Background: Polycystic ovary syndrome (PCOS) is a common, chronic gynaecological condition impacting women of reproductive age. Women with PCOS have hormonal, ovulatory, and metabolic dysfunction resulting in multiple symptoms. The correlation between hormonal disbalance and the impact on women’s mental health (MH) has been researched for decades. However, the prevalence among different ethnicities has not been fully evaluated. Aim: The aim of this study was to explore the prevalence of PCOS among minority ethnic populations. Methods: A systematic methodology was developed, and a protocol was published in PROSPERO (CRD42020210863); moreover, a systematic review of publications between 1st January 1990 and 30th January 2021 was conducted. Multiple electronic databases were explored using keywords and MeSH terms. The finalised dataset was analysed using statistical methods such as random-effect models, subgroup analysis, and sensitivity analysis. These were used to determine the prevalence using variables of PND, anxiety, PTSD, and stress. Results: We included 30 studies reporting on 3,944 PCOS women. The majority of the included studies addressed depression, anxiety, and common mental health symptoms. Studies showed fair to poor methodological quality and included both observational studies and Randomised Clinical Trials (RCTs). Overall, 17% (95% CI: 7% to 29%) of the women with PCOS examined had a clinical diagnosis of major or severe depression; 33% (95% CI: 26% to 40%) had elevated depressive symptoms or a clinical diagnosis of depression; 41% (95% CI: 28% to 54%) reported anxiety symptoms; and 31% (95% CI: 15% to 51%) had a form of common mental health symptomatology or were taking psychiatric medication for anxiety and/or depression. The use of various tools to assess mental health symptoms was among the reasons for the substantial heterogeneity across studies. Conclusions: PCOS is associated with an increased risk of mental health disorders, including depression, anxiety, and other conditions. Approximately 30% of individuals with PCOS are taking psychiatric medication for anxiety and/or depression. While BAME populations account for about 20% of most of the samples studied, stratification by ethnicity was rarely attempted in study design makes it difficult to elucidate the MH impact of PCOS on different communities.

Objective It is common practise that when patients in early pregnancy present acutely, they undergo a speculum examination to assess for signs of miscarriage. It was noted that high vaginal swabs (HVS) were being undertaken as a matter of routine without clinical indication. The main objective of this quality improvement project was to reduce the number of unnecessary HVS undertaken in women in early pregnancy, thus reducing workload and cost to the department. Design Our project was completed in a district general hospital setting, in line with the Institute for Healthcare Improvement's 'Model for Improvement': 'plan, do, study and act.' Data analysis of HVS taken in early pregnancy patients was conducted over an initial 12 week period, and once the hypothesis was confirmed, clinicians were reminded to only undertake HVS in early pregnancy if there was clinical suspicion of infection. The data was then recollected 12 weeks following implementation of change. Method The details of early pregnancy patients assessed acutely over the initial 12 week 'plan' phase (December 2019-March 2020) and subsequent 12 week 'study' phase (June 2020-September 2020) were obtained retrospectively from the gynaecology on-call lists. The COVID-19 lockdown period was excluded from analysis. A direct comparison between the number of unnecessary swabs undertaken per week in each phase was made using run-chart analysis. Results A total of 50 HVS were obtained during the 'plan' phase, with only 6 of these returning a positive result for infection. During the study phase, a dramatic reduction in the number of HVS undertaken in early pregnancy was seen;4 HVS were taken, 2 of which returned a positive result. All 8 positive cases had a documented indication for testing;of the 46 negative results, none had a documented indication for HVS. Before intervention, an average of 14.7 unnecessary HVS were obtained/month, equating to a cost of £3087.00/year. After intervention, an average of 0.7 unnecessary HVS were obtained/month, equating to a cost of £147.00/year. Conclusions Our project confirmed that the presence of a clinical indication for HVS in early pregnancy, such as a history or presence of abnormal discharge correlates strongly with a positive swab result. Furthermore, the incidence of an incidental positive result when no clinical signs are present is low (none in this study). We can therefore conclude that targeted HVS sampling in early pregnancy is safe practise, significantly reducing workload and cost for the department.