# Polycystic ovary syndrome and psychological distress: Urban–rural comparison among reproductive-aged women in Bangladesh

## TL;DR

This study finds that PCOS is common among Bangladeshi women and is linked to high rates of psychological distress, with rural women facing greater mental health challenges.

## Contribution

The study provides a rural-urban comparison of mental health disparities among PCOS-affected women in Bangladesh.

## Key findings

- PCOS prevalence was 50.9%, with high rates of depression, anxiety, stress, and insomnia.
- Rural women showed higher anxiety and insomnia compared to urban women.
- Meeting more Rotterdam criteria increased the likelihood of psychological distress.

## Abstract

Polycystic ovary syndrome (PCOS) is a common hormonal disorder of reproductive-aged women all over the world. Low- and middle-income countries, such as Bangladesh, often give inadequate attention to mental health issues. As a result, a growing number of women with PCOS are dealing with mental health issues, including an under diagnosis and under-treatment of psychological illnesses. The study assesses the prevalence and psychological impacts of PCOS among women in the reproductive age as well as compared the mental health inequalities between rural and urban women in Bangladesh. A sample of 212 women in the reproductive age was collected using a convenience sampling procedure. Additionally, for diagnosis of PCOS, the Rotterdam criteria were used. Depression, anxiety, stress, and insomnia were measured using DASS-21 and ISI-7 tool. To analyze the association and impact of PCOS on mental health problems, a chi-square test and multivariate binary logistic regression were conducted. The Mann-Whitney U test was implemented to assess mental health disparities among rural-urban reproductive women. Among the participants, the PCOS prevalence was 50.9%, and the rates of depression, anxiety, stress, and insomnia were 51.4%, 62.3%, 46.7%, and 53.3%, respectively. Based on the Rotterdam criteria, women with PCOS had a significantly greater prevalence of psychological disorders than women without PCOS. Women residing in rural region were more prone to meet Rotterdam criteria and had higher anxiety and insomnia syndrome. Women who met two or three diagnostic criteria had a higher chance of experiencing psychological distress than others. Furthermore, relationship status and BMI are useful predictive factors of mental health consequences. The findings showed a substantial prevalence of emotional distress among PCOS women in Bangladesh. Additionally, a comprehensive mental health investigation is suggested for PCOS. Addressing both the physical and psychological aspects of PCOS is essential to develop women’s overall well-being and quality of life.