How PCOS impacts women’s mental health

Article originally available on Dazed Digital, written by Serena Smith

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How PCOS impacts women’s mental health

New research shows women with PCOS are at a higher risk of suicide than women without the condition
13 February 2024

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Lola*, 23, was formally diagnosed with polycystic ovary syndrome (PCOS) when she was 18. “But my doctor had mentioned it in passing when I was 16,” she says. “He kind of just dropped the news on me and moved on.”
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Lola says she felt “freaked out” by the news – especially as she realised the condition could impact her fertility. “I don’t plan on having kids anytime soon, but it is something I know I want one day,” she says. When she asked her doctor about how the diagnosis would impact her ability to have children, he laughed, dismissing her concerns. “It’s been quite scary, because I’ve just been left to figure everything out myself.”
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PCOS is a common hormonal condition. The NHS estimates it impacts one in ten women in the UK, while PCOS charity Verity estimates the figure stands closer to one in eight. The condition is characterised by irregular periods, excess androgens (elevated testosterone levels), and multiple cysts developing on the ovaries, with most women discovering they have PCOS in their late 20s. Aside from irregular periods, symptoms can include hirsutism (excessive hair growth), weight gain, acne – and poor mental health.
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Lola says PCOS has certainly negatively impacted her mental health and catalysed issues with her body image. “A lot of women with PCOS tend to put on weight due to issues with insulin resistance,” she explains. “But then more often than not doctors just tell us to ‘lose weight’ as if it’s that simple and will fix all our problems.” She adds that almost every person she knows with PCOS suffers from an eating disorder – herself included. “PCOS just exacerbated an already toxic relationship with my body and food.”
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Lola’s experience isn’t unusual. There is a long-established link between having PCOS and suffering with poor mental health: research published in 2022 found that women with PCOS were 77 per cent more likely to have anxiety, 53 per cent more likely to have an eating disorder, and twice as likely to have depression compared to women without PCOS. Worryingly, a new study led by researchers in Taiwan suggests that people diagnosed with the condition also have an increased risk of suicide attempts, with women with PCOS being 8.47 times more likely to commit suicide than women without PCOS.
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Lola says these findings don’t surprise her. “We underestimate how intense the effect hormonal imbalances have on people,” she says. “It’s like living as a ghost in your body most of the time, just waiting in fear for the next time your body will turn against you.”

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Mariella, 34, is another woman who suffers from PCOS. She began noticing symptoms when she was 16, but was only diagnosed in her late 20s. “My hormones, my mental health, all of it was connected through PCOS and the diagnosis finally confirmed it. It made me feel a little more sane, to be honest,” she says. “I have good and bad days like everyone, but I also have bouts of depressive states along with anxiety at times.” She adds that, like Lola, she struggles most with her body image and disordered eating.
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Katy, 21, had a similar experience since being diagnosed with PCOS in 2020. “My PMS is so bad because of PCOS. I definitely have depressive symptoms that are more extreme than my friends when I’m PMSing,” she says. “I don’t want to get up. I kind of hate everything – it’s like I’m really angry at the world. I know this is quite a common feeling amongst women, but it’s just so extreme. Normally I'm not a very angry person; I’m not like that.” She too has developed disordered eating habits since receiving her diagnosis.
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As aforementioned, PCOS impacts a significant proportion of women in the UK, and the news that women with the condition are at greater risk of suicide highlights how imperative it is for medical professionals to support PCOS sufferers. Yet PCOS remains woefully underresearched. While there’s a lot of speculation surrounding the reasons why there is such a clear link between PCOS and poor mental health – some have suggested that the correlation could potentially be as a result of sufferers grappling with stressful symptoms such as weight gain, acne and fertility issues or due to hormonal imbalances – very little research is presently exploring this issue, resulting in a lack of concrete answers and adequate support for women struggling with PCOS.

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“While I cannot speak for all researchers, research in the area is hampered by lack of funding, and lack of general awareness and recognition of the impact of this condition” –  Dr Sophie Williams

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Dr Sophie Williams is a psychologist at the University of Derby whose research focuses on PCOS. “While we know that women with PCOS are more likely to have depression and anxiety symptoms and disorders than women without PCOS, the causes of this are still uncertain,” she explains. “Research has identified some associations between the types of symptoms a woman with PCOS experiences and the impact on their psychological wellbeing. However, there is also initial research which suggests a potential biological component which could be impacted on depressive and anxiety symptomology.”
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She adds that while steps have been taken in the UK with the Women’s Health Strategy for England, there is still a long way to go. “There is a need for the recognition of the impact of PCOS on mental health, and further research in this area,” she says. “While I cannot speak for all researchers, research in the area is hampered by lack of funding, and lack of general awareness and recognition of the impact of this condition.”

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Help is available for women who are struggling with PCOS, and Dr Williams says she urges anyone experiencing poor mental health to speak to a professional. Symptoms can be managed by taking medications which block the effects of the excess hormones, managing insulin levels, and, of course, mental health support is available through the NHS (although, sadly, waiting lists remain as long as ever). Lola recommends seeking out a female doctor if possible, and adds that she is feeling more optimistic now that she has spoken to someone who is more understanding and “compassionate” than her previous doctor.

Ultimately, though, there is no known cure for PCOS and the exact reasons why the hormonal changes that characterise the condition happen is still unclear. What women really need is for PCOS – and women’s health more broadly – to be adequately researched and treated as seriously as other conditions.

*Name has been changed

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