THE IMPACT OF POLYCYSTIC OVARY SYNDROME (PCOS) ON THE MENTAL HEALTH OF PATIENTS – A CROSS-SECTIONAL STUDY WITH EXTENDED CLINICAL AND PUBLIC HEALTH IMPLICATIONS

Keywords: Polycystic Ovary Syndrome, Depression, Anxiety, Stress, Women’s Health, Lifestyle Medicine

Abstract

Background: Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder affecting up to 10% of reproductive-aged women. Beyond reproductive symptoms, PCOS is increasingly associated with mental health challenges, including depression, anxiety, and stress, often overlooked in routine care.

Aim: This study assessed the prevalence and severity of psychological symptoms in women with PCOS and identified clinical and behavioral predictors of poor outcomes, with emphasis on modifiable lifestyle factors.

Methods: A cross-sectional study was conducted among 200 women aged 18–40 diagnosed with PCOS by Rotterdam criteria. Participants completed the Depression, Anxiety and Stress Scale-21 (DASS-21) and a survey on sleep, physical activity, nutrition, and social support. Clinical indicators included BMI, menstrual regularity, hirsutism, and acne. Pearson correlations and regression models were used to analyze associations.

Results: Moderate to severe depression affected 62% of participants, elevated anxiety 54%, and high stress 38%. Higher BMI, irregular cycles, and hirsutism were strongly correlated with worse psychological scores. Protective factors included regular physical activity, sufficient sleep, and positive body image. Regression analyses confirmed both clinical and behavioral predictors were significant (p < 0.05).

Conclusions: Women with PCOS experience a substantial psychological burden. Routine care should integrate mental health screening and multidisciplinary management. Lifestyle interventions focusing on exercise, sleep, and body image may significantly improve emotional well-being and overall quality of life.

References

Barry, J. A., Kuczmierczyk, A. R., & Hardiman, P. J. (2011). Anxiety and depression in polycystic ovary syndrome: A systematic review and meta-analysis. Human Reproduction, 26(9), 2442–2451. https://doi.org/10.1093/humrep/der197

Benson, S., Hahn, S., Tan, S., et al. (2009). Prevalence and implications of anxiety in polycystic ovary syndrome: Results from a cohort study. European Journal of Endocrinology, 161(3), 479–484. https://doi.org/10.1530/EJE-09-0384

Blay, S. L., Aguiar, J. V., & Passos, I. C. (2021). Polycystic ovary syndrome and mental disorders: A narrative review. Trends in Psychiatry and Psychotherapy, 43(1), 36–42. https://doi.org/10.47626/2237-6089-2020-0148

Bozdag, G., Mumusoglu, S., Zengin, D., Karabulut, E., & Yildiz, B. O. (2016). The prevalence and phenotypic features of polycystic ovary syndrome: A systematic review and meta-analysis. Human Reproduction, 31(12), 2841–2855. https://doi.org/10.1093/humrep/dew218

Cooney, L. G., Lee, I., Sammel, M. D., & Dokras, A. (2017). High prevalence of moderate and severe depressive and anxiety symptoms in PCOS. Human Reproduction, 32(5), 1075–1091. https://doi.org/10.1093/humrep/dex044

Cooney, L. G., Lee, I., & Dokras, A. (2017). Screening and treatment for depression and anxiety in PCOS. Current Psychiatry Reports, 19(11), 83. https://doi.org/10.1007/s11920-017-0830-6

Dokras, A. (2012). Mood and anxiety disorders in women with PCOS. Steroids, 77(4), 338–341. https://doi.org/10.1016/j.steroids.2011.12.008

Dokras, A., Clifton, S., Futterweit, W., et al. (2011). Increased risk for abnormal depression scores in women with PCOS. Obstetrics & Gynecology, 117(1), 145–152. https://doi.org/10.1097/AOG.0b013e31820213a2

Doshi, A., Zaheer, A., & Stiller, M. J. (1997). A comparison of current acne grading systems and proposal of a novel system. International Journal of Dermatology, 36(6), 416–418. https://doi.org/10.1046/j.1365-4362.1997.00099.x

Dunaif, A. (1997). Insulin resistance and the polycystic ovary syndrome: Mechanism and implications for pathogenesis. Endocrine Reviews, 18(6), 774–800. https://doi.org/10.1210/edrv.18.6.0318

Fauser, B. C. J. M., Tarlatzis, B. C., Rebar, R. W., et al. (2012). Consensus on women’s health aspects of PCOS. Human Reproduction, 27(1), 14–24. https://doi.org/10.1093/humrep/der396

Fernandez, R. C., et al. (2018). Poor sleep quality in women with PCOS: Links with insulin resistance and depression. Sleep Health, 4(5), 428–434. https://doi.org/10.1016/j.sleh.2018.07.001

Greenwood, E. A., Pasch, L. A., Shinkai, K., et al. (2018). Role of depression in inflammation in PCOS. The Journal of Clinical Endocrinology & Metabolism, 103(11), 4345–4354. https://doi.org/10.1210/jc.2018-00870

Hatch, R., Rosenfield, R. L., Kim, M. H., & Tredway, D. (1981). Hirsutism: Implications, etiology, and management. American Journal of Obstetrics and Gynecology, 140(7), 815–830. https://doi.org/10.1016/0002-9378(81)90554-2

Henry, J. D., & Crawford, J. R. (2005). The short-form version of the DASS-21: Construct validity and normative data. British Journal of Clinical Psychology, 44(2), 227–239. https://doi.org/10.1348/014466505X29657

IBM Corp. (2017). IBM SPSS Statistics for Windows, (Version 25.0) [Computer Software]. Armonk, NY: IBM Corp. Jiskoot, G., et al. (2020). Long-term effects of lifestyle intervention in women with PCOS. The Journal of Clinical Endocrinology & Metabolism, 105(3), e1061–e1070. https://doi.org/10.1210/clinem/dgz270

Jones, G. L., Hall, J. M., Balen, A. H., & Ledger, W. L. (2008). Health-related quality of life measurement in women with PCOS: A systematic review. Human Reproduction Update, 14(1), 15–25. https://doi.org/10.1093/humupd/dmm030

Karjula, S., et al. (2020). Social support and empowerment in PCOS peer groups. BMC Health Services Research, 20, 871. https://doi.org/10.1186/s12913-020-05753-4

Kitzinger, C., & Willmott, J. (2002). ‘The thief of womanhood’: Women’s experience of polycystic ovary syndrome. Social Science & Medicine, 54(3), 349–361. https://doi.org/10.1016/S0277-9536(01)00034-3

Lim, S. S., Norman, R. J., Davies, M. J., & Moran, L. J. (2013). The effect of obesity on polycystic ovary syndrome: A systematic review and meta-analysis. Obesity Reviews, 14(2), 95–109. https://doi.org/10.1111/j.1467-789X.2012.01053.x

Lovibond, S. H., & Lovibond, P. F. (1995). Manual for the Depression Anxiety Stress Scales (2nd ed.). Sydney: Psychology Foundation.

March, W. A., Moore, V. M., Willson, K. J., Phillips, D. I., Norman, R. J., & Davies, M. J. (2010). The prevalence of polycystic ovary syndrome in a community sample. Human Reproduction, 25(2), 544–551. https://doi.org/10.1093/humrep/dep399

Moran, L. J., Hutchison, S. K., Norman, R. J., & Teede, H. J. (2011). Lifestyle changes in women with PCOS: A systematic review. BMC Women’s Health, 11, 17. https://doi.org/10.1186/1472-6874-11-17

Moran, L. J., Ranasinha, S., Zoungas, S., et al. (2015). Sociodemographic predictors of mental health in women with PCOS. Journal of Psychosomatic Obstetrics & Gynecology, 36(3), 135–144. https://doi.org/10.3109/0167482X.2015.1059414

Naslund, J. A., & Aschbrenner, K. A. (2016). Digital technology for mental health in chronic illness. Psychiatric Services, 67(9), 964–966. https://doi.org/10.1176/appi.ps.201600093

Pasch, L. A., Gregorich, S. E., Katz, P. K., et al. (2016). Infertility-related stress in women with PCOS. Fertility and Sterility, 105(2), 450–458. https://doi.org/10.1016/j.fertnstert.2015.10.019

Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. (2004). Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertility and Sterility, 81(1), 19–25. https://doi.org/10.1016/j.fertnstert.2003.10.004

Streuli, I., Palladini, D., Keller, P., & Dubey, R. K. (2013). Psychological stress and reproductive function: A review. Reproductive Biomedicine Online, 27(4), 327–338. https://doi.org/10.1016/j.rbmo.2013.06.007

Teede, H. J., Misso, M. L., Costello, M. F., et al. (2018). Recommendations from the international evidence-based guideline for the assessment and management of PCOS. Human Reproduction, 33(9), 1602–1618. https://doi.org/10.1093/humrep/dey256

Trent, M. E., Rich, M., Austin, S. B., & Gordon, C. M. (2002). Quality of life in adolescent girls with PCOS. Archives of Pediatrics & Adolescent Medicine, 156(6), 556–560. https://doi.org/10.1001/archpedi.156.6.556

Tzanetakou, I. P., Karageorgiou, V., & Duntas, L. H. (2012). The impact of physical activity on PCOS-related depression and metabolic profile. Hormones, 11(4), 384–393. https://doi.org/10.14310/horm.2002.1390

Wild, R. A., Rizzo, M., Clifton, S., & Carmina, E. (2011). Lipid levels in polycystic ovary syndrome: A systematic review and meta-analysis. Fertility and Sterility, 95(3), 1073–1081.e11. https://doi.org/10.1016/j.fertnstert.2010.11.006

World Health Organization. (2008). WHO STEPwise approach to surveillance (STEPS). Geneva: WHO.

Views:

17

Downloads:

3

Published
2025-09-30
Citations
How to Cite
Julia Konat, Jan Noskowicz, Jan Urban, Wiktor Doroszuk, Dawid Sewruk, Katarzyna Sikora, Mathias Spitaleri, Arleta Gieniec, Filip Kieloch, & Agnieszka Fitas. (2025). THE IMPACT OF POLYCYSTIC OVARY SYNDROME (PCOS) ON THE MENTAL HEALTH OF PATIENTS – A CROSS-SECTIONAL STUDY WITH EXTENDED CLINICAL AND PUBLIC HEALTH IMPLICATIONS. International Journal of Innovative Technologies in Social Science, 6(3(47). https://doi.org/10.31435/ijitss.3(47).2025.3934

Most read articles by the same author(s)