Polycystic Ovary Syndrome (PCOS)

✨ What Is PCOS? Is It Lifelong?

Polycystic Ovary Syndrome (PCOS) is a hormonal and metabolic condition characterized by one or more of the following: irregular ovulation, signs of higher androgens, and/or polycystic-appearing ovaries on ultrasound.

While PCOS is considered a lifelong condition, symptoms can change over time and often improve with targeted lifestyle habits and medical support.

Quick Highlights:

• PCOS is diagnosed clinically (most often using the Rotterdam criteria after ruling out similar conditions such as thyroid disease, hyperprolactinemia, or non-classic CAH).

• Symptoms may shift during puberty, pregnancy, or menopause.

• Monitoring is important due to long-term metabolic risks (insulin resistance, diabetes).

• Research: International evidence-based PCOS Guidelines (2018/2023) provide the standard approach to diagnosis & care.

🔎 Common Symptoms

PCOS shows up differently for every individual, which is why a holistic, compassionate, and individualized approach is essential.

Some Possible Symptoms:

• Irregular or absent menstrual cycles

• Acne or oily skin

• Excess facial or body hair (hirsutism)

• Thinning scalp hair

• Weight changes or difficulty losing weight

• Fertility challenges

• Skin darkening (acanthosis nigricans) and/or skin tags

• Metabolic changes (higher blood sugar or lipids)

• Ovarian cysts

• Pelvic pain(sharp or dull)

• Mood changes (e.g., depression, anxiety)

• Possible prenatal hormonal influences, which are still being researched.

Research Note:

• Multiple studies link PCOS with higher rates of insulin resistance and cardiometabolic risk.

🧬 What Causes PCOS?

There is no single cause — PCOS is a multifactorial condition influenced by genetics, hormones, and metabolic function.

Key Contributors:

• Genetic predisposition

• Insulin resistance & elevated insulin

• Higher androgen (testosterone) levels

• Low-grade systemic inflammation

• Neuroendocrine changes affecting ovulation

Research Note:

• Current studies show that insulin resistance plays a central role in many, but not all, PCOS cases.

⚡ What Triggers PCOS Symptoms?

Triggers vary widely from person to person, but several common factors can intensify symptoms or make cycles more irregular.

Common Triggers:

• Weight fluctuations (especially central/abdominal gain)

• Poor nutrition (e.g., highly/ultra-processed or high-sugar foods/beverages)

• Poor sleep quality

• Chronic stress

• Inactivity or prolonged sitting

• Untreated sleep apnea

• Certain medications (depending on individual health history)

• Environment pollutants

• Endocrin Disruptors/Product Toxins: (e.g., PFAS [found in non-stick cookware, waterproof coatings, food packaging], BPA [plastics & can linings], Phthalates [plastics & personal care products], Parabens [cosmetics & personal care products], Triclosan [antibacterial products])

🌱 Lifestyle Approaches to Manage PCOS

Lifestyle strategies are considered first-line therapy in all major PCOS guidelines — and even small shifts can lead to meaningful progress.

Science-Backed Approaches:

• Nutrition:

  • Emphasize whole foods, fiber, plant proteins, and healthy fats. (e.g., whole food, plant-based, mediterranean diet)

  • Eliminate/Limit highly processed/ultra-processed foods and added sugars. If ingredient labels contain items that don’t sound like real food, they are likely chemical or laboratory-manufactured additives.

• Movement:

  • Aim for 150–300 minutes of moderate activity weekly.

  • Add resistance training 2–3 times per week.

  • Approach high-intensity interval training (HIIT)/vigorous activity training with caution.

    • Depending on the individual and the frequency/duration, these workouts can have either positive or negative impacts on symptoms.

• Sleep:

  • Target 7–9 quality hours; keep consistent sleep/wake times.

• Stress Management:

  • Breathwork, journaling, yoga, therapy, forest bathing, or mindfulness practices.

  • Learn more about the sources of self-inflicted stress and gradually take steps to lessen & eliminate them.

• Weight:

  • If overweight, even a 5–10% reduction can improve cycles and metabolic markers.

  • Weight loss can feel overwhelming; however, all positive lifestyle modifications that support a balanced, healthy weight range will promote overall wellness.

Research Note:

• Systematic reviews consistently support lifestyle change as the foundation for symptom reduction and metabolic improvement.

🧑‍⚕️ Best Healthcare Professionals for PCOS Support

PCOS responds best to a holistic, team-based approach, especially when symptoms affect multiple aspects of health.

Helpful Providers May Include:

• Primary care clinician or gynecologist (diagnosis & ongoing care)

• Endocrinologist (hormone & metabolic support)

• Reproductive endocrinologist (fertility care)

• Registered dietitian specializing in PCOS

• Dermatologist (hair + skin concerns)

• Mental health professional (stress, anxiety, body image)

• Wellness Coach for lifestyle, habit-building, and supportive accountability.

No matter who you pick for your team, a holistic approach will help you to better navigate the hormonal, metabolic, psychological and spiritual issues that may arise.

Research Note:

• The International evidence-based PCOS Guideline emphasizes multidisciplinary, patient-centered care.

💊 Medications That May Help

Medication is not required for everyone — but it can be very helpful depending on your goals (cycle regulation, fertility, acne/hair concerns, metabolic health).

Common Options:

• Combined oral contraceptives: Regulate cycles, reduce androgens, improve acne

• Metformin: Improves insulin sensitivity and may promote more regular ovulation

• Letrozole: First-line medication for fertility and ovulation induction

• Spironolactone: Reduces excess hair growth and acne (not used during pregnancy)

• Topical dermatologic treatments: For acne or hair concerns

• Inositol supplements: Some evidence shows they may improve insulin sensitivity and support ovulation (using myo-inositol and D-chiro-inositol in appropriate ratios).

Research Note:

• Large clinical trials show letrozole leads to higher live-birth rates than clomiphene for women with PCOS seeking pregnancy.

💛 Seek Compassion

Living with PCOS can be emotionally taxing, physically uncomfortable, and sometimes isolating — but you’re not alone, and nothing about this is your fault.

As symptoms and their intensity change across a person’s life (teen years, pregnancy, perimenopause, menopause, post-menopause), you will benefit from taking a lifelong, learning-centered approach to managing PCOS.

With the right support, most people can significantly improve symptoms, energy, and overall wellbeing.

Keep your healthcare provider(s) up to date regarding any changes that you are experiencing.

Partner with family & friends who are dealing with PCOS or who can offer you continued support.

You deserve care & support from those who can listen, honor your experience, and support your long-term health.