Challenges of PCOS

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Challenges of PCOS

Nicole BereolosContributor: Dr Nicole Bereolos, PhD, MPH, MSCP, CDCES
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Versión en español aquí.

Women have struggled with Polycystic Ovarian Syndrome (PCOS) symptoms for many years, but getting that accurate diagnosis is usually very difficult. Typically, women with PCOS struggle with irregular menstrual cycles/heavy cycles, acne, hair growth in unwanted places (face, chest, stomach), insulin resistance, difficulty becoming pregnant, difficulty managing weight, etc. PCOS is associated with having too much testosterone (females naturally have testosterone too, just not as much as males) and/or ovarian cysts (although you don’t need to have ovarian cysts to be diagnosed with PCOS). Many women are told to just “lose weight” and “all will be well.” Unfortunately, this is easier said than done for most women with PCOS. Women often increase physical activity and reduce caloric intake without much luck with weight loss. Having PCOS also greatly increases your risk of gestational and type 2 diabetes. The cause of PCOS is not known, but it is often treated with metformin (a common type 2 diabetes medication), birth control pills, and/or spironolactone (a special kind of diuretic). Other medications are used to treat PCOS, but it is done off-label with medications intended to treat type 2 diabetes. These medications, along with lifestyle changes, have been shown to help mitigate many PCOS symptoms.

Because PCOS is a syndrome (a cluster of different symptoms across multiple body systems), it can have a psychological toll. It can take years for healthcare providers to put the puzzle pieces together and finally diagnose PCOS. Women are often told to lose weight and exercise more. Many can make some lifestyle changes but continue to experience PCOS-related symptoms. This becomes extremely frustrating, and they feel as if there is something wrong with them since their actions are not leading to desired results. It has been demonstrated that there are higher rates of depression and anxiety in those with PCOS. It is mediated by higher weight and challenges with body image (Cooney et al., 2017). Binge eating in those with PCOS has also been shown to be nearly 6x more prevalent compared to those without PCOS (Lee et al., 2017).

If you are struggling with any of these challenges, it is crucial that you find a comprehensive healthcare team that you trust. The team you have now may not be the best one for you…and that’s ok! Small changes in current actions can lead to changes in outcomes and make you feel better about yourself. A team that will work with you, not against you, is crucial. Taking advantage of the diabetes online communities/peer-support communities and community-based organizations can help motivate you and fill in gaps.

Components of PCOS:

  1. Depression/anxiety
  2. Infertility
  3. Hirsutism (excess hair growth)
  4. Changes in menstrual cycle
  5. Pre-eclampsia
  6. Endometriosis
  7. Glucose intolerance/insulin resistance
  8. High cholesterol/triglycerides

Dr. Nicole Bereolos, Ph.D., MPH, MSCP, CDCES, is a clinical psychologist and certified diabetes care and education specialist with private practice offices in North Texas. She serves as the mental health and diabetes spokesperson for ADCES and is on the Board for ADCES (2018-2020). Dr. Bereolos has been featured in Healthline, WebMD, Diabetes Forecast, etc. For over 28 years, she has been living with type 1 diabetes. She can be found at and @DrNBereolos on Twitter.