PCOS: WTF Is Going On With My Hormones?

If your period is showing up whenever it feels like it (or not at all), your skin is breaking out like it’s 2008, and your energy levels are on a rollercoaster, PCOS might be the culprit.

Polycystic ovary syndrome (PCOS) is one of the most common hormone conditions, affecting roughly 1 in 10 people with ovaries. And yet, it’s still wildly misunderstood. So let’s break it down - what PCOS actually is, why it’s messing with your body, and what the experts say you can do about it.

What Even Is PCOS?

PCOS is a hormonal imbalance that can cause irregular periods, acne, weight fluctuations, and hair growth in places you’d rather it not be. The name polycystic ovary syndrome makes it sound like it’s all about ovarian cysts, but a fun fact - not everyone with PCOS actually has cysts.

Instead, doctors diagnose PCOS based on three main criteria:

• Irregular periods – Your cycle is unpredictable, missing in action, or just doing whatever it wants.
• Higher levels of androgens (aka "male hormones") – This can lead to acne, hair thinning on your head, and extra hair growth on places like your chin or chest.
• Polycystic ovaries – Your ovaries might have a bunch of tiny follicles that can mess with ovulation.

You don’t need all three to be diagnosed - if you tick two boxes, your doctor might give you the PCOS talk.

Why Does PCOS Happen?

The million-dollar question. Experts aren’t 100% sure, but research suggests a few likely causes:

• Insulin resistance – Many people with PCOS have higher insulin levels, which can tell your ovaries to pump out more androgens, leading to all the classic symptoms.
• Hormonal imbalances – If your body’s androgen levels are high, they can interfere with ovulation, cause breakouts, and leave you wondering why your hairbrush is suddenly full of strands.
• Genetics – If your mum, aunt, or sister has PCOS, there’s a good chance it runs in the family.

The Symptoms That Make No Sense (But Are Totally PCOS)

PCOS doesn’t show up the same way for everyone, but here are some common signs:

• Irregular or missing periods – You might go months without one or get surprise visits at random times.
• Acne that won’t quit – Especially around your jawline, chin, or back.
• Unwanted hair growth – Like on your face, chest, or stomach. Fun!
• Thinning hair – On your head, where you actually want it.
• Weight gain or difficulty losing weight – Even when you feel like you’re doing everything “right.”
• Low energy and fatigue – Because your hormones are throwing a tantrum.
• Mood swings, anxiety, or depression – Because of course your hormones are also messing with your emotions.

How Do You Know If You Have PCOS?

If you’re reading this and thinking, Wait, this sounds like me…, it might be time for a chat with your doctor. PCOS is usually diagnosed through:

• Blood tests – To check hormone levels, insulin, and other markers.
• Ultrasound – To see what’s going on with your ovaries. (Again, cysts aren’t required for a PCOS diagnosis.)
• Medical history – Your doctor will look at your cycle patterns, symptoms, and family history.

Can PCOS Be Fixed?

PCOS doesn’t have a cure (annoying, we know), but research shows that managing your hormones can help keep symptoms in check. Here’s what might make a difference:

• Blood sugar balance – Since insulin resistance is a big factor in PCOS, eating balanced meals with protein, healthy fats, and fibre can help keep things steady.
• Regular movement – Strength training, walking, and low-impact exercise can support insulin sensitivity and hormone balance.
• Hormonal birth control – Some people use it to regulate their cycle and manage symptoms like acne or excess hair growth.
• Supplements & medication – Things like inositol, omega-3s, or prescription meds like Metformin may help, but check with a healthcare pro first.
• Reducing stress – High stress can make PCOS symptoms worse (classic), so prioritising sleep, rest, and things that bring you joy might actually help.

Does PCOS Affect Fertility?

Short answer: It can, but it doesn’t mean pregnancy is impossible. PCOS can make ovulation less predictable, but plenty of people with PCOS conceive naturally, while others may need ovulation-inducing treatments. If you’re thinking about fertility options, a healthcare provider can guide you through it.

So When Should I See a Doctor?

If your periods are MIA, you’re struggling with acne, hair loss, or other symptoms that feel off, it’s worth getting checked out. A doctor can give you personalised advice, rule out other conditions, and help you figure out what works best for your body.

The Bottom Line

PCOS is common, frustrating, and often misunderstood - but knowing what’s going on with your body is the first step to managing it. Whether it’s tweaking your lifestyle, exploring medical options, or simply understanding what’s happening, you’ve got choices. And as always, your body isn’t broken - it just might need a little extra support.