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Polycystic ovary syndrome (PCOS) is known as one of the most common causes of fertility issues in women (typically due to ovulation dysfunction). This can usually be overcome with appropriate treatment, such as ovulation induction or in vitro fertilization (IVF)

In addition to subfertility, PCOS often comes with other frustrating challenges like hirsutism (unwanted hair growth), weight gain (in some patients), insulin resistance and acne. But not all PCOS symptoms are obvious—the condition also increases the risk of mental health issues like anxiety and depression in both teen and adult PCOS patients.1Barry JA, Kuczmierczyk AR, Hardiman PJ. Anxiety and depression in polycystic ovary syndrome: a systematic review and meta-analysis. Human reproduction. 2011 Sep 1;26(9):2442-51. 

As a reproductive endocrinologist who has worked with PCOS patients for over two decades, I have seen the physical and mental toll this condition can take. Let’s explore the link between PCOS and anxiety, how and why PCOS can impact your mental health, and how you can reduce your anxiety and depression symptoms through practical self-care.  

PCOS and anxiety: What’s the connection?

If you have PCOS and struggle with anxiety or depression, it’s not all in your head. Research has shown that women with PCOS have a significantly higher risk of depressive disorders (35%) than those without PCOS (10.7%),2Hollinrake E, Abreu A, Maifeld M, Van Voorhis BJ, Dokras A. Increased risk of depressive disorders in women with polycystic ovary syndrome. Fertility and sterility. 2007 Jun 1;87(6):1369-76. even after accounting for modifying factors such as age, race, education level, employment and marital status. Similarly, PCOS sufferers experience a higher level of anxiety than those without the condition.3Dybciak P, Humeniuk E, Raczkiewicz D, Krakowiak J, Wdowiak A, Bojar I. Anxiety and Depression in Women with Polycystic Ovary Syndrome. Medicina (Kaunas). 2022;58(7):942. Published 2022 Jul 16. doi:10.3390/medicina58070942

The American Society for Reproductive Medicine (ASRM) has recommended that those with PCOS should be routinely screened and adequately treated for depressive disorders, further validating the difficult experience that many PCOS patients share. 

But how exactly does the condition lead to higher levels of anxiety and depression? There are a whole host of challenges that affect people with PCOS: body acceptance, navigating associated health risks and side effects, hormonal fluctuations and a higher chance of subfertility.

Understandably, those with PCOS often face social stigma around their appearance (including excessive hair growth in places like the arms and face alongside hair thinning and acne) and may also undergo mood changes associated with menstrual irregularities. 

What causes anxiety and depression in PCOS patients?

Over the years, there has been speculation that a higher body mass index (BMI) might be one cause. However, the increased risk of depressive disorders in women with PCOS was found to be independent of weight, according to research like this 2007 study

Fluctuations in hormone levels and menstrual cycle irregularities have also been considered as culprits for increased psychological distress in those with PCOS, and it is highly likely that they do play a key role. 

Some studies have also highlighted the relationship between PCOS and higher levels of stress. In one instance, women with PCOS reported a significantly greater physiological reaction to stress in comparison to women without the condition and were more likely to be hospitalized with high levels of stress.4Dybciak P, Humeniuk E, Raczkiewicz D, Krakowiak J, Wdowiak A, Bojar I. Anxiety and Depression in Women with Polycystic Ovary Syndrome. Medicina (Kaunas). 2022;58(7):942. Published 2022 Jul 16. doi:10.3390/medicina58070942

While researchers have not been able to pinpoint a single root cause of increased anxiety and depression in individuals with PCOS, the above factors (and others) are highly likely contributors to this phenomenon. 

How to reduce anxiety and depression symptoms

Feeling anxious, depressed or overwhelmed by other PCOS symptoms? The first step is acknowledging that you deserve support and treatment for these challenges, and that professional help is available to you. 

The second step is reaching out to a healthcare professional, such as your OB-GYN, primary care provider, or a reproductive endocrinologist, who specializes in the diagnosis and treatment of endocrine disorders. Tell them what you are experiencing in detail and be honest and upfront about your day-to-day mental and physical health. 

Once you have connected with a healthcare provider, they will likely order some diagnostic testing, which may include blood work (to assess your hormone levels) and a transvaginal ultrasound (to assess your ovaries and overall reproductive health). 

What happens next?

As soon as your results are available, your doctor will discuss them with you and offer various treatment options to help lessen your symptoms, such as potentially helpful medications, lifestyle modifications, and tools you can use to improve your quality of life with PCOS.

Meeting with a licensed mental health professional can also be very beneficial for those experiencing anxiety and depression, as they will be able to offer specialized guidance to help lessen these invisible, yet distressing symptoms of PCOS. 

Note: If you need immediate mental health support, call or text the National Suicide & Crisis Lifeline at 988 or visit their website to chat with someone who can help locate available resources near you. 

4 expert tips on PCOS self-care

In addition to reaching out to healthcare professionals to explore treatment options and get specialized support, here are four easy ways to practice self-care with PCOS:

1. Include movement in your daily routine

Whether you choose to dance around the kitchen while cooking dinner, take longer walks with your dog, join a group fitness class, go swimming, or try at-home yoga, increasing your daily level of physical activity has been shown to reduce anxiety and depression symptoms, increase self-confidence, and improve insulin resistance (a common challenge with PCOS).  

2. Prioritize connection 

Studies have shown that those who feel connected to others not only experience increased happiness and reduced stress, but even see lowered blood glucose levels and a reduced risk of PCOS-related conditions like type 2 diabetes. 

3. Find your people

Educate yourself about PCOS and surround yourself with others who get what you’re going through. Set up your team of PCOS experts, join online or in-person groups for people with PCOS for helpful information and encouragement. 

4. Be proactive

Don’t wait to take action and make changes to improve your physical and mental wellbeing. When you’re struggling with anxiety or depression, it can be difficult to take steps to find the support you need. If you feel comfortable doing so, confide in family or friends about what you’re experiencing and ask them for help. Ask them to make phone calls to different medical providers to gather information or help make appointments for you to cross some of the to-dos off your list. 

A note on PCOS and anxiety

Your mental health matters: It can be easy to focus solely on the physical aspects of PCOS, but it’s essential to pay attention to your psychological and emotional well-being as well. 

Whether you’re experiencing increased anxiety, feeling depressed or hopeless, or simply want to find available resources to utilize should those issues arise, don’t hesitate to seek out support and guidance to better understand PCOS and get empowered with tools and resources that can help you live your healthiest, happiest life.


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