Experiences of women living with Polycystic Ovary Syndrome: A pilot case-control,  single-cycle, daily Menstrual Cycle Diary study during the SARS-CoV-2 pandemic

Kaitlin Nelson; Sonia Shirin; Dharani Kalidasan; Jerilynn C Prior

doi:10.1371/journal.pone.0296377

Menstrual Cycle · Cycle Disorders

Experiences of women living with Polycystic Ovary Syndrome: A pilot case-control, single-cycle, daily Menstrual Cycle Diary study during the SARS-CoV-2 pandemic

Nelson K, Shirin S, Kalidasan D, Prior JC

Published December 29, 2023 PloS One, 18(12), e0296377

DOI 10.1371/journal.pone.0296377 PMID 38157371 PMC PMC10756515

RRM Academy Synopsis

Women with PCOS and month-apart cycles reported more outside stress

Women with PCOS reported more outside stress than matched controls. Eight women with PCOS and 24 controls kept daily diaries in Vancouver during the pandemic. All had roughly month-apart cycles. PCOS is now also called PMOS (polyendocrine metabolic ovarian syndrome).

Key Findings

Eight women with physician-diagnosed PCOS were matched 1:3 to 24 controls by age and BMI, drawn from 112 women in the Menstruation & Ovulation Study 2.
Outside Stresses scored higher with PCOS (3.4 ± 0.2 versus 3.0 ± 0.5 on a 1 to 5 scale, P = .020).
Feeling of Self-Worth (P = .471), Feeling of Anxiety (P = .174) and Feeling of Depression (P = .649) did not differ significantly between the groups.
Cycle length (P = .593) and luteal phase length (P = .167) did not differ significantly; enrollment required month-apart cycles. Ovulation could be assessed in 7 of 8 women with PCOS.
Anovulation (no ovulation) occurred in 5 of the 7 women with PCOS assessed and in 9 of 24 controls. The ovulation categories did not differ significantly (P = .341).

Interpretation

This case-control study followed eight women with PCOS and 24 matched controls through one cycle each, using a daily diary during the pandemic in Vancouver. Women with PCOS reported more outside stress than controls. Self-worth, anxiety, and depression scores were similar between the groups. Ovulation was uncommon in both groups: no ovulation occurred in 5 of 7 women with PCOS assessed and in 9 of 24 controls. The authors note that pandemic conditions likely contributed to the frequent ovulatory disturbances seen across the whole cohort. The findings support larger studies of stress and ovulatory function in women with PCOS.

RRM Context

Cycle lengths of 21 to 35 days did not settle whether ovulation occurred. Most women in both groups fell in that range, yet luteal phases were short or absent in many. Restorative reproductive medicine treats ovulation as the event to document, and daily temperature charting is a cycle-charting tool for doing so. The authors conclude that pairing charting with a daily diary is feasible in a community cohort.

Our editorial summary of this paper, not the article's abstract.

Abstract

Polycystic Ovary Syndrome (PCOS) affects many people and is often distressing. Much medical literature about diagnosis and treatment exists, but little is known about PCOS menstrual cycle-related experiences except that cycles tend to be far-apart and unpredictable. Our purpose was to examine the menstrual cycle and daily life experiences in those with PCOS having approximately month-apart cycles compared with age and BMI-matched cohort controls using data from the Menstruation & Ovulation Study 2 (MOS2) during the first 1.5 years of SARS-CoV-2 pandemic. We hypothesized that those with PCOS would experience lower self-worth and more negative moods. This is a single-cycle prospective case-control study in community-dwelling women ages 19-35 years. Eight reported physician-diagnosed PCOS and were matched (1:3 ratio) with controls by age (within .6 years) and BMI (within .19 BMI units). Experiences were recorded daily (Menstrual Cycle Diary©, Diary). All kept daily morning temperatures to assess luteal phase lengths by the validated Quantitative Basal Temperature© analysis method. From 112 in MOS2, 32 women were compared: eight with PCOS versus 24 controls. Demographic, socioeconomic, comorbidities and lifestyle variables were not different between the two groups. Cycle lengths were similar in PCOS and controls (one PCOS and control each had oligomenorrhea; most lengths were 21-35 days, P = .593). Unexpectedly, luteal phase lengths were also similar between PCOS and controls (P = .167); anovulation occurred in 5 with PCOS, and in 9 controls. There were no significant Diary differences between the two groups except for greater "outside stress" in the PCOS group (P = .020). In contrast to our hypotheses, there were no significant differences in feelings of self-worth, anxiety nor depression. The SARS-CoV-2 pandemic was a stressful time for women. MOS2 captured granular menstrual cycles, ovulation and daily experiences in women with PCOS compared with age- and BMI-matched controls. These pilot data in women with milder PCOS are the first of more research required to understand the daily experiences in those living with PCOS.

Topics

Menstrual Cycle › Cycle Disorders › Ovulatory Disturbances · Reproductive Endocrinology › Luteal Phase › Luteal Phase Deficiency · Mental Health and Psychosocial Care › Mood and the Cycle › Cyclical Mood Symptoms

Kaitlin Nelson, Sonia Shirin, Dharani Kalidasan, Jerilynn C Prior

K Nelson, S Shirin, D Kalidasan, J Prior

PMID 38157371 38157371 DOI 10.1371/journal.pone.0296377 10.1371/journal.pone.0296377 Nelson et al. 2023, Nelson 2023

Keywords

Molybdenum