A history of childhood trauma, defined as events of abuse (physical, emotional or sexual) or neglect (physical or emotional) occurring before the age of 18 years is overwhelmingly present in individuals with Borderline Personality Disorder (BPD). This has been demonstrated repeatedly within the research, with reported figures of up to 84% of BPD patients having experienced some form of abuse or neglect and usually sexual and physical abuse. As such, childhood trauma is considered one of the most important factors in the aetiology of BPD. Childhood maltreatment coupled with genetic vulnerability evokes a stress response that can promote pathophysiological processes thus predisposing an individual to BPD. Chronic stress results from prolonged early life trauma, and also when the stressor itself is short in duration but is perceived to be threatening for much longer. As such, individuals with a history of childhood trauma often have altered hypothalamic–pituitary– adrenal (HPA) axis activity. The hyperactivation of the HPA axis due to chronic stress can increase the level of androgens in the body and result in clinical hyperandrogenism, which is a key feature in the diagnosis of polycystic ovarian syndrome (PCOS). Obesity is commonly associated with PCOS and also in women with early life trauma. In this presentation, the underpinning psychoneuroendocrine causal factors as well as the mental health consequences of obesity, PCOS and Borderline Personality Disorder will be discussed as well as novel treatment approaches