Emotional and psychosexual well‐being is influenced by ethnicity and birthplace in women and individuals with polycystic ovary syndrome in the UK and India
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Objective: To assess the association of ethnicity and birthplace on emotional and psychosexual well‐being in women with polycystic ovary syndrome (PCOS). Design: Cross‐sectional study. Setting: Community recruitment via social media campaigns. Population: Women with PCOS completing an online questionnaire in September–October 2020 (UK) and May–June 2021 (India). Methods: The survey has five components, with a baseline information and sociodemographic section followed by four validated questionnaires: Hospital Anxiety and Depression Scale (HADS); Body Image Concern Inventory (BICI); Beliefs About Obese Persons Scale (BAOP); and Female Sexual Function Index (FSFI). Main outcome measures: We used adjusted linear and logistic regression models, adjusting for age, education, marital status and parity, to evaluate the impact of ethnicity and birthplace on questionnaire scores and outcomes (anxiety and/or depression, HADS ≥ 11; body dysmorphic disorder (BDD), BICI ≥ 72). Results: A total of 1008 women with PCOS were included. Women of non‐white ethnicity (613/1008) reported higher rates of depression (OR 1.96, 95% CI 1.41–2.73) and lower BDD (OR 0.57, 95% CI 0.41–0.79) than white women (395/1008). Women born in India (453/1008) had higher anxiety (OR 1.57, 95% CI 1.00–2.46) and depression (OR 2.20, 95% CI 1.52–3.18) but lower BDD rates (OR 0.42, 95% CI 0.29–0.61) than women born in the UK (437/1008). All sexual domains, excluding desire, scored lower for non‐white women and women born in India. Conclusions: Non‐white women and women born in India reported higher emotional and sexual dysfunction, whereas white women and women born in the UK reported higher body image concerns and weight stigma. Ethnicity and birthplace need to be considered for tailored, multidisciplinary care.
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Weight stigma and its detrimental psychological effects, as well as weight regain, compromise the efficacy of dietary strategies for weight reduction in women with PCOS.
“While dietary strategies are effective for weight reduction in women who are overweight or obese, the widespread problem of weight stigma and its detrimental psychological effects, as well as weight regain, compromises their efficacy [2,5,6].”
From Role of Omega-3 Fatty Acids in Improving Metabolic Dysfunctions in Polycystic Ovary Syndrome (2024) · cites this paper as [5]
The Conclusion reports weight stigma, poor body image, anxiety and depression among women with PCOS. But this cross-sectional study does not show that weight stigma causes psychological harm or that stigma or weight regain compromises the effectiveness of dietary weight-loss strategies; the cited passages do not assess those strategies or weight regain. (LLM, conf=0.84)
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Cites
The Hospital Anxiety and Depression Scale
Zigmond, A. S., & Snaith, R. P. (1983) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1983.tb09716.x · Cited by 47,139 · see citing works
Depression and quality of life in older persons: A review
Sivertsen, H., Bjørkløf, G. H., Engedal, K., Selbæk, G., & Helvik, A.-S. (2015) · Dementia and Geriatric Cognitive Disorders · doi:10.1159/000437299 · Cited by 14,152 · see citing works
Rosen, C. B. (2000) · Journal of Sex & Marital Therapy · doi:10.1080/009262300278597 · Cited by 6,593 · see citing works
The Diagnosis of Polycystic Ovary Syndrome during Adolescence
Witchel, S. F., Oberfield, S., Rosenfield, R. L., Codner, E., Bonny, A., Ibáñez, L., Pena, A., Horikawa, R., Gomez-Lobo, V., Joel, D., et al. (2015) · Hormone Research in Paediatrics · doi:10.1159/000375530 · Cited by 3,113 · see citing works
Ehrmann, D. A. (2005) · New England Journal of Medicine · doi:10.1056/nejmra041536 · Cited by 1,884 · see citing works
Bozdag, G., Mumusoglu, S., Zengin, D., Karabulut, E., & Yildiz, B. O. (2016) · Human Reproduction · doi:10.1093/humrep/dew218 · Cited by 1,526 · see citing works
Epidemiology, diagnosis, and management of polycystic ovary syndrome
Sirmans, S. M., & Pate, K. (2013) · Clinical Epidemiology · doi:10.2147/clep.s37559 · Cited by 1,301 · see citing works
The polycystic ovary syndrome: a position statement from the European Society of Endocrinology
Conway, G., Dewailly, D., Diamanti-Kandarakis, E., Escobar-Morreale, H. F., Franks, S., Gambineri, A., Kelestimur, F., Macut, D., Micic, D., Pasquali, R., et al. (2014) · European Journal of Endocrinology · doi:10.1530/eje-14-0253 · Cited by 676 · see citing works
Kakoly, N. S., Khomami, M. B., Joham, A. E., Cooray, S. D., Misso, M. L., Norman, R. J., Harrison, C. L., Ranasinha, S., Teede, H. J., & Moran, L. J. (2018) · Human Reproduction Update · doi:10.1093/humupd/dmy007 · Cited by 384 · see citing works
Stronks, K., Kulu-Glasgow, I., & Agyemang, C. (2009) · Ethnicity and Health · doi:10.1080/13557850802509206 · Cited by 378 · see citing works
Anxiety and depression in polycystic ovary syndrome: a systematic review and meta-analysis
Barry, J. A., Kuczmierczyk, A. R., & Hardiman, P. J. (2011) · Human Reproduction · doi:10.1093/humrep/der197 · Cited by 336 · see citing works
Development of the body image concern inventory.
Littleton, H., Axsom, D., & Pury, C. L. S. (2005) · Behaviour Research and Therapy · doi:10.1016/j.brat.2003.12.006 · Cited by 286 · see citing works
An Online Survey of Hypothyroid Patients Demonstrates Prominent Dissatisfaction
Peterson, S. J., Cappola, A. R., Castro, M. R., Dayan, C. M., Farwell, A. P., Hennessey, J. V., Kopp, P. A., Ross, D. S., Samuels, M. H., Sawka, A. M., et al. (2018) · Thyroid · doi:10.1089/thy.2017.0681 · Cited by 231 · see citing works
Skiba, M. A., Islam, R. M., Bell, R. J., & Davis, S. R. (2018) · Human Reproduction Update · doi:10.1093/humupd/dmy022 · Cited by 220 · see citing works
Prevalence of Body Dysmorphic Disorder in a Community Sample of Women
Otto, M. W., Wilhelm, S., Cohen, L. S., & Harlow, B. L. (2001) · American Journal of Psychiatry · doi:10.1176/appi.ajp.158.12.2061 · Cited by 220 · see citing works
Racial and ethnic differences in the polycystic ovary syndrome metabolic phenotype
Engmann, L., Jin, S., Sun, F., Legro, R. S., Polotsky, A. J., Hansen, K. R., Coutifaris, C., Diamond, M. P., Eisenberg, E., Zhang, H., et al. (2017) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2017.01.003 · Cited by 144 · see citing works
Veale, D. M. (2004) · Postgraduate Medical Journal · doi:10.1136/pmj.2003.015289 · Cited by 119 · see citing works
Psychological well-being and sexarche in women with polycystic ovary syndrome
de Niet, J. E., de Koning, C. M., Pastoor, H., Duivenvoorden, H. J., Valkenburg, O., Ramakers, M. J., Passchier, J., de Klerk, C., & Laven, J. S. E. (2010) · Human Reproduction · doi:10.1093/humrep/deq068 · Cited by 103 · see citing works
Laggari, V., Diareme, S., Christogiorgos, S., Deligeoroglou, E., Christopoulos, P., Tsiantis, J., & Creatsas, G. (2009) · Journal of Psychosomatic Obstetrics & Gynecology · doi:10.1080/01674820802546204 · Cited by 99 · see citing works
Mitchell, A. L., Hegedüs, L., Žarković, M., Hickey, J. L., & Perros, P. (2021) · Clinical Endocrinology · doi:10.1111/cen.14340 · Cited by 81 · see citing works
Influence of ethnicity on different aspects of polycystic ovary syndrome: a systematic review
Şendur, S. N., & Yıldız, B. O. (2020) · Reproductive BioMedicine Online · doi:10.1016/j.rbmo.2020.12.006 · Cited by 80 · see citing works
Body image satisfaction and self-esteem status among the patients with polycystic ovary syndrome.
(2013) · Europe PMC (PubMed Central) · Cited by 80 · see citing works
Geiss, I. M., Umek, W. H., Dungl, A., Sam, C. E., Riss, P., & Hanzal, E. (2003) · Urology · doi:10.1016/s0090-4295(03)00487-4 · Cited by 77 · see citing works
Hillman, S., Bryce, C., Caleyachetty, R., & Dale, J. R. (2020) · British Journal of General Practice · doi:10.3399/bjgp20x708881 · Cited by 67 · see citing works
Ghadakzadeh, S., Ghazipour, A., Khajeddin, N., Karimian, N., & Borhani, M. (2011) · Aesthetic Plastic Surgery · doi:10.1007/s00266-011-9718-8 · Cited by 61 · see citing works
Sexual dysfunction in patients with polycystic ovary syndrome and its affected domains.
Eftekhar, T., Sohrabvand, F., Zabandan, N., Shariat, M., Haghollahi, F., & Ghahghaei‐Nezamabadi, A. (2014) · Europe PMC (PubMed Central) · Cited by 54 · see citing works
Ravi, R. P., & Kulasekaran, R. A. (2014) · Journal of Sexually Transmitted Diseases · doi:10.1155/2014/292157 · Cited by 49 · see citing works
MANAGEMENT OF ENDOCRINE DISEASE: Morbidity in polycystic ovary syndrome.
Glintborg, D., & Andersen, M. (2017) · European Journal of Endocrinology · doi:10.1530/eje-16-0373 · Cited by 43 · see citing works
Sexual dysfunction in polycystic ovary syndrome: a systematic review and meta-analysis
Loh, H. H., Yee, A. H. A., Loh, H. S., Kanagasundram, S., Francis, B., & Lim, L. (2020) · HORMONES · doi:10.1007/s42000-020-00210-0 · Cited by 41 · see citing works
Lau, G. M., Elghobashy, M., Thanki, M., Ibegbulam, S., Latthe, P., Gillett, C. D. T., O’Reilly, M. W., Arlt, W., Lindenmeyer, A., Kempegowda, P., et al. (2022) · Frontiers in Endocrinology · doi:10.3389/fendo.2022.1064937 · Cited by 36 · see citing works
Self-citationTsai, M., Strong, C., Latner, J. D., Lin, Y.-C., Pakpour, A. H., Lin, C., & Wang, S. (2019) · Health and Quality of Life Outcomes · doi:10.1186/s12955-019-1198-6 · Cited by 34 · see citing works
How Women Suffering from Endometriosis Disclose about their Disorder at Work
Krsmanovic, A., & Dean, M. (2021) · Health Communication · doi:10.1080/10410236.2021.1880053 · Cited by 30 · see citing works
Phenotypic Expression of Polycystic Ovary Syndrome in South Asian Women
Mehta, J. M., Kamdar, V. V., & Dumesic, D. A. (2013) · Obstetrical & Gynecological Survey · doi:10.1097/ogx.0b013e318280a30f · Cited by 23 · see citing works
Andrisse, S., Garcia‐Reyes, Y., Pyle, L. L., Kelsey, M. M., Nadeau, K. J., & Cree‐Green, M. (2021) · Journal of the Endocrine Society · doi:10.1210/jendso/bvab008 · Cited by 20 · see citing works
Dayo, O. M., Gordon, N. P., Chandra, M., Weintraub, M. R., & Lo, J. C.-M. (2020) · Fertility and Sterility · doi:10.1016/j.fertnstert.2020.08.1180 · Cited by 6 · see citing works
Mood Disorders in Polycystic Ovary Syndrome
Dokras, A. (2022) · Cambridge University Press eBooks · doi:10.1017/9781108989831.017 · Cited by 2 · see citing works
L-tryptophan does not affect food intake during recovery from depression
Russ, M. J., Ackerman, S. H., Banay‐Schwartz, M., Shindledecker, R. D., & Smith, G. P. (1991) · International Journal of Eating Disorders · doi:10.1002/1098-108x(199109)10:5 · Cited by 1 · see citing works
Flagged first, then by citations
1 of the 38 references couldn’t be matched to a known paper.
Research works printed but not linked: 1
- [31]Allison D, Basile V, Yuker H. The measurement of attitudes toward and beliefs about obese persons. Int J Eat Disord. 1991; 10(5): 599– 607.
Cited by
Sorted by citations
Alur-Gupta, S., Dokras, A., & Cooney, L. G. (2024) · Fertility and Sterility · doi:10.1016/j.fertnstert.2024.01.018 · Cited by 53 · see citing works
Malhotra, K., & Kempegowda, P. (2023) · Journal of Medical Internet Research · doi:10.2196/49220 · Cited by 26 · see citing works
Self-citationAlkheyr, Z., Murad, M. H., Das, P., Aljenaee, K., Kamel, C., Hajji, S. A., Flood, J., Atkin, S. L., & Ali, K. F. (2024) · PLoS ONE · doi:10.1371/journal.pone.0301707 · Cited by 23 · see citing works
Role of Omega-3 Fatty Acids in Improving Metabolic Dysfunctions in Polycystic Ovary Syndrome
Albardan, L., Platat, C., & Kalupahana, N. S. (2024) · Nutrients · doi:10.3390/nu16172961 · Cited by 18 · see citing works
“While dietary strategies are effective for weight reduction in women who are overweight or obese, the widespread problem of weight stigma and its detrimental psychological effects, as well as weight regain, compromises their efficacy [2,5,6].”
BackgroundElghobashy, M., Lau, G. M., Davitadze, M., Gillett, C. D. T., O’Reilly, M., Arlt, W., PCOS SEva Working Group, Lindenmeyer, A., & Kempegowda, P. (2023) · Frontiers in Endocrinology · doi:10.3389/fendo.2023.1175548 · Cited by 15 · see citing works
Self-citationThe current landscape of mental health challenges in women with PCOS: a narrative review
Khan, F., Govender, N., & Thandar, Y. (2025) · Current Psychology · doi:10.1007/s12144-025-07435-5 · Cited by 12 · see citing works
Rao, V. S., Peña, A. S., James, A., Phadke, A., Grover, J., Blendis, E., Choudhary, N., & Kampegowda, P. (2024) · Frontiers in Endocrinology · doi:10.3389/fendo.2024.1295705 · Cited by 9 · see citing works
Zhang, Z., Liu, M., Zhao, F., Chen, H., & Chen, X. (2024) · Cureus · doi:10.7759/cureus.70352 · Cited by 8 · see citing works
Gul, O. K., Akkuş, M., & Akkuş, F. (2025) · BMC Women s Health · doi:10.1186/s12905-025-03930-w · Cited by 7 · see citing works
Hu, S., Shen, Q., Li, Z., He, T., Luo, Y., Tu, P., Yan, C., & Lei, J. (2026) · Reproductive Biology and Endocrinology · doi:10.1186/s12958-026-01563-8 · Cited by 5 · see citing works
Malhotra, K., & Kempegowda, P. (2023) · DIGITAL HEALTH · doi:10.1177/20552076231220787 · Cited by 3 · see citing works
Self-citationBroughton, S., Armeni, E., Chu, A., Yee, A. L. J., Manta, A., Baig, S. A., Blendis, E., & Kempegowda, P. (2026) · European Journal of Endocrinology · doi:10.1093/ejendo/lvag023 · Cited by 3 · see citing works
Self-citationChen, J., Lei, X., Lazhen, W., Xie, S., Qian, S., Tan, H., Li, Y., Ren, Q., Deng, Q., & Zhou, Y. M. (2026) · BMC Women s Health · doi:10.1186/s12905-026-04284-7 · Cited by 2 · see citing works
Polycystic ovary syndrome: pragmatic management across levels of care
Arshad, A., Armeni, E., Broughton, S., Ali, A., Blendis, E., Gleeson, H. K., Robinson, L. L. L., & Kempegowda, P. (2025) · Gynecological Endocrinology · doi:10.1080/09513590.2025.2574874 · Cited by 1 · see citing works
Self-citationBody image concerns in endocrine conditions
Lathia, T. B. (2025) · Thyroid Research and Practice · doi:10.4103/trp.trp_42_24
Self-citationBhat, S. (2025) · Indian Journal of Endocrinology and Metabolism · doi:10.4103/ijem.ijem_423_24
Washington, A., Heera Shenoy, T., Prejisha, B., & Kumar, R. (2026) · BMC Women s Health · doi:10.1186/s12905-026-04609-6
- Authors
- Sheikh, J., Khalil, H., Shaikh, S., Hebbar, M., Zia, N., Wicks, S., Jayaprakash, S., Narendran, A., Subramanian, A., Malhotra, K., Chapman, R., Gillett, C., Gleeson, H. K., Robinson, L., Chu, J. J., Lathia, T., Selvan, C., O'Reilly, M. W., Manolopoulos, K. N., Arlt, W., Kempegowda, P., & the PCOS SEva team
- Affiliations
- University of Birmingham (GB)
- DY Patil Deemed to be University (IN)
- Barts Health NHS Trust (GB)
- Dudley Group NHS Foundation Trust (GB)
- King Edward VI High School for Girls Birmingham UK
- Dayanand Medical College & Hospital (IN)
- University Hospitals Coventry and Warwickshire NHS Trust (GB)
- University Hospitals Birmingham NHS Foundation Trust (GB)
- Birmingham Women's Hospital (GB)
- Apollo Hospitals (IN)
- M.S. Ramaiah Medical College (IN)
- Institute of Metabolism and Systems Research University of Birmingham Birmingham UK
- Corresponding author
- Kempegowda, Punith
- ORCID
- Venue
- BJOG: An International Journal of Obstetrics & Gynaecology
- Publisher
- Wiley
- Published
- 2023-03-08
- Volume
- 130
- Issue
- 8
- Pages
- 978-986
- ISSN
- 0306-5456 (ISSN-L)
- 1470-0328
- 1471-0528
- PMC
- PMC10952802
- OpenAlex
- W4321330722
- Cited by
- 18
- References
- 38
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 5 · 2023: 4
- FWCI
- 4.31
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- BJOG An International Journal of Obstetrics & Gynaecology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- University of Birmingham Research Portal (University of Birmingham) (publishedVersion, cc-by)
- Figshare (submittedVersion, cc-by)
- Funders
- Health Research Board (Emerging Clinician Scientist Award ECSA‐FA‐2020‐00)
- Birmingham Biomedical Research Centre (Grant Reference Number BRC‐1215‐20009)
- Wellcome Trust (Investigator Grant WT209492/Z/17/Z)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Keywords
- polycystic ovary syndrome, ethnicity, birthplace, emotional well-being, depression, anxiety, body dysmorphic disorder, body image concern, weight stigma, female sexual dysfunction, non-white women
- MeSH terms
- Cross-Sectional Studies, Ethnicity, Female, United Kingdom, Humans, India, Polycystic Ovary Syndrome, Surveys and Questionnaires
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