PCOS and Stress: disrupting the pattern

Everyone suffers from stress whether it’s losing your keys, preparing for an important work meeting or running late for an appointment. But there are different types of stress and their impact on our physical and mental wellbeing can differ massively. People with PCOS especially should be aware of the relationship between PCOS and stress – and the unfortunate chronic cycle between stress and symptoms of the condition.

Keep on reading to understand the link between PCOS and stress, and how we can disrupt the pattern to improve your symptoms.

What is PCOS?

Polycystic ovary syndrome, also known as PCOS, is the most common endocrine disorder affecting people assigned female at birth of reproductive age. The condition is recognised by physical symptoms such as hirsutism, alopecia and ance and is diagnosed using the Rotterdam criteria.

But what about the less visible factors, such as stress? First of all, let’s understand what exactly stress is.

What is stress?

Stress is our body’s natural response to pressure. It can be helpful, for example, it can help us move through pain or fear to complete a goal such as a marathon or escape from a dangerous situation. But too much stress can actually be linked to poorer health.

Acute vs. chronic stress

Acute stress is the type of stress experienced on a daily basis from relatively minor situations. Acute stress appears and disappears quickly compared to chronic stress. Examples of acute stressors include traffic, crowds, arguments, running late, deadlines and losing essentials.

Chronic stress, on the other hand, is ongoing and is consistent in its presence in your life, although it may increase or decrease in severity. Chronic stress from toxic workplaces or relationships, chronic illness or trauma can take a toll on your body and impact your physical and mental wellbeing.

Stress hormones

There are two stress hormones involved in the stress response: adrenaline and cortisol.

Adrenaline and cortisol are hormones released from the adrenal glands during a threatening or exciting situation.

When we perceive something as a threat (aka the cause of stress), this will trigger a physiological response within our bodies, activating our sympathetic nervous system (SNS) and our hypothalamic-pituitary-adrenal (HPA) axis. The SNS responds first resulting in a variety of bodily responses including increased heartbeat, increased breathing rate, and an increase in blood glucose and the redirecting of blood to our muscles. This is essentially preparing us for what’s commonly referred to as the fight or flight response.

As the body continues to perceive stress as a threat, the HPA axis is activated by the brain. The HPA axis is a hormonal system that initiates a sequence of chemical events causing the release of the two ‘stress hormones’ cortisol and adrenaline. Cortisol keeps the body in a state of high alert, whilst also; increasing blood glucose levels, suppressing insulin levels, reducing our immune response and wound healing, and altering our appetite and mood.

>> Learn more | Debunking PCOS adrenal fatigue and adrenal PCOS

Cortisol, stress and PCOS

Stress can have an impact both on the cause and worsening of PCOS. In fact, individuals with PCOS may be found to have elevated levels of cortisol and may be more sensitive to the impacts of stress, compared to individuals without the condition.

So how are the two interlinked?

Increased stress may disrupt the hormonal balance and increase levels of testosterone. This elevated testosterone is a key mechanism associated with hyperandrogenism, which is a factor in PCOS diagnosis. It can increase the likelihood of symptoms such as acne, excess hair growth and hair loss.

Cortisol is also found to impact insulin sensitivity, resulting in blood glucose levels remaining elevated. PCOS is associated with insulin resistance and increased blood glucose levels which can lead to symptoms such as carbohydrate cravings, increased inflammation, irregular ovulation, and poor sleep.

Stress management techniques

If you have been diagnosed with PCOS you may be more prone to stress and its effects. However, lifestyle changes such as stress management techniques can be successful in helping you to actively reduce stress levels and may help to manage the condition. Here are some of our favourite stress management techniques to help improve symptoms of stress.

Therapy or counselling

It is also imperative to mention that the common symptoms of PCOS like acne, hair loss, hair growth on the face, back and chest plus infertility are likely to increase stress levels. This creates a complex, continuous cycle of stress increasing symptom severity and symptom severity increasing stress in turn.

Seeking support from a PCOS-informed therapist or counsellor may be suitable if you are struggling with your PCOS diagnosis and symptoms or other stressful situations in your life.

Progressive muscle relaxation

PMR is a relaxation technique that has been around for many years. It involves tensing or tightening of one muscle group at a time, followed by a phase of relaxation with the release of tension. Usually, individuals start from the bottom of the body and work their way up to the top and it can be practised seated or lying down, preferably in a comfortable and quiet environment.

Research has found PMR can reduce stress-related activity in the brain, which is similar to the effects also seen with anxiety medication. As well as stress management it has been seen to improve sleep quality in some studies.

Guided recordings can be a great place to start if this is something new you’re trying out – we like this one from HelpGuide.org.


Meditation is a mental, physical and spiritual practice that helps to increase relaxation and calm. There are many types of meditation including transcendental and mindfulness.

In regards to stress and PCOS, meditation has many benefits, primarily reducing cortisol levels. In fact, a 2013 study of 30 medical students found that just four days of meditation reduced blood cortisol levels in participants. More long-term research on more participants is required, particularly on the impact of meditation on PCOS but the studies so far are promising.

Keep in mind that meditation takes practice and patience. To get you started, apps such as Calm and Headspace can be really useful when beginning your practice.


Whether you are into running, weight-lifting or yoga, movement can help with stress. Exercise reduces stress hormones such as cortisol and stimulates the release of endorphins to improve mood.

As well as benefiting stress levels, regular movement has been found to be beneficial for the quality of life and psychological wellbeing of individuals with PCOS.

>> Read more | Exercise and PCOS: can movement help PCOS?

Key takeaways: PCOS and stress

If you have been diagnosed with PCOS, you may be at a higher risk of experiencing stress, and therefore increased levels of cortisol and its effects on the body. As cortisol is a hormonal response to stress within the body, lifestyle changes such as stress management techniques may help.

Techniques such as therapy, meditation, movement and yoga have been found in research to improve psychological and physical aspects associated with stress.

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Annabel Sparrow ANutr Author at The PCOS Collective

Author | Registered Associate Nutritionist


Annabel is a Registered Associate Nutritionist and pilates teacher with an interest in gut health and pre-and post-natal nutrition. She has a BSc degree in Psychology and is passionate about building healthy relationships with food and understanding the connection between food and mood.

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