A tearful Naomi Osaka has briefly left a press conference in Cincinnati after her relationship with the media was put under the spotlight.

The four-time grand slam champ has lately had a strained relationship with journalists, saying her mental health is adversely impacted by certain lines of questioning.

It came to the fore again on Monday (local time) when a local Cincinnati reporter at the Western and Southern Open tournament suggested that Osaka benefited from her huge media profile and yet did not like speaking to journalists.

The world No.2 teared up as she tried to formulate an answer.

“When you say I’m not crazy about dealing with you guys, what does that refer to?” asked Osaka, who is of Japanese-Haitian heritage.

“Ever since I was younger, I have had a lot of media interest on me, and I think it’s because of my background as well.

“I can’t really help that there are some things that I tweet or some things that I say that kind of create a lot of news articles or things like that… but I would also say I’m not really sure how to balance the two.

“Like I’m figuring it out at the same time as you are, I would say.”

During the exchange, she wiped away tears and pulled her visor over her eyes to hide her face before the moderator called for a pause to proceedings.

Osaka left the room briefly but returned to complete the news conference after regaining her composure.

In the lead-up to the French Open in May, Osaka said she would be boycotting the obligatory post-match news conferences at the major to protect her mental health.

The decision led to a backlash from grand slam tournament organisers, who fined her and threatened to ban her from the majors if she refused to speak to the media.

The stand-off not only led to Osaka revealing that she has struggled to cope with depression for years but also prompted her to withdraw from Roland Garros and Wimbledon citing her mental health.

After losing early when she returned at the Tokyo Games, where she was given the honour of lighting the Olympic flame at the opening ceremony, she admitted she struggled to cope with the pressure and expectation placed on her.

Osaka’s agent Stuart Duguid condemned the reporter’s line of questioning on Monday in a written statement to Reuters.

“The bully at the Cincinnati Enquirer is the epitome of why player/media relations are so fraught right now,” the statement said.

“Everyone on that Zoom will agree that his tone was all wrong and his sole purpose was to intimidate. Really appalling behaviour.

“This insinuation that Naomi owes her off-court success to the media is a myth – don’t be so self-indulgent.”

The 23-year-old Osaka – who has received a bye into the Western and Southern Open second round – had used her platform to call attention to mental health issues.

“The biggest eye-opener was going to the Olympics and having other athletes come up to me and say they were really glad that I did what I did,” she said.

“I’m proud of what I did and I think that it was something that needed to be done.”