The interplay between cognitive impairment and mental health in women with PCOS: a systematic review
DOI:
https://doi.org/10.18203/2320-6012.ijrms20252416Keywords:
Cognitive dysfunction, Psychological distress, Hormonal imbalance, Neuropsychological assessment, Polycystic ovary syndromeAbstract
Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders affecting women of reproductive age. While its physical symptoms such as irregular menstruation, acne and infertility receive considerable attention, the cognitive and psychological burdens associated with PCOS often go unnoticed. This study conducted a systematic narrative review to synthesize the existing literature on the cognitive and mental health implications of PCOS. A comprehensive search across PubMed, Scopus and Web of Science was performed for studies published between 2015 and 2025. Using PRISMA guidelines, we identified 52 initial records, from which 12 high-quality studies were included. Both subjective tools (like psychological inventories) and objective assessments (e.g., MoCA, EEG, ERP) were analyzed to understand the interplay between PCOS and cognitive or emotional well-being. Findings revealed consistent patterns of cognitive impairments in attention, memory and executive functioning among women with PCOS. Neurophysiological data, such as reduced P300 amplitudes and abnormal EEG rhythms, supported these clinical symptoms. Simultaneously, a high prevalence of anxiety (up to 42%) and depression (around 37%) was reported, often aggravated by body image issues, infertility and sociocultural stigma. Notably, cognitive decline and psychological distress appeared interlinked, forming a feedback loop that intensifies suffering over time. A person's emotional and mental well-being are intricately related to polycystic ovary syndrome (PCOS). A multidisciplinary strategy is urgently needed to treat polycystic ovary syndrome (PCOS), which includes cognitive screening and psychological assistance as part of standard treatment.
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References
Majidzadeh S, Mirghafourvand M, Farvareshi M, Yavarikia P. The effect of cognitive behavioral therapy on depression and anxiety of women with polycystic ovary syndrome: a randomized controlled trial. BMC Psyc. 2023;23(1):332.
Ananthasubramanian P, Nair RS, Priyanka H, Barathi S, Vasantharekha R. Concomitant impact of polycystic ovarian syndrome and associated comorbidities on cognitive functions, neurotransmitters and metabolic enzymes in Indian women. 2022.
Redkar M, Khan A. The impact of polycystic ovary syndrome on attention: an empirical investigation. Biopsychosoc Med. 2025;19(1):53.
Showkath N, Sinha M, Ghate JR, Agrawal S, Mandal S, Sinha R. EEG-ERP Correlates of Cognitive Dysfunction in Polycystic Ovarian Syndrome. Ann Neurosci. 2022;29(4):225–32.
Bansal A, Sethi J, Parasher RK, Tomar M. Relationship between Clinico-Socio-Demographic Factors and Psychology of Women Diagnosed with Polycystic Ovary Syndrome. Univers. J Public Heal. 2023;11(2):205–13.
Río JPD, Dabed F, Díaz JP, Guevara ALD, Crisosto NP. Polycystic ovary syndrome and mental health: influence of hyperandrogenism during brain plasticity periods on emotional distress and social cognition. Obstet Gynecol. 2024;143:68-9.
Kansal L. Comparative analysis of subjective well-being and self-esteem among women having pcos pcos-related symptoms. Int J Interdiscip Approaches Psychol. 2024;2(5):2584.
Rajesh N, Davis F, Cognitive Distortion, Interpersonal Dependency and Suicidal Ideation Among Women with and without PCOS. Int J Indian Psychȯl. 2023;11(2)2:2378.
Braschi V, De Giuseppe R, Bosoni D, Nappi RE, Cena H. Dietary underreporting by women with Polycystic Ovary Syndrome (PCOS). Eur J Obstet Gynecol Reprod Biol. 2016;206:138–9.
Naz MGS. Possible cognition changes in women with polycystic ovary syndrome: a narrative review. Obstet Gynecol Sci. 2023;66(5):347–63.
Sundararaj RTH, Ramesh PL, Jain C. Hearing and auditory working memory in women with polycystic ovarian syndrome. J Phonetics Audiol. 2017;03(2):56..
Haddaway NR, Page MJ, Pritchard CC, L. A. McGuinness LA. PRISMA 2020 : An R package and Shiny app for producing PRISMA 2020‐compliant flow diagrams, with interactivity for optimised digital transparency and Open Synthesis. Campbell Syst. 2022;18(2):1230.