The silhouette of a woman near some concrete stepsShare on Pinterest
Experts say people with PCOS should closely monitor their mental health status. Vasily Pindyurin/Getty Images
  • PCOS is a common health problem that can cause infertility, irregular periods, irregular hair growth, acne, and weight gain
  • New research suggests women with PCOS have an eight-fold increased risk of suicide attempts.
  • Experts say PCOS is a tough condition to live with, but treatments are available to manage it.

People with polycystic ovary syndrome (PCOS) have an eight-fold higher risk of attempting suicide than those without the condition.

That’s according to research published today in the Annals of Internal Medicine in which researchers report that the increased risk was present in adolescents, young adults, and older adults with PCOS.

“Persons diagnosed with PCOS face a heightened susceptibility to suicide attempts and self-harm compared with those without the condition,” the study authors wrote.

“Challenges associated with fertility and the management of PCOS symptoms could further compound existing mental health challenges,” the researchers added. “Women with PCOS face stigmas due to obesity, hirsutism, menstrual irregularities, and infertility… The stigma linked to PCOS seems to be rooted in societal expectations, further adding to the burden of this condition.”

PCOS impacts between 6% and 12% of women in the United States of reproductive age. It is one of the most common causes of infertility in females, but the problems associated with the condition extend beyond child-bearing years.

Those living with PCOS can develop a variety of health complications including diabetes, heart disease, high levels of “bad” cholesterol (LDL), low levels of “good” cholesterol (HDL), high blood pressure, sleep apnea, and stroke.

People with PCOS are also at a higher risk of psychiatric conditions such as personality disorder, schizoaffective disorder, anxiety disorders, and depressive disorders.

Experts say the association with mental health challenges could be for a number of reasons.

“At this time, the exact cause is unknown and it is likely multifactorial. The higher androgens may play a role. Many women with PCOS also have insulin resistance, which also can increase mental illness such as depression. Women with PCOS may have higher rates of obesity and infertility, which are also associated with depression/anxiety. The physical changes associated with PCOS may also increase depression/anxiety,” Dr. Sun Kim, an associate professor of medicine in endocrinology at Stanford Medicine in California who was not involved the study, told Medical News Today.

“PCOS has been associated with increased risk for depression and anxiety. Thus, we may expect higher risk for suicide; however, the 8-fold risk is surprising,” she added.

The study authors examined data from nearly 19,000 women diagnosed with PCOS between 1997 and 2012. The data was from the Taiwanese nationwide database.

Even after accounting for other factors such as demographics, physical conditions, and psychiatric co-morbid conditions, those with PCOS had a 8.47 fold increase in the risk of attempting suicide compared with those in control groups.

The data from a subgroup of adolescents showed a 5.38 fold increased risk of suicide attempts.

People living with PCOS have higher levels of androgens. These are male hormones that are also present in females. This higher level of hormones can stop ovulation.

Many people with PCOS are also insulin resistant, meaning that although the body makes enough insulin, it can’t be used effectively.

Experts say this combination can lead to a number of symptoms, which may take a toll on the mental health of those living with PCOS.

“If you think about the disorder itself… you could see how that medical disorder could create psychological stress. The basic challenge [can be that] you’re overweight… You’re a woman that may be growing a beard. You’re not getting periods. And it’s like this wicked cycle because of the high insulin and you try to do things to lose weight and you don’t lose weight. And what if you want to get pregnant? Well, you can’t get pregnant if you’re not ovulating,” Dr G. Thomas Ruiz, an OB/GYN and the head of OB/GYN at MemorialCare Orange Coast Medical Center in California, told Medical News Today.

“It’s a tough medical condition and if your medical condition is a chronic medical condition, that in and of itself can lead to a reactive depression,” said Ruiz, who was not involved in the research.

Experts say addressing the mental health impacts of PCOS can be difficult.

“As an endocrinologist, I find being able to help people (with or without PCOS) find mental health services is challenging,” said Kim. “Of course, mental health is important. However, it is challenging to provide mental health services in general. Women with PCOS often seek care from endocrinologists and gynecologists and these providers are not equipped to fully manage their mental health.”

“Awareness of higher risk of mental illness is important. I try to understand what aspects of PCOS are most distressing to the patient and try to address those to alleviate some anxiety,” she added.

Kim says she is hopeful the study increases awareness of the mental health challenges associated with PCOS and encourages those with the condition to seek support.

“Acknowledging and discussing the risks are important. Having family/friend support is also helpful. Next step would be to discuss with their primary physician regarding mental health resources,” she said.

There is no cure for PCOS, but symptoms can be managed.

Losing weight, maintaining a healthy diet and exercising can help. Some medications can also be used to help ovulation, reduce hair growth, and reduce acne.

Ruiz says the first step in trying to avoid the mental health impact of PCOS is to properly treat the condition.

“Seek medical care and treat the condition so that you can control it. If you can control a woman’s insulin levels with PCOS, she will often start to ovulate spontaneously. And if you can control their insulin levels and establish weight loss, that’ll typically eventually lead to normal ovarian function,” he added.

“And once you have normal ovarian function, you can start to treat the other issues,” Ruiz said. “And if you become ovulatory and you’re trying to get pregnant, now you can get pregnant. By focusing on treating the condition and managing the condition, the patient will likely start to feel better about themselves because they’ll effectively see body image changes, which may be leading to their depression.”