Depression and Anxiety in Polycystic Ovary Syndrome: Etiology and Treatment

Abstract

Women with PCOS have increased odds of depressive symptoms (OR 3.78; 95% CI 3.03-4.72) and anxiety symptoms (OR 5.62; 95% CI 3.22-9.80). Obesity, insulin resistance, and elevated androgens may partly contribute to this association. Therefore, in addition to established treatment options, treatment of PCOS-related symptoms with lifestyle modification and/or oral contraceptive pills may be of benefit. Screening for anxiety and depression is recommended in women with PCOS at the time of diagnosis. The exact etiology for the increased risk in PCOS is still unclear. Moreover, there is a paucity of published data on the most effective behavioral, pharmacological, or physiological treatment options specifically in women with PCOS.

<p>Metformin Improves the Depression Symptoms of Women with Polycystic Ovary Syndrome in a Lifestyle Modification Program</p>

“…The need for novel information is critical because at present there is a perceivable paucity of data on pharmacological treatment options for the management of depression and anxiety among patients with PCOS. 18…”

“…[14][15][16] Among the factors contributing to the impairment of HRQoL is the frequent presence of poor self-perception and psychiatric disorders, such as anxiety and depression among women with PCOS. [17][18][19][20] It has been suggested that the prominent symptoms of the syndrome, such as obesity, infertility, acne, and hirsutism cause mental stress and might be responsible for the higher prevalence of psychiatric illnesses in this group of patients. 4,21 The higher likelihood of psychiatric disorders among women with PCOS might also be due to the hyperinsulinemia, which occurs because of insulin resistance and obesity.…”

What has sex got to do with it? The role of hormones in the transgender brain

“…Conversely, androgens have varying impact on brain and behavior across the female lifespan and have been well-studied in cis-gender males and females [64]. Increased levels of androgens have been linked to increases in irritability, hostility, and clinical mood disorders in women [64,65]. For example, higher free testosterone levels have been associated with premenstrual syndrome and depression in normally cycling women, with anger and depression among pregnant and postpartum women and with increased hostility in post-menopausal women [64].…”

“…PCOS affects almost 15% of women of reproductive age [66] and is characterized by chronically high free testosterone levels and low levels of progesterone and estradiol from puberty onward [64]. Females with PCOS are at substantial risk for psychological, metabolic, reproductive, and cardiovascular abnormalities [67,68], such as acne, obesity, type 2 diabetes, heart disease, and mood disorders like depressive, bipolar, and anxiety disorders, as well as lowered health-quality of life [65,[69][70][71][72][73][74].…”

Polycystic Ovary Syndrome: A Multifaceted Enigma

“…PCOS patients have increased risk of chronic metabolic derangements such as hypertension, hyperlipidemia, obesity, and diabetes mellitus which ultimately lead to long term complications such as cardiovascular and renal disease. Patients also have increased risk of depression and anxiety, further affecting their quality of life [18]. Additionally, there is an increased risk of certain cancers, such as endometrial cancer, likely due to anovulation and unopposed estrogen effects.…”