Share on PinterestExperts emphasize the importance of monitoring mental health for individuals with PCOS. Vasily Pindyurin/Getty ImagesPCOS is a prevalent health issue that can result in infertility, inconsistent periods, abnormal hair growth, acne, and weight gain. New findings propose that women with PCOS have an eightfold increased chance of attempting suicide. While PCOS is a challenging condition to live with, there are available treatments to manage it.People with polycystic ovary syndrome (PCOS) have an eightfold higher risk of attempting suicide compared to those without the condition. This is according to a recent study published in the Annals of Internal Medicine that revealed the heightened risk across different age groups, including adolescents, young adults, and older adults with PCOS.“Individuals diagnosed with PCOS face an increased susceptibility to suicide attempts and self-harm relative to those without the condition,” wrote the study authors. “Challenges associated with fertility and the management of PCOS symptoms could further compound existing mental health challenges,” they added. “Women with PCOS face stigmas due to obesity, hirsutism, menstrual irregularities, and infertility… The stigma linked to PCOS seems to be rooted in societal expectations, further adding to the burden of this condition.”PCOS affects 6% to 12% of women of reproductive age in the United States. It is a leading cause of infertility in females, and its implications extend beyond childbearing years. Individuals with PCOS may develop various health complications, including diabetes, heart disease, high levels of “bad” cholesterol (LDL), low levels of “good” cholesterol (HDL), high blood pressure, sleep apnea, and stroke.Those with PCOS also face a higher risk of psychiatric conditions such as personality disorder, schizoaffective disorder, anxiety disorders, and depressive disorders.Experts point out that the connection with mental health challenges could stem from various factors. Dr. Sun Kim, an associate professor of medicine in endocrinology at Stanford Medicine, explained, “At this time, the exact cause is unknown and it is likely multifactorial. The higher androgens may play a role. Many women with PCOS also have insulin resistance, which also can increase mental illness such as depression. Women with PCOS may have higher rates of obesity and infertility, which are also associated with depression/anxiety. The physical changes associated with PCOS may also increase depression/anxiety.”The study analyzed data from almost 19,000 women diagnosed with PCOS between 1997 and 2012, sourced from the Taiwanese nationwide database. Even after adjusting for other factors such as demographics, physical conditions, and psychiatric co-morbid conditions, those with PCOS had an 8.47-fold increase in the risk of attempting suicide compared with control groups. In a subgroup of adolescents, the data showed a 5.38-fold increased risk of suicide attempts. Individuals with PCOS have elevated levels of androgens, which are male hormones present in females. This hormonal imbalance can impede ovulation. Many individuals with PCOS also experience insulin resistance.Experts highlight that this combination may lead to several symptoms that can impact the mental well-being of those living with PCOS. Dr. G. Thomas Ruiz, an OB/GYN and the head of OB/GYN at MemorialCare Orange Coast Medical Center, explained, “If you think about the disorder itself… you could see how that medical disorder could create psychological stress. The basic challenge [can be that] you’re overweight… You’re a woman that may be growing a beard. You’re not getting periods. And it’s like this wicked cycle because of the high insulin and you try to do things to lose weight and you don’t lose weight. And what if you want to get pregnant? Well, you can’t get pregnant if you’re not ovulating.”“It’s a tough medical condition and if your medical condition is a chronic medical condition, that in and of itself can lead to a reactive depression,” added Ruiz.Experts note that addressing the mental health impacts of PCOS can be challenging. Dr. Kim expressed, “As an endocrinologist, I find being able to help people (with or without PCOS) find mental health services is challenging. Of course, mental health is important. However, it is challenging to provide mental health services in general. Women with PCOS often seek care from endocrinologists and gynecologists and these providers are not equipped to fully manage their mental health.” Dr. Kim emphasized the importance of increasing awareness about the mental health challenges associated with PCOS and encouraging those with the condition to seek support.“Acknowledging and discussing the risks are important. Having family/friend support is also helpful. Next step would be to discuss with their primary physician regarding mental health resources,” she recommended.PCOS has no cure, but its symptoms can be managed through weight loss, a healthy diet, and exercise. Some medications can also aid in promoting ovulation, reducing hair growth, and managing acne.Ruiz highlighted the initial step in mitigating the mental health impact of PCOS, stating, “Seek medical care and treat the condition so that you can control it. If you can control a woman’s insulin levels with PCOS, she will often start to ovulate spontaneously. And if you can control their insulin levels and establish weight loss, that’ll typically eventually lead to normal ovarian function.”“And once you have normal ovarian function, you can start treating the other issues,” Ruiz added. “And if you become ovulatory and you’re trying to get pregnant, now you can get pregnant. By focusing on treating the condition and managing the condition, the patient will likely start to feel better about themselves because they’ll effectively see body image changes, which may be leading to their depression.”
