Lifestyle management improves quality of life and depression in overweight and obese women with polycystic ovary syndrome
ABSTRACT To assess the impact of adding exercise to dietary restriction on depressive symptoms and health-related quality of life (HRQOL) in women with polycystic ovary syndrome (PCOS).
Analysis of depression and quality of life outcomes from a randomized, controlled prospective clinical intervention that evaluated the effects on a range of health outcomes in women with PCOS.
Clinical research unit.
One hundred four overweight/obese PCOS women (aged 29.3 ± 0.7 years; body mass index [BMI] 36.1 ± 0.5 kg/m(2)).
Randomized to one of three 20-week lifestyle programs: diet only, diet and aerobic exercise, or diet and combined aerobic-resistance exercise.
Depression and PCOS-specific HRQOL.
Forty-nine women completed the intervention (diet only = 14, diet and aerobic exercise = 15, diet and combined aerobic-resistance exercise = 20). By week 20 all groups achieved weight loss and had improvements in depression and PCOS-specific HRQOL scores, except for body hair domain score. There was no difference between treatments for all outcomes.
This study demonstrated that dietary restriction alone and combined with exercise had similar benefits for improving depression and HRQOL scores in overweight and obese women with PCOS.
[Show abstract] [Hide abstract]
ABSTRACT: The Healthy Eating for Reproductive Health study was conducted among 18 (45% non-white) mostly obese (BMI 39.9 ± 6.1) women with polycystic ovary syndrome (PCOS) who were experiencing infertility and interested in losing weight. A variety of markers were measured at baseline: body mass index (BMI), diet, physical activity, eating behaviors (using an Eating Behavior Inventory, a questionnaire which assesses both positive and negative eating behaviors associated with weight status, with a higher score indicating adoption of eating behaviors which have been shown in prior weight-loss research to promote a healthy weight (EBI) and the Three-Factor Eating Questionnaire, which assesses cognitive and behavioral components of eating among overweight adults), and a quality of life (PCOS Health-Related Quality of Life (PCOSQ)) index, which assesses satisfaction around five 'domains': emotional health, presence of body hair, infertility, weight, and menstrual problems). A comparison group of overweight women without PCOS (n = 28) was used to examine differences in measured outcomes between women with and without PCOS. Participants' habitual diets were high in fat and saturated fat and low in fiber, folate, and iron and contained significantly lower amounts of carbohydrate, iron, and whole grains compared with women without PCOS who had enrolled in a behavioral weight loss programme. Participants had a low EBI (indicating that most were not adopting eating behaviors associated with achieving a healthy weight), disinhibition (indicating participants had a tendency to overeat in the presence of highly palatable foods or were susceptible to emotional cues for eating, such as stress), and hunger scores (indicating participants did not report being susceptible to hunger, prompting overeating) and moderate dietary restraint (indicating they were not consistently attempting to restrict food intake consciously). PCOSQ scores were lowest for infertility and weight domains (indicating low satisfaction with current infertility and weight status); however all domains received low scores (emotional health, body hair, and menstrual problems). Higher energy intakes (kcal/day) were associated with a lower EBI score (r = - 0.60, P = 0.02), lower dietary restraint (r =- 0.50, P = 0.04), and higher disinhibition (r = 0.63, P = 0.01). Greater energy expenditure (kcal/day) was associated with lower PCOSQ scores for body weight (r =-0.54, P = 002) and infertility (r =- 0.51, P = 0.003) domains. Results suggest that overweight women with PCOS-related infertility have poor dietary intake, particularly in terms of whole grains, fiber, and iron, and eating behaviors inconsistent with achieving a healthy body weight, as well as low scores for PCOS-related quality of life.Human Fertility 06/2014; DOI:10.3109/14647273.2014.922704 · 1.02 Impact Factor
[Show abstract] [Hide abstract]
ABSTRACT: Background: There is evidence for differences between endocrinologists and other specialists in their approach to diagnosis and management of the polycystic ovary syndrome (PCOS). Objective: A mailed survey consisting of a simple questionnaire aiming to understand current practice for diagnosis and management of the PCOS by specialists across Europe. Methods: The questionnaire consisted of 23 questions grouped to achieve information on (i) the general characteristics of the respondents, (ii) patients with PCOS seen by endocrinologists (iii) the main diagnostic criteria (iv) biochemical parameters used in the differential diagnosis of hyperandrogenism, (v) long-term concerns and, finally (vi) treatment choices. A total of 357 questionnaires, representing 13.3% of the members of ESE were available for final analysis; 93% of the respondents were endocrinologists Results: In relation to the diagnostic criteria, respondents were most likely to select menstrual irregularity as the most frequent criteria used for the diagnosis of PCOS although very high rates were achieved for the use of hirsutism and biochemical hyperandrogenism. It therefore appears that the NIH criteria were followed by the majority of respondents. The most frequent biochemical parameters in the differential diagnosis of hyperandrogenism were total testosterone or free androgen index (FAI). Obesity and type 2 diabetes were regarded as the principal long-term concerns for PCOS. The most common treatments for patients with PCOS were metformin (33%), lifestyle modification (25%), and oral contraceptives (22%). More direct treatments of infertility, such as clomiphene citrate alone or combined with metformin were prescribed by 9% and 23%, respectively, whereas only 6% used other methods for induction of ovulation. Conclusion: The survey the ESE has produced is a good start for evaluating the perspective in the diagnosis and treatment of PCOS by endocrinologists in Europe.European Journal of Endocrinology 07/2014; 171(4). DOI:10.1530/EJE-14-0252 · 3.69 Impact Factor
[Show abstract] [Hide abstract]
ABSTRACT: To assess sexual function (SF) and quality of life (QOL) in women with polycystic ovary syndrome (PCOS).Archives of Gynecology and Obstetrics 08/2014; 291(2). DOI:10.1007/s00404-014-3423-1 · 1.28 Impact Factor