PCOS and Anxiety: Understanding the Link and How to Break the Cycle
When most people think of Polycystic Ovary Syndrome (PCOS), they picture irregular cycles, acne, or difficulties conceiving. But for many women, one of the most distressing symptoms isn’t physical at all — it’s the heightened anxiety that can come with the condition.
If you’ve felt constantly on edge, struggled with racing thoughts, or noticed your mood change alongside your hormones, you’re not alone. Research shows that women with PCOS are significantly more likely to experience anxiety than women without the condition (Barry et al., 2011).
The good news? Understanding why this happens is the first step towards regaining balance — in both body and mind.
Why PCOS Can Increase Anxiety Risk
1. Hormonal influences on the brain
PCOS is characterised by higher androgens (male hormones), disrupted oestrogen and progesterone patterns, and often insulin resistance. These hormonal changes can affect the brain’s neurotransmitters, including serotonin, dopamine, and GABA — chemicals that regulate mood and calmness. When these systems are out of balance, anxiety can become more likely.
2. Inflammation and metabolic health
PCOS is associated with chronic low-grade inflammation (Rasgon et al., 2003), which can influence the brain’s stress response and mood regulation. Inflammation has been linked to changes in how the brain processes emotions and handles stress.
3. The emotional impact of symptoms
Acne, hair thinning, unwanted hair growth, weight fluctuations, and fertility challenges can all take a toll on self-esteem and social confidence. For some, this can lead to social anxiety, body image concerns, or constant worry about the future.
Recognising Anxiety Linked to PCOS
While anxiety can look different for everyone, common signs include:
Persistent feelings of worry or dread
Difficulty relaxing or “switching off” thoughts
Physical symptoms such as rapid heartbeat, digestive upset, or muscle tension
Sleep disturbances, especially trouble falling or staying asleep
Feeling easily overwhelmed or irritable
If these symptoms are frequent and affecting your daily life, it’s worth speaking with a health professional who understands the overlap between PCOS and mental health.
6 Ways to Reduce Anxiety and Support Mental Wellbeing with PCOS
1. Balance Your Blood Sugar
Blood sugar spikes and crashes can trigger cortisol release, which in turn can heighten feelings of anxiety. Aim to combine high-fibre, low-GI carbohydrates with protein and healthy fats at each meal (Kazemi al., 2021). For example:
Porridge oats with chia seeds, berries, and a spoon of nut butter
Lentil and vegetable soup with a sprinkle of pumpkin seeds
Salmon with quinoa and roasted vegetables
2. Prioritise Regular Movement
Exercise supports insulin sensitivity, helps balance hormones, and can reduce anxiety by boosting mood-enhancing endorphins. Both resistance training and mind–body exercise (such as yoga or Pilates) have been shown to help (Stanton & Reaburn, 2014).
3. Support Gut Health
The gut–brain connection is real. A healthy gut microbiome plays a role in mood regulation via the vagus nerve and neurotransmitter production. Include:
Fermented foods like kefir, sauerkraut, and live yogurt
Prebiotic-rich foods such as onions, garlic, leeks, and asparagus
4. Manage Stress Proactively
Chronic stress can worsen both anxiety and PCOS symptoms by increasing cortisol and blood sugar levels. Consider daily practices such as:
5–10 minutes of deep breathing or meditation
Gentle stretching before bed
Short walks in nature
5. Consider Targeted Nutrients
Certain nutrients may help support both PCOS and mood health:
Omega-3 fatty acids – for reducing inflammation and supporting brain health
Magnesium – for calming the nervous system and supporting sleep
Vitamin D – linked to mood regulation and hormonal health
These should always be discussed with your practitioner or GP, and ideally supplemented after testing to tailor the dose.
6. Seek Emotional Support
Talking to someone who understands PCOS can be a huge relief. Options include:
Counselling or cognitive behavioural therapy (CBT)
Support groups (in person or online)
Confiding in trusted friends or family
The Bottom Line
Anxiety in PCOS is not “just in your head” — it’s often the result of complex hormonal, metabolic, and emotional factors working together. The right approach addresses both the root causes and the day-to-day triggers, so you can feel calmer, more in control, and better supported.
References
Barry JA, Kuczmierczyk AR, Hardiman PJ. Anxiety and depression in polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod. 2011;26(9):2442-2451. doi:10.1093/humrep/der197
Rasgon NL, Rao RC, Hwang S, et al. Depression in women with polycystic ovary syndrome: clinical and biochemical correlates. J Affect Disord. 2003;74(3):299-304. doi:10.1016/s0165-0327(02)00117-9
Kazemi M, Hadi A, Pierson RA, Lujan ME, Zello GA, Chilibeck PD. Effects of Dietary Glycemic Index and Glycemic Load on Cardiometabolic and Reproductive Profiles in Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Adv Nutr. 2021;12(1):161-178. doi:10.1093/advances/nmaa092
Stanton R, Reaburn P. Exercise and the treatment of depression: a review of the exercise program variables. J Sci Med Sport. 2014;17(2):177-182. doi:10.1016/j.jsams.2013.03.010