Are Women With PCOS More Depressed and Anxious?

PCOS (Polycystic Ovary Syndrome) is the most common complex hormonal disorder in women, with a prevalence of 3-22% in India (10% of adults and 20% of adolescents suffer from this problem). The exact cause of PCOS is not clearly known, genetics, environmental factors, lifestyle contributing to this problem.

PCOS is associated with many problems such as cosmetic problems: unwanted hair on the face and body (like men), acne, scalp hair loss, oily skin; weight gain, darkening of the skin; rare or irregular heavy periods; infertility or difficulty conceiving a child; depression and anxiety; diabetes, high blood pressure, high cholesterol; increased risk of uterine cancer in the long-standing disease.

Depression and anxiety are particularly distressing symptoms of PCOS because they sap vitality and make it difficult to seek help and cope. According to studies, the prevalence ranges from 28 to 64% (for depression) and 34 to 57% (for anxiety) in women with PCOS, with suicide rates seven times higher in women, compared to about 19% of those who do not have it. Likewise, significantly more PCOS patients than community controls reported eating disorders (12% vs. 4%) and / or social phobia (27% vs. 2%), which can lead to medical difficulties. , psychological, social and professional. All of these have a negative effect on the sex life of patients.

Depression – Most Common Signs and Symptoms:

Different people can react to depression in different ways.

– Fatigue, low energy levels

– loss of interest in doing things

– Sadness, guilt, low self-esteem

– Impotence, Anxiety

– Sleep disturbances

– Changes in appetite

– Weight fluctuations (also a sign of PCOS)

– Concentration problems

– Ineffective decision making

– Thoughts of suicide

Women with PCOS are at higher risk for depression for a number of reasons:

– The ovaries produce large amounts of androgens.

– Insulin resistance affects about 70%

– Obesity

– Long-term inflammation is linked to high levels of cortisol, leading to stress and depression.

– Infertility issues, weight gain, and skin symptoms (acne, hair loss, and excessive hair growth) can all affect mental well-being.

All women with PCOS should be screened for depression. There are standard questionnaires to do this. Phq 9 is recommended in India.

What are the treatment options?

Lifestyle modifications like exercise, yoga, meditation, healthy eating are recommended for all women with PCOS.

– Consultations by a psychologist.

– Antidepressants for severe depression and women with suicidal thoughts.

Therapeutic choices:

– Cognitive behavioral therapy teaches coping techniques and helps to discover and modify problematic thought patterns.

– Interpersonal therapy is a type of treatment that focuses on solving problems in personal relationships.

– Psychodynamic treatment focuses on identifying and analyzing harmful behavior patterns arising from past experiences, as well as efforts to change them.

– Support groups allow you to meet people in similar situations and gain new perspectives.

This article is written by Dr Chandrika Anand MD, DNB, Consultant in Obstetrics and Gynecology, Fortis Hospital, Nagarbhavi. Director, PCOS Center, South Zone Coordinator Endocrine Committee, FOGSI India.

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