THE IMPACT OF POLYCYSTIC OVARY SYNDROME ON MENTAL HEALTH AND BODY IMAGE IN WOMEN: A CLINICAL LITERATURE REVIEW
Abstract
Polycystic ovary syndrome (PCOS) represents the most common endocrine disorder in women of reproductive age, affecting 6–20% of this population depending on diagnostic criteria applied. Beyond its metabolic and reproductive consequences, PCOS significantly impacts mental health, particularly depression, anxiety, and body image disturbance. This clinical literature review synthesizes evidence from clinical studies and observational research examining the psychological burden of PCOS. Evidence indicates that women with PCOS experience markedly elevated rates of depression (approximately 49%) and anxiety compared to healthy controls, with depression predominantly presenting as mild to moderate severity. Lifestyle factors, including lack of exercise (OR=7.5), psychological stress (OR=6.5), sleep disturbance, and high-fat diet, constitute significant modifiable risk factors for depression. Body image disturbance emerges as a critical mediating factor between PCOS symptoms and psychological distress, affecting quality of life and overall well-being. Body appreciation, in contrast to mere absence of dissatisfaction, constitutes a particularly important protective factor for mental health. Cognitive-behavioral therapy (CBT) and psychosocial interventions demonstrate substantial efficacy in reducing depression and anxiety symptoms. Routine mental health screening and implementation of evidence-based psychological interventions are essential components of comprehensive PCOS care. This review emphasizes the necessity of integrated, multidisciplinary approaches addressing both physical and psychological aspects of PCOS, with particular attention to lifestyle modification as a therapeutic strategy.
References
Adali, E., Yildizhan, R., Kurdoglu, M., Kolusari, A., Edirne, T., Sahin, H. G., Yildizhan, B., & Kamaci, M. (2008). The relationship between clinico-biochemical characteristics and psychiatric distress in young women with polycystic ovary syndrome. Journal of International Medical Research, 36(6), 1188–1196. https://doi.org/10.1177/147323000803600604
Alkheyr, Z., Murad, M., Das, P., Almadani, H., Almasri, W., Aljandali, D., … & Al-Samawi, N. (2024). Self-esteem and body image satisfaction in women with PCOS in the Middle East: Cross-sectional social media study. PLOS ONE, 19(4), e0301707. https://doi.org/10.1371/journal.pone.0301707
Elsenbruch, S., Hahn, S., Kowalsky, D., Offner, A. H., Schedlowski, M., Mann, K., & Janssen, O. E. (2003). Quality of life, psychosocial well-being, and sexual satisfaction in women with polycystic ovary syndrome. Journal of Clinical Endocrinology & Metabolism, 88(12), 5801–5807. https://doi.org/10.1210/jc.2003-030562
Geller, S., Levy, S., & Avitsur, R. (2025). Body image, illness perception, and psychological distress in women coping with polycystic ovary syndrome (PCOS). Health Psychology Open, 12(1), 1–12. https://doi.org/10.1177/20551029251327441
Hofmann, K., Elbelt, U., Ahnis, A., Rose, M., & Klapp, B. F. (2025). Body image and mental health in women with polycystic ovary syndrome. Archives of Gynecology and Obstetrics, 311(2), 789–798. https://doi.org/10.1007/s00404-024-07547-2
Jannink, T., Bordewijk, E. M., Aalberts, J., van Dulmen, S., Lambalk, C. B., van Wely, M., … & Goddijn, M. (2024). Anxiety, depression, and body image among infertile women with and without polycystic ovary syndrome. Human Reproduction, 39(4), 784–791. https://doi.org/10.1093/humrep/deae016
Li, L., Kang, Z., Chen, P., Niu, B., Wang, Y., & Yang, L. (2024). Association between mild depressive states in polycystic ovary syndrome and an unhealthy lifestyle. Frontiers in Public Health, 12, 1361962. https://doi.org/10.3389/fpubh.2024.1361962
Majidzadeh, S., Mirghafourvand, M., Farvareshi, M., & Yavarikia, P. (2023). The effect of cognitive behavioral therapy on depression and anxiety of women with polycystic ovary syndrome: A randomized controlled trial. BMC Psychiatry, 23, 332. https://doi.org/10.1186/s12888-023-04814-9
Mansson, M., Holte, J., Landin-Wilhelmsen, K., Dahlgren, E., Johansson, A., & Landen, M. (2008). Women with polycystic ovary syndrome are often depressed or anxious: A case control study. Psychoneuroendocrinology, 33(8), 1132–1138. https://doi.org/10.1016/j.psyneuen.2008.06.003
Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. (2004). Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Human Reproduction, 19(1), 41–47. https://doi.org/10.1093/humrep/deh098
Teede, H. J., Tay, C. T., Laven, J. J. E., Dokras, A., Moran, L. J., Piltonen, T. T., … & Norman, R. J. (2023). Recommendations from the 2023 international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Journal of Clinical Endocrinology & Metabolism, 108(10), 2447–2469. https://doi.org/10.1016/j.fertnstert.2023.07.025
Yin, M. X. C., Donovan, L. B., Zalud, X. N., Fung, Y. L., Sun, Y. Y., Chan, C. H. Y., & Chan, C. L. W. (2021). Can psychosocial intervention suppress testosterone and triglycerides among women with polycystic ovary syndrome? A feasibility trial. Frontiers in Psychology, 12, 690539. https://doi.org/10.3389/fpsyg.2021.690539
Guo, S., Al-Sadi, R., Said, H. M., & Ma, T. Y. (2015). High-fat diet induces Toll-like receptor 4–dependent inflammatory activation and insulin resistance. Journal of Endocrinology, 225(1), 13–24. https://doi.org/10.1167/iovs.15-16504
Bergmans, R. S., Malecki, K. M., Peppard, P. E., & Engelman, C. D. (2017). The association of dietary inflammatory potential with depression and mental well-being among U.S. adults. Preventive Medicine, 99, 313–319. https://doi.org/10.1016/j.ypmed.2017.03.016
Clerici, M., Bottari, D., Bottari, B. (2025). Gut microbiome, diet and depression: Literature review of recent findings. Nutrients, 17(2), 238. https://doi.org/10.1007/s13668-025-00619-2
Hollinrake, E., Abreu, A., Maifeld, M., Van Voorhis, B. J., & Dokras, A. (2007). Increased risk of depressive disorders in women with polycystic ovary syndrome. Fertility and Sterility, 87(6), 1369–1376. https://doi.org/10.1016/j.fertnstert.2006.11.039
Copyright (c) 2026 Aleksandra Mazurkiewicz, Natalia Bednarczyk, Rafał Bednarczyk, Radosław Krzysztof Binkowski, Agnieszka Kurek, Natalia Krajewska, Aleksandra Lejman, Hubert Sidor, Monika Wołosik, Szymon Zysiak
This work is licensed under a Creative Commons Attribution 4.0 International License.
All articles are published in open-access and licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). Hence, authors retain copyright to the content of the articles.
CC BY 4.0 License allows content to be copied, adapted, displayed, distributed, re-published or otherwise re-used for any purpose including for adaptation and commercial use provided the content is attributed.
