Health-related quality of life and mental state in women with polycystic ovary syndrome and migration or minority background – A cross-sectional study

Introduction

Polycystic Ovary Syndrome (PCOS) is the most prevalent endocrine disorder among women of reproductive age on a global scale. The severity of symptoms and individual distress can vary greatly and may also depend on the respective ethnic and cultural background. This study aimed to investigate potential variations in health-related quality of life (HRQOL), depression, and anxiety between PCOS patients with a migration (MB) or minority background (Min) and those without (Non-MB/Non-Min).

Methods

An online questionnaire was anonymously distributed to gynecologists, hospitals, and women's clinics in Austria, Germany, and Switzerland, along with social media channels to reach women with PCOS. The survey was conducted between November 14th, 2023, and February 5th, 2024. Various aspects including HRQOL, levels of anxiety/depression and self-esteem were evaluated using the Modified-PCOS-Questionnaire (MPCOSQ), Hospital Anxiety and Depression Scale (HADS) and Rosenberg Self-Esteem Scale (RSE) respectively. The participants were screened for migration background and self-identification with a socially relevant minority. The selection of potential confounding variables was based on their plausibility and estimated impact. Adjusted odds ratios and their corresponding 95 % confidence intervals were calculated using regression analysis.

Results

The study involved 587 participants with PCOS. MB and Min exhibited significantly poorer HRQOL, and greater symptoms of depression compared to PCOS patients in the two control groups. (MPCOSQ-Total: MB/Non-MB p = 0.02; Min/Non-Min p < 0.001; HADS-Depression: MB/Non-MB p = 0.03; Min/Non-Min p = 0.01) Additionally, MB and Min had significantly lower self-esteem according to the RSE (RSE: MB/Non-MB p = 0.04; Min/Non-Min p = 0.049). In the univariate analysis, Non-MB and Non-Min were associated with partially better HRQOL and lower depression (or respectively poorer HRQOL and depression for MB and Min). However, in the multivariate analysis only Non-Min showed a statistically significant association with higher HRQOL (B: 0.34; CI: 0.04; 0.63; p = 0.03) and only Non-MB was associated with lower depression (B:1.28; CI:2.31; -0.24; p = 0.02).

Conclusion

This study highlights the association between MB or Min and poorer HRQOL, higher depression rates, and lower self-esteem among PCOS patients. While genetic and epigenetic factors may contribute, socioeconomic and sociocultural influences likely play significant roles. Healthcare professionals should remain attuned to the diverse needs of women with PCOS, especially those from migration or minority backgrounds, to ensure equitable access to care.