The psychosocial transition associated with spontaneous 46,XX primary ovarian insufficiency: illness uncertainty, stigma, goal flexibility, and purpose in life as factors in emotional health.

OBJECTIVE: To examine factors associated with emotional well-being in women with spontaneous primary ovarian insufficiency. DESIGN: Cross-sectional and case-control study. SETTING: Clinical research center, national U.S. health research facility. PATIENT(S): Women diagnosed with spontaneous 46,XX primary ovarian insufficiency (n = 100) at a mean age of 32.4 years and healthy control women of similar age (n = 60). INTERVENTION(S): Administration of validated self-reporting instruments. MAIN OUTCOME MEASURE(S): Illness uncertainty, stigma, goal disengagement/re-engagement, purpose in life, Positive and Negative Affect Schedule, Center of Epidemiologic Studies Depression Scale, State-Trait Anxiety Inventory. RESULT(S): Compared with controls, women with spontaneous primary ovarian insufficiency scored adversely on all measures of affect. Illness uncertainty and purpose in life were significant independent factors associated with anxiety (R(2) = 0.47), stigma and purpose in life were the significant independent factors associated with depression (R(2) = 0.51), and goal re-engagement and purpose in life were significantly and independently associated with positive affect (R(2) = 0.43). CONCLUSION(S): This evidence supports the need for prospective studies. Our findings are consistent with the hypothesis that clinicians could improve the emotional well-being of their patients with primary ovarian insufficiency by [1] informing them better about their condition, [2] helping them to feel less stigmatized by the disorder, and [3] assisting them in developing alternative goals with regard to family planning as well as other goals.

Women with spontaneous 46,XX primary ovarian insufficiency (hypergonadotropic hypogonadism) have lower perceived social support than control women.

OBJECTIVE: To test the hypothesis that women with spontaneous primary ovarian insufficiency differ from control women with regard to perceived social support and to investigate the relationship between perceived social support and self-esteem. DESIGN: Cross-sectional. SETTING: Mark O. Hatfield Clinical Research Center, National Institutes of Health. PATIENT(S): Women diagnosed with spontaneous primary ovarian insufficiency (n = 154) at a mean age of 27 years and healthy control women (n = 63). INTERVENTION(S): Administration of validated self-reporting instruments. MAIN OUTCOME MEASURE(S): Personal Resource Questionnaire 85 and Rosenberg Self-Esteem Scale. RESULT(S): Women with primary ovarian insufficiency had significantly lower scores than controls on the perceived social support scale and the self-esteem scale. The findings remained significant after modeling with multivariate regression for differences in age, marital status, and having children. There was a significant positive correlation between self-esteem scores and perceived social support in patients. We found no significant differences in perceived social support or self-esteem related to marital status, whether or not the women had children, or time since diagnosis. CONCLUSION(S): This evidence supports the need for prospective controlled studies. Strategies to improve social support and self-esteem might provide a therapeutic approach to reduce the emotional suffering that accompanies the life-altering diagnosis of spontaneous primary ovarian insufficiency.

Functional well-being is positively correlated with spiritual well-being in women who have spontaneous premature ovarian failure.

OBJECTIVE: To examine the relationship between spiritual well-being and functional well-being in women who have spontaneous premature ovarian failure. DESIGN: Cross-sectional. SETTING: The Mark O. Hatfield Clinical Research Center at the US National Institutes of Health. PATIENT(S): Women diagnosed with spontaneous premature ovarian failure (N = 138) at a median age of 28 years. INTERVENTION(S): Administration of validated self-reporting instruments. MAIN OUTCOME MEASURE(S): Functional Well-Being, Spiritual Well-Being, Meaning/Peace, and Faith scores. RESULT(S): We found a significant positive correlation between overall spiritual well-being and functional well-being scores. The Meaning/Peace subscale strongly correlated with functional well-being, explaining approximately 62% of the variance. In contrast, the Faith subscale was less strongly correlated with functional well-being, explaining only 7% of the variance. In multiple regression analysis evaluating the relative subscale contributions to functional well-being, only Meaning/Peace remained statistically significant. We found no significant associations between either spiritual well-being or functional well-being and age; age at diagnosis; time since diagnosis; or partner, children, or racial status. CONCLUSION(S): This study provides cross-sectional data supporting the need for prospective controlled studies. Strategies to improve spiritual well-being in the domains of meaning, purpose, and inner peace may provide a therapeutic approach to reduce the emotional suffering that accompanies the life-altering diagnosis of premature ovarian failure.