Polycystic Ovarian Syndrome (PCOS) is one of the most common hormonal conditions affecting 1 out of 10 women of reproductive age. Yet, it often goes undiagnosed because the signs and symptoms can be subtle and inconsistent. In this blog, Dr. Laurence Jacobs shares important information about how to know if you have PCOS and how different lifestyle and treatment approaches can improve your health.
Understanding PCOS
A common misconception is that all women with PCOS experience irregular periods, excess hair growth, ovarian cysts or weight gain. However, not every woman with PCOS has all of these symptoms. Because there is no single test to diagnose PCOS, some doctors may miss the correct diagnosis, especially in young women, by only treating irregular periods with birth control pills.
Signs and Symptoms of PCOS
PCOS may present differently from woman to woman, but symptoms often include:
- Irregular or absent periods
- Infrequent or absent ovulation
- Infertility
- Hirsutism (excessive hair growth) of face, chest or abdomen; acne
- Weight gain or obesity
- Insulin resistance
How is PCOS Diagnosed?
Women must have two out of three of the following diagnostic criteria:
- History of irregular or absent menstrual cycles and/or no ovulation since puberty
- Hirsutism and/or high blood levels of male hormones: Testosterone and Androgens
- Vaginal ultrasound evidence of polycystic ovaries (20 or more follicles in one or both ovaries)
It is also important to note:
-Other endocrine issues, such as various thyroid and adrenal diseases, must be ruled out as their symptoms can mimic signs of PCOS.
-Ultrasound diagnostic criteria no longer applies to teenage girls.
Key Considerations
- Not all PCOS patients are overweight (Classical PCOS). Some may have what is known as Lean PCOS.
- Women with PCOS often experience irregular periods and infertility due to lack of ovulation and/or egg quality.
- Insulin resistance is common in PCOS patients. This means their bodies do not respond to glucose properly. In order to maintain normal blood glucose levels, the pancreas produces excessive insulin, which then increases fat storage and disrupts hormone levels. This leads to symptoms such as irregular periods, obesity, infertility and excess hair growth.
Lifestyle and Treatment Approaches
The good news is that addressing insulin resistance can help restore normal ovarian function. Research shows that lifestyle and medical strategies can improve fertility and overall health in women with PCOS:
- Nutrition: A balanced, lower-carb diet can help regulate blood sugar and hormone levels.
- Exercise: Regular activity supports insulin sensitivity and weight management.
- Supplements: Vitamins like Inositol may help regulate insulin resistance and menstrual cycles.
- Medications: Insulin-sensitizing medications such as Metformin are often used to improve ovulation and restore hormone balance. The beneficial use of GLP-1 agonist medications, such as Semaglutide (Ozempic or Wegovy) and Tirzepatide (Zepbound) along with proper nutrition and lifestyle changes will be discussed in part 2 of this PCOS blog.
- Weight reduction: Even a weight loss of 5–10% can enhance fertility, improve natural ovulation and increase success rates with fertility treatments, including IVF.
Expert Care for PCOS
Dr. Jacobs has helped women manage their PCOS for more than 40 years and was formerly the Director of the PCOS Center of Excellence. He understands firsthand how medications, supplements and lifestyle modifications can profoundly impact the health and fertility of PCOS patients.
If you think you may have PCOS or are struggling with symptoms, Dr. Jacobs and our team can help with the correct diagnosis and treatment options. Click here to schedule a consultation.
Stay tuned for part two of this PCOS blog which will discuss management and treatment options for those PCOS patients dealing with infertility issues.