Quality of life in Sri Lankan women with polycystic ovary syndrome (PCOS) preliminary results

Abstract

BACKGROUND: Studies in the west reveal PCOS causes a major reduction in the quality of life of affected women. OBJECTIVE: To assess the health related quality of life in a Sri Lankan cohort with PCOS. METHOD AND DESIGN: A case control study. Two hundred and three consecutive women with PCOS (2004 diagnostic criteria) were contacted by post with 69 (33.9 percent) responders to date. Fifty controls with regular periods and at least one child were randomly selected from antenatal clinics of the same unit. A self administered pre-tested standardized questionnaire (based on SF 36, symptom checklist and life satisfaction) was given on two occasions to each subject to be completed 4 weeks apart. The impact of hirsuitism, obesity, and infertility was assessed using five-point rating scales, and sexual satisfaction was analyzed with visual analog scales. OUTCOME MEASURES: The response to each component of the questionnaire was assessed separately, and response to each group of questions analyzed and compared to determine quality of life i.e. health and activities, feelings, how they get along with others, day-to-day work, social problems, problems related to symptoms, and problems due to menstrual irregularities, infertility and sexual activity. RESULTS: PCOS- mean age 27.6 ñ7.3 years, mean duration since diagnosis of PCOS 4.8 ñ4.2 years; 50.7 percent married, 46.3 percent single, 4.3 percent divorced; mean duration since marriage 6.9ñ4.2years, 65.7 percent of married women were childless and 28.9 percent had 1 child, and 26.3 percent had suffered pregnancy loss. 29/69(42 percent) treated for infertility and the mean duration of infertility 4.5 ñ 3.6 years. 53.6 percent were on medication for PCOS; 76.8 percent had hirsuitism, 30.4 percent had acne, 50.4 percent had acanthosis nigricans and 65.2 percent were obese. Questionnaire- General attitude of health related quality of life Excellent 8.6 percent, Very Good 8.6 percent, Good 30.4 percent, Fair 20.2 percent. Mean score- 24.3 ñ14.8 (Higher the score a poorer quality of life) score of (0-25) 52.2 percent, score (25-50) 40.6 percent, score (50-75) 7.2 percent. Controls- mean age 30.3+5.8, all married with mean duration since marriage 7.1 ñ4.6 years. All had children, 54 percent had 1 child and 46 percent > 1 child. On self assessment 10 percent claimed hirsuitism, 20 percent acne, and 22 percent obesity. Questionnaire - General attitude of health related quality of life Excellent 26 percent, Very Good 42 percent, Good 24 percent, Fair 8 percent. Mean score - 7.4:1=7.9 (Higher the score, poorer quality of life), score (0-25) 96 percent, score (25-50) 4 percent, score (50-75)0 percent. Patients vs. Controls-Mean score 24.3 percent vs. 7.4 percent (p = 0.0008); Score 50-75 - 7.2 percent vs. 0 percent (p = 0.007) Score 25-50 - 40.5 percent vs. 4 percent (p=0.0000); Score 0-25 -52.1 percent vs. 96 percent (p = 0.0000) CONCLUSION: Health related quality of life of Sri Lankan women with PCOS is significantly less when, compared to age and ethnicity matched controls.