Evaluating the mental health impact of PCOS: Limitations of the PSS-10 scale as stress validation tool

The present study intended to outline the mental health status of women with PCOS. A total of 150 women of reproductive age (with follow-up data available for 113 participants) presenting with polycystic ovarian syndrome (PCOS) and infertility (Type I and II) were recruited from Gynecology OPD. Baseline data prior to intervention revealed that 67.3% of participants, particularly those aged 20–30 years (mean = 22.4; SD = 5.98; p < 0.001; OR = 1.39 × 10⁷⁴), exhibited moderate levels of stress based on the Perceived Stress Scale-10 (PSS-10). A significant proportion (60.2%) had a healthy body mass index (BMI) (n = 68; OR = ∞; p < 0.001). Severe hirsutism (score 4) was rare (0.9%) but associated with elevated stress risk (estimate = 6758.4; OR = ∞). Marital status emerged as an additive factor contributing to stress (estimate = 7355.2; OR = ∞), while women from middle-income families were more vulnerable to stress (estimate = 51.1; OR = 1.54 × 10²²; p < 0.001).Demographic analysis indicated that a rural background did not significantly increase the risk of stress (estimate = –3088.8; OR = 0; p < 0.001). Working women had significantly higher PSS scores compared to housewives (Estimate = 4646.7; OR = ∞; p < 0.001). Although yoga was associated with reduced stress levels, incorrect posture and breathing techniques limited its effectiveness (estimate = 9567.8; p < 0.001), yet it still proved more beneficial than other forms of exercise. Notably, BMI showed an inverse correlation with stress levels, although this conflicted with qualitative data from personal interviews. Interviews further revealed that PCOS-related symptoms (e.g., bust size), marital status, and socio-economic factors influenced stress perception—elements not adequately captured by the PSS-10. Follow-up assessments demonstrated reduced stress scores post-intervention.In conclusion, while PSS-10 was useful in identifying short-term stress levels, it failed to capture the broader psychological burden experienced by women with PCOS and infertility in this study. These findings underscore the need for a more comprehensive, rather than a condition-specific, stress assessment tool to better evaluate mental health in women with reproductive disorders such as PCOS or infertility.