Young women's psychological distress after a diagnosis of polycystic ovary syndrome or endometriosis

Abstract

Study question: Do young women with polycystic ovary syndrome (PCOS) or endometriosis report more psychological distress than their peers without a history of these conditions? summaryanswer: Youngwomen(aged 18-23 years) withPCOSor endometriosis had a greater risk ofmoderate to severe psychological distress than women without a history of these conditions. what is known already: Psychological distress appears common among women with PCOS and endometriosis. However, population- based studies that examine the psychological outcomes for adolescents and young women are generally absent from the literature. study design, size, duration: This is a secondary analysis of data collected from 17 015 young, Australian women participating in a national, longitudinal cohort study.Womenwere first surveyed in 2012-2013 when they were aged 18-23 years. In 2014,womencompleted the second survey when they were aged 19-24 years and 11324 (67%) women responded. participants/materials, setting, methods:We analysed data from11 238 women who participated in both Surveys 1 and 2 and who responded to questions about PCOS and endometriosis. Using logistic regression, we compared the odds of moderate to severe psychological distress at Surveys 1 and 2 for women reporting a recent diagnosis (within the last 12 months) of PCOS or endometriosis and women with a pre-existing diagnosis, with that for women without a history of these conditions. main results and the role of chance: At Survey 2, around 60% of women reporting a diagnosis of PCOSor endometriosis had moderate to severe levels of psychological distress. Compared to women without a history of these conditions, the odds of moderate to severe psychological distress at Survey 2 were significantly higher for women recently diagnosed with PCOS [Adjusted Odds Ratio (AOR) = 1.62, 95% CI = 1.21-2.18] or endometriosis (AOR= 1.77; 95% CI = 1.20-2.63) and for women with a pre-existing diagnosis of PCOS (AOR = 1.57, 95% CI = 1.30-1.89) or endometriosis (AOR = 1.61; 95% CI = 1.26-2.06).Women recently diagnosed with PCOS or endometriosis also had a greater likelihood of moderate to severe distress in the year prior to their diagnosis. The association between PCOS and psychological distress was attenuated when adjusting for BMI, but hormonal contraceptive use did not attenuate the risk of distress among the women with PCOS or endometriosis. limitations, reasons for caution: All datawere self-reported and, therefore, the diagnoses ofPCOSor endometriosis were not confirmed by a medical practitioner. wider implications of the findings: Health professionals should be aware of the potential psychosocial and healthcare needs among young women with these conditions, particularly women with PCOSwho are obese. While hormonal contraceptives may help to regulate the hormonal aspects of these conditions, theydo not appear to reducewomen's psychological distress. Because psychological distressamongthe youngwomenin this study remained elevated even after diagnosis, this supports the need for multidisciplinary health care to helpwomenadjust to their diagnosis and treatment regimens and facilitate positive, long-term mental health outcomes. Future research that examines medical and psychosocial sources of distress for young women with PCOS and endometriosis is needed. study funding/competing interest(s): I.J.R. was supported by an Australian National Health and Medical Research Council Centre for Research Excellence (grant number: APP1000986). G.D.M. is funded by the Australian Research Council Future Fellowship (FT120100812). The Australian Longitudinal Study onWomen's Health is funded by the Australian Government Department of Health. H.T. is supported by an Australian National Health and Medical Research Council Practitioner Fellowship. The authors declare that no competing interests exist. Trial registration number: N/A.