***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    ***EXAMPLES*** 
    Input: Background Women with polycystic ovary syndrome ( PCOS ) have symptoms of depression and anxiety and impaired health related quality of life ( HRQoL ) . Here we test the post-hoc hypothesis that acupuncture and exercise improve depression and anxiety symptoms and HRQoL in PCOS women . Methods Seventy-two PCOS women were r and omly assigned to 16 weeks of 1 ) acupuncture ( n = 28 ) ; 2 ) exercise ( n = 29 ) ; or 3 ) no intervention ( control ) ( n = 15 ) . Outcome measures included : change in Montgomery Åsberg Depression Rating Scale ( MADRS-S ) , Brief Scale for Anxiety ( BSA-S ) , Swedish Short-Form 36 ( SF-36 ) , and PCOS Question naire ( PCOSQ ) scores from baseline to after 16-week intervention , and to 16-week post-intervention follow-up . Results A reduction in MADRS-S and BSA-S from baseline to 16-weeks post-intervention follow-up was observed for the acupuncture group . The SF-36 domains role physical , energy/vitality , general health perception and the mental component of summary scores improved in the acupuncture group after intervention and at follow-up . Within the exercise group the role physical decreased after treatment , while physical functioning and general health perception scores increased at follow-up . The emotion domain in the PCOSQ improved after 16-weeks of intervention within all three groups , and at follow-up in acupuncture and exercise groups . At follow-up , improvement in the infertility domain was observed within the exercise group . Conclusion There was a modest improvement in depression and anxiety scores  in women treated with  acupuncture  , and improved HRQoL scores were noted in both intervention groups . While not a primary focus of the trial , these data suggest continued investigation of mental health outcomes in women treated for PCOS.Trial registration number Clinical Trials.gov Identifier : Abstract Polycystic ovary syndrome ( PCOS ) is a common endocrine disorder with a significant psychological burden throughout the life course of affected women . Thus , use of mindful awareness may be beneficial as an adjunct to conventional medical management of women with PCOS . A r and omized , controlled trial was conducted at the Evgenideion Hospital of the Athens University Medical School to explore the impact of an 8-week mindfulness stress management program on measures of depression , anxiety and stress as well as on the quality of life in reproductive age women with PCOS . The study was approved by the Research Ethics Committee . Twenty-three and 15 women with PCOS were r and omly allocated to the intervention or control group , respectively . All participants were administered  DASS21 , PSS-14 , PCOSQ , Daily Life  and General Life Satisfaction Question naires and provided three-timed daily sample s of salivary cortisol , before and after the intervention . Intervention group participants were provided with the  Credibility/Expectancy Question  naire at the day of enrolment , to check for possible placebo effect on the outcome . Post-intervention , between-group results revealed statistically significant reductions in stress , depressive and anxiety symptoms , as well as in salivary cortisol concentrations , along with an increase in Life Satisfaction and Quality of Life scores in the intervention group only . There was no significant  “  placebo ” effect on the outcome measures . Mindfulness techniques seem promising in ameliorating stress , anxiety , depression and the quality of life in women with PCOS and could be used as an adjunct method to the conventional management of these women In most of South Asia , prevalences and phenotypes of  polycystic ovary syndrome ( PCOS ) among women in the community are unknown . The authors aim ed to estimate prevalence and phenotype in a community setting in Sri Lanka and to test a valid , feasible screening approach to early diagnosis . A community-based , cross-sectional study was carried out in 2005 - 2006 . A r and om sample of 3,030 women aged 15 - 39 years was selected by cluster sampling proportionate to population size . An interviewer-administered question naire was utilized to screen for " probable cases " of PCOS based on menstrual history and clinical manifestations of hyper and rogenism . Selected " probable cases " underwent clinical , biochemical , and ovarian ultrasound  assessment . The response rate was 96.2 % ( n = 2,915 ) . A total of 220 ( 7.5 % ) " probable cases " were identified : 209 women with oligo/amenorrhea ( 95 % ) and 11 women with hirsutism ( 5 % ) . Further evaluation of the 220 probable cases confirmed 164 newly diagnosed cases of PCOS based on the 2003 Rotterdam diagnostic criteria . With 19 previously diagnosed cases already present , total prevalence was 6.3 % ( 95 % confidence interval : 5.9 , 6.8 ) . Of the women with " oligo/amenorrhea and /or hirsutism , " 91.1 % were confirmed to have PCOS ; 99.4 % of women with " regular cycles in the absence of clinical hyper and rogenism " were confirmed as normal . The most common phenotypes of PCOS were oligo/amenorrhea and polycystic ovaries ( 91.4 % ) and oligo/amenorrhea and hirsutism ( 48.3 % ) CONTEXT Polycystic ovary syndrome ( PCOS ) is associated with reduced health-related quality of life ( HRQOL ) and increased prevalence of depressive and anxiety disorders . The impact of PCOS-specific treatments on these co-morbidities is unclear . OBJECTIVE To assess the impact of weight loss and decreasing hyper and rogenism on HRQOL and mood and anxiety disorders in women with PCOS . DESIGN / SETTING / PARTICIPANTS A secondary analysis of a r and omized controlled trial ( OWL-PCOS ) of preconception treatment conducted at two academic centers in women ( age , 18 - 40 years ; body mass index , 27 - 42 kg/m(2 ) ) with PCOS defined by Rotterdam criteria . INTERVENTION Continuous oral contraceptive pill ( OCP ) or intensive lifestyle intervention or the combination ( Combined ) for 16 weeks . MAIN OUTCOME MEASURE(S ) Changes in HRQOL assessed by PCOSQ and SF-36 and prevalence of depression and anxiety disorder assessed by PRIME-MD PHQ . RESULTS The lowest scores were noted on the general health domain of the SF-36 and the weight and infertility domains on the PCOSQ . All three interventions result ed in significant improvement in the general health score on the SF-36 . Both the OCP and Combined groups showed improvements in all domains of the PCOSQ ( P < .01 ) compared to baseline scores . The Combined group had significant improvements in the weight , body hair , and infertility domains compared to a single treatment group ( P < .05 ) . In a linear regression model , change in weight correlated with improvements in the weight domain ( P < .001 ) and physical well-being ( P < .02 ) , change in T correlated with improvements in the hair domain ( P < .001 ) , and change in both weight and T correlated with the infertility ( P < .001 ) and menstrual domains ( P < .05 ) . CONCLUSIONS Both weight loss and OCP use result in significant improvements in several physical and mental domains related to quality of life , depressive symptoms , and anxiety disorders , and combined therapies offer further benefits in overweight/obese women with PCOS Background Few studies have assessed whether the amelioration of the clinical signs of polycystic ovary syndrome ( PCOS ) achieved by treatment leads to improvement in the health-related quality of life ( HRQoL ) of patients . This study was aim ed to examine the HRQoL of ethnic Chinese women with PCOS who received metformin treatment .  Methods This prospect i ve study was conducted at a medical center in Taiwan . Study participants aged 18–45 years were diagnosed as having PCOS according to the Rotterdam criteria , and all received metformin treatment .  Their HRQoL was assessed using generic ( WHOQOL-Bref ) and PCOS-specific ( Chi-PCOSQ ) instruments . Mixed effect models were used to examine the effects of metformin on repeatedly measured HRQoL. Additional analyses using stratified patients characteristics ( overweight vs. normal ; hyper and rogenism vs. non-hyper and rogenism ) were done . Results We recruited 109 participants ( 56 % were overweight , 80 % had hyper and rogenism ) . Among the domain scores of WHOQOL-Bref , the psychological domain score was the lowest one ( 12.64 ± 2.2 , range 4–20 ) . Weight ( 3.25 ± 1.59 , range 1–7 ) and infertility ( 3.38 ± 1.93 , range 1–7 ) domain scores were relatively low among the domain scores of Chi-PCOSQ . Overweight and hyper and rogenic patients had significantly lower HRQoL as compared with those of normal weight and non-hyper and rogenic patients , respectively . Metformin significantly improved the physical domain of WHOQOL-Bref ( p = 0.01 ) , and the infertility ( p = 0.043 ) and acne and hair loss aspects ( p = 0.008 ) of PCOS-specific HRQoL. In the subgroup analysis , significantly improved HRQoL  following metformin treatment appeared for only overweight and hyper and rogenism subgroups . Conclusions Metformin might improve health-related quality of life of polycystic ovary syndrome women  by ameliorating psychological disturbances due to acne , hair loss and infertility problems , especially for overweight and hyper and rogenic patients BACKGROUND In polycystic ovary syndrome ( PCOS ) , changes in physical appearance , menstrual disturbances and infertility result in psychological distress and reduced quality -of-life .  Metformin improves biochemical , clinical and reproductive parameters in PCOS women . In a prospect i ve , observational study , we analysed the effects of metformin treatment on health-related quality -of-life ( HRQL ) , emotional well-being and sexuality in PCOS . No placebo-treated control group was included . METHODS Before , during and after 6 months of treatment , changes in clinical and endocrine parameters , quality -of-life , psychological disturbances and sexuality were assessed in 64 PCOS patients using vali date d question naires ( SF-36 , SCL-90-R ) and visual analogue scales . Patients were also compared with published normative data for the vali date d question naires . RESULTS During treatment , HRQL , particularly the psychosocial aspects ( indicated by significant increases in SF-36 scales Vitality , Social Function , Emotional Role Function , Mental Health , Psychological Sum scale ) and emotional well-being ( reflected by significant lowering of SCL-90-R scales ) improved . These improvements in HRQL were significantly correlated with a reduction in body weight and significantly more pronounced in patients with normalized menstrual cycles . In addition , PCOS women were significantly more satisfied with their sex life and reported higher frequencies of sexual intercourse following treatment . CONCLUSION Treatment can improve the psychosocial , emotional and psychosexual situation of PCOS patients . Although at least some of these effects may be related to the reduction of individual clinical symptoms ( i.e. weight loss , normalization of menstrual disturbances , improvement of acne ) , this observational study does not allow us to clearly discern the role of symptom constellation and does not preclude non-specific and /or placebo effects . Nevertheless , emotional distress and reduced quality -of-life are clearly not an inevitable consequence of PCOS and should be considered as adjunct treatment goals in future studies BACKGROUND Ovulation induction with gonadotrophins is the st and ard treatment strategy for women with clomiphene citrate (CC)-resistant polycystic ovary syndrome ( PCOS ) .  Laparoscopic electrocautery of the ovaries is an alternative treatment modality , leading to a comparable cumulative pregnancy rate . In deciding which treatment to opt for , women 's health-related quality of life ( HRQoL ) should be taken into account . METHODS A total of 168 CC-resistant women with PCOS were r and omly assigned to receive either the electrocautery strategy , entailing laparoscopic electrocautery of the ovaries followed by CC and recombinant FSH ( rFSH ) if anovulation persisted , or ovulation induction with rFSH . We assessed women 's HRQoL with the st and ard question naires Short Form-36 , Rotterdam Symptom Checklist and Center for Epidemiological Studies Depression Scale , administered before r and omization and 2 , 12 and 24 weeks thereafter . RESULTS The intention to treat analysis revealed no significant differences between the treatment groups on any of the scales at any point during follow-up . In women without an ongoing pregnancy , those treated with rFSH showed significantly more depressive symptoms than women allocated to the electrocautery strategy , with or without CC , although differences were small . CONCLUSIONS Overall , HRQoL was not affected in both groups . In women still under treatment , rFSH was slightly more burdensome for women 's HRQoL than electrocautery with or without CC OBJECTIVE This study was design ed to evaluate the reliability , validity , and responsiveness of a newly developed , health-related quality -of-life measure . STUDY DESIGN A total of 137 women ( 122 from a Phase III clinical trial and 15 from a private practice setting ) with endometriosis completed the question naire several times . RESULTS Reproducibility and 
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All studies assessed different aspects of QoL in PCOS women and found that PCOS had negative effects on QoL in this population .
Conclusion The PCOSQ and the SF-36 were used most frequently for the assessment of QoL in PCOS women .
Perhaps using either a specific question naire solely or a specific question naire in conjunction with a generic measure would be more appropriate when measuring QoL in PCOS women .
However , both question naires showed that they are able to capture different aspects of QoL in PCOS women and to identify areas that can help to improve QoL in these women