Polycystic Ovary Syndrome (PCOS) is a common condition affecting 6 to 12% of women in the U.S. Both finding the cause and getting a diagnosis can be tricky, because there is no “PCOS test” and there are a variety of factors that can cause PCOS and its symptoms. 

The most common PCOS symptoms are:

• High Androgens: Androgens are known as “male hormones,” the most notable of which is testosterone, but also includes Androstenedione and Dehydroepiandrosterone (DHEA).
  
  
• Irregular Periods: Due to infrequent ovulation, your menstrual cycles might be unpredictable.
  
  
• Ovarian Cysts: When ovulation doesn’t happen, your ovaries may develop small cysts, which create androgens (testosterone, androstenedione, and DHEA).
  
  
• Excess Hair Growth: Elevated androgen (male hormone) levels can lead to increased facial and body hair, often on the face and nipples.
  
  
• Acne: Hormonal imbalances may cause persistent or severe acne.
  
  
• Fertility Struggles: Irregular ovulation can complicate conception, but don’t be discouraged — many women with PCOS successfully conceive with appropriate support and treatment.
  
  
• Weight Fluctuations: PCOS can contribute to difficulty putting on muscle and weight gain, especially on the abdomen.

If you experience any of these symptoms, make an appointment with your health care provider to explore your options. In order for a doctor to make a PCOS diagnosis, they must see  2 out of these 3 symptoms: high androgens (either biochemical  [through blood work] or symptom-based [hirsutism]), irregular periods, and cysts on the ovaries (found through an ultrasound). This is called the Rotterdam Criteria. 

What causes PCOS?

There can be many potential culprits, but the one that accounts for about 70% of PCOS diagnosis is insulin resistance, which causes high androgen levels (male hormones). 

What causes insulin resistance & excess androgens?

• Birth control: Birth control can affect all of your body's hormones,  including your androgens. Some common birth control methods have been linked to increasing androgens, even after you stop taking them.
  
  
• Genetic Predisposition: Hashimoto’s disease, obesity, and metabolic syndrome are linked to insulin resistance
  
  
• High cortisol (the stress hormone): Extreme stress over time can cause excess cortisol, which leads to insulin resistance and therefore excess androgens.
  
  
• Diet & Exercise: Diets high in sugar and carbohydrate and lack of exercise can cause insulin resistance, which then causes an excess of androgens.

Managing PCOS Day to Day:

If you've been diagnosed with PCOS, there are various medical treatments and natural remedies that can help manage your symptoms and potentially improve your condition. It's important to work with your doctor to create a plan that suits you, but some holistic options include:

• Eat within 30 mins of waking up & don’t skip meals
• Avoid worsening insulin resistance caused by blood sugar spikes. To keep blood sugar stable, eat a high-protein breakfast within 30 minutes of waking up, and consistent high-protein meals and snacks throughout the day.
  
  
• Diet: Focus on whole foods that support hormone balance, improve insulin sensitivity, and absorb excess androgens.
  
  
• Protein: Protein stabilizes blood sugar levels and supports muscle mass which is key in managing your body’s insulin  through glucose and glycogen storage.
  
  
• Omega-3s:  Eat cold-water fatty fish like salmon, ocean trout, mackerel, sardines and anchovies. Omega-3s reduce inflammation, triglycerides, and improve insulin sensitivity.
  
  
• Nuts: Eat nuts to reduce androgen levels, insulin levels, and cholesterol levels. Walnuts in particular are fantastic at boosting sex hormone-binding globulin (SHBG), and therefore reducing androgens.
  
  
• Flaxseeds: Flaxseeds have been shown to reduce free and total testosterone if you consume at least 30g per day.
  
  
• Strength training: Muscle mass helps regulate blood sugar and makes insulin work more effectively by storing glucose and glycogen. The more muscle mass, the more glucose the muscles can store to balance insulin. Try mixing in strength training and higher-impact workouts to your routine.
  
  

Herbs

• Spearmint tea – Spearmint reduces total and free testosterone, which in turn helps mitigate excess hair growth (hirsutism).
• Red Reishi (Ganoderma) – This mushroom reduces the activity levels of 5-alpha reductase, an enzyme that converts testosterone to dihydrotestosterone (DHT). High DHT levels are associated with acne and hair loss (4).
• Saw Palmetto – The berries of the American dwarf palm work to block the conversion of testosterone to DHT, thus reducing symptoms associated with high DHT.
• Chaste Tree – This herb has been used for hundreds of years to correct hormone imbalances. Clinical studies have shown this herb’s effectiveness in reducing PMS symptoms while also helping to balance progesterone levels, especially when prolactin serum levels are elevated.

Final Thoughts

If you think you might have PCOS, start by consulting a healthcare provider for a proper diagnosis and guidance. While a PCOS diagnosis can feel overwhelming, there are numerous medical and lifestyle strategies that can help manage or improve your condition. Many people with PCOS successfully achieve regular periods, consistent ovulation, and pregnancy. Draw strength from the wealth of resources available and the supportive community of other women with similar experiences.