Semin Reprod Med 2023; 41(01/02): 012-019
DOI: 10.1055/s-0043-1777086
Review Article

Bridging the Information Gap in Polycystic Ovary Syndrome: A Narrative Review with Systematic Approach

Chau Thien Tay
1   Monash Centre for Health Research and Implementation, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
,
Fleur Williams
2   Monash School of Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
,
Aya Mousa
1   Monash Centre for Health Research and Implementation, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
,
Helena Teede
1   Monash Centre for Health Research and Implementation, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
,
3   Division of Pediatric Endocrinology, Children's Mercy Kansas City, Kansas City, Missouri
› Author Affiliations

Abstract

Polycystic ovary syndrome (PCOS) is a complex endocrinopathy with wide-ranging implications for affected individuals. Literature has shown that patients with PCOS are dissatisfied with the health information provided to them and that healthcare professionals lack adequate knowledge. In this narrative review with systematic approach, we explored the unmet information needs in PCOS care for both patients and healthcare professionals. A comprehensive search of databases yielded 41 relevant studies, predominantly of observational and qualitative design. Adults and adolescents with PCOS desire wide ranging health information and express a keen desire for weight management guidance. Importantly, discussions surrounding weight should be addressed knowledgeably and without weight bias. Therefore, healthcare professionals should facilitate access to comprehensive evidence-based resources. Lack of information drives PCOS-related online searches. Referral to support groups that promote individual agency in the self-management aspects of PCOS can furthermore guide patient resource acquisition. Patients prefer guidance from professionals that understand the psychosocial complexity of PCOS and can empathize with experiences of stigmatization or even marginalization depending on the cultural context of the individual. The findings informed the 2023 International Evidence-Based PCOS Guideline, recommending patient-centered communication, evidence-based information resources, and culturally sensitive approaches to optimize PCOS care.

Supplementary Material



Publication History

Article published online:
05 December 2023

© 2023. Thieme. All rights reserved.

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  • References

  • 1 Bozdag G, Mumusoglu S, Zengin D, Karabulut E, Yildiz BO. The prevalence and phenotypic features of polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod 2016; 31 (12) 2841-2855
  • 2 Teede HJ, Tay CT, Laven J. et al; International PCOS Network. Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. Hum Reprod 2023; 38 (09) 1655-1679
  • 3 Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod 2004; 19 (01) 41-47
  • 4 Teede H, Deeks A, Moran L. Polycystic ovary syndrome: a complex condition with psychological, reproductive and metabolic manifestations that impacts on health across the lifespan. BMC Med 2010; 8: 41
  • 5 Teede H, Misso M, Costello M. et al. International evidence-based guideline for the assessment and management of polycystic ovary syndrome 2018. Accessed November 7, 2023 at: https://www.monash.edu/__data/assets/pdf_file/0004/1412644/PCOS_Evidence-Based-Guidelines_20181009.pdf
  • 6 Crete J, Adamshick P. Managing polycystic ovary syndrome: what our patients are telling us. J Holist Nurs 2011; 29 (04) 256-266
  • 7 Gibson-Helm M, Teede H, Dunaif A, Dokras A. Delayed diagnosis and a lack of information associated with dissatisfaction in women with polycystic ovary syndrome. J Clin Endocrinol Metab 2017; 102 (02) 604-612
  • 8 Gibson-Helm M, Dokras A, Karro H, Piltonen T, Teede HJ. Knowledge and practices regarding polycystic ovary syndrome among physicians in Europe, North America, and internationally: an online questionnaire-based study. Semin Reprod Med 2018; 36 (01) 19-27
  • 9 Piltonen TT, Ruokojärvi M, Karro H. et al. Awareness of polycystic ovary syndrome among obstetrician-gynecologists and endocrinologists in Northern Europe. PLoS One 2019; 14 (12) e0226074
  • 10 Chemerinski A, Cooney L, Shah D, Butts S, Gibson-Helm M, Dokras A. Knowledge of PCOS in physicians-in-training: identifying gaps and educational opportunities. Gynecol Endocrinol 2020; 36 (10) 854-859
  • 11 Hoyos LR, Putra M, Armstrong AA. et al. Measures of patient dissatisfaction with health care in polycystic ovary syndrome: retrospective analysis. J Med Internet Res 2020; 22 (04) e16541
  • 12 Page MJ, McKenzie JE, Bossuyt PM. et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021; 372 (71) n71
  • 13 Monash Centre for Health Research and Implementation. Evidence Synthesis Program Templates for Critical Appraisal and Risk of Bias (Adapted from Critical Appraisal Templates, Centre for Clinical Effectiveness, Southern Health, Melbourne 2010). Clayton, Australia: Monash University and Monash Health; 2013
  • 14 Critical Appraisal Skills Programme. CASP Qualitative Checklist. Accessed November 7, 2023 at: https://casp-uk.net/images/checklist/documents/CASP-Qualitative-Studies-Checklist/CASP-Qualitative-Checklist-2018.pdf
  • 15 Gibson-Helm ME, Lucas IM, Boyle JA, Teede HJ. Women's experiences of polycystic ovary syndrome diagnosis. Fam Pract 2014; 31 (05) 545-549
  • 16 Humphreys L, Costarelli V. Implementation of dietary and general lifestyle advice among women with polycystic ovarian syndrome. J R Soc Promot Health 2008; 128 (04) 190-195
  • 17 Hadjiconstantinou M, Mani H, Patel N. et al. Understanding and supporting women with polycystic ovary syndrome: a qualitative study in an ethnically diverse UK sample. Endocr Connect 2017; 6 (05) 323-330
  • 18 Tomlinson J, Pinkney J, Adams L. et al. The diagnosis and lived experience of polycystic ovary syndrome: a qualitative study. J Adv Nurs 2017; 73 (10) 2318-2326
  • 19 Ching HL, Burke V, Stuckey BG. Quality of life and psychological morbidity in women with polycystic ovary syndrome: body mass index, age and the provision of patient information are significant modifiers. Clin Endocrinol (Oxf) 2007; 66 (03) 373-379
  • 20 Holbrey S, Coulson NS. A qualitative investigation of the impact of peer to peer online support for women living with polycystic ovary syndrome. BMC Womens Health 2013; 13: 51
  • 21 Avery JC, Braunack-Mayer AJ. The information needs of women diagnosed with polycystic ovarian syndrome – implications for treatment and health outcomes. BMC Womens Health 2007; 7: 9
  • 22 Khan NN, Vincent A, Boyle JA. et al. Development of a question prompt list for women with polycystic ovary syndrome. Fertil Steril 2018; 110 (03) 514-522
  • 23 Authier M, Normand C, Jego M, Gaborit B, Boubli L, Courbiere B. Qualitative study of self-reported experiences of infertile women with polycystic ovary syndrome through on-line discussion forums. Ann Endocrinol (Paris) 2020; 81 (05) 487-492
  • 24 Williams S, Sheffield D, Knibb RC. ‘Everything's from the inside out with PCOS’: exploring women's experiences of living with polycystic ovary syndrome and co-morbidities through Skype™ interviews. Health Psychol Open 2015; 2 (02) 2055102915603051
  • 25 Ee C, Smith C, Moran L. et al. “The whole package deal”: experiences of overweight/obese women living with polycystic ovary syndrome. BMC Womens Health 2020; 20 (01) 221
  • 26 Hillman SC, Bryce C, Caleyachetty R, Dale J. Women's experiences of diagnosis and management of polycystic ovary syndrome: a mixed-methods study in general practice. Br J Gen Pract 2020; 70 (694) e322-e329
  • 27 Ismayilova M, Yaya S. What can be done to improve polycystic ovary syndrome (PCOS) healthcare? Insights from semi-structured interviews with women in Canada. BMC Womens Health 2022; 22 (01) 157
  • 28 Ismayilova M, Yaya S. ‘I’m usually being my own doctor': women's experiences of managing polycystic ovary syndrome in Canada. Int Health 2023; 15 (01) 56-66
  • 29 Kaur I, Suri V, Rana SV, Singh A. Treatment pathways traversed by polycystic ovary syndrome (PCOS) patients: a mixed-method study. PLoS One 2021; 16 (08) e0255830
  • 30 Pirotta S, Joham AE, Moran LJ, Skouteris H, Lim SS. Implementation of the polycystic ovary syndrome guidelines: a mixed method study to inform the design and delivery of a lifestyle management program for women with polycystic ovary syndrome. Nutr Diet 2021; 78 (05) 476-486
  • 31 Pirotta S, Joham AJ, Moran LJ, Skouteris H, Lim SS. Implementation of evidence-based PCOS lifestyle management guidelines: perceived barriers and facilitators by consumers using the Theoretical Domains Framework and COM-B Model. Patient Educ Couns 2021; 104 (08) 2080-2088
  • 32 Trent ME, Rich M, Austin SB, Gordon CM. Fertility concerns and sexual behavior in adolescent girls with polycystic ovary syndrome: implications for quality of life. J Pediatr Adolesc Gynecol 2003; 16 (01) 33-37
  • 33 Weiss TR, Bulmer SM. Young women's experiences living with polycystic ovary syndrome. J Obstet Gynecol Neonatal Nurs 2011; 40 (06) 709-718
  • 34 Young CC, Rew L, Monge M. Transition to self-management among adolescents with polycystic ovary syndrome: parent and adolescent perspectives. J Pediatr Nurs 2019; 47: 85-91
  • 35 Peña AS, Teede H, Hewawasam E, Hull ML, Gibson-Helm M. Diagnosis experiences of adolescents with polycystic ovary syndrome: cross-sectional study. Clin Endocrinol (Oxf) 2022; 96 (01) 62-69
  • 36 Schweisberger CL, Hornberger L, Barral R. et al. Gender diversity in adolescents with polycystic ovary syndrome. J Pediatr Endocrinol Metab 2022; 35 (11) 1422-1428
  • 37 Boyle J, Hollands G, Beck S. et al. Process evaluation of a pilot evidence-based polycystic ovary syndrome clinic in the Torres Strait. Aust J Rural Health 2017; 25 (03) 175-181
  • 38 Carron R, Kooienga S, Gilman-Kehrer E, Alvero R. Cultural experiences, patterns, and practices of American Indian women with polycystic ovary syndrome: an ethnonursing study. J Transcult Nurs 2020; 31 (02) 162-170
  • 39 Ning N, Balen A, Brezina PR. et al. How to recognize PCOS: results of a web-based survey at IVF-worldwide.com. Reprod Biomed Online 2013; 26 (05) 500-505
  • 40 Dokras A, Saini S, Gibson-Helm M, Schulkin J, Cooney L, Teede H. Gaps in knowledge among physicians regarding diagnostic criteria and management of polycystic ovary syndrome. Fertil Steril 2017; 107 (06) 1380-1386.e1
  • 41 Yan D, Yan-Fang W, Shi-Yang Z. et al. Is polycystic ovary syndrome appropriately diagnosed by obstetricians and gynaecologists across China: a nationwide survey. J Ovarian Res 2021; 14 (01) 25
  • 42 Copp T, Muscat DM, Hersch J. et al. Clinicians' perspectives on diagnosing polycystic ovary syndrome in Australia: a qualitative study. Hum Reprod 2020; 35 (03) 660-668
  • 43 Dutta D, Bhattacharya S, Khandelwal D. et al. Clinical practice patterns of polycystic ovary syndrome among doctors of different specialties—an Indian perspective. US Endocrinol 2020; 16: 74-79
  • 44 Asante A, Omurtag K, Stewart EA, Coddington CC. Screening for insulin resistance in polycystic ovary syndrome: views of physician members of the American Society for Reproductive Medicine. J Reprod Med 2015; 60 (9-10): 371-377
  • 45 Alzamil H, Aloraini K, AlAgeel R. et al. Disparity among endocrinologists and gynaecologists in the diagnosis of polycystic ovarian syndrome. Sultan Qaboos Univ Med J 2020; 20 (03) e323-e329
  • 46 Ma R, Zou Y, Wang W. et al. Obesity management in polycystic ovary syndrome: disparity in knowledge between obstetrician-gynecologists and reproductive endocrinologists in China. BMC Endocr Disord 2021; 21 (01) 182
  • 47 Doll I, Doll R, Buhling KJ. Diagnosis and therapy of polycystic ovarian syndrome: results of a survey among German gynecologists with a review on literature. Arch Gynecol Obstet 2012; 285 (03) 689-697
  • 48 Carron R, Simon N, Gilman-Kehrer E, Boyle DK. Improving rural nurse practitioner knowledge about polycystic ovary syndrome through continuing education. J Contin Educ Nurs 2018; 49 (04) 164-170
  • 49 Arif N, Khawaja S, Iqbal Q. Awareness of polycystic ovarian disease: knowledge and presence of presenting symptoms. Pak J Med Health Sci 2020; 14: 627-630
  • 50 Moran LJ, Tan ZQ, Bayer S, Boyle JA, Robinson T, Lim SS. Perspectives of allied health professionals on implementation of the lifestyle polycystic ovary syndrome guidelines: a qualitative study. J Acad Nutr Diet 2022; 122 (07) 1305-1316