Stress and PCOS: How to break the cycle

Stress is unavoidably a part of life and a feeling that everyone has experienced to some degree. Even on a daily basis, there will be stressors that arise whether it be meeting work deadlines, running errands, or even just trying to find a parking space. 

There are different types of stress and they are not created equally. Stress can sometimes strengthen your ability to adapt and overcome challenges, which can teach you how to conquer the next adversity (1). On the other hand, chronic stress can aggravate many health related issues including cancer, heart disease, mental illnesses, respiratory disorders, and more (1). 

If you have been diagnosed with polycystic ovary syndrome (PCOS), you may know that stress management is a crucial component of keeping symptoms at bay (2). However, this condition is often overwhelming and can be a major stressor in life, which feeds into a vicious cycle. That’s why learning how to cope with stress can be a key ingredient to managing your symptoms. 

In this article, we’ll be going over the following topics to help you understand the connection between stress and PCOS. Read on to learn:

• What is the difference between acute and chronic stress?
• How does stress impact PCOS?
• What are stress management techniques for PCOS?

Acute stress vs. chronic stress

When we talk about stress and the implications it has on health, we first have to acknowledge the difference between acute stress and chronic stress. 

When you experience a physiological and psychological reaction to a specific event, such as getting in a fight with your significant other, it is called acute stress. This kind of stress typically develops quickly, but does not last long and is also the most common. Chronic stress, however, is when those feelings persist over a long period of time, leaving the body in a constant state of  “fight, flight, or freeze” (3).

Once a threat is detected, the body releases cortisol in response to stress in order to prepare itself for that perceived threat. Cortisol is a hormone necessary in essential functions including increasing blood sugar, improving focus and memory, providing energy, and controlling blood pressure. 

Why then is cortisol deemed as “bad” when it is necessary for all of these functions?  

The problem occurs when the body remains under duress even after the threat is gone. In addition to affecting mental health, stress can also have physical consequences.  Daily elevated cortisol levels can disrupt the hypothalamus-pituitary-adrenal axis (HPA axis), which plays an important role in how the body reacts to stress (4).

 A dysfunction in the HPA axis can cause various symptoms including:

• Anxiety
• Fatigue
• Frequent illnesses 
• Headaches
• Irregular menstrual cycles 
• Digestive problems

There are many different underlying reasons why an individual may experience long-term stress. Individuals with a chronic condition such as PCOS may be more prone to stress due to the nature of the condition, which we will discuss in the next section.

How stress impacts PCOS

Due to its manifestations, PCOS itself is a catalyst for stress. Symptoms of PCOS include acne, weight gain, hair loss, hirsutism, and infertility, which can have a significant impact on an individual’s self esteem and lifestyle. A study published in 2016, showed that people with PCOS were six times more likely to experience stress, anxiety, and/or depression (5).

PCOS is also associated with high levels of inflammation in the body. As discussed previously, an imbalance in cortisol may have adverse health effects. Prolonged stress may cause cortisol dysfunction leading to widespread inflammation which can exacerbate PCOS symptoms (6).

Elevated androgens is a common hormonal imbalance associated with PCOS, known as adrenal PCOS. Your question may be: how does stress factor into this? 

Excess insulin can trigger elevated androgens. When the body produces excess cortisol, it also affects insulin secretion. This might be problematic to people with PCOS since it might cause insulin resistance, weight gain, diabetes, acne, and hair growth (7).

Stress management techniques

Considering the complex feedback loop of stress and PCOS, it is important to include mechanisms in your daily routine to manage your stress and symptoms.

By incorporating stress management tools that fit your lifestyle, you can improve your health both physically and mentally. You may even gain a deeper understanding of what specific stressors trigger you and learn the methods to best cope with them in the future.

Below are some ways that may be beneficial for stress management.

‍Therapy: A PCOS diagnosis can be confusing and overwhelming. If your symptoms are bothering you and affecting your everyday life, it may be beneficial to look into therapy or counseling. A therapist can help you develop healthy coping mechanisms and improve your emotional well-being. While therapy is not financially feasible for everyone, there has been an uptick in virtual and lower-cost options with the pandemic, and more health plans are covering counseling services than in the past. You can get help finding a therapist from your Pollie care coordinator if you do not know where to start.

Meditation: Meditation has been shown to have positive effects on stress and has even shown to be helpful for conditions worsened by stress, such as PCOS (8). Meditation may seem difficult at first, but even two to five minutes a day can help reduce stress by clearing your mind to focus on the present. There are various resources centered around meditation and you can find many options for self-guided meditations. Contact your Pollie care team if you would like to learn more about meditation.

Deep Breathing: Deep breathing, also known as belly breathing or diaphragmatic breathing, promotes relaxation, reduces stress, and increases body awareness. Talk to your Pollie health coach about deep breathing and how to incorporate it into your daily routine. 

Mindful movement: Not only does body movement improve our health, it also greatly reduces our stress levels. Try thinking of activities that you enjoy (walking, yoga, dancing, gardening, etc.) and jot them down so you can pick from the list when you are feeling overwhelmed. For more information on how movement helps manage PCOS, click here.

Keep in mind you may have to try a few things to figure out what is best for you. Something that works great for one person may not be as effective for you, so there can be some trial and error that you might go through. However, finding the tools that work for you can improve your quality of life and in turn, improve your symptoms!

 If you are unsure of where to start, reach out to your Pollie healthcare team so they can guide you in the right direction.

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Bibliography

1. Salleh M. R. (2008). Life event, stress and illness. The Malaysian journal of medical sciences : MJMS, 15(4), 9–18.
2. Centers for Disease Control and Prevention. (2020, March 24). PCOS (polycystic ovary syndrome) and diabetes. Centers for Disease Control and Prevention. Retrieved March 24, 2022, from https://www.cdc.gov/diabetes/basics/pcos.html#:~:text=PCOS%20is%20one%20of%20the,beyond%20the%20child%2Dbearing%20years 
3. Yale Medicine. (2019, November 15). Chronic stress. Yale Medicine. Retrieved March 24, 2022, from https://ym.care/xb8 
4. Guy-Evans, O. (2021, May 19). Hypothalamic-pituitary-adrenal axis. Simply Psychology. Retrieved March 24, 2022, from https://www.simplypsychology.org/hypothalamic%E2%80%93pituitary%E2%80%93adrenal-axis.html 
5. Blay, S. L., Aguiar, J. V., & Passos, I. C. (2016). Polycystic ovary syndrome and mental disorders: a systematic review and exploratory meta-analysis. Neuropsychiatric disease and treatment, 12, 2895–2903. https://doi.org/10.2147/NDT.S91700
6. Hannibal, K. E., & Bishop, M. D. (2014). Chronic stress, cortisol dysfunction, and pain: a psychoneuroendocrine rationale for stress management in pain rehabilitation. Physical therapy, 94(12), 1816–1825. https://doi.org/10.2522/ptj.20130597
7. Gurevich, R. (2022, February 18). Androgens & PCOS: Excess levels & what it means. Verywell Health. Retrieved March 24, 2022, from https://www.verywellhealth.com/androgens-and-pcos-excess-levels-what-it-means-4156771 
8. Mayo Clinic. (2020, April 22). Meditation: A simple, fast way to reduce stress. Mayo Clinic. Retrieved March 25, 2022, from https://www.mayoclinic.org/tests-procedures/meditation/in-depth/meditation/art-20045858#:~:text=Meditation%20can%20produce%20a%20deep,physical%20and%20emotional%20well%2Dbeing.

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