Abstract
Introduction
Polycystic Ovary Syndrome (PCOS) is a multifaceted disorder with physical, emotional, and social implications. Culturally adapted tools for assessing Health-Related Quality of Life (HRQoL) in Indian women, particularly those under 18 and over 45 years of age, need to be developed. This study aimed to culturally adapt the Nasiri-Amiri PCOS-specific HRQoL questionnaire for Malayalam-speaking women, evaluate its reliability and factor structure using exploratory factor analysis (EFA), and identify key HRQoL domains in this population.Methods
Between July 2024 and December 2025, a 52-item Malayalam-adapted questionnaire was distributed to women aged 13-52 years, of whom 201 met the inclusion criteria. Reliability assessments were performed using Cronbach's alpha. The ability of the data to be factored was evaluated using the Kaiser-Meyer-Olkin test and Bartlett's Test of Sphericity. Maximum likelihood extraction with Equamax rotation was used for exploratory factor analysis, with factor retention guided by the root-mean-square residual.Results
Strong internal consistency for the instrument (Cronbach's α = 0.818) and adequate sampling adequacy (KMO = 0.794; Bartlett's p Conclusion
Extending the assessment beyond the conventional 18-45 year reproductive window reveals that the PCOS-related burden persists into adolescence and adulthood. The adapted Malayalam PCOS-HRQoL tool showed acceptable reliability, making it a useful measure of quality of life in women with PCOS in this population. Further confirmatory factor analysis and longitudinal studies are required to confirm these findings.