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Polycystic ovary syndrome (PCOS) is the most common hormone-related problem in people with ovaries. It impacts 10% to 13% of women. That’s according to the European Journal of Endocrinology.

Also known as polycystic ovarian syndrome, PCOS causes a wide range of physical and emotional symptoms. These include irregular periods, excessive hair growth, and metabolic issues like insulin resistance. Often overlooked, however, are the mental health challenges associated with PCOS.

Let’s look at how PCOS affects mental health. We’ll also go over helpful ways to cope with mood swings, anxiety, and depression.

What Is PCOS?

PCOS is a condition marked by hormonal imbalance and metabolic problems. It can affect menstrual cycles, fertility, and emotional well-being.

What are the physical symptoms of PCOS?

First, let’s consider some PCOS symptoms that are outwardly visible. These may include:

• Acne.
• Hirsutism — Excessive hair growth in a “typically male” pattern.
• Male-pattern baldness — Hair loss at the head’s hairline and top.
• Obesity or overweight.

Many people with PCOS struggle to maintain a healthy weight. They may gain weight easily and struggle to lose it, particularly around the abdomen. Some call this stubborn abdominal fat “PCOS belly”

Other physical symptoms aren’t always visible to others. Doctors or the patients themselves may detect them.

Irregular menstrual cycles are an excellent example. Some people with PCOS experience infrequent or absent periods. Others deal with very heavy or prolonged bleeding.

Many people with PCOS also have insulin resistance. Their insulin hormone can’t properly regulate blood sugar, increasing blood sugar levels. Insulin resistance increases the risk of type 2 diabetes and other metabolic conditions over time.

What is the link between PCOS and mental health?

Some people with PCOS may think their mood symptoms are “just PMS.” Have you ever searched “premenstrual mood swings” or “PMS meaning” online? If so, you’ve probably come across terms like “premenstrual dysphoric disorder (PMDD).”

PMDD and premenstrual syndrome (PMS) do cause mood disturbances. But they aren’t always the leading cause of mental health problems in people with PCOS.

Compared to women without PCOS, those with the condition often experience higher rates of mental health conditions. These include anxiety, depression, and fatigue, among others.

A 2024 study in the journal Scientific Reports supports this pattern. Researchers compared non-obese people with PCOS to their non-obese peers without the condition. Those with PCOS experienced more symptoms of anxiety and depression.

Excessive fatigue is a common symptom of PCOS that affects mental health. Scientists don’t fully understand the causes of PCOS fatigue. It likely stems from several factors, including:

• Hormone imbalances.
• Disturbed sleep.
• Insulin resistance.
• The stress of living with a chronic health condition.

PCOS also affects sleep quality. People with PCOS have higher rates of obstructive sleep apnea. This limits sleep quality.

But even those who don’t have apnea report more sleep disturbances than people without PCOS.

Some people with PCOS struggle with body image concerns. Weight gain, acne, and atypical hair growth can negatively affect their self-esteem. In people with PCOS, poor body image strongly relates to depression.

How Do I Know if I Have PCOS?

Health care providers may diagnose PCOS with several different tools. However, the Rotterdam criteria are the most common and widely accepted. These criteria state that a patient must have at least two of the following three conditions:

1. High levels of androgens (the hormones associated with “typically male” sex characteristics).
2. Irregular or absent ovulation (the release of an egg from an ovary).
3. Polycystic ovaries — the presence of many fluid-filled sacs, or cysts, on one or both ovaries.

Note that despite the name of the condition, some people with PCOS don’t have cysts on their ovaries.

What Does PCOS Treatment Look Like?

Lifestyle interventions, which include daily habits such as exercise, dietary choices, and sleep patterns, are the gold standard for managing PCOS symptoms.

Exercise

Exercise, particularly high-intensity workouts, can improve mental health symptoms. A 2023 study investigated high-intensity interval training (HIIT) in women with PCOS. The participants who performed HIIT for three months reported reduced depression and anxiety.

Moderate-intensity aerobic exercise didn’t have the same strong effect on depression and anxiety, but it did reduce stress. A 2023 systematic review showed that moderate-intensity exercise regulated menstruation in people with PCOS. About 35% of the research participants also experienced ovulation.

Resistance training can improve insulin sensitivity in people with PCOS. However, these positive effects decline after three days, so consistency is key. Therefore, people with PCOS should strength-train two to three times per week.

Nutrition

Nutrition can help people with PCOS manage many elements of the condition. A 2024 randomized controlled trial investigated a combination diet called “MIND.” MIND combines the Mediterranean diet and the DASH diet for high blood pressure.

Both diets emphasize fruits, vegetables, and whole grains and limit the intake of highly processed foods. MIND provides anti-inflammatory and antioxidant effects that appear to help conditions like PCOS.

After eight weeks on MIND, study participants reported lower depression and anxiety levels.

Cognitive-behavioral therapy

Cognitive behavioral therapy (CBT) can help reduce depression and anxiety in people with PCOS. A 2023 randomized controlled trial provided eight sessions of CBT to people with PCOS. The women receiving CBT reported lower anxiety and depression levels than those who didn’t receive counseling.

How Can I Treat PCOS Fatigue?

Much like managing other symptoms, treating PCOS fatigue requires a multipronged approach. Lifestyle interventions are the first-line approach. For example, a regular exercise routine can help reduce fatigue related to PCOS.

PCOS experts also recommend addressing sleep disturbances. This typically includes screening for conditions such as obstructive sleep apnea, and improving sleep hygiene habits can help, too.

CBT can help people with PCOS learn how to manage fatigue symptoms.

Can I Still Get Pregnant if I Have PCOS?

PCOS is a leading cause of female infertility. For those who wish to have children, this can feel very stressful and upsetting.

Fortunately, many people with PCOS can conceive with the help of lifestyle changes, fertility treatments, or both. For example, a 2023 systematic review found that moderate-intensity exercise improved menstrual and reproductive health in people with PCOS.

Though there isn’t yet a cure for PCOS, lifestyle interventions can help people with the condition manage their symptoms. With the right support and strategies, people with PCOS can lead full and healthy lives.

Editor's Note: This article was originally published on May 28, 2025, and was last reviewed on June 11, 2025.