Polycystic ovary syndrome (PCOS) is often talked about as a problem with periods, weight or skin. But for many women it also affects mood, confidence and relationships. If you have PCOS and feel anxious, low or unhappy with your body, you are not imagining it, and you are not alone.
PCOS is not only about periods
According to the World Health Organization (WHO), PCOS affects an estimated 10 to 13% of women of reproductive age, and up to 70% of women with PCOS worldwide do not know they have it. The WHO notes that women with PCOS may experience anxiety, depression, eating disorders and negative body image, and that stigma around weight, unwanted hair and fertility can affect relationships, work and mental health. You may notice:
- Feeling anxious, low or tearful, sometimes more around your periods.
- Hating what you see in the mirror, or avoiding photos and functions.
- Feeling ashamed of acne, hair growth on the face or body, or hair thinning.
- A difficult relationship with food: strict dieting, then eating a lot, then guilt.
- Frustration that your weight does not change despite real effort.
- Worry about marriage, or about whether you will be able to have children.
- Feeling judged by relatives' comments.
Can PCOS cause depression and anxiety?
The WHO lists anxiety and depression among the effects that women with PCOS may experience. The reasons are likely a mix of hormonal changes, visible symptoms, the stress of managing a long-term condition, and the way others react. What matters most is that it is not your fault, and that support helps. If you have felt low or lost interest in most things for more than two weeks, see our pages on depression counselling and anxiety therapy.
Body image, weight talk and unwanted hair
Comments like "you have put on weight", "do something about your face before the rishta comes" or "just eat less" can sting for days. Social media adds pressure. A therapist can help you:
- Notice and quieten harsh self-talk, using approaches like cognitive behavioural therapy (CBT).
- Break the cycle of strict dieting, overeating and guilt.
- Build confidence that does not depend on the scale, and respond calmly to relatives. Our page on counselling for low self-esteem may also help.
The WHO recommends healthy eating and physical activity for all women with PCOS, even when they do not lead to weight loss. A dietitian can help you plan meals around Indian home food that are realistic and kind, rather than another crash diet. You can browse dietitians on Mindara.
Pressure about marriage and fertility
In many families, a PCOS diagnosis quickly turns into worries about marriage prospects and having babies. Having PCOS does not mean you cannot have children. The WHO describes several fertility options, from lifestyle changes to medical treatment, and a gynaecologist can explain what applies to you. A counsellor can help you handle family pressure, decide what to share with a partner or in-laws, and cope with the waiting and uncertainty if you are trying to conceive. If you are about to marry, premarital counselling can give you both a safe space to talk about health and family plans.
Small things that can help day to day
- Move in ways you enjoy, such as walking, dancing, yoga or a sport, for how it makes you feel, not only for the scale.
- Eat regular meals. Skipping meals often leads to strong cravings later.
- Protect your sleep, which affects mood, appetite and energy.
- Limit time with accounts that make you feel bad about your body.
- Track your mood alongside your cycle for a couple of months, and share it with your doctor or therapist.
- Talk to someone. A friend, a sister or a therapist can help you feel less alone with it.
For parents of teenagers with PCOS
PCOS is often first noticed in the teenage years, when body image is already fragile. Comments about weight, skin or marriage, even when meant kindly, can hurt deeply at this age. Focus on health habits for the whole family rather than on your daughter's weight, and make sure she has a doctor she trusts. If she seems withdrawn, is skipping meals or seems very low, a counsellor who works with young people can help.
Your PCOS care team
- Therapist or psychologist: mood, anxiety, body image, eating patterns and family pressure.
- Dietitian: sustainable eating plans that fit your life.
- Gynaecologist or endocrinologist: diagnosis, tests, periods, skin and hair symptoms, fertility and medicines. Mindara does not replace your doctor.
- Psychiatrist: if depression or anxiety is severe, a psychiatrist can assess you and check that any treatment fits with your other medicines.
You book each provider separately. Tell each of them about the others so their advice fits together. Never stop or change medicine without your doctor.
How many sessions, and does it work online?
Many women meet a therapist weekly or every two weeks for a few months, though this varies. Online sessions work well and are private: you can talk from your own room. Dietitian follow-ups are often spaced a few weeks apart. Blood tests and scans are done at a clinic or lab.
Choosing a provider, cost and free help
Many women prefer a female therapist for PCOS-related concerns; you can look for a female therapist and check the languages on each provider's card. Fees are shown in the box above and on every card, and many providers offer a free first session. Tele-MANAS (14416 or 1-800-891-4416) offers free mental health support 24×7. For other long-term conditions, see chronic illness counselling.
When to get urgent help
If you feel hopeless, are harming yourself or have thoughts of ending your life, call Tele-MANAS on 14416 or 112 now. If you are not eating, or are making yourself sick after eating, please tell a doctor soon.
