EXCLUSIVE: PCOS and Mental Health: All you need to know about how they are related
Polycystic ovary syndrome (sometimes sadly mentioned as a disease) may be a problem during which a woman’s hormones are out of balance. It can cause problems with one’s menstrual cycle and make it difficult to conceive. If it isn’t treated, over time it can cause serious health problems, like diabetes, heart condition and even cancers!
Most women who have PCOS tend to grow small cysts on their ovaries. That is why it's called polycystic ovary syndrome. The cysts themselves aren't harmful but cause hormone imbalances.
Symptoms of PCOS include:
- Weight gain and trouble losing weight.
- Extra hair on the face and body. Women often tend to get thicker and darker facial hair. Not only this but they also get hair on the chest, belly, and back.
- Thinning hair on the scalp.
- Irregular periods.
- Fertility Problems. Many women suffering from PCOS have trouble conceiving (infertility).
Polycystic ovaries have a large number of follicular cysts which are harmless and can go up to 8mm in size. Women with PCOS have sacs that are often unable to release an egg, leading to the prevention of ovulation. Although more than half of women who have PCOS do not display any symptoms, the condition is commonly associated with irregular periods – most commonly, prolonged or infrequent periods, High levels of male sex hormones (androgens), Small collections of fluid, called follicular cysts, on the ovaries and Insulin resistance, leading to elevated blood sugar levels.
Almost two-thirds of women who have PCOS are insulin-resistant. And for a few reasons, a better percentage of girls with both PCOS and insulin resistance also suffer from depression. According to a study, 27% to 50% of women with PCOS suffer from depression, compared to around 19% of women who do not have PCOS.
One theory is that insulin resistance can affect the body’s way of manufacturing hormones within the future, leading to depression and stress.
Factors that play a key role in affecting the mental health of a patient suffering from PCOS
Patients with PCOS also feel frustrated and anxious about getting pregnant, their body weight, and excess body and facial hair growth.
Two important influencing factors are the person’s values and therefore the culture they sleep in, as these can have a robust impact on which symptoms of PCOS they find distressing.
Women with PCOS who have anxiety or depression can also have lower levels of certain neurotransmitters like serotonin. Serotonin may be a chemical messenger within the systema nervosum that's related to positive feelings. It plays a vital role in a patient who starts to develop depression or anxiety.
While women with PCOS face an increased risk for depression and anxiety, one study showed that women who even have low levels of serotonin and other neurotransmitters report more symptoms of depression and anxiety.
Some patients with PCOS have insulin resistance, leading to higher levels of insulin in the bloodstream. This increased the risk for depression in some studies, while the other studies found no difference. Hence, more research is required to work out the particular situation.
Treatments for PCOS and mental health issues:
A doctor can prescribe antidepressant drugs for patients who want to undertake medication for his or her depression, but the side effects might not be so desirable. Antidepressants that belong to a gaggle referred to as selective serotonin reuptake inhibitors (SSRIs), like sertraline and escitalopram, can cause high levels of a hormone called prolactin to be released. This eventually interferes with the traditional production of other hormones, like oestrogen and progesterone which can cause irregular periods or prevent ovulation.
Supplements & medications
Women with PCOS can also be prescribed supplements or medications for anti-anxiety or insulin aids. Metformin, a diabetes drug, also works best for patients with anxiety symptoms. Key supplements for PCOS patients include omega-3 carboxylic acid from animal oil. It is often taken together with vitamin D, which can also help decrease symptoms of depression and anxiety in these patients.
Change in lifestyle
Patients with depression are advised to switch to low-calorie diets and add exercise to one’s routine which can help with depression but not anxiety. This is facilitated by the discharge of dopamines (the “feel-good” hormone), the pleasure of creating new friends or the reassurance of discipline, and the sense of achievement when you reach your fitness goals.
Alternative therapies are often an excellent add-on to treatments for handling depression and anxiety brought on by PCOS. Women with PCOS can try acupuncture, mindfulness practices, yoga, breathing exercises and meditation to decrease their anxiety.
Women with PCOS who see a rise in facial hair may feel uncomfortable and need to hunt treatment to get rid of it. Laser hair treatment may be a safe and lasting hair-removal procedure, which may help patients feel more confident about their appearance.
To conclude, mental and self-care are essential while dealing with PCOS and its effects on your physical and mental health.
About the author: Dr Tanveer Aujla, Senior Consultant Obstetrician & Gynaecologist, Motherhood Hospital, Noida