Quality of life and sexual function in women with polycystic ovary syndrome: a comprehensive review.

Polycystic Ovary Syndrome (PCOS) is the most common endocrinopathy among women of reproductive age. PCOS is a polysimptomatic disease, the leading manifestations of which are hyperandrogenic dermopathy, menstrual dysfunction, infertility and obesity. Dissatisfaction with one's own appearance, low self-esteem, a feeling of sexual unattractiveness cause chronic psychological discomfort, mood disturbances and problems in the relationship with a partner. The article presents an overview of scientific sources on the effect of polycystic ovary syndrome on the quality of life and the sexual function of women. Data recorded confirm the hypothesis that PCOS is not only an endocrine disorder, but a heterogeneous condition with reproductive, metabolic, and mental manifestations. The association of PCOS manifestations with a decrease in the quality of life and disorders in the sexual sphere of women was well assessed. Data presented in the review ensure the absolute medical and social importance of the study of PCOS.

Psychological Issues and Sexual Function in Women with Different Infertility Causes: Focus on Polycystic Ovary Syndrome.

The objectives of this study are to assess the prevalence of psychological complaints and changes in sexual function in infertile PCOS women compared with patients with other infertility causes (tubal and male infertility factors) and to identify the predisposing factors. An observational study with three cohorts of infertile women was designed including 37 PCOS patients, 36 women with tubal factor, and 31 women with male factor. Clinical history and physical examination were carried out in all patients. All subjects completed the Hamilton Anxiety Rating Scale, the Beck Depression Inventory, and the Female Sexual Function Index questionnaires. Women with infertility due to PCOS showed a significantly higher prevalence of depressive (48.6 vs 19.4 and 12.9%, p < 0.01) and anxiety symptoms (21.6 vs 5.6 and 3.2%, p = 0.041) than respondents of reference groups. Sexual function in PCOS subjects was impaired in the areas orgasm and satisfaction (p < 0.01 for both) compared to patients of reference groups. Clinical, biochemical hyperandrogenism, and overweight were associated with a higher incidence of depressive and anxiety symptoms in the infertile PCOS group (p < 0.01 for all). Besides, the severity of anxiety symptoms was associated with the number of medically assisted reproduction attempts (p = 0.014). Weight gain and age (p = 0.04 and p = 0.047) were associated with impaired sexual functioning. The relation between reduced sexuality and depressive/anxiety symptoms was found (p = 0.038 and p = 0.012, respectively). Infertile PCOS patients showed the highest prevalence of psychological complaints and some impairment in their sexual functioning. Mental health and sexual functioning need to be part of the routine clinical screening of every PCOS patient. The study was registered at clinicaltrials.gov (identifier: NCT03306459) https://clinicaltrials.gov/ct2/show/NCT03306459?cond=PCOS&cntry=ES&city=Barcelona&draw=2&rank=3.

Quality of Life in Infertile Women with Polycystic Ovary Syndrome: a Comparative Study.

To investigate the quality of life (QoL) of infertile women with polycystic ovary syndrome (PCOS) and analyze the association between the clinical/biochemical features of PCOS and the physical/psychological well-being of patients. An observational study with three independent groups women was designed including 37 infertile PCOS patients, 36 women with tubal factor infertility, and 31 women with male factor infertility referred to the Reproductive Medicine Unit of the Hospital Clinic Barcelona from December 2017 to June 2019. Clinical history, physical examination including Ferriman-Gallwey scores, and vaginal ultrasound were carried out in all patients. All subjects completed the 36-item Short Form Health Survey, and PCOS patients were asked to fill out the Polycystic Ovary Syndrome Questionnaire. The IBM SPSS 23.0 was used for the statistical analysis. Infertile women with PCOS reported significantly worse QoL scores of social functioning (p = 0.049), emotional role functioning (p = 0.041), mental health (p = 0.002), and the mental component summary (p = 0.002) compared with women with other causes of infertility. In addition, body pain (p = 0.006), general health (p < 0.001), and vitality (p = 0.002) scores were significantly lower in women with PCOS compared with those with male factor infertility. Infertile PCOS patients showed low scores in all domains of the PCOSQ. Hirsutism and weight gain were the factors most associated with impaired health-related QoL in PCOS. Infertile PCOS women presented worse QoL mainly due to psychological and emotional distress. The main predictors were clinical manifestations of hyperandrogenism and weight gain.

Current treatment options for postmenopausal vaginal atrophy.

Vulvovaginal atrophy (VVA) is a silent epidemic that affects up to 50%-60% of postmenopausal women who are suffering in silence from this condition. Hormonal changes, especially hypoestrogenism inherent in menopause, are characterized by a variety of symptoms. More than half of menopausal women are concerned about the symptoms of VVA, such as dryness, burning, itching, vaginal discomfort, pain and burning when urinating, dyspareunia, and spotting during intercourse. All these manifestations significantly reduce the quality of life and cause discomfort in the sexual sphere. However, according to research, only 25% of patients with the symptoms of VVA receive adequate therapy. This is probably due to the lack of coverage of this problem in the society and the insufficiently active position of specialists in the field of women's health regarding the detection of symptoms of VVA. Many patients are embarrassed to discuss intimate complaints with a specialist, which makes it difficult to verify the diagnosis in 75% of cases, and some patients regard the symptoms of VVA as manifestations of the natural aging process and do not seek help. Modern medicine has in the arsenal various options for treating this pathological condition, including systemic and topical hormone replacement therapy, the use of selective estrogen receptor modulators, vaginal dehydroepiandrosterone, use of lubricants and moisturizers, as well as non-drug therapies. Timely diagnosis and adequately selected therapy for the main symptoms of VVA lead to restoration and maintenance of the vaginal function and vaginal health.