Attitudes toward women and emotional well-being in women with spontaeous 46,XX primary ovarian insufficiency (hypergonadotropic hypogonadism)

Abstract

OBJECTIVE: Women with spontaneous 46,XX primary ovarian insufficiency (sPOI), previously referred to as premature ovarian failure (POF), score adversely compared to control women on measures assessing symptoms of depression and anxiety. In this study, we assess the association between affective measures and attitudes towards the rights and roles of women in contemporary society. DESIGN: Cross-sectional. MATERIALS AND METHODS: We recruited women with sPOI (n=100) and control women (n=60) between 18 and 42 years of age. Measures included a subset of 5 items from the Attitudes Towards Women Scale (ATW, Spence et al. 1973) assessing women's roles in the family, Center of Epidemiologic Studies Depression Scale (CES-D), and the state anxiety subscale of the State-Trait Anxiety Inventory (STAI). The ATW includes statements such as “Women should worry less about their rights and more about becoming good wives and mothers.” (1 - agree strongly, 2 - agree mildly, 3 - disagree mildly, 4 - disagree strongly). Statistical tests: Wilcoxon rank-sum tests and Spearman rank correlation. RESULTS: Patients and controls did not differ significantly with regard to age, race/ethnicity, marital status, or education. Women with sPOI had a significantly lower median (interquartile range) score on the ATW scale [17 (4) vs. 19 (3), p<0.03], indicating that as a group they had a more traditional view towards the rights and family roles of women in contemporary society. The ATW score in patients was negatively correlated with both depressive symptoms (r = -0.25, p < 0.02) and anxiety symptoms (r = -0.23, p <0.025). Among control women ATW was positively associated with level of education (r = 0.44, p <0.001) yet this was not true among women with sPOI (r = 0.14, p = 0.17). ATW scores did not associate with marital status, income, race, or age either in patients or controls or with age at diagnosis or time since diagnosis in women with sPOI. CONCLUSIONS: Women with sPOI have more conservative views toward the family role of women in contemporary society than controls. Further, the more conservative view a woman with sPOI has toward the role of women, the more symptoms of anxiety and depression. Broadening perspectives on the family roles of women may reduce affective disturbance related to infertility and should be examined as a potential target of intervention to promote emotional resilience among women with sPOI.