Prevalence of anxiety disorders and depression in women with polycystic ovary syndrome (PCOS): A literature review

Abstract

Introduction: Polycystic ovary syndrome (PCOS) is a common endocrine condition in women of reproductive age, frequently associated with significant psychological repercussions, including anxiety and depression, impaired self-esteem, and negative impacts on quality of life and sexual function. Clinical management of PCOS requires an integrated approach addressing the pathophysiological, metabolic, and psychosocial factors influencing patient well-being, with physiotherapy emerging as a promising complementary strategy for reducing anxiety and depression symptoms through supervised physical exercise and relaxation techniques. Objective: This literature review aimed to synthesize evidence on the prevalence of anxiety and depression in women with PCOS, identify the underlying pathophysiological and social mechanisms, and provide recommendations for multidisciplinary clinical practice, including the role of physiotherapy in improving mental health. Methods: This is a descriptive and analytical literature review based on national and international publications available in the Scientific Electronic Library Online (SciELO), Latin American and Caribbean Health Sciences Literature (LILACS), United States National Library of Medicine (PubMed), and Virtual Health Library (BVS) databases. Studies published between 2004 and 2024 were included, encompassing systematic reviews, meta-analyses, theoretical articles, and observational studies on mental health, quality of life, and hormonal factors in women with PCOS. Results: The literature indicates a high prevalence of anxiety and depression symptoms in women with PCOS, often associated with elevated androgen levels, insulin resistance, obesity, and psychosocial factors such as negative body image perception and perceived infertility. These symptoms negatively affect quality of life, self-esteem, and sexual function. Physiotherapeutic interventions, including aerobic and resistance exercises, stretching, and relaxation techniques, have proven effective in reducing anxiety and depressive symptoms, complementing psychological support and promoting both physical and mental well-being. Multidisciplinary approaches integrating hormonal assessment, psychological follow-up, social support, metabolic management, and physiotherapy targeting mental health have shown efficacy in reducing psychiatric symptoms and improving overall patient well-being. Conclusion: Management of PCOS requires a multidimensional approach considering endocrine, metabolic, and psychosocial aspects. Systematic screening for anxiety and depression symptoms, combined with psychological support, physiotherapeutic interventions, integrated clinical follow-up, and management of hormonal and metabolic factors, is essential to reduce psychological impact, improve quality of life, and optimize health outcomes in affected women. Investments in multidisciplinary protocols, professional training, and integration between gynecology, endocrinology, and mental health services are fundamental for effective PCOS care.