Providing lifestyle advice to women with PCOS: an overview of practical issues affecting success

Abstract

Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder affecting up to 13 % of women. Lifestyle interventions are first-line treatments, however attrition in women with PCOS is high. This review summarises current evidence on barriers to lifestyle management in PCOS and suggested strategies for overcoming these challenges, mapped to the Capability, Opportunity, Motivation and Behaviour model.Physical capability for lifestyle changes may be impacted by altered gut hormone regulation and energy expenditure in PCOS. This may contribute to difficulties with weight management. The higher prevalence of eating disorders, disordered eating, fatigue and sleep disturbances are further barriers. Psychological capability may be reduced due psychological symptoms and lack of critical health literacy. Women with PCOS face similar challenges in terms of Opportunity to make lifestyle changes as other women of reproductive age. However, these are complicated by features more common in PCOS including body dissatisfaction. Motivation to adopt healthy lifestyles may be impacted by suboptimal risk perception and intrinsic motivation.To address these barriers, screening for and management of eating disorders, disordered eating, depression, and Obstructive Sleep Apnoea should be undertaken as per international evidence-based guidelines. A weight-neutral approach may be appropriate with disordered eating. Building capability among health professionals to better partner with women with PCOS on their management is essential in addressing health literacy gaps. Behavioural strategies that target risk perception and build intrinsic motivation should be utilised. More research is required to understand optimal self-management strategies, risk perception, energy homeostasis and overcoming attrition in women with PCOS.

Prevalence and associated risk factors for mental health problems among patients with polycystic ovary syndrome in Bangladesh: A nationwide cross—Sectional study

“…According to our analysis, from the perspective of the socio-demographic profile, we concluded that marital status, education, financial background, area of residence, smoking habit, and family history of PCOS might be responsible for developing mental health issues among our participants. Therefore, an earlier study suggested that lifestyle change can be an option for the effective management of PCOS [ 49 ]. Another study revealed environmental and lifestyle factors contributing poor mental health of patients with PCOS [ 50 ].…”

The Effect of Tailored Short Message Service (SMS) on Physical Activity: Results from a Three-Component Randomized Controlled Lifestyle Intervention in Women with PCOS

“…Moreover, the decrease in sitting behaviour minutes, which in the SMS+ group amounted to several hours a day, may also be seen as a significant improvement. One could hypothesize that the above-mentioned findings do count as clinically relevant in this population of women with PCOS in which lifestyle habits are known to be difficult to improve [ 46 ].…”

Therapeutic Potential of Glucagon-like Peptide-1 Agonists in Polycystic Ovary Syndrome: From Current Clinical Evidence to Future Perspectives

“…At present, lifestyle change that is centered on weight reduction, combined with symptomatic treatment, is dominant. However, women with PCOS face several hurdles to successful lifestyle change, such as reduced metabolic flexibility, lack of intrinsic motivation, negative body image, depression, eating disorders, and altered risk perception [ 4 , 5 ]. Linking PCOS to inherited insulin resistance that is frequently aggravated by obesity-induced insulin resistance paved the way for trials of diabetes drugs in PCOS [ 6 , 7 ].…”