PCOS Isn’t Just About Periods: What Research Says About Anxiety and Depression

Short answer. Women with polycystic ovary syndrome (PCOS) reported depression and anxiety symptoms more often than women without it. A pooled analysis of 30 studies (18 for depressive symptoms, 9 for anxiety symptoms) found their odds of depressive symptoms were about 3.8 times higher, and their odds of anxiety symptoms about 5.6 times higher (Cooney et al., 2017). A separate overview of 10 reviews also found these problems common in women with PCOS (Infante-Cano et al., 2025). The studies found the two together more often, and they don't say which comes first.

Key facts

• Across 30 cross-sectional studies pooled together, women with PCOS had higher odds of depressive symptoms (OR 3.78, 18 studies) and anxiety symptoms (OR 5.62, 9 studies) than women without PCOS (Cooney et al., 2017).
• Matching groups for body mass index left the gap in place: depression OR 3.25 (4 studies) and anxiety OR 6.30 (3 studies). Weight alone doesn't seem to explain it (Cooney et al., 2017).
• How common these symptoms look depends on the questionnaire used. Reported prevalence for depressive symptoms ranged from about 31% to 46% (Infante-Cano et al., 2025).

A woman writing about PCOS said: “PCOS is honestly a disability and it's not treated like such… we're expected to just function like people who don't have any of these struggles.”

PCOS beyond cycles and hormones

The studies defined PCOS by either NIH or Rotterdam criteria (Cooney et al., 2017), and many people think of it as a gynecological or hormonal condition. The research here looks at how often women with PCOS also report low mood and anxiety, and two reviews cover it.

Depression and anxiety odds across 30 studies

Cooney and colleagues pooled 30 cross-sectional studies covering 3,050 women with PCOS and 3,858 controls (women without PCOS) from 10 countries. The results pointed the same way across symptom levels:

An odds ratio compares the odds in one group with the odds in another. So 3.78 doesn't mean that 3.78 times as many women are affected. The anxiety results also varied moderately to substantially from study to study (I² = 59.6%), which helps explain the wide confidence interval (the range where the true value probably falls). For depression, the studies differed little (Cooney et al., 2017).

Body weight as a possible explanation

Body weight is a natural suspect, so researchers checked it. Cooney and colleagues looked only at studies that matched groups for body mass index. The odds stayed high: 3.25 for depression and 6.30 for anxiety. Only four and three studies could be matched, though, and the confidence intervals were wide (Cooney et al., 2017). Body mass index doesn't seem to explain the whole gap, and the studies leave open what else might.

A 2025 overview of 10 reviews

Infante-Cano and colleagues (2025) looked at 10 systematic reviews that each pooled results from many studies. Together, the reviews put the pooled prevalence (the combined share of women affected) at 16.9% for anxiety disorders and 34.8% for depressive disorders in women with PCOS. When studies used symptom questionnaires, the numbers varied widely with the tool:

With a spread like that, read any single headline percentage with care (Infante-Cano et al., 2025).

Bringing it up at appointments

Mood and anxiety symptoms were common among women with PCOS in these reviews. That's a reason to mention them at appointments, even when the visit is about cycles, skin, or fertility, since it may help your doctor ask the right questions. No treatment was tested, so the studies can't say what works.

What the research can’t tell us

• All 30 studies in the meta-analysis were cross-sectional. That means they can't show whether PCOS leads to depression and anxiety, whether it's the other way round, or whether something shared drives both (Cooney et al., 2017).
• On anxiety, the studies differed moderately to substantially, so one pooled figure hides a wide range (Cooney et al., 2017).
• The studies used different questionnaires, and prevalence changed with the questionnaire, so the figures are hard to compare (Infante-Cano et al., 2025). The studies also defined PCOS by either NIH or Rotterdam criteria, which may add differences between them (Cooney et al., 2017).
• Neither source explains how PCOS and mood might be connected, and this article doesn't offer an explanation either.

When should you talk to a professional?

See a doctor if low mood, anxiety, or loss of interest lasts or keeps getting worse, if sleep or appetite change a lot, or if symptoms affect work or relationships. Mention your PCOS, since it's relevant background. If you have thoughts of harming yourself, contact local emergency services or a crisis line right away.

Where Soula can fit in

Soula is an AI companion for emotional support. It isn't a therapist, and it can't diagnose PCOS, depression, or anxiety. Its cycle tracking keeps a record of your cycle that you can show a doctor, and the check-ins and AI-assistant chat help you put your mood into words. If patterns persist, Soula encourages you to seek professional care.

FAQ

Is it normal to feel anxious or low with PCOS?

Many women with PCOS report low mood or anxiety, and mentioning it to your doctor is reasonable. Odds were higher for moderate or severe symptoms too (OR 4.18 for depression, 6.55 for anxiety) (Cooney et al., 2017).

Is it just because of my weight?

Not by itself. When only studies that matched groups for body mass index were counted, the odds were 3.25 for depression and 6.30 for anxiety (Cooney et al., 2017).

Does PCOS cause depression?

That isn't shown. Women with PCOS reported low mood more often, and the research leaves open whether something else drives both.

Is PCOS linked to anxiety and depression?

Yes, in the research covered here. Women with PCOS had higher odds of both, and an overview of 10 reviews also found the problems common (Cooney et al., 2017; Infante-Cano et al., 2025).

Does PCOS cause depression?

The studies can't say. All 30 were cross-sectional, so each woman was assessed once, and the order of events is unknown (Cooney et al., 2017).

How common is depression in women with PCOS?

An overview of 10 systematic reviews reports a pooled prevalence of 34.8% for depressive disorders. For symptoms, the figures varied widely with the questionnaire (Infante-Cano et al., 2025).

Is the link explained by weight?

Not entirely. Only four studies for depression and three for anxiety could be matched, and the confidence intervals were wide, so treat the answer as rough (Cooney et al., 2017).

References

1. Cooney, L. G., Lee, I., Sammel, M. D., & Dokras, A. (2017). High prevalence of moderate and severe depressive and anxiety symptoms in polycystic ovary syndrome: A systematic review and meta-analysis. Human Reproduction, 32(5), 1075–1091. https://doi.org/10.1093/humrep/dex044
2. Infante-Cano, M., García-Muñoz, C., Matias-Soto, J., et al. (2025). The prevalence and risk of anxiety and depression in polycystic ovary syndrome: An overview of systematic reviews with meta-analysis. Archives of Women’s Mental Health, 28(3), 475–489. https://doi.org/10.1007/s00737-024-01526-1