Date of Award

Fall 2021

Document Type

Open Access Dissertation

Department

College of Nursing

First Advisor

Cynthia L. Corbett

Second Advisor

Bernardine M. Pinto

Abstract

Polycystic ovary syndrome (PCOS) is the most common endocrinopathy among premenopausal women with a prevalence that ranges 15-21%. The estimated financial burden in the United States for evaluating and treating premenopausal women with PCOS was over $8 billion in 2020. PCOS etiology is complex and poorly understood, as is the optimal treatment and management. Endocrine Society Clinical Practice Guidelines recommend exercise as first-line treatment. Yet, the optimal exercise type and “dosing” are not defined. As last reported for women with PCOS, less than 60% are regularly physically active and more than 25% are sedentary. Additionally, little to no published data exist about their perceived exercise barriers/benefits and exercise outcome expectations. The overall objective of this dissertation was to gain knowledge to begin developing exercise interventions for women with PCOS. The research used multiple methods with three specific aims: 1) Explore the relationships among biopsychosocial characteristics, perceived exercise benefits and barriers, exercise outcome expectations, and depressive symptoms among premenopausal women with PCOS; 2) Explore the relationships among, anthropometric attributes, hormonal concentrations, lipid profiles, and fitness levels of premenopausal women with PCOS; and 3) Identify supports (people, services, technology, and/or behavioral change strategies) that may promote initiation and maintenance of exercise in premenopausal women with PCOS. Findings from Aim 1 revealed that many women with PCOS present with low health-related quality-of-life, high depressive symptoms, and neutral exercise outcome expectations with more perceived exercise barriers than benefits. Phenotypically, the women who participated in Aim 2 were obese (BMI 32.2 ± 8.3m2 /kg, percent body fat 41.1± 8.1%) with high levels of free testosterone (6.4 ± 4.0 pg/mL). Self-reported level of physical activity was negatively correlated with BMI (rs=-0.64, p=0.04) and waist-to-hip ratio (rs=-0.76, p=0.01). Cardiovascular endurance was negatively correlated with free testosterone (rs=-.70, p=0.02) and depressive symptoms (rs=-0.69, p=0.02 and positively correlated with health-related quality-of-life (rs=0.62, p=0.04). All women who participated in Aim 3 reported external types of motivation when considering exercise, such as incentives, and a preference for a structured PCOS-knowledgeable support system to help initiate and sustain exercise. Additionally, the self-determination theory was useful toward identifying unmet psychological needs, that if met, could promote internal self-regulation.

Available for download on Thursday, December 15, 2022

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