Polycystic Ovary Syndrome (PCOS) is a very common endocrine condition that affects 1 in every 10 women and those assigned female at birth in the UK. It manifests differently in each person and can be incredibly debilitating to an individual’s self esteem and quality of life, as Tara Costello from Verity, the UK’s PCOS charity, explains in this guest blog.
Polycystic ovary syndrome is a complex condition that impacts many aspects of a person’s health. This common condition is the leading cause of female infertility and also a risk factor for other life-threatening conditions such as diabetes, cancer, and heart disease. If not properly managed, it can lead to additional health problems later in life meaning much of the discussion surrounding PCOS focuses on physical health. Whilst this is vital information, it’s important to note that PCOS can impact a person’s mental health too.
People who have been diagnosed with PCOS are three times more likely to be diagnosed with anxiety and depression than people without 1, 2, 3. Although from a scientific standpoint it is still unclear what the link between anxiety and depression for those with PCOS is, at Verity we see first-hand the emotional toll PCOS can take on a person.
How depression and anxiety manifest
Depression negatively affects the way a person thinks, how they feel and how they act. People with depression often have persistent and extreme negative thoughts and feelings that make everyday life hard. It can make a person withdrawn and stop you from doing everyday activities making it difficult to function both physically and emotionally.
Anxiety is a persistent feeling of nervousness or worry that something bad is going to happen. For some, it can be extremely debilitating as ongoing feelings of anxiety often interfere with daily life and have physical effects too.
The effects of depression and anxiety
Depression and anxiety affects a person’s quality of life in numerous ways. Physically it takes a toll on the body and has been known to disrupt important factors such as food habits and sleeping patterns. It also affects a person psychologically by reducing their motivation to do everyday activities and things that usually bring them joy. It can increase feelings of ineptitude and this directly impacts a person’s social life and relationships. Both anxiety and depression can feel all-consuming if not treated.
What is the link between PCOS and mental health issues?
The exact cause for the increased risk for anxiety and depression among people with PCOS is not clear, but there’s a few factors that could come into play.
It could be due to the hormonal differences associated with PCOS. Insulin resistance is a common symptom of PCOS which results in higher levels of insulin in the bloodstream. One study found that greater insulin resistance increased the risk for depression4 and another study shows that people with greater insulin resistance reported anxiety symptoms5.
People with PCOS who have anxiety or depression may have lower levels of neurotransmitters (which are chemicals that send signals throughout the body). A neurotransmitter called serotonin that is involved in promoting a happy mood and positive feelings plays a role in depression and anxiety. One study showed that those with PCOS who have low levels of serotonin report more symptoms of depression and anxiety6.
The emotional toll some PCOS symptoms can have on a person are worth noting too.
Some of the most common symptoms of PCOS are irregular (or lack of) periods and ovulation, excess hair, hair loss, acne and weight issues, all of which can have an impact on appearance and self-esteem. Pair this with the fact that there are a lot of misinformation and misconceptions out there, PCOS can sometimes be an isolating condition.
Verity as a charity was established and exists to help support women with PCOS from pre-diagnosis through to an understanding of long term health risks. This support is provided in a number of ways, which you can read about here: http://www.verity-pcos.org.uk/support-for-you.html
1 Barry JA, Kuczmierczyk AR, Hardiman PJ. Anxiety and depression in polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod. 2011;26(9):2442–51.
2 Blay SL, Aguiar JV, Passos IC. Polycystic ovary syndrome and mental disorders: a systematic review and exploratory meta-analysis. Neuropsychiatr Dis Treat. 2016;12:2895-903.
3 Brutocao C, Zaiem 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.
4 Greenwood EA, Pasch LA, Cedars MI, Legro RS, Eisenberg E, Huddleston HG. Insulin resistance is associated with depression risk in polycystic ovary syndrome. Fertil Steril. 2018;110(1):27-34.
5 Livadas S, Chaskou S, Kandaraki AA, Skourletost G, Economou F, Christou M, et al. Anxiety is associated with hormonal and metabolic profile in women with polycystic ovarian syndrome. Clin Endocrinol. 2011;75:698-703.
6 Shi X, Zhang L, Fu S, Li N. Co-involvement of psychological and neurological abnormalities in infertility with polycystic ovarian syndrome. Arch Gynecol Obstet. 2011;284:773-8.
More information
Find out more about Polycystic Ovary Syndrome and PCOS Awareness Month.
If you are concerned that you might have a condition such as PCOS or just want to learn more about your fertility – book a free consultation with a fertility nurse specialist.
Difficulty losing weight can be one of the symptoms of PCOS. Strategies for improving nutrition and gaining a healthy BMI will be discussed at the Fertility Support Group Meeting on 14 September 2022.
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