Psychological evaluation in women with premature ovarian insufficiency using Hormonal therapy: depression, anxiety, and stress

Camila Menezes Lima (BR), Daniela Angerame Yela (BR), Cristina Laguna Benetti-Pinto (BR)

[Menezes Lima] School of Medical Sciences, University of Campinas, [Angerame Yela] School of Medical Sciences, University of Campinas, [ Laguna Benetti-Pinto] School of Medical Sciences, University of Campinas

Context: Considering our society and the social pressure within, fertility is usually directly related to female achievement. Infertility often generates frustration, stigmatization, and sense of inferiority feeling in the female context. Thus, Premature Ovarian Insufficiency (POI) has become an important condition to be studied by their psychological consequences. Objective: To assess psychological aspects such as anxiety, stress, depression in POI women using hormone therapy (HT). Methods: A Cross-sectional study, approved by the ethics committee. The significance level adopted for the statistical tests was 5%. The Mann-Whitney test was used to compare the groups and the Spearman coefficient test to analyze the correlation between the numerical variables. Patients: 100 women aged 18 and 45 years divided into two groups: the study group consists of 50 women diagnosed with POI and using HT, and the control group of 50 women with preserved ovarian function, matched by age (± 2 years). Interventions: Three inventories were applied: Beck Depression Index (BDI), Beck Anxiety Index (BAI), Adult Stress Symptom Inventory (SSI). All were validated in Brazil. Main Outcome Measures: To compare the score of depression, anxiety, and stress between POI women using HT and women with normal ovarian function. Results: Women with POI had respectively 35.8 ± 7.8 and 35.3 ± 7.4 years (P = 0.6). The BDI results were 13.3 ± 9.8 and 13 ± 8.1 (P = 0.8); BAI of 15.2 ± 11.5 and 16.6 ± 11.0 (P = 0.46) and SSI of 17.4 ± 11.0 and 18 ± 10.7 (P = 0.6). The period of time since diagnosis of POI correlated negatively with BDI in women with POI (R = 0.30 and P = 0.03). In this group, there was direct correlation between the depression index and other disorders (BAI R = 0.56 ; ISSL R = 0.72). In POI patients, age presented a weak positive correlation with anxiety (R = 0.28 and p = 0.05). Conclusions: Based on the results, there was no difference in depression, anxiety and stress indexes in women with POI compared to women with normal ovarian function. Nevertheless, the impact of the diagnosis of depression was evident, since a longer diagnosis often comes with a lower depression rate. Considering the importance of multidisciplinary care, the service provides to the patient also involves support of nutritionists, psychologists, and physiotherapists who provide a complete attention to the woman in treatment.