Polycystic Ovarian Syndrome, or PCOS, is one of the most common yet misunderstood health conditions affecting women today. Despite its prevalence, PCOS often goes undiagnosed, sometimes for years, leaving millions of women struggling with unexplained symptoms, frustration, and unanswered questions.

In fact, research suggests that up to 70% of women with PCOS don’t even know they have it. That means countless women are living with symptoms that could be better managed or even improved with the right treatment plan. At BioSymmetry Wilmington, our mission is to educate, empower, and equip patients to take control of their health, and PCOS is a condition where knowledge truly is power.

 

What PCOS Really Is (and Isn’t)

The name “polycystic ovarian syndrome” is a little misleading. Many assume PCOS is simply a gynecological issue caused by ovarian cysts, but that’s not the full picture. In fact, you can be diagnosed with PCOS without ever having cysts on your ovaries.

PCOS is best understood as a complex endocrine disorder—a condition that affects hormone balance and metabolism throughout the entire body. Diagnosis usually requires at least two of three key features:

  • Irregular or absent ovulation (leading to missed or unpredictable periods)

  • Excess androgen levels (excess “male” hormones such as testosterone, which can cause acne, excess hair growth, or hair thinning)

  • Polycystic ovaries seen on ultrasound

The true driving force behind PCOS, however, is insulin resistance. When the body has trouble using insulin effectively, the pancreas produces more and more of it. Excess insulin lowers levels of sex hormone-binding globulin, which in turn increases free testosterone. This hormonal imbalance disrupts ovulation, leading to irregular cycles, fertility struggles, and other common PCOS symptoms.

 

Why So Many Women Are Undiagnosed

If PCOS is this common, why is it so often overlooked? There are a few key reasons:

  1. No single test exists. Diagnosis relies on a combination of history, lab work, and ruling out other conditions.

  2. Symptoms vary widely. One woman may experience irregular cycles and fertility struggles, while another may have acne or hair growth but otherwise normal periods. Some are overweight, while up to 30% of women with PCOS are of normal weight.

  3. Awareness gaps in healthcare. PCOS straddles the line between endocrinology and gynecology, which sometimes means patients fall through the cracks.

  4. Normalization of symptoms. Irregular periods, acne, or weight gain are too often dismissed as “just being part of growing up” rather than being investigated further.

This combination of factors explains why so many women live with PCOS symptoms without ever receiving a diagnosis.

 

Signs and Symptoms to Watch For

Recognizing PCOS starts with paying attention to the body. Common signs include:

  • Irregular or missed periods (cycles longer than 35 days or fewer than eight per year)

  • Excess hair growth on the face, chest, or back (known as hirsutism)

  • Persistent acne resistant to typical treatments

  • Thinning hair on the scalp

  • Weight gain, particularly around the midsection

  • Mood challenges such as anxiety or depression

  • Difficulty conceiving due to irregular ovulation

PCOS is about more than reproduction. Left untreated, it increases the risk of type 2 diabetes, cardiovascular disease, and even endometrial cancer. That’s why early recognition and proactive care are essential.

 

Evidence-Based Treatment Options

The good news? PCOS is manageable. With the right approach, many women experience dramatic improvements in symptoms, fertility, and long-term health.

Lifestyle Modifications

Lifestyle is considered the gold standard first-line treatment. Even a 5–7% reduction in body weight can restore ovulation and improve menstrual regularity. A few key strategies include:

  • Nutrition: Women with PCOS often do well with a lower-carbohydrate diet that minimizes processed foods and supports healthy insulin levels.

  • Exercise: Moderate aerobic activity (“conversational cardio”) paired with resistance training improves insulin sensitivity and hormone balance.

  • Stress Management: Yoga, meditation, and mindful breathing can reduce cortisol, which plays a role in worsening insulin resistance.

Medications and Hormone Support

For women needing additional support, several medical therapies may help, including:

  • Metformin to regulate insulin and improve ovulation

  • GLP-1 medications (such as semaglutide) to support weight management and insulin sensitivity

  • Spironolactone to address acne and excess hair growth

  • Bioidentical progesterone to restore hormonal balance, support fertility, and reduce cancer risk

Every treatment plan should be individualized, addressing not just reproductive health but the whole person.

 

Taking Action

If you suspect you may have PCOS, or if you’ve been struggling with symptoms like irregular cycles, acne, or unexplained weight gain, don’t wait. Keep a health diary, track your menstrual cycles, and bring this information to a qualified provider.

At BioSymmetry Wilmington, our team specializes in hormone optimization and metabolic health. We take a comprehensive, evidence-based approach to PCOS, working with you to restore balance, improve energy, and reduce long-term risks.

PCOS is common, but it doesn’t have to be a life sentence of frustration. With proper care, women can live full, healthy, optimized lives.

 

Ready to learn more? Contact BioSymmetry Wilmington today to schedule a consultation. Our mission is simple: to help you live Life Optimized.

Disclaimer: This blog is for general informational purposes only and does not constitute the practice of medicine, nursing, or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of the information on this blog or material linked from this blog is at the user’s own risk. The content of this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions.