Weight Loss and Lowering Androgens Predict Improvements in Health-Related Quality of Life in Women With PCOS

Dokras, Anuja; Sarwer, David B.; Allison, Kelly C.; Milman, L.W.; Kris-Etherton, Penny M.; Kunselman, Allen R.; Stetter, Christy; Williams, Nancy I.; Gnatuk, Carol L.; Estes, Stephanie J.; Fleming, Jennifer; Coutifaris, Christos; Legro, Richard S.

doi:10.1210/jc.2016-1896

Cited by 132 publications

(126 citation statements)

References 40 publications

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“…Women with PCOS and irregular menstrual cycles with hirsutism, had higher anxiety symptoms but not depressive symptoms than control women (86). Among women with PCOS who lost weight during a 16 week intervention with oral contraceptive pills or a lifestyle modification program, anxiety symptoms decreased significantly (87). Clinicians should be aware when treating ovarian hormone related disorders, such as PCOS, that anxiety or affective symptoms may also occur.…”

Section: Epidemiology Of Anxiety Disorders Across the Female Lifespanmentioning

confidence: 99%

Anxiety Disorders Among Women: A Female Lifespan Approach

Hantsoo

Epperson

2017

FOC

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Anxiety symptoms may present differently between women and men, and at different points in the female lifespan. The female lifespan includes distinct epochs of hormonal function, including puberty, the premenstruum, in some women pregnancy or postpartum, and the menopausal transition. These stages give rise to important treatment considerations when treating anxiety in women. When making assessments, the clinician should consider reproductive events and hormonal status, as well as sex differences in anxiety presentation. This review is structured to: 1) Define major epochs of the female lifespan, 2) Provide a brief summary of the major anxiety disorders, with a focus on prevalence and presentation in the context of sex differences and at points in the female lifespan, 3) Describe potential biopsychosocial underpinnings of anxiety disorders among women, 4) Provide guidelines for assessment and differential diagnosis, and 5) Describe treatment options with attention to reproductive events such as pregnancy.

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Section: Epidemiology Of Anxiety Disorders Across the Female Lifespanmentioning

confidence: 99%

Anxiety Disorders Among Women: A Female Lifespan Approach

Hantsoo

Epperson

2017

FOC

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“…According to the recent International Evidencebased Guidelines for the Assessment and Management of PCOS, all women with PCOS should be screened and monitored for QOL status to prevent, identify, and manage their health concerns. While these guidelines recommended that improving the QOL of the patients should consider as an important goal of treatment [11,35,36], the effect of OCs on psychological health and QOL of PCOS has been investigated only in a limited number of previous studies [12][13][14][15]. Available data showed that treatment with OC was associated with a signi cant improvement in the QOL in a 16-week randomized controlled trial (RCT) [13], a 12-month RCT [12], and a 6-month observational trial [14].…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have been suggested that the management of PCOS can improve both physical and psycho-emotional aspects of QOL [10,12,13]. To assess the effects of OCs on QOL domains, we used a speci c questionnaire with a multi-dimensional concept, which was developed for examining the impact of PCOS or its treatment on psychosocial-emotional, self-image, fertility, sexual function, hirsutism, and obesity-menstrual disorders.…”

Section: Discussionmentioning

confidence: 99%

“…Despite numerous studies on the association between PCOS and QOL [6][7][8][9][10], a limited number of studies have evaluated the effects of OCs on the QOL of PCOS patients [11][12][13][14]. Besides, to the best our knowledge, there is no study comparing the effectiveness of these pharmacological treatments on the QOL of patients based on their progestin component.…”

Section: Introductionmentioning

confidence: 99%

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Effects of oral contraceptives on the quality of life of women with polycystic ovary syndrome: a crossover randomized controlled trial

Amiri

Nahidi

Khalili

et al. 2020

Preprint

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Background and objective A limited number of studies have evaluated the effects of oral contraceptives (OCs) on the quality of life (QOL) of polycystic ovary syndrome (PCOS) patients. This study aimed to compare the effects of using OCs containing levonorgestrel (LNG) and those containing desogestrel (DSG), cyproterone acetate (CPA) or drospirenone (DRSP) for 6 months on the QOL with PCOS. Methods In this crossover randomized controlled 6-arm trial, 200 eligible patients with PCOS scheduled for OC therapy were randomly assigned to one of the 6 study arms. All 6 arms include two 6-month treatment periods, one period with OCs containing LNG, and the other with each of the 3 OCs containing DSG, CPA, or DRSP. Outcomes of interest were the total score of QOL and its domains, which were assessed using a specific and valid health‐related quality of life questionnaire for PCOS, which is consisted of six domains, including psychosocial–emotional, self-image, fertility, sexual function, hirsutism, and obesity– menstrual disorders.Results Finally, a total of 88 patients were analyzed for this study. The results showed that use of OCs containing DSG, CPA, and DRSP for 3 months was not associated with significant differences in the total scores of QOL compared to those OCs containing LNG, whereas, after 6 months of treatment, patients treated with OCs containing CPA had more improvements in their total scores of QOL, in comparison to OCs containing LNG (P < 0.042). We found no significant differences in QoL domains, including psychosocial–emotional, self-image, fertility, sexual function, hirsutism, and obesity-menstrual disorders after 3- 6 months of treatment with DSG, CPA, or DRSP, compared to LNG. The sequence and period effects were not significant in any of the analyses at 3 and 6 months of treatment. The carry-over effect was not significant for most outcomes assessed. Conclusions This crossover study demonstrated non-inferiority of OCs with newer generation progestins on different domains of QOL, in comparison with older compounds, although usage of products containing CPA was significantly associated with more improvement in total QOL of PCOS patients, compared to those containing LNG after 6-month of treatment. Clinical Trial Registration Number: IRCT201702071281N2.

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“…However, given that the present study demonstrated no association between pre-training IMAT levels and changes in insulin resistance, or between pre-training vitamin D levels and changes in IMAT, it does not appear that potential benefits of higher vitamin D in PCOS are attributable to lower muscle fat infiltration. Nevertheless, addressing low vitamin D and physical inactivity in women with PCOS may provide significant improvements in quality of life through reductions in adiposity [36]. This may be relevant to other features of PCOS, given that higher vitamin D levels are associated with greater reproductive success in women with PCOS [37], and that there is evidence that vitamin D reduces cytokine secretion through its effects on the NF-κB pathway in adipocytes [38], which may reduce systemic inflammation observed in PCOS.…”

Section: Discussionmentioning

confidence: 99%

Associations of Vitamin D with Inter- and Intra-Muscular Adipose Tissue and Insulin Resistance in Women with and without Polycystic Ovary Syndrome

et al. 2016

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Low vitamin D and insulin resistance are common in polycystic ovary syndrome (PCOS) and associated with higher inter- and intra-muscular adipose tissue (IMAT). We investigated associations between vitamin D, IMAT and insulin resistance in a cross-sectional study of 40 women with PCOS and 30 women without PCOS, and pre- and post-exercise in a 12-week intervention in 16 overweight participants (10 with PCOS and six without PCOS). A non-classical body mass index (BMI) threshold was used to differentiate lean and overweight women (BMI ≥ 27 kg/m2). Measurements included plasma 25-hydroxyvitamin D (25OHD), insulin resistance (glucose infusion rate (GIR; mg/m2/min), fasting glucose and insulin, and glycated haemoglobin), visceral fat, mid-thigh IMAT (computed tomography) and total body fat (dual-energy X-ray absorptiometry). Women with both PCOS and low 25OHD levels had the lowest GIR (all p < 0.05). Higher IMAT was associated with lower 25OHD (B = −3.95; 95% CI −6.86, −1.05) and GIR (B = −21.3; 95% CI −37.16, −5.44) in women with PCOS. Overweight women with pre-exercise 25OHD ≥30 nmol/L had significant increases in GIR, and decreases in total and visceral fat (all p < 0.044), but no associations were observed when stratified by PCOS status. Women with PCOS and low 25OHD levels have increased insulin resistance which may be partly explained by higher IMAT. Higher pre-training 25OHD levels may enhance exercise-induced changes in body composition and insulin resistance in overweight women.

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Weight Loss and Lowering Androgens Predict Improvements in Health-Related Quality of Life in Women With PCOS

Abstract: Both weight loss and OCP use result in significant improvements in several physical and mental domains related to quality of life, depressive symptoms, and anxiety disorders, and combined therapies offer further benefits in overweight/obese women with PCOS.

Cited by 132 publications

References 40 publications

Anxiety Disorders Among Women: A Female Lifespan Approach

Anxiety Disorders Among Women: A Female Lifespan Approach

Effects of oral contraceptives on the quality of life of women with polycystic ovary syndrome: a crossover randomized controlled trial

Associations of Vitamin D with Inter- and Intra-Muscular Adipose Tissue and Insulin Resistance in Women with and without Polycystic Ovary Syndrome

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