Rethinking PCOS: It’s More Than Hormones
Polycystic Ovary Syndrome (PCOS) has long been considered a reproductive or hormonal disorder. Irregular periods, cystic ovaries, elevated testosterone; these are the classic signs most people associate with the diagnosis.
But that’s only part of the picture.
Today, research is shifting the way we understand PCOS. It’s no longer just about hormones or fertility. It’s a metabolic condition at its core, and the symptoms we often focus on: acne, irregular cycles, facial hair, and weight gain, are downstream effects of a deeper imbalance.
PCOS Is Rooted in Metabolic Dysfunction
Many people are surprised to learn that insulin resistance is a major driver of PCOS, even in those who are lean.
Insulin is the hormone that helps move glucose (sugar) into your cells. When your body becomes less sensitive to insulin, your pancreas pumps out more to compensate. That excess insulin can trigger the ovaries to make more androgens (like testosterone), disrupt ovulation, and contribute to many of the hallmark PCOS symptoms.
In fact, up to 70% of people with PCOS show signs of insulin resistance, even if their blood sugar labs appear “normal.”
When the Metabolic System Is Off, Hormones Follow
If your cells aren’t responding well to insulin, a cascade begins:
Ovarian function shifts: ovulation becomes irregular or disappears altogether
Testosterone rises: leading to acne, hair thinning, or facial/body hair
Estrogen and progesterone become imbalanced: impacting mood, energy, and cycles
Weight gain or stubborn fat can follow, particularly around the midsection
Inflammation increases, worsening symptoms, and creating a vicious cycle
In short, the reproductive hormone issues are often a symptom, not the root.
What Does This Mean for Treatment?
If the root issue is metabolic, then the most effective treatment strategy isn’t just about regulating periods or suppressing testosterone.
It’s about supporting insulin sensitivity, balancing blood sugar, reducing inflammation, and restoring hormone harmony from the ground up.
This may include:
Nutrition tailored to blood sugar regulation (not extreme restriction)
Movement that improves metabolic flexibility and muscle mass
Hormonal support when appropriate, including ovulatory cycle restoration or progesterone therapy
GLP-1 or other medications for insulin resistance and body composition support, when indicated
Addressing sleep, stress, and gut health — all of which impact metabolic balance
The Diagnosis Is Outdated But Your Care Doesn’t Have to Be
Despite the name, you don’t have to have cysts to be diagnosed with PCOS, and the criteria are still based on an outdated understanding of the condition. This leads to confusion, missed diagnoses, or blanket treatments like birth control and metformin without deeper investigation.
At our practice, we do it differently.
We listen to your story. We look at your symptoms in the context of your whole body. And we build a care plan that gets to the root of your PCOS, so you’re not left treating surface symptoms forever.
You Deserve a Modern, Root-Cause Approach
Whether you’re trying to get pregnant, improve your skin, lose stubborn weight, or simply feel more like yourself again. PCOS care should be personalized, science-backed, and designed to restore balance.
If you’ve been dismissed, handed a prescription, or told to "just lose weight," know that your experience is valid and that there is another way.
We’re here to help you feel heard, supported, and empowered in your care.
Ready to learn more about our approach?
Book a consultation today and let’s create a plan that finally makes sense.