Could PCOS be the silent trigger for anxiety and depression in women?

Polycystic Ovary Syndrome (PCOS) is commonly referred to in relation to irregular menstrual cycles, weight gain, or infertility. However, what is often not said is its impact on mental well-being.New studies indicate women with PCOS are two to three times more likely to have anxiety, depression, and body image disturbance than those without the syndrome. According to a meta-analysis in Human Reproduction Update, nearly 40% of women with PCOS exhibited significant depressive episodes. Similarly, more than 30% respondents were diagnosed with anxiety.This relationship can hardly be considered coincidental. The hormonal dysregulations behind PCOS, specifically elevated androgens and insulin resistance, also impact neurotransmitters involved in mood management.Coupled with these are observable features, such as acne, hirsutism, or weight changes, which can undermine self-worth. Social stigma regarding infertility and physical appearance further adds to the stress, and women become trapped in a vicious cycle of anxiety and loneliness.Experts have repeatedly emphasised that psychiatrists and gynaecologists are both required for optimal management of PCOS symptoms.Changes in lifestyle, including a healthy diet, exercise, and quality sleep, have been demonstrated to enhance not only metabolic well-being but also to alleviate symptoms of depression and anxiety. Additionally, mindfulness exercises, keeping a journal, and formalised stress management skills can contribute to enhanced emotional resilience. Peer support groups, both online and offline, provide that vital sense of belonging that is so important in dispelling the silence many women experience.However, lifestyle interventions have their boundaries. Physicians warn against writing off mental health issues as “secondary.” If sadness, anxiety, or disordered eating habits persist, early consultation with a psychologist or psychiatrist is essential. Established treatments, such as cognitive behavioural therapy (CBT), along with medical treatment for PCOS, can significantly enhance quality of life.PCOS is a body-wide health problem. Treating the emotional aspect is a necessary component of the treatment. Lifestyle changes are beneficial, but professional intervention should never be postponed if symptoms become overwhelming. Getting help is not a weakness; it is the beginning of regaining both body and mind.Dr Sweta Kumar – Consultant, Obstetrics and Gynaecology at Surya Mother and Child Super Specialty Hospital, Pune