(378) Updated Insights into Mental Health Issues in Women with Polycystic Ovary Syndrome

Objective : To identify the pathophysiological interplay of mental health issues and both the symptoms and treatments of polycystic ovary syndrome (PCOS) in women. To describe current guideline recommendations related to pharmacologic and non-pharmacologic options.

Methods: Compared changes in recommendations from the collaborative international guidelines, updated in 2023 (previous update published in 2018). Conducted search within PubMed to identify literature published in or after 2000 utilizing “pcos and depression”, “pcos and psychotherapy”, and “pcos and body image” as key search phrases. Summarized these changes and current literature to fulfill objectives.

Results: Cardinal PCOS symptoms (including hyperandrogenism, insulin resistance contributing to obesity, and infertility) appear to be the primary cause of mental health issues in women with PCOS. However, independent biological processes may be the cause of some mental health issues in those who do not display these cardinal symptoms. Guidelines recommend cognitive behavioral therapy (CBT) for women with PCOS and low self-esteem. In those experiencing depression, anxiety, and/or eating disorders, management should follow guidelines and established standards of care specific to each. All patients should be offered mental health screenings and appropriate resources to encourage adherence to pharmacologic and non-pharmacologic PCOS and mental health treatments.

Conclusions: Mental health issues appear to be increased in women with PCOS compared to those without PCOS. Pharmacists should emphasize treatment which includes psychotherapy while retaining an openness to pharmacotherapy when indicated. Student pharmacist education should include content which raises awareness of these realities, ideally within mental health-related learning experiences.