adaptogenic herbs

PCOS and Anxiety

People with polycystic ovary syndrome (PCOS) are particularly vulnerable to symptoms of anxiety. In fact, PCOS patients are about three times more likely to suffer from anxiety than the general population (1). 

In this article, we’ll discuss PCOS and anxiety and provide tips to address the root causes to treat both of these conditions.

Why might PCOS cause anxiety symptoms?

There are a few different factors that may explain why women with PCOS experience more anxiety than the general population.

Issues with HPA Axis 

The HPA axis is a communication pathway involving your hypothalamus, pituitary gland, and adrenal glands. Your hypothalamus and pituitary gland are located in the brain and your adrenal glands are located on top of each kidney. The primary function of your HPA axis is to regulate your response to stress by controlling a stress hormone called cortisol. While cortisol is normally produced in varying levels throughout the day, the HPA axis regulates what is commonly known as your “fight-or-flight” response.  It is designed to manage short-term stressors. HPA axis dysfunction is a major root cause of PCOS and is often referred to as adrenal PCOS. In women with adrenal PCOS, we generally see higher cortisol and DHEA-S levels than normal. DHEA-S is an androgen (like testosterone) produced by the adrenal glands. Unfortunately, high cortisol and DHEA-S levels may be connected to anxiety disorders (1).

Hormonal imbalances

The hormonal imbalances caused by PCOS may contribute to increased anxiety. For example, progesterone is a reproductive hormone released after ovulation. Progesterone prepares the body for a potential pregnancy in the event that the released egg is fertilized. If the egg is not fertilized, progesterone production falls and a new menstrual cycle begins. Progesterone is known as your calming hormone and has many benefits like lowering anxiety and promoting healthy sleep. However, many women with PCOS have a progesterone deficiency due to lack of ovulation, luteal phase deficiency, or underlying hypothyroidism. By promoting regular ovulation with healthy hormone levels and correcting hypothyroidism, you may also see an improvement in your anxiety symptoms.


Researchers suggest imbalances in gut bacteria, or dysbiosis, may be the triggering factor in the development of PCOS (2). Interestingly, there is also a proposed relationship between dysbiosis and anxiety. Thankfully, interventions aimed to correct dysbiosis via diet, probiotics, or other gut health protocols show promising results in reducing anxiety symptoms (3).

How to Treat PCOS and Anxiety

In our practice, we solve PCOS problems at the root cause by using functional medicine and food with purpose. This is no different in our patients with PCOS who also report anxiety. By treating the root causes of their PCOS, we often see significant improvements in related symptoms, like anxiety, as well. Here are some tangible actions you can start today to treat the root cause of PCOS and anxiety. 

Balance cortisol levels

Most individuals with PCOS present with higher than normal cortisol levels. This is often the result of chronic stress and lifestyle habits. To reduce high cortisol levels:

  • Incorporate at least one stress-reducing activity into your daily routine like deep breathing, yoga, meditation, stretching, or journaling. Even five minutes makes a difference!
  • Aim to get at least seven hours of sleep each night and practice good sleep habits like avoiding afternoon caffeine, reducing screen time before bed, creating a bedtime routine, and sleeping in a cool, dark room.
  • Consider taking an adaptogen, like ashwagandha. Adaptogens are herbs that have cortisol balancing effects and may help reduce anxiety.
You can purchase our Root ashwaganda here: 


Our favorite adaptogen
We know that life is busy and stressful sometimes. It’s not always possible to remove the stressful situations in your life, but it is possible to manage how we react and respond to these situations.

Promote regular periods

Irregular or absent periods are extremely common in women with PCOS. By incorporating interventions to encourage regular periods, you may see a reduction in your anxiety. From beginning to end, a healthy menstrual cycle typically lasts between 24 and 35 days with ovulation about halfway through this time period. 

To encourage regular periods, we first recommend starting our PFC Balance Method. PFC is a simple meal planning formula that includes protein, fat, and high-fiber carbohydrates with each meal and snack. PFC is highly effective at treating insulin resistance, which is a major root cause of irregular periods in PCOS. Learn more about the PFC Balance Method

Next, we often recommend adding Ovasitol into your supplement regimen. Ovasitol is a supplement designed for women with PCOS and is very helpful in promoting regular periods. Plus, one study showed Ovasitol may reduce anxiety in women with PCOS as well (4). 


There’s a reason we call it magic period dust…

Improve gut health

Dysbiosis is a contributing factor to both PCOS and anxiety. While gut health is a complex topic, here are a few tips to encourage a healthy balance of gut bacteria:

  • Limit foods high in added sugar, like candy, pastries, and sugar-sweetened beverages.
  • Aim to eat at least 25 grams of dietary fiber per day.
  • Avoid unnecessary antibiotics.
  • Eat a diverse and colorful diet rich in fruits, vegetables, nuts, and seeds.

You may also consider taking a probiotic. MegaSporeBiotic is one of our most recommended probiotics because it actively treats dysbiosis. Learn more about MegaSporeBiotic.


Recondition your gut microbiome with just one capsule per day.


Physical activity can treat various root causes of your PCOS. For example, regular exercise can help balance insulin levels to correct irregular periods, improve blood sugar levels, boost your mood, and may even reduce anxiety (5). The best type of exercise is the one you will do consistently. This may include walking, cycling, yoga, strength training, swimming, and more. 

Seek professional guidance

Functional medicine is an approach to treating health conditions by finding the root cause of your health issues. Mental health is especially important to consider in your overall health and quality of life. Many of our patients work regularly with a therapist for various reasons! While treating the root cause of PCOS will greatly reduce or even eliminate some of your symptoms, there are many times in which participating in therapy is the most helpful solution to anxiety disorders.

PCOS and Anxiety: Takeaways

Women with PCOS are three times more likely to suffer from anxiety than the general population. PCOS may cause anxiety due to its effect on high cortisol levels, a progesterone deficiency, or dysbiosis of the gut. You can treat both of these conditions by implementing healthy lifestyle habits, using the PFC Balance Method for planning meals, and seeking professional therapy when needed.
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