Polycystic Ovary Syndrome – Symptoms, causes and treatment

Polycystic Ovary Syndrome (PCOS) is a common condition that affects a woman’s hormonal balance, causing the formation of small cysts in the ovaries.

If untreated, this disruption can affect the menstrual cycle and hormone levels and lead to adverse health outcomes. Many women ignore the initial symptoms, thinking they’re a part of being female or due to a hectic lifestyle.

In the US, around 6 to 12% of women of reproductive age have infertility caused by this reproductive condition [1]. It’s a growing concern due to a sedentary lifestyle, unhealthy eating habits, and other environmental factors.

Types of PCOS

PCOS comes in many forms, and its treatment can vary depending on the type.

To help you understand better, here’s a brief overview of the various types of PCOS and their respective characteristics.

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Adrenal PCOS

This type of polycystic ovary syndrome is caused by the adrenal glands’ excess production of androgen hormones.

Androgens are male hormones also present in females, and excess levels can disrupt the hormonal balance in the body, leading to symptoms like acne, irregular periods, weight gain and hair loss or growth [2].

Adrenal PCOS, though not as prevalent as the common kind caused by ovary imbalances, can considerably impact a woman’s health and overall well-being.

Treatment options may include hormone-level-regulating medication or removal of the affected adrenal gland via surgery.

Insulin-resistant PCOS

PCOS of this type is identified by insulin resistance, which is a condition where the body’s cells resist the hormone insulin. When the body is insulin-resistant, it can cause various metabolic issues such as high blood sugar levels and weight gain.

Women with insulin-resistant PCOS may have elevated insulin and glucose levels in addition to the classic PCOS features [3].

Insulin-resistant PCOS can be managed with exercise, a balanced diet, and sometimes medication like Metformin.

Post-pill PCOS

Post-Pill PCOS occurs when a woman develops PCOS-like symptoms after stopping hormonal birth control, such as the birth control pill [4].

Hormonal birth control can mask underlying symptoms, and stopping birth control can reveal the classic PCOS features.

Post-pill PCOS
Photograph: seventyfourimages/Envato

Inflammatory PCOS

Inflammatory PCOS is characterized by chronic inflammation, which may lead to insulin resistance, weight gain and other metabolic issues [5].

Women with this type may have elevated levels of inflammatory markers in addition to the classic PCOS features.

However, not all women with PCOS fit into these categories. There may be overlap or variation in symptoms and characteristics.

Working with a healthcare professional to identify the underlying causes and develop an individualized treatment plan for managing symptoms and improving overall health is essential.

What is the main cause of PCOS?

PCOS has no identifiable cause, but several factors contribute to its onset. 

Insulin resistance

One of the most significant factors contributing to PCOS, is insulin resistance, which occurs when the body cannot use insulin effectively. This often leads to elevated insulin levels, as the pancreas produces more insulin to compensate.

The excess insulin can cause the ovaries to produce more androgens, which are male hormones typically found in lower levels in females. Increased androgen levels can cause the development of cysts in the ovaries and other symptoms associated with PCOS [6].

Hormonal imbalance

PCOS develops mainly as a result of hormonal imbalances. Women frequently have an overabundance of androgens in their bodies that result in masculine features like severe acne and uncontrollable hair growth. Additionally, these women may struggle to conceive and have irregular periods [7].

Genetics

It is frequent for women diagnosed with PCOS to have family members like mothers or sisters diagnosed with the same condition. This indicates that the probability of developing this reproductive condition might be genetically inherited within families [8].

However, it’s essential to understand that having these genetic variations doesn’t guarantee that someone will develop PCOS but increases their risk.

The presence of these genes, combined with environmental and lifestyle factors, can contribute to the onset and severity of the condition.

Lifestyle and environmental factors

Metabolic stress, sedentary lifestyles, poor diets and nutrition and contact with endocrine-disrupting chemicals are a few of the causes that can lead to hormone imbalances and polycystic ovary syndrome [9], [10].

It’s important to understand that every woman’s experience with this condition is different. For optimal results, it’s essential to comprehend how various factors affect each woman and to develop a specific plan of action to manage the condition.

How will you know if you have PCOS?

PCOS symptoms vary from one woman to another. However, these are a few common signs you should be aware of [11]. For an accurate diagnosis and advice, speak with your OB-GYN or a medical expert if you’ve ever had any of these symptoms.

  1. Irregular menstrual cycles: Infrequent, irregular, or even completely absent periods are the most common symptom of PCOS.
  2. Excess androgen: High levels of male hormones, or androgens, can result in physical signs such as severe acne, excess facial and body hair, or male-pattern baldness.
  3. Polycystic ovaries: Women with Polycystic Ovary Syndrome might develop enlarged ovaries with multiple small sacs filled with fluid, visible through an ultrasound.
  4. Infertility: Women with PCOS often experience irregular or absent ovulation due to hormonal imbalances, making it difficult to predict when they are most fertile. This irregularity makes it more challenging to conceive naturally.
  5. Weight gain: Many women with PCOS struggle with weight gain or have difficulty losing weight.
  6. Insulin resistance: When left untreated, PCOS can lead to type 2 diabetes, often associated with insulin resistance.
  7. Sleep apnea: Several studies have found a connection between PCOS and sleep apnea, which is often overlooked. Women suffering from this condition are more at risk of sleep apnea than those without it. This link may be because of several factors, such as hormonal imbalances, obesity, and insulin resistance, all common in women with PCOS.

Consult a healthcare professional if these symptoms persist for a long time. Early diagnosis and proper management can prevent complications and improve quality of life.

Now that we understand polycystic ovary syndrome, the next section will delve deeper into the causes and factors that lead to this frustrating and challenging hormonal disorder.

Is PCOS a serious problem?

Polycystic Ovary Syndrome is a complex condition with various long-term health implications. It’s essential to be aware of these complications and take steps to manage this disorder to reduce the risk of severe health problems.

Let’s explore some of the common complications of PCOS.

1. Infertility

As discussed earlier, infertility is a common complication of PCOS, affecting up to 70% of women with the condition. The hormonal imbalances, irregular ovulation and poor egg quality associated with PCOS can make it more difficult for women to conceive.

However, many women with this disorder can achieve successful pregnancies with appropriate treatment and lifestyle modifications.

2. Type 2 diabetes

Insulin resistance, a common feature of PCOS, may lead to the development of diabetes. Being insulin-resistant means the body produces more insulin to make up for it, which can cause higher blood sugar levels.

Over time, these elevated levels can damage the insulin cells, leading to Type 2 diabetes. Insulin resistance must be managed with diet, exercise and medication to lower the risk of Type 2 diabetes in women with polycystic ovary syndrome.

3. Cardiovascular diseases

Heart attacks and strokes are other cardiovascular conditions more likely to affect women with PCOS. This increased risk is due to the hormonal imbalances and insulin resistance associated with the condition.

Reducing the risk of cardiovascular disease can be achieved by managing the risk factors through lifestyle changes like maintaining a healthy diet, engaging in regular exercise and taking medication as necessary.

4. Endometrial cancer

Endometrial cancer, which damages the lining of the uterus, is another condition more likely to impact women with PCOS.

This elevated risk is thought to be caused by PCOS-related hormonal imbalances, which can result in abnormal thickening of the endometrial lining.

Thus, women with PCOS should undergo regular screenings for endometrial cancer; in some cases, hormonal therapy or surgery may be necessary to manage this risk.

5. Hormonal imbalances and mood swings

The hormonal imbalances associated with PCOS can lead to mood swings, irritability, and other emotional symptoms.

Fluctuations in estrogen, progesterone and androgens can cause mood changes throughout the menstrual cycle.

It’s essential to recognize and manage these mood swings by adopting stress-reducing techniques like exercise, relaxation and mindfulness practices.

6. Anxiety and depression

Women with polycystic ovary syndrome are at higher risk of developing anxiety and depression. The physical symptoms, hormonal imbalances and long-term health risks associated with PCOS can lead to feelings of anxiety, hopelessness and despair.

It’s essential to recognize the symptoms of anxiety and depression and seek appropriate treatment, such as therapy or medication. Self-care practices such as exercise, social support and stress management can help alleviate these symptoms.

Anxiety and depression
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Should you get PCOS diagnosed?

Despite experiencing some of these symptoms, many women opt not to see a medical professional, thinking that it’s no big deal and it will just sort itself out.

Unfortunately, it won’t. The longer some women avoid seeking medical help, the more complicated dealing with this frustrating reproductive condition might become. 

So, when should you see a doctor?

If you have irregular periods, weight gain, hair loss or excessive hair, acne or skin tags, or fertility problems, you should book an appointment with your doctor as soon as possible. Don’t be shy or embarrassed – your doctor has seen it all, and they’re here to help.

When diagnosing, your doctor will ask about your medical history and symptoms to help them better understand what could be going on [12]. They may also perform physical and pelvic exams to check for any signs of polycystic ovaries.

Depending on the results, they may order blood tests to check your hormone levels or ultrasounds to check the condition of your ovaries. These tests will help your doctor determine if you have PCOS.

So, take that step and make an appointment today!

What treatment options are available for PCOS?

While there’s no cure for polycystic ovary syndrome, treatment options are available to help reduce the risk of long-term health complications and manage the symptoms.

Some of the standard treatment options include:

Medications

Various medications are the go-to treatment option for women suffering from PCOS. Birth control pills, for instance, can regulate hormone levels to relieve symptoms such as acne, irregular periods and unwanted hair growth.

Hormonal therapy, such as anti-androgen drugs, can help reduce male hormone production, leading to acne and hair growth.

While for women trying to conceive, ovulation induction drugs and other fertility treatments can be used [13].

Lifestyle changes

Besides medications, lifestyle changes can make a huge difference in managing PCOS symptoms [14].

Maintaining a nutritious diet and exercising regularly can help fight insulin resistance and weight gain linked to the condition.

Furthermore, a low glycemic index diet rich in fiber, lean protein and whole grains can help stabilize blood sugar levels and promote weight loss.

Surgery

While rare, surgery may be an option for women with PCOS who fail to respond to other treatments.

Ovarian drilling, a procedure to reduce androgen production in the ovaries, can improve ovulation and regulate periods [15].

Additionally, bariatric surgery may also be an option for obese women with PCOS to facilitate weight loss.

Fertility treatments

For women with difficulty conceiving because of PCOS, fertility treatments like ovulation induction or in vitro fertilization (IVF) might be recommended [16].

Unconventional or alternative medicine

Alternative treatments, such as acupuncture, can relieve symptoms by correcting hormone imbalances and improving blood flow to the ovaries [17]. 

Supplements

Inositol, curcumin and vitamin D are dietary supplements that can aid in PCOS symptom management [18].

But before seeking alternative remedies or taking supplements, be sure to consult a healthcare practitioner.

What does a PCOS diet look like?

One of the most effective ways to manage PCOS symptoms is through diet and lifestyle modifications.

A healthy diet can help manage insulin resistance, improve hormone balance and reduce inflammation [19].

Let’s take a detailed look at how to adopt a PCOS-friendly diet.

1. Balance macronutrient intake

A healthy PCOS diet should aim for a balanced macronutrient intake, focusing on complex carbohydrates, lean protein sources and healthy fats.

  • Complex carbohydrates: Whole grains, fruits and vegetables can help manage insulin resistance and promote stable blood sugar levels.
  • Lean protein sources: Food like chicken, turkey, fish and legumes can help manage insulin resistance and improve hormone balance.
  • Healthy fats: Choosing healthy fats like nuts, seeds, avocados and olive oil can help reduce inflammation and improve hormone balance.

2. Choose low-glycemic index foods

The glycemic index (GI) measures how quickly food-related carbohydrates raise blood sugar levels. Choosing low-GI foods can help manage insulin resistance and improve symptoms. Some examples of low-GI foods include:

  • Whole grains (such as brown rice, quinoa and whole-wheat bread)
  • Non-starchy vegetables (such as leafy greens, broccoli and carrots)
  • Legumes (such as chickpeas, lentils and beans)
  • Nuts and seeds

3. Limit processed and high-sugar foods

Processed and high-sugar foods can contribute to insulin resistance, weight gain and inflammation – all of which can exacerbate PCOS symptoms.

Limiting these foods can help manage the disorder and improve overall health. Some examples of foods to limit include:

  • Sugary drinks (such as soda and juice)
  • Baked goods (such as cookies, cakes and pastries)
  • Processed snacks (such as chips and crackers)
  • Fried foods

4. Avoid inflammatory foods

Inflammation is a common feature of PCOS and choosing anti-inflammatory foods can help reduce inflammation and improve symptoms.

Examples of anti-inflammatory foods include:

  • Fatty fish (such as mackerel, tuna, salmon and sardines)
  • Berries (such as blueberries, raspberries and strawberries)
  • Leafy greens (such as spinach and kale)
  • Turmeric
  • Ginger
  • Garlic

5. Prevent micronutrient deficiencies

Women with PCOS may be at risk for specific nutrient deficiencies, such as Vitamin D and B vitamins.

Choosing nutrient-dense foods and considering supplementation may help manage these deficiencies and improve symptoms. Examples of nutrient-dense foods include:

  • Dark leafy vegetables (such as spinach and kale)
  • Fatty fish (such as salmon, tuna, trout, mackerel and sardines)
  • Whole grains (such as brown rice, quinoa, oats and barley)
  • Nuts and seeds
  • Legumes (such as chickpeas, lentils and beans)
  • Berries (such as blueberries, raspberries and strawberries)

6. Watch portion sizes

Portion sizes can play a significant role in managing symptoms, as overeating can lead to weight gain and insulin resistance. It’s essential to monitor portion sizes and prepare balanced meals that include a variety of nutrient-dense foods.

7. Stay hydrated

Maintaining proper hydration is essential for good health and can aid in managing symptoms associated with the condition. Drinking water and avoiding sugary beverages can help control insulin resistance and improve gut health.

Can I live a normal life with PCOS?

Living with Polycystic Ovary Syndrome can be a highly intricate and multifaceted experience, fraught with physical, emotional and social repercussions that can significantly affect a woman’s life.

However, with the appropriate treatment, lifestyle modifications and support, women suffering from this condition can lead fulfilling and healthy lives [20].

Here are some recommendations for living with PCOS and managing the condition.

1. Seek appropriate medical care

It is imperative to seek appropriate medical care, including regular check-ups, screenings for potential complications and treatment for specific symptoms.

Work with a medical professional who thoroughly understands the complexities of the condition and can provide appropriate treatment and guidance.

Seek appropriate medical care
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2. Adopt a healthy lifestyle

Adopting a healthy lifestyle can be vital in managing PCOS symptoms and improving overall well-being. This includes adhering to a well-balanced and nutritious diet, engaging in regular physical exercise, ensuring adequate sleep and employing relaxation techniques to manage stress.

3. Learn how to manage hormonal imbalances

To effectively manage PCOS, hormonal imbalances, including insulin resistance, must be addressed. This can be accomplished by taking the proper medications, changing your lifestyle, or doing both simultaneously.

4. Address emotional and mental health

Women with PCOS experience emotional and mental health problems, so addressing these issues through appropriate support and care is essential. This may include therapy, medication, or support groups.

5. Build a support network

Building a robust support network of friends, family, healthcare professionals and other women with PCOS can provide much-needed emotional support and a sense of connection.

Joining a support group or online community can be an invaluable resource for connecting with others who understand the challenges of living with the disorder.

6. Educate yourself

Education is a potent tool for managing polycystic ovary syndrome. Understanding the condition, its symptoms and potential complications can empower women to make informed decisions about their health and treatment options. 

Closing thoughts

Living with PCOS can make one feel helpless, anxious, and frustrated. And while there is no cure, the good news is it’s manageable. Women can take charge of their health and well-being by combining the appropriate medications, treatment, lifestyle, and nutritional needs.


Seeking support and medical care is also crucial when dealing with this condition. This includes regular check-ups and advocating for the care and attention you need to manage your symptoms.

It may not always be easy, but incorporating these habits we mentioned into your daily routine can help you feel your best.

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[1]https://www.cdc.gov/diabetes/basics/pcos.html 
[2]https://healthmatch.io/pcos/adrenal-pcos#adrenal-glands-in-the-context-of-pcos   
[3]https://www.pollie.co/blog/pcos-types   
[4]https://www.emilyjensennutrition.com/blog/4-types-of-pcos-and-how-to-know-which-one-you-have  
[5]https://www.pollie.co/blog/pcos-types 
[6]https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/symptoms/ 
[7]https://www.jeanhailes.org.au/health-a-z/pcos/symptoms-causes 
[8]https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/causes/ 
[9]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6935309/ 
[10]https://jrhm.org/role-of-genetic-environmental-and-hormonal-factors-in-the-progression-of-pcos-a-review/   
[11]https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/symptoms/ 
[12]https://www.nichd.nih.gov/health/topics/pcos/conditioninfo/diagnose 
[13]https://www.hopkinsmedicine.org/health/conditions-and-diseases/polycystic-ovary-syndrome-pcos  
[14]https://nyulangone.org/conditions/polycystic-ovary-syndrome/treatments/lifestyle-changes-for-polycystic-ovary-syndrome  
[15]https://pubmed.ncbi.nlm.nih.gov/15257815/  
[16]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6935873/  
[17]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7935573/ 
[18]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9710389/ 
[19]https://www.hopkinsmedicine.org/health/wellness-and-prevention/pcos-diet 
[20]https://www.hollandhospital.org/healthy-life/articles/hannah-clark-fnp/living-with-polycystic-ovary-syndrome-pcos 

Photograph: AtlasComposer/Envato
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