Scientific Society Symposium
“PCOS Insuline Resistant and mood disorders: An intricately overlapped story” Polycystic ovary syndrome (PCOS) is the most common endocrine disorder affecting approximately 5-10% females of reproductive age. It is a chronic disease with health implications across the lifespan characterized by hyperandrogenism and menstrual disorders. Women with PCOS are at increased risk for metabolic disorders. Insulin resistance (IR) is found in up to 70% of affected women. PCOS is also associated with increased depression, anxiety, eating disorders, obsessive-compulsive symptoms, and reduced quality of life. The relationship between PCOS – IR and mood disorders is complex. Neurotransmitters mediate the neuromodulatory effects of insulin. Hyperinsulinemia increases oxidative stress and induces an inflammatory state, compromising neuronal and glial activity associated with the affective symptoms seen in mood disorders. IR decreases cortical excitation in response to insulin and alters catecholamine reuptake, turnover and transport. Women with IR-PCOS have Opioid system dysfunction leading to depression and anxiety symptoms, which are resolved after treatment with metformin demonstrating the intricately overlapping of metabolic and mood disorders. On the other hand, any increase in anxiety can activate the adrenal glands via the hypothalamic–pituitary–adrenal axis (HPA) and raises the testosterone levels exacerbating the symptoms of PCOS and worsening the IR as well. Furthermore, women with PCOS show a stronger HPA response to a stressor than healthy women. Levels of anxiety and depression are higher in women with PCOS Therefore, recognition of poor psychological well-being in PCOS is important to prompt intervention. Mood in PCOS might be improved through weight control, using anti-androgens and insulin sensitizers as well as conventional antidepressant and anxiolytic therapy. Cognitive behavioural therapy or counselling, should be considered too.