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      Understanding and supporting women with polycystic ovary syndrome: a qualitative study in an ethnically diverse UK sample

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          Abstract

          Objective

          Polycystic ovary syndrome (PCOS) is a lifelong condition. Its symptoms have been linked with psychological consequences, but less attention has been given to the daily implications of living with PCOS. We aimed to explore women’s experiences living with PCOS, and the potential acceptability of group education sessions for this target group.

          Methods

          Women with PCOS were recruited from an ethnically diverse UK community. Twelve semi-structured interviews were conducted. Analysis was underpinned by the constant comparative approach and involved the identification and exploration of key themes.

          Results

          Participants reported a range of symptoms linked with PCOS, including problems relating to menstruation and weight difficulties. Hirsutism was reported as the most distressing symptom. Emergent themes included perceptions about symptoms and delays in receiving a diagnosis; psychological distress; practical implications of living with the condition; coping with PCOS and perceived support needs. Some findings were specific to cultural backgrounds. Participants were supportive of the idea of group education for women with PCOS and suggested a need to provide education within the community and health care providers.

          Discussion

          Women with PCOS experience high psychological distress and difficulties with coping with their condition. Suggested strategies to reduce the negative psychological impact include education at various levels.

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          Most cited references21

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          Qualitative data analysis for applied policy research

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            Consensus on women's health aspects of polycystic ovary syndrome (PCOS): the Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS Consensus Workshop Group.

            Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in females, with a high prevalence. The etiology of this heterogeneous condition remains obscure, and its phenotype expression varies. Two widely cited previous ESHRE/ASRM sponsored PCOS consensus workshops focused on diagnosis (published in 2004) and infertility management (published in 2008), respectively. The present third PCOS consensus report summarizes current knowledge and identifies knowledge gaps regarding various women's health aspects of PCOS. Relevant topics addressed-all dealt with in a systematic fashion-include adolescence, hirsutism and acne, contraception, menstrual cycle abnormalities, quality of life, ethnicity, pregnancy complications, long-term metabolic and cardiovascular health, and finally cancer risk. Additional, comprehensive background information is provided separately in an extended online publication. Copyright © 2012 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
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              Emotional distress is a common risk in women with polycystic ovary syndrome: a systematic review and meta-analysis of 28 studies.

              BACKGROUND For a number of reasons, the results of previous meta-analyses may not fully reflect the mental health status of the average woman suffering from polycystic ovary syndrome (PCOS), or the causes of this distress. Our objective was to examine emotional distress and its associated features in women with PCOS. METHODS A comprehensive meta-analysis of comparative studies reporting measures of depression, anxiety or emotional-subscales of quality of life (emoQoL) was performed. PubMed, Embase, PsychInfo and the Cochrane trial register databases were searched up to November 2011 (see Supplementary Data for PUBMED search string). Unpublished data obtained through contact with authors were also included. The standardized mean difference (SMD) of distress scores was calculated. Subgroup analyses and meta-regression analysis of methodological and PCOS-related features were performed. RESULTS Twenty-eight studies (2384 patients and 2705 control women) were included. Higher emotional distress was consistently found for women with PCOS compared with control populations [main outcomes: depression: 26 studies, SMD 0.60 (95% confidence interval (CI) 0.47-0.73), anxiety: 17 studies, SMD of 0.49 (95% CI 0.36-0.63), emoQoL: 8 studies, SMD -0.66 (95% CI -0.92 to -0.41)]. However, heterogeneity was present (I(2) 52-76%). Methodological and clinical aspects only partly explained effect size variation. CONCLUSIONS Women with PCOS exhibit significantly more emotional distress compared with women without PCOS. However, distress scores mostly remain within the normal range. The cause of emotional distress could only partly be explained by methodological or clinical features. Clinicians should be aware of the emotional aspects of PCOS, discuss these with patients and refer for appropriate support where necessary and in accordance with patient preference.

                Author and article information

                Journal
                Endocr Connect
                Endocr Connect
                EC
                Endocrine Connections
                Bioscientifica Ltd (Bristol )
                2049-3614
                July 2017
                17 May 2017
                : 6
                : 5
                : 323-330
                Affiliations
                [1 ]University of Leicester Diabetes Research Centre, Leicester Diabetes Centre, Leicester General Hospital, Leicester, UK
                [2 ]Department of Diabetes and Endocrinology Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, Leicester, UK
                Author notes
                Correspondence should be addressed to H Mani; Email: hamidreza.mani@ 123456uhl-tr.nhs.uk
                Article
                EC170053
                10.1530/EC-17-0053
                5510451
                28515051
                0c51d52f-fe39-42c3-a090-f7fd089261a2
                © 2017 The authors

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 15 May 2017
                : 16 May 2017
                Categories
                Research

                polycystic ovary syndrome,quality of life,wellbeing,multi-ethnic,qualitative

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