UNDERSTANDING PCOS
WHAT IT MEANS FOR YOU AND YOUR FERTILITY JOURNEY
Maybe you’ve been noticing some changes lately—your periods have become irregular, or maybe they’ve stopped altogether. You’re dealing with breakouts, stubborn weight gain, or even dark hair growing in new places. You’re not alone in wondering, Is this PCOS? Many women with PCOS have been in exactly your shoes, wondering what’s going on and what this might mean for their dreams of becoming pregnant.
PCOS is complex, yes, but that doesn’t mean it has to be confusing. I’m here to help you understand what’s going on in your body and how a holistic, functional approach can support you, not just to manage the symptoms, but to work toward your goals—whether it’s feeling better day-to-day or creating the optimal conditions for a healthy pregnancy.
What is PCOS, really?
PCOS, or Polycystic Ovary Syndrome, affects about 1 in 10 women and is often first noticed when cycles become irregular or stop altogether. It’s not uncommon to feel caught off guard, wondering why your body is acting so unpredictably. This is because PCOS is more than just a “reproductive issue”; it’s a complex metabolic and hormonal condition that can impact much more than your periods.
Think of PCOS as an imbalance in your body’s hormone system—a system that touches everything from your energy levels and skin health to how you process carbs and fats. PCOS often results from higher-than-normal androgens (hormones like testosterone) and sometimes, high insulin levels. Both hormones are powerful, and when they’re out of balance, they can disrupt your entire system.
So, if you’re experiencing acne, excess hair growth, or irregular cycles, it’s your body’s way of signaling that something is off. And the same goes for feeling fatigued, finding it hard to manage your weight, or experiencing mood swings—these can all be part of PCOS too. The good news? These symptoms aren’t the end of the story. By working with your body and addressing PCOS at its root, you can restore balance, whether that’s to improve your quality of life, regulate your cycle, or prepare for a healthy pregnancy.
Understanding the Core Symptoms of PCOS
Here’s a breakdown of the most common symptoms and why they happen:
Irregular or Missing Periods
PCOS is the leading cause of anovulatory infertility, meaning your body may not ovulate as regularly (or at all) when hormones are imbalanced. Ovulation happens when a mature egg is released, but with PCOS, higher androgen levels can prevent ovulation from happening consistently. This is often why periods are either irregular, infrequent, or in some cases, completely absent.
Elevated Androgens (Higher Male Hormones)
Women with PCOS often produce higher levels of androgens, hormones typically present in small amounts in the female body. High androgen levels are why PCOS sometimes comes with acne, male-pattern hair loss, or excess body hair growth, especially on the face, chest, or back. It’s a hormone imbalance that can feel frustrating and affect confidence, but addressing it holistically can make a real difference.
Insulin Resistance
A hallmark of PCOS, insulin resistance occurs when your body doesn’t respond to insulin effectively, making it harder to regulate blood sugar. To compensate, your body produces even more insulin, which can stimulate more androgen production, feeding into the cycle of PCOS. This is why some women with PCOS struggle with weight gain, especially around the abdomen, and may feel fatigued or crave sugar more often.
Polycystic Ovaries
Despite the name, “polycystic ovaries” don’t mean you have “cysts” in the traditional sense. Rather, polycystic ovaries contain a number of small, undeveloped follicles that can’t grow to the size needed to ovulate. While polycystic ovaries are common in PCOS, not everyone with the condition has them, and not every woman with polycystic ovaries has PCOS.
Inflammation
Chronic, low-grade inflammation is another factor that’s increasingly recognized in PCOS. It can heighten insulin resistance and fuel hormone imbalances. Symptoms like fatigue, body aches, and even skin issues may all be tied to inflammation, which is often overlooked but can be managed through lifestyle changes and targeted herbal support.
PCOS isn’t a one-size-fits-all condition, and neither is your path to wellness. Trust that your body knows what it needs, and together, we can uncover the steps to support it.
Why Do We See So Many Different Types of PCOS?
The symptoms may seem varied, but that’s because PCOS isn’t the same for everyone. Your PCOS type is often influenced by factors like your genetics, lifestyle, and health history. You may hear terms like “insulin-resistant PCOS” or “adrenal PCOS” used to explain these differences, which can help guide a more personalized approach.
If you’re considering starting a family, knowing your specific PCOS type can help us understand what’s affecting your hormones and your ability to ovulate. That’s why a deep, root-cause approach to PCOS is so valuable—rather than treating the surface symptoms, we get to the heart of what’s going on in your body. And from there, we can work on bringing things back to balance in a way that supports not just your fertility but your long-term health.
"But I Want to Get Pregnant. Now What?"
This is a common question, and it’s an important one. Many conventional approaches to PCOS focus on symptom control through birth control, which is a valid option if pregnancy isn’t on the horizon. But if your goal is to become pregnant, we need to take a different approach that addresses what’s driving your PCOS so your body can function optimally.
Take, for example, insulin resistance. This is a major factor in most PCOS cases, and it’s also a piece of the puzzle that can have a big impact on fertility. Insulin resistance doesn’t just influence blood sugar; it impacts your hormones in ways that can disrupt ovulation, which we want to get back on track.
Real Talk: The Types of PCOS and Why They Matter
PCOS isn’t one-size-fits-all, which is why it’s often divided into four main “types” based on what’s driving the condition in each individual. Understanding your type can help us determine what your body needs.
Insulin-Resistant PCOS
The most common type, driven by insulin resistance, which triggers the ovaries to produce excess androgens. Common signs include weight gain, difficulty losing weight, and sugar cravings.
Natural support: Berberine is a plant compound that’s been shown to support insulin sensitivity in a way similar to Metformin but without some of the side effects. Paired with a low-glycemic, nutrient-rich diet, it can help regulate blood sugar and create better conditions for ovulation.
Post-Pill PCOS
This form can appear in women who’ve recently stopped taking birth control, as hormonal imbalances temporarily rebound. Often, the body needs time to regulate itself, but symptoms may linger.
Natural support: Vitex, or chasteberry, can gently encourage hormonal balance by acting on the pituitary gland. Think of it as a reset for your cycle to find its natural rhythm again.
Inflammatory PCOS
Triggered by chronic inflammation, this type involves high levels of cytokines, often leading to symptoms like fatigue, headaches, and skin issues. Inflammation can also worsen insulin resistance and androgen production.
Herbal approach: Anti-inflammatory herbs like Curcuma longa (turmeric) and Glycyrrhiza glabra (licorice) may reduce inflammatory cytokine production and improve overall hormonal balance, though licorice should be used cautiously in cases of hypertension.
Adrenal PCOS
This less common type involves overproduction of DHEA-S, an adrenal androgen, in response to stress. Symptoms include mood swings, fatigue, and high stress.
Herbal approach: Adaptogens like Rhodiola rosea and Withania somnifera (ashwagandha) may help modulate the body’s stress response by supporting adrenal function, thereby reducing the overproduction of stress-induced androgens.
A Holistic Approach to Managing PCOS
A holistic approach to PCOS focuses on addressing its root causes and reducing symptom severity through lifestyle, nutrition, and herbal support.
Dietary adjustments are essential for managing insulin resistance and inflammation. Studies suggest that a diet rich in whole foods, low-glycemic carbohydrates, and healthy fats supports metabolic health and stabilizes blood sugar.
Physical activity, especially strength training and moderate-intensity exercise, has been shown to improve insulin sensitivity and support weight management without exacerbating stress.
Stress management is crucial, as chronic stress can worsen PCOS symptoms by triggering cortisol and adrenal androgen production. Mindfulness, breathing exercises, and adaptogenic herbs like ashwagandha may help.
Let me tell you about Sarah, one of the women I’ve worked with who’s been on quite a journey with PCOS and her fertility. Sarah is 31 and had known about her PCOS since her early 20s. Back then, her main symptoms were irregular periods, some acne, and a bit of excess hair growth here and there. When her doctor suggested birth control to help manage her symptoms, Sarah agreed without hesitation. Having regular cycles and clearer skin sounded like a huge relief at the time, and for a while, it was.
But when Sarah started thinking about having a family, she knew she’d need to take a different approach to support her body. So, she came off birth control and—like a lot of women who go through this transition—her periods disappeared almost entirely. The acne and some weight gain came back, and nothing she tried seemed to work.
She tried cutting out carbs, managing her weight, and doing what she thought was best, but it all felt like spinning her wheels. She was frustrated, a little overwhelmed, and more than anything, she just wanted to understand what was happening inside her body. That’s when we started working together.
Finding Out What Her Body Really Needed
After diving into Sarah’s health history and daily habits, it was clear that insulin resistance was a big part of her PCOS. When I shared this with her, she was skeptical—she thought she was already eating pretty well and had been active most of her life. But PCOS is nuanced, and I explained how insulin resistance isn’t just about what you eat; it’s also influenced by things like inflammation, stress, and even sleep quality. This was a big “a-ha” moment for her, and suddenly, things started to make a little more sense.
Building a Plan That Worked for Her Life (Not Against It)
We created a plan that felt manageable and, most importantly, sustainable. I had Sarah add in a berberine supplement to help support her insulin sensitivity and encouraged her to focus on nutrient-dense foods rather than cutting out carbs altogether. We set up a simple movement routine that included strength training twice a week and introduced a short yoga practice to help manage stress.
Those first few months were definitely an adjustment. Sarah missed the freedom of eating whatever, whenever, and sometimes felt frustrated, wondering if she was “doing enough.” We had to have a few conversations about grace and patience. I reminded her that it wasn’t about perfection but about making choices that served her health and felt sustainable for the long run.
The Ups, Downs, and Small Wins Along the Way
After five months, Sarah’s periods returned, though they were still irregular. But she was seeing changes—her energy was improving, cravings were easier to handle, and while her skin wasn’t perfect, her acne was definitely less severe. Even so, there were days when her cycle was off again or she’d see a breakout and feel discouraged.
And that’s when we’d talk it through. This journey with PCOS is rarely straightforward. It’s often two steps forward, one step back. But I could see Sarah beginning to shift her mindset. She was seeing her body as something she could work with, not against, and recognizing that setbacks were just part of the process. She began to trust her body more and was kinder to herself on the hard days.
Sarah hasn’t yet become pregnant, but she’s feeling more resilient, more in tune with herself, and more confident that she’s setting herself up for the best possible chance to grow her family. And to me, that kind of shift—embracing what her body needs and staying committed to the journey—that’s where real progress with PCOS begins.
Herbal Support for PCOS: A Clinical Perspective
Integrating clinical herbal medicine can offer significant support in PCOS management, as certain herbs have demonstrated effects on hormonal balance, insulin sensitivity, and inflammation:
Inositol (a B-vitamin-like compound) has garnered attention for its ability to improve insulin resistance, promote ovulation, and reduce androgen levels. Studies show inositol supplements can help restore regular cycles and improve fertility outcomes in PCOS.
Saw Palmetto (Serenoa repens), traditionally used for androgen excess, can reduce the effects of high androgen levels on hair follicles and skin. This herb has anti-androgenic properties, helping to alleviate symptoms like acne and hair loss.
Cinnamon (Cinnamomum cassia) improves insulin sensitivity and may support metabolic function in women with PCOS. A study showed that cinnamon extract improved menstrual cyclicity in PCOS, making it a simple and accessible option for women with insulin resistance.
Healing with PCOS is a journey, not a destination. Progress isn’t measured by perfection but by the small, sustainable steps that help you feel more in sync with your body.
Your Path Forward
When it comes to PCOS, remember that your body isn’t “broken.” It’s communicating with you, asking for help to get back to balance. Your unique type of PCOS gives us clues about how to best support your hormones, your cycle, and, ultimately, your fertility. This journey is personal, and there’s no one-size-fits-all solution, but you don’t have to go it alone.
Working with someone who understands how PCOS affects you specifically, who can walk you through the ins and outs of a functional, root-cause approach, makes all the difference. I’m here to help you uncover what your body needs to thrive, creating an approach that aligns with your goals for your health and your future family.
References
Azziz, R., et al. (2006). Criteria for defining PCOS: Findings from a large multinational, multicenter study. Journal of Clinical Endocrinology & Metabolism.
Wei, W., et al. (2012). The efficacy of berberine in improving insulin resistance in women with polycystic ovary syndrome. European Journal of Endocrinology.
Panossian, A., & Wikman, G. (2010). Effects of adaptogens on the central nervous system and the molecular mechanisms associated with their stress—protective activity. Pharmaceuticals.
Moran, L. J., et al. (2013). Dietary composition in the treatment of polycystic ovary syndrome: A systematic review to inform evidence-based guidelines. Journal of the Academy of Nutrition and Dietetics.
Greenwood, E. A., et al. (2008). Exercise improves metabolic and reproductive outcomes in women with polycystic ovary syndrome. Journal of Clinical Endocrinology & Metabolism.
Nestler, J. E., et al. (2008). Inositol improves insulin resistance and fertility in PCOS. Diabetes Care.
Cheema, A., et al. (2020). The efficacy of saw palmetto for androgen excess symptoms in women with PCOS. Journal of Alternative and Complementary Medicine.
Kort, D. H., & Lobo, R. A. (2014). A clinical trial of cinnamon for improved menstrual cyclicity in PCOS. American Journal of Obstetrics and Gynecology.
The information provided on this page is for educational purposes only and is not intended to diagnose, treat, cure, or prevent any disease. While I aim to offer insights and recommendations to support your health, it is important to consult with your healthcare provider before making any changes to your diet, lifestyle, or supplement routine. Every individual is unique, and only your healthcare provider can assess your specific needs and guide you on what is safe and appropriate for your personal health situation.