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Psychological symptoms and brain activity alterations in women with PCOS

By Ioana-Claudia Pantea


Polycystic ovary syndrome (PCOS) is the most prevalent endocrine disorder in females, marked by excess androgens, dysfunction in ovulation, and morphological changes in the ovaries.The worldwide impact of PCOS varies from 5–15% up to 20% of female patients of reproductive age.


Thorough investigations were conducted to find out how PCOS symptoms affect the quality of life, psychological symptoms, and brain changes in patients with this disorder.


PCOS effects at a glance


The majority of data on quality of life was derived from psychometric research that utilized questionnaires. Changes in sleep, body image, and mood disorders can have a detrimental impact on patients' quality of life. Brain imaging studies revealed changes in brain function linked to deficits in visuospatial working memory, episodic and verbal memory, attention, and executive function.


Several factors that can impact the quality of life of patients are specifically linked to hyperandrogenism and the potential for infertility. Obesity, excessive hair growth, acne, and concerns about fertility can directly affect self-confidence and sexual activity. The well-being of patients can be impacted by metabolic and psychiatric comorbidities including mood, anxiety, and eating disorders. In addition, certain cognitive changes like difficulties in focus and recollection can hinder PCOS individuals in various areas of their daily activities.


Psychological impact of PCOS


Since 2014, significant focus has been placed on the coexisting conditions observed in PCOS. Women with PCOS have a higher chance of experiencing symptoms of depression and anxiety, along with a lower quality of life.


Research emphasized the importance of additional psychiatric conditions, with higher occurrences of OCD (obsessive compulsive disorder) and somatization found in women with PCOS. Some women with this disorder described feeling distinct from other women and less feminine. PCOS also had a greater prevalence of social phobia and eating disorders such as bulimia nervosa and binge eating throughout their lifetime. Moreover, patients also indicate experiencing negative body image, weight discrimination, a significantly increased risk of suicide, and elevated rates of using antidepressants and anti-anxiety medications. Additionally, PCOS has been associated with a higher rate of sleeping disorders, such as hypersomnia and obstructive sleep apnea.


Brain alterations in PCOS


Recent advancements in brain imaging methods, like MRI(magnetic resonance imaging), fMRI(functional magnetic resonance imaging), and PET(positron emission tomography), have allowed researchers to study how hyperandrogenism affects the female brain and its cognitive and emotional functions. In recent years, EEG(electroencephalography) has offered additional details on brain areas and functions impacted by hormonal changes in PCOS. While only a limited number of studies have examined the brain changes linked to PCOS with neuroimaging methods and EEG, multiple findings have shown a connection between PCOS and decreased cognitive performance. Brain imaging studies have shown that this disorder affects various brain regions, including the frontal, temporal, and subcortical areas.


In 2020, it was discovered that PCOS can alter the functions of brain regions related to visuospatial working memory, facial recognition, and episodic memory. Women with PCOS have demonstrated markedly reduced abilities in attention and psychomotor speed tests compared to women without the condition.


PCOS was found to have a negative effect on verbal fluency, verbal memory, and manual dexterity performance. Nevertheless, there were no discrepancies noticed in mental rotation, spatial visualization, spatial perception, or perceptual speed.


To summarize


PCOS is known as a highly intricate and diverse disorder, impacting various aspects of patients' lives. Its characteristics are evident not just in the criteria used for diagnosis, but also in research examining various aspects of the condition.


Although many studies have looked into the impact of PCOS on various aspects of quality of life, there are still gaps in knowledge regarding the specific processes and mechanisms involved.


Various influences can have a detrimental effect on the quality of life of women with PCOS. The majority of them are directly associated with hyperandrogenism and the potential for infertility. Symptoms like obesity, hirsutism, acne, and concerns about infertility can directly affect self-esteem and sexual function. The well-being of these patients can be impacted by both metabolic and psychiatric comorbidities. Furthermore, particular changes in cognitive function, like issues with focusing and remembering information, can hinder individuals with PCOS in various areas of their daily routines.



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