The lived experiences of women with polycystic ovary syndrome and its psychological challenges: A systematic review and meta-synthesis

Polycystic ovary syndrome (PCOS) presents psychological challenges in women due to persistent symptoms such as hirsutism, irregular menstruation, and weight gain, and long-term complications like infertility. Women with PCOS face higher risks of depression, anxiety, body image dissatisfaction, and social challenges. Research often overlooks the psychological burden of PCOS, despite its documented effects. This systematic review aims to explore the lived psychological experiences of women with PCOS, encompassing mental health challenges, emotional well-being, and psychosocial factors. It also aims to identify sociocultural variations in psychosocial challenges. A systematic search was conducted across six bibliographic databases (MEDLINE, Web of Science, Cochrane, CINAHL, PubMed, and SCOPUS) from inception to April 2024. Qualitative and mixed-methods studies in English exploring the psychological experiences of women with PCOS were included. Study quality was assessed using the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI), and findings were synthesized using a JBI-guided pragmatic meta-aggregation approach. A total of 43 studies were included, yielding 240 unequivocal findings and 46 credible findings which were meta-aggregated into two themes: (1) Mental Health Challenges associated with PCOS (2) Psychosocial Challenges associated with PCOS. Depression, anxiety, body image dissatisfaction, and social stigma significantly impact women with PCOS. Hirsutism and being overweight are prominent stressors, particularly affecting psychological well-being in this group. Sociocultural factors play a role in shaping psychological experiences. Effective PCOS care requires mental health support, fertility counselling, and culturally sensitive interventions to improve health outcomes. PCOS symptoms (e.g., hirsutism, weight gain, irregular menses, infertility) are key biological stressors that trigger psychological distress. The meaning and intensity of this distress (e.g., depression, anxiety, low self-worth) are shaped by sociocultural expectations of femininity, appearance, and motherhood. Infertility and visible symptoms intensify stigma, social comparison, and relationship strain, reinforcing feelings of inadequacy and isolation. Psychological challenges evolve across the life course, intersecting with changing cultural and social pressures. The Biopsychosocial Model illustrates how PCOS is not only a medical condition but also a psychosocial and existential burden, underscoring the need for culturally sensitive, holistic interventions.