Conceptualizing the lived experience of polyendocrine metabolic ovarian syndrome through metaphor: a qualitative study of Turkish women

Polyendocrine metabolic ovarian syndrome (PMOS), previously named polycystic ovary syndrome (PCOS), is a heterogeneous endocrinopathy with substantial psychological burden. Qualitative research has explored women’s lived experience, but structured analyses of the metaphorical language patients use to conceptualize the condition remain scarce. We aimed to describe the metaphor categories used by Turkish women with PMOS across ten domains of illness experience. This single-centre qualitative study enrolled 50 women diagnosed according to Rotterdam criteria at a tertiary training hospital in Istanbul between 10 October and 15 December 2025. Each participant attended one face-to-face interview (40–65 min) using an open-ended questionnaire covering ten illness-experience domains, yielding 500 responses in total (50 participants × 10 domains). Responses were independently coded by two clinicians into five a priori metaphor categories (Journey, Confinement, Nature/Weather, Struggle, Transformation), and re-coded by two external clinicians blinded to initial codes and to codebook development. Trustworthiness was addressed using the framework of Korstjens and Moser, including member checking with 20 of the 50 participants (40%) one month after the initial interview. Across the 500 responses, the dominant categories were Journey (130/500, 26.0%), Confinement (111/500, 22.2%), Nature/Weather (109/500, 21.8%), Struggle (86/500, 17.2%) and Transformation (57/500, 11.4%); seven responses (1.4%) did not fit the codebook. Domain-specific concentrations were pronounced: Struggle metaphors dominated weight management (34/50, 68%), Nature/Weather metaphors the emotional impact of PMOS (42/50, 84%) and physical changes (30/50, 60%), and Journey metaphors overall living with PMOS (23/50, 46%) and primary fear (28/50, 56%). Participants had a mean age of 26.3 ± 5.5 years and a mean body mass index of 27.8 ± 5.7 kg/m². Turkish women with PMOS conceptualized their condition primarily through journey, confinement and nature/weather imagery, with domain-specific concentrations rather than a single global illness metaphor. These descriptive findings may inform clinical communication and provide a basis for hypothesis-driven research linking metaphor profiles to validated psychological outcomes.