Androgens and mood dysfunction in women: Comparison of women with polycystic ovarian syndrome to healthy controls

Objective: Our understanding of the organizational and activational effects of human gonadal hormones on behavior has depended on the study of endocrine disorders. Polycystic ovarian syndrome (PCOS) is a hormonal disorder that begins in puberty and is characterized by chronically augmented free testosterone (FT) levels. The purposes of this study were 1) to compare negative mood states of women with PCOS to those of women with normal hormonal levels and 2) to examine the relationship between negative moods and androgens. Methods: Twenty-seven women with PCOS were case-matched to 27 normal menstruating women on body mass index since being over-weight is a common symptom of PCOS and could affect mood states. Serum levels of FT, total testosterone, sex hormone binding globulin, estradiol, and progesterone were determined. Self-reported depression, anger, anxiety, and aggression were analyzed between groups, and individual scores were compared across groups to hormone values. Results: Depression was significantly increased in the PCOS group and remained so after considering the variance related to physical symptomatology and other mood states. Furthermore, a curvilinear relationship between FT and negative affect across groups was suggested: the most elevated negative mood-scale scores were associated with FT values just beyond the upper limits of normal, while lower negative mood levels corresponded to both normal and extremely high values of FT. Conclusions: These results are consistent with a model of activational influences of testosterone on adult female behavior. Implications are discussed for future research and for treatment of PCOS and other menstrual-cycle mood disorders.