Polycystic ovary syndrome (PCOS) has become a serious public health problem, being the most common of endocrine disorders in women of reproductive age, with a proportion of one in five people in this population. It is a multifactorial disease, comorbid in many cases with obesity, dyslipidemia, endometrial hyperplasia, cardiovascular disorders, menstrual period disorders and infertility, breast cancer, endometrial cancer and pro-inflammatory processes; this condition, in turn, affects glucose metabolism tolerance, insulin resistance and potentiates hyperandrogenism.
These somatic symptoms usually precipitate psychological problems among which are stress, anxiety, depression, decreased quality of life, changes in body image and identity, low self-esteem, and psycho-sexual dysfunctions, as well as the execution of unhealthy practices compared, for example, with diabetic patients; Moreover, these affectations are not only related to the disease itself, but also to fears of metabolic and cardiac risks, and infertility.
The objective of this research is to present a systematic review of both the empirical evidence documented regarding the psychological factors that have been demonstrated as comorbid with the PCOS, as well as its comprehensive approach.
The management of PCOS involves focusing on aspects such as bio-psycho-social support, preventive education, and the direction of psychological factors for a better lifestyle, essentially involving significant changes in habits such as diet and the realization of prescribed physical activity with its corresponding professional accompaniment to guarantee weight loss. To that extent, the treatment must be comprehensive, including psychological counseling and participation in support groups that allow the construction of effective coping alternatives to the various conditions that affect the quality of life in these patients. It is curious to note that despite the psychological distress and deterioration in the quality of life in health perceived by patients with PCOS, only 55% of them seek professional help for the resolution of their somatic symptoms, as others consider that the symptoms do not deserve sufficient attention, or identify a poor offer of specialized and efficient health services. In principle, for some patients, increasing the perception of risk may contribute to an increase in the rate of execution of protective behaviors. The change of lifestyles, together with high self-motivation and self-image, enhances the reduction of metabolic and psychosocial risks, as well as improving their indicators on sexual and reproductive health. However, the interventions of this cut should be performed with caution, given that if these indicators are high, motivation is reduced; therefore, it is necessary to intervene in distress to ensure that these patients have adequate management of diet and medication. A useful way to reduce stress and related physiological indicators could be mindfulness, which although it reports good results in perceived well-being, needs more studies to confirm the possible generalization of this therapeutic approach to PCOS patients.
The establishment of dietary programs with and without aerobic exercise support contributes to weight reduction, an increase in a functional mood, and the improvement of indicators of perceived quality of life in PCOS patients.
On the other hand, the establishment of psychosocial support offers allows patients to have spaces to express their emotions, strengthen their coping strategies to the situations associated with the disease itself, and create social bonds, all of them key alternatives in increasing the Self-image and self-esteem. Additionally, it is important to include the strengthening of self-control, for example, given the intake of substances not endorsed by the medical community, or of the suggested dosage, and to carry out educational programs, so that patients deliberately choose between the different therapeutic options available. Strengthening of their coping strategies to the situations associated with the disease itself, and creation of social ties, all of them are key alternatives in increasing self-image and self-esteem.
Finally, it is important to have the company of family members, so that they understand the situation and serve as material and emotional support in the face of emotional crises that the patient may manifest. Strengthening these links may contribute to avoid feelings of unhappiness, frustration and depression, and increase levels of optimism, self-esteem and perceived social well-being. However, the strengthening of social support must also be done with caution, because although it contributes to aspects such as the understanding of the situation by other peers, the building of bonds of trust with professionals, decision-making regarding participation in certain treatment , and the adjustment in the management of symptoms, in some individuals promotes excessive dependence on the support group.