Health-related Quality Of Life Assessment In Women With Polycystic Ovary Syndrome

Background:Polycystic ovary syndrome(PCOS)is the most common endocrine disorder in reproductive age women.It has heterogeneous clinically manifestations including amenorrhea,oligomenorrhea,hirsutism,obesity.It is a life-long disorder and cannot be completely cured.The disorder may affect normal life in PCOS patients,leading to a lower quality of life.The evaluation on the quality of life in PCOS patients was started relatively earlier in western countries compared to our country.Questionnaires used in our country are the generic ones.These questionnaires are not specifically designed for patients with PCOS.Taiwan scholars have translated English version PCOSQ into Chi-PCOSQ.It is a effective tool to evaluate the quality of life in patients with PCOS.Objective: To assess the quality of life in patients with PCOS and the controls using questionnaires of SF-36 and Chi-PCOSQ.To explore the correlation between the symptoms such as hirsutism,obesity and the quality of life in patients with PCOS.Methods: The study was carried out in the Gynecologic outpatient clinic at the First Affiliated Hospital of Dalian Medical University with two group comparison.The first group consisted of 36 patients(including previous 15 PCOS patients interviewed by telephone call),who were diagnosed with PCOS according to 2003 Rotterdam Criteria.The second group consisted of 37 women(including the patients' family members),who had regular menstruation and had diagnoses of common disorder.Two groups are aged 18-35 years old.All participants provided written informed consent regarding their willingness to participate in the research.A well-trained interviewer assessed each participant,and confirmed that all participators completed the SF-36,Chi-PCOSQquestionnaires,and demographic questions regarding age,the highest education level and so on.Body height and weight were measured to calculate body mass index(BMI).We collected gynecological Ultrasound(Count number of follicles),sex hormone level in plasma and use SPSS 20.0 for statistical analysis.Result: 1.The mean age in two groups were respectively: 27.97±4.85,28.08±4.15 years old.The nationality,the highest education level,career,history of pregnancy of the two groups was not significantly different.Women with income monthly more than5000 RMB in control group were more than in the PCOS group.There were 91.67%PCOS patients presenting oligomenorrhea and 8.33% shortened menstrual cycle.Percentage of women with overweight and obesity in two groups were respectively:35.14% and 16.22%,24.32% and 2.70%,the differences were significant.The waist-to-hip ratios in two groups were respectively 0.85±0.07,0.76±0.04,the difference was significant.41.67% PCOS patients had hirsutism.The proportion of PCOS patients with family history of hypertension was higher(p=0.012)and it was tend to higher for family history of diabetes compared to women in the control(p=0.06).2.Scores using SF-36 in two groups had significant difference in the following six domains: physiological role: 79.17±33.07,92.84±19.68,bodily pain: 73.71±22.28,82.95±20.28(p<0.05);general health: 58.50±21.66,80.43±16.0,energy: 67.92±11.63,82.30±15.27,social function: 79.28±18.66,92.57±7.7,mental health: 68.78±15.77,83.57±8.81(p<0.001).There was no difference in physical function: 95.00±6.24,97.43±3.61,role emotional: 62.92±42.17,78.41±33.99(p>0.05).3.Domain scores using Chi-PCOSQ in two groups were respectively: weight:4.05±1.77,6.12±1.28;infertility: 4.32±1.42,6.97±0.16;emotion: 4.51±1.01,6.91±0.13;menstrual disorder: 5.05±0.88,6.39±0.87;body hair: 5.33± 1.38,6.79±0.45.There are significant difference in the five domains(P<0.001).The quality of life in women with PCOS is low,the most common concern was weight,followed indescending order by infertility,emotion,menstrual disorder,body hair.4.There are negative association between BMI and physical function domain(r=-0.399,P<0.05);There are negative association between Testosterone and physiologicalrole domain(r=-0.377,P<0.05);F-G and Testosterone have negative association with body hair(r=-0.742,P<0.001;r=-0.373,P<0.05).Conclusion:1.PCOS patients present characteristics of oligomenorrhea,hirsutism,overweight/obesity.The proportion of PCOS patients with family history of hypertension was higher and it was tended to be higher for family history of diabetes compared to women in the control.2.The assessment using SF-36 questionnaires show that the quality of life in women with PCOS is lower than the control in the following six domains: physiological role,body pain,general health,vitality,social function,mental health.3.The investigation results using Chi-PCOSQ show that the quality of life in women with PCOS is lower than the control group.The main factor which influences the quality of life is weight,followed by subsequent infertility,mood,menstrual irregularity,body hair.Correlation analysis show that the higher BMI and hairy,the lower the quality of life.