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Impact of a Lifestyle Modification Program on Menstrual Irregularity among Overweight or Obese Women with Polycystic Ovarian Syndrome

  • Marzouk, Tyseer (Woman's Health and Midwifery Nursing Department, Faculty of Nursing, Mansoura University) ;
  • Nabil, Hanan (Obstetrics and Gynecology Department, Faculty of Medicine, Mansoura University) ;
  • Senna, Mohammed (Rheumatology and Rehabilitation Department, Faculty of Medicine, Mansoura University)
  • Received : 2015.03.13
  • Accepted : 2015.08.12
  • Published : 2015.09.20

Abstract

Purpose: This study aimed to evaluate the impact of a lifestyle modification program on menstrual irregularity among overweight and obese women with polycystic ovarian syndrome. Methods: A quasi experimental research design was used to conduct this study on 82 women with polycystic ovarian syndrome at the Gynecology and Obesity clinics of Mansoura University Hospital, Egypt. Two groups were included; the study group received a lifestyle modification program for 48 weeks, while the control group was not subjected to this program. Data collection was done for the following variables, a structured interview questionnaire was used to assess the women's general characteristics, menstrual patterns, and 24-hour dietary recall and the researcher took anthropometric measurements and assessed hirsutism by the Ferriman-Gallwey scale. Results: After one year of lifestyle modification, the number of menstrual cycles significantly increased from $2.7{\pm}1.6$ to $6.9{\pm}1.5$ (t=12.26, p<.001) in the study group compared to insignificant minor changes among the control group (t=0.69, p=.488). Additionally, 58.5% were menstruating regularly compared to none in the control group (${\chi}^2=33.93$, p<.001). Conclusion: Participating in a lifestyle modification program was effective in reducing menstrual cycle's irregularity among overweight and obese women with PCOS. Thus, it is recommended to motivate the nurses in counseling the PCOS women on lifestyle modifications.

Keywords

References

  1. Ehrmann DA. Polycystic ovary syndrome. New England Journal of Medicine. 2005;352(12):1223-1236. https://doi.org/10.1056/NEJMra041536
  2. Abdelhafeez AT, Taha SA, Ahmad NA, Khalaf MR. Familial prevalence of PCOS and PCOS related features in Upper Egypt. Al-Azhar Assiut Medical Journal. 2003;1(3):1-8.
  3. 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. BioMed Medicine. 2010;8:41.
  4. Hoeger KM. Role of lifestyle modification in the management of polycystic ovary syndrome. Best Practice and Research. Clinical Endocrinology & Metabolism. 2006;20(2):293-310.
  5. Guzick DS, Wing R, Smith D, Berga SL, Winters SJ. Endocrine consequences of weight loss in obese, hyperandrogenic, anovulatory women. Fertility and Sterility. 1994;61(4):598-604. https://doi.org/10.1016/S0015-0282(16)56632-1
  6. Moran LJ, Brinkworth GD, Norman RJ. Dietary therapy in polycystic ovary syndrome. Seminars in Reproductive Medicine. 2008;26(1):85-92.
  7. Galal OM. The nutrition transition in Egypt: Obesity, undernutrition and the food consumption context. Public Health Nutrition. 2002;5(1A):141-148.
  8. Moran LJ, Lombard CB, Lim S, Noakes M, Teede HJ. Polycystic ovary syndrome and weight management. Women's Health. 2010;6(2):271-283. https://doi.org/10.2217/whe.09.89
  9. Moran LJ, Hutchison SK, Norman RJ, Teede HJ. Lifestyle changes in women with polycystic ovary syndrome. Cochrane Database Systematic Review. 2011;16(2):CD007506.
  10. Fearnley EJ, Marquart L, Spurdle AB, Weinstein P, Webb PM. Polycystic ovary syndrome increases the risk of endometrial cancer in women aged less than 50 years: An Australian casecontrol study. Cancer Causes and Control. 2010;21(12):2303-2308. https://doi.org/10.1007/s10552-010-9658-7
  11. Ferriman D, Gallwey JD. Clinical assessment of body hair growth in women. Journal of Clinical Endocrinology and Metabolism. 1961;21:1440-1447. https://doi.org/10.1210/jcem-21-11-1440
  12. World Health Organization. Obesity: Preventing and managing the global epidemic. Report of a WHO convention. Geneva, Switzerland: World Health Organization; 2000.
  13. NHANES III. National Health and Nutrition Examination Survey. Body measurements(Anthropometry) [Internet]. Rockville: National Health and Nutrition Examination Survey; 1988 [cite 2010 October 22]. Available from: http://www.cdc.gov/nchs/data/nhanes/nhanes3/cdrom/nchs/manuals/anthro.pdf
  14. Karvetti RL, Knuts LR. Validity of the 24-hour dietary recall. Journal of the American Dietetic Association. 1985;85(11): 1437-1442.
  15. Roza AM, Shizgal HM. The Harris Benedict equation reevaluated: Resting energy requirements and the body cell mass. American Journal of Clinical Nutrition. 1984;40(1):168-182. https://doi.org/10.1093/ajcn/40.1.168
  16. Moran LJ, Ko H, Misso M, Marsh K, Noakes M, Talbot M, et al. Dietary composition in the treatment of polycystic ovary syndrome: A systematic review to inform evidence-based guidelines. Journal of the Academy of Nutrition and Dietetics. 2013;113(4):520-545. https://doi.org/10.1016/j.jand.2012.11.018
  17. Stener-Victorin E, Jedel E, Janson PO, Sverrisdottir YB. Lowfrequency electroacupuncture and physical exercise decrease high muscle sympathetic nerve activity in polycystic ovary syndrome. American Journal of Physiology. Regulatory, Integrative and Comparative Physiology. 2009;297(2):R387-395. https://doi.org/10.1152/ajpregu.00197.2009
  18. Jedel E, Labrie F, Oden A, Holm G, Nilsson L, Janson PO, et al. Impact of electro-acupuncture and physical exercise on hyperandrogenism and oligo/amenorrhea in women with polycystic ovary syndrome: A randomized controlled trial. American Journal of Physiology. Endocrinology and Metabolism. 2011;300(1): E37-45. https://doi.org/10.1152/ajpendo.00495.2010
  19. Yildiz BO, Knochenhauer ES, Azziz R. Impact of obesity on the risk for polycystic ovary syndrome. Journal of Clinical Endocrinology and Metabolism. 2008;93(1):162-168. https://doi.org/10.1210/jc.2007-1834
  20. Raisbeck E. Understanding polycystic ovary syndrome. Nurse Prescribing. 2009;7(9):390-396. https://doi.org/10.12968/npre.2009.7.9.43998
  21. Lindenbaum C. Polycystic ovarian syndrome. Where genetics and environment collide. Advances for Nurse Practitioners. 2010;18(2):20-26.
  22. Badawy A, Elnashar A. Treatment options for polycystic ovary syndrome. International Journal of Woman's Health. 2011;8 (3):25-35.
  23. Lass N, Kleber M, Winkel K, Wunsch R, Reinehr TH. Effect of lifestyle intervention on features of polycystic ovarian syndrome, metabolic syndrome, and intima-media thickness in obese adolescent girls. Journal of Clinical Endocrinology and Metabolism. 2011;96(11):3533-3540. https://doi.org/10.1210/jc.2011-1609
  24. Hoeger KM, Kochman L, Wixom N, Craig K, Miller RK, Guzick DS. A randomized, 48-week, placebo-controlled trial of intensive lifestyle modification and/or metformin therapy in overweight women with polycystic ovary syndrome: A pilot study. Fertility and Sterility. 2004;82(2):421-429. https://doi.org/10.1016/j.fertnstert.2004.02.104
  25. Azziz R, Carmina E, Dewailly D, Diamanti-Kandarakis E, Escobar-Morreale HF, Futterweit W, et al. Positions statement: Criteria for defining polycystic ovary syndrome as a predominantly hyperandrogenic syndrome: an Androgen Excess Society guideline. Journal of Clinical Endocrinology and Metabolism. 2006;91(11):4237-4245. https://doi.org/10.1210/jc.2006-0178
  26. Lee S, Bacha F, Gungor N, Arslanian SA. Waist circumference is an independent predictor of insulin resistance in black and white youths. Journal of Pediatrics. 2006;148(2):188-194. https://doi.org/10.1016/j.jpeds.2005.10.001
  27. Ornstein RM, Copperman NM, Jacobson MS. Effect of weight loss on menstrual function in adolescents with polycystic ovary syndrome. Journal of Pediatric and Adolescent Gynecology. 2011;24(3):161-165. https://doi.org/10.1016/j.jpag.2011.01.002
  28. Ahmed EMS, Salem ME, Sweed MS. Effect of lifestyle modifications on polycystic ovarian syndrome symptoms. Journal of American Science. 2012;8(8):535-544.