An intro to PCOS: Symptoms, types & lifestyle tips

Whether you’ve already been diagnosed with polycystic ovary syndrome (PCOS) or are just researching the condition, we’ve compiled this guide to help you learn everything you need to know – from what the condition is to its various symptoms and causes.

PCOS is characterised by three main things:^2,3

PCOS can have many different causes. One being when your ovaries create excess hormones called androgens (male hormones), this can lead to your cycles either lasting for much longer than usual or becoming irregular.^4,5

However, in many, but not all, women, the condition can also be caused due to insulin resistance and what’s known as ‘hyperinsulinaemia’, which is higher levels of insulin in the blood than what's considered healthy.^4,5

Over time, studies have shown that higher insulin levels can not only reduce the amount of sex hormone globulin (SHBG) produced in the liver but also increase the level of androgen production, leading to the potential onset of PCOS.^4,5

The term ‘polycystic ovaries’ refers to the large number of follicles (fluid-filled sacs in which eggs develop) that form on the ovaries. With PCOS, these sacs are often unable to release an egg, which means that ovulation won’t take place.¹

However, despite its name, you don’t actually have cysts if you have PCOS.¹

Since PCOS can cause different experiences for different people, it probably won’t come as any surprise to learn that there are different types of PCOS. You might have heard of these types of PCOS:

Take a look at our dedicated article for more information about the different types of PCOS.

As PCOS is classed as a ‘syndrome’, experiencing multiple symptoms is needed for a diagnosis.^14,15 Generally speaking, these symptoms tend to become apparent when you’re in your 20s.

Some of the most common symptoms of PCOS include:^{3, 16}

Remember though, everyone’s experience of PCOS is different. Since these symptoms can indicate other conditions as well, it’s important to arrange a chat with your GP if you start to experience any of them.

To be diagnosed with PCOS, you need to have at least two of the following features, as mentioned previously:^1,3

Unfortunately, there's no cure for PCOS. However, with a combination of lifestyle changes and medications, your symptoms can be managed more easily.¹

Some of the main treatment options for PCOS include:^1,17

Occasionally, metformin may be recommended. More commonly used to treat diabetes, this medication can help regulate hormones by reducing insulin resistance, especially in women at risk of diabetes or heart disease.¹⁷

There are certain lifestyle changes you can make to try and manage your PCOS.

Generally speaking, the most important areas to look at are exercise, nutrition, supplements, and lifestyle choices. We’ll explain a bit more about these areas and the changes you can make that may positively impact your health.

Another way to potentially help manage PCOS is through your diet. Try to opt for three nutritionally dense meals a day that all include a source of high-quality protein, fibre, greens, and healthy fats.²⁰

Following a low glycaemic index (GI) food plan might be helpful – especially as it reduces spikes in glucose levels after meals and balances the underlying insulin resistance associated with the condition.^21,22

Looking at foods which have an anti-inflammatory effect can also be particularly beneficial as PCOS is one of a group of inflammatory conditions. Therefore, foods rich in antioxidants can really help, as can switching from black tea to green tea.

Following a Mediterranean diet rich in oily fish, whole grains, and vegetables can not only help maintain your health but it can also reduce your risk of diabetes or heart disease – two conditions that women with PCOS are significantly at increased risk of if they’re overweight or have a pre-existing family history.^7,23,24

Studies have also shown that reducing carbohydrate intake and increasing protein can promote PCOS weight loss,^20,25 whereas high-fibre diets can help support chronic inflammation, reproductive health, blood sugar management, and gut health.^26,27

Eating cruciferous vegetables (including leafy greens, broccoli, cabbage, kale, and bok choy) is also important, as a lot of them contain something called ‘DIM’ (diindolylmethane). Although limited in data, this nutrient is believed to have anti-androgenic and oestrogenic activity, which means it may help to reduce testosterone levels in people with high androgen PCOS.^28,29

We’re yet to fully understand the role of nutrition in PCOS, but eating a healthy balanced diet with plenty of wholefoods and vegetables is thought to be beneficial for general health – PCOS or not!

Certain supplements may be able to help with PCOS. For example, some studies suggest that myo-inositol and folate could help with some types of PCOS, with one study showing that 70% of participants had ‘restored ovulation’.³³

Researchers have even found that, when the two are combined, 88% of patients had at least one episode of restored ovulation and 18 of these patients experienced normal menstruation activity during the six month follow-up period.34 The two combined, can therefore be seen just as effective as traditional medication.^33,35

However, more research is required on these two supplements as existing research has had limitations such as small sample sizes

Zinc supplements may also be beneficial for people with high androgen PCOS, as some studies have shown that they can have positive effects on hirsutism (excess hair) and alopecia.³⁶ After eight weeks, one study involving 48 women concluded a 29.2% reduction in alopecia in patients with PCOS who supplemented with zinc, as well as a significant reduction in hirsutism.³⁶

For people with inflammatory PCOS, glutathione, N-acetyl cysteine and ALA (alpha lipoic acid) may be able to help as they’ve been found to possess anti-inflammatory properties. However, more studies are needed to clarify this link.^37-40

If you don’t eat oily fish regularly, omega-3 supplements have also been shown to reduce insulin resistance, improve cholesterol profiles and, in some studies, even help regulate cycles in women with PCOS, although further research is needed in this area due to limitations in the research.^41,42

Smoking is well-known for its ill effects on our health. However, people with PCOS may further benefit from quitting as smoking has been shown to aggravate insulin resistance and increase testosterone levels and fat levels.^43,44

Similarly, alcohol consumption can negatively affect hormone and blood sugar regulation, which can subsequently cause high blood sugar levels.^45,46 This can be particularly concerning for people with insulin-resistant PCOS.

Finally, if you’re living with PCOS, you should prioritise sleep. This is especially important as sleep loss can raise inflammation, which can exacerbate certain PCOS symptoms.⁴⁷

Making the right lifestyle choices is one of the key ways to live with PCOS in a way that benefits your body and wellbeing.

From prioritising nutritious meals to good-quality sleep, we hope this guide has made you feel more informed about what PCOS is and how to manage it.

However, if you’d like more information or think you may have PCOS, it’s important to speak to a doctor to find out which treatments are available to you.