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What is PCOS?
PCOS is a collection of symptoms related to hormonal imbalance. It affects 1 in 10 women, and the impacts are wide-ranging. There is no cure for PCOS, but it is manageable with the proper care. There is no one right way to treat PCOS. Every body reacts differently to treatments depending on their metabolic, genetic, environmental, and habitual makeup. Having this condition means a much greater risk for serious health complications down the road, so preventing it from spiraling is just as important as immediate symptom relief.
Typical concerns with PCOS include infertility, weight gain, excess facial hair, acne, insulin resistance, low energy, brain fog, male-pattern hair loss, and mental health struggles.
A medical diagnosis according to the Rotterdam criteria requires two of the following three:
Elevated androgen levels in bloodwork
Irregular periods
A "string of pearls" appearance on an ultrasound of the ovaries
Why do people have PCOS?
Research for this complex condition is ongoing, and we still don't know an exact cause.
We do know the following are contributing factors:
Insulin resistance - "Insulin is a hormone that the pancreas makes. It allows cells to use sugar, your body's primary energy supply. If cells become resistant to the action of insulin, then blood sugar levels can go up. This can cause your body to make more insulin to try to bring down the blood sugar level.
Too much insulin might cause your body to make too much of the male hormone androgen. You could have trouble with ovulation, the process where eggs are released from the ovary.
One sign of insulin resistance is dark, velvety patches of skin on the lower part of the neck, armpits, groin or under the breasts. A bigger appetite and weight gain may be other signs."Low-grade inflammation - "White blood cells make substances in response to infection or injury. This response is called low-grade inflammation. Research shows that people with PCOS have a type of long-term, low-grade inflammation that leads polycystic ovaries to produce androgens. This can lead to heart and blood vessel problems."
Heredity - "Research suggests that certain genes might be linked to PCOS. Having a family history of PCOS may play a role in developing the condition."
Excess androgen - "With PCOS, the ovaries may produce high levels of androgen. Having too much androgen interferes with ovulation. This means that eggs don't develop on a regular basis and aren't released from the follicles where they develop. Excess androgen also can result in hirsutism and acne."
Source: Mayo Clinic
Misconceptions
PCOS is caused by obesity
This rumor caused many people to stay silent about their PCOS for years. PCOS is a condition shrouded in shame. As a teen, I was told I had caused this syndrome because I was overweight, when in reality, this condition was causing my weight gain! We have better information now, but many people (even doctors) still believe this.
Birth control fixes everything
Hormonal birth control (BC) can relieve some symptoms and is a great option for many people. However, it is poorly tolerated by many others and does not align with their goals. It covers up symptoms rather than addressing the root causes. BC can even give people without PCOS these symptoms when coming off of it.
PCOS = Cysts on ovaries
PCOS is a metabolic condition first and foremost. Many people with PCOS have cysts on their ovaries, but they are not required for a diagnosis. These "cysts" are different from what we typically assume. They are follicles that did not properly mature, causing anovulation. These follicles do not release, so they have nowhere to go, and they form a bumpy appearance on the surface of the ovary. "Cysts" is used as shorthand, but it is important to remember there are many types of ovarian cysts.
PCOS Symptoms
Acne
Anxiety
Bloating
Depression
Disordered eating
Fatigue
Hair loss
Hidradenitis suppurativa
High blood pressure
High cholesterol
Hirsutism
Infertility
Insulin resistance
Irregular or missed periods
Low energy
Nonalcoholic fatty liver
Sleep disorders
Oily skin
Pain in lower abdomen or pelvis
Skin discoloration
Skin tags
Weight gain or difficulty losing weight
Sexual dysfunction (low libido)
People with PCOS have a significantly higher likelihood of struggling with:
Obesity | Insulin resistance | Metabolic syndrome
Type 2 diabetes | Cardiovascular disease | Obstructive sleep apnea
Mood disorders | Inflammation | Eating disorders
PCOS Treatments
The experience of PCOS is highly individual, which means its care is just as unique.
Typically, management includes a combination of many of the following options.
Medications
Birth control, metformin, Ozempic, and spironolactone are common prescriptions.
Exercise/Nutrition
Moving in ways that don’t increase the body’s stress response, while focusing on whole foods and balancing insulin.
Therapy/Psychiatry
Seeking support for the psychological impact of PCOS, as well as treatment for depression, anxiety, and disordered eating.
Environment
Decreasing toxins where possible is important, as the liver is closely connected to our hormones. Focus on reducing endocrine-disrupting toxins.
Holistic Medicine
Acupuncture, supplements, and herbalism can often be effective treatments for PCOS, though their success is highly dependent on individual cases.
Sleep
Increasing both the quality and quantity of sleep can drastically improve symptoms. Focus on improving sleep quality as well as getting adequate sleep.
As your PCOS coach, I can provide:
PCOS education
Health organization support
Habit-building accountability
Medical advocacy
Insurance navigation assistance
Suggested care plans
Nutritional education and strategy
Supplement and herbal education
Consistent emotional support
A companion in the trial and error process
Dispelling shame and misinformation
Guidance in creating a health team
Take a look at my unique coaching tracks to see what might fit you best.
Schedule a free 15-minute consultation call to get started!
Do you enjoy researching on your own? Check out these sites and articles to get started:
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