Polycystic Ovarian Syndrome (PCOS)

Polycystic Ovarian Syndrome (PCOS) is a complex, lifelong hormonal and metabolic condition that affects people with ovaries. It is one of the most common endocrine disorders worldwide, yet it is also one of the most misunderstood.

PCOS is not just a reproductive condition and it is not limited to the ovaries. It impacts multiple systems in the body, including hormonal regulation, metabolism, cardiovascular health, and mental well-being. Symptoms and severity vary widely, and no two experiences with PCOS look exactly the same.

What Is PCOS?

PCOS is a condition rooted in hormonal dysregulation and metabolic imbalance. While the name suggests ovarian cysts, many individuals with PCOS never develop cysts at all—and many people without PCOS do.

At its core, PCOS involves:

  • Disrupted communication between the brain, ovaries, and adrenal glands

  • An imbalance of reproductive and metabolic hormones

  • Altered ovulation patterns

  • Systemic inflammation and insulin dysfunction in many cases

PCOS exists on a spectrum, meaning symptoms can range from mild to severe and may change over time due to age, stress, pregnancy, or menopause.

Hormonal and Metabolic Imbalance in PCOS

One of the defining features of PCOS is elevated androgen levels, often referred to as “male-type hormones,” though all bodies naturally produce them. When these hormones are higher than typical, they can interfere with ovulation and contribute to symptoms such as acne, excess hair growth, or scalp hair thinning.

PCOS is also closely linked to insulin resistance, a condition in which the body struggles to use insulin effectively. This can lead to:

  • Increased insulin levels

  • Increased androgen production

  • Difficulty managing weight

  • Increased inflammation

Importantly, not all individuals with PCOS have insulin resistance, but for many, it plays a significant role in symptom expression.

PCOS Is Not Caused by Lifestyle Choices

PCOS is not caused by poor diet, lack of exercise, or weight. It is a medical condition influenced by genetics, hormones, and metabolic function.

That said, lifestyle interventions may be used as supportive tools to manage symptoms—not as a cure, and not as a measure of personal responsibility.

Health Risks Associated With PCOS

Because PCOS affects multiple systems in the body, it is associated with several long-term health risks—especially when symptoms go unmanaged or unrecognized.

Metabolic and Cardiovascular Risks

  • Insulin resistance and Type 2 diabetes

  • Prediabetes

  • High cholesterol

  • High blood pressure

  • Increased risk of heart disease

Reproductive and Hormonal Risks

  • Chronic anovulation

  • Irregular or absent menstrual cycles

  • Increased risk of endometrial hyperplasia due to prolonged lack of ovulation

Inflammatory and Sleep-Related Risks

  • Chronic low-grade inflammation

  • Sleep apnea, particularly in individuals with insulin resistance

Mental Health Risks

  • Anxiety

  • Depression

  • Disordered eating

  • Body image distress

Mental health challenges are common in PCOS and are often compounded by delayed diagnosis, medical dismissal, and societal stigma.

Living With PCOS

Living with PCOS means managing a condition that can evolve across different life stages—from adolescence to adulthood and beyond.

PCOS may affect:

  • Energy levels

  • Mood and emotional health

  • Self-esteem

  • Relationships

  • Family planning decisions

  • Long-term health monitoring

Because PCOS is lifelong, care often requires a holistic, individualized approach that considers physical health, mental well-being, and quality of life—not just symptom suppression.

PCOS Management Is Not One-Size-Fits-All

There is no single treatment plan that works for everyone with PCOS. Symptom management may change over time and often involves a combination of medical care, education, and supportive strategies.

Effective PCOS care centers on:

  • Understanding your body and symptoms

  • Addressing metabolic health when relevant

  • Supporting hormonal balance

  • Prioritizing mental and emotional well-being

  • Advocating for informed, respectful care

Most importantly, PCOS management should be collaborative, informed, and patient-centered.

PCOS Across the Lifespan

PCOS does not end with reproductive years. Symptoms and risks may continue—or shift—during perimenopause and menopause.

Ongoing education and monitoring remain important throughout life to reduce long-term health risks and support overall well-being.

A Condition That Deserves Understanding

PCOS is common, complex, and real. It is not a cosmetic issue. It is not a personal failure. And it is not “just irregular periods.”

With accurate information, informed care, and proper support, individuals with PCOS can lead full, healthy lives.