Is PCOS linked to depression?
Yes, depression is more common with PCOS. Studies find it in about 1 in 3 women with PCOS. Talking therapy can be the first step. But your PCOS treatment may help your mood too.
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Is PCOS linked to depression?
Yes. The NHS lists depression or anxiety as one of the main symptoms of PCOS. It now calls the condition PMOS.
A 2023 review pooled 19 studies of over 4,000 women with PCOS. On average, 31% had depression. That made it more than 2.5 times as likely as in women without PCOS.
Source: J Clin Med 2023 review
These studies show the two go together, not why. The NHS says the cause of PCOS is unknown, but it may involve insulin and testosterone not working properly.
The 2023 international PCOS guideline says doctors should check everyone with PCOS for depression and anxiety.
Felt low most of the day, every day, for more than 2 weeks? That’s the NHS line to see a GP.
Is it PCOS or depression?
It can be both, and the signs overlap. Tired all the time could be either.
| Sign | With PCOS | With depression |
|---|---|---|
| Energy | Feeling very tired | Lack of energy |
| Weight | Weight gain or trouble losing weight | Changes in appetite or weight |
| Mood | Depression or anxiety is a main symptom | Low mood that won’t lift, feeling anxious or worried |
| How you see yourself | PCOS features can harm body image | Low self-esteem |
| Sex life | Weight, extra hair, mood, fertility and PCOS medicines can all affect it | Low sex drive |
Sources: NHS: PMOS; NHS: symptoms of depression; PCOS guideline 2023
Some signs are on the NHS depression list but not the PCOS one. These include no interest or joy in things, feeling hopeless, and thoughts of suicide or self-harm.
There’s no physical test for depression. A GP may do blood or urine tests to rule out look-alikes, such as an underactive thyroid. See PCOS or thyroid symptoms and blood tests for low mood.
Next step: tick which rows fit you, and for how long. Take that to your GP.
How is depression treated with PCOS?
The guideline says to follow the usual guidelines for everyone, and your own preference.
What the PCOS guideline advises for low mood
- 1
Check
Questions about your mood at diagnosis. These may be repeated later, for example around pregnancy and birth.
- 2
Assess
If symptoms are moderate or severe: a closer look, a referral or treatment.
- 3
Talking therapy
Could be the first treatment.
- 4
Antidepressants
Considered in adults if depression is clear and lasting, or if you have suicidal thoughts.
Source: PCOS guideline 2023
You don’t need a GP to start talking therapy. If you’re 18 or over and registered with a GP, you can refer yourself to NHS Talking Therapies. Some areas take you from 16.
It includes CBT, where a therapist helps you change how you think and act. You don’t need a diagnosis first.
Offered a medicine? The guideline asks doctors to limit ones that make PCOS symptoms worse, such as weight gain. Ask about that.
Never stop or change a prescribed medicine without your prescriber.
Eating feels hard to manage? The guideline says to think about eating disorders whatever your weight, especially during weight loss plans. For these, a GP usually refers you.
If that’s you, book a GP appointment.
Can treating PCOS help my mood?
It may. The guideline says some PCOS treatments should be considered, given their potential to improve mood. These are healthy habits, the combined pill, metformin (a diabetes medicine also used for PCOS) and laser hair removal.
Laser for unwanted facial hair is one example, though the evidence for its mood effect is weak.
Exercise has its own trials. Across 7 small trials in women with PCOS, exercise cut symptoms of depression. The authors say to read this with care, as the trials were few and small.
It works the other way too. The guideline warns that low mood left alone may make it harder to stick with PCOS treatment.
Five steps to take this month
- Ask your GP to check you for depression and anxiety, as the guideline advises for everyone with PCOS.
- Refer yourself to NHS Talking Therapies if you’re 18 or over and registered with a GP.
- Ask whether the combined pill, metformin or laser hair removal could help your main PCOS symptom.
- Exercise regularly, as the NHS advises for PCOS.
- If you’re offered an antidepressant, ask whether it can cause weight gain.
Sources: PCOS guideline 2023; NHS: PMOS; NHS Talking Therapies
Pick one step for this week. For each treatment, see PCOS treatment. For the tests behind a diagnosis, see the PCOS blood test.
When to speak to a GP
With the right treatment and support, most people with depression can make a full recovery. Book an appointment if:
- You’ve had signs of depression most of the day, every day, for more than 2 weeks.
- Your mood isn’t improving, or it affects your work, interests or relationships.
- You have thoughts of suicide or self-harm.
- You think you might have PCOS, or your symptoms affect your everyday life, work and relationships.
- You have, or think you might have, an eating disorder. A GP can refer you.
Need urgent help for your mental health? Call 111 and choose the mental health option, or ask for an urgent GP appointment. You can call Samaritans on 116 123.
Call 999 or go to A&E if someone’s life is at risk, for example they’ve seriously hurt themselves or taken an overdose. Do the same if you don’t feel you can keep yourself or someone else safe.
Don’t drive yourself to A&E. More on the signs: depression signs and symptoms.