Polycystic Ovary Syndrome and the Psychological Effects


Are physicians aware of the effects—particularly psychological—of this condition?

Polycystic Ovary Syndrome

Polycystic Ovary Syndrome (PCOS) affects 15%-20% of adolescents and women of childbearing age. It is a result of androgen excess and leads to the progression of several endocrine, metabolic, cardiovascular, reproductive, and psychological disorders. The increased androgen levels may be due to the underlying hormonal imbalance and insulin resistance that is involved in PCOS.1

Most adolescents reported that the primary symptoms associated with PCOS such as acne, obesity, hirsutism, infertility, and menstrual problems had the most negative impact on their lives. These symptoms caused mood fluctuations that affected personal relationships.2 Many of these clinical manifestations occur in puberty and have a long-term impact on an adolescent’s or a woman’s daily wellbeing and activities of daily living; which increase the potential risk for many clinical, physical, and psychological manifestations.3

Research shows that adolescents and women of childbearing age will visit numerous clinicians before being diagnosed with PCOS and that 50% to 75% of those adolescents and women will present to the primary care provider with already existing clinical manifestations of PCOS.21

Over many decades, women around the world have suffered from the adverse health effects of polycystic ovary syndrome (PCOS). There are multiple clinical symptoms associated with PCOS, and there are inadequacies involved in diagnosis and treatment of this problem. Clinical awareness of the psychological adverse effects experienced by adolescents and women who are diagnosed with PCOS continues to be a major concern.5 Therefore, clinical awareness of the psychological adverse effects of PCOS is essential for improvement in practice standards of care, promotion of patient awareness, improving patient health outcomes, and providing a holistic treatment approach.

Psychological Effects

The psychological effects of PCOS can be very devastating for women of all ages. A meta-analysis conducted by 5 investigating depressive symptoms showed that women with PCOS had approximately four times more of an increase in depression. In a Brazilian cohort of women with PCOS, researchers found that approximately 58% had one depressive disorder, 78% had behavioral changes, 26% had major depressive disorder, and 11% had bipolar disorder. In a study performed by Cipkala-Gaffin et al.6 regarding psychosocial concerns, research revealed that the influence of PCOS on Health-Related Quality of Life (HQOL) had a more profound effect on emotional and social functioning. In addition, Weiss and Bulmer7 conducted a study assessing psychological characteristics of PCOS and found that 24% of women had mild depression, 5% of women had moderate depression, and 2% of women had severe depression.

The psychological impact of PCOS has become a major concern within the healthcare industry for adolescents and women who suffer with the long-term complications of this syndrome.2 The psychological clinical concerns such as depression, social isolation, anxiety, and mood disorders are the result of many of the psychological changes that are experienced by adolescents and women with PCOS that affects their psychological functioning. Due to the lifelong overwhelming psychological effects of PCOS on the health outcomes of adolescents and women of childbearing age, PCOS is now being viewed as a major concern for physical health.5


Treatment inadequacies exist in practice due to clinicians’ lack of awareness of the psychological effects of PCOS. The main problems identified by adolescents and women at the time of being diagnosed with PCOS are the lack of physician’s knowledge about the syndrome, lack of ability to build a rapport with physician, inconsistency of care, and a lack of knowledge regarding the psychological effects of the disorder. The healthcare industry failed to meet the long-awaited fulfillment of improving health outcomes for adolescents and women who suffer with PCOS symptoms.2 There is an increased need for clinicians to become more aware of the psychological effects of PCOS and a need to provide a holistic treatment and management approach that incorporates the psychological clinical symptoms of PCOS.8


  1. Stirmans, S.M., Pate, K.A. Epidemiology, diagnosis, and management of polycystic ovary syndrome. J Clin Epidemiol. 2013; 1: 1-13.
  2. Jones, G. L., Hall, J. M., Lashen, H. L., Balen, A. H., Ledger, W. L. Health-related
  3. quality of life among adolescents with polycystic ovary syndrome. J Obstet Gynecol Neonatal Nurs. 2011; 40(5): 577-588.
  4. Buggs, C., Rosenfield, R.L. Polycystic ovary syndrome in adolescence. Endocrinol Metab Clin North Am. 2005; 34: 667-705.
  5. Shannon, M., Wang, Y. Polycystic ovary syndrome: a common but often unrecognized condition. J Midwifery Women’s Health. 2012; 57(3): 221-230.
  6. Lee, J. S. It’s not just physical: the adverse psychosocial effects of polycystic ovary syndrome in adolescent. Women’s Healthcare: A Clinical Journal for NPs. 2015; 3(1): 20-27.
  7. Cipkala-Gaffin, J., Talbott, E. O., Song, M., Bromberger, J., Wilson, J.
  8. Associations between psychologic symptoms and life satisfaction in women with polycystic ovary syndrome. J Women’s Health. 2012; 21(2): 179-187.
  9. Weiss, T. R., Bulmer, S. M. Young women’s experiences living with polycystic ovary syndrome. J Obstet Gynecol Neonatal Nurs. 2011; 40(6): 709-718.

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About Author

Fredricka Marsh, APRN, MSN, RN
Fredricka Marsh, APRN, MSN, RN

Fredricka Marsh’s reputation precedes her as an energetic, motivated, dedicated, and intellectual individual. She was born and raised in Miami, Florida and currently reside in Fort Lauderdale, Florida with her husband, Nathaniel Marsh, and three daughters, Sh’ene Marsh-Beckford, Sha’Ricka ,and Sha’Rena Marsh. Fredricka began her nursing career at Mcfatter Vocational School in 1997 and earned her Licensed Practical Nurse (LPN) degree. She furthered her nursing career as an LPN and attended Broward Community College in 1998 to earn a Registered Nurse (RN) degree. After working at Broward General Hospital, Fredricka registered at Nova Southeastern University in 2003 and earned a bachelor’s degree in nursing (BSN) in 2005 and a master’s degree in nursing education in 2006. Fredricka earned a Post Master’s Degree in Family Nursing Practice (FNP) in 2013 at Frontier Nursing University and is currently pursuing her doctoral degree as a Doctor of Nursing Practice (DNP) at the University of Alabama. Fredricka graduated from South Broward High School in 1982. She attended Atlantic Vocational School in 1990 and become a Court Stenographer in 1992. She was employed at Jack Besner &Associates where she worked in the Miami Judiciary System. Fredricka’s nursing career has afforded her many wonderful opportunities as a registered nurse in many different specialty areas within the hospital, clinical and community settings. She has been employed in Medical-Surgical Nursing, Telemetry, Maternity Nursing, Pediatrics Nursing, Simulation, and Home Health Care. After receiving her master’s degree in education, Fredricka was employed as a nursing instructor at City College in 2008 and over the past decade has broadened her teaching career at several other colleges and universities. Fredricka is currently employed with United Healthcare (Optum) as a Housecall Nurse Practitioner. Fredricka past professional background in education and clinical expertise that proceeds her to the doctoral level in nursing. Her leadership skills provide her with a foundational platform that assists her in future endeavors for enhancing her professional skills for advanced practice improvement within a leadership role.

Dr. Jemimah Mitchell-Levy, PhD, ARNP

Dr. Jemimah Mitchell-Levy, PhD, ARNP is a Senior Associate Professor at the Benjamin Leon School of Nursing, Miami Dade College.

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