Abstract
BACKGROUND: Lifestyle interventions have been proposed to be the first-line treatment for polycystic ovarian syndrome (PCOS), but our knowledge of PCOS-related lifestyle factors is still limited. This study aimed to explore PCOS-related lifestyle factors in reproductive-age women in China. METHODS: A case-control study was carried out in Shandong, China, from June to October 2014. 350 PCOS-related infertile women were recruited as cases, while 308 women who were seeking the treatment of fallopian tube obstruction or assisted reproduction due to male infertility were recruited as controls. Several specific lifestyle and behavioral factors associated with EDC exposure were examined. Multivariate logistic regression analysis was used to estimate the odds ratios (ORs) and 95% confidence intervals (CI). RESULTS: There were no differences in socio-demographic characteristics, smoking, and alcohol consumption between the cases and controls. PCOS women had significantly more obesity than the controls (P < 0.01). After controlling for potential confounders, using foam or plastic cups at home (daily vs. never: adjusted odds ratio [aOR] 2.6, 95% confidence interval [CI] 1.4–4.5), using foam or plastic tableware at home (occasionally vs. never: aOR 1.7, 95% CI 1.2–2.5), eating melons and fruits without pericarp (for occasionally vs. always/often: aOR 1.6, 95% CI 1.0–2.5), drinking tap water vs. spring water/bottled water (aOR 1.5, 95% CI 1.1–2.2), cooking (daily vs. ≤ 1 time/week: aOR 1.8, 95% CI 1.2–2.8), contacting liquid detergent (1.5 to 3 h/week vs. < 1.5 h/week, aOR 2.5, 95% CI 1.3–4.9), and contacting soap or shampoo (3–6 vs. < 3 h/week, aOR 2.1, 95% CI 1.2–3.8) were significantly associated with PCOS. The association between mild cooking oil fumes and PCOS risk was attenuated after adjustment, but it remained borderline significant (aOR 1.4, 95% CI 0.97–1.9). CONCLUSIONS: Our study suggests that PCOS may be associated with certain lifestyle factors. Future prospective studies are needed to confirm our findings. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13048-026-02034-9.