Wearing Teal: Role of Therapy in PCOS Management

“Another month, another irregular cycle.”

“My skin breaks out no matter what I do.”

“No matter which treatment I try, these dark patches won’t fade.”

“I try to eat healthy, but the weight just won’t budge.”

For many women living with polycystic ovary syndrome (PCOS), these daily struggles go far beyond the physical symptoms.

Each September, teal ribbons surface as a symbol of PCOS Awareness Month, reminding us of the millions of women affected by this condition. PCOS affects an estimated 1 in 10 women of reproductive age, yet more than a third remain undiagnosed. PCOS presents with physical symptoms of irregular periods, acne, excessive facial hair or male pattern baldness, and weight; however, there is still less talk on the challenges and struggles that the condition quietly burdens mental health. For many women, managing PCOS isn’t only about regulating hormones or balancing blood sugar; it’s about navigating feelings of anxiety, frustration, self-doubt, and even grief.

PCOS and the Hidden Emotional Weight

Research consistently shows that women with PCOS are:

• 2.5 times more likely to experience depression

• 5 times more likely to struggle with anxiety

• At increased risk for obsessive-compulsive disorder (OCD), eating disorders, body image distress, and sleep problems.

• Sari et al. (2020) found that adolescent women with PCOS have lower self-esteem when compared with their peers without PCOS.

• During adulthood, many women also face challenges related to fertility, early menopause, or irregular uterine bleeding.

• Studies show that PCOS often results in poor quality of life, particularly when women feel a lack of control over the disease. Even those who reported a good QoL still found their symptoms bothersome, revealing underlying mental health struggles.

  
  

These emotional struggles aren’t just accompanying symptoms or side effects of PCOS. They are core experiences of living a life with PCOS. These hidden struggles profoundly shape how women perceive themselves, interact with their bodies, and interact with the people around them.

How Therapy Supports PCOS Healing

A recent study by Standeven and Hantsoo (2024) suggested two therapeutic modalities that are particularly effective in managing physical and mental health symptoms of PCOS: Cognitive Behavioural Therapy (CBT) and Mindfulness-Based Interventions. Moradi and colleagues (2020) also found that acceptance-based therapy improves QoL for women with PCOS.

Cognitive Behavioural Therapy (CBT)

CBT is an action-oriented and goal-directed therapy. CBT identifies and reshapes unhelpful thoughts associated with the physical symptom. It also supports:

• Developing healthier strategies for managing stress or food cravings

• Using behavioural activation to improve QoL and reduce symptoms like depression, low mood and motivation

• Learning to separate self-worth from quantifiable variables to qualitative measures

Example: A woman struggling with the thought, “I’ll never feel attractive because of my acne,” learns in CBT to reframe this into, “My skin doesn’t define my value. I can care for my body in other ways that make me feel confident.”

Mindfulness-Based Therapy

Mindfulness helps women tune into the present moment with compassion rather than judgment. In PCOS, mindfulness practices can:

• Reduce rumination about fertility or weight

• Improve body acceptance and reduce shame

• Lower stress hormones to improve physical symptoms

• Support better sleep and emotional regulation

  
  

Try this: Spend 2 minutes each day placing a hand on your belly, taking slow breaths, and paying attention to sensory experience and feelings of your body. This slight pause can calm stress responses that fuel PCOS symptoms.

Acceptance and Commitment Therapy (ACT)

ACT is a values-based therapy that helps individuals accept difficult emotions while committing to actions that align with their personal values. ACT helps women to make space for themselves and focus on living a meaningful life despite challenges associated with PCOS.

ACT promotes:

• Psychological flexibility to respond more effectively to stressful experiences

• Acceptance of uncomfortable emotions rather than fighting against them

• Clarification of personal values, guiding healthier and more fulfilling choices

  
  

Example: A woman who thinks, “I’ll never feel happy unless I lose this weight,” learns in ACT to accept that thought without letting it control her actions. Instead, she clarifies that her deeper value is connection, so she chooses to spend quality time with loved ones.

Beyond Symptom Management: Redefining Healing

What makes therapy transformative is not just targeting symptoms and distress, but it’s about rewriting the PCOS narrative. Many women come into therapy carrying years of stigma, isolation, or frustration after being dismissed and simply unaware of their inner struggles.

Through therapy, healing can look like:

• Reclaiming identity beyond physical appearance, menstrual and fertility struggles

• Strengthening resilience in the face of uncertainty

• Finding agency in small, empowering lifestyle shifts

• Building community with others who understand the journey

  
  

In Summary

This September, as we wear teal to honour PCOS Awareness Month, let’s remember: If you or someone you love is navigating PCOS, therapy deserves a place alongside medical care. Therapy offers more than coping skills. It provides a space to release shame, rediscover your self-worth, and reclaim your story.

References

Dubé-Zinatelli, E., Anderson, F., & Ismail, N. (2025). The overlooked mental health burden of polycystic ovary syndrome: Neurobiological insights into PCOS-related depression. Frontiers in Neuroendocrinology, 78, 101203. https://doi.org/10.1016/j.yfrne.2025.101203

Holmes, B. (2025, May 22). Everything you need to know about depression, anxiety, and PCOS. Clue. https://helloclue.com/articles/cycle-a-z/depression-anxiety-and-pcos

Ligocka, N., Chmaj-Wierzchowska, K., Wszołek, K., Wilczak, M., & Tomczyk, K. (2024). Quality of life of women with polycystic ovary syndrome. Medicina, 60(2), 294. https://doi.org/10.3390/medicina60020294

Moradi, F., Ghadiri-Anari, A., Dehghani, A., Reza Vaziri, S., & Enjezab, B. (2020). The effectiveness of counseling based on acceptance and commitment therapy on body image and self-esteem in polycystic ovary syndrome: An RCT. International Journal of Reproductive BioMedicine (IJRM), 18(4), 243–252. https://doi.org/10.18502/ijrm.v13i4.6887

Polycystic ovary syndrome awareness month. (n.d.). Cochrane Canada. Retrieved September 3, 2025, from https://canada.cochrane.org/news/polycystic-ovary-syndrome-awareness-month

Sari, S. A., Celik, N., & Uzun Cicek, A. (2020). Body perception, self-esteem, and comorbid psychiatric disorders in adolescents diagnosed with polycystic ovary syndrome. Journal of Pediatric and Adolescent Gynecology, 33(6), 691–696. https://doi.org/10.1016/j.jpag.2020.08.018

Standeven, L. R., Ho, A., & Hantsoo, L. (2024). Bridging the gap: Integrating awareness of polycystic ovary syndrome into mental health practice. Focus, 22(1), 53–62. https://doi.org/10.1176/appi.focus.20230024

Thannickal, A., Brutocao, C., Alsawas, M., Morrow, A., Zaiem, F., Murad, M. H., & Javed Chattha, A. (2020). Eating, sleeping and sexual function disorders in women with polycystic ovary syndrome (PCOS): A systematic review and meta‐analysis. Clinical Endocrinology, 92(4), 338–349. https://doi.org/10.1111/cen.14153

World Health Organization: WHO. (2025, February 7). Polycystic ovary syndrome. World Health Organization: WHO. https://www.who.int/news-room/fact-sheets/detail/polycystic-ovary-syndrome