Polycystic Ovary Syndrome (PCOS) is an endocrine disorder that presents in women of reproductive age and results from excessive production of androgens, or testosterone. PCOS affects 6%-15% of women, and research suggests that individuals with PCOS are at an increased risk of experiencing depression and anxiety (Carron, Kooienga, Boyle, & Alvero, 2017). Women with PCOS experience symptoms such as excessive bodily hair, acne, obesity, hair loss around the scalp, irregular menstrual cycles, and are at an increased risk of diabetes and cardiovascular disease (Carron, Kooienga, Boyle, & Alvero, 2017). As many studies have tried to address PCOS and causes, research is still inconclusive as to whether the symptoms cause psychological distress or the actual metabolic imbalance causes psychological distress. Research suggests that women utilize many different coping strategies to deal with upsetting symptoms, such as utilizing social support, avoidance (i.e. not attending treatment appointments), or self-blame (Carron, Kooienga, Boyle, & Alvero, 2017). For mental health clinicians working with premenopausal women, it is important to ask for any co-occuring endocrine or metabolic disorders along with symptoms, adaptive and maladaptive coping strategies, and medical care they utilize to deal with PCOS. As research suggests the month prior to menses can result in significantly impairing symptoms similar to those experienced in Premenstrual Dysphoric Disorder which may result from excessive testosterone such as feelings of extreme irritability, hopelessness, excessive fatigue, excessive conflict with others, and a decreased sense of interest in usual activities (Barry, Qu, & Hardiman, 2018). Clinicians may be able to create action plans with clients to identify warning signs of anxious or depressed moods that may onset prior to menstruation and plan to work on CBT skills such as cognitive reframing in order to see PCOS in a different light and be able to live more comfortably with a metabolic disorder (Carron, Kooienga, Boyle, & Alvero, 2017).
Author: Nora Brier, M.S.