PCOS

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What Is PCOS?

Polycystic Ovary Syndrome (PCOS) is a complex hormonal and metabolic disorder that affects 1 in 10 women of reproductive age. Despite the name, not all women with PCOS have ovarian cysts. Instead, PCOS is defined by a combination of symptoms related to ovulation dysfunction, excess androgens (male hormones), and insulin resistance.

It is a spectrum condition—meaning symptoms and severity can vary widely from person to person.



PCOS Is More Than Just Ovaries

PCOS is not just a reproductive condition—it is a whole-body metabolic issue.


Key features include:

  • Insulin resistance (even in lean women)
  • Hormonal imbalance:

elevated testosterone, DHEA-S, or LH

  • Inflammation and immune system dysregulation
  • Estrogen dominance with low progesterone due to anovulation

This hormonal chaos can cause a ripple effect through the body.


Short-Term Symptoms

  • Acne, especially jawline and back
  • Hair loss (androgenic alopecia)
  • Oily skin and unwanted hair growth (hirsutism)
  • Weight gain or difficulty losing weight
  • Mood swings, anxiety, and depression
  • Irregular or absent periods



What Is Skinny PCOS?

Not all women with PCOS are overweight. "Lean PCOS" or "Skinny PCOS" affects women with a normal BMI who still experience hormone imbalances, acne, infertility, or ovulatory dysfunction.

Lean PCOS often involves more adrenal hormone imbalance (high DHEA-S), lower insulin resistance, but similar risks to metabolic PCOS over time.



Long-Term Health Effects

If left untreated or poorly managed, PCOS can lead to:

  • Infertility due to chronic anovulation
  • Endometrial thickening (from unopposed estrogen)
  • Uterine cancer risk due to lack of progesterone
  • Type 2 diabetes and insulin resistance
  • High cholesterol and high blood pressure
  • Fatty liver disease
  • Increased risk of miscarriage and pregnancy complications


Ovarian vs. Adrenal PCOS

  • Ovarian PCOS: More classic presentation, with elevated LH:FSH ratio, high testosterone, irregular periods, and insulin resistance
  • Adrenal PCOS: High DHEA-S (from adrenal glands), stress-driven, often in younger women or those with lean PCOS

These can coexist. Some women have a mix of adrenal and ovarian features. Treatment must be personalized.



Management Strategies

There is no "cure" for PCOS, but it can be well managed throughout life with a combination of medical and lifestyle strategies.

Medications:

  • Metformin: Improves insulin sensitivity
  • Spironolactone: Reduces acne and hair growth
  • Hormonal birth control: Regulates cycles and suppresses androgens
  • Clomiphene or Letrozole: For fertility induction

Supplements:

  • Inositol (myo- and D-chiro): Improves ovulation and insulin resistance
  • Berberine: Natural insulin sensitizer
  • Vitamin D, magnesium, zinc, omega-3s

Lifestyle:

  • Low-glycemic, anti-inflammatory diet
  • Strength training and regular movement
  • Sleep optimization and stress reduction



A Lifelong Spectrum

PCOS is a lifelong condition, often with a genetic component. It may appear differently in your 20s than it will in your 40s or after menopause. The goal is not to "fix" it but to support your body and manage symptoms.

Many women with PCOS go on to live full, healthy lives—conceiving children, balancing hormones, and avoiding long-term complications through knowledge and consistent care.



Final Thoughts

PCOS is not a disease—it’s a syndrome that reflects how your body is adapting to hormonal, metabolic, and environmental challenges. With proper guidance, education, and support, you can take control of your health.

You are not alone. You are not broken. PCOS is manageable—and so are its symptoms.