What is PCOS?

o Polycystic Ovarian Syndrome (PCOS) is a complex metabolic and endocrine condition that causes hormonal imbalances in women and girls of reproductive age. Hormonal imbalances prevent ovulation and the release of an egg to meet the sperm, often resulting in fertility issues.

Wondering if your irregular cycles or struggles to conceive might be caused by PCOS? Take our short PCOS symptoms quiz for a quick assessment and learn what to do next.

In this article:

Polycystic ovary syndrome (PCOS) is a complex metabolic and endocrine condition that causes hormonal imbalances, typically in girls and women of reproductive age. These hormonal imbalances can also prevent regular ovulation and the release of an egg to meet the sperm, often resulting in fertility issues.

But PCOS doesn’t just affect women of reproductive age – it can impact life far beyond these years, stretching into menopause and contributing to other health issues. PCOS also affects people who don’t identify as women (including non-binary, queer, and trans folks), and excluding them from the narrative can lead to delayed diagnoses and reduced awareness. 

If you suspect you might have PCOS or want to learn more about its common symptoms, take the short quiz below or skip ahead to explore frequently asked questions about the condition.

This quiz is provided for informational purposes only. Content is not intended to substitute a comprehensive consult with a trained medical professional. Always consult a medical professional with any questions you may have regarding your health.

1. How often do you get your period?

1. I often go 35 days or longer without getting my period
2. I frequently go months without getting a period
3. I get my period every 20 days or less, on average
4. I am currently on birth control (unsure of my regular cycle timing)
5. I get my period every 21 to 34 days, like clockwork

2. If trying to conceive, have you been successful?

1. No, it has been more than 1 year and I’m still not pregnant
2. I have been able to conceive, but have not carried a pregnancy to term
3. Yes, it was very easy for me to get pregnant

3. Do you struggle to lose excess weight?

1. Yes, it is very difficult for me – even with diet and exercise
2. I am able to lose weight, but it takes a lot of effort
3. No, I’ve always been within my normal weight range

4. Do you have intense cravings for sweets and/or carbs (i.e. pasta, bread)?

1. Yes, my cravings for certain foods are very hard to ignore 
2. I sometimes experience cravings, but can ignore them
3. No, I don’t have any specific cravings

5. Has anyone in your family been diagnosed with PCOS?

1. Yes, there at least one person (i.e. mother, sister, grandmother, or aunt) who has PCOS
2. No, but I have a family member who is overweight and has high blood pressure
3. No one in my family has been diagnosed with PCOS (that I’m aware of)

6. How is your skin?

1. I have frequent breakouts of bad acne 
2. I have occasional acne, but nothing serious
3. My skin is typically clear with no acne

7. Do you have any skin tags or dark patches on your skin?

1. Yes, I notice quite a few of both
2. I have one or the other – but not much
3. No, I don’t have either

8. Do you often feel lightheaded or dizzy?

1. Yes, I often do 
2. Occasionally
3. No, not really

9. Is your hair thinning and/or do you have hair growth in unwanted places?

1. Yes, I am experiencing both issues
2. I am noticing extra hair growth OR thinning hair, but not much
3. No, I don’t have either issue

10. Do you tend to gain extra weight in your midsection?

1. Yes, I carry most of my weight in my midsection 
2. No, my weight is pretty evenly distributed
3. No, I don’t really carry any extra weight

How to Calculate Your Score

If you selected A for most questions above, you are showing some of the most common signs of PCOS. We encourage you to schedule a consultation with an endocrinologist for further exploration.

If you selected B for most questions above, you may be exhibiting some signs of PCOS. We still encourage you to see an endocrinologist for an evaluation.

If you selected C for most questions above, you are likely not experiencing many common symptoms of PCOS. However, speaking with your primary doctor or an endocrinologist may still be helpful, as they can help rule out this or other conditions.

The exact cause of PCOS is currently unknown, and it is thought to be multifactorial, meaning several factors may contribute to its development. Some studies show that there is a genetic component, and it tends to run in families. Women with PCOS are more likely to have a mother, sister, or aunt who was also diagnosed with PCOS in the past.

The Rotterdam Criteria is the most widely accepted criteria used to diagnose PCOS. Patients must possess two of the following three features: irregular or absent ovulation, symptoms or lab work that indicate high androgen levels (hormones such as testosterone or dehydroepiandrosterone sulfate (DHEAS), and polycystic-appearing ovaries.

Occasionally, patients receive a PCOS diagnosis because they have had an ovarian cyst or elevated AMH level, but these are not part of the criteria. Early confirmation of PCOS is key in adopting a healthier lifestyle that can prevent many unwanted symptoms of PCOS.

Unfortunately, there is no cure for PCOS, but symptoms caused by PCOS can be managed accordingly. Lifestyle changes may help to restore ovulation and achieve pregnancy, including introducing dietary changes and exercise goals.

It is best to work with your PCOS team to develop a multidisciplinary treatment plan that caters specifically to you and your goals.

• Lack of regular ovulation, which can lead to fertility challenges
• Absent or irregular menstrual periods
• Hirsutism – increased hair growth on the face, stomach, back, etc.
• High numbers of follicles in the ovaries
• Weight gain, difficulty losing weight, or weight being carried in the midsection
• Frequent acne
• Excessive hair loss or hair thinning
• Anxiety or depression

What is insulin resistance?

Insulin is a hormone produced by the pancreas that helps regulate blood glucose levels in the body. After eating, blood glucose levels rise, and insulin brings glucose from the blood into the cells to give them energy. Insulin resistance occurs when your body makes enough insulin, but the insulin is not being used effectively.

When this occurs, blood glucose levels can be higher than normal, and the body works harder and produces more insulin in response. If the pancreas cannot keep up with the extra insulin produced, type 2 diabetes may develop.

Patients with PCOS are at an increased risk of developing insulin resistance, so it is important to check this with blood work. The best test to assess your glucose and insulin metabolism is a 2-hour oral glucose tolerance test.

What treatments are available for PCOS?

If you do not plan to become pregnant, birth control pills (OCPs) can be used to regulate periods, reduce androgens in the blood, and clear acne.

If you do want to achieve pregnancy, oral/injectable medicine can be used to achieve ovulation. If insulin resistance plays a role in PCOS, the medication Metformin might be utilized. Metformin can help to improve the body’s sensitivity to insulin, resulting in improved blood glucose levels.

Injectable GLP-1 RA medications like Wegovy or Mounjaro are another option to explore.

Absolutely, but some women may require help from a reproductive endocrinologist to achieve pregnancy. Most people who have fertility challenges due to PCOS do not ovulate on their own. Thankfully, there are simple treatments that can help induce ovulation, most notably oral medications to stimulate follicle growth.

In vitro fertilization (IVF) is also an option for many patients with PCOS, depending on their personal circumstances. It’s best to discuss your specific case with a reproductive endocrinologist if you feel that fertility treatment may be right for you.

What can I do to stay healthy with PCOS?

PCOS can cause a variety of health issues, so it’s important to be proactive. Unfortunately, there can be a correlation between PCOS and weight gain, gestational diabetes, and type 2 diabetes, making it all the more important to know how to mitigate your risk factors.

Note: Not everyone who has PCOS struggles with excess weight. Around 20% of patients have what’s called lean PCOS. 

People with PCOS are also at higher risk for hypertension, high cholesterol, fatty liver, and sleep apnea. It is important to see your doctor regularly, have a good diet and exercise regimen, and keep up to date with health screenings.

Why should I see a nutritionist?

Diet can impact insulin resistance in PCOS, and it is important that patients diagnosed with PCOS know how this occurs. Nutritionists are trained to help aid and teach patients about realistic and sustainable ways to eat and understand the impact of food on insulin levels with a diagnosis of PCOS.

Nutritionists are also able to break down blood work results and help teach patients how to tailor their diet and exercise regimen to improve insulin levels, aid in weight loss, and adapt to a healthier lifestyle. We recommend seeking out a registered dietitian nutritionist (RDN), as they have more specialized training than a nutritionist who doesn’t hold those credentials. 

Why should I have annual blood work?

Blood levels can fluctuate with different treatment protocols. It is recommended that you follow up with routine blood work, whether that be every six months or annually. Every patient’s PCOS diagnosis is a little different, so treatment protocols are tailored accordingly on a patient-by-patient basis.

If you are started on a medication or treatment regimen, it is important to check blood work to ensure your specific treatment protocol is still working for you and no changes need to be made to medications. Occasionally, a dose may be too high or too low for a patient, and blood work will tell us if adjustments need to be made.

Awareness is the first step in understanding this complex endocrine condition, but taking action is even more important, given the increased risk of other health challenges with PCOS. Reach out to a PCOS expert today to take control of your symptoms and learn how you can not only survive, but thrive with PCOS!