What does PCOS have to do with Quality of Life?
Quality of Life is a construct that represents the perceived quality of living someone has. To do so, Quality of Life has six domains: physical health, psychological health, level of independence, social relationships, and environment and spirituality/religion/personal beliefs. Health-Related Quality of Life represents a very similar construct but solely focused on how health-related aspects of life, mainly physical, impair a person’s life.
Health-Related Quality of Life is more impaired in classic PCOS, because it is the more pronounced expression of this disease. However, similar psychological profiles are found in all types of PCOS, so even in milder presentations of PCOS, well-being may be impaired. Apart from the physically painful and/or uncomfortable symptoms PCOS brings, sociocultural pressures also play a role in decreased well-being and quality of life in these patients. This means that Quality of Life may not be so homogeneous as Health-Related Quality of Life.
For example, being overweight, having male-like hair distribution, acne, and hair loss contribute to a different appearance that the patient does not like and others might judge, leading to diminished self-esteem, recurrent shame, sadness, and disrupted social interactions. The way this disease impacts women varies across the world.
- For Turkish women with PCOS, an irregular menstrual cycle and hirsutism had the biggest impact on their Quality of Life.
- For Iranian women, menstrual irregularities and infertility had the biggest impact on their Quality of Life, followed by hirsutism, weight, emotional concerns, and acne.
- For Brazilian women, body weight and infertility had the biggest impact on their Quality of Life.
- A study attempted to develop a questionnaire to screen Quality of Life in regards to PCOS, called PCOSQOL. A sample of UK women was used. The PCOSQOL scale represents aspects of quality of life important to British women with PCOS. The PCOSQ includes five subscales: emotions, body hair, infertility, weight, and menstrual problems.
Other psychological symptoms, such as anxiety and depression, also often appear associated with treatment (PCOS treatment and fertility treatment), due to uncertainty of outcomes, waiting periods, trying different therapies, and a sense of inability to cope.