Quality of Life in Polycystic Ovary Syndrome after Anti-Androgen Therapy Using PCOSQOL-47 and PCOSQOL-42

Introduction: Hyperandrogenism in Polycystic ovary syndrome (PCOS) negatively affects health-related quality of life (HRQOL). Anti-androgens may improve both biochemical and patient-related outcomes. Objectives: To evaluate the impact of combined finasteride and spironolactone on HRQOL in married and unmarried women with PCOS using PCOSQOL-47 and PCOSQOL-42, respectively. Methods: A total of 263 married and 236 unmarried women with PCOS were enrolled from two tertiary centers. All received finasteride (5mg) and spironolactone (100mg) daily and were followed every four months over a year. HRQOL was assessed using PCOSQOL-47 for married and PCOSQOL-42 for unmarried women, alongside evaluating their biochemical and clinical hyperandrogenism. Results: After one year, significant reductions were observed in total and free testosterone, dehydroepiandrosterone sulfate, body mass index (BMI), and a decrease in modified Ferriman-Gallwey (mFG) scores. Both groups showed marked HRQOL improvement, greater in unmarried women. In PCOSQOL-47, psychological and emotional domains improved most, while fertility and sexual domains improved least. In PCOSQOL-42, menstrual and fertility domains had the highest gains, while coping improved least. Both groups had a 25% reduction in mFG score and 5% reduction in BMI. Discussion: This is the first study to evaluate combined finasteride and spironolactone on HRQOL domains in PCOS using PCOSQOL-47 and PCOSQOL-42. Prior studies assessing anti- androgens used other tools, without distinction between married and unmarried women. Conclusions: Combined finasteride and spironolactone significantly improved all HRQOL scales and reduced hyperandrogenism within the first four months in women with PCOS, supporting its role alongside lifestyle measures.