Role of supplements in treatment for polycystic ovary syndrome in a multi-ethnic ovulation and menstruation cohort
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INTRODUCTION: Polycystic Ovary Syndrome (PCOS) is a reproductive and endocrine disorder common among women of reproductive age. It is characterized by elevated androgen levels, menstrual irregularities, and several cysts ranging from 2 to 9 mm on one or both ovaries. PCOS is prevalent in approximately 10% of women typically between the ages of 18-44. It is significantly underdiagnosed due to variation in disease manifestation. Treatment for PCOS includes oral contraceptives, Metformin, and Spironolactone. However, supplements such as zinc and magnesium are increasingly promising additions to PCOS treatment regimens to manage symptoms and co-morbid chronic diseases. The objective of this thesis is to determine the prevalence of supplement use as a treatment for PCOS in the Ovulation and Menstruation Health Pilot Study (OM). The OM Pilot study is an epidemiological, online survey that aims to study the characteristics and determinants of female reproductive diseases in a diverse population. This thesis also explores the overall role of nutrition in PCOS management. METHODS: The goal of the OM Pilot Study is to determine women’s gynecological health outcomes in a multi-ethnic cohort and to characterize the lifestyle, health, and menstrual risks of reproductive diseases such as polycystic ovary syndrome, endometriosis, and uterine fibroids. The eligibility criteria included: being of reproductive age, having the ability to menstruate, being able to read in English, and having a working email address to receive the link to the survey. The survey and questions were designed by a board-certified reproductive endocrinology and infertility specialist at Boston Medical Center and was administered through REDCap, a cloud-based clinical software application for building and managing online surveys and databases. The questionnaire was comprised of each of the following sections: Demographics, Baseline Questionnaire, Anthropometrics, Menstrual Cycle, Contraceptive History, Health and Body, Polycystic Ovary Syndrome, Reproductive Health Questions, General Health Questions, Diet and Lifestyle, and Pregnancy and Birth History. Participants were recruited from multiple cities across the United States using in-person recruiting methods, online recruitment through a link, flyers, posters, word-of-mouth, and advertisements on Facebook and other social media websites such as Twitter and LinkedIn. Consenting participants were entered into a raffle to win a $200 gift card. Data analysis was conducted on SAS 9.4 and manually as needed. RESULTS: In terms of prevalence of PCOS: Of the 249 women who completed the survey, 60 women self-reported to having polycystic ovary syndrome (37 were diagnosed by a physician and 23 diagnosed by self). And of those 60 women who reported having PCOS, 24 reported taking medication for PCOS and out of these women, 10 women reported taking one, two, or three of the supplementary treatment options. Of the 60 women with PCOS, 4 women currently take a multivitamin for PCOS, 2 women currently take a dietary supplement, 2 women currently take herbal remedies, and 4 women reported drinking spearmint tea to help with PCOS management. Additionally, out of the 60 women who reported yes to having PCOS whether they were diagnosed by a physician and self-diagnosed, 11 women also reported yes to having an eating disorder. Of those 11 women, 7 women have anorexia, 7 women have bulimia, and 4 women have binge eating disorder. CONCLUSION: In this thesis, the prevalence rates of PCOS diagnoses, supplement use among PCOS patients, and eating disorders among PCOS patients were determined. Based on current literature on the effectiveness of supplements on PCOS symptoms, it seems advisable to study the effects of supplements further to incorporate them into treatment. With additional research, medical personnel such as physicians and registered dietitians should consider adding supplements to treatment regimen for PCOS. A personalized diet and exercise plan along with a plan to treat mental health to curb the prevalence of eating disorders may be beneficial to add to the treatment regimen for PCOS.