PCOS and depression symptoms: The hidden link behind mood swings and missed periods

Women with PCOS often experience more stress, irritability, and emotional fatigue due to hormonal imbalances, which can lead to increased anxiety and depressive episodes (Image: Canva)

Polycystic Ovary Syndrome (PCOS) is often recognised for its physical symptoms; irregular periods, acne, facial hair, and weight gain. Nevertheless, many don’t realise is how closely PCOS is linked to mental health. From anxiety to low self-esteem, the emotional effects of PCOS are real, and too often ignored.

PCOS is a hormonal issue that impacts nearly every part of a woman’s life, especially her emotional wellbeing, says Dr Suruchi Desai, Senior Consultant, Obstetrics and Gynaecology, Nanavati Max Super Speciality Hospital, Mumbai. “Women with PCOS often experience increased levels of stress, irritability, and emotional fatigue due to hormonal imbalances. These shifts in hormone levels can further lead to increased anxiety and depressive episodes. While irregular periods and weight changes may be visible signs, the emotional struggle often remains hidden,” she says.

Alongside physical discomfort, PCOS brings several emotional challenges. Common symptoms include low mood, poor sleep, anxiety, and mood swings. “Many women report feeling overwhelmed, particularly when symptoms like acne or hair growth affect their confidence,” adds Dr Desai.

Also read | Polycystic Ovary Syndrome: Master PCOS with these 7 lifestyle tips supported by science

Gradual weight gain and visible skin issues can quickly chip away at self-esteem. In some households, delayed periods or difficulty conceiving leads to unwelcome questions and assumptions about fertility. “This scrutiny, especially for younger, unmarried women, can cause deep emotional distress. For married women, infertility can become a painful stigma, pushing them into silence. Sadly, most women never discuss these issues with their doctors, as mental health is still seen as a taboo, even in medical settings,” she says.

Dr Desai shares 6 truths about PCOS and mental health:

• More than hormonal imbalance: Mood swings, anxiety, and even depressive episodes are often dismissed as ‘just stress’, but they’re strongly linked to the hormonal imbalances caused by PCOS. Fluctuations in insulin, androgens, and oestrogen can directly affect brain chemistry. It’s not in your head—it’s your body signalling that something’s off, and it deserves attention.

• Self-esteem takes a hit: Weight gain that refuses to budge, facial hair, thinning scalp hair, and persistent acne can really knock confidence. Unrealistic beauty standards can make women feel unattractive. Over time, this deeply impacts how they view themselves.

• Fertility fear is real: Many women with PCOS worry about whether they’ll ever be able to conceive. For unmarried women, irregular periods often spark constant family chatter about future fertility. For those married, difficulty conceiving can attract unwanted sympathy or judgment.

• Mental health isn’t discussed: Women often avoid bringing up mental health concerns with doctors, fearing they’ll be brushed aside or misunderstood. Some doctors don’t ask either, focusing only on physical symptoms. As a result, conditions like anxiety or depression go undiagnosed and untreated, even though they’re part of the PCOS experience for many.

• Silence worsens it: Friends and family may mean well, but often say little, or nothing, about the emotional toll of PCOS. The silence isolates women, making them believe they’re alone in how they feel when they’re really not.

• Support makes a difference: With the right help, things can get better. Talking to a counsellor, joining PCOS support groups, or simply hearing someone say “I understand” can offer huge relief. Add in balanced nutrition, regular exercise, and consistent medical care, and women can start to feel more in control of both their bodies and minds.