Polycystic ovary syndrome (PCOS) is characterized by ovarian cysts – follicles that form like a pearl necklace on the ovaries. But these follicles produce no eggs. Although there can be up to 100 cysts, they aren’t dangerous – they don’t increase in size, aren’t cancerous, and don’t require surgery. 

PCOS is largely underdiagnosed – symptoms vary and can morph over time and include infertility, irregular or absent cycles, acne, weight loss resistance, systemic inflammation, hair loss, and excess hair growth. Long-term effects can include anxiety, depression, moodiness, anger, low libido, heart disease, abnormal liver enzymes, and an increased risk of breast and endometrial cancer.

The hormonal imbalances underlying PCOS aren’t fully understood. What we do know is that the pituitary gland and ovaries don’t communicate, which leads to irregular ovulation and irregular build-up and shedding of the uterine lining. It’s also understood that most women with PCOS have high androgens – “masculine” hormones like testosterone and DHEA that can result in adult acne and excess hair growth on the belly, arms, thighs, breasts, chin, or upper lip.

But women with PCOS don’t simply have high androgens; they also have high cortisol and insulin. Most women with high androgens have insulin resistance. This is why many doctors are quick to prescribe drugs like Metformin or Glucophage (Type 2 diabetes drugs).

[Click here for our Managing PCOS post and chapbook.]

PCOS is systemic. It’s impossible to “treat” PCOS with diabetes drugs – or the birth control pill. Neither gets to the root of the condition. The birth control pill stops you from ovulating – with PCOS, you’re already not ovulating. If you’re looking to get pregnant, the pill isn’t a helpful strategy to begin with.

Women with PCOS will often go for months without a menstrual cycle and then begin bleeding heavily – sometimes for days. This happens when the uterine lining has gotten so thick that the body must shed it.

Because PCOS disrupts regular ovulation, it’s one of the primary causes of infertility. Given that the condition so often falls under the diagnostic radar, it’s important to rule out PCOS if you’re having difficulty getting pregnant. For many women, some straightforward dietary and lifestyle changes can be all that’s needed to conceive. A PCOS diagnosis doesn’t mean that a healthy pregnancy is out of the question.

Fortunately, PCOS is often temporary. The condition responds very well to natural dietary and lifestyle strategies, especially strategies for insulin resistance. If a woman with PCOS takes the commonly-prescribed meds for PCOS but doesn’t make changes to her diet and lifestyle, her ovaries may become polycystic again when she stops taking either drug.

If you suspect you have PCOS, ask your doctor for a complete evaluation, including checking for insulin resistance. This includes a physical examination, a fasting lipid profile, a glucose test, hormone levels, and an insulin test (before and two hours after a high-carbohydrate meal). Although we recommend this comprehensive testing for proper diagnosis, you can also monitor your own blood sugar at home with a glucometer.

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The information on this website is not intended to diagnose, treat, cure, or prevent any disease or condition. It is for informational purposes only and is not a substitute for advice from your physician or other healthcare professional.

You should not use the information on this website for diagnosis or treatment of any health problem. Consult with a healthcare professional before starting any diet, exercise, or supplementation program, before taking any medication, or if you have or suspect you have a health condition.