The Link Between PCOS and Depression

Polycystic ovary syndrome is the most common endocrine disorder and is a chronic hormonal condition that is caused by an imbalance of reproductive hormones, and there are a variety of factors behind why women with PCOS may feel depressed. 

Insulin Resistance

On a clinical level, insulin resistance could be one reason. Approximately 70% of women with PCOS are insulin-resistant. Elevated blood sugars and insulin resistance are tied to depression, however, scientists aren’t entirely sure why. 

A 2021 Stanford Medicine study found that people with insulin resistance had double the risk of having depression. A 2023 study published in the Biochemistry and Biophysics report also found a link, with insulin resistance promoting neuroinflammation. 

Insulin resistance occurs when the cells in the muscles, fat, and liver no longer respond to insulin, which causes blood sugar levels to rise. The pancreas must produce more insulin to move glucose. The body isn’t able to keep up and produce enough insulin, resulting in the excess sugar being stored as fat. 

Inflammation and Stress

PCOS can often cause inflammation in the body like high cortisol which is linked to increased stress and depression. High cortisol and insulin resistance can both promote weight gain, which in turn, can lead to stress over appearance. 

People with PCOS have elevated levels of androgens that could possibly contribute to mood changes. If androgens remain elevated for a long period of time, symptoms like acne and excess body hair may appear. This could be another factor that can contribute to stress and depression. 

Infertility

Many women with PCOS are depressed over their inability to have children. Treating infertility can also worsen depression as it puts strains on finances and can also be unsuccessful. The stress on the body can physically exhaust a woman when trying to conceive. 

Moreover, PCOS can increase pregnancy complications and can lead to: 

• Gestational diabetes
• High blood pressure
• Preeclampsia
• Preterm birth
• C-section delivery due to high blood pressure and obesity

Recovering or dealing with this type of complication can cause someone to experience more amounts of stress or depressive symptoms as well. 

PCOS and Other Health Conditions

In addition to depression, research has found that PCOS is also linked to obsessive-compulsive disorder (OCD), bipolar disorder, autism spectrum disorder, eating disorders, and sleep disorders. 

Other health conditions related to PCOS include diabetes, high blood pressure, cardiovascular disease, endometrial hyperplasia, and endometrial cancer. 

If you believe you have PCOS, or if your doctor is concerned, testing will involve a pelvic examination, a physical examination, a blood test, or an ultrasound to help with the diagnosis. 

Treatment for PCOS and depression

In order to get depression under control, it’s important to treat PCOS, too. While there is currently no cure for PCOS, patients can manage their conditions. 

Birth Control and Diet

Treatment for PCOS includes birth control pills for hormonal imbalances or eating a more nutritious diet for insulin resistance. While there isn’t much scientific research linking mood and diet for people with PCOS, some studies have found that the Mediterranean diet, which consists of fish, vegetables, and legumes protects people from depressive symptoms.  In a 2023 study in Scientific Reports, women with PCOS who exercised had lower symptoms of depression than women with and without PCOS. 

Therapy

In addition to lifestyle changes, treating both PCOS and depression can include talk therapy to discuss the changes you’re feeling from the condition and how you’re coping.

Medication

Antidepressants for depression are common, however, some antidepressants can cause weight gain and could lead to more detrimental health impacts. Sertraline, an SSRI, is commonly prescribed to women with PCOS, however, there needs to be more research done on how medication can treat the condition’s side effects. 

Other medications include metformin, which is typically used to treat type 2 diabetes but can regulate and lower insulin and blood sugar levels. It’s also been found to improve ovulation and regulate periods. 

Supplements

If you’re looking for more holistic measures, taking omega-3s like a fish oil supplement has been linked to improving moods. Acupuncture has been known to increase blood flow and reduce the number of ovarian cysts in PCOS patients. It can also be a stress reliever. 

Overall, finding support if you have PCOS is crucial. Whether it’s for mental or physical support, the condition can wreak havoc on your body and your mind. If you’re struggling with moderate or severe symptoms of PCOS, visit your healthcare provider for more information about how to move forward and find the care you need.