Polycystic ovary syndrome (PCOS), a reproductive endocrine disorder, affects between 12-18% of the general female population and up to 21% of Indigenous women. PCOS appears to place a high physical and psychological burden on women. The associated metabolic and reproductive features of PCOS, such as insulin resistance, metabolic syndrome, increased prevalence of obesity, menstrual irregularity, infertility, acne and hirsutism likely impact psychological functioning including increased depression, anxiety, negative body image, and compromising overall quality of life. Significantly more women with PCOS have clinical depression (34%) compared to women in the general population (7%) and around 45% experience anxiety compared to 18% of women in the general population.
The reasons for a higher prevalence of anxiety and depression in women with PCOS are likely to be complex. Physical symptoms of PCOS are varied and frustrating, however evidence is inconsistent in relation to which specific factor/s cause the most psychological distress. While acne, hirsutism, BMI and negative body image are linked to increased psychological distress in some studies, other researchers suggest that women having difficulties with fertility are more likely to be depressed and that weight gain was a significant factor in reduced health related quality of life, which ultimately impacted mood.
Regardless of the cause, higher prevalence and more severe levels of psychological dysfunction are important to recognise and understand in women with PCOS. Mood is highly clinically relevant given that it impacts self-efficacy, that PCOS therapy requires motivation, positive self-belief, lifestyle change and adherence to therapy. PCOS is common and psychological function should be considered in all women with PCOS.