Between 6 million and 17 million women in the United States between the ages of 18 to 44 are estimated to be affected by polycystic ovary syndrome (PCOS). The disorder is characterized by irregular menstrual cycles, ovarian cysts, excess body hair, weight gain, and sometimes infertility. A recent study of which symptoms are most likely to cause psychological distress to the patient revealed a surprise.

The disorder is fueled by excessive production of the hormone, testosterone, thus the growth of body hair usually considered unwanted by women. The research team, led by Nancy Reame, Professor of Disease Prevention and Health Promotion at the Columbia University School of Nursing in New York City, expected to find PCOS patients were distressed by the unwanted hair, infertility, and excessive weight gain but it's actually the menstrual irregularities that make most PCOS sufferers feel unfeminine.

The Reame study is considered small but it suggests "we can't treat PCOS effectively unless we pay close attention to any signs of mental distress." To gauge psychological distress, the research team had participants complete a standard survey used to evaluate a patient's mental health — the Brief Symptom Inventory (BSI) — in nine categories.

The participants comprised three groups:

  • 126 PCOS patients
  • A matched group of women in the general population
  • A matched group of women undergoing psychiatric care on an outpatient basis

The research revealed a higher level of distress in the PCOS group than in the general population group. Of the nine mental health disorders included in the BSI, the PCOS group almost matched the psychiatric-care group for more than half of them.

When compared to the general population, the PCOS group scored higher for anxiety, depression, interpersonal sensitivity, and somatization. Somatization is the manifestation of psychological distress as physical symptoms.

The PCOS women most distressed about menstrual irregularities and body hair were highly likely to experience anxiety. Excess weight was most likely to trigger feelings of hostility. Reame says, "We were surprised to find that menstrual abnormalities in women with PCOS were the strongest predictor for mental health issues" when so many other symptoms can make women feel unfeminine.

Polycystic ovary syndrome is one of the leading causes of infertility in the US. No single diagnostic test confirms it and there is no cure. The excess production of testosterone associated with the disorder leads to fluid-filled sacs (cysts) on the ovaries and ovulation irregularity.

Find out if your period is normal with our menstrual period calculator!

Source: "Psychiatric Complications in Women with Polycystic Ovary Syndrome Most Often Linked to Menstrual Irregularities (press release)." Columbia University School of Nursing. Columbia School of Nursing. Mar 24, 2014. Web. Apr 3, 2014.