Polycystic Ovarian Syndrome (PCOS) is a complex and somewhat difficult-to-understand diagnosis. In many cases, it’s a “diagnosis of exclusion”—that is to say, if you come to the doc’s office with a series of symptoms and they can’t place all the symptoms (or if tests come back inconclusive for other stuff), they likely will call it the closest “non-testable” diagnosis. Irritable Bowel Syndrome (IBS) is another such diagnosis. PCOS is fairly common in women of reproductive age, affecting from 5 to 10% of women.

PCOS also offers a somewhat philosophical experience of “which came first: the chicken or the egg?:” many of the causes of the syndrome are also its effects. Crazy, right? And no fun. For example: PCOS is caused by/causes a hormonal imbalance involving an increase in male sex hormones (androgens). This can cause some male characteristics (male pattern baldness or hairiness on the back or the face), and it is this hormonal imbalance that can cause weight gain, which in turn perpetuates the hormonal imbalance. Excess weight can cause hormonal issues with estrogen and releasing mature eggs, which is (guess what?) a major symptom of PCOS. It hurts the brain, doesn’t it?

Anxiety is one of those challenges with PCOS. Many folks with PCOS report feeling anxiety and depression, and there are a few causes that could be considered. First are the hormones: those little buggers floating through our bloodstream and all around our body have such a profound connection with our mental state and overall mental health, we haven’t fully even discovered the extent of it. Reproductive hormones are especially powerful in women, and when those are out of balance, life can get really rough emotionally.

The second cause for anxiety could be some of the effects of the syndrome itself: if you are losing hair on your head and growing hair on your face, you might feel anxious too! This anxiety and depression might lead to a more sedentary lifestyle, in which you don’t go out as often leading you to feel isolated, which leads to more (again…) depression and anxiety. Isn’t this fun?

One of the only tests for PCOS is to actually study the amounts of the different hormones in your body, but this is only a snapshot, rather than a full image of what’s going on. Still, it is helpful. If this sounds like you, it is definitely worth talking to your doctor about.

Anxiety may cause weight gain from lack of exercise or poor eating habits. And weight gain is a symptom (or a cause?) of PCOS, which can further exacerbate the hormonal imbalance in your body. When a woman’s body carries too much weight, it can lead to an imbalance of estrogen, causing a potential lack of release of mature eggs from the ovaries. Strangely enough, this is exactly what happens in PCOS!

So, what can you do to help your body regulate itself? Exercise, eat healthy, and maintain a healthy weight. In addition, for the anxiety, watch funny movies; spend time with cool people, plus all of the above. PCOS can be a challenging thing to live with, but it can be managed.