Can PCOS Cause Anxiety?

PCOS (polycystic ovary syndrome) is among the common causes of female infertility, affecting approximately 1 in 10 women of childbearing age in the US.¹

Women with PCOS often have hormonal imbalances and issues with their metabolism, which can affect their overall health. 

Some studies have linked the condition to anxiety, depression, and decreased quality of life.²

But does PCOS cause anxiety? Let’s examine the connection between PCOS and anxiety. 

What is PCOS?

PCOS is a hormonal disorder affecting women of childbearing age. Women with this syndrome often have higher levels of androgens and are insulin resistant.

While the exact cause of PCOS is still unclear, some evidence links the syndrome to genetic and environmental factors.³

Symptoms of PCOS include:

• Irregular periods

• Acne

• Hair loss 

• Hirsutism (excessive hair growth in a male-like pattern)

• Weight gain

• Anovulation (you stop ovulating)

• Ovarian cysts (fluid-filled sacs on one or both ovaries)

In addition to these symptoms, PCOS may affect your mental health. 

What is anxiety?

Anxiety is an emotion or feeling of fear, dread, and uneasiness that varies from mild to severe. 

This disorder causes you to respond to certain situations or things with apprehension. It's normal to experience occasional anxiety in life. However, it may sometimes be extremely overwhelming and a cause for concern.

Some physical signs of anxiety include: 

• Sweating

• A pounding heart

• Restlessness

Your doctor may diagnose a medical disorder if you have high anxiety levels. Anxiety disorders may cause symptoms that interfere with daily activities like schoolwork, job performance, and relationships. 

Can PCOS cause anxiety?

According to a community-based study published in the Journal of Psychological Medicine, women with PCOS report increased anxiety levels.⁴ The study found that about 50% of women with PCOS have a high prevalence of anxiety symptoms compared to 39.2% of women without PCOS.

According to the study, stress is the most significant contributor with links to increased anxiety levels. Women with PCOS were still more likely to experience anxiety after adjusting for body mass index, socio-demographic factors, and infertility.

In another study, the authors conducted a systematic review and meta-analysis to assess the rate of comorbid psychiatric disorders in women with PCOS.⁵ Five studies reported a higher rate of anxiety symptoms in those with PCOS than in women without the syndrome. The study concluded that anxiety symptoms are more prevalent in women with PCOS.

Another systematic review and meta-analysis found that women with PCOS had increased odds of anxiety symptoms and severe anxiety. The researchers matched the subjects on BMI, and women with PCOS still had higher odds of anxiety symptoms. 

We still need more robust, conclusive research to establish the connection between PCOS and anxiety.

What links PCOS to anxiety?

The connection between PCOS and anxiety is still unclear. Researchers are yet to identify why those with PCOS experience an increased risk of anxiety. 

However, there are some possible explanations, including:

Symptoms

PCOS causes various symptoms, including irregular periods, infertility, and hirsutism. These symptoms can sometimes cause anxiety in women. A study revealed that hirsutism is the most distressing PCOS symptom that may cause anxiety.⁶

Moreover, people with PCOS may feel anxious and frustrated about their symptoms. For instance, some may be anxious about their weight, excess facial and body hair, and ability to become pregnant. They may also be concerned about their lack of control over their bodies and health—which could cause anxiety.

Also, the symptoms you find distressing will depend on your culture and personal values. Still, there’s an increased prevalence of anxiety symptoms in those with PCOS, regardless of the syndrome's symptoms. 

Hormonal imbalance/differences

Insulin resistance is a common symptom in people with PCOS. Your body uses insulin as a bridge to move glucose from your bloodstream into your cells, so they can use it for energy. When you’re insulin resistant, your cells don’t respond properly to insulin, leaving glucose in your bloodstream. This can cause issues such as weight gain and a higher risk of type 2 diabetes. 

Although we still need further research, people with greater insulin resistance may record more anxiety symptoms.

Moreover, studies believe higher levels of DHEAS (an androgen hormone) may increase anxiety risk in women with PCOS.⁷

Brain chemicals

People with PCOS who have anxiety may have reduced levels of certain neurotransmitters. These chemicals relay information throughout the nervous system and brain. Serotonin is a neurotransmitter that plays an essential role in controlling anxiety.

Therefore, people with PCOS and lower serotonin levels or other essential neurotransmitters may experience more anxiety symptoms.

PCOS and anxiety complications

Anxiety can have severe implications, whether caused by PCOS or any other cause. It can cause or worsen other physical or mental conditions.

Some complications that may result from PCOS and anxiety include:

• Depression

• Substance misuse

• Digestive or bowel problems

• Social isolation

• Headaches and chronic pain

• Trouble sleeping

• Problems functioning at work or school

• Poor quality of life

How to treat anxiety in PCOS

Certain levels of anxiety are normal, and most people can easily cope with occasional anxious feelings. However, your doctor may diagnose you with an anxiety disorder if levels are high.

It's always best to talk to your doctor if you're anxious or notice mood changes. Your healthcare provider will discuss and recommend various treatments.

Here are some ways to treat anxiety in PCOS:

Keep physically active

An active lifestyle may boost your mental health. Regular exercise reduces stress, improves mood, and enables you to stay healthy.

You might want to devise a routine for daily physical activity to minimize the symptoms of anxiety caused by PCOS. This could be running, yoga, or simply walking around the block.

Medication and supplements

There are no specific medications for treating anxiety in people with PCOS. However, many anti-anxiety medications may help your anxiety symptoms. 

Your healthcare provider may prescribe certain antidepressants to treat anxiety. In limited circumstances, they may prescribe sedatives for short-term relief of anxiety symptoms.

Complementary and alternative therapies

Some small studies have reported improvements in anxiety symptoms for people with PCOS who receive acupuncture or practice mindfulness for 30 minutes daily.

Also, yoga practice with guided relaxation and breathing exercises may improve anxiety symptoms in people with PCOS.

The lowdown

PCOS is a common syndrome affecting about 1 in 10 women. It is also among the common causes of infertility in women. Symptoms of PCOS include irregular periods, weight gain, and acne.

Multiple studies have linked PCOS to anxiety. Most studies found that women with PCOS have a high prevalence of anxiety symptoms. This is due to hormonal imbalances and brain chemicals, among other causes. However, we still need more research to establish the connection between PCOS and anxiety.

Treatment for PCOS-related anxiety includes physical activity, medication, and complementary therapies like yoga and meditation.

Frequently asked questions

How do I control my PCOS anxiety?

The best way is to seek treatment for PCOS if it's the cause of your anxiety. You can also try anxiety-reduction remedies like exercise and meditation.

Can PCOS mess with your emotions?

Having PCOS can be stressful due to symptoms and complications, like infertility. PCOS also has links to changes in neurotransmitters, which are key to regulating your emotions. So yes, PCOS can interfere with your emotions. 

How prevalent is anxiety in PCOS?

Research has found that 26.1% of women with PCOS have symptoms of anxiety and 52% have depression symptoms.⁸ Another study found that 50% of those with PCOS have a high prevalence of anxiety symptoms.⁹