Polycystic ovary syndrome: Unveiling the multifaceted contributors, mechanisms, and psychological impacts

Polycystic ovary syndrome (PCOS), also known as Stein-Leventhal syndrome, is a prevalent endocrine disorder affecting 6-13 % of women of reproductive age, with a significant proportion remaining undiagnosed. Characterized by hyperandrogenism, menstrual irregularities, and ovarian dysfunction, PCOS has extensive dermatological and metabolic implications, often contributing to adverse mental health outcomes. While depression and anxiety are commonly reported, distinguishing their etiology from obesity's frequent comorbidity with PCOS remains challenging. Emerging evidence suggests that hyperandrogenism may also influence the prevalence of schizophrenia, eating disorders, and neurodevelopmental conditions such as attention-deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Prenatal androgen exposure has been implicated in neurodevelopmental alterations, with recent studies linking maternal PCOS to an increased risk of ASD in offspring. Structural brain differences, including white matter alterations, have also been observed in affected individuals. This review explores the intricate interplay between PCOS, metabolic dysfunction, and neuropsychiatric outcomes, emphasizing the need for further investigation into its neurodevelopmental and psychiatric implications. Additionally, we will explore the relationships between hormonal interplay and ASD, further elucidating the role of endocrine dysregulation in neurodevelopment.