By Author
  By Title
  By Keywords

April 2023, Volume 73, Issue 4

Student's Corner

Emergence of symptoms of Polycystic ovary syndrome among university students due to psychological distress

Areeba Shafiq  ( First Year MBBS Student, Dow University of Health Sciences, Karachi, Pakistan. )
Rayaan Imran  ( First Year MBBS Student, Dow University of Health Sciences, Karachi, Pakistan. )
Danisha Kumar  ( First Year MBBS Student, Dow University of Health Sciences, Karachi, Pakistan. )

Madam, Polycystic Ovary Syndrome (PCOS) is a highly prevalent endocrine disorder that affects women of reproductive age. It shows signs and symptoms resulting from dysfunction of ovaries and excess androgen production. It can cause missed or irregular menstrual periods, excess hair growth, acne, infertility, and weight gain leading to body image issues and emotional distress. Similarly, external emotional or psychological distress can elevate other symptoms of PCOS.1 This letter highlights how increased psychological distress in female undergraduate students of Pakistan can cause their PCOS symptoms to worsen.

About 40 per cent of women with PCOS experience depression, especially young girls, and the increased prevalence of PCOS is determined to be between 5 to 10 per cent of the general population worldwide. Women with PCOS frequently experience depression and anxiety, yet these conditions are constantly ignored and neglected. It is statistically proven that women with PCOS more frequently have moderate to severe depression primarily due to PCOS symptoms like an increase in androgen, monthly irregularities, infertility, obesity, hirsutism, or alopecia. It is crucial to draw attention to PCOS because of the rise in cases of the condition today is characterized by noticeable symptoms, particularly depression, throughout the adolescent stage.2 This shows that along with already existing body image issues that come hand in hand with PCOS, any additional psychological distress can elevate the prevalence of depression in women with PCOS.

Now, particularly female university students in Pakistan must endure excessive emotional distress as a result of low self-esteem, a competitive environment, imposter syndrome, parental issues, and societal pressure due to the conservative nature of the Pakistani community. A study conducted at GC Women University, Sialkot in total duration of five months from February 2019 to June 2019 shows that more than half of the students are seriously affected by mental health problems in Sialkot, which can give us a bigger picture of the female university students of Pakistan in general as well.3 Women with PCOS have also been found to produce more cortisol than usual which means that they may have more sensitive stress response systems. Cortisol chronically activates the adrenal gland leading to excess androgen production, which causes the PCOS symptoms to aggravate.4

Hence, female university students in Pakistan, specifically those with PCOS, should be given awareness about stress management and lifestyle changes to help them manage their PCOS symptoms effectively. There is no permanent cure for PCOS. However, lifestyle changes including losing weight, exercising, practicing meditation, and eating a balanced diet are proven to assist PCOS women to combat their symptoms. Behavioural modification can be done by educating the parents, and schools, and finally, social media, the internet, official websites, and television commercials can all play a significant part. Therefore, to combat this rising health issue, raising awareness of the risk factors, symptoms, and necessity of leading a healthy lifestyle is crucial.5


Disclaimer: None. Conflict of interest: None.


Funding disclosure: None.




Submission completion date: 30-08-2022


Acceptance date: 16-11-2022




1.      Ye W, Xie T, Song Y, Zhou L. The role of androgen and its related signals in PCOS. J. Cell. Mol. Med. 2021; 25: 1825-37. 

2.      Cooney LG, Lee I, Sammel MD, Dokras A. High prevalence of moderate and severe depressive and anxiety symptoms in polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod 2017; 32: 1075–91.

3.      Asif S, Mudassar A, Shahzad TZ, Raouf M, Pervaiz T. Frequency of depression, anxiety and stress among university students. Pak J Med Sci 2020; 36: 971–6.

4.      Benjamin JJ, Kuppusamy M, Koshy T, Kalburgi Narayana M, Ramaswamy P. Cortisol and polycystic ovarian syndrome - a systematic search and meta-analysis of case-control studies. Gynecol Endocrinol 2021; 37: 961–7.

5.      Kaundal A, Renjhen P, Kumari R. Awareness of Lifestyle Modifications in the Management of PCOS: A Population-Based Descriptive Cross-Sectional Study. [Online] 2022 [cited 2022 Jul 9]; Available from: URL:

Journal of the Pakistan Medical Association has agreed to receive and publish manuscripts in accordance with the principles of the following committees: