Links to Mood
PCOS has been associated with a higher risk of mental health and cognitive difficulties, including symptoms that overlap with attention-deficit/hyperactivity disorder.“The increased prevalence of mental health disorders in women with PCOS may be partly explained by hormonal imbalances,” Mpho Tshukudu, an integrative and functional nutritionist, said in an interview with The Epoch Times.
Altered Body Image
Body image struggles and disordered eating behaviors are also common with PCOS. Higher androgen levels may increase appetite and emotional lability, while insulin resistance can lead to blood sugar crashes that fuel intense carbohydrate cravings. When these physiological drivers combine with social pressure to be thin and the stigma surrounding weight, it can lead to patterns of binge eating or cycles of restriction and overeating.“I’ve worked with many women in their 20s and 30s who have been diagnosed with PCOS,” Yasi Ansari, a registered dietitian who specializes in eating disorders, said.
“Often, they’ve been told to drastically change their diet or lose weight, which can feel overwhelming and confusing. That emphasis on weight can trigger disordered eating and harm their relationship with food and their body.”
Treat the Whole Person
Ansari emphasized that treatment should be both individualized and integrative, with care plans designed to address the full spectrum of a person’s physical and mental health needs.There are numerous opportunities to enhance care, according to Dr. Licy Yanes Cardozo, a physician-scientist and practicing endocrinologist at the University of Mississippi Medical Center. A comprehensive, multidisciplinary team approach is essential for managing PCOS effectively over the long term, she stated.
“Addressing mental health should be a priority in the care of women with PCOS,” Cardozo said.
Tshukudu noted that mental health is often overlooked or insufficiently addressed in current PCOS treatment plans.
While guidelines recommend including mental health professionals, psychologists and psychiatrists are not always part of the care team. Ansari noted that the focus tends to remain on hormonal health—weight, fertility, insulin resistance, and the menstrual cycle—often managed by gynecologists, endocrinologists, and dietitians.
Modify Diet
“When I give nutritional guidance, I focus on practices that support energy levels, nourishment, and well-being, without centering everything around weight,“ Ansari said. ”The goal is for clients to feel no shame or pressure to restrict any foods or food groups.”No matter a person’s weight or age, improved nutrition and regular physical activity are considered the first line of treatment for PCOS.
- Eat a wide variety of fruits, vegetables, whole grains, legumes, raw nuts, seeds, fermented dairy, lean meats, herbs, and spices. These foods are rich in fiber, prebiotics, and phytonutrients, which support gut health and help regulate blood sugar.
- Choose lower-glycemic carbs and high-quality fats and proteins as they help improve satiety, stabilize blood sugar, and reduce inflammation. Build balanced meals and include healthy snacks as needed.
- Include omega-3s from oily fish such as salmon, mackerel, sardines, and herring, as well as from plant sources such as chia seeds, flaxseeds, walnuts, spirulina, and chlorella.
- Drink plenty of fluids such as filtered water and unsweetened herbal or fruit teas to support digestion and stay hydrated.
- Minimize ultra-processed and sugary foods, which are often high in energy but low in fiber, vitamins, and minerals. These foods are less satiating, can lead to overeating, and often displace healthier whole foods—negatively affecting blood sugar, hormonal balance, and weight.
Vary Lifestyle Interventions
Because PCOS affects so many aspects of health, from hormones and metabolism to mood and cognition, care should be broad and multidisciplinary.In addition to focusing on quality nutrition, Tshukudu also emphasized the importance of other lifestyle factors.
Sleep problems are common in PCOS, with many experiencing poorer sleep quality and increased daytime sleepiness. In teens, there are often changes in circadian rhythms, including later sleep timing and longer melatonin release at night.
Practices such as deep breathing, yoga, time in nature, and creative hobbies—such as knitting or painting—may help reduce stress and support emotional regulation, Tshukudu said.
Finally, incorporate a mix of aerobic exercise, strength training, and gentle practices such as Pilates. Physical activity improves insulin sensitivity, balances sex hormones, lowers inflammation, and can reduce symptoms of anxiety and depression.