Adverse childhood experiences and risk of polycystic ovary syndrome among young adult females from Delhi NCR, India

Abstract

Abstract Introduction Polycystic ovary syndrome (PCOS) is a complex endocrine disorder affecting 6%-20% of reproductive-aged females globally. In India, one in five females is affected, surpassing the global average. PCOS is linked to hormonal, genetic, metabolic, and environmental factors. Recent research suggests early-life adverse experiences, such as trauma and stress, may increase the risk of PCOS by impacting the hypothalamic-pituitary-ovarian axis, immune system, and epigenetic pathways. This study aims to explore the association between Adverse Childhood Experiences (ACEs) and PCOS in young adult females in Delhi National Capital Region (NCR), a region with high prevalence rates of both conditions. Material and methods A cross-sectional study was conducted with 1,149 female participants aged 18–25 years from Delhi NCR. Participants were selected from colleges in the University of Delhi and Amity University, Noida. PCOS was identified based on self-reported prior diagnosis and the Rotterdam criteria. The ACE International Questionnaire (ACE-IQ) was used to assess 13 ACE categories across four domains: abuse, neglect, family dysfunction, and violence. Data were analyzed using chi-square tests and logistic regression to examine the relationship between ACEs and PCOS. Results Of the participants, 17.26% were diagnosed with PCOS. 71.5% reported at least one ACE, with 16% experiencing severe ACEs (4 + ACEs). Females with severe ACEs showed a 2.1-fold increased risk of developing PCOS compared to those with fewer or no ACEs. Abuse (physical, emotional, sexual), household violence, bullying, and exposure to community violence were significantly associated with higher PCOS prevalence. Conclusion The findings indicate a strong association between ACEs and PCOS, with severe childhood adversities doubling the risk of PCOS in young adult females. Addressing early-life trauma could reduce the risk of PCOS and improve long-term health outcomes. Further research is needed to explore the causal mechanisms and develop targeted therapeutic approaches for managing PCOS in individuals with a history of childhood trauma.

Keywords

• Adverse Childhood experience
• Poly cystic ovary syndrome
• Abuse
• Childhood neglect
• Oligomenorrhea
• Female health