PCOS is a complex and common hormonal condition affecting 15-20 % of ladies which impairs many aspects of a person's health manifesting from puberty up to reproductive age.
It has a strong connection to one's mental health.
Unknown and unclear in its aetiology, there exist many possible causes such as hyperandrogenism (high levels of male hormones), genetic predisposition, insulin resistance and inflammation.
Some symptoms of PCOS include missed or irregular periods, excess body and facial hair (hirsutism), weight gain, thinning of hair, acne or oily skin, skin tags, fertility issues, fatigue, insomnia, pelvic pain, depression and anxiety amongst others.
What is the connection between Mental health and PCOS?
Several studies have shown that women with PCOS experiencing symptoms such as excess hair growth on the body and face, acne, weight change and fertility issues can negatively affect mood, body confidence issues and body image. Furthermore, the late discovery of being diagnosed with PCOS, unfortunately, increases the likelihood to become more depressed and/or anxious.
Studies suggest that PCOS can be associated with mood and psychiatric disorders and is 3 times more likely than in non-PCOS patients. It can also be associated with an increased risk of a diagnosis of depression, anxiety, bipolar mood disorder, obsessive-compulsive disorder (OCD), attention deficit hyperactivity disorder (ADHD) and eating disorders.
Symptoms related to mental health in women with PCOS include:-
body image issues
poor interpersonal skills
A study supervised by the Columbia University School of Nursing that was published in the Journal of Behavioural Health Services & Research identifies PCOS complications that may be most responsible for psychiatric problems, stating while weight gain and unwanted body hair can be distressing, irregular menstrual cycle(s) is the one symptom of PCOS most strongly associated with psychiatric problems.
Some other theories claim that it may be due to hyperandrogenism and the resulting somatic symptoms. These symptoms can be stigmatising for women and it lowers their quality of life.
Another study in the Journal of Neuropsychiatric Disease and Treatment further explores the association between anxiety, depression and PCOS. The paper concluded that depression and anxiety are more prevalent in patients with PCOS.
The possible neuropsychological aetiology discussed in this research paper includes HPA (hypothalamus-pituitary-adrenal) dysregulation leading to an excess of androgen production and lack of cortisol level regulation. Some other studies have shown an increased prevalence of disordered eating in women with PCOS compared to controlled groups without PCOS.
Eating disorders such as bulimia nervosa, binge eating disorders and night eating disorders are also linked with PCOS where there is an increased risk of obesity and depression that causes these eating disorders.
Some suggestions for treatment options and supportive therapy:-
- Routine screening for mental health symptoms
- Routine screening for eating disorders
- Comprehensive hormone blood profile
- Lifestyle changes such as good quality restful sleep, healthy low carb, low sugar, no gluten, no dairy diet and daily exercise regimes.
- Supplementations such as Magnesium, Zinc, Omega 3 fish oil, Vitamin D3, 5-HTP.
- Bio-identical hormone replacement therapy such as Progesterone & Thyroid.
- Androgen blocker.
- Practicing mindfulness.
- Behavioral therapy
The best way to treat and reverse your PCOS symptoms is through lifestyle changes however education, mindfulness and awareness of PCOS are necessary because so many women that have it, are unaware of it. Awareness helps the people around us understand that symptoms such as the above-mentioned are not something to be ignored and getting it checked is necessary. It is very important for women suspecting they have PCOS, and even those diagnosed with PCOS to speak with their healthcare provider or preventive medicine practitioner about possible treatment options for all their symptoms. Many women have reversed their PCOS naturally and it can be done. Remember, it is never a “one size fits all” for PCOS.
1. Blau, S.L., Aguilar, J.V.A. And Passos, I.C., 2016. Polycystic ovary syndrome and mental disorders: a systematic review and exploratory meta-analysis. Neuropsychiatric Disease and Treatment, 12, p.2895
2. Brutocao C, Aeim F, Alsawas M, Morrow AS, Murad MH, Javed A. Psychiatric disorders in women with polycystic ovary syndrome: a systematic review and meta-analysis. Endocrine. 2018.
3. Damone AL, Joham AE, Loxton D, Earnest A, Teede HJ, Moran LJ. Depression, anxiety and perceived stress in women with and without POS: a community-based study, Psychol Med. 2018.