PCOS explained: Symptoms, causes, and what you can do

Polycystic Ovarian Syndrome (PCOS) is one of the most common gynaecological conditions, affecting up to 15% of women of reproductive age. Yet, so many of us grow up without ever hearing about it - or only learn about it when we go off the pill, or start struggling with irregular cycles, skin issues, or fertility challenges. Because of this gap in awareness, countless women go undiagnosed for years.

This article is here to change that. We’ll walk you through what PCOS actually is, what symptoms to look out for, why it happens, and what can help.

Table of contents

1. What PCOS really means

2. Common symptoms of PCOS

3. Causes and contributing factors

4. How to manage PCOS symptoms

5. Key takeaways

What is PCOS?

Despite the name, PCOS isn’t simply about having “many cysts” on the ovaries. In fact, you don’t need to have cysts at all to be diagnosed.

Doctors usually use three criteria to make a diagnosis. If you have two out of three, it may point to PCOS:

• Irregular or absent periods

• Higher levels of male-type hormones (androgens)

• Polycystic-looking ovaries on an ultrasound

What shows up as “cysts” are usually multiple immature follicles - tiny sacs containing eggs that haven’t matured enough to be released. This disrupted ovulation explains why cycles can become irregular.

How can you recognise PCOS?

PCOS can look different for everyone, which makes it tricky to diagnose. Still, some signs are more common:

• Irregular or absent periods: Some women may go months without bleeding, while others experience very heavy or painful periods.

• Androgen-related symptoms: Acne, oily skin, hair growth on the face or body, thinning hair on the scalp.

• Weight challenges: Many women with PCOS experience difficulties maintaining a healthy weight, often linked to insulin resistance.

• Fertility issues: Problems with ovulation can make it harder to conceive, though it doesn’t mean pregnancy is impossible.

  
  

  💭 PCOS is best thought of as a spectrum. Symptoms may shift over time, sometimes improving or worsening depending on lifestyle, hormones, and other health factors.

  
  

What causes PCOS?

The truth is: we don’t know the exact cause. But several factors are known to play a role.

• Hormone imbalance: Higher androgens and disrupted oestrogeen and progesteron interfere with regular ovulation.

• Insulin resistance: When the body doesn’t respond well to insulin, blood sugar and insulin levels rise, driving further hormone imbalance.

• Inflammation: Chronic low-grade inflammation, from stress, poor diet, or lifestyle factors, can worsen both insulin resistance and hormone issues.

What can you do about PCOS?

There’s no single “cure” for PCOS, but lifestyle shifts and medical support can make a big difference.

Diet and nutrition

Eating for PCOS means focusing on balance. Fibre slows digestion and helps regulate blood sugar. Anti-inflammatory foods like berries, leafy greens, and omega-3-rich fish can calm inflammation. Lean proteins support energy and stable hunger. On the flip side, processed foods and refined sugars can worsen insulin spikes, so it’s worth limiting them when you can.

🍳 Breakfast is especially powerful for blood sugar balance. Aim for 25–30g of protein with a mix of healthy fats and fibre: think a veggie omelette with avocado on wholegrain toast or Greek yoghurt with berries and nuts.

Lifestyle habits

• Movement: Regular activity (like walking, cycling, or strength training) improves insulin sensitivity and mood. Even short walks after meals help.

• Sleep: 7–9 hours of quality sleep keeps hormones more balanced. A calming routine before bed can really help.

• Stress management: High stress increases cortisol, which disrupts hormones further. Meditation, journaling, or simply spending time with loved ones can all lower stress.

Medical support

Hormonal birth control is often prescribed to regulate cycles and lower androgen symptoms if pregnancy isn’t a current goal. While it doesn’t fix the underlying causes, it can ease day-to-day challenges.

Closing thoughts

Living with PCOS can feel overwhelming, especially when so much about it still isn’t widely understood. But knowledge really is power here. Understanding how PCOS works - and how much influence your daily habits can have - means you’re not powerless.

With the right support, small but consistent steps can make a real difference in how you feel. And remember: you are not alone. Millions of women share this experience, and there is support, community, and treatment out there for you.

Key takeaways

• PCOS affects up to 15% of women, yet many remain undiagnosed.

• Symptoms vary widely, but irregular cycles, skin changes, and fertility struggles are common.

• Hormone imbalance, insulin resistance, and inflammation all play a role.

• Diet, exercise, sleep, stress reduction and sometimes medical treatment have a major influence on PCOS symptoms.

• If you suspect you might have PCOS, don’t wait—speak with a healthcare professional who understands women’s hormonal health.

References:

Deswal, R., Narwal, V., Dang, A., & Pundir, C. S. (2020). The Prevalence of Polycystic Ovary Syndrome: A Brief Systematic Review. Journal of Human Reproductive Sciences, 13(4), 261–271. https://doi.org/10.4103/jhrs.JHRS_95_18

Purwar, A., & Nagpure, S. (2022). Insulin resistance in polycystic ovarian syndrome. Cureus, 14(10). https://doi.org/10.7759/cureus.30351

Skiba, M. A., Islam, R. M., Bell, R. J., & Davis, S. R. (2018). Understanding variation in prevalence estimates of polycystic ovary syndrome: a systematic review and meta-analysis. Human Reproduction Update, 24(6), 694–709. https://doi.org/10.1093/humupd/dmy022

Zhao, H., Zhang, J., Cheng, X., Nie, X., & He, B. (2023). Insulin resistance in polycystic ovary syndrome across various tissues: an updated review of pathogenesis, evaluation, and treatment. Journal of Ovarian Research, 16(1). https://doi.org/10.1186/s13048-022-01091-0