Relationship between hypothalamic–pituitary–adrenal axis activity and menstrual irregularities in women with polycystic ovary syndrome

Objective: This study was conducted to assess hypothalamic-pituitary-adrenal axis activity, perceived stress, and metabolic markers across menstrual status categories in women with polycystic ovary syndrome (PCOS), and to test whether perceived stress is independently associated with menstrual irregularity. Methods: In this retrospective cross-sectional study, 296 women with PCOS (2023-2024) were classified as having regular menses, oligomenorrhea, or amenorrhea. Hormonal, metabolic, and biochemical parameters were recorded, and perceived stress was measured using the 10-item Perceived Stress Scale (PSS-10). Correlations, multivariable logistic regression (amenorrhea vs. other categories), and receiver operating characteristic analyses were performed. Results: PSS score was correlated with homeostatic model assessment of insulin resistance (HOMA-IR) (r=0.619, p