What Is PCOS? Top Insights You Need to Know

If you’re wondering whether you have PCOS, then chances are you’ve searched “what is PCOS?’ to find a collection of symptoms that make up this condition. The question of exactly what PCOS is can be hard to answer, though, since it’s not diagnosed through one blood test, or the presence of one hormone in your body. Rather it’s a hormonal disorder that can present with 1) an excess of male hormones (androgens) in the body, as well as 2) insulin resistance. Some physical manifestations of these underlying issues can include missed periods, acne, unintentional weight gain, hair loss, and excessive body hair (hirsutism).

PCOS is typically diagnosed through something called the Rotterdam criteria, which essentially means you need to fit two out of the three requirements (namely, hyperandrogenism, lack of ovulation, or cysts on the ovaries). 

Being diagnosed with PCOS, or even researching PCOS symptoms, can feel overwhelming at first. That’s why we’ve put together this short guide to answer essential questions like: 

  • What are the first signs of PCOS? 
  • What causes PCOS? 
  • What should you do if you think you have PCOS? 
  • How big of an impact could a PCOS diagnosis have on your lifestyle?

Let’s dive in. 

What is PCOS? What causes it?

Like we alluded to earlier, PCOS is an endocrine and metabolic condition that is more common than you might think among reproductive-age women in the US. According to the US Office of Women’s Health, approximately 10% of women have polycystic ovarian syndrome. 

Researchers aren’t exactly sure what causes PCOS as of now, but it is thought to be a combination of environmental and genetic factors. For instance, if your mother or sister has PCOS, there seems to be an increased likelihood that you could have it. In times of stress it can feel more present, while in other periods of your life it may feel more “cured” because – as a syndrome – its symptoms can peak and trough over an entire lifespan. 

One theory suggests that potential underlying insulin resistance (meaning, cells in your body don’t respond well to insulin, and so can’t use glucose from your body for energy; in order to make up for it, you produce more insulin, which causes blood sugar levels to rise) exacerbates a potential hormone imbalance. Specifically, the overproduction of insulin can interfere with hormones released by your ovaries, and prevent ovulation, as well as an increase in androgens (male hormones). To be clear, insulin resistance is not the cause of PCOS, but rather a potential contributor to it. 

First signs of PCOS 

Women with PCOS experience this condition differently. There is no consensus on one or two symptoms that show themselves ‘first;’ more often than not, PCOS is often characterized by experiencing multiple symptoms. 

Here are some popular symptoms of PCOS: 

  • Excess hair growth (hirsutism)
  • Acne 
  • Irregular (or absent) periods 
  • Thinning hair on scalp
  • Unintentional weight gain 
  • Darkening of skin (particularly along neck creases, under breasts, and around the groin area)
  • Skin tags

It’s important to note that there are some symptoms, however, that may go more unnoticed than others. 

For instance, for the first two years after a woman begins her period, it’s not uncommon to have missed or irregular periods. This is thanks to something called ‘anovulatory cycles’ which means the body isn’t ovulating monthly yet. (Note: it is a good idea to track your period if you can, because missed periods can be a sign of a deeper health issue that may or may not be PCOS, such as stress, thyroid issues, low body weight, or other root causes). 

PCOS is unique in that its physical manifestations also have a psychological impact on women who suffer from this condition. Research has indicated women with PCOS may be at an increased risk for mood disorders, such as anxiety and depression (one study estimated around 40% of women with PCOS may suffer from depression). Research also indicates that women with PCOS are 6 times more likely to suffer from eating disorders, and as many as 33% of women with PCOS suffer specifically from binge eating disorder. Contributing factors include the emotional toll of PCOS as well as high insulin levels causing low blood sugar, which can trigger a strong desire for carbohydrates.  

Similar to if you have unexplained physical changes, if you have a decline in your mental health, we highly suggest seeing a therapist or other mental healthcare professional. 

What should you do if you think you have PCOS? 

First of all, make an appointment with your primary care physician. They will give you a physical exam and ask you questions about your symptoms. 

For the time in between your appointment and now, write down symptoms that you have been experiencing, how they manifest themselves, and for how long you’ve been experiencing them. Try to be as detailed as possible. This information will be useful to share with your doctor.

From there, your physician may order an ultrasound scan to check your ovaries for cysts, though this isn’t always the case. Sometimes signs of hyperandrogenism (such as excess hair growth and acne) combined with irregular or skipped periods are enough to warrant a PCOS diagnosis. 

Previous to this meeting, we also suggest you write down any questions you have for your doctor. Useful questions to ask may be: 

  • What is your recommended treatment plan for handling PCOS? 
  • How would you describe your approach to treating PCOS? 
  • How often would you suggest I check in with you about symptoms, efficacy of treatments, and so on?

Your doctor should discuss an approach to tackling your PCOS symptoms, which may include medication, as well as lifestyle changes. At the end of your appointment, you should feel heard and understood. If your physician shrugs off your concerns, or fails to listen to your perspective, we highly encourage you to seek out a second physician’s opinion regarding managing your PCOS symptoms. 

If you, like many women who deal with PCOS, are also experiencing distress, anxiety, or unmanageable sadness about your symptoms, it is important to share this with your doctor or therapist as soon as possible. Though physical symptoms are something you should definitely pay attention to, your mental and emotional health are also critical factors to your overall well-being. 

Once you’ve met with your primary care physician, consider learning more about PCOS. (This article on ‘What is PCOS?’ is a great start!). We have others, too, that may be useful as a jumping off point as you navigate your PCOS journey. Articles such as: 

Are all foundational pieces that give you research-based insights into your options when it comes to alleviating symptoms. 

You may also want to consider working with PCOS specialists. At Allara, we take a holistic approach to PCOS, which means pairing you with a medical doctor, certified nutritionist, and community of women who also have PCOS, in order to not only give you the physical and emotional support you deserve, but also formulate a thoughtful treatment plan that aligns with your short and long-term health goals. 

How big of an impact could PCOS have on your lifestyle?

In short: a PCOS diagnosis can have as big of an impact, or as little of an impact, on your lifestyle as you like. You get to decide your approach to PCOS. However, if you want to mitigate PCOS symptoms, improve fertility, and reduce your chances of encountering long-term health implications (like cardiovascular disease and type 2 diabetes, both of which women with PCOS are at increased risk of): then we suggest you work with a healthcare professional to develop a PCOS treatment plan that works for you

Oftentimes, a successful PCOS plan is one that takes a research-based approach to PCOS and that fits in with your values, lifestyle, and goals. 

There are certain measures you can take, such as increasing your exercise, swapping some popular foods for more nutritional alternatives, and considering research-supported supplements and helpful medications for PCOS, which all taken together, can have a profound impact on reducing symptoms. 

In addition, we are always big proponents of learning more about your condition (ideal sources include our blog, as well as our Nutrition Evidence Library!). Now you know the ins and outs of exactly “What is PCOS?” you can empower yourself to make informed decisions about your long-term health. 

Allara Health provides personalized treatment that takes the guesswork out of managing PCOS, and offers a customized, holistic plan of attack that merges nutrition, medication. supplementation, and ongoing, expert support to begin healing your body.