For many women, Polycystic Ovary Syndrome (PCOS) is assumed to be a hormonal problem: irregular periods, acne, or fertility issues. But experts now warn that its impact often runs much deeper, as in on metabolism, mental health, and long-term wellbeing. " COS is a multifaceted disorder that extends beyond hormonal imbalances. It also encompasses metabolic, reproductive, and psychological dimensions," explains Dr. Isha Wadhawan, Attending Consultant, Obstetrics & Gynaecology, Fortis Faridabad. She points out that insulin resistance, a common feature of PCOS, increases the risk of diabetes and cardiovascular disease. Meanwhile, visible symptoms such as acne, excessive hair growth, and obesity often take a toll on self-esteem and emotional well-being.
Recent national studies underscore how serious and widespread PCOS is in India, not just among women seeking infertility treatment, but across urban and rural populations. According to a large cross-sectional study of nearly 10,000 women aged 18-40 across India, PCOS prevalence was 7.2% using NIH criteria, 19.6% using Rotterdam criteria, and 13.6% under the AE-PCOS criteria.
How Common Is PCOS In India?
In the same study mentioned above, among women diagnosed with PCOS, 43.2% were obese, 91.9% had dyslipidemia, 32.9% had non-alcoholic fatty liver disease, 24.9% metabolic syndrome, 3.4% diabetes, 8.3% hypertension. Meta-analysis covering multiple Indian studies (2010-2021) using Rotterdam or AES criteria puts pooled prevalence at about 11.3% (95% CI: 7.7-15.6%). Using NIH criteria, it's lower at around 5.8%.
These numbers suggest that depending on how PCOS is diagnosed (which criteria are used), nearly 1 in 5 women may meet criteria under some definitions. But even with lower estimates, the numbers are large enough to make it a public health concern.
Physical Symptoms And Metabolic Risks Of PCOS
"Irregular menstrual cycles, weight gain, acne, excessive hair growth, and hair loss are the most common concerns," says Dr. Wadhawan. The data backs this up: in the India-wide study, many women with PCOS also had obesity or overweight (around 43%), were lipid abnormal, or showed features of metabolic syndrome (around 25%) or NAFLD (around 33%) even if diabetes per se was less common.
Another clinic-based study found that among 226 women with confirmed PCOS, about 67% had insulin resistance, 72% were overweight or obese (by Asian cutoffs), 35% had metabolic syndrome, and a sizeable fraction had non-alcoholic fatty liver disease (NAFLD). These numbers matter because metabolic risk factors (high cholesterol / fats in blood, fatty liver, obesity) increase the risk not only of type-2 diabetes but cardiovascular disease, liver problems, etc.
Mental Health And Quality Of Life With PCOS
Beyond the physical, PCOS deeply affects mind and emotional health. "Anxiety, stress, depression, and low self-esteem are quite prevalent among women with PCOS," notes Dr. Wadhawan. Concerns about fertility, body image, and long-term health risks can weigh heavily on patients.
Indian studies confirm this: Psychological distress, including anxiety and depression, is common. Clinic studies report over 50% of women with PCOS showing elevated psychological distress. The combination of cosmetic issues (acne, hirsutism) plus metabolic and weight issues often erodes self-confidence.
Why Ignoring Mental Health Can Backfire
When psychological health is neglected, effects compound. Physical symptoms may worsen under stress, lifestyle choices suffer (poor diet, low activity), and adherence to treatments declines. Dr. Wadhawan emphasizes this cycle: Mental wellbeing is not "extra," but central to managing PCOS effectively.
Multidisciplinary And Lifestyle-Based Care For PCOS
"What works best for PCOS management? According to Dr. Wadhawan, the key is collaboration. "I adopt a multidisciplinary approach that includes working closely with psychologists and psychiatrists to address emotional and psychological challenges." Alongside medical treatment, patient education plays a vital role. Women must be informed about how PCOS affects their bodies and what they can do to manage it. "Lifestyle changes, like healthy eating, exercise, and stress management, are central to treatment," she adds.
Clinic-based experience in India supports this: women who attended integrated PCOS clinics, with support from nutritionists, dermatologists, psychologists, and endocrinologists, reported improved awareness, better lifestyle adherence (diet, exercise), and overall improvements in symptoms and wellbeing.
PCOS is not just a disorder of hormones. It is a full-body, full-mind condition. In India, data shows it's both common and deeply interconnected with metabolic disease and psychological stress. As Dr. Wadhawan warns, addressing only the visible or hormonal symptoms leaves many women vulnerable to long-term consequences.
For better outcomes, India needs to scale holistic care: routine screening (physical, metabolic and psychological), awareness that mental health matters, and clinics that integrate multiple specialists. Lifestyle interventions (diet, exercise, stress reduction) are not optional, they are central. With those in place, women with PCOS can manage symptoms better, prevent complications, and live healthier, more confident lives.
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