Back in February, I was officially diagnosed with Polycystic Ovary Syndrome—commonly known as PCOS.

According to the World Health Organization, PCOS affects roughly 10–13% of women of reproductive age, and up to 70% of those affected may not even know they have it. That gap between prevalence and diagnosis is part of what makes this condition so frustrating—and, at times, isolating.

For those unfamiliar, PCOS is a hormonal and metabolic condition that originates in the ovaries. As the name suggests, it often involves the development of multiple small cysts, but more importantly, it disrupts the body’s hormonal balance at a foundational level.

One of the most difficult aspects of PCOS is that its exact cause remains unknown. Despite extensive research, there is no single, definitive explanation—only a growing understanding of how it manifests and how it can be managed.

Because PCOS affects hormone regulation, it can lead to elevated androgen levels (often referred to as “male hormones”) and broader endocrine imbalance. The effects can be wide-ranging: irregular or absent menstrual cycles, chronic pain, hirsutism (excess facial or body hair), scalp hair thinning, acne (often cystic), oily skin, skin tags, and darkened skin in areas like the underarms or under the breasts. Many people also experience insulin resistance, weight gain—especially around the abdomen—and, in some cases, ovarian cysts.

Due to its impact on ovulation, PCOS is one of the leading causes of infertility. While it can begin as early as adolescence, it’s often diagnosed later—particularly when someone struggles to become pregnant. That wasn’t my experience. I began to suspect something was wrong earlier, when I noticed changes like hair thinning, unexpected hair growth, and persistent skin issues.

PCOS is also a chronic metabolic condition. Over time, it increases the risk of insulin resistance, type 2 diabetes, and obesity. While there is no cure, symptoms can be managed—and long-term health risks reduced—through a combination of lifestyle changes and medical treatment.

Because of its metabolic nature, PCOS is associated with an increased risk of several other conditions, including:

• Weight gain
• Type 2 diabetes
• Hypertension (high blood pressure)
• High cholesterol
• Cardiovascular disease
• Obesity
• Sleep apnea
• Metabolic-associated steatohepatitis (a progressive liver condition linked to fat accumulation and inflammation)

Diagnosis typically requires at least two of the following criteria, after ruling out other causes:

• Clinical or biochemical signs of elevated androgens (such as excess hair growth, acne, or hair loss)
• Irregular or absent menstrual cycles
• Polycystic ovaries visible on ultrasound

Since there’s no cure, treatment focuses on improving quality of life and managing symptoms early. Common treatments include hormonal birth control to regulate cycles and reduce acne or excess hair, androgen blockers for hormonal symptoms, and medications like metformin or GLP-1 receptor agonists to address insulin resistance.

How I’m Managing My PCOS

Diet has been one of the biggest areas of focus for me.

I already followed a Mediterranean-style diet, leaning heavily plant-based. I don’t eat red meat, rarely eat pork, and mostly stick to fish and chicken. However, because PCOS is closely tied to insulin resistance, I’ve had to make additional adjustments.

I’m transitioning to a lower glycemic approach—swapping traditional pasta for chickpea or buckwheat pasta, and moving away from white rice toward brown varieties. I focus on fiber-rich, protein-dense foods and avoid sugary drinks as much as possible.

For beverages, I’ve shifted to zero-sugar lemonade when I want something sweet, along with probiotic sodas and sparkling water.

Exercise is also recommended—particularly strength training—but I’ve been easing into that. For now, even short walks are part of the plan, though consistency has been a challenge with the weather.

What My Meals Look Like

My diet centers around chicken, seafood, vegetables, berries, avocado, and salads. Most of my grains are now chickpea- or buckwheat-based, with a gradual transition away from white rice. I also make simple, healthier versions of comfort foods—like homemade pita pizzas with lighter ingredients.

I’m still figuring out what works best for snacks, which has been one of the trickier adjustments.

Mental Health

Looking back, the signs were there long before I was diagnosed with Polycystic Ovary Syndrome.

As a teenager, I struggled with severe cystic acne—something that only improved when I went on birth control. At the time, I didn’t think much of it beyond “bad skin,” but in hindsight, it was likely one of the earliest indicators.

A few years ago, I started noticing worsening hirsutism. What had once been an occasional hair here or there became much more noticeable around 2023. It stopped being something I could casually manage and started feeling like a real, persistent change in my body.

Then came the weight gain—over 30 pounds in about six months. That was the tipping point that pushed me to finally see a doctor.

Around the same time, other things in my life started to unravel. I was struggling academically in ways I hadn’t before, and my mental health took a sharp downturn. What had previously been considered “mild” depression and anxiety escalated into something much more intense—moderate to severe, and harder to manage.

When you understand how deeply hormones influence mental health, it starts to make sense. PCOS is associated with chronic inflammation and insulin resistance, both of which can affect mood regulation. Elevated insulin levels can create metabolic stress, which in turn impacts brain function and emotional stability.

Research shows that women with PCOS are up to three times more likely to experience depression and anxiety. Estimates suggest anxiety rates are roughly 28–30% higher, while depression rates increase by about 11–25% compared to those without PCOS.

PCOS can also contribute to chronic fatigue and sleep disturbances, including insomnia and sleep apnea. And when sleep is disrupted, it often worsens both depression and anxiety—creating a difficult cycle to break.

On top of that, elevated androgen levels can directly affect mood, increasing irritability and emotional volatility.

To help manage this, I’m currently taking Escitalopram (15 mg), an SSRI commonly prescribed for major depressive disorder and generalized anxiety disorder.

I haven’t noticed a dramatic shift myself—but someone else has. When my doctor asked how I’d been doing, my partner mentioned that I haven’t said “I feel depressed” in a while. And honestly, that says more than I probably could.

Medications and Supplements

There’s a lot of misinformation surrounding PCOS treatments, especially online, so I’ve tried to be intentional and evidence-based in my approach.

While GLP-1 medications are increasingly used for insulin resistance and weight management, they’re not the right fit for me—primarily due to cost and potential side effects.

Instead, my OB prescribed me Metformin, a well-established medication that improves insulin sensitivity by reducing glucose production in the liver and increasing the body’s response to insulin. It’s affordable, accessible, and widely used in PCOS management.

In addition to metformin and birth control, I take:

• A daily multivitamin
• A B-complex with vitamin C (to offset potential deficiencies, especially with metformin and a plant-based diet)
• Inositol (myo- and D-chiro), which supports insulin signaling and may improve hormonal balance

I’ve also incorporated natural DHT blockers to address androgen-related symptoms like hair thinning and excess hair growth. These work, in part, by inhibiting the enzyme 5-alpha-reductase, which converts testosterone into dihydrotestosterone (DHT), a more potent androgen linked to many PCOS symptoms.

The ones I use include:

• Saw palmetto
• Pumpkin seed oil
• Pygeum
• Stinging nettle root

By reducing 5-alpha-reductase activity, these compounds may help lower DHT levels, which can in turn slow unwanted hair growth (hirsutism), reduce scalp hair thinning, and decrease excess oil production that contributes to cystic acne.

Managing Side Effects

Both GLP-1 medications and metformin can cause gastrointestinal side effects, including nausea, bloating, and diarrhea. For metformin specifically, these effects are often related to changes in the gut microbiome and digestion speed.

To manage this, I prioritize fiber intake and take both prebiotics and probiotics. I use a probiotic supplement and a clear fiber supplement that can easily be added to drinks.

Taking metformin with food has also been important—not just to reduce GI issues, but to avoid blood sugar drops.

Where I Am Now

I’m still learning. PCOS isn’t something you “fix”—it’s something you manage, adapt to, and understand over time. There’s a lot of trial and error involved, especially when it comes to diet, supplements, and lifestyle changes.

But having a diagnosis has given me clarity—and a starting point.