Stress has become a constant feature of our lives, be it juggling endless responsibilities, taking care of kids and/or aging parents, or some other life-altering decision such as marriage/divorce. While some amount of stress pushes us outside of our comfort zone, being in a constant fight-or-flight mode has long-term health implications. Stress is widely encountered by women with PCOS. Emotional stress and PCOS are closely associated. While having PCOS puts us at risk for emotional anxiety and stress, higher anxiety/emotional stress worsens PCOS conditions.
Most of us are treated mainly for the symptoms of PCOS, but, current studies have shown that holistic treatment for both body and mind is required to reverse PCOS. So, for the best results, stress management strategies should be a part of your PCOS management plan along with diet and exercise.
How does having PCOS put you at risk for emotional stress?
With PCOS, our bodies are at a high risk of experiencing emotional stress. Most women with PCOS are subjected to metabolic stress throughout their lifespans. Metabolic stress encompasses the biochemical and metabolic alterations occurring due to PCOS. Due to these alterations, the hormone production system is affected in all organs, including the ovary. Insulin resistance, chronic inflammation, and oxidative stress – all contribute to metabolic stress. Oxidative stress is quite common in women with PCOS. It is an imbalance between free radicals and antioxidants in our bodies. If more free radicals are present compared to antioxidants, this imbalance causes the body to attack fatty tissue, DNA, and proteins in the body. Some studies have also found that cortisol and alpha-amylase, which are stress-related biomarkers were higher for women with PCOS, even as young as 13 years old. Higher metabolic stress and cortisol levels impact our psychological health, putting us at risk for emotional stress and anxiety.
Intense physical exercise can be a stressor
While moderate exercise is beneficial for PCOS, too much exhaustion due to over-exercising can be a potential stressor. Exhaustive exercise can generate free radicals that cause oxidative stress. The degree of damage or oxidative stress caused does not depend on the intensity of the exercise but on the exhaustion of the person doing it. This is why listening to your own body is so important, instead of following an exercise regime that works for other people. An intense HIIT session or running 15 miles everyday can do you more damage than good, if it is exhausting you completely. The best strategy would be to give your body enough time to adjust to an intense exercise session. Moderate exercises such as brisk walking, biking and low intensity cardio exercises could be a good starting point.
Low-calorie diets can increase your stress
Studies have found a low-calorie diet (1200 kcal) to increase cortisol levels, while calorie counting has been linked to increasing perceived stress. Restricting caloric intake can be a biological stressor because one of the main functions of cortisol is to increase the availability of energy in the body. The stress resulting from restricting one’s caloric intake to a mere 1200 kilocalories, therefore, may have reduced the absolute amount of energy available to the body, therefore leading to increased cortisol output to release energy stores. Alternatively, the increase in cortisol under conditions of caloric restriction may simply reflect a biological freeing of energy that is entirely not stress-mediated. In this context, a low-calorie diet would mean different for different people, as it depends on your energy expenditure. So, instead of blindly following an extremely low-calorie diet that has worked for others, your diet should be personalized according to your own body conditions and energy expenditure.
How can you manage stress?
Yoga, pilates, tai-chi have been found to be effective in stress management. Meditation has been found to be highly effective in reducing stress and anxiety. An 8-week study found mindfulness stress management to effectively reduce stress and anxiety levels of women with PCOS. The mindfulness stress management included mindfulness breathing and diaphragmatic breathing exercises. Another study found mindfulness programs to reduce certain eating behaviors like binge eating and emotional eating. Mindfulness meditation has also been found to reduce anxiety and panic attacks.