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PCOS and Your Self Esteem

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Updated September 28, 2011

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Though not fatal or deadly, having PCOS is still difficult for the thousands of women who suffer from it. With symptoms like acne, abnormal hair growth (called hirsutism), hair loss, obesity and infertility, it’s no wonder that PCOS can dramatically affect a woman’s self esteem.

Certainly every woman’s experience with PCOS is different; not everyone has the same severity of symptoms or issues with infertility. As a result, the effect that this syndrome has is very different from woman to woman. In addition to the external factors such as the issues above, self-esteem is shaped by one’s life experiences, and coping skills.

Symptoms

PCOS causes androgen levels (a class of hormone that includes testosterone) in women to be higher than usual. Because testosterone is the primary male hormone, the elevated levels cause symptoms that are typically male – acne, male pattern baldness, and hair growth on the face, chest or stomach. The high androgen levels also cause irregular periods. With PCOS causing all of these masculine traits to develop, it’s no wonder that many women with this syndrome feel masculine or unfeminine. And let’s be honest, there aren’t many women who don’t have self esteem issues during a breakout or when they are dealing with hair loss or excess facial hair.

What’s so difficult about the symptoms of PCOS is that they are a result of hormonal imbalances and can be a challenge to treat. Traditional medication and treatment regimens for conditions like acne or hair loss may not be effective without addressing these hormonal abnormalities as well.

Weight

Weight is a major issue for women with PCOS. The elevated androgen levels can cause insulin resistance and weight gain, especially around the abdomen and waist. Further, women with PCOS have an extraordinarily difficult time losing that weight, regardless of the effort that she makes in losing it.

Because of the obesity crisis that America is currently facing, many people who are overweight (and not just women with PCOS) report feeling judged or discriminated against. They are sometimes made to feel as if being heavy was their fault, or that they are not trying hard enough to lose weight.

The truth is that women with PCOS have a truly difficult time with weight loss. Even though everyone has their days where they crave a bag of chips or a cookie, people who are overweight often feel that everything they eat or do is scrutinized.

Infertility

Infertility is a condition that can dramatically affect how a woman feels about herself and her identity as a woman. After all, what is more feminine than getting pregnant, and when that is difficult, it can change a woman’s perception of herself. Add that to the other symptoms that she is experiencing and it’s easy to see why depression and self-doubt are so rampant in women with PCOS.

Going through infertility treatment and having ones private, intimate relationship open to scrutiny is inherently stressful on a marriage, only furthering self-esteem issues. She may feel blamed or have feelings of guilt, as if the infertility and resulting medical treatment (and possible debt) is her fault.

Other Health Issues

Besides changes in her appearance and fertility, PCOS can cause health problems such as diabetes, heart disease, hypertension, endometrial cancer and high cholesterol. Having a chronic disease at a young age or the fear that one will develop can negatively affect a woman’s feelings of self worth. It can be difficult to feel as if you need to eat perfectly or exercise all the time in order to stay healthy or keep from getting sick.

Depression

In fact, several studies have found that women with PCOS are more likely to develop depression or depressive symptoms. It’s believed that this depression may be a result of the changes in their appearance and the self-esteem issues that stem from that.

What to Do About It

First, recognize that you have a medical condition and treat it as such. Don’t be hard on yourself for something you can’t control. If your symptoms are severe, see an endocrinologist or dermatologist and request treatment; don’t be afraid to get a second opinion or see another doctor if you aren’t happy with his proposed treatment. There are many different medications and treatments available and it might take some time until you find the one that works for you.

If you are experiencing some of the physical signs of depression (depressed mood, loss of motivation, insomnia, overeating, sleeping too much and not eating) and feel that you are very overwhelmed with PCOS, seeing a therapist or counselor might be best thing for you. They can help you develop coping skills and a plan of attack for your PCOS. Try finding a therapist with experience in reproductive issues, infertility or women’s health. Because this field is so specialized, reproductive therapists are more able to give you more useful and accurate information. Check with your OB/Gyn or local fertility specialist for a referral.

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