PCOS Isn’t Just a Hormone Issue — It’s a Global Women’s Health Crisis
You’re tired all the time. Your periods are irregular or gone. Your skin is breaking out, and your body doesn’t feel like it used to—but when you ask what’s wrong, you’re told it’s just stress, weight, or “normal.”
If that sounds familiar, you might be one of the 1 in 10 women and people assigned female at birth living with PCOS—Polycystic Ovary Syndrome.
Despite how common it is, PCOS remains one of the most misunderstood, underdiagnosed, and undertreated conditions in women’s health. It impacts your hormones, metabolism, fertility, and mental health—but it’s often brushed off, delayed, or mismanaged for years.
Even its name is misleading: you don’t need cysts to have it, and it’s not just about your ovaries.
At HerSay, we’ve spoken with women across Canada navigating frustrating appointments, missed diagnoses, and symptoms that don’t make sense until you put them all together. We built HerSay to help women feel seen and prepared in medical conversations—because your experience matters, even if your labs are “normal.”
This blog post breaks down what PCOS really is, the symptoms to watch for, why diagnosis is so hard, and how to advocate for care that actually listens.
Let’s start by clearing up some of the biggest misconceptions.
What Is PCOS (And What It’s Not)
Polycystic Ovary Syndrome (PCOS) is a complex hormonal condition that affects the ovaries, but it’s not just a reproductive disorder. It impacts your entire endocrine and metabolic system—including insulin regulation, mood, skin, energy, and long-term disease risk.
It’s estimated that up to 1 in 10 women and people assigned female at birth live with PCOS—but many don’t know it until they struggle with fertility or persistent symptoms are finally taken seriously.
📚 CDC
The Clinical Definition (Rotterdam Criteria)
Doctors typically diagnose PCOS when at least two of these three signs are present:
Irregular or absent periods (indicating infrequent or absent ovulation)
Elevated androgen levels (seen in symptoms like acne, excess facial/body hair, or blood test results)
Polycystic ovaries on ultrasound (enlarged ovaries with many small follicles)
👉 But here’s what most people don’t realize:
You don’t need ovarian cysts to be diagnosed. And having cysts alone doesn’t mean you have PCOS.
What PCOS Is Not
Not just a fertility issue. While PCOS can disrupt ovulation, it’s also linked to insulin resistance, inflammation, chronic fatigue, mental health challenges, and a higher risk of type 2 diabetes and cardiovascular disease.
Not caused by lifestyle. While nutrition and movement can help manage symptoms, PCOS is not your fault. It’s a genetic and hormonal condition—not a reflection of willpower.
Not all about weight. PCOS can affect people of all sizes, races, and body types. Lean PCOS exists and is frequently overlooked.
Not one disease. PCOS shows up in different ways. Some experts describe four main “types” or drivers:
Insulin-resistant PCOS
Post-pill PCOS
Inflammatory PCOS
Adrenal PCOS
(Note: These subtypes are clinically debated but useful for patient education.)
PCOS Is a Whole-Body Condition
This isn’t just about periods—it’s about how your body processes hormones, sugar, stress, and inflammation over time.
Without diagnosis and proper management, PCOS can increase the risk of:
Type 2 diabetes (up to 4x higher risk)
High cholesterol and blood pressure
Sleep disorders like sleep apnea
Endometrial cancer
Anxiety, depression, and disordered eating
At HerSay, we believe that understanding your body is the first step to advocating for it. In the next section, we’ll break down the symptoms of PCOS—some that are widely known, and others that are easy to overlook.
PCOS Symptoms & Red Flags
PCOS doesn’t come with a single checklist. It’s a spectrum—and that’s part of why so many people go undiagnosed. Some symptoms are loud (like missed periods), others are subtle (like low energy or cravings), and many are chalked up to stress, aging, or “just how your body is.”
But when you put the pieces together, a pattern starts to emerge.
Common Symptoms of PCOS
Irregular or missed periods
Oily skin or hormonal acne, often on the jawline
Unwanted facial or body hair (hirsutism), especially on the chin, chest, or stomach
Hair thinning or hair loss at the crown or temples
Unexplained weight gain, particularly around the midsection
Fatigue and low energy, even with adequate sleep
Difficulty getting pregnant, due to irregular ovulation
Cravings or blood sugar crashes, often tied to insulin resistance
📚 CDC, Mayo Clinic
Symptoms That Are Easy to Miss
Mood swings, anxiety, or depression
Sleep issues or snoring (linked to sleep apnea)
Skin darkening in body folds (acanthosis nigricans)
Bloating or GI distress
Brain fog and difficulty concentrating
Low libido or fluctuating sex drive
These symptoms are rarely mentioned in the doctor’s office—but they’re real, and they matter.
Why PCOS Symptoms Are So Confusing
They come and go. You might have clear skin for months, then suddenly break out with no change in routine.
They mimic other conditions. Hypothyroidism, perimenopause, adrenal issues, and IBS can look similar.
They get normalized. Teens are told it’s puberty. Adults are told it’s aging or lifestyle. The pattern gets missed.
What You Can Do Now
🧠 Track your symptoms over time, not just during your cycle.
📱 Use the HerSay app to record mood, energy, skin, cravings, and period patterns in one place.
💬 Use that data to build a credible case for testing and diagnosis at your next appointment.
Diagnosis Challenges & Gaps
For a condition that affects millions globally, PCOS remains one of the most misunderstood and underdiagnosed disorders in women’s health. Studies estimate that up to 70% of people with PCOS don’t even know they have it.
That’s not a coincidence. It’s a symptom of a broken system—one that often overlooks or minimizes women’s health concerns until they become impossible to ignore.
Why PCOS Is So Often Missed
1. There’s No Single Test
PCOS isn’t diagnosed with a simple blood test or scan. It’s a clinical diagnosis based on a combination of symptoms, hormone levels, and sometimes an ultrasound. That means:
It depends heavily on your provider’s judgment
It varies based on what you report
It can change depending on your life stage (e.g. postpartum, post-pill, menopause transition)
2. Birth Control Can Mask the Signs
Many are prescribed hormonal birth control to regulate cycles or treat acne—without investigating the underlying cause. As a result, PCOS can stay hidden for years until symptoms return.
3. Weight Bias Skews Diagnosis
People in larger bodies are more likely to be labeled with PCOS (even when it’s not the root issue), while people in smaller bodies are often told they “look healthy” and dismissed—even when they have the exact same hormone imbalances.
PCOS does not have a size.
4. Narrow Definitions & Outdated Assumptions
Depending on the criteria used (Rotterdam, NIH, or Androgen Excess Society), your diagnosis might change. Some providers still believe cysts are required—or that if you’re not trying to get pregnant, PCOS doesn’t matter. Both are false.
5. Symptoms Overlap with Other Conditions
PCOS shares signs with:
Thyroid disorders
Endometriosis
Cushing’s syndrome
Adrenal hyperplasia
Depression and anxiety
Without a holistic, pattern-based approach, misdiagnosis is common.
Why This Matters
A delayed or missed diagnosis can lead to:
Years of unmanaged symptoms
Increased risk for diabetes, heart disease, and endometrial cancer
Unnecessary fertility struggles
Undiagnosed mental health impacts
Deep frustration, shame, and self-doubt
HerSay Can Help You Be Taken Seriously
You shouldn’t have to memorize your symptoms or explain them from scratch at every appointment.
HerSay helps you:
Track your full health story in one place
Connect symptoms across cycle, mood, energy, and metabolism
Prepare a credible case for testing and referral
Walk into appointments with clarity and confidence
The Physical, Mental & Emotional Impact of PCOS
PCOS doesn’t just show up in your lab work—it shows up in your day-to-day life.
It affects your energy, skin, weight, confidence, mood, and even how you feel in your own body. And the worst part? Many people are told it’s not a big deal unless they’re trying to get pregnant.
That could not be further from the truth.
The Physical Weight of PCOS
Chronic Fatigue – Even with a full night’s sleep, many people with PCOS report brain fog, exhaustion, or a “flatline” in daily energy.
Insulin Resistance – Up to 70% of people with PCOS struggle with insulin regulation, which can lead to stubborn weight gain, sugar cravings, and an increased risk of type 2 diabetes.
Irregular Cycles – Not knowing when (or if) your period is coming makes it hard to plan anything—from your fertility journey to your next vacation.
Skin & Hair Changes – Cystic acne, unwanted facial/body hair, and hair thinning on the scalp can damage confidence and signal deeper hormonal shifts.
The Emotional & Mental Toll
Living with PCOS can feel like a rollercoaster—only you never agreed to the ride.
Anxiety & Depression – Studies show people with PCOS are significantly more likely to experience mood disorders. This is driven by both biochemical imbalances and the emotional strain of being dismissed or misdiagnosed.
Body Image Issues – From weight stigma in the doctor’s office to unwanted hair or breakouts, PCOS can erode self-esteem—especially when these changes are publicly visible but privately misunderstood.
Disordered Eating – Restrictive dieting is often recommended without context, leading to cycles of guilt, bingeing, or food anxiety. PCOS requires careful nourishment, not shame-driven nutrition.
Social Withdrawal – When your symptoms don’t match society’s version of “sick,” it’s easy to feel isolated—even from friends who care.
What Most Healthcare Systems Miss
The emotional experience of living with PCOS is rarely acknowledged in the treatment plan. You’re expected to “lose weight,” “come back when you want kids,” or “just deal with it.”
But PCOS is not just a fertility or weight issue. It’s a quality of life issue.
HerSay Helps You Capture the Full Picture
HerSay is designed to reflect how PCOS really shows up:
Log your cycle, skin, energy, and mood
Track your sleep, hunger, and triggers
Prepare to talk about more than periods—because you are more than a diagnosis
Treatment Options and What to Ask For
There’s no one-size-fits-all approach to treating PCOS—because there’s no one way it shows up.
The right treatment plan depends on your symptoms, goals (e.g., cycle regulation, fertility, weight stability, skin clarity), and how PCOS is affecting your daily life. But what every person with PCOS deserves is personalized care that goes beyond “take the pill and lose weight.”
Medical Treatment Options
1. Hormonal Birth Control
Often prescribed to regulate periods, reduce androgens, and improve acne.
Doesn’t fix the root cause but may manage symptoms.
Not suitable for everyone—especially if you’re trying to conceive or sensitive to synthetic hormones.
2. Metformin
A medication originally for type 2 diabetes, now often used in PCOS to:
Improve insulin sensitivity
Support weight management
Restore regular ovulation in some patients
3. Anti-Androgens (e.g. Spironolactone)
Used to reduce excess facial/body hair and acne. Often paired with birth control, and not safe during pregnancy.
4. Fertility Medications
If pregnancy is a goal, ovulation induction meds like letrozole or clomiphene citrate are often first-line.
Other options may include IUI or IVF, depending on your cycle and hormonal response.
Lifestyle Management (Not a Cure—but Often a Catalyst)
1. Nutrition for Insulin Regulation
Focus on:
Low-glycemic, high-fiber carbs
Protein and healthy fats with every meal
Stabilizing blood sugar over extreme restriction
⚠️ Avoid crash diets or “PCOS meal plans” rooted in shame—evidence shows that sustainable, anti-inflammatory nutrition improves hormonal balance over time.
2. Strength-Based Movement
Resistance training and walking may improve insulin sensitivity and mood
Consistency matters more than intensity—no need to burn out at bootcamp
3. Stress & Sleep Hygiene
High cortisol = more inflammation = worse symptoms. Managing PCOS means managing:
Mental load
Sleep quality
Emotional regulation
Tools like therapy, journaling, yoga, and CBT can be just as vital as medication.
What to Ask Your Doctor
Don’t settle for vague answers. Go in with clarity:
“Do you use the Rotterdam criteria to diagnose PCOS?”
“Can we test for insulin resistance, androgens, and inflammatory markers?”
“What are my options beyond hormonal birth control?”
“Can we monitor how my symptoms respond to changes in treatment over time?”
You don’t have to be an endocrinologist to have a voice. You just need the right questions—and a tool to help you ask them.
HerSay Helps You Prepare with Purpose
Track how food, stress, and sleep impact your cycle and energy
See what’s improving—and what’s not
Generate personalized questions before every visit
Document next steps and follow-up instructions so nothing gets lost
How to Advocate for Yourself (or a Loved One)
Living with PCOS often means being your own translator, coach, and medical historian—all while managing symptoms that are invisible to everyone but you.
You shouldn’t have to be an expert to get basic care. But the reality is, self-advocacy is one of the most powerful tools you have.
And you don’t have to do it alone.
Step 1: Start with a Symptom Log
Most appointments last 10–15 minutes. That’s not enough time to explain years of missed periods, breakouts, mood swings, and fatigue—unless you come prepared.
Use a structured symptom tracker like HerSay to document:
Cycle irregularities
Skin and hair changes
Mood fluctuations and anxiety
Cravings, fatigue, and brain fog
What’s getting worse, what’s improving
🧠 Patterns speak louder than isolated complaints.
Step 2: Know What Tests to Ask For
If PCOS is suspected, ask about:
Testosterone and DHEA-S
LH/FSH ratio
Fasting insulin and glucose
A1C (for blood sugar trends)
Pelvic ultrasound (but remember, cysts aren’t required for diagnosis)
Also ask your doctor to rule out other conditions with overlapping symptoms—like thyroid dysfunction or adrenal disorders.
Step 3: Prepare Key Questions
HerSay can generate questions for you based on your logged symptoms. A few good starters:
“Do you use the Rotterdam criteria for diagnosing PCOS?”
“Could my fatigue and cravings be linked to insulin resistance?”
“What non-hormonal options are available for symptom relief?”
“How do we track whether this treatment is actually helping?”
“Can we set a follow-up to reassess progress?”
📲 Use HerSay to keep your questions front and center in your appointment—not stuck in your Notes app.
Step 4: Bring Backup (Emotional or Physical)
Bring a friend, partner, or written summary if you’re nervous. If you’re dismissed or misunderstood, it’s okay to say:
“I’d like to revisit this—these symptoms are affecting my daily life.”
Or simply:
“I need a referral to someone who specializes in PCOS.”
Supporting Someone with PCOS?
If you love someone navigating this condition:
Believe them—even if the symptoms don’t make sense to you
Offer to help prep for appointments
Avoid commenting on weight or appearance
Remind them: this isn’t their fault
HerSay Makes Advocacy Practical
We built HerSay to:
Help you collect your health story in one place
Turn lived experience into real data
Generate smart, credible questions before every appointment
Log next steps so you don’t leave confused
Being your own advocate shouldn’t feel like a full-time job. HerSay helps you do it with clarity and confidence.
The Future of PCOS Care
For decades, PCOS has lived in the shadows—under-researched, underfunded, and underdiagnosed. But that’s changing.
We’re standing at a turning point where technology, awareness, and patient advocacy are beginning to rewrite what care can look like. The future of PCOS treatment won’t be built around one-size-fits-all birth control—it will be built around you.
Better Research, Finally
Until recently, PCOS received only a fraction of the funding that comparable chronic conditions received—even though it affects up to 1 in 10 people of reproductive age.
That’s starting to shift:
NIH and international researchers are prioritizing PCOS in new funding rounds
Scientists are exploring non-invasive diagnostics (like hormone pattern mapping and AI-powered analysis)
There’s growing interest in the link between PCOS, inflammation, gut health, and mental health
📚 NIH Office of Research on Women’s Health – PCOS
Femtech Is Filling the Gaps
When the system falls short, technology steps up. Digital health tools like HerSay are giving patients more power in the room:
Track patterns that aren’t visible in a 10-minute visit
Prepare appointment questions tailored to your actual symptoms
Follow up with clarity and accountability
Shift the narrative from reactive to proactive care
Other femtech tools are enabling ovulation tracking, sleep and insulin monitoring, and even mental health support for women with hormone-sensitive mood disorders.
Tech isn’t here to replace your doctor—it’s here to help you be heard by your doctor.
But We Still Have Work to Do
The future of PCOS care must be:
Inclusive – PCOS affects all races, body types, and gender identities
Whole-person focused – Mental health and metabolic health must be part of the conversation
Culturally competent – No more “just lose weight” prescriptions without trauma-informed support
Co-created with patients – Women and people with PCOS must have a seat at the table
HerSay’s Role in What Comes Next
At HerSay, we’re not waiting for permission to innovate. We’re designing tools that:
Amplify your voice
Make invisible symptoms visible
Equip you with data, structure, and support
Because the future of PCOS care should start with listening—and we’re building that future with you, not for you.
If you’ve made it this far, you’re probably carrying more than just symptoms.
Maybe you’ve carried the weight of being dismissed. The shame of being told to “just try harder.” The quiet fear that something’s wrong—but no one’s listening.
Let us be clear:
PCOS is real. Your pain is real. And what you’re feeling is valid.
You don’t need to wait for a diagnosis to start advocating for yourself. You don’t need permission to start tracking your health, preparing for appointments, and demanding better.
At HerSay, we believe women shouldn’t have to navigate chronic health issues alone—or from memory. That’s why we built a tool that helps you:
Log and track your full health story
Prepare smarter, more strategic doctor visits
Stay organized and supported through the ups and downs of PCOS care
Because you deserve more than vague advice and a prescription. You deserve clarity. You deserve compassion. You deserve a seat at the table.
What You Can Do Next
✅ Download HerSay to start building your PCOS care plan with clarity
💡 Use it to generate questions for your next appointment
📲 Share this article with someone who’s still searching for answers
✨ Trust yourself—your experience is worth listening to
Your voice matters. HerSay helps make sure it’s heard.