What is the Psychological Impact of Polycystic Ovary Syndrome (PCOS)?

How does PCOS affect the mental health of affected women?

Taking care of oneself, adopting a healthy lifestyle, and making informed health decisions can become significant challenges when our mental well-being is at stake. Recent research highlights that women with Polycystic Ovary Syndrome (PCOS) are at an increased risk of developing depressive disorders, underscoring the negative impact of physiological issues associated with PCOS on their emotional well-being.

Physical Symptoms

The underlying reasons for the predisposition of women with Polycystic Ovary Syndrome (PCOS) to experience anxiety and depression remain largely mysterious. This situation could stem from the obvious symptoms of PCOS, the associated hormonal fluctuations, or result from a combination of as yet unidentified factors.

Infertility and excessive growth of body and facial hair are two characteristic markers of PCOS. Some women affected by this syndrome express their frustration and anxiety related to infertility, weight issues, excessive hair growth on their body and face, as well as a feeling of loss of control over their health and appearance.

It's important to note that what is considered problematic varies depending on individual values and cultural influences. Furthermore, these characteristics may have an impact on the mental health of individuals who do not suffer from PCOS.

Hormonal Influence

Researchers have explored the underlying reasons for the heightened risk of anxiety and depression observed in women with Polycystic Ovary Syndrome (PCOS), wondering if these emotional disorders are partly attributable to hormonal fluctuations. In some individuals with PCOS, blood insulin levels rise due to insulin resistance.

A study has shown a link between more pronounced insulin resistance and an increased risk of depression. In fact, a study conducted by American researchers, involving a sample of 331 adults, yielded surprising results. Contrary to what might have been anticipated, this research, published in the "Psychosomatic Medicine" journal, revealed that insulin resistance was associated with less effective stress management. The researchers found that individuals with high insulin levels displayed a significantly stronger response to negative stimuli compared to positive stimuli. Additionally, hyperglycemia was linked to increased right-brain asymmetry and impaired cognitive performance. Furthermore, cortisol levels were disrupted in individuals with hyperglycemia.

Moreover, in women affected by PCOS, increased levels of DHEAS, a form of androgen hormone, may also be associated with a higher risk of depression. These findings underscore the complexity of hormonal factors and their interactions in understanding emotional disorders in women with PCOS. It should be understood that DHEA is involved in stress regulation. It acts as a counterpart to the stress hormone, cortisol. Adequate levels of DHEA can help mitigate the effects of stress on the body, thus promoting better emotional stress management. Conversely, if DHEA levels are not optimal, emotional instability is more pronounced.

Brain Activity Influence

Women with Polycystic Ovary Syndrome (PCOS) who experience anxiety may have reduced levels of certain neurotransmitters, including serotonin, a brain chemical messenger associated with positive emotions. These neurotransmitters play a significant role in triggering feelings of sadness and anxiety. Women with PCOS who exhibit reduced levels of serotonin and other neurotransmitters are more likely to manifest more pronounced symptoms of depression and anxiety.

Understanding the Emotional Impact: Why Does PCOS Cause Mood Swings?

Polycystic Ovary Syndrome (PCOS) is closely associated with insulin resistance, meaning the body resists the effects of insulin and produces more insulin as a result. This leads to a high amount of insulin in the bloodstream, which, through a series of steps, prompts the ovaries to produce more testosterone and other androgens.

The excess of androgens, often described as "male hormones," in women with PCOS leads to many physical symptoms of PCOS, including hirsutism (unwanted hair growth), acne, and significant hair loss, known as androgenetic alopecia. Insulin resistance also has a negative impact on weight, explaining why many women with PCOS are overweight and struggle to lose weight.

The body and mind are inherently connected and constantly influence each other. It can be challenging for women with PCOS to cope with these symptoms, which can lead to a sense of misunderstanding.

There is strong evidence showing that PCOS can have a negative impact on mental health. A systematic study on anxiety and depression in the context of PCOS concluded that "women with PCOS tend to suffer from slightly higher levels of anxiety and depression, much more than women without PCOS."

Furthermore, high levels of insulin are sometimes associated with chronic inflammation, which, in turn, can have a negative influence on emotional well-being. In fact, inflammation is closely linked to stress and depression.

What Should Women Know About the Connection Between PCOS and Anxiety?

Anxiety is defined as "a feeling of discomfort, such as worry or fear, that can vary in intensity." It is part of the human experience, and while everyone may experience it at some point in their lives, this emotion is typically short-lived. Common examples that can trigger anxiety include exams or job interviews. These challenges are temporary and, once overcome, contribute to soothing individuals and restoring their emotional comfort.

But what if you feel anxious because you've been diagnosed with a chronic condition like PCOS?

PCOS symptoms include:

• Irregular or absent menstruation
• Infertility
• Weight gain
• Increased facial acne
• Hirsutism
• Mood swings
• Poor sleep

The physical expression of these symptoms can contribute to triggering anxiety. Regarding fertility, individuals striving to become parents are also more prone to experiencing significant anxiety. The use of assisted reproductive methods, such as in vitro fertilization (IVF), represents another potential source of anxiety.

Women with PCOS who become pregnant may also be concerned about pregnancy complications associated with this condition, such as an increased risk of developing diabetes or high blood pressure (pre-eclampsia) during pregnancy.

Individuals with PCOS have a higher prevalence of anxious and depressive symptoms. They are three times more likely to exhibit symptoms of anxiety than those without PCOS. The correlation between having PCOS and feeling anxious is evident, indicating that living with PCOS on a daily basis is a challenge, not only for the body but also for the mind.

Well-being and PCOS 

Taking care of yourself can genuinely help build defenses against the stress associated with PCOS, which can sustain harmful anxiety. However, finding the approach that suits you best can be complex. For many individuals, this approach may involve a relaxing day at a spa or adopting a completely different approach. It is essential to regularly take the time to evaluate how you pamper yourself. Establishing a well-being routine can help you manage the anxiety that comes with living with PCOS.

We have considered five different categories of self-care:

• Physical: In addition to physical activity and your fitness, do you ensure you have a proper diet to help manage your PCOS, and do you take appropriate supplements to alleviate symptoms? Ensure you have medical support and regular health check-ups to maintain your physical condition.
• Social: During busy times in life, it's common to set aside social interactions. It becomes essential to stay in touch, dedicate quality time with loved ones. Sometimes, sharing your PCOS-related challenges with a trusted person can be beneficial.
• Mental: At times, dealing with PCOS symptoms can prompt the desire to isolate and engage in mentally stimulating activities such as puzzles, games, reading, or watching movies. However, it's just as important to confront inner challenges. Cultivating kind and compassionate thoughts toward yourself will help boost self-esteem and improve your mental health.
• Spiritual: Taking care of your mind doesn't necessarily have to involve religion. Stepping back and appreciating nature or anything that gives you a sense of well-being can help you take care of yourself.
• Emotional: It's entirely normal to experience negative emotions regarding PCOS, given that the symptoms can trigger emotional fluctuations that result in not only anxiety but also anger and sadness. It's essential to acknowledge these emotions and seek healthy ways to manage them.

One complementary solution available to emotionally support yourself is the use of plants, specifically adaptogenic plants. You can also consult specialized naturopaths like Imane Harmonie (https://imaneharmonie.com), who has dedicated her career to the natural management of Polycystic Ovary Syndrome (PCOS).