Polycystic ovary syndrome (PCOS) is a common hormonal condition marked by some combination of irregular or missed periods, signs of elevated androgens (acne, excess facial or body hair, scalp thinning), and polycystic-appearing ovaries on ultrasound. It affects roughly 1 in 10 women of reproductive age and is a leading cause of infertility, but many women go years undiagnosed. PCOS is not just a reproductive issue: it is closely tied to insulin resistance and raises long-term risk of type 2 diabetes and heart disease. It is manageable, and treatment is tailored to your symptoms and goals, whether that is regulating cycles, addressing skin and hair changes, or trying to conceive.
What are the main symptoms of PCOS?
The core symptoms are irregular, infrequent, or absent periods; signs of excess androgens like persistent acne, excess hair on the face or body (hirsutism), and male-pattern scalp thinning; and difficulty losing weight or unexplained weight gain. Many women also experience darkened skin patches, skin tags, fatigue, and trouble getting pregnant. Symptoms vary widely, and you do not need every one to have PCOS. Some women have mainly cycle problems; others mainly skin and hair changes.
How is PCOS diagnosed?
PCOS is diagnosed using the Rotterdam criteria, which require at least 2 of 3 features: irregular or absent ovulation, clinical or lab signs of high androgens, and polycystic-appearing ovaries on ultrasound. Crucially, it is a diagnosis of exclusion, so a clinician will run bloodwork to rule out thyroid disease, high prolactin, and other conditions that mimic it. Expect labs (hormones, glucose or insulin, lipids) and often a pelvic ultrasound. Because thyroid problems overlap, see our guide on hypothyroidism for comparison.
What does PCOS management involve?
Management targets your specific symptoms and goals. For irregular cycles and skin or hair symptoms, hormonal birth control is common. For insulin resistance, metformin and lifestyle changes (nutrition, movement, sometimes medical weight management) are used. For fertility, ovulation-inducing medications are an option. Anti-androgen medications can help acne and excess hair. There is no single cure, but consistent management lowers symptom burden and long-term health risks. Treatment requires a medical evaluation and labs, and individual results vary.
Is there a connection between PCOS, mood, and metabolism?
Yes. Women with PCOS have higher rates of anxiety and depression, partly from the hormonal changes and partly from the strain of living with symptoms like weight changes and unwanted hair. PCOS is also tightly linked to insulin resistance and metabolic risk. This is exactly why hormones, mood, and metabolism are best treated together rather than in silos, which we cover in why hormones, mood, and metabolism should be treated together.
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Frequently asked questions
Can I get evaluated for PCOS by telehealth in Florida?
Partly. A Florida-licensed clinician can take your history, review your symptom pattern, and order labs through a telehealth visit, with bloodwork done at a local lab. An ultrasound, if needed, requires an in-person imaging appointment. Telehealth is a strong starting point for evaluation and ongoing management. Contact Ascend to ask about a Florida evaluation.
Can you have PCOS with regular periods?
Yes. Because diagnosis needs only 2 of 3 criteria, some women have regular cycles but meet criteria through high androgens plus polycystic ovaries. Regular periods do not rule PCOS out.
Does PCOS cause weight gain or does weight cause PCOS?
The relationship runs both ways. Insulin resistance, common in PCOS, makes weight gain easier and weight loss harder, while excess weight can worsen PCOS symptoms. Many lean women also have PCOS, which shows weight is not the root cause. Addressing insulin resistance helps either way.
Will PCOS go away after menopause?
The ovarian and fertility issues ease as periods stop, but the metabolic side, like insulin resistance and cardiovascular risk, persists and still needs monitoring after menopause.
Medically reviewed by
Dr. Jason Saylor, DO
This article is for general educational purposes only and is not medical advice. It does not create a provider-patient relationship. Talk with a qualified Florida-licensed clinician about your individual situation.
Sources
- American College of Obstetricians and Gynecologists (ACOG). "Polycystic Ovary Syndrome (PCOS)" patient resource. acog.org.
- Endocrine Society. "Polycystic Ovary Syndrome (PCOS)" patient and clinical guidance. endocrine.org.
- NIH Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). "Polycystic Ovary Syndrome (PCOS)." nichd.nih.gov.