Chapter 6: An Intersectional Perspective on Counseling Adolescents with Polycystic Ovary Syndrome: The Case of a South Asian American Teen

Polycystic ovary syndrome (PCOS) is a chronic endocrine-metabolic disorder affecting approximately 5–10% of women of reproductive age (Trent & Gordon, 2020). Although there is no clear etiology of PCOS, it is considered to manifest through the interaction of genetic, environmental, neuroendocrine, metabolic, and lifestyle factors (Trent & Gordon, 2020). Research on the incidence of PCOS among diverse populations in the United States (US) is sparse and inconsistent, despite there being significant variance in the pathogenesis and clinical presentation of PCOS based on race/ethnicity (National Institutes of Health [NIH], 2019).

The clinical presentation of PCOS and its symptom severity can vary but, according to Chandrasekaran and Sagili (2018), symptoms typically arise as a cluster and may include the presence of irregular menstruation (oligomenorrhea) or the absence of menstruation (anovulation), subfertility, dermatological issues (e.g., acne, hirsutism, and alopecia) and metabolic syndrome (e.g., central obesity, hyperinsulinemia, and insulin resistance). Approximately 33% of women with PCOS are affected by metabolic syndrome, placing them at increased risk for endometrial, pancreatic, postmenopausal breast and colorectal cancers, type II diabetes, cardiovascular disease, and sleep apnea (Chandrasekaran & Sagili, 2018). Women with PCOS also have been found to experience increased psychosocial stressors, report decreased quality of life, and are 50% more likely to have a psychiatric diagnosis compared to women without PCOS (Burgart, 2020). Studies have found higher rates of depression in women with PCOS compared to the general population (Dokras et al., 2016), and have found a higher propensity of anxiety and eating disorders, as well as difficulties with navigating interpersonal relationships (Chandrasekaran & Sagili, 2018).