A research survey conducted in 2019 concluded that around 80% of the female population experiences hormonal imbalances, and around 70% are unaware that they may be developing conditions such as PCOS and endometriosis. These are gynaecological conditions, which occur as a result of hormonal imbalances, and they disproportionately affect Black and South Asian females. Such conditions are often under-diagnosed and paid little attention to. Often, they are misunderstood, and the greatest misconception surrounding endometriosis and PCOS is that they are often considered only to be fertility diseases, when in reality, there is so much more to consider. The main topic of discussion is not the physical aspects of such conditions and imbalances, but the psychological ones.
Women with PCOS or endometriosis have a higher risk for affective disorders and psychological morbidity which affects their daily life. In fact, patients with these conditions have been more likely to develop eating disorders and the suicide rates among such women was seven times greater than those without such conditions. Lifetime use of antidepressants among these women is also more common, and women affected by PCOS or endometriosis also experience greater social anxiety and phobia.
Why do such women have a greater chance of developing psychological morbidity?
This has to do with the symptoms or the effects of hormonal imbalances. PCOS, a condition in which there is an excess of the male hormone, testosterone, also results in an increase in the facial hair. PCOS may also cause excessive acne, hair loss and obesity. The above mentioned factors are likely to be causes of insecurity within females, resulting in an increased withdrawal from social situations due to the fear of ostracism or social rejection. On the other hand, there are also some significant and purely medical causes for the link between hormonal imbalances and depression. Majority of the women having PCOS are insulin resistant, which means that the cells do not absorb enough glucose leading to high blood sugar level. Certain theories lead to the conclusion that insulin resistance, blood cholesterol, and sugar levels were linked to increased depression. Insulin resistance affects the ability to make certain hormones, for example, impairments in insulin causes a disruption in the dopamine signalling which affects the body’s reward system and causes a general lack of interest, as well as interfering with the ability to feel pleasure or satisfaction. Such hormonal imbalances also cause inflammation and prolonged inflammation results in an increased cortisol levels, and hence increased stress levels.
To summarise, hormonal imbalances and conditions resulting from them are not only concerned with or limited to fertility problems, however these particular conditions are far more complex and prescribing birth control as a control system is not sufficient. Birth control may attempt to reduce some apparent symptoms, it is certainly not a cure and it has multiple side effects such as: nausea, worsened migraines, weight gain, breast tenderness, impact to mood, and changes in menstrual cycle that can lead to extra bleeding or missing a cycle entirely. Moreover, for women with PCOS who are already prone to frequent mood variations, birth control elevates the frequent mood changes. In fact, almost half of all women who go on the pill stop using it within the first year due to intolerable side effects such as frequent mood swings, intolerable anxiety, intolerable depression and often both.
Instead of simply prescribing birth control in order to mitigate the effects of hormonal imbalances, guidelines to a healthier lifestyle must be discussed with patients, in accordance to their requirements. Women with PCOS and endometriosis have concerns beyond the scope of prescribing medication, and it is important for such women to be given external help if they seek so. Stress management and relief ideas include : Making sure to get some form of movement each day, Spending time in nature simply walking or meditating, as well as journaling (or simply listing) your worries and anxieties. Moreover, it is necessary for women facing severe depressive episodes and mood instability to have access to trained psychiatrists and therapists with knowledge of their physical history and its impact on their mental health so as to effectively help. Moreover, stress-induced inflammation can be addressed by stress reduction techniques such as breathing exercises and meditation. The mind and brain are interconnected and it is not useful or helpful to seperate the two. In order to treat one, the other must be overseen as well.