If you suffer with PCOS, you’ll know that one of the main symptoms is stress. Everybody experiences stress from time to time. But research suggests that people with PCOS have increased perceived stress than those who don’t have PCOS. 

This is partly down to the fact that women with polycystic ovaries produce far more stress hormones, such as cortisol, than usual - which in turn can lead to anxiety, depression, fertility complications and increased levels of insulin resistance.

Stress and PCOS – how are the two connected?

What’s the link between stress and PCOS? Well, for starters, studies^1 have found that depression, anxiety and perceived stress are more likely to be present in people who have PCOS than those who don’t. This could be caused by symptoms such as hirsutism and hair loss, a hormonal imbalance, or a combination of reasons.

And, that’s not all. Studies have also found that high levels of cortisol^2 (the hormone that’s released when we’re under stress) could interfere with the body’s insulin response – not ideal for the 65-70%^3 of people who have PCOS and are insulin resistant.

Stress isn’t inherently “bad”. Eustress, the name given to “good” or helpful stress, can actually be really positive. It’s the fizzing excitement you feel when you start a new job you’re really looking forward to. It increases alertness, so can be beneficial for physical activity, starting new hobbies or work projects, and socialising too.  

Stress becomes harmful when it exceeds our ability to cope. And, left unchecked, it can have physical, psychological, emotional and behavioural impacts, including muscle pain and tension, restlessness, anxiety, reduced sex drive, fatigue, and drug or alcohol misuse. Long term, chronic stress could increase your risk of heart and circulatory disease.

What are the symptoms of stress?

Stress can manifest as physical, mental, and behavioural symptoms. According to the NHS, some of them include:

• Headaches
• Dizziness
• Muscle tension or pain
• Chest pain or a racing heartbeat
• Sexual issues
• Difficulty concentrating
• Difficulty making decisions
• Feeling overwhelmed
• Constantly worrying
• Forgetfulness
• Feeling irritable 
• Sleeping too little or too much
• Eating too little or too much
• Drinking or smoking more

If you’re experiencing ongoing, chronic stress that’s interfering with your ability to live a normal life, see your GP. It’s really important that you get necessary support – both for managing your PCOS and your mental wellbeing.

Does stress make PCOS worse?

Honestly? The relationship between PCOS and stress isn’t 100% clear cut. We know that stress doesn’t cause PCOS, but it’s widely believed that it may have an influence on symptoms. 

What we do know, however, is that stress impacts everything from sleep and appetite to mental wellbeing, all of which can have a knock-on effect when it comes to PCOS symptoms. Therefore, it's advisable to take measures to manage your stress, when possible. 

There are plenty of ways to do this, so we’ve picked our top five tips for staying relaxed and adding a little calm to your life.

1. Get Plenty of Exercise

Movement has many, many benefits. Research supports that it can be helpful for treating PCOS (120 minutes of moderate-vigorous intensity exercise per week is thought to be a sweet spot for people with PCOS), and it’s also great for reducing stress, too.

Gentle, restorative fitness routines are the way to go - trying to attempt a high-intensity workout when your body is already stressed is almost certainly not going to help.

Instead, try some calming yoga or pilates, or head off into the outdoors for a long walk; there’s evidence that being amongst nature is also a great stress-reducer, so spend some time surrounded by nature.

If you aren’t sure where to start, experiment with different types of activity until you find something you genuinely enjoy (you’re more likely to be consistent with exercise if you find it fun). You could start with walking, swimming or cycling,, for instance. 

2. Try Meditation And Other Relaxation Techniques

When combined with the right nutrition, meditation is a great way to control those stress levels if you suffer from polycystic ovary syndrome. It can make you feel more relaxed, boost sleep quality and will also help with focusing thoughts and calming the mind.

One of the most important parts of meditation practice is learning how to breathe correctly; focusing on deep breathing automatically relaxes the body, and will lower cortisol levels, which in turn reduces insulin resistance. Meditation has also been shown to help boost the digestive system, which will work towards aiding any weight loss goals you might have.

Relaxation techniques can help to slow down your heart rate, lower blood pressure, improve digestion, and reduce activity of stress hormones, so they’re well worth a try if you’re looking to get better at managing stress. Some relaxation techniques you could experiment with include:

• Visualisation
• Breathwork
• Meditation
• Journalling
• Massage
• Yoga
• Aromatherapy
• Tapping
• Sound therapy

3. Add in a Self-Care Routine

One of the best ways to relax and beat stress or anxiety is to simply take some time for yourself. A good self-care routine doesn’t have to be long baths and candles, either - it should be anything that helps boost your mental health and makes you feel good.

For example, allowing yourself the time to focus on perfecting your diet is a great idea - the right foods can not only help with PCOS symptoms and aid weight loss, but they can also help with mental health. You could also choose to spend time in nature, read a good book, take up a new hobby, spend time with friends and loved ones or even binge-watch a favourite TV show.

Studies have confirmed that partaking in leisurely activities that you find enjoyable is associated with improved wellbeing. To capitalise on this, make time in your schedule every week (or, every day if you can manage it) for your hobbies – whether you love to read, sew, paint, cook, game, or brunch with friends. Approach your allocated hobby time in the same way you would an important meeting – don’t cancel, don’t push it to the bottom of your to-do list, don’t do it half-heartedly. 

 4. Prioritise Sleep Quality

A lack of quality sleep can have a huge impact on your mental wellbeing, so it’s important to prioritise getting enough kip every night. One study, which explored possible links between sleep duration and stress, found that short sleep duration may be associated with increased perceived stress compared with adequate sleep duration. This means that quantity is just as important as quality when it comes to sleep.

What can you do to improve your sleep quality? First and foremost, allow plenty of time to sleep – 7-9 hours is ideal for most people. The next port of call is to improve your sleep hygiene (which, essentially, means cultivating healthy habits when it comes to sleep). Try:

• Sticking to the same bedtime and wake-up time every day (yes, even on the weekends).
• Investing in quality bedding – a supportive mattress, a cosy duvet and pillows, and sheets made from natural and breathable fibres.
• Setting aside time to wind down before bed. This could involve dimming lights, turning off devices, doing your skincare routine, and engaging in calming activities, such as reading, journalling, or meditating.
• Avoiding alcohol and caffeine close to bedtime.
• Ridding your bedroom of light and sound pollution by investing in black-out window dressings and, possibly, a white noise machine if loud noises often disrupt your sleep.

5. Create A Support Network

One of the best ways to reduce stress and anxiety is to surround yourself with people who you can talk to, and who make you feel supported.

It can be hard to feel sociable during difficult times, but making plans with friends and family and sticking to them will help to boost your mental health. Alternatively, there are plenty of support groups, both online and in-person, where you can find other women who are on the same journey as you.

If you’re keen to connect with others who understand what it’s like to have PCOS, join The PCOS Collective – our private Facebook group for Cysters to share stories, experiences, and offer support to one another.

If you feel you could benefit from professional mental health support, speak to your GP or healthcare professional to explore the option of talking therapy. 

References:

1. Damone AL, Joham AE, Loxton D, Earnest A, Teede HJ, Moran LJ. Depression, anxiety and perceived stress in women with and without PCOS: a community-based study. Psychological Medicine. 2019;49(9):1510-1520. doi:10.1017/S0033291718002076

2. Sharma K, Akre S, Chakole S, Wanjari MB. Stress-Induced Diabetes: A Review. Cureus. 2022 Sep 13;14(9):e29142. doi: 10.7759/cureus.29142. PMID: 36258973; PMCID: PMC9561544.

3. Marshall JC, Dunaif A. Should all women with PCOS be treated for insulin resistance? Fertil Steril. 2012 Jan;97(1):18-22. doi: 10.1016/j.fertnstert.2011.11.036. PMID: 22192137; PMCID: PMC3277302.