PCOS: Practical Guide to Symptoms, Tests, and Treatment
Polycystic ovary syndrome (PCOS) is one of the most common hormonal conditions in people with ovaries. It often shows up as irregular periods, heavier facial or body hair, acne, stubborn weight gain, and trouble getting pregnant. Not everyone has the same signs—some only notice missed periods, others face mood changes and skin problems. Recognizing patterns early helps you get treatment that actually improves daily life.
Why it matters: PCOS raises the risk of insulin resistance, type 2 diabetes, and heart issues over time. It also affects fertility and can be emotionally draining. That doesn’t mean it’s untreatable—many people manage PCOS with simple changes and targeted meds.
How doctors diagnose PCOS
Diagnosis usually combines your story, a physical exam, blood tests, and sometimes an ultrasound. Doctors look for irregular cycles, high male-hormone signs (like acne or excess hair), and ovarian cysts on ultrasound. Blood tests check hormone patterns and screen for thyroid problems or elevated blood sugar. You don’t need all three classic signs to get a diagnosis—your doctor will consider the full picture.
Treatment options that actually help
There’s no one-size-fits-all cure, but treatments focus on your main goal: regular periods, clearer skin, weight control, or pregnancy. Lifestyle changes—losing even 5% of body weight, eating lower-glycemic foods, and moving more—often improve symptoms quickly. For periods and skin, combined birth control pills are commonly used to regulate cycles and lower male hormones. Metformin helps if insulin resistance or blood sugar problems are present and can aid weight loss and cycle regularity. For unwanted hair or acne, doctors may prescribe spironolactone or topical treatments. If you want to get pregnant, letrozole is now a go-to drug to stimulate ovulation more effectively than older options.
Supplements like inositol (myo-inositol) show promise for improving insulin sensitivity and cycle regularity in some people. Vitamin D deficiency is common with PCOS, so checking levels and correcting low vitamin D can help mood and metabolic health. Always check with a clinician before starting supplements, especially if you’re trying to conceive or taking other meds.
Practical tips: track your cycles with an app, get fasting glucose and lipid tests annually, and prioritize sleep—poor sleep worsens insulin resistance. If you struggle to lose weight, focus on small, consistent changes rather than extreme diets. Find a provider who listens and offers follow-up; PCOS changes over time and treatment often needs tweaking.
When to see a specialist: if you can’t get pregnancy after six months to a year of trying (depending on age), if your periods are very irregular, or if you have sudden worsening of symptoms like rapid weight gain or severe hair growth. Endocrinologists and reproductive specialists work well together for complex cases.
PCOS is manageable. With the right mix of lifestyle, targeted meds, and regular checkups, most people see real improvement in symptoms, fertility, and long-term health.
Keep a symptom diary and bring questions to appointments; small changes now reduce future risk and help treatments work better for you daily.
