Living with polycystic ovary syndrome (PCOS) can be emotionally challenging. Beyond physical symptoms, many women experience changes to their body, concerns about fertility, and the ongoing stress of managing a long-term condition. These experiences can have a profound impact on self-esteem, relationships, and emotional wellbeing.
In this article, I focus on how PCOS affects emotional wellbeing in everyday life, what can help when coping feels difficult, and when psychological support may be helpful.
How does PCOS affect body image and self-esteem?
Visible and life-altering symptoms of PCOS can significantly affect how a person sees themselves. Symptoms such as:
- Acne
- Excess hair growth (hirsutism)
- Hair thinning or hair loss
- Weight gain
can strongly impact body image and self-esteem.
Managing these changes within societal beauty standards can lead to anxiety, shame, and social withdrawal, and over time may contribute to lower mood and reduced quality of life.
How can I cope with body image difficulties caused by PCOS?
Speaking with a therapist who specialises in long-term health conditions can be helpful. Therapy can support people in coming to terms with a PCOS diagnosis and exploring what the condition means for them personally.
Cognitive behavioural therapy (CBT) has evidence for supporting anxiety and depression, particularly by helping people reframe negative thoughts, challenge an internal critical voice, and address body image concerns.
Compassion-focused therapy can also support self-kindness, acceptance of what is beyond personal control, and a shift towards valuing health over perfection.
Group therapy or peer support can be powerful. Sharing experiences with other women living with PCOS can reduce isolation and help people feel less alone.
Alongside psychological support, some people find practical interventions helpful, such as treatments for acne or hair changes (including medication or laser hair removal), as well as lifestyle changes such as regular movement and dietary approaches that support metabolic health.
How do fertility concerns affect emotional wellbeing in PCOS?
PCOS is a leading cause of anovulatory infertility. The uncertainty surrounding fertility, along with the emotional and relational strain of fertility investigations or treatment, can be a significant source of stress, anxiety, and low mood.
It is important to avoid comparing yourself to others. Practising self-compassion, focusing on personal strengths, and using reflective tools such as journalling can help support emotional wellbeing.
Speaking with a fertility specialist experienced in supporting women with PCOS can also be reassuring. There are different approaches available to support ovulation and improve the chances of pregnancy, and having clear, personalised information can help reduce distress.
How can I cope with the stress of living with PCOS long term?
Managing a complex, lifelong condition is inherently stressful, and support plays a crucial role.
Helpful sources of support include:
- PCOS support groups
- Digital tools such as the AskPCOS app
- Talking openly with trusted friends or family
- Introducing manageable lifestyle changes
- Accessing psychological therapy when needed
If PCOS is affecting how you feel emotionally, you do not have to manage this alone. Psychological support can play an important role in helping you cope with both the visible and invisible emotional impact of PCOS.
About the author
Dr Sarah Jane Khalid is a Counselling Psychologist, Coach and certified Meditation Teacher with experience across the NHS, charitable organisations and private practice. She specialises in stress, low self-esteem, workplace challenges and women’s mental health, using evidence-based approaches including CBT, mindfulness, ACT and Compassion Focused Therapy.
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