Interestingly, with PCOS, the medical presentation of cysts may not be the same as the cysts present on your ovaries. In some cases, you may not have cysts at all for you to be diagnosed with PCOS.

The diagnostic criteria commonly followed is the Rotterdam Criteria which consists of the following:

1. PCO (polycystic) appearance of the ovaries.

2. Elevated androgens – excessive male-pattern hormones causing clinical symptoms like excessive body hair and facial hair, male-pattern hair loss, and acne. The other sign can be seen in elevated levels of androgens in blood work.

3. Anovulation – Not getting to an ovulatory point in a cycle, irregular periods, or skipped periods. One must have two out of three of these criteria to be diagnosed with PCOS.

Other signs and symptoms in patients include: being overweight, low insulin sensitivity, darkening of the skin, and skin tags.

80% of ovulatory infertility cases are due to PCOS. A majority of patients who go to fertility clinics have PCOS, and have had successful pregnancies. So, yes, you can conceive with PCOS, often without going through a medicated cycle. To assist with conception, fertility clinics often use medication to help you become more insulin-sensitive and help with follicle development and ovulation

Lifestyle modifications can significantly help a PCOS patient. Some examples: Increase fibre and protein intake in your diet. Exercise to manage insulin resistance and reduce weight. Stress less and sleep well as both stress and sleep impact insulin sensitivity, cell metabolism and hormones. Add supplements to your diet and ensure you’re using the right type and amount of product for a suitable duration. Supplements like Myo-inositol, berberine, NAC, white peony, liquorice root, and spearmint are some recommended supplements. Speak with your healthcare provider to understand if and how you should use these supplements.

Track your cycles, cervical mucus, and body temperature with an app like ‘Kindara’. Having data is essential to start seeing change once you start your treatment. If you think you have PCOS, get in touch with your healthcare provider and start with blood work and testing. You can also go to a fertility-focused MD to manage PCOS.

Going to a clinic with an integrated model that focuses on the various aspects of your health is essential. A lot of PCOS-related conditions are lifestyle conditions and need long-term management. The process should not just focus on conception but also on managing metabolic and hormonal conditions during and post-pregnancy. It can put one at a higher risk of gestational diabetes and placental development issues if not managed well.

PCOS is multifaceted – affecting hormones, metabolism, and other aspects of health. Certain elements of thyroid dysfunction can mimic certain components of PCOS. Insulin resistance present with PCOS can increase the risk of elevated thyroid antibodies. A good fertility clinic will help you manage a thyroid condition with PCOS. It’s not just the sex hormones that affect PCOS; other hormones, too, are at play.