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title: PCOS and Anxiety

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# PCOS and Anxiety


"I feel tired right after waking up in the morning. Even before the day begins, I want it to end again. I want to come back to my room and just stay here. Looking in the mirror, I see someone who is not the ideal woman society desires. The acne and the extra weight have become the story of every day, as if there is nothing beyond superficial beauty standards." These are common complaints verbalized by women with PCOS every day.

# What causes PCOS?
Polycystic Ovary Syndrome (PCOS) is more common than you often perceive it to be. It affects around 6–13% of women of reproductive age globally. It is a significant proportion, yet many women live with it silently. They are not aware of how deeply it affects their physical and mental health.

PCOS creates a hormonal imbalance in your body. Your ovaries produce excessive levels of androgens and show insulin resistance. These imbalances can interfere with ovulation, meaning your ovaries may not release eggs regularly as they are supposed to. As a result, small fluid-filled follicles develop along the ovaries. These follicles contain immature eggs, known as cysts.

Another key feature of PCOS is an imbalance between estrogen and progesterone. When ovulation does not occur regularly, progesterone is not produced enough, while estrogen continues to remain at higher levels. This state is often referred to as estrogen dominance. It can lead to many physical symptoms of PCOS and significantly cause mood disruptions and anxiety.

# PCOS Symptoms
* Disrupted menstrual cycle: You might notice that some months your period lasts for three to four days, while sometimes it's longer than seven days. Sometimes it occurs at the beginning of the month, sometimes it occurs in the middle of it, and at times it doesn't occur at all.
* Weight issues: You may often crave food. You notice rapid weight gain. Even when you try to manage your weight, the efforts fail.
* Skin issues: Your skin may become oilier and acne more persistent.
* Hair issues: After waking up, you may notice too many strands of your hair on your pillow, or every time you comb, there is a patch of hair in it. You can feel your hair getting thin day by day. Unwanted facial hair may also show up.

# Can PCOS cause [anxiety](https://https://gabapsychiatrist.com/anxiety-treatment/)?
PCOS is caused by an imbalance of hormones. Sufferers have estrogen dominance with relatively low levels of progesterone in comparison to estrogen. The imbalance contributes to anxiety, especially before menstruation. In some cases, medication strategies are used to help bring balance to your hormones.

# Progesterone and anxiety
PCOS disrupts the way your body functions. Low levels of progesterone are produced. Progesterone normally helps calm your brain by supporting GABA (a neurotransmitter that regulates stress and mood). Hence, low levels of progesterone mean less calming effect. This makes us more likely to be anxious. Your health care provider may suggest medication strategies when symptoms are severe.

Progesterone not only regulates your menstrual cycle but supports your sleep and emotional stability as well. You may face trouble sleeping or staying asleep. Poor sleep keeps your nervous system in alert mode. You may find it difficult to cope with your daily stress. Persistent sleeplessness makes you irritated. Medication strategies are often considered to improve your sleeplessness. Without enough sleep, your patience often runs short with people and makes you snap at your family or friends.

Poor sleep increases your stress hormones like cortisol and adrenaline. When you are in a constant fight or flight state, you feel further anxious and drained.

In a healthy menstrual cycle, estrogen and progesterone work in balance. Estrogen stimulates energy and growth, while progesterone provides a calming effect. In PCOS, this balance is disrupted. Your estrogen remains high while progesterone stays low. Without progesterone’s calming influence, estrogen’s stimulating effects can become overwhelming. It will make your anxiety and irritability worse.

# Estrogen and anxiety
Estrogen regulates neurotransmitters like serotonin, dopamine, and norepinephrine. They control your mood and stress responses. When estrogen levels are persistently high or fluctuate, as seen in PCOS, this regulation is disrupted. As a result, your emotional stability weakens, and you become more sensitive to stress. You may find yourself becoming irritated more often. This is particularly noticeable during PMS (premenstrual syndrome). During hormonal fluctuations, medication strategies often help stabilize your mood.

# Insulin level and anxiety
People with PCOS don't process their insulin properly. High levels of insulin make your ovaries release male hormones like androgens. These hormones suppress ovulation and lead to other PCOS symptoms as well. Insulin resistance disrupts your neurotransmitter functions.

High insulin levels disrupt the development of serotonin and dopamine, the hormones managing your mood and emotional stability. Medication strategies that address insulin resistance can also improve your mood. You can get moody. You may not enjoy what you previously enjoyed, like going out with friends or hitting the gym.

# Androgen and anxiety
High levels of androgen keep your ovaries from releasing eggs. This results in irregular menstrual cycles. You may observe facial hair that you normally notice on men. This is the hormone responsible for excess hair growth.

Research shows that androgens can influence your brain's stress regulation systems and alter emotional pathways. They contribute to mood disturbances and make you further anxious. Women with PCOS often have chronic low-grade inflammation, which is linked to depression and anxiety.

# Mental effect of PCOS
The impact of PCOS is not limited to your physical health. The long-term condition takes a toll on your mental and emotional well-being.

Most of the symptoms of PCOS are visible to others. They are difficult to hide, even if we try. "Did you gain weight?" might seem like a simple question, but the heaviness it makes you feel is anything but simple. Knowing that you are trying to lose weight, yet you can't see the effect, and then others ask such questions. It makes you feel exposed.

You may constantly worry that your physical appearance warrants unwanted attention. You may feel embarrassed and choose to avoid hanging out with others. You feel like wanting to build walls around you so that you can protect yourself from others' scrutiny.

PCOS is a major cause of infertility, but before that happens, the fear of the uncertain consumes you. Your thoughts circle around whether you will be able to have a child or build a family, and are full of "what ifs." The fear of the future takes your present away.

PCOS creates an imbalance in your hormones. These hormonal changes and sleep disturbances trigger a stress response in your nervous system. Managing emotions becomes difficult and increases your social anxiety.

You may feel tired, yet you can't rest because it affects your sleep as well. You find the presence of your loved ones a weight, a burden. Instead of looking forward to meeting them, the entire thing may feel draining. You just want to distance yourself from others.

# PCOS treatment
Lifestyle changes are a great way to manage PCOS. However, remember, you do not have to go through this journey alone. If your anxiety feels unmanageable, reaching out to a professional healthcare provider can be a life-changing step. They can help guide you in your journey.

An integrative psychiatrist can play a crucial role in managing anxiety related to PCOS by focusing on your overall well-being. They do not treat anxiety alone. They address hormonal health, nutrition, and psychiatric concerns together.

Many [integrative psychiatrists](https://https://gabapsychiatrist.com/integrative-psychiatrist/) and mental health professionals today offer online consultations. This allows women with PCOS to seek timely support without any wait.

Managing PCOS and anxiety is not only about treating symptoms. You need to restore your hormonal balance. Supporting progesterone levels and reducing excess estrogen can help calm your nervous system. Over time, it will reduce your anxiety. When this balance is restored, many women notice improvements not only in their menstrual cycles but also in their emotional well-being.

# Medication
* SSRIs and SNRIs
SSRIs and SNRIs can help with anxiety and premenstrual dysphoric disorder (PMDD). PMDD is often more severe in women with PCOS due to the hormonal fluctuations. According to clinical research, SSRIs severely reduce the emotional and behavioral symptoms of PMDD. They include anxiety, irritability, and mood swings.


* Hormone therapy
Optimum PCOS treatment involves regulating the estrogen-progesterone balance. Hormone therapy, for instance, oral contraceptives, helps regulate the menstrual cycle. If you are experiencing anxiety, lower-estrogen contraceptives are often preferred, as higher estrogen levels may worsen anxiety.
Hormonal therapy helps manage your estrogen levels and support progesterone balance. By helping regulate estrogen levels and support progesterone balance, hormone therapy can reduce both physical symptoms and hormone-driven anxiety.
Low-estrogen contraceptive pills are often used to manage your menstrual cycles and lower the estrogen levels. This helps with symptoms like acne and excess body hair. You may witness reduced heavy bleeding and less pain after consuming the pills. The pills can also help with your mood and anxiety.
* Additional supportive medications
Metformin improves your insulin resistance and lowers insulin levels. The diabetes medication helps lower androgen levels. This helps with your acne and facial hair. Metformin can help restart your ovulation.
Mood stabilizers can help with irritability and anger outbursts.
Clomiphene is an oral anti-estrogen medication that you can take during the first part of your menstrual cycle.
Other medications like buspirone and gabapentin can help with premenstrual symptoms, such as pain and irritability.

# Lifestyle changes
* Supplements
Certain foods and dietary supplements help reverse PCOS and enhance fertility in women. They include vitamin D, myo-inositol, magnesium, and selenium. Supplements stimulate the ovary, increase your ovulation, and reduce inflammation. They can have a positive impact on your mood.


* Weight loss
 Weight loss improves insulin sensitivity and supports hormonal balance. Even modest weight loss can help restore your estrogen-progesterone balance. This benefits not only physical symptoms but mental well-being as well


* Exercise
 Exercise is a proven way that helps with anxiety. They help restore your estrogen-progesterone balance. Exercise supports neurotransmitters like serotonin and dopamine. These hormones directly help reduce your anxiety and make you feel better.
 Start with short goals, don't overwhelm yourself. Get out of your negative thoughts, get out of bed, and engage yourself in physical activity. You can also opt for other intense workouts. Exercising not only helps your mood but also manages your weight.
* Meditation and yoga
 Meditation and yoga help you calm your mind and focus your energy. Yoga not only helps reduce anxiety, but it can also decrease testosterone levels and give relief from pain. Meditating will help you improve your positive thoughts and behaviors.

As we understand more about the psychiatric symptoms associated with PCOS some psychiatry clinics are dealing with an integrative approach. Dr Lynn Bornfriend, integrative psychiatrist at [Gaba Telepsychiatry](https://https://gabapsychiatrist.com/) states it is important to condone nutrition and hormones when treating PCOS.' An integrative approach is better than medication alone.' Dr Bornfriend also uses pharmacogenomic testing to optimize strategies.

Living with PCOS and anxiety can feel overwhelming. Small but consistent steps can make a meaningful difference. For many women, medication strategies alongside lifestyle changes can bring better emotional balance. Observe your body and emotions. You can keep track of your menstrual cycle, sleep patterns, mood changes, and anxiety levels.

You must not hesitate to involve a mental health professional if anxiety starts affecting your daily life. Remember, you do not have to go through it alone. By focusing on lifestyle changes and proper medical care, you can manage PCOS and anxiety.

