# Facial emotion recognition accuracy in women with symptoms of polycystic ovary syndrome: Reduced fear and disgust perception

## TL;DR

Women with polycystic ovary syndrome (PCOS) symptoms are less accurate at recognizing fear and disgust in facial expressions, possibly due to higher androgen levels.

## Contribution

This study is the first to show that PCOS symptoms are linked to reduced accuracy in recognizing specific emotions like fear and disgust.

## Key findings

- Women with PCOS symptoms had lower overall emotion recognition accuracy compared to women without PCOS.
- Women with PCOS symptoms made more errors in identifying fear and disgust compared to women without PCOS.
- Men were the least accurate at emotion recognition, followed by women with PCOS symptoms.

## Abstract

Research suggests that women with polycystic ovary syndrome (PCOS) are more likely to suffer from mental health disorders, emotional distress, and have altered hormone profiles (e.g., higher androgens). Past research suggests facial emotion processing is affected by hormones (e.g., androgens), mental health-related disorders, and may be altered in PCOS.

The present study examined whether facial emotion recognition (FER) differs between women with and without PCOS symptoms.

Observational case-control design.

Three groups of participants (women with provisional PCOS, women without PCOS, and men; N = 178) completed a FER task that involved identifying emotions (anger, disgust, fear, happiness, sadness, surprise, or neutral) in images of emotional faces. Overall emotion recognition and emotion-specific accuracy were examined. PCOS symptom severity and provisional diagnoses were also assessed in women via self-report measures, including the polycystic ovary syndrome questionnaire.

Women with provisional PCOS had significantly lower emotion recognition accuracy than those without PCOS, and emotion-specific differences were found for fear and disgust. A significant linear effect also emerged for overall FER, revealing men as the least accurate, followed by women with provisional PCOS, and then women without PCOS.

The results suggest that women with PCOS may have difficulty with emotion recognition, especially fear and disgust. The sex difference in emotion recognition was in line with previous research. These findings are consistent with the theory that androgens affect emotion recognition and suggest implications for PCOS symptoms on women’s emotional well-being and socioemotional functioning.

Women with symptoms of polycystic ovary syndrome (PCOS) were less accurate at identifying facial emotions

Accurately recognizing facial emotional expressions affects our ability to develop relationships, to avoid dangerous situations, and contributes to social and occupational success. Women have a subtle advantage over men in their ability to accurately recognize facial emotions. However, little research has looked at differences within women. There are a few theories about what might affect the ability to accurately recognize facial emotions. One theory is that higher levels of androgen-related hormones, such as testosterone, reduce the ability to recognize emotional expressions. This explanation makes sense as men have higher androgens and are less accurate at recognizing facial emotions than women. Our study examined emotion recognition in women reporting symptoms of polycystic ovary syndrome (PCOS). This syndrome affects 4 to 20% of women of reproductive age and has higher rates of emotional difficulties. As women with PCOS tend to have higher androgen levels and androgenic symptoms (e.g., facial hair), we wondered whether women with PCOS symptoms would be less accurate at recognizing emotions than women without PCOS. We examined women with symptoms of PCOS as opposed to only women with PCOS because PCOS is underdiagnosed. Participants were shown a series of faces with different emotions, and were asked to report which emotion was present on each face. The results supported our hypothesis. On the task overall, women with PCOS symptoms were less accurate at recognizing emotions than women without PCOS. When identifying specific emotions, we found that women with high PCOS symptoms made more errors than women without PCOS in recognizing fear and disgust. These results may help us understand more about the role hormones such as androgens may play in emotion recognition, and in conditions like PCOS. The findings also suggest that difficulties with facial emotion recognition may contribute to social and emotional challenges in PCOS.