What Is PCOS? Understanding the Basics Every Woman Should Know
Polycystic Ovary Syndrome (PCOS) is one of the most common hormonal disorders affecting women of reproductive age, estimated to affect up to 10% of women—yet it often goes undiagnosed for years. PCOS is a metabolic and endocrine condition that affects how the ovaries function. Instead of releasing an egg each month, the ovaries may develop small, fluid-filled follicles and struggle to ovulate regularly. But PCOS is about much more than ovarian cysts—it impacts hormones, insulin metabolism, skin, hair, energy, and long-term health.
Common Symptoms of PCOS
PCOS can look different for every woman, but the most common symptoms include:
Irregular or absent periods
Acne, especially along the jawline or chin
Hair loss or thinning on the scalp
Excess hair growth on the face, chest, or abdomen (hirsutism)
Weight gain or difficulty losing weight, often linked to insulin resistance
Ovarian “cysts” on ultrasound (which are actually immature follicles.
Mood changes, anxiety, or fatigue
Trouble with ovulation, which can affect fertility
Because these symptoms overlap with many other conditions, PCOS is commonly missed or dismissed for years. Often times women are just told to go on birth control for their irregular cycles and don’t do further testing to understand why they are having irregular cycles, which delays the diagnosis of PCOS.
How PCOS Is Diagnosed
There is no single test that diagnoses PCOS. Instead, clinicians use a combination of the following:
1. Irregular cycles or lack of ovulation
Cycles longer than 35 days, missing periods, or unpredictable ovulation patterns.
2. Signs of high androgens
This can be physical (acne, hair growth, hair thinning) or shown on bloodwork (elevated testosterone, DHEA-S, etc.).
3. Polycystic-appearing ovaries on ultrasound
Not everyone with PCOS has this, and you can have PCOS without cysts.
Most diagnoses use the Rotterdam criteria, which require any 2 out of the 3 above.
Because PCOS is a spectrum, many women slip through the cracks—especially if their symptoms are subtle.
Why So Many Women Are Put on Birth Control — and Why This Can Delay Diagnosis
It’s incredibly common for girls and women to be prescribed birth control at their first complaint of irregular periods, acne, or painful cycles. Birth control can:
Regulate bleeding
Improve acne
Reduce hair growth
Provide predictable cycles
But here’s the catch: birth control does not treat PCOS. It simply masks the symptoms.
When a young woman is placed on birth control before her hormones have been fully evaluated:
The irregular cycles appear “normal”
The acne improves
Ovulation or androgen issues remain hidden
No one checks her insulin, testosterone, or ovarian function
Years later, when she stops birth control, symptoms return—often more dramatically—and the underlying PCOS is finally recognized. This delay can impact fertility planning, metabolic health, and early intervention.
The Bottom Line
PCOS is a whole-body condition that deserves thorough evaluation—not a quick fix. With the right testing, personalized nutrition, targeted supplements, lifestyle support, and sometimes medication, women can dramatically improve their symptoms and long-term health.
If you’ve been struggling with irregular periods or hormonal symptoms and were told to “just go on birth control,” consider getting a deeper evaluation. You deserve clarity, not band-aids.
