Abstract
Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder affecting up to 13 % of women. Lifestyle interventions are first-line treatments, however attrition in women with PCOS is high. This review summarises current evidence on barriers to lifestyle management in PCOS and suggested strategies for overcoming these challenges, mapped to the Capability, Opportunity, Motivation and Behaviour model.Physical capability for lifestyle changes may be impacted by altered gut hormone regulation and energy expenditure in PCOS. This may contribute to difficulties with weight management. The higher prevalence of eating disorders, disordered eating, fatigue and sleep disturbances are further barriers. Psychological capability may be reduced due psychological symptoms and lack of critical health literacy. Women with PCOS face similar challenges in terms of Opportunity to make lifestyle changes as other women of reproductive age. However, these are complicated by features more common in PCOS including body dissatisfaction. Motivation to adopt healthy lifestyles may be impacted by suboptimal risk perception and intrinsic motivation.To address these barriers, screening for and management of eating disorders, disordered eating, depression, and Obstructive Sleep Apnoea should be undertaken as per international evidence-based guidelines. A weight-neutral approach may be appropriate with disordered eating. Building capability among health professionals to better partner with women with PCOS on their management is essential in addressing health literacy gaps. Behavioural strategies that target risk perception and build intrinsic motivation should be utilised. More research is required to understand optimal self-management strategies, risk perception, energy homeostasis and overcoming attrition in women with PCOS.
Highlights
Polycystic Ovary Syndrome (PCOS) is a multisystem disorder with reproductive, metabolic, and psychological manifestations [1] affecting up to 13 % of women of reproductive age [2]
Women with PCOS have a higher prevalence of overweight and obesity and a higher rate of longitudinal weight gain compared to women without PCOS [8]
In another study we reported that women with PCOS presenting with depression symptoms upon program initiation are at greater odds of drop-out across lifestyle interventions [124]
Summary
Polycystic Ovary Syndrome (PCOS) is a multisystem disorder with reproductive, metabolic, and psychological manifestations [1] affecting up to 13 % of women of reproductive age [2]. Similar research and practice gaps in the domain of critical health literacy have been highlighted in lifestyle management of other women of reproductive age due to a lack of patient involvement in intervention development [105].
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