How Polycystic Ovary Syndrome Impacts the Quality of Care (Essay Sample)

How Polycystic Ovary Syndrome (PCOS) impacts the quality of care, patient safety, and costs to the system and individual
Polycystic Ovary Syndrome causes hyperandrogenism and anovulation. It increases the risk of multiple health conditions such as diabetes mellitus, cardiovascular disease, and infertility (Pereira & Kreider, 2017). PCOS is commonly diagnosed in the early reproductive years presenting as the absence of menstrual cycle although this period presents challenges because a large percentage of women with a recent menarche onset are more likely to have irregular periods (Pereira & Kreider, 2017). Women with PCOS will first present either to the dermatologist or in a primary care setting with a cutaneous PCOS-related problem such as acne, hirsutism, or androgenic alopecia without the knowledge that the acne may be a symptom of an underlying condition. About 20-40% of women with PCOS will have acne, typically in the acne-prone areas of the face, chest, and back. This acne is usually resistant to treatment using topical creams or antibiotics and continues into adulthood. Hirsutism occurs in approximately 60-90% of these women and is a distressing symptom. In hirsutism, terminal coarse hair can grow in many areas among them the face, usually the sideburns area, lower jaw, chin, and upper lip areas, upper neck, upper and lower back, chest, upper and lower abdomen, arms, and thighs. Androgenic alopecia is found in 40-70% of women with PCOS. It is characterized by thinning of the hair on the scalp in a male distribution pattern, usually hair loss in the central scalp (Pereira & Kreider, 2017). 50-90%of women with PCOS will have menstrual dysfunction presenting as irregular menstrual periods or total absence of menstruation.
PCOS affects patient safety in many different ways. It is associated with insulin resistance which puts the patient at the risk of impaired glucose tolerance or pre-diabetes or type 2 diabetes mellitus. Impaired glucose tolerance is found in about 30-35% of women with PCOS while 3-10% will have type 2 diabetes mellitus. Besides, there is an increased risk of gestational diabetes in women with PCOS (Pereira & Kreider, 2017). The other comorbid condition associated with PCOS is cardiovascular disease. The risk of cardiovascular disease is increased by multiple risk factors in PCOS such as impaired glucose tolerance, depression, anxiety, dyslipidemia, and metabolic syndrome. 33-47% of women with PCOS have metabolic syndrome. Besides, there is an increased risk of increased levels of anxiety and depression in women with PCOS as well as decreased health-related quality of life. Weight is a major contributor to decreased quality of life in women with PCOS. Women with PCOS are also at risk of endometrial cancer (Carron, 2016).
According to Riestenberg et al,. (2021), the economic burden of PCOS in the US is estimated at $8 billion annually. These costs include direct costs of treating long-term metabolic health conditions associated with PCOS such as stroke and type 2 diabetes mellitus as well as pregnancy-related costs. The long term metabolic health conditions and reproductive health problems such as hirsutism, menstrual dysfunction, abnormal uterine bleeding, and infertility constitute the most expensive aspects of PCOS. Approximately 5% of the PCOS cost is due to complications related to pregnancy such as preeclampsia and gestational diabetes. Initial diagnosis of PCOS accounts for less than 2% of these costs. According to Riestenberg et al,. (2021), early diagnosis of PCOS can help reduce some of the complications that women with PCOS experience which can then help reduce the overall cost of providing care for PCOS. 
In my nursing practice, about half of the costs associated with PCOS are due to metabolic and cardiovascular morbidities, mainly type 2 diabetes mellitus and strokes. Major costs related to PCOS in my nursing practice are also because of pregnancy-related complications such as gestational diabetes, preeclampsia, and gestational hypertension. The initial diagnostic process for PCOS in my practice doesn’t cost much.
State board nursing practice standards and/or organizational or governmental policies
There exist many nursing recommendations from international evidence based guideline for the assessment and management of PCOS. These guidelines are either evidence based recommendations, clinical consensus recommendations or clinical practice points with regards to the assessment and management of PCOS (Teede, et al. 2018).