Key Takeaways

• Polycystic ovary syndrome, or PCOS, is a condition of hormonal imbalance that affects up to 20% of women after puberty and before menopause.

• The exact cause is not clear, but risk factors include genetics, being overweight, and having diabetes or insulin resistance.

• Having PCOS can make it harder to lose weight, due to the high insulin level associated with the condition.

• People with PCOS have a higher risk for a variety of long-term health complications. Weight loss helps to reduce this risk.

• For people with PCOS, a well-designed lifestyle plan can help with weight loss. This may or may not be enough on its own. 

• Medications may also be helpful in controlling symptoms and promoting weight loss.

What is PCOS?

Polycystic ovary syndrome, or PCOS, is a condition of hormonal imbalance. It’s very common, affecting up to 20% of all women in their reproductive years (after puberty and before menopause). Women with PCOS generally have higher levels of androgens, which are “male” hormones such as testosterone. Insulin resistance is also a very common aspect of this condition.

Researchers are still working to gain a better understanding of what causes PCOS, but we do have treatments that can help to address the symptoms and improve the quality of life for women experiencing this condition.

What are the causes?

It’s currently not clear exactly what causes some women to get PCOS. However, there are certain risk factors that make a person more likely to be diagnosed with this condition. Some of these include:

• Being overweight

• Having a family history of PCOS

• Having diabetes or insulin resistance

Even though PCOS is very common, it’s still poorly understood. It’s not entirely clear whether some of these factors are a cause or a result of PCOS – and they could be both. For example, stress could lead to changes in the body that ultimately result in PCOS, and PCOS can also cause more stress in a person’s life. Similarly, being overweight increases the risk of PCOS, and having PCOS also tends to cause people to gain weight.

Symptoms of PCOS

The symptoms of PCOS vary from person to person. Some of the symptoms may include:

• Irregular or absent menstrual periods

• Infertility

• Weight gain, especially around the belly

• Acne

• Excessive hair growth on the face and body

• Enlarged ovaries, with multiple cysts (fluid-filled sacs)

• Dark or thickened patches of skin, usually in certain areas (such as on the back of the neck, in the armpits, under the breasts, and in the groin area)

If you have symptoms like these and you think that you might be experiencing PCOS, it’s a good idea to talk to a specialist. A proper diagnosis and treatment plan can help to address your symptoms and improve your quality of life.

Weight gain and PCOS

It’s well-known that PCOS is strongly associated with being overweight. People who are overweight are more likely to develop PCOS, but having PCOS also tends to make weight loss harder. Although there are a variety of reasons why this may be the case, insulin resistance is believed to play a major role.

Insulin is a hormone that helps your body to process glucose in your blood. Insulin signals cells throughout your body to take up glucose from the bloodstream, and either use it for energy or store it as fat. In people with insulin resistance, the tissues don’t respond to insulin as well as they should. The body responds by secreting extra insulin to compensate. Because insulin promotes the storage of calories as fat, these higher insulin levels lead to weight gain. Insulin also increases hunger, which further contributes to weight gain.

Although people with PCOS often find that weight loss is particularly challenging, there are techniques that can help. Having support from a team of specialists can assist you with finding the best weight loss plan for you. Learn more about NOVI Optimum Plus, our medically backed health coaching for sustainable weight loss.

What are the complications of PCOS?

Because PCOS is associated with insulin resistance and weight gain, it can lead to some serious health complications over the long term. 

People with PCOS have an increased risk for:

• High blood pressure

• High cholesterol

• Diabetes

• Heart disease

• Cancer

• Dementia

• Pregnancy complications

Getting your weight and your blood sugar back under control greatly reduces your risk of these serious complications.

How will the specialist determine if I have PCOS?

To determine whether you have PCOS, a specialist may use:

• Your medical history. This includes the symptoms that you’re currently having, any other medical conditions that you may have, and your family history.

• A physical exam. Your specialist will particularly look for signs of increased androgens and insulin resistance.

• Blood tests. These include tests of the levels of various hormones, including testosterone as well as other reproductive hormones. Your blood sugar and cholesterol levels will also be checked.

• Pelvic ultrasound. This allows your doctor to look at your ovaries, to determine whether they’re enlarged and to check for cysts.

The diagnosis of PCOS is made when you have two of three criteria:

• Irregular ovulation (usually indicated by irregular or absent menstruation)

• Increased androgen levels

• Multiple cysts on the ovaries

Many people with PCOS have all three of these signs, but having just two of the three is enough to diagnose you with PCOS.

How is PCOS treated?

The majority of people with PCOS are significantly overweight. Weight loss often makes a huge difference in the symptoms, and is a central aspect of the treatment plan. The specific plan varies for each individual, but some treatments that may be used include:

• Nutrition. Certain dietary approaches tend to be more successful for women with PCOS, such as low-carbohydrate diets and intermittent fasting. 

• Exercise. It’s crucial to get enough physical activity to stay at a healthy weight as well as to maintain your cardiovascular health. It may help to have a coach or trainer help to plan your exercise program.

• Medications to improve insulin sensitivity (such as metformin). By helping insulin act more effectively throughout the body, this may lower insulin levels and make weight loss easier. It will also help to control blood sugar to avoid long-term complications.

• Oral contraceptives. In people with PCOS who aren’t trying to get pregnant, these may be used to promote hormone balance. This can help with weight loss as well as addressing symptoms.

• Weight loss medications. A class of prescription drugs known as GLP-1RAs are increasingly being used to help promote weight loss in people who are very overweight and are experiencing health complications as a result. This class includes medications like semaglutide and liraglutide.

How do I manage if I have PCOS?

In most cases, weight loss is a central aspect of managing PCOS. Most people will find that their symptoms improve significantly when they’re at a healthier weight. At the same time, PCOS itself makes weight loss harder. This can create a frustrating situation for people experiencing PCOS, who often want to lose weight but find it very difficult to do so.

Professional support is often crucial for successful and sustainable weight loss. Some people find that a personalized lifestyle plan is enough, while others benefit from adding medications. You may benefit from the support of a team of professionals, to help you to design and stick to a lifestyle plan, monitor your health to catch any complications early, and assess whether you’d be a good candidate for prescription treatments.

What now?

If you’re experiencing symptoms that could indicate PCOS, then you should book a consultation with a qualified medical specialist with experience treating hormonal conditions. Before your appointment, take some time to think about the symptoms that you’re experiencing, and make a list of questions that you’d like to ask or topics that you’d like to discuss. If you track your menstrual cycles (which is generally something that every woman should do), bring the record to your appointment.

Weight loss can greatly improve symptoms and quality of life for many people with PCOS. At the same time, the condition itself tends to make weight loss harder. 

A medically-backed program with support from a variety of different health professionals can make a huge difference. We’ve designed NOVI Optimum Plus using the latest science on weight loss and hormonal health. With the right support, you can manage your PCOS symptoms.