Global Prespective
Polycystic ovary syndrome (PCOS) is a multifactorial disease caused by both genetic and environmental factors acting concurrently with rising prevalence at an alarming rate. It is a health problem that affects 1 out of 10 women of childbearing age. Approximately 6.6% of unselected reproductive-aged women are diagnosed with PCOS in USA. The annual cost burden is 93 million dollar for initial evaluation only and total cost for evaluation and treatment for reproductive-aged PCOS women is 4.36 billion dollar in USA. Polycystic ovary syndrome affects 15-20% of reproductive women. Approximately 5-10% women are affected by PCOS in fertility ages. PCOS have negative impact on quality of life. Infertility is main cause of decrease quality of life in women age above 25 year. PCOS can also lead to abortion. Quality of life determinants depends upon different demographic variables. Hirsutism, oligomenorrhea or amenorrhea, hypertension, weight gain, hair loss and acne shows significant association with PCOS. Hirsutism is main cause of decrease quality of life among women below 25 years of age. On the other hand, infertility is one of the main reason for decreased quality of life in women age above 25 year. The increasing prevalence of depression in PCOS patients has been reported significantly with time. Obesity, body hair, and infertility may decrease self-confidence and create depressive symptoms in patients with PCOS. In addition, changes in hormonal levels may lead to anxiety directly. Insulin resistance is significantly associated with depression in patients with polycystic ovary syndrome patients. Poor body image cause inauspicious consequences on sexual satisfaction of women with PCOS. Acne appearing mostly on face effects the personality of a patient which decreased quality of life. Moreover, outer appearance cause depression in PCOS women.
Impact of PCOS on Women Quality of Life
PCOS is a health problem that affects 1 out of 10 women of childbearing age. PCOS have negative impact on quality of life resulting in depression. The importance of health related quality of life of polycystic ovary syndrome patients has been long recognized in developed countries but in developing countries like Pakistan this concept is still in early stages. The prevalence of PCOS among general population is 3-7 % while in 20.7 % of the cases it is associated due to different co morbidities and in 6-8% of the cases it leads to infertility 10. PCOS is associated with obesity in 60% of the women and also increases the risk of diabetes and cardiovascular disease in 10 % and 33 % of the women, respectively Nearly 85-90% of women suffer oligomenorrhoea while 30-40% present with amennorhoea as clinical features of anovulation but not all patients show these symptoms while PCOS was diagnosed in 16 % of the patient during surgery. The major reasons for the increasing burden of the disease is lack of awareness, healthcare facilities, technical equipment’s for diagnosis and financial support due to which most of the people are left untreated, resulting in decrease quality of life and increased depression. In the past few decades, various contributing factors effecting quality of life were studied worldwide for better understanding of different aspects associated with decreased health related quality of life and increased psychosocial burden among PCOS women, but women reproductive health is still one of the neglected areas in most of the developing countries including Pakistan.
A study was conducted to determine the health related quality of life and depression among polycystic ovary syndrome patients in Pakistan. Health care facilities both from public and private sector were included in study. The results of the study concluded that polycystic ovary syndrome had a negative impact on health related quality of life of patients across all domains with a significant likelihood of depression. While all domains were affected, the greatest impact was seen on infertility followed by body hairs and role limitation due to increased psychological and emotional problems. Low educational and income background had negative effect on mental and emotional HRQoL of polycystic ovary syndrome patients and depression.