How to Manage PCOS Symptoms

There may not be a cure for polycystic ovary syndrome, but there are ways to treat PCOS symptoms. Keep reading to learn how to manage PCOS acne, weight gain, and more. 

By OBGYN and fertility expert Dr. Kenosha Gleaton

Anywhere from 5-15% of women of reproductive age are thought to have polycystic ovary syndrome (PCOS). It is the most common endocrine pathology in females and is characterized by a cluster of symptoms surrounding hormone imbalance and polycystic ovaries. The presentation of PCOS can vary widely and can even impact fertility and pregnancy. 

Diagnosing PCOS and common symptoms

As stated previously, PCOS is a syndrome, which means it is characterized by the presence of multiple symptoms. The Rotterdam criteria was agreed upon in 2003 and is a checklist used for diagnosing PCOS. There are three symptoms listed: irregular release of eggs (ovulation), increased male hormones, also known as androgens, and over 12 cysts on both ovaries. If someone is experiencing at least two of these symptoms, they can be given a PCOS diagnosis. 

Other common symptoms of PCOS include irregular menstrual cycles, infertility, hair growth, acne, weight gain, and more. Many women with PCOS experience insulin resistance, which is when the body doesn’t respond correctly to insulin. If untreated, insulin resistance may lead to high blood sugar and prediabetes. 

Most of these symptoms are in direct relation to the hormonal imbalance that PCOS causes. High levels of androgens can cause the body to produce acne, excessive hair growth, weight gain, and may play a role in menstrual irregularities. Infertility and irregular ovulation are a likely result of high androgen levels as well as polycystic ovaries. Did you know that PCOS and endometriosis share some similar symptoms? Read more about the differences between endo and PCOS. 

Managing PCOS symptoms

Not all treatment options will be right for everyone. PCOS management is dependent on your specific symptoms and reproductive goals. If there is a treatment you’re interested in, be sure to talk to your healthcare provider first. 

How can diet and weight loss control symptoms of PCOS?

LIfestyle changes like weight loss, dietary changes, and increased physical activity are often the first recommendation from many healthcare providers for managing PCOS. Research shows that even minimal weight loss may be helpful for improving PCOS symptoms. A study also found that consuming low starch and low dairy foods was helpful for reducing testosterone levels and improving weight loss and insulin sensitivity. 

A reduction in weight has been shown to improve cardiovascular health, improve acne and excessive hair growth, improve menstrual cycle regularity, and may even help reduce depression associated with PCOS. 

How can supplements control PCOS symptoms?

Research supports the use of some supplements for treating PCOS symptoms, specifically for improving ovarian function and hormonal balance. A few examples include B-12, inositol, folate, vitamin D, and others. 

Inositol, often seen as myo-inositol or d-chiro-inositol, is a supplement that may be beneficial for many PCOS patients. Research shows that inositol may improve ovarian function, reduce androgen levels, and decrease insulin resistance in PCOS patients. A separate double-blind study found that in obese women with PCOS, folate supplementation improved glucose metabolism and reduced cholesterol.

Many of the other vitamins and minerals found to improve PCOS symptoms can be found in prenatal vitamins. If you’re trying to conceive (TTC) soon, it’s recommended by The American College of Obstetricians and Gynecologists to begin taking supplements at least a month before pregnancy. Remember, you should always speak to your healthcare provider before adding any new supplements to your routine. 

Medications for PCOS treatment

Aside from dietary supplements, there are multiple prescription medications that are sometimes recommended for PCOS patients. These include hormonal contraceptives, insulin-sensitizing agents, and anti-androgens. 

Birth control pills or other hormonal contraceptives are a great option for those not actively TTC. The use of estrogen and progestin has been shown to improve cycle regularity, reduce androgens, and improve acne and excess hair growth. 

Insulin-sensitizing agents work by improving the body's response to insulin, improving glucose levels and even lowering cholesterol levels. A commonly known example is metformin, which is a drug used to treat type 2 diabetes. Research shows that drugs similar to metformin improve PCOS by reducing acne and hair growth, improving weight loss, regulating periods, and potentially improving ovulation. 

PCOS symptom management also includes anti-androgens, sometimes called testosterone blockers, that work by blocking androgen receptors in the body or suppressing the production of androgens. One important thing to note is these medications can cause birth defects, so they are prescribed with hormonal contraceptives in order to prevent pregnancy. Anti-androgens are helpful for those with high male hormone levels and experiencing symptoms such as excess hair growth, oily or patchy skin, and acne. 

Other ways to manage PCOS symptoms

There are even more ways to treat PCOS. Finding stand-alone remedies for symptoms can be a great way to target any problems you may be experiencing. This can include acne treatment, such as a prescribed medication from a healthcare professional. Removing unwanted hair can also be done through shaving, waxing, laser hair removal, or application of hair removal creams. 

If you are looking for ways to increase your chances of getting pregnant with PCOS, you should try tracking your cycles to determine if you’re experiencing ovulation. If you qualify, you may be a candidate for ovulation induction, which can be done virtually or in person. 

What makes PCOS symptoms worse?

There is no known cause of PCOS, although there is evidence that some genetic and environmental factors do play a role in its development. Most PCOS symptoms are caused by increased androgen levels, which causes a hormonal imbalance. Increased weight can also exacerbate PCOS symptoms, so it’s recommended to stay within a healthy weight range for your height. A diet high in dairy and carbohydrates isn’t recommended, and you should avoid increasing testosterone levels any further. Aside from this, there isn’t much that you can do to make PCOS symptoms worse. Speak with your healthcare provider if you have specific concerns around your PCOS or lifestyle habits.

Key Takeaways

• Anywhere from 5-15% of women of reproductive age are thought to have PCOS.

• The Rotterdam criteria is used for diagnosing PCOS, meaning at least two out of three symptoms must be present for a diagnosis.

• Common symptoms of PCOS are weight gain, irregular periods, hair growth, and acne. 

• Managing PCOS is dependent on the symptoms experienced. Not all treatments will be useful for everyone living with PCOS. 

• Dietary supplements and maintaining a healthy weight are two options for managing PCOS.

• Medications such as insulin-sensitizing agents, hormonal contraceptives, and anti-androgens may help with symptoms. 

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