PCOS 101: Everything You Need to Know

Polycystic Ovary Syndrome (PCOS) is one of the most common hormonal conditions affecting 6-10% of people with ovaries during their reproductive years. Despite being so widespread, it’s often misunderstood and under-diagnosed. Let’s break down the basics of PCOS and what it can mean for your health.

What is PCOS?

PCOS (Polycystic Ovary Syndrome) is a hormonal disorder that affects how the ovaries work. The name comes from the appearance of small fluid-filled sacs (cysts) on the ovaries, but not everyone with PCOS has cysts. At its core, PCOS is about hormonal imbalance, especially higher-than-normal levels of androgens (sometimes called “male hormones”) and disruptions in how the body uses insulin. These imbalances can impact ovulation, fertility, metabolism, and overall health.

What are the Symptoms of PCOS?

PCOS looks different for everyone, but some common symptoms include:

• Irregular or missed periods
• Excess hair growth on the face, chest, or stomach (a symptom called hirsutism)
• Acne that’s persistent and hard to treat
• Thinning hair or hair loss on the scalp
• Weight gain or difficulty losing weight
• Dark patches of skin (often on the neck, armpits, or under the breasts)
• Ovarian cysts (though not always present)

Because symptoms can vary, PCOS can sometimes be overlooked or mistaken for other conditions.

How is PCOS Diagnosed?

There isn’t one single test for PCOS, but diagnosis usually involves a combination of:

• Medical history review: Talking about your menstrual cycle and symptoms.
• Physical exam: Checking for visible signs like excess hair growth or skin changes.
• Blood tests: Measuring hormone levels, including androgens, thyroid hormones, and insulin.
• Ultrasound: Looking for multiple small cysts on the ovaries and assessing ovary size.

Doctors often use the Rotterdam Criteria, which requires at least two of the following: irregular ovulation, high androgen levels, or polycystic ovaries on ultrasound.

What are Treatment Options for PCOS?

There’s no one-size-fits-all cure, but PCOS can be managed with a mix of lifestyle changes and medical treatments:

• Lifestyle adjustments: Balanced diet, regular movement, and stress management can help regulate hormones and improve symptoms.
• Birth control pills: Often prescribed to regulate periods, reduce androgen levels, and clear acne.
• Anti-androgen medications: To help with excess hair growth and acne.
• Metformin: A medication that improves insulin sensitivity, sometimes used for PCOS-related insulin resistance.
• Fertility treatments: If pregnancy is the goal, medications like letrozole or clomiphene can help trigger ovulation.

The right plan depends on your symptoms and health goals.

Does PCOS Affect Your Period?

Yes. Irregular periods are one of the hallmark signs of PCOS. Some people may have fewer than eight periods a year, while others may have very heavy or prolonged bleeding. Because PCOS can disrupt ovulation, cycles can become unpredictable. Missing periods for long stretches isn’t just inconvenient—it can also increase the risk of endometrial (uterine) issues over time, which is why period regulation is often part of PCOS treatment.

The Bottom Line:

PCOS is common, but it doesn’t look the same for everyone. If you suspect you might have PCOS, reaching out to a healthcare provider is the best step toward understanding your body and finding a treatment plan that works for you.

Customize Your Period Routine

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