PCOS—Polycystic Ovary Syndrome—is the hormonal equivalent of a traffic jam in your ovaries. It’s a common condition affecting up to 10% of women of reproductive age.

The cause? It’s a tangled web of genetics, insulin resistance, inflammation, and hormone imbalances. Genes load the gun, but environment (think: weight, stress, lifestyle) pulls the trigger. Most women with PCOS have higher levels of androgens (male-type hormones) and often some degree of insulin resistance—even if they’re not overweight.

Symptoms like to travel in packs. The most common are:

• Irregular or missing periods

• Extra hair where you don’t want it (face, chest, belly)—called hirsutism

• Acne that overstays its welcome

• Scalp hair loss

• Weight gain or trouble losing weight

• Signs of insulin resistance (darkened skin under arms or neck)

Not everyone has cysts—despite the name—so don’t let that fool you.

Diagnosis uses the “Rotterdam Criteria.” You need two of these three:

• Irregular or absent ovulation (less frequent periods)

• Signs of excess androgens (acne, hair growth, or raised testosterone)

• “Polycystic” ovaries seen on ultrasound (many small follicles, not actual cysts)

Here’s the twist—even if your ultrasound is clear, you can still have PCOS if you have the other two criteria. Cysts are optional!

While PCOS can sometimes make it trickier to conceive due to irregular ovulation, the good news is that most women with PCOS can and do become pregnant—many even without medical help! Your ovaries haven’t lost their magic, they just need a little encouragement. Cutting-edge research shows that positive lifestyle changes, targeted supplements like inositol, and new medications such as GLP-1 agonists can significantly boost ovulation and fertility.
And if you ever need an extra nudge, today’s fertility treatments—from gentle medication to advanced IVF—are more successful than ever. With the right team and a personalized plan, your dream of parenthood is absolutely within reach. PCOS might slow you down, but it won’t stop you!

This syndrome isn’t just skin deep. Women with PCOS are at 2–3 times higher risk of depression and anxiety compared to other women; body image issues and the stress of dealing with symptoms (acne, weight, fertility challenges) can make things harder. Nearly 40–60% of women with PCOS report mood symptoms, so you’re not alone—and it’s very real, needing real support and care.

Women with PCOS aren’t just juggling periods; they’re managing lifelong risks, including:

• Type 2 diabetes (risk is doubled to quadrupled)

• High blood pressure, high cholesterol

• Sleep apnea

• Heart disease

• Higher rates of endometrial (uterine) cancer (from infrequent periods not “shedding” the lining)

• Weight management challenges

Not at all! Birth control regulates cycles and reduces androgen-driven symptoms, but it’s just one piece of the toolkit. 

GLP-1 Agonists (semaglutide, liraglutide, exenatide):
Let’s start with the latest blockbuster: GLP-1s do far more than trim the waistline! They improve weight (by an average of 10–15%), lower androgens, boost ovulation, and have shown in clinical trials to increase pregnancy rates, especially for those with excess weight and PCOS. Recent research even shows they may outperform metformin for fertility and metabolic improvements. Bonus: they also help lower cholesterol and protect your heart.

Metformin:
Tried and true, metformin improves your cell’s response to insulin, helps restore regular periods, and can jumpstart ovulation. It’s also beneficial for reducing future diabetes and can aid gentle weight management—especially if prediabetes is present.

Inositol (myo-inositol & d-chiro-inositol):
Think of inositol as PCOS’s gentlest hormonal helper! Large studies (including a 2023 meta-analysis) show it regulates cycles, lowers testosterone, and supports ovulation just as well as metformin, but with fewer digestive side effects. It’s a win for both period regularity and fertility.

NAC (N-acetylcysteine):
Don’t let its cough syrup reputation fool you! NAC is a promising antioxidant shown in meta-analyses to improve ovulation rates, restore menstrual regularity, and support insulin sensitivity—with a stellar safety profile.

Spironolactone:
This anti-androgen delivers on “cosmetic” symptoms: it blocks testosterone, taming acne and unwanted hair growth (hirsutism), without increasing cardiovascular risk. It often works best paired with birth control for those wanting comprehensive cycle and skin support.

Oral Contraceptives:
They’re effective at regulating cycles, reducing androgen symptoms (acne, excess hair), and protecting the uterine lining—but they’re just one tool among many, and can be combined with other approaches.

Natural and Botanical Therapies (with Scientific Backing):

• Licorice Root:
  Some studies (mainly from Europe and Asia) show that licorice extract reduces testosterone and may improve menstrual frequency. Best used under medical supervision, especially if you have blood pressure concerns.

• Saw Palmetto:
  Traditionally used for hirsutism, early trials suggest it can inhibit the conversion of testosterone to its more potent form (DHT). Thought to help with acne and excess hair—again, only as part of a broader strategy.

• Omega-3 Fatty Acids:
  High-quality fish oil or algae-based omega-3s may improve menstrual regularity, lower inflammation, and slightly reduce testosterone. Multiple studies highlight benefits for cholesterol and heart health in PCOS.

• Other Botanicals Under Study:
  Flaxseed, spearmint tea, cinnamon, and some adaptogens show promise in small studies for reducing androgens, balancing blood sugar, or easing PCOS symptoms. Always use botanicals thoughtfully—discuss with your ND, especially if combining with prescription meds.

And always—the true foundation:

• Lifestyle first: Even 5% weight loss can restore cycles, improve fertility, and boost energy. Focus on whole foods, regular movement, restorative sleep, and stress management—every small step makes hormonal ripples.

• Psychological and Skin/Hair Support: Mental health, self-image, and tailored cosmetic treatments round out a whole-person plan.

Bottom line:

There’s no one-size-fits-all fix for PCOS—and that’s the point. Whether it’s GLP-1s, metformin, inositol, NAC, spironolactone, or carefully selected botanicals, your treatment should be as unique as your hormones. We’ll help you build the right blend for better balance, fewer symptoms, and long-term metabolic health.