Abstract
BACKGROUND: Polycystic ovarian syndrome (PCOS) is a complex endocrine disorder affecting both physical and psychological health in women of reproductive age. While its metabolic and reproductive symptoms are well-documented, fatigue remains an underrecognised yet significant concern. Psychological distress, including anxiety, depression and stress, may contribute to fatigue in women with PCOS, either directly or by influencing sleep disturbances. While insomnia is commonly reported in this population, this study primarily focuses on fatigue and its association with psychological distress, with sleep disturbances considered as a secondary factor requiring further exploration. AIM: This study aims to investigate the association between psychological distress (anxiety, depression and stress) and fatigue in women with PCOS. In addition, it explores whether sleep disturbances show any association with fatigue, providing insights into factors that may contribute to fatigue severity in this population. SETTINGS AND DESIGN: This is a cross-sectional pilot study conducted in a university outpatient department. MATERIALS AND METHODS: A total of 52 women, diagnosed with PCOS were included in this cross-sectional study. Data collection involves scoring of fatigue by administering the fatigue severity scale (FSS) and insomnia severity index (ISI) for insomnia and components of psychological distress (stress, depression and anxiety) using the Depression Anxiety Stress Scale-21. STATISTICAL ANALYSIS USED: Data were analysed using IBM SPSS version 25. Pearson correlation coefficients were used to explore bivariate relationships between fatigue and independent variables. Statistical significance was set at P < 0.05. RESULTS: The findings revealed significant associations between FSS and psychological distress, particularly anxiety (r = 0.507, P = 0.038) and depression (r = 0.595, P = 0.012). In addition, insomnia (ISI) showed the strongest correlation with fatigue (r = 0.705, P = 0.002), indicating that sleep disturbances may further exacerbate fatigue in women with PCOS. CONCLUSION: This study highlights a strong association between psychological distress, insomnia and fatigue in women with PCOS. The findings suggest that higher levels of anxiety, depression and sleep disturbances contribute significantly to fatigue severity, emphasising the need for integrated psychological and sleep management strategies in PCOS care. Further research with larger cohorts and longitudinal designs is necessary to establish causal relationships and develop targeted interventions for improving overall well-being in this population.