Polycystic Ovary Syndrome (PCOS) is one of the most misunderstood—and misdiagnosed—conditions in women’s health. Affecting up to 1 in 10 women of reproductive age, PCOS can show up in many different ways: acne, hair loss, irregular cycles, anxiety, depression, infertility, weight changes, or fatigue.
But what exactly is PCOS? And why are so many women told different things about it?
Let’s clear up the confusion and dig into what you really need to know.
What Is PCOS?
PCOS is fundamentally an ovulation disorder. It means the body isn’t ovulating regularly, predictably, or at all. Irregular ovulation has a ripple effect on hormones, including estrogen, progesterone, testosterone, and insulin.
Ovulation problems lead to hormonal imbalances. And those imbalances drive the symptoms you experience.
The Root Causes
There’s no one-size-fits-all explanation for PCOS. While about 60% of cases are driven by high androgens (male-type hormones like testosterone, dihydrotestosterone and/or DHEAs), the remaining 40% are driven by other disruptions:
- High stress
- Thyroid dysfunction
- Low body fat or malnutrition. When your body fat is too low, a gland in your brain known as the hypothalamus may elect to shut the ovaries down until body fat increases. When resources are scarce, your body can decide to prioritize vital organs like your brain, heart, and lungs, at the expense of your ovaries. This is not actually PCOS, the proper term is Hypothalamic Hypogonadism. This can be determined via thorough blood testing.
- High prolactin. Prolactin is a hormone associated with breastfeeding in women. However, it can increase for other reasons, like stress. If it is too high, it can suppress the ovaries.
Every woman’s root cause mix is different, which is why PCOS needs a personalized approach, not just a generic diagnosis.
PCOS Types
There are several PCOS types or “patterns” of PCOS. While they’re not officially recognized in mainstream medicine, they help guide more targeted care:
- A: Classic PCOS: This is the most classic and frequently observed type. It includes all three core features: hyperandrogenism (high male hormones), oligo-anovulation (irregular or no ovulation), and polycystic ovarian morphology (cysts on the ovaries on ultrasound).
- B: This type presents with hyperandrogenism and oligo-anovulation, but without the polycystic ovaries.
- C: This type includes hyperandrogenism and polycystic ovaries, but with regular menstrual cycles (ovulatory).
- D: This type presents with oligo-anovulation and polycystic ovaries, but without hyperandrogenism.
Common Misconceptions
- You must have cysts to have PCOS → False. Many don’t, because you only need to have two out of three of the Rotterdam criteria. PCOS types A, C, and D may show cysts on the ovaries, while Type B may not.
- Regular periods mean you’re ovulating → Not necessarily. Up to 40% of women can have a regular cycle but do not ovulate.
- It’s just a cosmetic issue → PCOS has much more serious implications for your short-term health, mental and physical well-being, and your long-term health. It affects fertility, metabolism, cardiovascular health, mental health, diabetes risk, the health of any children, and long-term hormonal balance.
- Just take the pill or metformin → These may suppress symptoms, but don’t address the root causes. Addressing the root cause helps you take charge of the situation and manage your health in the long term.
What Works?
Managing PCOS requires a whole-person approach:
- Diet & blood sugar regulation
- Exercise that supports insulin sensitivity
- Stress reduction strategies
- Root-cause lab testing & proper lab result analysis
- Possible targeted supplements (based on testing)
PCOS isn’t something you cure. It’s something you manage. And the good news? Management works and keeps you healthier in the long term.
With the right tools, education, and support, women with all of the PCOS types can feel better, clear their skin, restore their cycles, and even get pregnant naturally.
Ready to Get Started?
Let’s take the guesswork out of your hormones.
