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Background: Women with PCOS experience great psychological distress. The majority of them have an elevated level of testosterone and irregular menstrual. The imbalanced hormonal levels, changed appearance and uncertain fertility potential brought by PCOS can create anxiety and depression, leading to poor quality of life (QoL). However, very little research has focused on their holistic health and well-being till today, and non-pharmaceutical intervention for their long-term disease management is still lacking. An Integrative Mind-Body-Spirit (IBMS) intervention have been supported to be conducive to many kind of patients’ physical and mental health.
Methods: This was a longitudinal intervention study. Fifty-five women with PCOS diagnosed by Rotterdam Criteria were approached, while twenty-eight participated in a tailored-made IBMS intervention. Three rounds of the six-session weekly IBMS intervention were conducted with each accommodating eight to ten participants. All participants took the blood tests during their menstrual period in two to three weeks before [T0] and after [T1] the intervention. Before the first intervention session and at the end of the last session, a questionnaire measuring anxiety, depression, QoL, body shame, and holistic well-being was distributed. In two to three months [T2] and one year to 15 months after the intervention [T3], the same questionnaire was sent. Open questions were asked.
Results: 28 joined the intervention while 21 filled in the first follow-up questionnaire, 15 completed the one-year follow-up. Most suffered from menstrual irregularity (24/28, 85.7%) and appearance change (78.6%). Results indicated that the IBMS method could long-termly improve women’s physical, mental and spiritual health with PCOS. Participants’ mean Body Mass Index (p<0.01) and testosterone (p<0.001) reduced significantly at T1. At T2, most participants (17/21, 81.0%) menstruated without taking medicine, while two of the twenty who had childbearing intentions became pregnant naturally; at T3, only two participants (2/15, 13.3%) reported still irregular menstrual; two (13.3%) were pregnant, while six (40%) had given birth. In terms of psychological improvements, their levels of depression (p<0.01) and affliction (p<0.01) reduced significantly while emotion-related QoL (p<0.05), and total health-related QoL (p<0.01), and equanimity (p<0.01) increased significantly at T1. Anxiety (p<0.05), depression (p<0.001), body shame (p<0.01), and affliction (p<0.01) reduced significantly; infertility-related (p<0.01), menstrual-related (p<0.001), emotion-related QoL (p<0.001), and total health-related QoL (p<0.001) increased significantly at T3. Most of the psychological outcomes improved significantly with a medium to large effect size in the long-term follow-up. Longitudinal qualitative follow-ups clarified the importance of exercise and lifestyle management, and practical roles of self-acceptance and self-love to attain holistic well-being.
Implications: The non-pharmaceutic mind-body intervention brought definite and statistically significant improvement for women with PCOS physically, mentally, and spiritually with medium to large effect sizes over a sustained follow-up of one year. Consequently, this intervention can be used for future empirical studies on other females or patients with other chronic diseases.