Psychosocial Considerations and Quality of Life Issues in Polycystic Ovary Syndrome

Since polycystic ovary syndrome (PCOS) is a condition that is not associated with significant mortality and extreme illness, there is a tendency to underestimate the effect it has on the quality of life of women who suffer from this disorder. Quality of life may be defined as the aspects of a person's happiness that are affected by illness or general health. Much of the information on quality of life issues pertaining to women with PCOS has been gleaned from small studies and requires larger populations to validate the data. However, there are several patterns that seem to be clear.

Polycystic ovary syndrome causes a significant degree of emotional stress in many women due to changes in their physical appearance and concerns about infertility. These issues may lead to altered sexual attitudes as well as changed perceptions of their own sexuality, femininity, and their very identity as women. Women with PCOS scored lower than women in control groups for self-esteem, body image, romantic satisfaction and involvement and comfort in social activity. They have a higher incidence of depression and an increased reaction to stress. Unfortunately, PCOS usually manifests itself in women who are at an age where they are becoming aware of their own sexuality (adolescence) and may be looking for a partner and/or marriage. Quality of life issues appear to be similar for obese and non-obese women with PCOS.

Adolescents with PCOS also experience a reduced quality of life. They encounter similar problems to adult women with PCOS in addition to problems with general behavior and feelings of alienation from family and friends.

Symptoms associated with hirsutism were reported as a greater source of distress than menstrual irregularities and infertility in women with PCOS. Facial hair appears to be a significant cause of emotional distress to approximately 90% of the women. Women with PCOS also reported having significantly higher social fears than the control group as well as increased anxiety.

Women with PCOS who have acne also suffer considerably in their psychological wellbeing. Women with PCOS and acne reported:

• Higher rates of considering suicide
• Impaired social functioning
• Reduced social involvement
• Reduced vitality
• More mental health problems

Women with PCOS who develop diabetes report that it has a significant effect on their physical as well as psychological functioning and well being. Quality of life appears to deteriorate with increasing need for medical intervention (i.e. diet to medication to insulin) for treatment of diabetic related PCOS.

Woman with PCOS who experience Obstructive Sleep Apnea Syndrome (OSAS) indicate that it has a significant effect on their level of daily functioning and well as a reduction of energy and vitality. Women who are treated for OSAS with continuous positive airway pressure (CPAP) report improvement in their quality of life.

Education and support are critically important in helping women with PCOS to cope with the physical and psychosocial aspects of PCOS. Doctors and other health professionals should be particularly mindful about evaluating and treating more than just the physical symptoms of PCOS. Support groups and organizations that disseminate information about PCOS, diabetes, and infertility are valuable resources for women with this disorder.