Understanding PCOS

Polycystic Ovarian Syndrome (PCOS) is one of the most common and yet misunderstood hormonal disorders affecting people with ovaries, especially during their reproductive years. As a physician and friend, I have seen how deeply PCOS can impact daily life, from irregular cycles to mood changes, weight struggles, or difficulty conceiving. Understanding the condition is the first step to feeling more in control.

What Is PCOS?

PCOS is a hormonal and metabolic disorder. The name refers to “polycystic ovaries,” but not everyone with PCOS has ovarian cysts, and cysts alone do not mean you have PCOS.

PCOS is diagnosed based on a combination of:

• Irregular menstrual cycles

• Signs of excess androgen hormones such as acne, excess hair growth, or hair thinning

• Polycystic appearance of the ovaries on ultrasound

A formal diagnosis usually requires two of the three.

Common Symptoms

PCOS can look very different from person to person, but common symptoms include:

Hormonal & Menstrual Changes

• Infrequent, unpredictable, or absent periods

• Trouble with ovulation

• PMS-like symptoms or heavier, prolonged periods when they do occur

Skin & Hair Changes

• Acne after the teen years

• Increased facial or body hair

• Hair loss on the scalp

Metabolic Symptoms

• Weight gain or difficulty losing weight

• Insulin resistance or prediabetes

• High cholesterol

Other Effects

• Pelvic discomfort

• Mood swings or increased anxiety

• Fatigue or poor sleep

• Night sweats

Not everyone has all of these symptoms, and the severity can vary.

Why Does PCOS Happen?

Current research in 2025 suggests there is a combination of:

• Insulin resistance leading the body to produce more insulin, which stimulates the ovaries to produce more androgens

• Genetics 

• Hormonal imbalance of higher androgen levels that subsequently disrupt ovulation

Lifestyle factors don’t cause PCOS, but they can worsen symptoms.

Treatment Options

Treatment should be personalized based on your symptoms and goals (cycle regulation, acne, weight management, fertility, etc.).

Lifestyle Support

• Nutrition: Balanced whole-food patterns, consistent meals, and moderated carbohydrates

• Movement: Regular exercise improves insulin sensitivity

• Sleep & stress: Both play a major role in hormone balance

Medications

Depending on symptoms, treatment may include:

• Hormonal contraceptives to regulate cycles

• Metformin for insulin resistance

• Anti-androgen medications like spironolactone for acne or excess hair

• Ovulation-supporting medications for those trying to conceive

Please consider discussing these options with a physician who knows your unique situation.

Enjoying life with PCOS

PCOS is a whole-body condition. With early detection and consistent care, you may be able to reduce any long-term risks associated with PCOS including prediabetes, high blood pressure, high cholesterol, depression and anxiety, and pregnancy complications.

PCOS can feel overwhelming, but it is very manageable with support, education, and a personalized approach. I work closely with patients to monitor symptoms, adjust treatment plans, and support lifestyle changes with ongoing access and unrushed appointments. If you think you may have PCOS or want help managing symptoms, you don’t have to navigate it alone. Please reach out and we can build a care plan that fits your health journey.