The Mental and Emotional Impacts of PCOS

Imagine the following: Your menstrual cycles are unpredictable and short, but not awful. You’ve struggled with teen or adult cystic acne and experienced ridicule for maturing sooner than other girls. You’ve gone to multiple doctors seeking answers but you’re ignored, minimized, or told you just need to exercise more, eat less, or try harder.

You’re now in your thirties and ready to expand your family. It feels like your body has failed you and only now are your doctors concerned. After many tears and tests, you finally get the Polycystic Ovarian Syndrome (PCOS) diagnosis and while there is relief, you’re also angry and frustrated. This is a common experience for persons living with PCOS. An estimated 50-75% of people living with PCOS are either undiagnosed or misdiagnosed. To add insult to injury, PCOS research, consensus on diagnostic criteria, and physician literacy have been limited. These impacts are exacerbated if you are a BIPOC person, transgender identifying individual or exist in a fat body. There is limited research at this time illuminating how gender identity, socioeconomic status, and cultural identity may impact these experiences and more needs to be done.

Mental and Emotional Impacts of PCOS

PCOS doesn’t have a specific size, scale number, shape, ethnicity or socioeconomic status. PCOS is a genetic, hormonal, and cardiometabolic condition that impacts mental health, cardiovascular health, and reproductive health. However, focus by clinicians on primarily the reproductive implications can delay diagnosis and affect how people living with PCOS are seen. Research highlights an increased risk for depression, anxiety disorders, attention deficit hyperactivity disorder (ADHD), and eating disorders (ED) in folx with PCOS. In one study, about 60% of young people with PCOS or endometriosis reported moderate to severe psychological distress. The study additionally found these odds were significantly higher for women recently diagnosed with PCOS.

Recognizing Eating Disorders

ED (or disordered eating) involves a disconnect or unhealthy relationship to the body and/or food. There is substantial pressure placed on those assigned female at birth (AFAB) to meet intense beauty standards. The combination of having a mental health issue like anxiety, societal stressors, and critical comments on your body or eating by family, physicians, or even strangers, increases the likelihood of developing ED. So what are some potential ED red flags?

• Self-criticism of your body, eating habits, or shape
• Recurrent dieting, restrictive eating, or gorging
• Skipping meals
• Disconnect or lack of control when eating or food is mentioned
• Moralist thinking - food is the enemy, or is “bad” or “good”
• Food negotiation - “I can eat this if I work out or skip the next meal”
• Body discomfort or “not feeling at home”
• Secrecy about what you eat, or avoidance of eating when others are present
• Overexercising, or using flush outs (laxatives) for weight loss

If reading these stirred feelings, take this moment to pause and breathe. It can be jarring to notice a lack of compassion for ourselves (self-hatred) or that our child may be having this experience. Thankfully you don’t have to do this alone.

Eating disorder recovery

The first step to healing from ED is awareness and acceptance of what is occurring. The other steps require community and a re-engagement with self. ED creates a chasm with yourself and those around you, therefore support is paramount to make peace with your body and or food.

Some of the resources include:

• National Eating Disorders Association (NEDA) USA
• National Initiative for Eating Disorders (NIED) CA
• National Eating Disorder Information Centre (NEDIC) CA
• Association for Size Diversity and Health
• Health at Every Size (HAES) therapist or other licensed mental health professional
• HAES resources
• Support for your child
• Support groups specific to your experience
• Asking your child’s pediatrician to only discuss weight concerns when your child is absent
• Being mindful of comments about you or your child’s bodies
• Speaking up when you or your loved one’s clinician fat shames them
• Healing your wounds around your body, food, and judgement so you can raise children who love themselves and understand body autonomy.

Making Peace                    

PCOS is a serious condition that impacts physical and mental health. These mental/emotional impacts can include various forms of disordered eating which can be greatly exacerbated by delays in diagnosis, societal beauty standards, fat shaming, and having a preexisting mental health condition. You don’t have to face these challenges alone though, there are trained providers, books, and support groups that work in concert to make peace with your body and or food.

If you or someone you know is experiencing body image issues or an eating disorder please use one of the resources listed or consider speaking with your therapist. Shame urges suffering in silence, but courage whispers, and speaking brings healing.

You may also enjoy: What is PCOS?, Natural Ways to Treat PCOS (Polycystic Ovary Syndrome), and Hormone Myths of the Menstruating Woman.