Does PCOS Keep You in Fight-or-Flight Mode?
When was the last time a jaguar chased you down? Unless you spend a lot of time in the jungle, probably never! But if you have PCOS, there’s evidence to suggest your body thinks it’s happening on the regular.
Even as you’re sitting at your desk reading this, your body can be in total fight-or-flight mode. This is because PCOS has been associated with an overactive fight-or-flight response, triggered by a type of nervous system dysregulation. Even though you may not realize it, thinking about your dentist appointment tomorrow, or the deadline on a project at work, or procrastinating on that ever-growing to-do list can put your body into fight-or-flight mode. And with PCOS it can be more difficult to return to a relaxed state.
Basically, as your nervous system sends signals to your body that you’re in danger, your heart rate increases, your breath becomes shallower, and digestion slows.
Doesn’t sound like a great way to feel, right? Except many of us aren’t aware that feeling this way isn’t normal.
Many of the common features of PCOS, such as insulin resistance, excess body fat around the belly, and even sleep apnea are associated with autonomic nervous system dysfunction—specifically, overactivation of the sympathetic nervous system (1). And researchers now think that overactivation of the sympathetic nervous system has a role to play in the root cause of PCOS.
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A quick background about your nervous system
Your nervous system controls everything that happens in your body, from heart rate to breathing, to digestion and hormone production. Today, we’re going to focus on the part of your nervous system that connects your brain and spinal cord to your organs, like your heart, stomach, and intestines.
This system is made of up two different arms:
- The sympathetic nervous system is responsible for activating your fight-or-flight response when you’re under stress. This part of the nervous system is what makes your heart rate go up, your pupils dilate, and your breath fast and shallow when you’re in a stressful situation.
- The parasympathetic nervous system is responsible for calming the body down after the stressor has passed. Think of it like the brakes to the sympathetic nervous system’s gas pedal.
Related: Is This Hormone Waking You Up at Night? Here’s What to Do
PCOS causes autonomic dysfunction
Normally, when the sympathetic nervous system is activated, the parasympathetic nervous system kicks in afterwards to bring the body back to a state of “rest and digest”. But with PCOS, evidence suggests that the fight-or-flight arm of the nervous system stays overactivated, even when you’re not actively experiencing any type of stress.
The problem is, the human body isn’t designed to stay in fight-or-flight mode for a prolonged time. Ideally, you experience something stressful (the jaguar chasing you), you hurry to safety, and then return to rest.
But when stress—in this case sympathetic activation—continues, you start to experience the consequences in the form of cortisol dysregulation, insomnia, obesity, and anxiety.
Rest-and-digest (parasympathetic) mode is associated with:
- Better insulin sensitivity & blood sugar levels
- Less risk of stroke & heart problems
- Lower blood pressure
- Better digestion
- Fewer headaches and migraines
- A stable mood & less anxiety
Overactivation of fight-or-flight (sympathetic) mode is associated with:
- Elevated blood pressure & heart rate
- Depression & anxiety
- Diabetes
- Fatigue
- Difficulty concentrating
- Worsening inflammatory conditions, autoimmune disease, IBS, etc.
Women with PCOS often have an imbalance between these two systems, which leads to chronic stress and a host of other problems.
PCOS and POTS
POTS is a condition that shares some similarities with PCOS (2). It stands for postural orthostatic tachycardia syndrome and it’s a form of dysautonomia, or autonomic dysfunction. In other words, it’s when your autonomic nervous system isn’t working properly. POTS essentially keeps your body from relaxing into a rest-and-digest state, instead triggering an overactivation of the fight-or-flight mode.
POTS is characterized by lightheadedness, fainting, fatigue, brain fog, and heart palpitations. These symptoms happen as a result of a drop in blood pressure and an increase in heart rate when you stand up from lying down. In someone with POTS, the autonomic nervous system doesn’t properly adjust blood flow when moving from lying down to standing up.
There are a variety of triggers or causes for POTS, and genetic components can make you more susceptible to the condition.
Read: How to Fix Adrenal Fatigue & Cortisol Dysregulation in Women
One gene connects 2 complex conditions
MTHFR is a gene that’s responsible for encoding an enzyme that controls a crucial biochemical process called methylation. Methylation is involved in everything from DNA replication, to the production of neurotransmitters and cellular energy.
MTHFR mutations are common, with as many as 30-50% of the population carrying at least one mutation, but having a MTHFR mutation doesn’t necessarily mean you’ll experience any health problems (3). In fact, most people with MTHFR mutations don’t even know they have them.
Methylation is important for women with PCOS because it plays a key role in balancing hormones and reducing inflammation. Women with PCOS often have trouble methylating properly, which can make symptoms worse.
There are three common MTHFR mutations:
- C677T
- A66G
- A1298C
Some studies have shown a link between PCOS and MTHFR A1298C and C677T, possibly due to its effect on homocysteine levels (4). Women with PCOS who carry the A1298C variant are more likely to have elevated levels of homocysteine, which results in increased inflammation throughout the body (5). This may play a role in anxiety, depression, and insulin resistance associated with PCOS.
MTHFR mutations are relatively common, so if you have PCOS or are struggling with stress, anxiety, or depression, ask your doctor if testing is right for you. There are simple blood tests that can check for MTHFR mutations.
Related: PCOS & Leaky Gut? The Gut-Hormone Connection
Can you treat PCOS by regulating your nervous system?
Because it’s likely that with PCOS you’ll also have an overactive fight-or-flight response driven by your sympathetic nervous system, taking steps to shift back into a parasympathetic state (rest-and-digest), could benefit some PCOS symptoms.
How to reset your nervous system in 4 steps
The good news is that a few simple methods can help to calm down your nervous system and shift you back into a parasympathetic state. The key is to provide physiological feedback to your brain and body that it is safe, and can fall back to a calm, relaxed state. This means your heart rate will slow down, breathing becomes deeper, digestion can progress, and you can even fall asleep easier.
So, how do you send feedback telling your brain and body to relax? Try these:
- Slow, deep, diaphragmatic breathing, or belly breathing. When you’re stressed or excited, your breathing becomes shallow. Breathing from your diaphragm, located on top of your belly—rather than shallow breaths from the top of your lungs—stimulates the vagus nerve, which sends calming signals to your brain. Stimulating the vagus nerve is one major way to shift back into a restful state.
- Humming, or exhaling with low tones. Because humming focuses primarily on the exhale, it can help slow your heart rate and activate your parasympathetic nervous system. Humming also stimulates the vocal cords, which are also connected to the vagus nerve, and low tones have been shown to send calming signals to the brain. You can hum a song, or just try repeating a single, low tone.
- Meditation activates the parasympathetic nervous system and downregulates the sympathetic nervous system in part by simply helping us relax. Meditation lowers heart rate and blood pressure, improvs sleep quality, and decreases perceived stress.
- Practice mindfulness. Recognizing when you’re in fight-or-flight mode is the first step toward getting your body back to a resting state. Many of us are so busy and disconnected with our bodies that it’s difficult to be present in the moment, and this only perpetuates nervous system dysregulation. Being aware of what’s going on and how you’re feeling in the present moment can help you become more in sync with your physical, mental, and emotional needs.
Have you experienced higher stress levels with PCOS, or do you have trouble relaxing? If so, you may be in a state of nervous system dysregulation. Shifting from a sympathetic (fight-or-flight) to parasympathetic (rest-and-digest) can help resolve some of the issues associated with this kind of nervous system dysregulation. What ways do you get back into a restful state? Try these tips and see how they help you!
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