El síndrome de ovario poliquístico: aspectos psicológicos

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Abstract

Antecedentes: La gran mayoría de la literatura científica sobre el síndrome de ovario poliquístico (SOP) ha utilizado un enfoque bio-médico para analizar esta enfermedad. En América Latina, y específicamente en idioma español, hay escasa información sobre las relaciones del SOP con factores psicológicos. Objetivo: Analizar este trastorno ginecológico de origen endocrino y su asociación con diferentes factores psicológicos, así como su abordaje integral. Método: Se realizó una búsqueda en bases de datos en los últimos años con los términos "SOP", "calidad de vida", "ansiedad", "depresión", "imagen corporal" y "disfunción sexual". Resultados: El SOP es una enfermedad multifactorial que se ha vinculado a la depresión, la ansiedad, el estrés, la insatisfacción de la imagen corporal, trastornos sexuales y de la alimentación, el funcionamiento cognitivo, calidad de vida y el bienestar psicológico; la co-ocurrencia de este tipo de situaciones psicológicas alimenta la condición somática en mención. Conclusión: El abordaje psicológico puede complementar las acciones preventivas y terapéuticas que influyen en la efectividad del tratamiento y el bienestar subjetivo informado por los pacientes.

Translated abstract

Background: The vast majority of the scientific literature on polycystic ovary syndrome (PCOS) have used a bio-medical approach to analyzing this disease. In Latin America, specifically in Spanish, little is known about the relationship of PCOS with psychological factors. Aim: To analyze this gynecological disorder of endocrine origin and their association with different psychological factors and their comprehensive approach. Method: A search was performed in databases in recent years with the terms "PCOS", "quality of life", "anxiety", "depression", "body image" and "sexual dysfunction." Results: PCOS is a multifactorial disease that has been linked to depression, anxiety, stress, dissatisfaction with body image, sexual and eating disorders, cognitive functioning, quality of life and psychological well-being; the co-occurrence of such psychological situations feed the somatic condition analyzed. Conclusion: The psychological approach can complement the preventive and therapeutic actions that influence the effectiveness of treatment and subjective well-being reported by patients.

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Polycystic ovary syndrome: a complex condition with psychological, reproductive and metabolic manifestations that impacts on health across the lifespan

H J Teede, Amanda Deeks, Steven Moran (2010)

Polycystic ovary syndrome (PCOS) is of clinical and public health importance as it is very common, affecting up to one in five women of reproductive age. It has significant and diverse clinical implications including reproductive (infertility, hyperandrogenism, hirsutism), metabolic (insulin resistance, impaired glucose tolerance, type 2 diabetes mellitus, adverse cardiovascular risk profiles) and psychological features (increased anxiety, depression and worsened quality of life). Polycystic ovary syndrome is a heterogeneous condition and, as such, clinical and research agendas are broad and involve many disciplines. The phenotype varies widely depending on life stage, genotype, ethnicity and environmental factors including lifestyle and bodyweight. Importantly, PCOS has unique interactions with the ever increasing obesity prevalence worldwide as obesity-induced insulin resistance significantly exacerbates all the features of PCOS. Furthermore, it has clinical implications across the lifespan and is relevant to related family members with an increased risk for metabolic conditions reported in first-degree relatives. Therapy should focus on both the short and long-term reproductive, metabolic and psychological features. Given the aetiological role of insulin resistance and the impact of obesity on both hyperinsulinaemia and hyperandrogenism, multidisciplinary lifestyle improvement aimed at normalising insulin resistance, improving androgen status and aiding weight management is recognised as a crucial initial treatment strategy. Modest weight loss of 5% to 10% of initial body weight has been demonstrated to improve many of the features of PCOS. Management should focus on support, education, addressing psychological factors and strongly emphasising healthy lifestyle with targeted medical therapy as required. Monitoring and management of long-term metabolic complications is also an important part of routine clinical care. Comprehensive evidence-based guidelines are needed to aid early diagnosis, appropriate investigation, regular screening and treatment of this common condition. Whilst reproductive features of PCOS are well recognised and are covered here, this review focuses primarily on the less appreciated cardiometabolic and psychological features of PCOS.

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Why Are Autism Spectrum Conditions More Prevalent in Males?

Simon Baron-Cohen, Michael V Lombardo, Bonnie Auyeung … (2011)

Autism Spectrum Conditions (ASC) are much more common in males, a bias that may offer clues to the etiology of this condition. Although the cause of this bias remains a mystery, we argue that it occurs because ASC is an extreme manifestation of the male brain. The extreme male brain (EMB) theory, first proposed in 1997, is an extension of the Empathizing-Systemizing (E-S) theory of typical sex differences that proposes that females on average have a stronger drive to empathize while males on average have a stronger drive to systemize. In this first major update since 2005, we describe some of the evidence relating to the EMB theory of ASC and consider how typical sex differences in brain structure may be relevant to ASC. One possible biological mechanism to account for the male bias is the effect of fetal testosterone (fT). We also consider alternative biological theories, the X and Y chromosome theories, and the reduced autosomal penetrance theory. None of these theories has yet been fully confirmed or refuted, though the weight of evidence in favor of the fT theory is growing from converging sources (longitudinal amniocentesis studies from pregnancy to age 10 years old, current hormone studies, and genetic association studies of SNPs in the sex steroid pathways). Ultimately, as these theories are not mutually exclusive and ASC is multi-factorial, they may help explain the male prevalence of ASC.

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Clinical and psychological correlates of quality-of-life in polycystic ovary syndrome.

Susanne Hahn, Sigrid Elsenbruch, Klaus Mann … (2005)

Polycystic ovary syndrome (PCOS) has been shown to cause a reduction in quality of life. This study examines the extent of different PCOS symptoms on quality-of-life, psychosocial well-being and sexual satisfaction. Complete metabolic, hormonal, clinical and psychosocial data were obtained from a total of 120 women with PCOS. Patients were compared with 50 healthy women to establish reductions in quality-of-life and emotional well-being. In addition, the correlation between psychosocial variables and the major clinical PCOS features obesity (body mass index (BMI)), excessive body hair (hirsutism score), acne, hyperandrogenism (serum testosterone levels), disturbed insulin regulation (area under the insulin response curve and homeostasis model assessment of insulin resistance), menstrual cycle disturbances and infertility were analyzed. PCOS patients showed significant reductions in quality-of-life, increased psychological disturbances, and decreased sexual satisfaction when compared with healthy controls. BMI and hirsutism scores, but not the presence of acne, were associated with physical aspects of quality-of-life and sexual satisfaction. No clear effect of androgens or insulin resistance on psychosocial variables was detected. Similarly, the type of menstrual cycle disturbances or infertility had no impact on psychological well-being. In PCOS, changes in appearance, particularly obesity and hirsutism, reduce physical dimensions of quality-of-life and decrease sexual satisfaction. The role of biochemical, endocrine and metabolic parameters as well as menstrual irregularities and infertility appeared to be less important. Clinicians should pay attention to the psychosocial dimensions of PCOS on an individual basis, regardless of symptom severity or treatment response.

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Journal

Journal ID (publisher-id): rchog

Title: Revista chilena de obstetricia y ginecología

Abbreviated Title: Rev. chil. obstet. ginecol.

Publisher: Sociedad Chilena de Obstetricia y Ginecología (Santiago, , Chile )

ISSN (Print): 0048-766X

ISSN (Electronic): 0717-7526

Publication date (Print and electronic): August 2015

Volume: 80

Issue: 4

Pages: 341-347

Affiliations

[03] orgnameUniversidad de San Buenaventura Colombia

[01] orgnameFundación Universitaria Sanitas Colombia

[02] orgnameFundación Universitaria Sanitas orgdiv1Grupo de Investigación Psychology and Health Sanitas Colombia

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Publisher ID: S0717-75262015000400010 Publisher ID: S0717-7526(15)08000400010

SO-VID: 511b4e1f-7228-486e-a2bc-00f826bbad39

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

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El síndrome de ovario poliquístico: aspectos psicológicos

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Abstract

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SciELO Chile

Most cited references 86

Polycystic ovary syndrome: a complex condition with psychological, reproductive and metabolic manifestations that impacts on health across the lifespan

Why Are Autism Spectrum Conditions More Prevalent in Males?

Clinical and psychological correlates of quality-of-life in polycystic ovary syndrome.

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