I have PCOS and I feel very moody. Is there anything I can do about it?

PCOS is more than a physical disorder and self-care can help you manage symptoms better

Dr Garima Srivastava

Polycystic Ovary Syndrome (PCOS) is one of the most common hormonal disorders among women of reproductive age. PCOS is classified as a syndrome because it is a heterogeneous disorder: not all women with PCOS will express all of the symptoms associated with the disorder. 

The better known and acknowledged symptoms of PCOS include the physical symptoms including menstrual irregularities, hirsutism (excessive hair growth), obesity, acne, and alopecia. But what often goes unnoticed and unreported is that women with PCOS are also at elevated risk of mental health problems.

PCOS and mood issues

Studies report that psychiatric illnesses such as anxiety and depression in women with PCOS often go undetected1. Experiencing these comorbidities can create a negative impact on their quality of life. As the mind and the body are interlinked, changes in one can affect the other. For example, the hormonal fluctuations that women with PCOS experience are also likely to bring about mood swings or emotional instability, which could be one of the symptoms of depression as well.

Apart from the biological consequences, PCOS also has psychological and social implications, the management of which can help the woman cope with the disorder in a holistic manner.

Treatment for PCOS differs from one woman to the other. The goal of the treatment is to manage or alleviate the person's symptoms. Different treatment options may be suggested as per the symptoms and their severity. The aim of management is to educate and support the person, while emphasizing on the importance of a healthy lifestyle. Apart from pharmacological treatment, lifestyle modification which includes taking care of one's exercise and diet routine, can drastically improve many aspects of PCOS. Lifestyle modification is the first line of treatment for women with PCOS because weight loss and prevention of weight gain are vital to the improvement of PCOS symptoms, and a better quality of life.

Lifestyle changes

Exercise and diet has been shown to be very effective way of dealing with PCOS. Even just a 5-10% reduction in weight can create positive changes to the metabolic, reproductive, and psychological symptoms.

In addition to dietary restrictions, exercise is critical since it increases the efficiency with which the body digests glucose, increases the sensitivity of cells to insulin, and reduces hyperandrogenism. The benefits of exercise continue after cessation of exercise. Exercise on a regular basis should ideally include both resistance training and aerobic exercises.

Family support is crucial

Depressive features, anxiety, poor body image issues, and negative self-esteem are associated comorbid conditions that make PCOS much more than just a physical disorder. In fact, as discussed above, PCOS has very clear biopsychosocial connotations. Therefore, to manage the symptoms manifested in psychological and social areas, help is needed from those around.

  • Most of the women revealed that many times people don’t take their PCOS symptoms very seriously. Some women on the other hand also experience stigma associated with its symptoms centering around infertility or the inability to conceive. This is why it becomes important that the woman and her support system read up about the condition and speak to a medical practitioner or counselor about the distress they may be experiencing and also clear any myths about PCOS.
  • Having a supportive network of family members and friends is as important in the management of PCOS as it is in any other condition, more so because women with PCOS are often psychologically distressed. Having someone to talk to about how they are feeling (as mood changes or feeling low are associated symptoms) or talking about any concerns they have about implications of PCOS in the future (for e.g., fertility and conception related problem) it would help them feel understood through the various stages of PCOS, which in turn will help them deal with their own problems in a better manner.
  • The role of medical practitioners and gynecologists in the management of PCOS is of paramount importance. They need to inform about the diagnosis in a sensitive manner, educate not just the person with PCOS but also the family, and assist them during the different stages of the treatment.
  • Recent studies have brought to light the need for mental health professionals such as counsellors and psychologists in the management of PCOS.
  • Self-care is also considered to be effective in managing PCOS symptoms. In addition to lifestyle modification, it would also help immensely to take good care of one's physical and psychological health. Current research shows that almost all the countries including India now have online support groups that help women with PCOS discuss their problems and encourage each other to manage their issues better.

References:

1. Williams, Sheffeld and Knibb, 2015

2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1069067/

3. https://www.womenshealth.gov/files/assets/docs/fact-sheets/polycystic-ovary-syndrome.pdf