Polycystic ovarian syndrome (PCOS) is the most prevalent endocrine condition affecting women in reproductive age. Symptoms include amenorrhea, hirsutism, obesity, infertility, acne vulgaris, and androgenic alopecia. PCOS negatively impacts a woman’s identity, mental health, and quality of life (QOL), yet it remains underexplored in India. Understanding symptoms from the patient’s perspective is crucial for managing PCOS effectively. To improve patient outcomes, we need to identify which symptoms have the most significant impact. The research on PCOS’s psychological effects in India is inconsistent and unclear, highlighting an important information gap given the high prevalence and considerable physical and psychological toll of the condition.
PCOS affects individuals psychologically beyond its physiological aspects. It is a complex medical condition that includes endocrine abnormalities, such as excess androgen, insulin resistance, and irregular menstruation. Compared to the general population, women with PCOS have higher rates of anxiety and depression. Both international and Indian guidelines recommend considering psychological aspects and screening all women with PCOS for depression and anxiety. However, only four Indian studies have been published on this topic. While physical symptoms often dominate treatment focus, addressing the psychosocial components of PCOS is essential for comprehensive, patient-centered care. Managing stigma, overcoming cultural beliefs, and navigating the complex interactions between physical and mental health are crucial for those with PCOS.
Understanding the Emotional Wellbeing of PCOS Patients
We frequently hear the term “mood swings”. Mood swings occur when you experience rapid changes in mood, such as laughing one minute and crying the next without an apparent reason. Persistent and recurrent mood swings may diminish your quality of life and require professional assistance.
Biopsychological Factors Affecting Mood
Menstruation in women is regulated by hormones like progesterone, estrogen, and FSH. Imbalances in progesterone and estrogen levels can alter mood. Serotonin, a neurotransmitter responsible for mood regulation, if deficient, can lead to sleep difficulties, excessive thinking, heightened anxiety, and mood swings, contributing to irritability and other affective disorders.
Depression
Depression results from persistent mental exhaustion and a negative mood due to a lack of mental energy. Symptoms include a loss of interest in previously enjoyed activities, changes in eating and sleep patterns, weight fluctuations, and reduced social engagement. Cognitive distortions, which are flaws in thought processes, can also affect interpersonal relationships.
Anxiety
Anxiety is characterized by uncontrollable worrying and persistent anxiousness, often focused on worst-case scenarios, which increases stress levels. Physical symptoms of anxiety include headaches, light-headedness, nausea, and gastrointestinal issues such as constipation or irritable bowel syndrome (IBS).
Impact of Depression and Anxiety
Physically: Low serotonin levels can influence appetite, leading to either increased or reduced food intake, excessive or insufficient sleep, weight changes, and other behaviors that impact physical health.
Psychologically: Consistently low mood and poor mood regulation can lead to a lack of motivation, impacting one’s sense of achievement and self-worth.
Socially: Low mental energy can decrease the desire to socialize, affecting relationships and causing conflicts, especially in the workplace.
Stress
Stress is common among people with PCOS. According to the National Institute of Mental Health, stress is a significant risk factor for depression. Elevated stress levels can increase cortisol, which is linked to major depressive disorders. Cortisol affects immune system regulation, metabolic processes, and inflammatory responses, exacerbating depression. Stress-induced cytokines can also contribute to increased inflammation.
Self-Image
Body image refers to how someone perceives their body. Factors influencing body image include health perceptions, beauty standards, physical fitness, body size, and personal beliefs. PCOS can alter physical appearance, challenging conventional notions of femininity and self-worth. Many women with PCOS report feeling less physically appealing and healthy, which can be emotionally challenging.
Impact on Relationships and Infertility
PCOS can affect relationships, impacting romantic and family ties. Fertility concerns are common among those with PCOS and can cause emotional distress and relationship strain. Addressing the emotional toll of PCOS on both individuals and their partners is crucial for providing comprehensive support and fostering open communication.
Measures to Help Individuals with PCOS
- Public Awareness Campaigns
- Empowering individuals through knowledge
- Peer support groups
- Lifestyle modification training
- Integrating psychosocial support into PCOS care
Ways to Self-Regulate PCOS
- Maintain a schedule.
- Recognize and sit with your emotions.
- Pay attention to your mental state.
- Reduce screen time.
- Engage in physical activity.
- Spend time in nature and sunshine.
- Connect with your creative side through activities like writing, art, dancing, or music. The focus should be on expression rather than creating a perfect product.
- Write yourself a note for self-reflection and encouragement.
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