Alaina Malik, MHC

PCOS is more closely linked to your mental health than you’d think.

Polycystic Ovary Syndrome (PCOS) is a medical condition that affects 5-10% of womxn of reproductive age in the US population (citation 1). This is approximately 5 million individuals who have a uterus that is impacted by the effects of PCOS. But, there’s more to know about this syndrome than meets the eye - such as its emotional/mental health impact.

PCOS is typically diagnosed by a gynecologist. But, it’s actually a gut issue impacted by hormones (citation 2). The correct doctor to diagnose polycystic ovaries is an endocrinologist. PCOS is popularly written off as a medical condition for many womxn who struggle with or are susceptible to diabetes, obesity, or hereditary PCOS. However, that isn’t entirely true. PCOS can affect any womxn, regardless of her body type or susceptibility to diabetes or obesity, and even if PCOS doesn’t run in the maternal family.

PCOS occurs when the ovaries (located in the lower abdomen to each side of your uterus) and/ or the adrenal glands (located on top of each kidney, responsible for cortisol production - aka stress) begin to overproduce androgen (a hormone that regulates bone density, kidneys, liver, metabolism, sex drive, and fertility). The 2 main factors that influence the ovaries and adrenal glands to overproduce androgen are insulin resistance and adrenal fatigue (citation 5).

1. Insulin: As your body breaks down the food you eat to turn it into energy, it secrets a hormone known as insulin. Insulin specifically turns sugar into energy, which is needed for healthy living (citation 4). When the body experiences insulin resistance, it overflows in the production of insulin to the body. These high levels of insulin prevent routined ovulation from occurring in the body. The ovaries produce their own set of hormones, such as estrogen (citation 6). These higher levels of insulin and stagnation of estrogen can make you feel: fatigued - wanting more sugar after meals to keep you going, needing more caffeine but feeling like it’s never enough, and having hard crashes in energy after lunch. This overproduction of insulin can also make you feel anxious: nauseous, jittery, mentally foggy or spacey, scared of environmental changes, and difficulty managing daily stress.

2. Adrenal Fatigue: Diet-induced inflammation causes dysregulation of the adrenal glands. Inflammation feels uncomfortable to the body, but what’s really going on behind the scenes is that oxygen-containing molecules are overexpanding within cortisol production (citation 7). This means that as you eat food that causes inflammation to the body, there is an overproduction of stress occurring within the body, as well. As the adrenal glands overwork to reduce oxidative stress caused by the inflamed [over expanded molecules filled with extra oxygen] molecules of cortisol, it is believed that the glands experience exhaustion from keeping up with arousal towards the environmental fight-or-flight response of inflammation. This increase in stress production in the body leads to the overproduction of androgens by the adrenal glands influencing PCOS. This increase in stress on the body impacts your mental health by causing anxiety, fatigue, headaches, mood swings, and depression.

The emotional toll on your body caused by PCOS is more significant and important than you’d think. The gut control estrogen, cortisol, and insulin. These are hormones that directly impact your emotions by causing anxiety, depression, social phobias, panic attacks, and stress (citation 3). It can be beneficial to talk to your licensed mental health provider about your diagnosis of PCOS as it can give a better understanding of your overall wellbeing. If the gut isn’t happy, reorganizing mental health care can be helpful to living a holistically healthy and balanced life.

Citations:

1. 5 Myths About Polycystic Ovary Syndrome (PCOS). Pennmedicine.org. (2020, March). https://www.pennmedicine.org/updates/blogs/fertility-blog/2020/march/five-myths-aboutpcos#:~:text=Myth%20%233%3A%20PCOS%20is%20a,among%20women%20of%20reproductive%20age.

2. Polycystic ovary syndrome. Patient Care at NYU Langone Health. (n.d.), from https://nyulangone.org/conditions/polycystic-ovary-syndrome

3. Brutocao C;Zaiem F;Alsawas M;Morrow AS;Murad MH;Javed A; (2018, November). Psychiatric disorders in women with polycystic ovary syndrome: A systematic review and meta-analysis. NCBI.

4. Watson, S. (2021, March). How secreted insulin works in your body. WebMD. https://www.webmd.com/diabetes/insulin-explained#:~:text=Insulin%20is%20a%20hormone%20that,and%20then%20store%20the%20rest.

5. Types of PCOS – what are PCOS symptoms and treatment. Types of PCOS: What Are the Different Types of PCOS | Indira IVF. (2022, April). https://www.indiraivf.com/blog/types-of-pcos

6. U.S. Department of Health and Human Services. (2017). What causes PCOS? Eunice Kennedy Shriver National Institute of Child Health and Human Development. https://www.nichd.nih.gov/health/topics/pcos/conditioninfo/causes#

7. M;, K. N. S. Y. M. (2009). Chronic inflammation and oxidative stress as a major cause of age-related diseases and cancer. Recent patents on inflammation & allergy drug discovery. https://pubmed.ncbi.nlm.nih.gov/19149749/#:~:text=Inflammatory%20process%20induces%20oxidative%20stress,proteins%20impairing%20their%20function%20permanently.