Women on the Other Side of War and Poverty : Its Effect on the Health of Reproduction

Polycystic ovarian syndrome (PCOS) is one of the most common metabolic and endocrine disorders in reproductive aged women and important reason for infertility due to failure in ovulation (1,2). Diagnosis of this syndrome is possible by rejecting other causes that lead to irregular menstruation and increased androgen levels, which is generally based on clinical and laboratory criteria or ultrasound. In this disorder, at least 2 out of total conditions should be present, including oligo/ anovulation (e.g., oligomenorrhea: irregular cycles above 34 days), increased androgen levels or clinical symptoms of hyperandrogenism, and ultrasound findings (3,4). This syndrome leads to increased risk factors such as diabetes (type II), obesity, hypertension, cardiovascular diseases, dyslipidemia, ovarian cancer, breast and endometrial disorders, insulin resistance, and hyperinsulinemia (4, 5). Quality of life is one of the most important indices of general and mental health (6), which has been suggested as the basis for disease control and treatment (7). Moreover, health-related quality of life measurement plays a substantial role in evaluating the effects of chronic diseases on people (8). PCOS is a chronic disease and, due to different symptoms, can affect various aspects of people’s life; therefore, measuring quality of life can provide great information about the profits of treatment or intervention from the patient’s perspective (9). Some studies have reported negative effects of PCOS symptoms including acne and hirsutism on quality of life, but they have applied a general quality of life questionnaire for individuals (2,10,11). Almost 50% of women with PCOS are obese or overweight, who complain of uncontrolled and excessive consumption of carbohydrate sources without a sense of satiety. In such women, weight gain is associated with hyperandrogenism (12). Furthermore, an imbalanced Abstract Objectives: Polycystic ovarian syndrome (PCOS) is a common hormonal disorder that can lead to hirsutism, menstrual disorders, obesity, acne, and sometimes abortion and infertility. Considering the effect of PCOS-induced obesity on quality of life, the present study was aimed to evaluate the quality of life specified for polycystic ovary syndrome and its relationship with nutritional attitude and behavior. Materials and Methods: This cross-sectional study was done on 150 PCOS cases through convenience sampling in educational hospitals of Tabriz, Iran, in 2015. The used tools included socio-demographic questionnaire, Polycystic Ovarian Syndrome Questionnaire (PCOSQ), Three-Factor Eating Questionnaire (TFEQ-R18: uncontrolled eating (UE), cognitive restraint (CR), and emotional eating (EE)), and a questionnaire of eating attitudes (Eat-26: including food preoccupation, dieting, and oral control). The relationship between the quality of life and nutritional attitudes and behaviors was evaluated by Pearson correlation and multivariate regression analysis. In this study, P < 0.05 was considered significant. Results: A mean quality of life score of 16.58±4.18 was obtained out of 0-35. Nutritional behavior averaged 42.28±19.63 out of a min-max range of 18 to 72. Mean nutritional attitude score was 24.64±12.55 out of 0-78. A significantly inverse relationship was observed between the quality of life and nutritional attitude (P < 0.001, r=-0.317), as well as nutritional behavior (P = 0.015, r=-0.198) in participants. In other words, the quality of life scores increased when nutritional attitude and behavior (positive attitude and behavior) decreased. Multivariate regression analysis showed that EE, dieting, and history of pregnancy were predictive variables affected the quality of life. Conclusions: There was a relationship between nutritional attitude and behavior and quality of life specified for polycystic ovary syndrome. Therefore, it is necessary to pay attention to nutritional and other predictors through better health planning for these women.