprogram. BMI was assessed at Weeks 0, 8, 16, and 24 of the program. The HRQoL was measured at Week 0, 12, and 24 of the program using the PolyCystic Ovary Syndrome Questionnaire (PCOSQ) and a Visual Analogue Scale (VAS) to evaluate the influence of acne on HRQoL. Results: During a 24-week period no significant decrease in BMI occurred (mean difference = 1.71, 95% confidence interval [CI] [-1.38, 4.81]. During that period, there was a significant positive evolution of the total PCOSQ score, F(2, 37.5) = 23.7, the emotions, F(2, 37.9) = 4.2, weight, F(2, 42.1) = 24.8, body hair, F(2, 35.6) = 3.3, and infertility problems domain scores, F(2, 43.1) = 15.64, of the PCOSQ, as well as of the acne VAS score, F(2, 29.3) = 4.2. These effects primarily occurred during the first 12 weeks. Conclusion: In spite of no significant changes in BMI, the HRQoL of overweight adult women with PCOS significantly improved during a 24-week lifestyle modification program