While the etiology of PCOS is still unknown, theories for hyperandrogenism's role in psychological comorbidities can help to explain why people with PCOS have elevated rates of depression, anxiety, personality disorders, and more. Associations between testosterone and symptoms include fatigue and low mood, anger, and hormonal instability.

Grand Valley State University

Excess testosterone, also known as hyperandrogenism, is the primary source of hormonal dysregulation in people with PCOS. A common misconception is that PCOS is caused by hypoestrogenism, or low estrogen; in fact, the fluctuations of both hormones and the body's attempt to compensate for them are the reason for symptoms. 

Excess Testosterone

Barry, J. A., Qu, F., & Hardiman, P. J. (2018). An exploration of the hypothesis that testosterone is implicated in the psychological functioning of women with polycystic ovary syndrome (PCOS). Medical Hypotheses, 110, 42–45. https://doi.org/10.1016/j.mehy.2017.10.019

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