Polycystic Ovary Syndrome Recognise & Understand PCOS

PCOS

What is the polycystic ovary syndrome (PCOS)?

Polycystic ovary syndrome, PCOS for short, is the most common hormone disorder in girls and women, and more and more women are suffering from it. Experts believe that 10% to 20% of all women in their fertile years now live with PCOS. On the one hand, the causes are partly congenital and hereditary. On the other hand, many experts believe that environmental and lifestyle factors also have an influence - the exact relationships are still being researched. PCOS can severely affect your fertility and general well-being.

Typical symptoms of PCOS

The symptoms of PCOS vary greatly and can develop gradually.

The most common symptoms include:

Irregular or very long cycles (35 days or more)
Unfulfilled desire to have children due to absent or irregular ovulation
Skin blemishes, including severe acne
Hirsutism: increased facial and body hair, e.g. more hair on the chin, abdomen, or back
Hair loss or a receding hairline
Darkened patches of skin (acanthosis nigricans), especially on the neck, armpits, or groin
Elevated male hormones (androgens), which can lead to masculinization (virilization)
Psychological symptoms, such as low mood or depression
Weight gain, especially around the abdomen
Sleep disturbances and fatigue

These symptoms may occur individually or in combination. PCOS is a diagnosis of exclusion, meaning that other conditions—especially thyroid and adrenal disorders—must be ruled out before the diagnosis can be confirmed.

How is PCOS diagnosed?

For the diagnosis of PCOS, doctors use the so-called Rotterdam criteria. Most women are diagnosed with Polycystic Ovary Syndrome between the ages of 20 and 40.

PCOS is usually diagnosed when other causes of the symptoms (e.g. thyroid disease) can be ruled out and two or all of the following criteria are met:

An- or oligoovulation (i.e., no or infrequent ovulation)
Virilization (the physique becomes more masculine, the voice deeper)
Polycystic ovaries

A comprehensive blood test is used to determine hormone levels such as LH, FSH, testosterone, SHBG, DHEA-S, and insulin. Additionally, blood sugar and cholesterol levels are measured, as PCOS is often associated with insulin resistance and a disrupted lipid metabolism.

Polycystic Ovary Syndrome is characterized by enlarged ovaries with many small cysts, which may be visible on an ultrasound image (see figure).

This cyst formation occurs in approximately 70% of women with PCOS. The doctor also measures the concentration of androgens, the male sex hormones, in the blood. Even in women, testosterone and other androgens play an important role in well-being and fertility. An excess of androgens can cause a more masculine appearance and disrupt ovulation, which may be absent or irregular—this occurs in 60% of women with PCOS.

Causes and Risk Factors

The exact causes of PCOS are not yet fully understood. A combination of genetic predisposition, hormonal imbalances, and lifestyle factors appears to be decisive.

The following aspects are considered risk factors:

Family history of PCOS, type 2 diabetes, or metabolic disorders
Unhealthy diet, overweight, lack of physical activity
Chronic stress and sleep deprivation
Environmental factors that disrupt hormonal balance

Women with PCOS often develop insulin resistance, where the body’s cells no longer respond properly to insulin. This can lead to type 2 diabetes in the long term.

Therapeutic Approaches for PCOS

Holistic and Individualized

The treatment of PCOS depends on the specific symptoms and circumstances of the individual. The goal of therapy is to regulate hormone levels, restore ovulation, improve metabolic markers, and enhance overall well-being.

Lifestyle Changes as Primary Therapy

A healthy lifestyle is the most important approach in treating PCOS. Even a moderate weight loss of 5-10% can significantly improve symptoms. Recommendations include:

Balanced diet: high in fiber, low in sugar, with quality fats and plant-based proteins
Exercise: at least 150 minutes of moderate physical activity per week
Stress management through yoga, mindfulness, or meditation

Pharmacological Treatment

Depending on the symptoms, different medications are used:

Metformin to treat insulin resistance, often used when trying to conceive
Clomiphene to induce ovulation in cases of infertility
Anti-androgens or combined hormonal contraceptives to treat hirsutism, acne, and menstrual irregularities
Spironolactone for severe hirsutism (only under medical supervision)

Support through cycle tracking

Women with PCOS who still ovulate can track their cycles using cycle computers like Daysy. By measuring basal temperature daily, it becomes evident whether ovulation has occurred. This not only helps with family planning but also allows tracking the effectiveness of dietary changes or medication therapies.

Psychological support

Many women with PCOS experience emotional distress due to infertility, physical changes, or chronic symptoms. Psychotherapy or support groups can be very beneficial in providing relief.

Long-term consequences and monitoring

Untreated PCOS can increase the risk of the following conditions in the long run:

Type 2 diabetes
Cardiovascular diseases
High blood pressure
Sleep apnea
Endometrial cancer

Therefore, regular monitoring of hormone levels, weight, blood pressure, blood sugar, and cholesterol is strongly recommended.

PCOS and fertility

Chances of getting pregnant

Although PCOS is one of the most common causes of infertility, it does not mean that pregnancy is impossible. With the right approach—including lifestyle changes, hormone therapy, ovulation induction, or assisted reproductive techniques—many women are able to conceive. Early diagnosis and personalized treatment significantly increase the chances.

PCOS is manageable in most cases

Polycystic Ovary Syndrome is a complex condition, but in most cases, it is very manageable—especially when diagnosed early. A combination of healthy lifestyle choices, targeted medical treatment, and regular medical monitoring forms the foundation of successful care. Women with PCOS should not be discouraged: with knowledge, self-awareness, and medical support, it is possible to live well with the condition.

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FAQs

Can I get pregnant despite having PCOS?

Yes, many women with PCOS can become pregnant—either naturally or with medical support. Even if ovulation is irregular or absent, successful pregnancies are possible through lifestyle changes, hormonal treatments (such as clomiphene or letrozole), or assisted reproduction (e.g. IVF).

What can I do myself to manage PCOS?

A healthy lifestyle is essential. Weight loss, a low-sugar diet, regular exercise, and stress reduction can significantly improve symptoms such as irregular cycles, acne, or insulin resistance. Losing just 5–10% of body weight can already make a noticeable difference.

Why is cycle tracking especially important with PCOS?

Cycle tracking is particularly valuable for women with PCOS, as it helps to better understand hormonal patterns and detect irregular or absent ovulation. By observing your menstrual cycle—via basal body temperature, cervical mucus, or digital cycle tracking tools like Daysy—you can monitor and document changes in your body early on.

Benefits of cycle tracking with PCOS:

Detecting ovulation: Even with PCOS, ovulation can occur—tracking helps identify it.
Recognizing cycle patterns: Even with long or irregular cycles, consistent tracking can reveal individual patterns.
Supporting fertility treatment: Cycle data provides a helpful basis for medical decisions when trying to conceive.
Monitoring lifestyle changes: Improvements through diet, exercise, or medication become visible through tracking.
Early detection of problems: Sudden changes in your cycle can be identified early and discussed with a doctor.

Especially with PCOS—where the body often doesn’t follow a “standard” 28-day cycle—cycle tracking offers valuable insights into your health and supports greater body awareness and self-empowerment.

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