Polycystic Ovary Syndrome (PCOS) in adolescent female is a prevalent multifaceted endocrine disorder, characterized by hyperandrogenism, chronic anovulation, and polycystic ovaries ^[1]. It manifests through a range of symptoms such as menstrual irregularities, hirsutism, acne, obesity, and psychological disturbances including anxiety and depression.

The incidence of PCOS among adolescents is difficult to determine precisely, due to varying diagnostic criteria and the overlap of PCOS symptoms with normal pubertal development. The prevalence of PCOS among adolescents varies globally, influenced by genetic, environmental, and lifestyle factors. Studies have reported prevalence rates ranging from 3% to 26% among adolescent girls, depending on the population studied and the diagnostic criteria used^[4,5]. In India, the prevalence of PCOS among adolescent girls is estimated to be around 9-36%, which is higher compared to some Western countries.

Studying PCOS during adolescence is important because the condition often manifests around puberty and makes diagnosis challenging. Early identification and management are crucial as PCOS in adolescents can lead to long-term health issues, including metabolic syndrome, type 2 diabetes, cardiovascular disease, and infertility. Moreover, for adolescents with PCOS, quality of life is often compromised due to the chronic and visible nature of the symptoms. The impact of PCOS on QoL encompasses physical discomfort, emotional distress, and social challenges. Symptoms of PCOS, particularly those affecting appearance, such as hirsutism and acne, significantly affect body image and self-esteem. This can lead to social withdrawal, academic challenges, and a decreased overall sense of well-being.

Objectives: To correlate symptoms of polycystic ovary syndrome with quality of life in  adolescent girls.

This is a cross-sectional study of 100 participants, conducted at Department of Obstetrics and Gynaecology at Netaji Subhash Chandra Bose medical college and hospital Jabalpur, Madhya Pradesh done in a time period of 18 months. Inclusion criteria 1. Adolescent girls of age group 10-19 yrs with • irregular menstrual cycle (oligomenorrhea/ amenorrhea) • clinical features of physiological hyperandrogenism • Polycystic ovary on ultrasound 2. Patient willing to give informed consent. Exclusion criteria 1. Socio psychiatric illness. 2. Chronic medical illness. 3. Substance dependence 4. Physiologically irregular cycles or irregular cycles due to other reasons The study on adolescent girls with PCOS was done by using a proforma for collecting socio demographic and clinical details by using Ferriman–Gallwey score for hirsutism, acne by global acne grading system, BMI by WHO guidelines , depression and anxiety by Hamilton scale respectively. The quality of life was assessed by questionnaire regarding symptoms of PCOS affecting t attendance, academic performance and participation in co curricular activities. Statistical analysis was recorded in the predesigned proforma and entered in the MS excel and analyzed eventually by using statistical software SPSS Version 21. DATA COLLECTION METHOD, Approval of the institutional ethical committee was obtained for the study, Purpose of conducting the study was explained to the subjects, Identity of the patients is kept confidential, written Informed consent was taken from all the subjects and data collection was done from all patients fulfilling the above mentioned criteria.

Table no. 1 Distribution of adolescent girls with PCOS according to depressed and anxious mood.

• The table shows distribution of depressed and anxious mood in study groups. It suggested that out of total 100 Adolescent PCOS girls taken, 56% percent girls had depressed mood. 35% girls show mild , 20% show moderate and 1% show severe depressed mood, Whereas 44% girls did not complained of depressed mood. On overall assessment, we found that  depressed mood contributes significantly in affecting life of adolescent PCOS girls, whereas for anxious mood it suggests out of 100 adolescent girls 57% faces anxious mood. In which 35% have mild and 22% have moderate anxious mood. Whereas 43% have no anxious mood issues. It shows anxiety is a common issue among adolescent PCOS population, requiring attention for its management.

Table no. 2 Distribution of adolescent girls with PCOS according to effect on school attendance

• The above table show effect on school attendance in study group. It shows that out of 100 adolescent girls with PCOS 62% girls Have reported that their school attendance is affecting whereas 38 % girl’s attendance remain unaffected. girls facing challenges with attending school due to PCOS-related issues. It shows Adolescent PCOS faces challenges in attending school, Poor attendance can potentially lead to academic setbacks, social isolation and increased stress.

Table no. 3 Distribution of adolescent girls with PCOS according to effect on academic performance

• The above table show effect on academic performance in study group. It shows that out of 100 Adolescent PCOS 42% girls suffering from PCOS also suffering in their academic whereas 58% girl’s academic remains unaffected. This suggest that PCOS has affected ability to perform academically.

Table no. 4 Distribution of adolescent girls with PCOS according to effect of participation in co curricular                   activities

• The above show effect on participation in co curricular activities in the study group. It shows that out of 100 adolescent PCOS girls, 55% girls don’t participate in co curricular activities whereas 45 % remain unaffected. This suggests that due to PCOS the ability or willingness to engage in extracurricular activities has affected. This could be related to physical symptoms (such as fatigue or pain) or emotional challenges (such as anxiety or mood disturbances which are acting as hurdles.

• In our study, the distribution of depressed mood among adolescent girls with PCOS was found that 44% had no depressive symptoms ,35% Adolescent had mild, 20% had moderate and only 1% had severe depressed mood symptom. This indicates that 56% of the girls with PCOS experienced some level of depressed mood, with the majority reporting mild to moderate symptoms. Dokras et al. in 2011 [2] conducted a study on 206 women with PCOS and found that 67% of the participants reported symptoms of depression. Our study found a slightly lower prevalence of 56% in the adolescent population, which could be attributed to age differences or varying diagnostic criteria for depression. Rasgon et al. in 2003[3] examined 115 women with PCOS and discovered that 34% had mild depressive symptoms, 22% had moderate depressive symptoms, and 10% had severe depressive symptoms. Our study showed a similar distribution with 35% mild, 20% moderate, and 1% severe depressive symptoms, indicating that while severe depression is less common in adolescents, mild to moderate depression is prevalent. • In our study, we enquired about anxious mood among adolescent girls with PCOS and found that 43% adolescent had no anxious mood, 35% has Mild and 22% has shown moderate anxious mood. This indicates that 57% of the girls with PCOS experienced some level of anxiety, with the majority reporting mild to moderate symptoms. Dokras et al. in 2011[2] conducted a study on 206 women with PCOS and found that 58% of the participants reported symptoms of anxiety. Our study found a similar prevalence of 57% in the adolescent population, suggesting that anxiety is a common symptom in both adolescent and adult populations with PCOS. Hart and Doherty in 2015[4] examined 150 women with PCOS and reported that 40% had mild anxiety and 18% had moderate anxiety. Our study showed comparable results with 35% having mild anxiety and 22% having moderate anxiety, indicating that anxiety severity in adolescents with PCOS is consistent with findings in adult populations. • In our study, we enquired about the effect of PCOS on school attendance among adolescent girls, and found that school attendance of 62% girls was affected while 38% show no effect on school attendance due to PCOS. This indicates that a majority of adolescent girls with PCOS reported that their condition has a noticeable impact on their school attendance. Trent et al. in 2002 examined quality of life in adolescents with various chronic health conditions and noted that managing these conditions can lead to missed school days and challenges in academic achievement. They reported a similar impact, with 60% of adolescents affected by chronic conditions experiencing disruptions in school attendance. Laggari et al in 2009 explored psychosocial aspects in adolescents with PCOS and emphasized the role of anxiety and body image concerns in school absenteeism. They found that 65% of adolescents with PCOS reported difficulties attending school due to these factors, indicating a slightly higher impact compared to our study's finding of 62%. • In our study, we examined the impact of PCOS on academic performance among adolescent girls. We found that no effect seen on academic performance in 58%, while 42% had impact on academic performance. Trent et al. in 2002 examined quality of life in adolescents with various chronic health conditions and noted that managing these conditions can lead to decreased academic achievement. They reported similar findings, with approximately 55% of adolescents affected by chronic conditions experiencing disruptions in academic performance. Laggari et al. in 2009 explored psychosocial aspects in adolescents with PCOS and emphasized the role of anxiety, depression, and body image concerns in academic performance. They found that 65% of adolescents with PCOS reported difficulties in academic performance due to these factors, which aligns closely with our study's finding of 60%. • In our study, we investigated the impact of PCOS on participation in co-curricular activities among adolescent girls. It shows that no effect on co curricular activities seen in 45% whereas 55% Adolescent girl’s activities were affected. Trent et al. in 2002[5] examined quality of life in adolescents with various chronic health conditions and noted that managing these conditions can lead to reduced social engagement, including participation in extracurricular activities. They reported similar findings, with approximately 50% of adolescents affected by chronic conditions experiencing limitations in participating in extracurricular activities. Laggari et al. in 2009[6] explored psychosocial aspects in adolescents with PCOS and highlighted the role of anxiety, depression, and body image concerns in limiting social participation, including extracurricular activities. They found that 60% of adolescents with PCOS reported barriers to participating in extracurricular activities due to these factors, which aligns closely with our study's finding of 55% Limitations of the study: It was single hospital based study and was for short duration (18 months).

The psychosocial impact of PCOS in adolescents done in our study, emphasize the significant impairment in quality of life caused by the disorder. Understanding these aspects are crucial for developing effective diagnosis and  management to improve the well-being of adolescents with PCOS. A holistic care strategies to support educational outcomes to address both the physical and psychological aspects of the syndrome. Our study findings emphasize the importance of creating inclusive environment and providing tailored support to enable adolescents with PCOS to participate fully enhance their overall well-being.

1. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. (2004). Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertility and Sterility, 81(1), 19-25.
2. Dokras, A., Clifton, S., Futterweit, W., & Wild, R. (2011). Increased prevalence of anxiety symptoms in women with polycystic ovary syndrome: Systematic review and meta-analysis. Fertility and Sterility, 97(1), 225-230.
3. Rasgon, N. L., Rao, R. C., Hwang, S., Altshuler, L. L., Elman, S., Zuckerbrow-Miller, J., & Korenman, S. G. (2003). Depression in women with polycystic ovary syndrome: Clinical and biochemical correlates. Journal of Affective Disorders, 74(3), 299-304
4. Hart, R., & Doherty, D. A. (2015). The potential implications of a PCOS diagnosis on a woman's long-term health using data linkage. Journal of Clinical Endocrinology & Metabolism, 100(3), 911-919.
5. Trent, M., Rich, M., Austin, S. B., & Gordon, C. M. (2002). Quality of life in adolescent girls with polycystic ovary syndrome. Archives of Pediatrics & Adolescent Medicine, 156(6), 556-560.
6. Laggari, V., Diareme, S., Christogiorgos, S., Deligeoroglou, E., Christopoulos, P., Tsiantis, J., & Chrousos, G. (2009). Anxiety and depression in adolescents with polycystic ovary syndrome and Mayer-Rokitansky-Küster-Hauser syndrome. Journal of Psychosomatic Obstetrics & Gynecology, 30(2), 83-88.